脉∶耳病肾虚迟濡；其脉浮大为风；洪动火贼；沉涩气凝；数实热塞。此久聋者，专于肾责；暴病浮洪，
两尺相同；或两尺数，阴火上冲。
耳者，肾之窍。肾虚则耳聋而鸣也。
滋肾通耳汤
当归 川芎 白芍 生地黄 知母（酒炒） 黄柏（酒炒） 黄芩（酒炒） 柴胡 白芷 香附（各等分）
上锉一剂，水煎温服。胸膈不快加青皮、枳壳少许。
耳左聋者，忿怒动胆火也。
龙胆汤
黄连 黄芩 栀子 当归 陈皮 胆星（各一钱） 龙胆草 香附（各八分） 玄参（七分） 青黛
木香（各五分） 干姜（炒黑、二分）
上锉一剂，生姜三片，水煎至七分，入玄明粉三分，痰盛加至五分，食后服。如作丸药，加芦荟五分、麝
香二分为末，神曲糊丸，如梧桐子大。每服五十丸，淡姜汤下。
耳右聋者，色欲动相火也。
滋阴地黄汤
熟地黄（一钱六分） 山药（八分） 山茱萸（去核、八分） 牡丹皮 泽泻 白茯苓 黄柏（酒炒）
石菖蒲（各六分） 知母（酒炒，六分） 远志（去心，六分） 当归（酒炒，八分） 川芎（八分） 白芍
（煨、八分）
上锉一剂，水煎，空心服。如作丸，用炼蜜为丸，如梧
桐子大。每服百丸，空心盐汤送下，酒亦可。亦治大病后耳聋。
两耳俱聋者，浓味动胃火也。防风通圣散（方见中风）。根据本方加酒煨大黄，再用酒炒三次，及诸药俱用
酒炒。
两耳肿痛者，肾经有风热也。
荆芥连翘汤
荆芥 连翘 防风 当归 川芎 白芍 柴胡 枳壳 黄芩 山栀 白芷 桔梗（各等分） 甘草（减半）
上锉一剂，水煎食后服。
两耳出脓者，肾经亦风热也。
蔓荆子散 治上焦热，耳内生脓，或耳鸣而聋。
蔓荆子 升麻 木通 赤芍 桑白皮（蜜水炒） 麦门冬（去心） 炙甘草 生地 前胡 赤茯苓 甘菊
花（各等分）
上锉一剂，生姜三片、枣二枚，水煎，食后服。
吹耳散
干胭脂 海螵蛸 龙骨 枯矾 冰片 密陀僧（ ） 胆矾 青黛 硼砂 黄连 赤石脂（减半） 麝香（少许）
上为细末，先用绵纸条拭干脓水后，吹入末药。
有气闭耳聋者，候气复顺自明也。
治耳闭不明 用真麝香为末，葱管吹入耳内，后将葱塞耳孔内，耳自明矣。
通明利气汤 治虚火升上，痰气郁干耳中，或闭或鸣，痰火炽盛，忧郁痞满，咽喉不利，烦躁不宁。
苍术（盐水炒） 白术（瓦焙） 香附（童便炒） 生地黄（姜汁炒） 槟榔（各一钱） 抚芎（八分）
陈皮（盐水浸炒，一钱） 贝母（三钱） 黄连（酒浸猪胆汁炒） 黄芩（同上制。各一钱） 黄柏（酒炒）
栀子仁（炒） 玄参（酒洗，各一钱） 木香 甘草（炙。各五分）
上锉作二剂，姜煎，入竹沥同服。
清聪丸 治耳鸣及壅塞至于聋者。
橘皮（盐水洗，去白，一两半） 赤茯苓（去皮） 半夏（姜制，一两） 青皮（醋炒） 柴胡梢 酒黄芩
玄参 蔓荆子 桔梗 全蝎（去毒） 菖蒲 黄连（酒炒。各一两五钱） 生甘草（五钱）
上为细末，酒糊丸，绿豆大。每服一百二十丸，临卧茶清送下。
清聪化痰丸 治耳聋耳鸣，壅闭不闻声音，乃饮食浓味，夹怒气以动肝胃之火，宜清窍也。
橘红（盐水洗，去白） 赤茯苓（去皮） 蔓荆子（各一两） 枯芩（酒炒，八钱） 黄连（酒炒） 白芍
（酒浸，煨） 生地黄（酒洗） 柴胡 半夏（姜汁炒。各七分） 人参（六钱） 青皮（醋炒，五钱）
生甘草（四钱）
上共十二味为细末，葱汤浸蒸饼丸，如绿豆大。每服百丸，晚用姜汤茶清任下。
治耳聋耳鸣方 甘草、生地胭脂包，甘遂、草乌白绵包。日夜换塞两耳，常塞其耳自通。
肾虚耳聋，用六味丸加黄柏、知母、远志肉、石菖蒲。（方见补益。）
耳鸣用六味丸，以全蝎二十枚，炒去毒为末。每用三钱，调酒送下百丸，空心服。
李少宰耳如蝉鸣，服四物汤耳鸣益甚。余以为足三阴虚。五更服六味丸，食前服补中益气汤顿愈。（方见补益。）
黎司马因怒耳鸣吐痰，作呕不食，寒热胁痛，用小柴胡汤（方见伤寒） 合四物汤（方见补益）、加山栀、
茯神、陈皮而痊。
脉象：耳病若因肾虚，脉象表现为迟而濡；若因风邪所致，脉象浮大；若因火邪为患，脉象洪动；若因气机凝滞，脉象沉涩；若因热邪壅塞，脉象数实。对于久聋者，应专门从肾脏寻找病因；突发耳聋且脉象浮洪，两侧尺部脉象相同；或者两侧尺部脉象数，这是阴火上冲所致。
滋肾通耳汤
当归、川芎、白芍、生地黄、知母（用酒炒）、黄柏（用酒炒）、黄芩（用酒炒）、柴胡、白芷、香附（各等分）。
以上药材锉碎为一剂，加水煎煮，温服。若胸膈部感觉不适，加入少许青皮、枳壳。
龙胆汤
黄连、黄芩、栀子、当归、陈皮、胆星（各一钱）、龙胆草、香附（各八分）、玄参（七分）、青黛、木香（各五分）、干姜（炒黑，二分）。
