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The pulse at both Cun (Inch) positions is floating, surging, and overflowing to the Yuji area, termed "Overflowing Pulse" (Yi Mai). The pulses at both Chi (Cubit) positions are short and faint, or large and rapid. All these belong to Yin Deficiency syndromes. The treatment principle should be to tonify Yin to suppress Yang hyperactivity. A surging and rapid pulse at the left Cun indicates Heart Fire flaming upward; surging or rapid pulses at both Chi positions indicate Ministerial Fire flaming upward. The patient will inevitably experience spermatorrhea, nocturnal emission with sexual dreams, cicada-like tinnitus in both ears, or deafness.

The ears belong to the Kidney, open into the Shaoyang region, and connect with the three Hand-Yang meridians. When Kan (Kidney Water) and Li (Heart Fire) interact, Qi gathers to govern auditory acuity. The ear meridians relate to the Kidney and penetrate the brain. The *Neijing* states: "When the five Zang organs are not harmonious, the nine orifices become blocked." Tinnitus, itching of the ears, and deafness all belong to Kidney deficiency, caused by the failure of Kidney Water to ascend and clear Qi to rise. Treatment should proceed from the Tonification category. For robust adults and children, ear swelling, pain, and otorrhea are caused by wind-heat stagnation in the three Yang meridians. It is appropriate to use Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) added with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma). Taking Jinhua Wan (Golden Flower Pill) in the evening as an adjunct is sufficient.

One discussion posits that excessive thinking causes vexation and scatters the Spirit, while Essence escapes downward, preventing True Yin from nourishing the Niwang Palace (brain), causing Qi to fail to gather. Thus, tinnitus, heavy hearing, and ear itching occur. Anshen Fuyuan Tang (Calming the Spirit and Restoring Origin Decoction) is recommended.
Ingredients: Huangqi (Astragali Radix, honey-fried 1.5 qian), Renshen (Ginseng Radix et Rhizoma 1.5 qian), Danggui (Angelicae Sinensis Radix, wine-washed 1.5 qian), Chaihu (Bupleuri Radix 1 qian), Shengma (Cimicifugae Rhizoma 0.5 qian), Huanglian (Coptidis Rhizoma, wine-fried 1 qian), Huangqin (Scutellariae Radix, wine-fried 1 qian), Huangbai (Phellodendri Cortex, wine-fried 3 qian), Zhimu (Anemarrhenae Rhizoma 1 qian), Fangfeng (Saposhnikoviae Radix 1 qian), Manjingzi (Vittadiniae Fructus 0.7 qian), Maimendong (Ophiopogonis Radix 1 qian), Fushen (Poria with Hostwood 1 qian), Suanzaoren (Ziziphi Spinosae Semen, fried 1.5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma 0.5 qian), Gouqizi (Lycii Fructus 1.5 qian).
Crush the above ingredients for one dose, add three longan arils, decoct in water, and take orally.

