耳者肾之候，小儿肾经气实，其热气上冲于耳，遂使津液壅滞，为脓为汁者也。亦有澡浴水入耳中，水湿停留，搏
于血气， 酿成热，亦令耳脓，久而不瘥，变成聋耳，龙骨散主之。又汤氏有五般 耳候。 耳者，常有黄脓出是也。
脓耳者，常有红脓出是也。缠耳者，常有白脓出是也。底耳者，里面腥臭。囊耳者，里面虚鸣，时出清脓。然五般病源
一也，皆由风水入耳，内有积热上壅而成，若不早治，久则成聋，胭脂膏等治之，仍服化痰退热等剂即愈。
龙骨散 治脓耳。
明矾（ ） 龙骨（ 、各二钱） 黄丹（炒、一钱半） 胭脂（一钱） 麝香（一钱、研）
上为细末，先以绵拈拭去脓汁，次以鹅毛管吹药入耳。本方加海螵蛸末尤妙。
龙黄散 治小儿 耳，汁出不止。
枯矾 龙骨（ ） 黄丹（炒、各半两） 麝香（研、一钱）
上同研细，先以绵杖子拈却耳中脓水，用一字掺在耳内，但用之，勿令风入。
干胭脂膏 治小儿 耳，常出脓水不止。
干胭脂 白龙骨 白矾（ ） 白石脂（研、等分）
上研如粉，用枣肉和丸枣核大，以绵裹一丸纳耳中，日三换之。
金箔散
枯矾 胭脂（各半两） 金箔（七片）
上同研令匀，为细末，日三四度，掺少许于耳内。
蔓荆子散 治内热，耳出脓汁。
升麻 木通 赤芍药 桑白皮 生地黄 麦门冬（去心） 前胡 甘菊花 赤茯苓 蔓荆子 甘草（炙、各等分）
上锉散，每服三钱，姜一片，枣二枚，水一盏，煎六分，食后临卧服。
The ear is the external manifestation of the Kidney. In children, the Qi of the Kidney meridian is robust; when heat rises and rushes to the ear, it causes stagnation of body fluids, which transform into pus and discharge. There are also cases where water enters the ear during bathing; the retained dampness interacts with blood and Qi, generating heat, which similarly leads to purulent otorrhea. If left untreated for a long time, this may develop into deafness, treated primarily with Longgu San (Dragon Bone Powder). Additionally, Tang Shi describes five types of ear conditions: Er Geng (Ear Gangrene) is characterized by frequent yellow purulent discharge; Nong Er (Pus Ear) features frequent red purulent discharge; Chan Er (Entangled Ear) involves frequent white purulent discharge; Di Er (Bottom Ear) presents with a foul, fishy odor inside the ear; and Nang Er (Sack Ear) manifests as internal tinnitus with occasional clear purulent discharge. However, the etiology of these five conditions is identical: they result from wind-water invading the ear combined with accumulated internal heat rising and obstructing. If not treated early, prolonged illness may lead to deafness. These can be treated externally with Yanzhi Gao (Carmine Ointment) etc., and internally with formulas that resolve phlegm and reduce heat, leading to recovery.
Longgu San (Dragon Bone Powder): Treats purulent otorrhea.
Mingfan (Alumen, alum) [dosage unspecified] Longgu (Fossilia Os Mastodi, fossilized mammal bone) [2 qian each] Huangdan (Minii Oxidum Rubrum, red lead) [stir-fried, 1.5 qian] Yanzhi (Carmine) [1 qian] Shexiang (Moschus, musk) [1 qian, ground]
Grind all ingredients into a fine powder. First, wipe away the pus with a cotton swab, then blow the powder into the ear using a goose quill tube. Adding Hai Piaoxiao (Sepiae Endoconcha, cuttlefish bone) powder to this formula yields excellent results.
Longhuang San (Dragon Bone and Yellow Lead Powder): Treats pediatric Er Geng (Ear Gangrene), with continuous discharge of pus.
Kufan (Calcinatum Alumen, calcined alum) Longgu (Fossilia Os Mastodi, fossilized mammal bone) [dosage unspecified] Huangdan (Minii Oxidum Rubrum, red lead) [stir-fried, 0.5 liang each] Shexiang (Moschus, musk) [ground, 1 qian]
Grind all ingredients together finely. First, remove pus and fluid from the ear with a cotton-tipped stick. Apply a quantity equivalent to "one character" (approx. 0.5-1g) of the powder into the ear. Ensure no wind enters the ear during use.
Gan Yanzhi Gao (Dry Carmine Ointment): Treats pediatric Chan Er (Entangled Ear), with continuous purulent discharge.
Gan Yanzhi (Dry Carmine) Bai Longgu (White Fossilia Os Mastodi, white fossilized mammal bone) Bai Fan (White Alumen, white alum) [dosage unspecified] Bai Shizhi (Kaolinite, white kaolin) [ground, equal parts]
Grind all ingredients into a powder. Mix with jujube pulp to form pills the size of a jujube pit. Wrap one pill in cotton and insert it into the ear. Replace three times daily.
Jinbo San (Gold Leaf Powder)
Kufan (Calcinatum Alumen, calcined alum) Yanzhi (Carmine) [0.5 liang each] Jinbo (Lamina Aurea Folium, gold leaf) [7 pieces]
Grind all ingredients uniformly into a fine powder. Apply a small amount into the ear 3-4 times daily.
Manjingzi San (Vitex Fruit Powder): Treats internal heat causing purulent otorrhea.
Shengma (Cimicifugae Rhizoma, black cohosh rhizome) Mutong (Akebiae Caulis, akebia stem) Chishao (Paeoniae Radix Rubra, red peony root) Sangbaipi (Mori Cortex, mulberry bark) Sheng Dihuang (Rehmanniae Radix, raw rehmannia root) Maimendong (Ophiopogonis Tuber, ophiopogon tuber) Qianhu (Peucedani Radix, peucedanum root) Gan Juhua (Chrysanthemi Flos, chrysanthemum flower) Chi Fuling (Red Poria) Manjingzi (Viticis Fructus, vitex fruit) Gancao (Glycyrrhizae Radix et Rhizoma, licorice root) [roasted, equal parts]
Cut the herbs into fragments. For each dose, take 3 qian, add one slice of fresh ginger and two jujubes, decoct in one cup of water until reduced to 0.6 cups. Take after meals and before bedtime.