耳中出血。谓之耳衄。肾开窍于耳。而肾脉却不能上头。肾与心交。假心之府小肠之脉。上贯于耳。为司听
之神所居。其形如珠。皮膜包裹真水。是为神之所出。声之所入。内通于脑。为空虚之府。他物不得而扰之。
即或肾虚。阴火上冲。则为耳鸣。神水不足。则为耳聋。亦断无血从此出者。其有血从耳出者。则以足少阳
胆脉。绕耳前后。手少阳三焦之脉入耳。相火旺。挟肝气上逆。及小肠相火内动。因得挟血妄行。或因瘟疫
躁怒。火气横行。肆走空窍。衄出于耳。总系实邪。不关虚劳。治法总宜治三焦。胆肝与小肠经。自无不愈。小
柴胡汤。加五苓散统治之。分治肝胆。宜龙胆泻肝汤。治三焦。柴胡梅连散。治小肠宜导赤饮。加黄芩黄连
薄荷川芎。三经皆司相火。治法大抵相同。愈后皆宜常服六味地黄汤。补水济火。
外治。法用十灰散。吹耳中。麝香龙骨末。和吹耳中。壁钱窠烧灰吹入。燕窠泥涂耳前后。
齿虽属肾。而满口之中。皆属于胃。以口乃胃之门户故也。牙床尤为胃经脉络所绕。故凡衄血。皆是胃火
上炎。血随火动。治法总以清理胃火为主。胃中实火。口渴龈肿。发热便闭。脉洪数者。通脾泻胃汤。加蒲黄
藕节治之。如大便不闭者。不须下利。但用清凉解之。犀角地黄汤。加葛根贯仲枳壳莱菔汁。
胃中虚火。口燥龈糜。其脉细数。血不足者。宜甘露饮。加蒲黄以止衄。玉女煎。引胃火以下行。兼滋其阴。
以上两条。所论齿龈虚实。二证均属于火。有火中挟风者。宜加防风白芷。火中挟湿者。宜加防己木通。
亦有肾虚火旺。齿豁血渗。以及睡则流血。醒则血止者。皆阴虚。血不藏之故。统以六味地黄汤。加牛膝二
冬碎补蒲黄。上盛下虚。火不归元。尺脉微弱。寸脉浮大者。加桂附。
外治之法。宜用冷水漱口。取血遇冷则凝之义。醋漱。取酸以收之之义。百草霜糁。十灰散糁。取血见黑则
止。亦以清降其火。火降则血降也。枯矾五倍子蚯蚓。同为末糁。更能固牙。
Bleeding from the ear is called Ear Hemorrhage (Er Xu). The Kidney opens into the ears, but the Kidney Meridian cannot ascend directly to the head. The Kidney interacts with the Heart, borrowing the meridian of the Small Intestine (the Fu organ of the Heart) which ascends through the ear. This is the residence of the spirit governing hearing. Its shape is like a pearl, wrapped in skin and membrane containing True Water (Kidney Essence), which is where the spirit emerges and sound enters. It connects internally to the Brain, forming an empty cavity that other pathogens cannot disturb. Even if there is Kidney Deficiency causing Yin Fire to rush upward, it results in Tinnitus (Er Ming); if Spirit Water is insufficient, it leads to Deafness (Er Long). However, blood will absolutely not flow from here under normal pathological conditions of deficiency. If blood does flow from the ear, it is because the Foot-Shaoyang Gallbladder Meridian winds around the front and back of the ear, and the Hand-Shaoyang Sanjiao Meridian enters the ear. When Ministerial Fire (Xiang Huo) is excessive, it carries Liver Qi upward in rebellion, and internal movement of Ministerial Fire in the Small Intestine causes blood to run recklessly. Alternatively, due to epidemic febrile diseases or violent anger, Fire Qi runs rampant, freely traversing hollow orifices, causing hemorrhage from the ear. This is always caused by Excess Pathogens, unrelated to Consumption Diseases (Xu Lao). The treatment method generally should regulate the Sanjiao, Gallbladder, Liver, and Small Intestine meridians, ensuring recovery. Xiao Chai Hu Tang combined with Wu Ling San can be used for comprehensive treatment. For separate treatment of the Liver and Gallbladder, Long Dan Xie Gan Tang is appropriate; for treating the Sanjiao, Chai Hu Mei Lian San is used; for treating the Small Intestine, Dao Chi Yin added with Huang Qin, Huang Lian, Bo He, and Chuan Xiong is employed. These three meridians all govern Ministerial Fire, so the treatment methods are largely similar. After recovery, one should frequently take Liu Wei Di Huang Tang to nourish Water to control Fire.
External treatment: Use Shi Hui San blown into the ear; or mix She Xiang (Musk) and Gu Long (Dragon Bone) powder and blow into the ear; burn Bi Qian Ke (Spider Web Nest) to ash and blow it in; or apply Yan Ke Ni (Swallow Nest Mud) to the front and back of the ear.
Although teeth belong to the Kidney, the entire mouth belongs to the Stomach, because the mouth is the gateway of the Stomach. The gums are particularly surrounded by the collaterals of the Stomach Meridian. Therefore, any hemorrhage is due to Stomach Fire flaming upward, with blood moving along with the fire. The treatment principle is primarily to clear Stomach Fire. For Excess Fire in the Stomach, characterized by thirst, swollen gums, fever, constipation, and a surging and rapid pulse, Tong Pi Xie Wei Tang added with Pu Huang and Ou Jie is used. If the stool is not obstructed, purgatives are not needed; instead, cooling agents should be used. Xi Jiao Di Huang Tang added with Ge Gen, Guan Zhong, Zhi Ke, and Lai Fu Zhi Zhi (Radish Juice) is suitable.
For Deficient Fire in the Stomach, characterized by dry mouth, ulcerated gums, a fine and rapid pulse, and blood deficiency, Gan Lu Yin added with Pu Huang to stop bleeding is appropriate. Yu Nu Jian guides Stomach Fire downward and simultaneously nourishes Yin. The above two points discuss the excess and deficiency of the gums; both syndromes belong to Fire. If Wind is trapped within the Fire, Fang Feng and Bai Zhi should be added; if Dampness is trapped within the Fire, Fang Ji and Mu Tong should be added. There are also cases of Kidney Deficiency with hyperactive Fire, leading to loose teeth and seeping blood, or bleeding during sleep and stopping upon waking. These are all due to Yin Deficiency, where blood fails to be contained. Generally, Liu Wei Di Huang Tang added with Niu Xi, Er Dong (Tian Dong and Mai Dong), Sui Bu, and Pu Huang is used. If there is upper excess and lower deficiency, with Fire failing to return to its source, manifested by a weak Chi pulse and a floating and large Cun pulse, Rou Gui and Fu Zi should be added.
External treatment methods include rinsing the mouth with cold water, based on the principle that blood coagulates when exposed to cold; rinsing with vinegar, based on the principle that sour flavors astringe; dusting with Bai Cao Shuang (soot from burning various herbs) or Shi Hui San, based on the principle that "blood stops when it sees black," which also serves to clear and descend Fire. Since descending Fire leads to descending Blood, this is effective. Grinding Ku Fan (Alum), Wu Bei Zi (Galla Chinensis), and Qiu Yin (Earthworm) into powder and applying it can further strengthen the teeth.