Library

[Eye] If eye disease is not treated, enduring it in the hope of spontaneous recovery, or if treatment is inappropriate, violating contraindications, damaging the meridians and collaterals, leading to deep penetration, and further left untreated, causing pathogenic factors to knot and mix without being able to disperse. Or, at specific times of the year, month, or day, like flowers blooming or tides rising, symptoms manifest when the time comes and resolve when the time passes. Long-term neglect, combined with triggering factors, can lead to severe harm. Before onset, inquire about the timing of attacks to distinguish which meridian and location the root pathology resides in. After onset, examine the clinical manifestations and subtle pulse characteristics to identify the affected part, then proceed with treatment.

[Ear] The ear is associated with the Foot-Shaoyin Kidney Meridian. (The *Zhongzang Jing* states: "The kidney is the residence of spirit and the root of life, externally connecting to the ear." The *Suwen* states: "The kidney opens into the ear; when kidney qi is harmonious, the ear can hear the five tones." The *Lingshu·Shichuan* states: "The kidney governs external perception, enabling distant hearing. Observing the condition of the ears reveals its nature. Thus, ears positioned forward near the Jiache acupoint indicate a properly positioned kidney. Note: Jiache refers to the Jiache acupoint, located in the depression at the end of the curved jaw below the ear. Ears positioned high indicate a tilted kidney; high ears indicate a high kidney; depressed posterior ears indicate a low kidney; firm ears indicate a solid kidney; thin and unfirm ears indicate a fragile kidney." The *Xuanzhu* states: "Thin ears that are black or white indicate kidney failure.") It is also associated with the Hand-Shaoyin Heart Meridian. (The *Suwen* states: "Southern red color internally connects to the heart, opening into the ear." It further states: "The collateral of the Hand-Shaoyin meridian converges in the ear.") It is also associated with the Hand-Taiyin Lung Meridian. (Li Dongyuan stated: "Although the ear is primarily governed by the kidney, its ability to hear sound relates to Metal; this implies lung water exists within the ear, as Earth generates at Shen hour." Wang Taipu stated: "The collateral of the Hand-Taiyin Lung meridian converges in the ear; lung deficiency leads to shortness of breath and inability to take deep breaths, resulting in deafness.") It is also associated with the Foot-Jueyin Liver Meridian. (The *Suwen* states: "Liver qi rebellion causes deafness and poor hearing." Zhu Danxi stated: "Deafness belongs to Heat; Shaoyang and Jueyin meridians often have excessive heat.") It is also the convergence point of the Hand-Foot Shaoyang Sanjiao and Gallbladder Meridians, and the Hand-Taiyin Small Intestine Meridian. (The *Lingshu* states: "Shaoyang roots at Qiaoyin and knots at Chuanglong; Chuanglong refers to the ear." The *Suwen* states: "A solitary whistle from One Yang indicates Shaoyang rebellion; the terminal stage involves deafness. Note: 'Whistle' refers to tinnitus sounding like a whistle. Both Gallbladder and Sanjiao meridians enter the ear, so rebellious qi causes tinnitus." It further states: "Shaoyang governs the Gallbladder; its meridian circulates along the hypochondrium and connects to the ear. Thus, after three days of Cold Damage affecting Shaoyang, there is hypochondriac pain and deafness. After nine days, as Shaoyang disease declines, hearing slightly returns." The *Lingshu* states: "Diseases generated by the Hand-Taiyin meridian include deafness and yellow eyes.") It is also the convergence point of the Hand-Foot Yangming Large Intestine and Stomach Meridians. (The *Suwen* states: "Headache, tinnitus, and dysfunction of the nine orifices arise from the stomach and intestines." The *Lingshu* states: "For deafness with pain, select the Hand-Yangming meridian; for deafness without pain, select the Foot-Shaoyang meridian." It further states: "The ear is the gathering place of the Zong vessels. When the stomach is empty, the Zong vessels become deficient; deficiency leads to downward flow, and where vessel qi exhausts, tinnitus occurs.") It is also associated with the Foot-Taiyang Bladder Meridian. (The *Suwen* states: "Tinnitus attributed to Taiyang occurs because yang qi, like flourishing things, surges upward, causing tinnitus.") It is also associated with the collaterals of the Hand-Foot Shaoyin Heart-Kidney, Hand-Foot Taiyin Lung-Spleen, and Foot-Yangming Stomach Meridians. (The *Suwen* states: "These five collaterals all belong to the center of the ear, ascending to connect with the left corner of the head; if evil Qi lodges here, disease occurs.")

[Preauricular Area] Convergence of the Hand-Foot Shaoyang Sanjiao-Gallbladder Meridians and Foot-Yangming Stomach Meridian. (The *Suwen* states: "Upper Human region, the arterial pulse before the ear. Note: Located in the depression before the ear, pulsating under the hand, this is where the Qi of the Hand-Shaoyang meridian flows.")