以上药材锉碎为一剂，加生姜三片，水煎至七分量，加入玄明粉三分，若痰多则加至五分，饭后服用。如果制成丸药，加入芦荟五分、麝香二分为细末，用神曲糊制作成梧桐子大小的丸药。每次服用五十丸，用淡姜汤送服。
滋阴地黄汤
熟地黄（一钱六分）、山药（八分）、山茱萸（去核，八分）、牡丹皮、泽泻、白茯苓、黄柏（用酒炒）、石菖蒲（各六分）、知母（用酒炒，六分）、远志（去心，六分）、当归（用酒炒，八分）、川芎（八分）、白芍（煨，八分）。
以上药材锉碎为一剂，水煎，空腹服用。如果制成丸药，用炼蜜制作成梧桐子大小的丸药。每次服用一百丸，空腹时用盐汤送服，酒送服也可以。此方也治疗大病后的耳聋。
双耳均聋者，是由于饮食肥甘厚味导致胃火上升。防风通圣散（方剂见中风章节）。根据本方加入用酒煨的大黄，再用酒炒三次，以及所有其他药物均用酒炒。
荆芥连翘汤
荆芥、连翘、防风、当归、川芎、白芍、柴胡、枳壳、黄芩、山栀、白芷、桔梗（各等分）、甘草（减半）。
以上药材锉碎为一剂，水煎，饭后服用。
蔓荆子散 治疗上焦热盛，耳内生脓，或耳鸣且耳聋。
蔓荆子、升麻、木通、赤芍、桑白皮（用蜜水炒）、麦门冬（去心）、炙甘草、生地、前胡、赤茯苓、甘菊花（各等分）。
以上药材锉碎为一剂，加生姜三片、大枣二枚，水煎，饭后服用。
吹耳散
干胭脂、海螵蛸、龙骨、枯矾、冰片、密陀僧、胆矾、青黛、硼砂、黄连、赤石脂（减半）、麝香（少许）。
以上药物研为细末，先用棉纸条拭干脓液，然后将药末吹入耳内。
治疗耳闭不明：用真麝香研为细末，通过葱管吹入耳内，随后用葱段塞住耳孔，耳朵自然就能听清了。
通明利气汤 治疗虚火上升，痰气郁结于耳中，或耳闭或耳鸣，痰火炽盛，忧郁痞满，咽喉不利，烦躁不宁。
苍术（用盐水炒）、白术（瓦焙）、香附（用童便炒）、生地黄（用姜汁炒）、槟榔（各一钱）、抚芎（八分）、陈皮（用盐水浸炒，一钱）、贝母（三钱）、黄连（用酒浸猪胆汁炒）、黄芩（同上法炮制，各一钱）、黄柏（用酒炒）、栀子仁（炒）、玄参（用酒洗，各一钱）、木香、甘草（炙，各五分）。
以上药材锉碎作两剂，用姜煎煮，加入竹沥同服。
清聪丸 治疗耳鸣及耳部壅塞直至耳聋。
橘皮（用盐水洗，去白，一两半）、赤茯苓（去皮）、半夏（姜制，一两）、青皮（醋炒）、柴胡梢、酒黄芩、玄参、蔓荆子、桔梗、全蝎（去毒）、菖蒲、黄连（用酒炒，各一两五钱）、生甘草（五钱）。
以上药物研为细末，用酒糊制作成绿豆大小的丸药。每次服用一百二十丸，临睡前用茶清送服。
清聪化痰丸 治疗耳聋耳鸣，耳部壅闭听不见声音，这是由于饮食肥甘厚味，夹杂怒气导致肝胃之火上升，应当清利耳窍。
橘红（用盐水洗，去白）、赤茯苓（去皮）、蔓荆子（各一两）、枯芩（用酒炒，八钱）、黄连（用酒炒）、白芍（用酒浸，煨）、生地黄（用酒洗）、柴胡、半夏（用姜汁炒，各七分）、人参（六钱）、青皮（醋炒，五钱）、生甘草（四钱）。
以上十二味药共研为细末，用葱汤浸泡蒸饼制作成绿豆大小的丸药。每次服用一百丸，晚上用姜汤或茶清任意送服。
治疗耳聋耳鸣的方子：用甘草、生地包裹胭脂，用甘遂、草乌白绵包裹。日夜交替塞入双耳，经常塞耳，耳朵自然通畅。
肾虚耳聋，使用六味丸加入黄柏、知母、远志肉、石菖蒲。（方剂见补益章节。）
耳鸣使用六味丸，配合全蝎二十枚，炒去毒后研为细末。每次取三钱，调酒送服六味丸一百丸，空腹服用。
李少宰耳朵像蝉鸣一样响，服用四物汤后耳鸣更加严重。我认为这是足三阴经虚损。在五更天服用六味丸，饭前服用补中益气汤，顿时痊愈。（方剂见补益章节。）
黎司马因为愤怒导致耳鸣、吐痰、呕吐不能进食，伴有寒热和胁痛，使用小柴胡汤（方剂见伤寒章节）合四物汤（方剂见补益章节），加入山栀、茯神、陈皮而痊愈。
Pulse: For ear diseases caused by Kidney deficiency, the pulse is slow and soggy; if caused by wind, the pulse is floating and large; if caused by fire pathogen, the pulse is surging and active; if caused by Qi stagnation, the pulse is deep and choppy; if caused by heat obstruction, the pulse is rapid and excess. For chronic deafness, the cause should be sought specifically in the Kidneys; sudden deafness with a floating and surging pulse, where both Chi (Cun-Kuan-Guan) positions are identical; or if both Chi positions are rapid, this indicates Yin fire rushing upward.
