耳疮属手少阳三焦经，或足厥阴肝经血虚风热，或肝经燥火风热，或肾经虚火等因。若
发热
热作痛，属肝经风热，用小柴胡汤，加山栀、川芎。若内热口干，属肾经虚火，用加味地黄
丸；如不应，用加减八味丸。余当随症治之。
治验
文选姚海山耳根赤肿，寒热作痛，此属三焦风热也。但中气素虚，以补中益气，加山栀
、炒黄芩、牛蒡子，治之而愈。
一儒者因怒，耳内作痛出水，或用祛风之剂，筋挛作痛，肢体如束，此肝火伤血也，
用六味丸料，数服而愈。
举人毛石峰子年二十，耳内出水，或作痛年余矣，脉洪数，左尺益甚，此属肝肾二经虚
热也，用加减八味丸料，一剂而愈。
一男子每入房，耳内或作痒，或出水，常以银簪探入，甚喜阴凉，此属肾经虚热也，用
加减八味丸而愈。
一妇人因怒发热，每经行即两耳出脓，两太阳作痛，以手按之，痛稍止。怒则胸胁乳房
胀肿，或寒热往来，或小便频数，或小腹胀闷，此皆属肝火血虚也。先用栀子清肝散二剂，又用
加味逍遥散数剂，诸症悉退；又以补中益气加五味而全愈。
一妇人经行后，因怒气劳役，发热寒热，耳内作痛，余以经行为血虚，用八珍汤加柴胡
。怒气为肝火，用加味逍遥散。劳役为气伤，用补中益气汤加山栀而愈。
一妇人耳内作痛，或肿 ，寒热发热，面色素青黄，经行则变赤。余以为怒气伤肝，郁
结伤脾。用加味归脾汤、加味逍遥散而愈。
一妇人耳内肿痛，寒热口苦，耳内出水， 连颈项，饮食少思，此肝火甚而伤脾也。用
小柴胡汤加山栀、牡丹皮稍愈，用加味逍遥散，及八珍汤加柴胡、山栀、丹皮，调补肝脾而
一孀妇，或耳内外作痛，或项侧结核，内热晡热，月经不调，唾痰少食，胸膈不利。余
以
太卿魏庄渠，癸卯仲冬，耳内作痛，左尺洪大而涩。余曰∶此肾水枯竭，不能生肝木，
当滋
明年季春十八日，复请治。昏愦不语，顺耳之分已有脓矣，且卵缩便数，方信余言，求治。
辞不克，用六味丸料一钟，阴茎舒出，
小便十减六七，神思顿醒。余曰∶若砭脓出，庶延数日，
为立嗣之计，否则脓从耳出，死立待矣，或谓不砭可
生者。余因辞归，翌日，果耳内出脓，至二十一日，己未火日而卒。
宪副姜时川，癸卯冬，右手寸口浮数而有痰，口内若有疮然。余曰∶此胃火传于肺也，
，慎起居，以御之。甲辰秋，尺脉洪数而无力。余曰∶此肺金不能生肾水，无根之火上炎也
。宜静调养，滋化源以治之。彼云∶今喉耳不时燥痛，肢体不时发热。果是无根之火，殒无
疑矣。后会刘古峡云∶姜公之病，已如尊料。遂拉同往视，喉果肿溃，脉愈洪大，又误以为
疮毒，而投苦寒之剂。卒于仲冬二十八日，乃药之促其亡也，否则尚能延至仲夏。
Auricular sores (Ear sores) belong to the Hand-Shaoyang Sanjiao Meridian, or may be caused by Blood deficiency with Wind-Heat in the Foot-Jueyin Liver Meridian, Dry-Fire and Wind-Heat in the Liver Meridian, or Deficient-Fire in the Kidney Meridian. If fever occurs accompanied by pain upon onset, it belongs to Wind-Heat in the Liver Meridian; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Gardenia (Gardeniae Fructus) and Ligusticum chuanxiong (Chuanxiong Rhizoma). If there is internal heat and dry mouth, it belongs to Deficient-Fire in the Kidney Meridian; use Jia Wei Di Huang Wan (Modified Rehmannia Pill); if ineffective, use Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill). Other cases should be treated according to symptoms.
Clinical Records:
Yao Haishan, a Literary Selection Compiler, had redness and swelling at the root of the ear, alternating chills and fever with pain. This belongs to Wind-Heat in the Sanjiao. However, his Middle Qi was inherently deficient. He was treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Gardenia, Stir-fried Scutellaria (Scutellariae Radix), and Arctium lappa (Arctii Fructus), and was cured.