[Retroauricular Area] Convergence of the Hand-Foot Shaoyang Sanjiao-Gallbladder Meridians. (Li Dongyuan stated: "Shaoyang, evil exits from the front and back of the ear. This comment corroborates the preceding text.")

[Lower Curved Jaw] Convergence of the Foot-Shaoyang Gallbladder Meridian and Yangming Large Intestine Meridian, also associated with the Hand-Taiyin Small Intestine Meridian. (The *Lingshu* states: "Hand-Taiyin corresponds to the curved jaw.")

[Anterior to Curved Jaw] Convergence of the Foot-Shaoyang Gallbladder Meridian and Yangming Large Intestine Meridian.

[One Cun Anteriorly] Associated with the Hand-Yangming Large Intestine Meridian.

[Posterior to Curved Jaw] Associated with the Foot-Shaoyang Gallbladder Meridian. (The *Lingshu* states: "Foot-Shaoyang is behind the lower curved jaw.") The *Baoming Ji* states: "Regarding the ear, as an orifice it belongs to Water, regarding sound it belongs to Metal, and regarding meridians, both Hand and Foot Shaoyang converge within it. Deafness from internal inability to hear is governed by the Zang organs; inability to receive sound from outside is governed by the meridians. Sounds may resemble bell ringing, chimes, or fire crackling, each corresponding to observed meridians; their deficiency or excess must be carefully examined. For example, why treat the Lung for deafness? The Lung governs sound, and nasal congestion is also a Lung issue. Why treat the Heart? The Heart governs smell. Extending this logic, treatment begins from the origin of receiving Qi: Kidney receives Qi at Si hour, Heart at Hai hour, Liver at Shen hour, Lung at Yin hour, Spleen at the four seasons. These treatments follow the Dao of growth. Zhao Yi-de stated: 'The ear is the orifice of the Kidney, governed by the Foot-Shaoyin meridian, yet the Heart also寄 (lodges) its orifice in the ear. Among the twelve meridians, excluding Foot-Taiyang and Hand-Jueyin, the remaining ten collaterals enter the ear. Roughly, the Kidney governs internal Yin, and the Heart governs external Yang, conforming to the Way of Heaven and Earth. Essence and Qi communicate everywhere, so clear and bright Qi ascends to the orifices; the ear receives it, granting acute hearing. Thus, the ear is the orifice of these two Zang organs.' Consequently, all meridians imbibe Yin-Yang and Five Elements; clarity ascends into the ear, allowing discrimination of the five tones (Gong, Shang, Jue, Zhi, Yu). The Classics state: 'Accumulated Yang becomes Heaven, accumulated Yin becomes Earth; clear Yang emerges from the upper orifices.' If the two Qi do not harmonize, communication fails, leading to obstruction of Yang Qi and obscuration by Earth Qi. Obstruction of Yang Qi may result from: fatigue causing Yin deficiency and floating Qi; Wei Qi failing to descend and accumulating above; pathogenic wind combining with excessive Yang; excessive Heat; independent flare-up of Sanjiao Fire causing muffled hearing; accumulation of Heat in meridians and Zang organs; or anger causing Qi to rise without descending. All such cases stem from imbalance of Heart Qi deficiency/excess. Deficiency prevents Yang from descending to interact with Yin; excess relies on strong Yang to sever connection with Yin. The Classics state: 'Extreme Yin deficiency leads to cutoff of Heavenly Qi.' Obscuration by Earth Qi may result from: unresolved sorrow causing Yin obstruction preventing Yang communication; internal/external dampness/phlegm blocking Qi ascent/descent, causing muffled hearing; exhaustion of Kidney essence (if due to febrile disease, cutoff of Chi pulse indicates death); or blockage by cerumen due to disharmony of the two Qi. All such cases stem from Kidney Qi disharmony. Deficiency means weak Yin cannot ascend to interact with Yang, while sudden Yang excess causes rebellious Yin to reject Yang. The *Lingshu* states: 'Kidney Qi connects to the ear; harmony allows hearing the five tones. Disharmony of the Five Zang leads to obstruction of the seven orifices.' Thus, any deficiency or excess Qi entering the ear via meridians/collaterals disrupts the clarity governed by the two Zang organs. Sudden deafness refers to acute illness. Chronic deafness varies by Kidney deficiency/excess. Left Kidney (Yin) governs Essence; Right Kidney (Yang) governs Qi. Insufficient Essence and excess Qi indicate deficiency-type deafness. A thin, dark-complexioned person with strong bones/muscles has excess Essence/Qi and blocked storage, indicating excess-type deafness, a sign of longevity. Both are constitutional and require no treatment. Sudden deafness: The Classics state, 'Failure to regulate Yin-Yang and the Seven Losses/Eight Benefits leads to premature aging.' At