某 温邪上郁。耳 右胀。（风温上郁）
薄荷 马勃 桔梗 连翘 杏仁 通草
某（二二） 先起咳嗽。继而耳 胀痛。延绵百日不愈。此体质阴亏。触入风温。未经清理。外因伤及阴分。少阳
相火陡起。故入暮厥痛愈剧。当先清降。再议育阴。
苦丁茶 鲜菊叶 金银花 生绿豆皮 川贝母 鲜荷叶梗 益元散
某（女） 风温发热。左耳后肿痛。
干荷叶 苦丁茶 马勃 连翘 杏仁 黑栀皮
毕（三三） 壮年脉来小促数。自春月风温咳嗽。继以两耳失聪。据述苦降滋阴不效。是不明虚实经络矣。内经以
春病在头。膏粱之质。浓味酒醴助上痰火。固非治肾治肝可效。每晚卧时。服茶调散一钱。
又 鲜荷叶汁 羚羊角 石膏末 连翘 元参 鲜菊叶 牛蒡子 午服。
又 照前方去牛蒡菊叶加鲜生地鲜银花。
叶 火风侵窍。耳聋。
连翘 薄荷 甘菊 淡黄芩 苦丁茶 黑山栀
顾（二二） 暑邪窍闭。耳失聪。（暑）
鲜荷叶 鲜菊花叶 苦丁茶 夏枯草 蔓荆子 连翘 淡黄芩 黑山栀
某（十八） 左耳 痛。舌白。脉数。体质阴虚。挟受暑风。上焦气热。宜用辛凉轻药。
鲜菊叶 苦丁茶 黑山栀 飞滑石 连翘 淡竹叶
某（二五） 暑热上郁耳 作胀。咳呛。当清气热。
杏仁 连翘壳 淡竹叶 川贝 白沙参 六一散
宓 头重。耳 胀。目微赤。少阳相火上郁。以辛凉清解上焦。（胆火上郁）
连翘 羚羊角 薄荷梗 丹皮 牛蒡子 桑叶
某 风木之郁。耳胀欲闭。
连翘 羚羊角 薄荷梗 苦丁茶 夏枯草花 黑山栀皮 小生香附
倪（十三） 因大声喊叫。致右耳失聪。想外触惊气。内应肝胆。胆脉络耳。震动其火风之威。亦能郁而
阻窍。治在少阳。忌食腥浊。
青蒿叶 青菊叶 薄荷梗 连翘 鲜荷叶汁 苦丁茶
汪 耳聋咳嗽。形体日瘦。男子真阴未充。虚阳易升乘窍。书云。胆络脉附耳。先议清少阳郁热。
以左耳为甚故也。
桑叶 丹皮 连翘 黑山栀 青蒿汁 象贝母
丁 肾开窍于耳。心亦寄窍于耳。心肾两亏。肝阳亢逆。故阴精走泄。阳不内根据。是以耳鸣时闭。
但病在心肾。其原实由于郁。郁则肝阳独亢。令胆火上炎。清晨服丸药以补心肾。午服汤药
以清少阳。以胆经亦络于耳也。（郁伤心肾胆火上炎）
水煮熟地（四两） 麦冬（一两半） 龟版（二两） 牡蛎（一两半） 白芍（一两半） 北味（一两）
建莲（一两半） 磁石（一两） 茯神（一两半） 沉香（五钱） 辰砂（五钱为衣）
煎方
夏枯草（二钱） 丹皮（一钱） 生地（三钱） 山栀（一钱） 女贞子（三钱） 赤苓（一钱半）
生甘草（四分）
姚（三十） 气闭耳鸣。（气闭）
鲜荷叶 杏仁 浓朴 广皮 木通 连翘 苦丁茶 防己
金（三八） 下虚。耳鸣失聪。（肾虚） 磁石六味去萸加川斛龟甲远志。
王 肾窍开耳。胆络脉亦附于耳。凡本虚失聪治在肾。邪干窍闭治在胆。乃定例也。今年已六
旬。脉形细数。是皆肾阴久亏。肝阳内风上旋蒙窍。五行有声。多动真气火风。然非苦寒直降
可效。填阴重镇。滋水制木。佐以咸味入阴。酸以和阳。药理当如是议。
熟地 龟版 锁阳 牛膝 远志 茯神 磁石 秋石 萸肉 五味
某 八十耳聋。乃理之常。盖老人虽健。下元已怯。是下虚上实。清窍不主流畅。惟固补下焦。使
阴火得以潜伏。磁石六味加龟甲五味远志。
肾开窍于耳。心亦寄窍于耳。胆络脉附于耳。体虚失聪。治在心肾。邪干窍闭。治在胆经。盖
耳为清空之窍。清阳交会流行之所。一受风热火郁之邪。与水衰火实。肾虚气厥者。皆能
失聪。故先生治法。不越乎通阳镇阴。益肾补心清胆等法。使清静灵明之气。上走空窍。而
听斯聪矣。如温邪暑热火风侵窍而为耳聋痛胀者。用连翘山栀薄荷竹叶滑石银花。轻
