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A person suffers from sudden swelling and pain in both ears, with clear fluid draining internally, which later turns into pus and blood. The body experiences chills and fever, and the ears produce sounds like boiling water or cicada chirping. This is due to the stagnation of Shaoyang Gallbladder Qi (Shaoyang Gallbladder Qi Stagnation), allowing Wind Pathogen (Wind Evil) to invade. Fire cannot dissipate, thus causing this disease. The treatment principle should be to soothe and release Gallbladder Qi, assisted by herbs that dispel wind and purge fire, leading to recovery. However, why do some treatments fail? It is because the Gallbladder, affected by Wind and Fire pathogens, has its bile dried up. Using only wind-dispelling and fire-purging decoctions will further dry the bile and intensify Gallbladder Fire. Fire borrows strength from Wind, burning more fiercely, worsening the ear condition. The formula Run Dan Tang (Moistening Gallbladder Decoction) is used: Bai Shao (White Peony Root, 1 liang), Dang Gui (Angelica Sinensis, 1 liang), Chai Hu (Bupleurum Root, 1 qian), Chao Zhi Zi (Fried Gardenia Fruit, 2 qian), Xuan Shen (Scrophularia Root, 1 liang), Tian Hua Fen (Trichosanthes Root, 3 qian), Chang Pu (Acorus Rhizome, 8 fen). Decoct in water and take orally. After one dose, pain lightens; after two doses, swelling subsides; after three doses, pus and blood stop; after four doses, chills and fever disappear completely; after ten doses, full recovery occurs.

Dang Gui and Bai Shao enter not only the Gallbladder channel but also the Liver channel. When the Gallbladder is diseased, the Liver is inevitably involved; calming the Liver calms the Gallbladder. Chai Hu and Zhi Zi are also herbs that soothe the Liver; soothing the Liver is precisely how one soothes the Gallbladder. As Liver Blood becomes abundant, Gallbladder Bile will naturally be moistened. The pathogenic Wind and Fire already have the potential to dissipate without treatment; adding Tian Hua Fen to eliminate phlegm removes the allies of Wind and Fire. Chang Pu opens the orifices in the ear, guiding Xuan Shen to subdue floating Fire. Naturally, Wind and Fire are gradually dispelled, the Upper Jiao (Upper Burner) becomes cool, and the ear disease heals.

This condition can also be treated effectively with Zhi Ming Dan (Stop Tinnitus Pill): Bai Shao (5 qian), Chai Hu (2 qian), Chao Zhi Zi (3 qian), Sheng Di Huang (Rehmannia Root, 3 qian), Mai Dong (Ophiopogon Tuber, 3 qian), Chang Pu (5 fen), Fu Ling (Poria, 3 qian), Ban Xia (Pinellia Tuber, 5 fen). Decoct in water and take orally. Several doses lead to cure.

Some people experience sharp, needle-like pain in the ears without fluid discharge, only hearing a boiling sound. Many attribute this to Fire Pathogen, unaware that it is actually due to the depletion of Kidney Water. The Kidneys open into the ears; insufficient Kidney Qi leads to ear blockage. However, before blockage, there must be pain, followed by deafness. Why? Because of Kidney Fire rushing upward. If Fire rushes but cannot exit, the pathway for Fire becomes blocked and unpatent. Consequently, Fire no longer travels through the ears, resulting in deafness. But if Fire rushes upward to the ear orifices, why does the pathway become blocked? The Fire Pathogen rushes into the inner ear orifices, creating a sensation of obstruction. Therefore, such diseases require rapid treatment; otherwise, they progress to difficult-to-treat deafness. The formula Yi Shui Zhun Huo Tang (Nourishing Water and Calming Fire Decoction) is used: Shu Di Huang (Prepared Rehmannia Root, 1 liang), Sheng Di Huang (Raw Rehmannia Root, 1 liang), Mai Dong (1 liang), Xuan Shen (1 liang), Chang Pu (1 qian). Decoct in water and take orally. Pain stops after one dose; ringing ceases after two doses; full recovery occurs after three doses, preventing future deafness.