The ears are the orifices of the Kidneys. When Kidney Qi is deficient, it leads to deafness and tinnitus.
Zishen Tong'er Decoction (Nourishing Kidney and Opening Ear Decoction)
Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shengdihuang (Rehmanniae Radix Recens), Zhimu (Anemarrhenae Rhizoma, stir-fried with wine), Huangbai (Phellodendri Cortex, stir-fried with wine), Huangqin (Scutellariae Radix, stir-fried with wine), Chaihu (Bupleuri Radix), Baizhi (Angelicae Dahuricae Radix), Xiangfu (Cyperi Rhizoma). All in equal parts.
Crush these ingredients for one dose, decoct with water, and take warm. If there is discomfort in the chest and diaphragm, add a small amount of Qingpi (Aurantii Fructus Immaturus) and Zhike (Aurantii Fructus).
Deafness in the left ear is caused by anger stirring up Gallbladder fire.
Longdan Tang (Gentian Decoction)
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Danning (Arisaematis Cum Bile), each 1 qian; Longdancao (Gentianae Radix et Rhizoma), Xiangfu (Cyperi Rhizoma), each 8 fen; Xuanshen (Scrophulariae Radix), 7 fen; Qingdai (Indigo Naturalis), Muxiang (Aucklandiae Radix), each 5 fen; Ganjiang (Zingiberis Rhizoma, charred black), 2 fen.
Crush these ingredients for one dose, add three slices of fresh ginger, decoct with water until reduced to 70%, then add Xuanmingfen (Mirabilite). If phlegm is abundant, increase Xuanmingfen to 5 fen. Take after meals. If preparing as pills, add Lulu (Aloe), 5 fen, and Shexiang (Moschus), 2 fen, grind into fine powder, and bind with Shenqu (Massa Medicata Fermentata) paste into pills the size of paulownia seeds. Take 50 pills per dose, washed down with light ginger soup.
