论
《内经》曰∶肾者作强之官，技巧出焉。又曰∶耳为肾之外候。一曰∶肾通窍于耳。一曰∶心通窍于耳。夫肾之为
脏，水脏也，天一生水，故有生之初，先生二肾而一阴藏焉，而又有相火存乎命门之中也，每挟君火之势而侮所不胜，
经所谓一水不能胜二火是矣。其或嗜欲无节，劳役过度，或中年之后，大病之余，肾水枯涸，阴火上炎，故耳痒耳鸣，
无日而不作也。或如蝉噪之声，或如钟鼓之响，甚为可恶，早而不治，渐而至于龙钟，良可叹哉！治法宜泻南方之
火，补北方之水，无有不安者焉。钱仲阳曰∶肾有补而无泻。厥有旨哉。
脉法
两寸脉浮洪上鱼为溢，两尺脉短而微，或大而数，皆属阴虚，法当补阴抑阳。
左寸洪数，心火上炎，两尺脉洪或数者，相火上炎，其人必遗精，梦与鬼交，两耳蝉鸣或聋。
方法
丹溪曰∶大病后耳聋，及阴虚火动而聋者，宜补阴降火，四物汤加黄柏主之。
耳鸣，宜当归龙荟丸；多饮酒人，宜木香槟榔丸。
耳聋，以茱萸、乌头尖、大黄三味为末，津调贴涌泉穴，以引火下行。
又方 治耳痛，以白矾枯吹入耳中，及青矾烧灰吹之，皆效。
又方 治耳痛及 耳，用桑螵蛸炙黄为末，加麝少许，吹入耳中，极效。或用胭脂胚子、蛀竹末，加麝香少许，
吹入妙。
又方 治诸虫入耳，用香油滴入耳中，其虫即出，或死于耳内。或用驴牛乳或鸡冠血滴入皆好。
又方 治诸虫入耳，用桃叶卷作角子，切齐其头，纳入耳中，其虫从角中走出。
大补丸 治耳鸣欲聋。
用黄柏一味，不拘多少，细切盐酒拌，新瓦上炒褐色，为细末，滴水丸如梧桐子大，每服一百丸。如气虚，以四君
子煎汤下；血虚，以四物汤下。
凡耳鸣耳聋，皆是阴虚火动，或补肾丸，或虎潜丸，或滋阴大补丸皆好。
（以上丹溪方法凡九条）
滋肾丸（东垣） 治耳鸣耳聋。
黄柏（盐酒炒，一两） 知母（去毛，酒浸，一两） 肉桂（五分）
上为细末，炼蜜为丸，如梧桐子大，每服五十丸，淡盐汤下。
柴胡聪耳汤（东垣） 治耳中干结，耳鸣而聋。
连翘（四钱） 柴胡（三钱） 炙甘草（少许） 当归身 人参（各一钱） 水蛭（五分炒另研） 虻虫（三个，
去翅足炒，另研） 麝香（少许，另研）
上除后三味别研外，其余细切作一服，加生姜三片，水二盏，煎至一盏，去渣加三味末子，再煎一、二沸，食远服。
蔓荆子散（东垣） 治上焦热，耳鸣而聋，及出脓汁。
炙甘草 升麻 木通 赤芍药 桑白皮（蜜制） 麦门冬 生地黄 前胡 甘菊花 赤茯苓 蔓荆子（各五分）
上细切，作一服，加生姜三片，大枣一枚，水盏半，煎至一盏，去渣食后服。
鼠粘子汤 治耳痛生疮。
昆布 苏木 生甘草 蒲黄 草龙胆（各二分） 鼠粘子 连翘 生地黄 当归梢 黄芩 炙甘草 黄连（各三分）
柴胡 黄 （各四分） 桔梗（一钱五分） 桃仁（三个，去皮尖，另研） 红花（少许）
上细切，作一服，水二盏，煎至一盏，稍热食后服。忌寒药利大便。
（祖传方）
治耳内忽大痛，如有虫在内奔走，或有血水流出，或干痛不可忍者，用蛇蜕皮烧存性，细研，以鹅翎管吹入耳中，
立愈。
论
《黄帝内经》说：肾是负责强力工作的官职，技巧由此产生。又说：耳朵是肾脏的外在征象。一种说法是：肾通过窍道与耳相通。另一种说法是：心通过窍道与耳相通。肾作为脏器，属于水脏，天一生水，所以在生命初始阶段，先生成两个肾脏，其中藏有一阴之气，同时命门之中存有相火（寄居于肾中的火），常常挟带君火（心火）的势头来克制其所不能胜的脏腑，这就是经文所说的“一水不能胜二火”。如果嗜欲没有节制，劳役过度，或者中年之后，大病初愈之时，肾水枯竭干涸，阴火向上炎升，所以耳朵发痒、耳鸣，没有一天不发作的。声音有时像蝉鸣，有时像钟鼓敲击，非常令人厌恶，早期如果不治疗，逐渐发展到听力衰退（龙钟），实在令人叹息！治疗方法应当泻南方（心/火）的火，补北方（肾/水）的水，没有不安宁的。钱乙（钱仲阳）说：肾只有补法而没有泻法。这确实有深意啊。
脉法
两手寸脉浮洪且上达鱼际称为溢脉，两手尺脉短而微弱，或者大而数，都属于阴虚，治法应当补阴抑阳。
左寸脉洪数，是心火上炎；两手尺脉洪或数，是相火上炎，此人必定遗精，梦中与鬼交合，两耳蝉鸣或耳聋。
方法
朱丹溪说：大病后耳聋，以及阴虚火动导致的耳聋，应当补阴降火，用四物汤加黄柏为主方。
耳聋，用茱萸、乌头尖、大黄三味药研为末，用唾液调和贴敷涌泉穴，以引火下行。
又一方 治疗耳痛，将白矾烧枯后吹入耳中，以及将青矾烧成灰吹入，都有效。
又一方 治疗耳痛及耳部流脓，用桑螵蛸炙黄研为末，加入少许麝香，吹入耳中，极效。或者用胭脂胚子、蛀竹末，加入少许麝香，吹入效果奇妙。
又一方 治疗各种虫子进入耳中，用香油滴入耳中，虫子就会出来，或者死在耳内。或者用驴牛乳或鸡冠血滴入也很好。
又一方 治疗各种虫子进入耳中，用桃叶卷成角状，切齐其头部，纳入耳中，虫子会从角中走出。
只用黄柏一味，不拘多少，细切后用盐和酒拌匀，在新瓦上炒至褐色，研为细末，滴水制成如梧桐子大小的丸剂，每次服用一百丸。如果气虚，用四君子煎汤送服；如果血虚，用四物汤送服。
凡是耳鸣耳聋，都是阴虚火动所致，或者补肾丸，或者虎潜丸，或者滋阴大补丸都可以。
（以上丹溪的方法共九条）
黄柏（盐酒炒，一两） 知母（去毛，酒浸，一两） 肉桂（五分）
以上药物研为细末，炼蜜制成丸剂，如梧桐子大小，每次服用五十丸，淡盐汤送服。