These four ingredients nourish Water and purge Fire within Water without damaging Kidney Qi, causing Kidney Fire to descend naturally. Chang Pu guides Kidney Qi upward to connect; Fire finds a path to ascend, eliminating concerns of obstruction. This type of disease is most common in the elderly. Although deafness in the elderly is often seen as a sign of longevity and might seem unnecessary to treat, one must understand that established deafness may not need treatment, but impending deafness must be treated. This formula has miraculous effects even on established deafness, let alone on ears that have not yet lost hearing.

This condition can also be treated with Xi Fei Tang (Stopping Boiling Decoction): Shu Di Huang (2 liang), Shan Zhu Yu (Cornus Fruit, 1 liang), Mai Dong (5 qian), Bei Wu Wei Zi (Schisandra Berry, 10 berries), Chang Pu (1 qian), Yuan Zhi (Polygala Root, 5 fen), Dan Shen (Salvia Root, 3 qian). Decoct in water and take orally. Ten doses lead to cure.

After ear pain subsides, some still suffer from tinnitus. People assume Wind and Fire remain in the ear and continue using wind-dispelling and fire-purging herbs, which worsens the tinnitus. However, pressing on the ear with the hand temporarily relieves the tinnitus, indicating Yang Deficiency (Yang Xu) and Qi Blockage (Qi Bi). The treatment principle should focus on tonifying Yang Qi while simultaneously addressing Liver and Kidney deficiency. The formula Fa Yang Tong Yin Tang (Raising Yang and Opening Yin Decoction) is used: Ren Shen (Ginseng Root, 2 qian), Fu Ling (3 qian), Bai Zhu (Atractylodes Macrocephala Rhizome, 2 qian), Huang Qi (Astragalus Root, 3 qian), Rou Gui (Cinnamon Bark, 5 fen), Shu Di Huang (5 qian), Dang Gui (2 qian), Bai Shao (3 qian), Chai Hu (1 qian), Gan Cao (Licorice Root, 5 fen), Bai Jie Zi (White Mustard Seed, 2 qian), Jing Jie (Schizonepeta Spike, fried black, 1 qian). Decoct in water and take orally. Lightens after one dose; cures after two doses; three doses are unnecessary.

This formula is a variation of Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction), suitable for Qi and Blood deficiency. Why is it suitable for Yang Deficiency? Yang Deficiency rarely exists without concurrent Yin Deficiency. Tonifying Yang alone might cause Yang to flourish and Yin to decline, stirring Fire. Instead, tonifying Yin allows Yin to control Yang. When Yin and Yang mutually support each other, Qi flows freely, and tinnitus disappears instantly.

This condition can also be treated with Kai Bi Dan (Opening Obstruction Pill): Huang Qi (1 liang), Dang Gui (5 qian), Rou Gui (5 fen), Gan Cao (5 fen), Chang Pu (1 qian), Yuan Zhi (1 qian), Chai Hu (1 qian), Xiang Fu (Cyperus Rhizome, 1 qian), Tian Hua Fen (2 qian). Decoct in water and take orally. Cures after two doses.

Some people suffer from bilateral deafness, unable to hear thunderous noises, yet their ears do not hurt. This occurs after severe illness or in the elderly, caused by internal closure of Kidney Fire and Qi blockage. It is difficult to treat. Treatment requires both internal and external approaches. Internally, one must greatly tonify the Heart and Kidneys. Although the ears belong to the Kidneys, without Heart Qi connection, Heart and Kidney do not interact, leading to blockage. Thus, Kidney-nourishing herbs are used to allow Kidney Fluids to nourish the Heart, and Heart-tonifying agents are used to allow Heart Qi to descend to the Kidneys. Once Heart and Kidney Qi interact, they naturally ascend and connect to the ears. The formula Qi Qiao Tang (Opening Orifices Decoction) is used: Shu Di Huang (2 liang), Shan Zhu Yu (1 liang), Mai Dong (1 liang), Yuan Zhi (3 qian), Wu Wei Zi (Schisandra Berry, 2 qian), Shi Chang Pu (Stone Acorus Rhizome, 1 qian), Chao Suan Zao Ren (Fried Sour Jujube Seed, 3 qian), Fu Shen (Poria with Hostwood, 3 qian), Bai Zi Ren (Biota Seed, 3 qian). Decoct in water and take orally. After four consecutive doses, ringing in the ears indicates the onset of hearing restoration. Continue with the same prescription for ten doses. Externally: Long Gu (Dragon Bone, 1 fen), Xiong Shu Dan Zhi (Male Rat Gallbladder Juice, 1 piece), She Xiang (Musk, 1 li), Bing Pian (Borneol, 3 li). Grind into an extremely fine powder, form into pills, divide into three portions, wrap in cotton, and insert into the ear. Do not remove. Hearing restores within one day, with extreme efficacy.