可去实之法。轻清泄降为主。如少阳相火上郁。耳聋 胀者。用鲜荷叶苦丁茶青菊叶夏
枯草蔓荆子黑山栀羚羊角丹皮。辛凉味薄之药。清少阳郁热。兼清气热为主。如心肾两
亏。肝阳亢逆。与内风上旋蒙窍而为耳鸣暴聋者。用熟地磁石龟甲沉香二冬牛膝锁阳
秋石山萸白芍。味浓质重之药。壮水制阳。填阴镇逆。佐以酸味入阴。咸以和阳为主。因症
施治。从虚从实。直如庖丁之导 矣。（邹时乘）
徐评 耳聋之法多端。然大段不过清上镇下二条。案中方极稳当。至于外治之法。及虚寒等
症。则不可不知也。
某患者：温邪上郁。耳（风温上郁）
薄荷 马勃 桔梗 连翘 杏仁 通草
某患者（二十二岁）：起初起咳嗽，继而耳朵胀痛，拖延百日不愈。这是体质阴亏，触入风温，未经清理，外因伤及阴分，少阳相火陡起，所以入暮厥痛愈剧。当先清降，再议育阴。
苦丁茶 鲜菊叶 金银花 生绿豆皮 川贝母 鲜荷叶梗 益元散
某患者（女）：风温发热，左耳后肿痛。
干荷叶 苦丁茶 马勃 连翘 杏仁 黑栀皮
毕患者（三十三岁）：壮年脉来小促数。自春月风温咳嗽，继以两耳失聪。据述苦降滋阴不效，是不明虚实经络矣。内经以春病在头，膏粱之质，浓味酒醴助上痰火，固非治肾治肝可效。每晚卧时，服茶调散一钱。
又方：鲜荷叶汁 羚羊角 石膏末 连翘 元参 鲜菊叶 牛蒡子 午服。
又方：照前方去牛蒡菊叶加鲜生地鲜银花。
叶患者：火风侵窍，耳聋。
连翘 薄荷 甘菊 淡黄芩 苦丁茶 黑山栀
顾患者（二十二岁）：暑邪窍闭，耳失聪。（暑）
鲜荷叶 鲜菊花叶 苦丁茶 夏枯草 蔓荆子 连翘 淡黄芩 黑山栀
某患者（十八岁）：左耳痛，舌白，脉数，体质阴虚，挟受暑风，上焦气热，宜用辛凉轻药。
鲜菊叶 苦丁茶 黑山栀 飞滑石 连翘 淡竹叶
某患者（二十五岁）：暑热上郁耳作胀，咳呛，当清气热。
杏仁 连翘壳 淡竹叶 川贝 白沙参 六一散
宓患者：头重，耳胀，目微赤，少阳相火上郁，以辛凉清解上焦。（胆火上郁）
连翘 羚羊角 薄荷梗 丹皮 牛蒡子 桑叶
某患者：风木之郁，耳胀欲闭。
连翘 羚羊角 薄荷梗 苦丁茶 夏枯草花 黑山栀皮 小生香附
倪患者（十三岁）：因大声喊叫，致右耳失聪，想外触惊气，内应肝胆，胆脉络耳，震动其火风之威，亦能郁而阻窍，治在少阳，忌食腥浊。
青蒿叶 青菊叶 薄荷梗 连翘 鲜荷叶汁 苦丁茶
汪患者：耳聋咳嗽，形体日瘦，男子真阴未充，虚阳易升乘窍，书云，胆络脉附耳，先议清少阳郁热，以左耳为甚故也。
桑叶 丹皮 连翘 黑山栀 青蒿汁 象贝母
丁患者：肾开窍于耳，心亦寄窍于耳，心肾两亏，肝阳亢逆，故阴精走泄，阳不内根据，是以耳鸣时闭。但病在心肾，其原实由于郁，郁则肝阳独亢，令胆火上炎。清晨服丸药以补心肾，午服汤药以清少阳，以胆经亦络于耳也。（郁伤心肾胆火上炎）
水煮熟地（四两） 麦冬（一两半） 龟版（二两） 牡蛎（一两半） 白芍（一两半） 北味（一两）
建莲（一两半） 磁石（一两） 茯神（一两半） 沉香（五钱） 辰砂（五钱为衣）
煎方
夏枯草（二钱） 丹皮（一钱） 生地（三钱） 山栀（一钱） 女贞子（三钱） 赤苓（一钱半）
生甘草（四分）
姚患者（三十岁）：气闭耳鸣。（气闭）
鲜荷叶 杏仁 浓朴 广皮 木通 连翘 苦丁茶 防己
金患者（三十八岁）：下虚，耳鸣失聪。（肾虚） 磁石六味去萸加川斛龟甲远志。
王患者：肾窍开耳，胆络脉亦附于耳，凡本虚失聪治在肾，邪干窍闭治在胆，乃定例也。今年已六旬，脉形细数，是皆肾阴久亏，肝阳内风上旋蒙窍，五行有声，多动真气火风，然非苦寒直降可效，填阴重镇，滋水制木，佐以咸味入阴，酸以和阳，药理当如是议。