连翘（四钱） 柴胡（三钱） 炙甘草（少许） 当归身 人参（各一钱） 水蛭（五分炒后另研） 虻虫（三个，去翅足炒后另研） 麝香（少许，另研）
以上除后三味分别研末外，其余细切为一剂，加生姜三片，水两盏，煎至一盏，去渣后加入三味药末，再煎一二沸，饭后远时服用。
炙甘草 升麻 木通 赤芍药 桑白皮（蜜制） 麦门冬 生地黄 前胡 甘菊花 赤茯苓 蔓荆子（各五分）
以上细切，为一剂，加生姜三片，大枣一枚，水一盏半，煎至一盏，去渣后饭后服用。
昆布 苏木 生甘草 蒲黄 草龙胆（各二分） 鼠粘子 连翘 生地黄 当归梢 黄芩 炙甘草 黄连（各三分） 柴胡 黄芪（各四分） 桔梗（一钱五分） 桃仁（三个，去皮尖，另研） 红花（少许）
以上细切，为一剂，水两盏，煎至一盏，稍热后饭后服用。忌用寒凉药导致大便泄利。
（祖传方）
治疗耳内突然剧烈疼痛，如有虫子在内奔走，或有血水流出，或干痛不可忍受，用蛇蜕皮烧存性，细研，用鹅翎管吹入耳中，立即痊愈。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Kidney is the official responsible for strength and vigor, and skills emerge from it. It also states: The ears are the external manifestation of the Kidney. One view holds: The Kidney connects to the auditory orifice. Another view holds: The Heart connects to the auditory orifice. As an organ, the Kidney belongs to the Water element. "Heaven generates one as Water"; thus, at the beginning of life, two Kidneys are formed first, harboring a Yin aspect, while Mingmen Fire (Ministerial Fire residing in the Gate of Life) exists within the Mingmen. This fire often accompanies the momentum of Zhenhuo (Monarch Fire, i.e., Heart Fire) to overact upon what it cannot overcome, which is what the classics refer to as "one Water cannot overcome two Fires." If desires are unregulated, labor is excessive, or after middle age and convalescence from severe illness, Kidney Water becomes dry and depleted, causing Yin Fire to flare upward. Consequently, the ears itch and ring, occurring daily without cessation. The sound may resemble cicada chirping or bell and drum strikes, which is highly disagreeable. If not treated early, it gradually progresses to hearing impairment (longzhong), which is truly lamentable. The treatment method should involve purging the Fire of the South (Heart/Fire) and tonifying the Water of the North (Kidney/Water), ensuring peace and stability. Qian Zhongyang (Qian Yi) stated: The Kidney has only tonification methods, no purgation methods. This indeed carries profound significance.
Pulse Diagnosis
If the Cun pulses on both hands are floating, surging, and extend to the fish border (Yuji area), it is called a "Yi" pulse. If the Chi pulses on both hands are short and faint, or large and rapid, all belong to Yin deficiency. The method should be to tonify Yin and suppress Yang.