Deafness in the right ear is caused by sexual excess stirring up Ministerial fire.
Ziyin Dihuang Tang (Nourishing Yin and Rehmannia Decoction)
Shudihuang (Rehmanniae Radix Praeparata), 1.6 qian; Shanyao (Dioscoreae Rhizoma), 8 fen; Shanzhuyu (Corni Fructus, pitted), 8 fen; Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), BaiFuling (Poria), each equal parts; Huangbai (Phellodendri Cortex, stir-fried with wine), Shichangpu (Acori Tatarinowii Rhizoma), each 6 fen; Zhimu (Anemarrhenae Rhizoma, stir-fried with wine), 6 fen; Yuanzhi (Polygalae Radix, heart removed), 6 fen; Danggui (Angelicae Sinensis Radix, stir-fried with wine), 8 fen; Chuanxiong (Chuanxiong Rhizoma), 8 fen; Baishao (Paeoniae Radix Alba, roasted), 8 fen.
Crush these ingredients for one dose, decoct with water, and take on an empty stomach. If preparing as pills, use refined honey to form pills the size of paulownia seeds. Take 100 pills per dose, washed down with salted water on an empty stomach; wine may also be used. This formula also treats deafness following severe illness.
Deafness in both ears is caused by rich flavors stirring up Stomach fire. Fangfeng Tongsheng San (Wind-Dispersing and Unblocking Powder) (see Stroke chapter). Add Da Huang (Rhei Radix et Rhizoma) stir-fried with wine to this formula, stir-fry three times with wine, and stir-fry all other herbs with wine.
Swelling and pain in both ears indicate wind-heat in the Kidney meridian.
Jingjie Lianqiao Tang (Schizonepeta and Forsythia Decoction)
Jingjie (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix), Zhike (Aurantii Fructus), Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), all in equal parts; Gancao (Glycyrrhizae Radix et Rhizoma), halved.
Crush these ingredients for one dose, decoct with water, and take after meals.
Pus discharge from both ears also indicates wind-heat in the Kidney meridian.
Manjingzi San (Vitex Seed Powder) Treats upper jiao heat, pus formation inside the ear, or tinnitus accompanied by deafness.
Manjingzi (Viticis Fructus), Shengma (Cimicifugae Rhizoma), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Sangbaipi (Mori Cortex, stir-fried with honey water), Maidong (Ophiopogonis Radix, heart removed), Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Shengdi (Rehmanniae Radix), Qianhu (Peucedani Radix), Chifuling (Poria), Ganhuihua (Chrysanthemi Flos), all in equal parts.
Crush these ingredients for one dose, add three slices of fresh ginger and two dates, decoct with water, and take after meals.
Chui'er San (Ear-Blowing Powder)
Ganyanzhi (Dry Carmine), Haipiaoxiao (Sepiae Endoconcha), Longgu (Fossilia Ossis Mastodi et Humeri), Kufan (Alumen Exsiccatum), Bingpian (Borneolum Syntheticum), Miduoseng (Lithargyrum), Danfan (Melanteritum), Qingdai (Indigo Naturalis), Pengsha (Borax), Huanglian (Coptidis Rhizoma), Chishizhi (Halloysit Rubra, halved), Shexiang (Moschus, a little).
Grind all into a fine powder. First, wipe dry the pus and fluid with a cotton strip, then blow the powder into the ear.
For deafness due to Qi blockage, wait for the Qi to flow smoothly again, and hearing will naturally recover.
Treatment for ear closure and unclear hearing: Use real Moschus ground into powder, blow it into the ear through a scallion tube, then plug the ear hole with the scallion. The ear will naturally clear.
Tongming Liqi Tang (Unblocking Brightness and Promoting Qi Flow Decoction) Treats rising deficient fire, phlegm-Qi stagnation obstructing the ear, causing blockage or tinnitus, excessive phlegm-fire, melancholy and fullness, throat discomfort, and restlessness.