熟地 龟版 锁阳 牛膝 远志 茯神 磁石 秋石 萸肉 五味
某患者：八十耳聋，乃理之常，盖老人虽健，下元已怯，是下虚上实，清窍不主流畅，惟固补下焦，使阴火得以潜伏，磁石六味加龟甲五味远志。
肾开窍于耳，心亦寄窍于耳，胆络脉附于耳，体虚失聪，治在心肾，邪干窍闭，治在胆经，盖耳为清空之窍，清阳交会流行之所，一受风热火郁之邪，与水衰火实，肾虚气厥者，皆能失聪，故先生治法，不越乎通阳镇阴，益肾补心清胆等法，使清静灵明之气，上走空窍，而听斯聪矣。如温邪暑热火风侵窍而为耳聋痛胀者，用连翘山栀薄荷竹叶滑石银花，轻可去实之法，轻清泄降为主，如少阳相火上郁，耳聋胀者，用鲜荷叶苦丁茶青菊叶夏枯草蔓荆子黑山栀羚羊角丹皮，辛凉味薄之药，清少阳郁热，兼清气热为主，如心肾两亏，肝阳亢逆，与内风上旋蒙窍而为耳鸣暴聋者，用熟地磁石龟甲沉香二冬牛膝锁阳秋石山萸白芍，味浓质重之药，壮水制阳，填阴镇逆，佐以酸味入阴，咸以和阳为主，因症施治，从虚从实，直如庖丁之导矣。（邹时乘）
Patient: Warm pathogen stagnates upward. Ear (Wind-Warmth stagnates upward).
Bohe (Menthae Haplocalycis Herba) Mabo (Pleuroti Ostreati Fructus) Jiegeng (Platycodonis Radix) Lianqiao (Forsythiae Fructus) Xingren (Armeniacae Semen Amarum) Tongcao (Tetrapanacis Medulla)
Patient (22 years old): Initially started with cough, followed by ear distension and pain, lingering for a hundred days without healing. This is due to Yin deficiency constitution, invaded by Wind-Warmth, not cleared properly. External factors injured the Yin aspect, Shaoyang Ministerial Fire suddenly rose, thus evening twilight convulsive pain became more severe. First clear and descend, then discuss nourishing Yin.
Kudingcha (Ilex kudingcha Chunhua) Xianjuye (Chrysanthemi Indici Folium) Jinyinhua (Lonicerae Japonicae Flos) Shenglvdoupi (Phaseoli Radiati Pericarpium) Chuanbeimu (Fritillariae Cirrhosae Bulbus) Xianheyegeng (Nelumbinis Nucleus Caulis) Yiyuan San (Yi Yuan Powder)
Patient (Female): Wind-Warmth fever, left ear posterior swelling and pain.