Another discussion addresses Lao Lou (Fatigue Deafness), Qi Lou (Qi Stagnation Deafness), Feng Lou (Wind Deafness), Xu Lou (Deficiency Deafness), Du Lou (Toxin Deafness), Jiu Lou (Chronic Deafness), and Tinnitus. Lao Lou is caused by fire from fatigue stirring the auditory aperture; Qi Lou is caused by Qi obstruction stagnating in the auditory aperture; Feng Lou is caused by heat blocking the auditory aperture; Xu Lou is caused by depletion of Qi and Blood rendering the Shen ineffective; Du Lou is caused by pus and blood obstructing the auditory aperture; Jiu Lou is caused by pathogenic factors stagnating due to prolonged illness. Any of these deafness conditions will inevitably involve tinnitus, so they are collectively treated as tinnitus.
Qianjin Bushen Wan (Thousand Gold Kidney-Tonifying Pill) is recommended.
Ingredients: Danggui (Angelicae Sinensis Radix, wine-washed), Baishao (Paeoniae Radix Alba, wine-fried), Huaishudihuang (Rehmanniae Radix Preparata, wine-steamed), Huangqi (Astragali Radix, honey-fried), Renshen (Ginseng Radix et Rhizoma), Baifushen (Poria with Hostwood), Shanzhuyu (Corni Fructus, wine-steamed, pitted), Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), Tusizi (Cuscutae Semen, wine-processed), Shihu (Dendrobii Caulis), Shechuangzi (Cnidii Fructus), Roucongrong (Cynomorii Herba), Ganjiang (Zingiberis Rhizoma), Guixin (Cinnamomi Ramulus), Dafuzi (Aconiti Lateralis Radix Preparata, processed, skin and umbilicus removed), Bajitian (Morindae Officinalis Radix, heart removed), Yuanzhi (Polygalae Radix, heart removed), Xixin (Asari Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, each 2 liang), Shichangpu (Acori Tatarinowii Rhizoma 1 liang), Fangfeng (Saposhnikoviae Radix 1.5 liang). Total twenty-three herbs. Mr. Xiyuan adds 2 liang of Yam (Shanyao) for excellent effect.
Grind the above into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take fifteen pills per dose, increasing to thirty or forty pills, washed down with salt water.

Another discussion suggests that Rising Deficient Fire and Phlegm-Qi stagnation in the ears cause blockage or tinnitus. If Phlegm-Fire is vigorous, or depression causes fullness and throat discomfort with restlessness:
Tongming Liqi Tang (Clear Brightness and Regulating Qi Decoction) is recommended.
Ingredients: Cangzhu (Atractylodis Rhizoma, salt-water fried 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome fried 1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma 0.8 fen), Chenpi (Citri Reticulatae Pericarpium, salt-water soaked 2 qian), Xiangfu (Cyperi Rhizoma, child's urine fried 2 qian), Huangbai (Phellodendri Cortex, wine-fried 2 qian), Zhizi Ren (Gardeniae Fructus, fried 1 qian), Beimu (Fritillariae Bulbus 3 qian), Shengdihuang (Rehmanniae Radix, ginger juice soaked 1 qian), Huanglian (Coptidis Rhizoma 1.5 qian, wine-soaked, pig bile-fried), Xuanshen (Scrophulariae Radix, wine-washed 2 qian), Muxiang (Aucklandiae Radix 0.5 fen), Binglang (Arecae Semen 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, roasted 0.4 fen), Huangqin (Scutellariae Radix 1.5 qian, wine-soaked, pig bile-fried).
Crush the above for two doses, decoct in ginger water, and take with bamboo sap.

Another discussion states that Yin Deficiency with Fire Hyperactivity causing deafness or tinnitus should be treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (see Tonification section). Add Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Shichangpu (Acori Tatarinowii Rhizoma), and Yuanzhi (Polygalae Radix, de-heart) to this formula; it has proven effective repeatedly.

Another main prescription for treating tinnitus:
Ingredients: Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Danningxing (Arisaematis Cum Bile Rhizoma, each 1 qian), Longdancao (Gentianae Radix), Xiangfu (Cyperi Rhizoma, each 0.8 fen), Yuanshen (Scrophulariae Radix 0.7 fen), Qingdai (Indigo Naturalis), Muxiang (Aucklandiae Radix, each 0.5 fen), Ganjiang (Zingiberis Rhizoma, charred black 0.3 fen).
Crush the above for one dose, add three slices of fresh ginger, decoct until reduced to 70%, add Yuanmingfen (Mirabilite 0.3 fen). Increase to 0.5 fen if phlegm is abundant. Take after meals. To make pills, add Lvhui (Aloe 0.5 fen) and Shexiang (Moschus 0.2 fen), grind to powder, bind with dough made from Medicated Leaven (Shenqu). Take fifty pills per dose, washed down with light ginger soup. For Kidney Deficiency tinnitus, take Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).