Cangzhu (Atractylodis Rhizoma, stir-fried with salt water), Baizhu (Atractylodis Macrocephalae Rhizoma, baked on tile), Xiangfu (Cyperi Rhizoma, stir-fried with children's urine), Shengdihuang (Rehmanniae Radix Recens, stir-fried with ginger juice), Binglang (Arecae Semen), each 1 qian; Fuxiong (Chuanxiong Rhizoma), 8 fen; Chenpi (Citri Reticulatae Pericarpium, soaked and stir-fried with salt water), 1 qian; Beimu (Fritillariae Bulbus), 3 qian; Huanglian (Coptidis Rhizoma, soaked in wine and pig bile), Huangqin (Scutellariae Radix, prepared similarly), each 1 qian; Huangbai (Phellodendri Cortex, stir-fried with wine); Zhiziren (Gardeniae Semen, roasted); Xuanshen (Scrophulariae Radix, washed with wine), each 1 qian; Muxiang (Aucklandiae Radix), Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried), each 5 fen.
Crush these ingredients to make two doses, decoct with ginger, and take together with Zhuli (Bambusae Sap).
Qingcong Wan (Clear and Acute Pill) Treats tinnitus and blockage leading to deafness.
Jupi (Citri Reticulatae Pericarpium, washed with salt water, white pith removed), 1.5 liang; Chifuling (Poria, peeled), Banxia (Pinelliae Rhizoma, processed with ginger), 1 liang; Qingpi (Aurantii Fructus Immaturus, stir-fried with vinegar); Chaihu shao (Bupleuri Radix tip); Jiu Huangqin (Scutellariae Radix, stir-fried with wine); Xuanshen (Scrophulariae Radix); Manjingzi (Viticis Fructus); Jiegeng (Platycodonis Radix); Quanxie (Scorpio, detoxified); Changpu (Acori Tatarinowii Rhizoma); Huanglian (Coptidis Rhizoma, stir-fried with wine), each 1.5 liang; Shenggancao (Glycyrrhizae Radix et Rhizoma), 5 qian.
Grind all into a fine powder, bind with wine paste into pills the size of mung beans. Take 120 pills per dose, washed down with clear tea before bed.
Qingcong Huatan Wan (Clear and Acute Phlegm-Resolving Pill) Treats deafness and tinnitus, ear blockage preventing sound perception, caused by rich diet combined with anger stirring Liver and Stomach fire. It should clear the orifices.
Juhong (Citri Reticulatae Pericarpium Rubrum, washed with salt water, white pith removed); Chifuling (Poria, peeled); Manjingzi (Viticis Fructus), each 1 liang; Kuqin (Scutellariae Radix, stir-fried with wine), 8 qian; Huanglian (Coptidis Rhizoma, stir-fried with wine); Baishao (Paeoniae Radix Alba, soaked in wine and roasted); Shengdihuang (Rehmanniae Radix, washed with wine); Chaihu (Bupleuri Radix); Banxia (Pinelliae Rhizoma, stir-fried with ginger juice), each 7 fen; Renshen (Ginseng Radix et Rhizoma), 6 qian; Qingpi (Aurantii Fructus Immaturus, stir-fried with vinegar), 5 qian; Shenggancao (Glycyrrhizae Radix et Rhizoma), 4 qian.
Grind these twelve ingredients into a fine powder, soak steamed bingbing (fermented rice cake) in scallion water, and form pills the size of mung beans. Take 100 pills per dose, washed down with ginger soup or clear tea at night.
Formula for treating deafness and tinnitus: Wrap Gancao (Glycyrrhizae Radix et Rhizoma) and Shengdi (Rehmanniae Radix) in carmine; wrap Gansui (Euphorbiae Pekinensis Radix) and Caowu (Aconiti Radix Preparata) in white cotton. Plug both ears alternately day and night. Frequent plugging will naturally open the ears.
For Kidney deficiency deafness, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Yuanzhi rou (Polygalae Radix flesh), and Shichangpu (Acori Tatarinowii Rhizoma). (See Tonification chapter.)
For tinnitus, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) combined with Quanxie (Scorpio), 20 pieces, stir-fried to remove toxicity and ground into powder. Take 3 qian each time, mixed with wine to wash down 100 pills of Liuwei Wan, taken on an empty stomach.
Li Shaozai had tinnitus like cicadas. After taking Siwu Tang (Four-Substance Decoction), his tinnitus worsened. I diagnosed it as deficiency of the three Foot Yin meridians. He took Liuwei Wan (Six-Ingredient Pill with Rehmannia) at wu geng (3-5 AM) and Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) before meals, resulting in immediate recovery. (See Tonification chapter.)
Li Sima suffered from tinnitus, expectoration, vomiting, loss of appetite, alternating chills and fever, and hypochondriac pain due to anger. He was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) (see Cold Damage chapter) combined with Siwu Tang (Four-Substance Decoction) (see Tonification chapter), plus Zhizi (Gardeniae Fructus), Fushen (Poria cum Radix), and Chenpi (Citri Reticulatae Pericarpium), leading to recovery.