Ganheyeye (Dry Nelumbinis Nucleus Caulis) Kudingcha Mabo Lianqiao Xingren Heizhipi (Gardeniae Fructus Cortex)
Bi Patient (33 years old): Young adult pulse is small, hurried, rapid. Since spring, Wind-Warmth cough, followed by bilateral deafness. It is stated that bitter descent and Yin nourishment were ineffective; this shows ignorance of deficiency/excess meridians. The Neijing states spring diseases affect the head. For those rich in food and drink, strong flavors and wine assist upper phlegm-fire, certainly treating kidney or liver alone is ineffective. Every night before sleep, take Chatiao San one qian.
Another prescription: Xianheyezhi (Fresh Nelumbinis Nucleus Juice) Lingyangjiao (Saigae Tataricae Cornu) Shigaomo (Gypsum Fibrosum Pulvis) Lianqiao Yuannan (Scrophulariae Radix) Xianjuye Niubangzi (Arctii Fructus) Take at noon.
Another prescription: Follow previous formula, remove Niubangzi and Juye, add Xianshengdi (Rehmanniae Radix Recens) Xianyinhua (Lonicerae Japonicae Flos Recens).
Ye Patient: Fire-Wind invades orifices, deafness.
Lianqiao Bohe Ganju (Chrysanthemi Flos) Danhuangqin (Scutellariae Radix) Kudingcha Heishanzhi (Gardeniae Fructus)
Gu Patient (22 years old): Summer-heat pathogen blocks orifices, ear loses hearing. (Summer-heat)
Xianheyeye Xianjuyehua Kudingxia Kucaocao (Prunellae Spica) Manjingzi (Viticis Semen) Lianqiao Danhuangqin Heishanzhi
Patient (18 years old): Left ear pain, white tongue, rapid pulse, Yin deficiency constitution, complicated by Summer-Wind, Upper Jiao Qi heat, should use acrid-cool light drugs.
Xianjuye Kudingcha Heishanzhi Feihuashi (Talcum) Lianqiao Danzhuye (Bambusae Folium)
Patient (25 years old): Summer-heat stagnates upward, ear distension, coughing and wheezing, should clear Qi heat.
Xingren Lianqiaoke (Forsythiae Fructus Shell) Danzhuye Chuanbei Baishashen (Glehniae Radix) Liuyi San (Liuyi Powder)
Mi Patient: Heavy head, ear distension, eyes slightly red, Shaoyang Ministerial Fire stagnates upward, use acrid-cool to clear and resolve Upper Jiao. (Gallbladder Fire stagnates upward)
Lianqiao Lingyangjiao Bohegeng (Menthae Haplocalycis Caulis) Danpi (Moutan Cortex) Niubangzi Sangye (Mori Folium)
Patient: Wind-Wood stagnation, ear distension wanting to close.
Lianqiao Lingyangjiao Bohegeng Kudingcha Xiakucacaohua (Prunellae Spica Flower) Heishanzhipi Xiangfu (Cyperi Rhizoma)
Ni Patient (13 years old): Due to loud shouting, right ear lost hearing. Likely external shock qi, internally affecting Liver and Gallbladder. Gallbladder meridian connects to ear, shaking its Fire-Wind power, also can stagnate and block orifices. Treatment focuses on Shaoyang. Avoid greasy and turbid foods.
Qinghaoye (Artemisiae Annuae Folium) Qingjuye (Chrysanthemi Indici Folium) Bohegeng Lianqiao Xianheyezhi Kudingcha
Wang Patient: Deafness and cough, body daily wasting. Male True Yin not yet filled, Deficient Yang easily rises to invade orifices. Books say, Gallbladder meridian attaches to ear. First discuss clearing Shaoyang stagnant heat, because left ear is more severe.