Another discussion on Wind affecting the ears: Ear swelling and pain, trismus, alternating chills and fever, inability to eat.
Shegan San (Belamcanda Powder) is recommended, transmitted by Wu Shaoyuan of Kuzhu.
Ingredients: Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), Shegan (Belamcandae Rhizoma), Kunbu (Laminariae Thallus), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma).
Crush the above, decoct in water, and take hot. Recovery occurs immediately upon sweating. It also treats facial swelling, toothache, and sore throat with miraculous effect.

Another method for tinnitus sounding like flowing water, ear itching, and wind noise: If untreated, it leads to deafness. Take raw Aconitum (Sheng Wutou) alone. Dig it up, peel it while wet to the size of a jujube pit, and insert it into the ear. Change once in the morning and once at night. Cure within three days.

Another discussion on using ear plugs for deafness with special efficacy:
Ingredients: Shichangpu (Acori Tatarinowii Rhizoma, 1 cun), Badou (Crotonis Fructus, 1 seed, shelled), Quanxie (Scorpio, 1 specimen, legs and tail removed).
Grind to powder, bind with green onion juice into pills the size of a jujube pit. Wrap in cotton and insert into the ear; patency is immediate.

Another discussion on ear plugs specifically for deafness caused by disease, Qi stagnation, or wind invasion. Deafness in the elderly is difficult to treat.
Remove earth from earthworms, dry in shade, and grind to powder (0.7 fen). Mix with Moschus (0.3 fen). Cut green onion into inch-long pieces, insert the medicine inside. For left ear deafness, plug the right ear; for right ear deafness, plug the left ear. For bilateral deafness, plug both ears. Immediate effect.

Another treatment for deafness:
Tongling Dan (Spirit-Connecting Pill) is recommended.
Ingredients: Anshixiang (Benzoin Resin 1.5 qian), Sangpiaoxiao (Mantis Ootheca 1.5 qian),awei (Ferulae Resina 1.5 qian), Zhusha (Cinnabar 0.5 fen), Bamazi Ren (Ricini Semen 7 seeds), Badou Ren (Crotonis Fructus 7 seeds), Dusuan (Single Clove Garlic 7 cloves).
Grind to fine powder. Grind the two seeds and garlic together to form pills the size of a jujube pit. Use one pill per application, wrap in cotton, and insert into the ear. Remove if slight pain is felt.

Another discussion on purulent otorrhea and yellow discharge:
Hongmian San (Red Cotton Powder) is recommended.
Ingredients: Kubaijian (Calcined Alum 0.5 fen), Ganyanzhi Fen (Dried Madder Root Powder 0.25 fen), Shexiang (Moschus, a little), Piannao (Borneolum Syntheticum 0.1 fen), Shuluganshi (Calcined Calamine 0.5 fen).
Grind to powder. First, wipe dry the pus and discharge with a cotton swab. Then, use a goose feather tube to deliver the medicine to the bottom of the ear. Another method uses worm-eaten bamboo powder, alum, and calamine, which is also effective.

Another treatment for sudden ear swelling with pus discharge: Use calcined alum powder, blow into the ear with a brush tube, three to four times daily. Or wrap in cotton and insert into the ear.

Another treatment for upper heat causing purulent otorrhea:
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Shengma (Cimicifugae Rhizoma), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Sangbaipi (Mori Cortex, fried), Shengdihuang (Rehmanniae Radix), Qianhu (Peucedani Radix), Chifuling (Poria with Hostwood dyed red), Manjingzi (Vittadiniae Fructus), Ganjuhua (Chrysanthemi Flos, equal parts).
Crush the above, decoct with ginger and jujube, and take orally.