If the left Cun pulse is surging and rapid, it indicates Heart Fire flaring upward. If both Chi pulses are surging or rapid, it indicates Ministerial Fire flaring upward. Such a person will likely experience seminal emission, dream of sexual intercourse with spirits, and suffer from bilateral cicada-like tinnitus or deafness.
Methods
Zhu Danxi said: For deafness following severe illness, and deafness caused by Yin deficiency with Fire hyperactivity, one should tonify Yin and descend Fire, using Siwu Tang (Four Substances Decoction) added with Huangbai (Phellodendri Cortex).
For tinnitus, Danggui Longhui Wan (Angelica Longia Pill) is suitable; for those who drink alcohol excessively, Muxiang Binglang Wan (Aucklandia and Areca Nut Pill) is suitable.
For deafness, use Cornus officinalis fruit (Shanzhuyu), Aconitum carmichaelii lateral root processed product (Wutoujian), and Rheum palmatum root (Dahuang) ground into powder. Mix with saliva and apply to Yongquan (KI1) acupoint to guide Fire downward.
Another prescription: To treat earache, blow burnt white alum (Baifan) into the ear, or blow ash from calcined green vitriol (Qingfan); both are effective.
Another prescription: To treat earache and otorrhea (ear discharge), use dried larva case of mantis (Sangpiaoxiao) roasted until yellow and ground into powder, add a small amount of Moschus (Shexiang), and blow into the ear; this is extremely effective. Alternatively, use胭脂胚子 (Yanzhi Peizi - likely a specific preparation involving cochineal or similar material), powder from bamboo infested by insects, add a small amount of Moschus, and blow into the ear; this is wonderful.
Another prescription: To treat various insects entering the ear, drip sesame oil (Xiangyou) into the ear; the insect will exit or die inside. Alternatively, dripping donkey/cow milk or rooster comb blood is also good.
Another prescription: To treat various insects entering the ear, roll peach leaves into a horn shape, cut the head flat, insert into the ear; the insect will walk out through the horn.
Dabu Wan (Great Tonification Pill): Treats tinnitus progressing toward deafness.