age fifty, heaviness and dull senses occur, also requiring no treatment. Only acute deafness, where Yin-Yang separation is not severe, meridians desire flow but are blocked, impacting the interior and drumming the auditory canal, producing roaring/windy sounds proportional to Qi intensity, can be treated by expelling evil, tonifying deficiency, and draining excess, ensuring Yin-Yang harmony so clear Qi ascends to the ear, restoring hearing. You asked: If Water and Fire share this orifice, why does *Yuanbing Shi* oppose warming/tonification? Answer: The Heart's orifice is the tongue; since the tongue is not a cavity, it lodges in the ear. Thus, Kidney is the master of the ear orifice, Heart is the guest. Regarding Five Zang orifices on the face, divided by Yin Essence/Yang Qi: Kidney/Liver are Yin, governing Eye/Ear (Yin Essence); Heart/Lung/Spleen are Yang, governing Mouth/Tongue/Nose (Yang Qi). Yin Essence governance values coolness and dislikes heat; Yang Qi governance values warmth and dislikes cold. Jiegu Laoren argued that Eyes/Ears should not be warmed/tonified. *Renqi Zhizhi* states: 'Kidney communicates with the ear, governing Essence. Harmonized Essence and sufficient Kidney Qi grant acute hearing. Labor/injury to Qi/Blood, wind attacking deficiency, causing Essence depletion and Kidney exhaustion, leads to deafness.' There is also Qi-Rebellion Deafness (Jue Long), Wind-Clasping Deafness (Feng Long), and Labor-Injury Deafness (Lao Long). Since twelve meridians connect to the ear, if Yin-Yang meridians intersect, Zang Qi rebels causing Jue; Jue Qi clashes into ear meridians, causing Jue Long, often accompanied by vertigo. Ear is attached to Zong vessels; vessel deficiency allows wind invasion, blocking meridian Qi, causing Feng Long, often with headache. Labor injures Qi/Blood, lust depletes Essence, leading to emaciation and weakness, causing Lao Long. Proper care restores balance, temporarily alleviating deafness; chronic labor/wind stagnation causes chronic deafness. Additionally, wind striking the ear clashing with Qi causes roaring tinnitus (Xu Ming), sometimes with visual fire. Heat invading via vessels, accumulating without dispersing, discharging pus, is Nong Er (Pus Ear). Fluids in the ear are harmless unless wind-heat binds them into kernels blocking the ear, causing sudden deafness, called Ding Er (Cerumen). These conditions are diagnosed via Kidney pulse: Wind is Floating/Excessive, Heat is洪 (Surging)/Solid, Deficiency is Se/Ruo (Choppy/Soft). Treat Wind by dispersing, Heat by clearing/draining, Deficiency by nourishing. After evil retreats, use formulas to open the ear, regulate Qi, and calm the Kidney. Wind-Deficiency Deafness: Paifeng Tang, Guixing San, Sheep Kidney Soup, Fish Brain Ointment, Cishi Wan, Jiangxie San. Wind-Heat Deafness: Xijiao Yinzi, Shaoyao San, Xijiao San, Fushen San. Deafness generally belongs to Heat, especially Shaoyang/Jueyin Heat; use Tongsheng San, Gutan Wan to resolve phlegm and scatter wind-heat. Deafness due to Depression: Tongsheng San with Rhubarb (wine-fried three times, added last); other herbs wine-fried. Jue Long: Heji Liuqi Yin with Shichangpu, 3 qian per dose, decocted with Ginger/Green Onion, taken post-meal. Chenxiang Jiangqi Tang, Suzi Jiangqi Tang, Buhuanjin Zhengqi San, Zhimi Qiqi Tang. Mild cases: Laifu Dan; severe cases: Yangzheng Dan. Treating deafness always requires regulating Qi. Qi-Rebellion Deafness involves Liver, Hand-Taiyang, Hand-Shaoyang. Classics: 'Liver Qi rebellion causes headache, deafness, cheek swelling.' 'Taiyang floating deafness is Qi-related.' Luo Qianfu: Hand-Taiandon Qi rebellion causes deafness with fullness; Hand-Shaoyang Qi rebellion causes muffled hearing. Treat with Siwu Tang + Longhui Wan to descend Fire, plus Fuyuan Tongqi San to regulate Qi. Deafness with Damp-Phlegm: Binglang Shenxiong Wan to purge. Deafness with dark cheeks: Essence depletion/Kidney deficiency. Luo Qianfu: 'Classics say Essence depletion causes deafness. Kidney is Foot-Shaoyin, storing Essence, connecting to ear. Harmonized Essence strengthens Kidney, enabling hearing. Labor/Wind damaging Kidney/Essence causes deafness.' When Yin-Yang Qi merges in meridians connected to the ear, Zang Qi rebels (Jue), clashing into ear meridians causing deafness. Kidney Essence depletion deafness presents with dark zygomatic color. Hand-Shaoyang pulse movement indicates Qi rebellion deafness (muffled hearing). Hand-Taiyang rebellion deafness presents with fullness. Use Shao Shen San. Shao Shen San, Yishen San, Bushen Wan, Congrong Wan, Rong Rong Wan, Sangpiaoxiao Tang are for Kidney Deficiency with Cold. *Benshi Fang* Dihuang Tang is for Kidney Deficiency with Heat.