Sangye (Mori Folium) Danpi Lianqiao Heishanzhi Qinghaozhi (Artemisiae Annuae Juice) Xiangbeimu (Fritillariae Thunbergii Bulbus)
Ding Patient: Kidney opens into ears, Heart also寄 (resides) orifice in ears. Heart and Kidney both deficient, Liver Yang hyperactive and counterflow, thus Yin essence leaks out, Yang does not anchor internally, hence tinnitus and intermittent closure. But disease is in Heart and Kidney, root actually due to stagnation. Stagnation causes Liver Yang alone to be hyperactive, making Gallbladder Fire flare up. Morning take pill medicine to tonify Heart and Kidney, noon take decoction to clear Shaoyang, because Gallbladder meridian also connects to ears. (Stagnation injures Heart/Kidney, Gallbladder Fire flares up)
Shu Shudi (Four liang) Maidong (One and a half liang) Guiban (Testudinis Carapax et Plastrum) Muli (Ostreae Concha) Baishao (Paeoniae Radix Alba) Beiwei (Schisandrae Fructus)
Jilian (One and a half liang) Cishi (Magnetitum) Fushen (Poria Cum Radix) Chenxiang (Aquilariae Lignum Resinatum) Chensha (Cinnabaris five qian as coating)
Decoction Formula
Xiakucao (Two qian) Danpi (One qian) Shengdi (Three qian) Shanzhi (One qian) Nvzhenzi (Ligustri Lucidi Fructus) Chiling (Polyporus)
Shenggancao (Four fen)
Yao Patient (30 years old): Qi closure tinnitus. (Qi closure)
Xianheyeye Xingren Nongpo (Magnoliae Officinalis Cortex) Guangpi (Citri Reticulatae Pericarpium) Mutong (Akebiae Caulis) Lianqiao Kudingcha Fangji (Stephaniae Tetrandrae Radix)
Jin Patient (38 years old): Lower deficiency, tinnitus and deafness. (Kidney deficiency) Cishi Liuwei Qu Yu add Chuanhu Guijia Yuanzhi.
Wang Patient: Kidney orifice opens to ear, Gallbladder meridian also attaches to ear. Generally, root deficiency deafness treated in Kidney, pathogen invading orifice closure treated in Gallbladder, this is a fixed rule. Now sixty years old, pulse shape fine and rapid, all are long-term Kidney Yin deficiency, Liver Yang internal wind rotates upward to obscure orifices. Five elements have sound, often moves True Qi Fire-Wind, but bitter-cold direct descent cannot be effective. Fill Yin heavy sedation, nourish Water control Wood, assist with salty flavor entering Yin, sour flavor harmonizing Yang, pharmacology should be discussed thus.
Shudi Guiban Suoyang (Cynomorii Herba) Niuxi (Achyranthis Bidentatae Radix) Yuanzhi (Polygalae Radix) Fushen Cishi Qiushi (Urini Suis Praeparatus) Yurou (Corni Fructus) Wuwei (Schisandrae Fructus)
Patient: Eighty years old deafness, is natural law. Although elderly are healthy, lower origin is already weak, this is lower deficiency upper excess, clear orifices do not flow smoothly. Only solidly tonify Lower Jiao, make Yin fire able to lie latent, Cishi Liuwei add Guijia Wuwei Yuanzhi.
Kidney opens into ears, Heart also resides orifice in ears, Gallbladder meridian attaches to ears. Body deficiency deafness, treatment in Heart and Kidney, pathogen invading orifice closure, treatment in Gallbladder meridian. Ears are clear empty orifices, place where Clear Yang meets and flows. Once invaded by Wind-Fire-Heat stagnation pathogen, or Water decline Fire excess, Kidney deficiency Qi reversal, all can cause deafness. Thus Master's treatment methods do not exceed passing Yang suppressing Yin, benefiting Kidney tonifying Heart clearing Gallbladder etc. methods, making clear quiet spiritual Qi go upward to empty orifices, and hearing becomes clear. Like Warm pathogen Summer-heat Fire-Wind invading orifices causing deafness pain distension, use Lianqiao Shanzhi Bohe Zhu ye Huashi Yinhua, light can remove excess method, light clear descending as main. Like Shaoyang Ministerial Fire stagnates upward, deafness distension, use Xianheyeye Kudingcha Qingjuye Xiakucao Manjingzi Heishanzhi Lingyangjiao Danpi, acrid-cool thin flavored drugs, clear Shaoyang stagnant heat, simultaneously clear Qi heat as main. Like Heart-Kidney both deficient, Liver Yang hyperactive, and internal wind rotating upward obscuring orifices causing tinnitus sudden deafness, use Shudi Cishi Guijia Chenxiang Er Dong Niuxi Suoyang Qiushi Shanyoubaishao, thick flavored heavy substance drugs, strengthen Water control Yang, fill Yin suppress rebellion, assist with sour flavor entering Yin, salty flavor harmonizing Yang as main. Treat according to symptoms, follow deficiency or excess, just like Cook Ding guiding [the ox]. (Zou Shicheng)
Xu Commentary: Methods for deafness are many, but broadly only two lines: clear upper, suppress lower. Formulas in cases are very steady. As for external treatment methods, and deficiency-cold etc. syndromes, must know them.