A scholar suffered from pain and discharge in the ear due to anger. Someone used Wind-dispelling agents, resulting in tendon spasms and pain, with limbs feeling bound. This was Liver-Fire injuring Blood. He was treated with Liu Wei Di Huang Wan material (Six-Ingredient Pill with Rehmannia), and after several doses, he recovered.
The son of Mao Shifeng, a Jinshi degree holder, was twenty years old. He had ear discharge and intermittent pain for over a year. His pulse was surging and rapid, especially in the left Chi position. This belongs to Deficient-Heat in the Liver and Kidney meridians. He was treated with Jia Jian Ba Wei Wan material, and recovered after one dose.
A man experienced itching or discharge in the ear after intercourse. He often inserted a silver hairpin into the ear and preferred cool environments. This belongs to Deficient-Heat in the Kidney Meridian. He was cured using Jia Jian Ba Wei Wan.
A woman developed fever due to anger. Every time her menstruation occurred, pus discharged from both ears, and pain occurred in both temporal regions, which subsided slightly upon pressure. Anger caused distension and swelling in the chest, hypochondrium, and breasts; sometimes there were alternating chills and fever, frequent urination, or lower abdominal fullness. All these belong to Liver-Fire and Blood deficiency. She first took Zhi Zi Qing Gan San (Gardenia Clearing the Liver Powder) for two doses, then Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for several doses, after which all symptoms receded. Finally, she took Bu Zhong Yi Qi Tang with Wu Wei Zi (Schisandra Berry) and was fully cured.
After menstruation, a woman suffered from fever and chills, and ear pain due to anger and overwork. I considered menstruation as Blood deficiency and used Ba Zhen Tang (Eight-Treasure Decoction) with Chai Hu (Bupleuri Radix). Anger represents Liver-Fire, treated with Jia Wei Xiao Yao San. Overwork injures Qi, treated with Bu Zhong Yi Qi Tang plus Gardenia, and she recovered.
A woman had ear pain and occasional swelling, with fever and chills. Her complexion was usually greenish-yellow, turning red during menstruation. I attributed this to anger injuring the Liver and stagnation injuring the Spleen. She was cured using Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) and Jia Wei Xiao Yao San.
A woman had painful swelling in the ear, alternating chills and fever, bitter taste, ear discharge extending to the neck, and poor appetite. This indicates severe Liver-Fire injuring the Spleen. She improved slightly with Xiao Chai Hu Tang plus Gardenia and Moutan Cortex (Moutan Radicis Cortex). She was then treated with Jia Wei Xiao Yao San, and Ba Zhen Tang plus Chai Hu, Gardenia, and Dan Pi to regulate and tonify the Liver and Spleen, leading to recovery.
A widow experienced pain inside and outside the ears, or nodules on the side of the neck, internal heat with afternoon fever, irregular menstruation, expectoration of phlegm, poor appetite, and chest diaphragm discomfort. [Text fragment missing]. Wei Zhuangqu, Grand Secretary, in mid-winter of the Gui-Mao year, had ear pain with a surging, large, and choppy pulse in the left Chi position. I said: This is exhaustion of Kidney Water, unable to nourish Liver Wood; it requires nourishing... [Text fragment missing].
On the 18th day of late spring the following year, treatment was requested again. The patient was confused and mute. Pus had formed along the ear meridian distribution, and the testicles were retracted with frequent urination. Only then did he believe my words and seek treatment. Unable to refuse, I administered one cup of Liu Wei Di Huang Wan material. The penis extended, urination decreased by six or seven tenths, and mental clarity returned suddenly. I said: If the pus were drained by scarification, life might be prolonged for a few days. For the sake of establishing an heir, otherwise, with pus discharging from the ear, death is imminent. Some said survival was possible without scarification. I declined and returned home. The next day, pus indeed discharged from the ear. On the 21st day, the Ji-Wei Fire day, he died.
Jiang Shichuan, Vice Commissioner, in winter of the Gui-Mao year, had a floating and rapid pulse at the right Cun Kou position with phlegm, and oral lesions resembling sores. I said: This is Stomach Fire transmitting to the Lung. Attend carefully to daily routine to resist it. In autumn of the Jia-Chen year, the Chi pulse was surging, rapid, and powerless. I said: This is Lung Metal unable to generate Kidney Water, with Rootless Fire flaming upward. It requires quiet recuperation and nourishing the source of transformation. He said: Now my throat and ears are occasionally dry and painful, and my limbs occasionally feel hot. Indeed, this is Rootless Fire; death is inevitable. Later, meeting Liu Guxia, he said: Lord Jiang's illness has proceeded exactly as you predicted. We went together to examine him. The throat was indeed swollen and ulcerated, and the pulse became even more surging and large. Mistakenly diagnosed as toxic sores, bitter-cold agents were administered. He died on the 28th day of mid-winter. This medication hastened his death; otherwise, he could have survived until mid-summer.