Use only Huangbai (Phellodendri Cortex), any quantity. Cut finely, mix with salt and wine, roast on a new tile until brown, grind into fine powder. Make pills with water, size of Sophora japonica seeds (Wutongzi). Take 100 pills per dose. If Qi deficient, take with decoction of Sijunzi Tang (Four Gentlemen Decoction); if Blood deficient, take with Siwu Tang (Four Substances Decoction).
All cases of tinnitus and deafness are due to Yin deficiency and Fire hyperactivity. Tonifying Kidney Pills, Hujian Wan (Tiger Hidden Pill), or Ziyin Dabu Wan (Nourishing Yin Great Tonification Pill) are all suitable.
(Above are nine methods from Danxi.)
Zishen Wan (Tonify Kidney Pill) by Li Dongyuan: Treats tinnitus and deafness.
Huangbai (Phellodendri Cortex) (salted wine stir-fried, 1 liang) Zhimu (Anemarrhenae Rhizoma) (de-haired, wine-soaked, 1 liang) Rougui (Cinnamomi Cortex) (5 fen)
Grind all into fine powder. Use refined honey to make pills, size of Sophora japonica seeds. Take 50 pills per dose, with light salt water.
Chaihu Cong'er Tang (Bupleurum Ear-Enhancing Decoction) by Li Dongyuan: Treats dryness and obstruction in the ear, tinnitus, and deafness.
Lianqiao (Forsythiae Fructus) (4 qian) Chaihu (Bupleuri Radix) (3 qian) Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) (a little) Danggui shen (Angelicae Sinensis Radix body) Renshen (Ginseng Radix) (each 1 qian) Shizhi (Hirudo) (5 fen, stir-fried and separately ground) Mengchong (Blatta orientalis / Housefly larvae? Note: Usually refers to Blatta or similar insect in ancient texts, WHO term often uses 'Blatta' or specific insect name, here context implies insect used for breaking stasis) (3, wings and feet removed, stir-fried and separately ground) Shexiang (Moschus) (a little, separately ground)
Except for the last three ingredients which are separately ground, cut the rest finely for one dose. Add 3 slices of fresh ginger, 2 cups of water, decoct to 1 cup. Strain, add the three powdered ingredients, boil for 1-2 more boils. Take well after meals.
Manjingzi San (Vitex Fruit Powder) by Li Dongyuan: Treats upper jiao heat, tinnitus, deafness, and otorrhea.
Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) Shengma (Cimicifugae Rhizoma) Mutong (Akebiae Caulis) Chishaoyao (Paeoniae Radix Rubra) Sangbaipi (Mori Cortex) (honey-processed) Maidong (Ophiopogonis Radix) Shengdihuang (Rehmanniae Radix) Qianhu (Peucedani Radix) Ganjuhua (Chrysanthemi Flos) Chifuling (Poria) Manjingzi (Viticis Fructus) (each 5 fen)
Cut finely for one dose. Add 3 slices of fresh ginger, 1 jujube, 1.5 cups of water, decoct to 1 cup. Strain and take after meals.
Niuzi Tang (Arctii Decoction): Treats earache and sores.
Kunbu (Laminariae Thallus) Sumu (Sappan Lignum) Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) Puhuang (Pollinis Typhae) Caolongdan (Gentianae Radix) (each 2 fen) Niuzi (Arctii Fructus) Lianqiao (Forsythiae Fructus) Shengdihuang (Rehmanniae Radix) Danggui shao (Angelicae Sinensis Radix tip) Huangqin (Scutellariae Radix) Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) Huanglian (Coptidis Rhizoma) (each 3 fen) Chaihu (Bupleuri Radix) Huangqi (Astragali Radix) (each 4 fen) Jiegeng (Platycodonis Radix) (1.5 qian) Taoren (Pruni Semen) (3, skin and tip removed, separately ground) Honghua (Carthami Flos) (a little)
Cut finely for one dose. Add 2 cups of water, decoct to 1 cup. Take slightly warm after meals. Avoid cold herbs that cause diarrhea.
(Ancestral Prescription)
To treat sudden severe pain in the ear, as if insects are running inside, or bleeding/fluid discharge, or unbearable dry pain: Use shed snake skin (Shetupi) burned to retain its nature, finely ground. Use a goose feather tube to blow the powder into the ear; immediate cure.