After hearing restores, continue taking the previous decoction. One month later, use a large dose of Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) for follow-up care; otherwise, long-term hearing may not be maintained.

This condition can also be treated with Tong Er Tang (Unblocking Ear Decoction): Shu Di Huang (3 liang), Mai Dong (1 liang), Chao Suan Zao Ren (3 qian), Fu Shen (3 qian), Xuan Shen (3 qian), Chang Pu (1 qian), Bai Zi Ren (3 qian), Chao Hei Jing Jie (Fried Black Schizonepeta Spike, 3 qian). Decoct in water and take orally. Natural patency occurs after ten doses.

Some people, when at rest, suddenly hear wind/rain sounds or drum/horn noises in their ears. People assume this is excessive Kidney Fire, but it is actually extreme Heart Fire Hyperactivity (Heart Fire Hyperactivity). Only when Heart and Kidney interact can the upper and lower parts remain clear and calm, governing hearing and vision. Kidney not interacting with Heart, or Heart not interacting with Kidney, both cause auditory confusion. For Kidney to interact upward with Heart, and Heart to interact downward with Kidney, both must accept each other to maintain peace. If Kidney Fire is too strong, Heart fears Kidney inflammation and dares not descend; if Heart Fire is too strong, Kidney fears Heart flames and dares not ascend. Both cause tinnitus, but Heart-Kidney non-interaction causes lighter tinnitus, while Kidney-Heart non-interaction causes heavier tinnitus. Hearing wind/drum sounds indicates heavy tinnitus. To restore Kidney Qi to the Heart, Heart Qi must return to the Kidney. The formula Liang Gui Tang (Two Returns Decoction) is used: Mai Dong (1 liang), Huang Lian (Coptis Rhizome, 2 qian), Sheng Suan Zao Ren (Raw Sour Jujube Seed, 5 qian), Shu Di Huang (1 liang), Dan Shen (3 qian), Fu Shen (3 qian). Decoct in water and take orally. Tinnitus stops after two doses; does not recur after four doses.

This is a Heart-cooling formula. Once the Heart is cool, Kidney does not fear Heart heat and willingly returns. There is no need for mutual attraction to unite. Moreover, the formula contains only Heart-benefiting and Kidney-nourishing items. The Heart avoids excessive dryness, and the Kidney enjoys nourishment. It is like a harmonious couple enjoying fish-in-water intimacy without separation sorrow, avoiding noise in the room.

This condition can also be treated with Ding Xuan Tang (Stabilizing Noise Decoction): Xuan Shen (3 liang), Sheng Di Huang (1 liang), Bei Mu (Fritillaria Bulb, 2 qian). Decoct in water and take orally. Tinnitus stops after one dose.

Some people have healthy ears until sexual intercourse, after which the ears hurt, itch incessantly, or discharge foul-smelling fluid. Applying cold objects brings great relief. People attribute this to excess Kidney Fire, but it is actually Kidney Fire Deficiency (Kidney Fire Deficiency). The Fire in the Kidneys is Dragon-Thunder Fire. When Fire is strong, it is hard to move but easy to extinguish; when Fire is weak, it is easy to move but hard to extinguish. Why? Strong Fire implies abundant Water; weak Fire implies deficient Water. Deficient Water cannot control Fire, making Fire prone to movement; deficient Water cannot nourish Fire, making Fire hard to extinguish. Therefore, tonifying Water requires tonifying Fire, and tonifying Fire generates Water. They mutually control and complete each other. The Kidneys open into the ears; Kidney Water deficiency leads to Kidney Fire deficiency. Ear itching and pain occurring after intercourse manifest the deficiency of Water and Fire in the Kidneys. Treatment must tonify Kidney Fire, but Fire cannot be tonified alone; it must be tonified within Water. The formula Jia Jian Ba Wei Wan Tang (Modified Eight-Ingredient Pill Decoction) is used: Shu Di Huang (1 liang), Shan Zhu Yu (5 qian), Dan Pi (Moutan Cortex, 5 qian), Ze Xie (Alisma Rhizome, 2 qian), Fu Ling (3 qian), Shan Yao (Dioscorea Rhizome, 5 qian), Mai Dong (5 qian), Bei Wu Wei Zi (1 qian), Rou Gui (2 qian). Decoct in water and take orally. Pain lightens after one dose; stops after two doses; itching stops after three doses; discharge stops after four doses; full recovery after ten doses.