Another treatment for cicada-like tinnitus: If taking Siwu Tang (Four Substances Decoction) worsens the tinnitus, this indicates Yuan Qi (Primal Qi) deficiency. Take Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) at dawn, and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) before meals for instant relief. If Blood Deficiency with Fire, use Bazhen Tang (Eight Treasures Decoction) added with Zhizi (Gardeniae Fructus) and Chaihu (Bupleuri Radix). If Qi Deficiency with Fire, use Sijunzi Tang (Four Gentlemen Decoction) added with Zhizi (Gardeniae Fructus) and Chaihu (Bupleuri Radix). If deafness or tinnitus is triggered by anger, excess pattern uses Xiaochaihu Tang (Minor Bupleurum Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Zhizi (Gardeniae Fructus); deficiency pattern uses Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Zhizi (Gardeniae Fructus). If symptoms are worse in the morning, use Siwu Tang (Four Substances Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria). Long-term use of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If symptoms are worse in the afternoon, use Dihuang Wan (Rehmannia Pill).

Another discussion on treating tinnitus caused by anger, with expectoration, vomiting, anorexia, chills, fever, and hypochondriac pain: Use Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substances Decoction), added with Zhizi (Gardeniae Fructus), Fuling (Poria), and Chenpi (Citri Reticulatae Pericarpium) for cure.

Another discussion on tinnitus caused by reckless movement of Deficient Fire and restless Spirit: Use Yiqi Tang (Qi-Tonifying Decoction) removing Shengma (Cimicifugae Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Huangqi (Astragali Radix), adding Banxia (Pinelliae Rhizoma), Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Zhuru (Bambusae Folium in Desiccato), Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Tianma (Gastrodiae Rhizoma), Manjingzi (Vittadiniae Fructus), and Xixin (Asari Radix et Rhizoma).

Another discussion on constant tinnitus: Insert cut raw Rehmannia root (Shengdihuang) into the ear, changing it frequently until cured. Another method: wrap in paper and roast in ash fire for good effect.

Another treatment for ear pain due to Lung Fire excess and Kidney Qi deficiency: Use Siwu Tang (Four Substances Decoction) 4 qian, Huangbai (Phellodendri Cortex) 3 qian, decoct in child's urine, take on an empty stomach.

A widow suffering from pain inside and outside the ears, intermittent chills and fever, with a pulse overflowing to Yuji, has a Blood Excess syndrome. Treat with Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shengdihuang (Rehmanniae Radix) to subdue the Blood and achieve cure. For neck lymph node swellings resembling beads with chills and fever, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction) and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) to regulate and tonify Liver and Spleen for cure.
(Note: Liuwei Dihuang Wan formula is in the Tonification section; Buzhong Yiqi Tang formula is in the Internal Injury section; Bazhen Tang formula is in the Tonification section; Sijunzi Tang formula is in the Tonification section; Xiaochaihu Tang; Jiawei Xiaoyao San; Jiawei Guipi Tang formulas are all in the Female Consumption section.)

Another specific treatment for constant ear ringing and deafness:
Dusheng Wan (Unique Victory Pill) is recommended.
Ingredients: Chuan Huangbai (Phellodendri Cortex, peeled 8 liang, mixed with human milk, dried, then fried in salt water, wrapped in silk).
Grind to fine powder, bind with water paste into pills the size of paulownia seeds. Take one hundred pills per dose, on an empty stomach, washed down with salt water.

Another treatment for ear swelling, pain, and purulent bloody discharge: Use calcined alum powder with a little Moschus, blow into the ear, three to four times daily. Or wrap in cotton and insert into the ear for immediate cure.

Another treatment for deafness: Grind Xixin (Asari Radix et Rhizoma) to powder, melt beeswax to form pills the size of mouse feces, wrap in cotton, and insert into the ear for immediate cure. Additionally, moxa seven cones on the depression in front of the ear.

Another treatment for Qi channel obstruction causing bilateral deafness: Use Kansui (Kansui Radix) the size of a jujube pit, wrap in cotton, and insert into the ear. Simultaneously, place Licorice (Gancao) in the mouth and chew as desired. Alternatively, insert raw white part of green onion into the ear, changing frequently until patency is restored.