耳者心肾之窍。肝肾之经也。心肾主内证精血不足。肝胆主外证风热有余。或聋聩或虚鸣者。
禀赋虚也。或胀痛或脓痒者。邪气客也。禀赋不足。地黄丸。肝经风热。柴胡清肝散。若因血燥。
栀子清肝散。不应。佐以六味丸。若因肾肝疳热。朝用六味丸。夕用芦荟丸。若因乳母膏粱积热
而致者。子母并服加味清胃散。
曹氏云。鼻乃肺之窍。皮毛腠理。乃肺所主。因风邪客于肺。而鼻塞不利者。内服消风散。
外用葱白七茎。入腻粉少许。擂摊帛上。掌中护温贴囟门。小儿鼻衄。多因惊仆气散。血无所羁
而随气上脱。先用小乌沉汤。次用止衄散。或异功散加柴胡、山栀。久不愈。用麦冬、黄 、当
归、生地、人参、五味煎服。若衄久血脱。但出淡红水。或带黄黑色者难已。
解颅者。生下囟门不合也。长必多愁少笑。目白睛多。面色 白。肢体消瘦。皆属肾虚。按
肾主髓。脑为髓海。因父母精血不足。不能敛固也。地黄丸加五味、鹿茸。更用天南星微炮为末。
醋调摊绯帛。烘热贴囟门。虚寒。用细辛、桂心、干
姜为末。乳汁和敷上。干复敷之。儿面赤即愈。又方。半夏、生姜、芎 、细辛、桂心、乌头。
苦酒煮去滓。以帛浸药汁中。适寒温以熨囟上。冷更温之。复熨如前。朝暮各三四熨乃止。二十
日可愈。有至七八岁。或十四五岁。气血既盛而自合。若纵恣色欲。戕贼真阴。终焉不寿。此证
若在乳下。当兼补其母。更以软帛束紧儿首。使其易合。亦有囟陷囟填。俱属赋禀不足。或五疳
久病。元气亏损。泻利气虚。脾气不能上充所致者。补中益气及十补丸。若手足并冷。前汤加姜、
桂。不应。虚寒之甚也。急加附子。缓则不救。
The ear is the orifice of the Heart and Kidney, and is also the pathway of the Liver and Gallbladder meridians. The Heart and Kidney govern internal conditions characterized by insufficiency of essence and blood; the Liver and Gallbladder govern external conditions characterized by excess of wind-heat. Deafness or tinnitus (ringing in the ears) results from congenital deficiency. Pain, distension, pus, or itching result from pathogenic factors lodging in the body. For cases due to congenital insufficiency, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). For cases due to wind-heat in the Liver meridian, use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder). If caused by blood dryness, use Zhizi Qinggan San (Gardenia Liver-Clearing Powder); if ineffective, supplement with Liuwei Dihuang Wan. If caused by heat from liver-kidney guan disease (parasitic malnutrition), administer Liuwei Dihuang Wan in the morning and Lushui Wan (Aloe Pill) in the evening. If caused by accumulated heat from the nursing mother's consumption of rich foods, both mother and child should take Jiawei Qingwei San (Modified Stomach-Clearing Powder).
Cao stated: The nose is the orifice of the Lung, and the skin, hair, and interstices are governed by the Lung. When wind-pathogens lodge in the Lung, causing nasal congestion and obstruction, internally administer Xiaofeng San (Wind-Expelling Powder). Externally, use seven stalks of scallion white mixed with a small amount of nifen (calomel), ground and spread on cloth, warmed in the palm, and applied to the fontanelle. Pediatric epistaxis (nosebleed) is often caused by fright or falling leading to qi dispersion, where blood loses its constraint and ascends with qi. First administer Xiao Wuchen Tang (Minor Black Stagnation Decoction), then Zhi Xu San (Hemostasis Powder), or Yigong San (Extraordinary Efficacy Powder) added with Chaihu (Bupleuri Radix) and Shanzhi (Gardeniae Fructus). For chronic cases unresponsive to treatment, decoct Maidong (Ophiopogonis Radix), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Renshen (Ginseng Radix), and Wuweizi (Schisandrae Fructus) for oral administration. If prolonged bleeding leads to blood loss, presenting only as pale red fluid or yellow-black discharge, it is difficult to cure.
Jielu (Split Skull/Unfused Fontanelle) refers to the failure of the fontanelle to close at birth. As the child grows, they may exhibit melancholy with little laughter, prominent whites of the eyes, pale complexion, and emaciated limbs; these all belong to Kidney deficiency. According to theory, the Kidney governs marrow, and the brain is the sea of marrow. This condition arises because the parents' essence and blood were insufficient, failing to consolidate and restrain. Use Liuwei Dihuang Wan added with Wuweizi (Schisandrae Fructus) and Lurong (Cervi Cornu Colla). Additionally, use Tian Nan Xing (Arisaematis Rhizoma) slightly roasted and powdered, mixed with vinegar, spread on red silk, heated, and applied to the fontanelle. For deficiency-cold patterns, powder Xi Xin (Asari Radix), Gui Xin (Cinnamomi Ramulus), and Gan Jiang (Zingiberis Rhizoma), mix with milk, apply topically, and reapply when dry. Healing is indicated when the child's face turns red. Another prescription: Ban Xia (Pinelliae Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Xi Xin (Asari Radix), Gui Xin (Cinnamomi Ramulus), and Wu Tou (Aconiti Radix), boiled in Ku Jiu (vinegar), strained. Soak cloth in the medicinal juice and apply warm compresses to the fontanelle; re-warm when cool. Repeat this process three to four times each morning and evening until cessation. Recovery occurs within twenty days. Some children's fontanels close naturally between ages seven and eight, or fourteen and fifteen, when qi and blood become robust. Indulgence in sexual desire damages true yin, leading to premature death. For infants still in the nursing stage, the mother should also be tonified, and the infant's head should be tightly bound with soft cloth to facilitate closure. Sunken or bulging fontanels also stem from congenital insufficiency, or chronic guan diseases depleting yuan qi, or diarrhea and qi deficiency preventing Spleen qi from ascending. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Shibu Wan (Ten-Tonification Pill). If hands and feet are cold, add Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex) to the previous decoction. If ineffective, indicating severe deficiency-cold, urgently add Fu Zi (Aconiti Lateralis Radix Praeparata); delay will result in untreatable conditions.