This formula tonifies both Fire and Water, with more emphasis on Water than Fire, because Fire should not be excessively strong. When Water flourishes over Fire, Fire enjoys peace. Fire guided within Water, and Water nourished within Fire, prevents Fire from moving easily and becoming hard to extinguish, stopping it from rising to the ear gate to cause pain, itching, and discharge.

This condition can also be treated with Bu Yin Zhi Huo Tang (Tonifying Yin and Restraining Fire Decoction): Shu Di Huang (2 liang), Shan Zhu Yu (1 liang), Qian Shi (Chinese Chestnut Seed, 1 liang), Rou Gui (1 qian). Decoct in water and take orally. Full recovery after ten doses.

Women who become angry and develop fever, experiencing pus discharge from both ears during menstruation, pain in both temples, breast distension and stuffiness, alternating chills and fever, difficult urination, and fullness/pounding below the navel, suffer from rebellious Liver Qi (Liver Qi Rebellion) and excessive Fire with Blood Deficiency. Although the Kidneys open into the ears and ear diseases are usually attributed to the Kidneys, the Liver is the child of the Kidney. Since Kidney Qi connects to the ears, Liver Qi can also connect, following the mother-child relationship. Furthermore, the Liver stores Blood; anger causes Blood to fail to store. During menstruation, Blood should flow downward with the menses, not stay in the collaterals causing pain and distension. The Liver prefers free flow; anger causes Qi to rebel and rush upward. With Qi rebelling, Blood refuses to flow downward normally, scattering into collaterals without exiting. Fire follows the stagnant Qi rushing upward between the ears, transforming into pus and flowing out from the Kidney Mother's orifice. Taiyang refers to the Bladder position; Kidney and Bladder are exterior-interior pairs. If Liver Qi travels through the Kidney orifice, can it not travel through the Bladder pathway? Difficult urination is indeed Liver Qi attacking the Bladder. Kidney Qi connects to the waist and umbilicus; fullness below the navel is Liver Qi attacking the Kidney. Breast distension is clear evidence of Liver rebellion, as the hypochondrium belongs to the Liver, and breasts lie between the hypochondria. Treatment should soothe Liver Qi to restore smoothness; treating the ears is unnecessary as they will heal themselves. The formula Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is used: Bai Shao (1 liang), Chai Hu (2 qian), Dang Gui (1 liang), Gan Cao (1 qian), Chen Pi (Tangerine Peel, 1 qian), Fu Shen (3 qian), Bai Zhu (5 qian), Chao Zhi Zi (1 qian), Tian Hua Fen (2 qian), Zhi Ke (Aurantii Fructus, 5 fen), Dan Pi (3 qian). Decoct in water and take orally. All symptoms resolve after two doses.

This formula is the supreme herb for calming the Liver and a divine agent for resolving anger. It tonifies Blood without causing stagnation and clears Fire without excessive coldness. Treating the Kidney is included within it; unblocking the Bladder is encompassed within it. Why is this flexible method often abandoned?

This condition can also be treated with Mo Chou Tang (No-Worry Decoction): Bai Shao (5 qian), Sheng Di Huang (5 qian), Dang Gui (1 liang), Chao Zhi Zi (2 qian), Tian Hua Fen (2 qian), Xiang Fu (2 qian), Gan Cao (1 qian), Cang Zhu (Atractylodes Lancea Rhizome, 1 qian), Chao Jing Jie (Fried Schizonepeta Spike, 3 qian), Zhi Ke (5 fen). Decoct in water and take orally. Lightens after one dose; cures after two doses.