【方歌】耳衄上焦血热成，鲜血时流耳窍中，肝火柴胡清肝治，
胃热生地麦门冬。
【注】此证由上焦血热所致，耳窍中时流鲜血。若肝脉弦数者
，以柴胡清肝汤服之；肾脉虚数者，以生地麦冬饮主之
。总以凉血为急，乃抽薪止沸之法也。外以神塞丸塞之
即瘥。
方剂：生地麦冬饮
组成：生地 黄麦冬（去心，各五钱）
水二钟，煎八分，食后服。
【方歌】生地麦冬耳衄鲜，上焦血热是其原，各用五钱煎食后，
清肺降火保平安。
又方：神塞丸
组成：麝香（一分） 生白矾（一钱）
沈香（三分） 糯米（五十粒）
共研细末，面糊为丸，如梧桐子大。每丸薄绵裹之
，如左耳出血塞右鼻，右耳出血塞左鼻；右鼻出血塞右
耳，右鼻出血塞左耳；两耳俱出血塞两鼻，两鼻俱出血
塞两耳。
【方歌】神塞麝香生白矾，沈糯同研面糊丸，大如梧子薄绵裹，
塞入耳鼻衄血痊。
又方：柴胡清肝汤（见前鬓疽）
【方歌】耳痔蕈挺耳窍生，肝肾胃火凝结成，微肿闷疼皮损破，
塞久令人必重听。
【注】此三证皆生耳内，耳痔形如樱桃，亦有形如羊奶者；耳
蕈形类初生麻菇，头大蒂小；耳挺形若枣核，细条而长
，努出耳外。俱由肝经怒火、肾经相火、胃经积火凝结
而成。微肿闷疼，色红皮破，不当触犯偶犯之，痛引脑
巅。皆宜服栀子清肝汤，外用硵砂散点之，渐渐消化。
方剂：栀子清肝汤
组成：栀子（生研） 川芎
当归 柴胡
白芍（酒炒） 丹皮（各一钱）
甘草（生，五分） 石膏（〔火段〕）
牛蒡子（炒，研，各一钱） 黄芩
黄连（各五分）
水二钟，煎八分，食后服。
【方歌】栀子清肝蕈痔挺，肾肝胃火忿怒成，芎归柴芍丹皮草，
膏蒡芩连用有功。
又方：硵砂散
组成：硵砂（一钱） 轻粉
雄黄（各三钱） 冰片（五厘）
共研细末，水调浓，用谷草细梗咬毛，蘸点痔上。
【方歌】硵砂散实有奇功，痔蕈挺在耳内生，轻片硵雄研为末，
水调点痔消缩形。
【方歌】耳衄（耳出血）由上焦血热所致，鲜血不时从耳窍中流出。若属肝火，可用柴胡清肝汤治疗；若属胃热，可用生地麦冬饮治疗。
【注】此证候是由上焦血热引起的，表现为耳窍中不时流出鲜血。如果肝脉呈现弦数之象，服用柴胡清肝汤；如果肾脉呈现虚数之象，以生地麦冬饮为主治方剂。总的原则是以凉血为急务，这是“抽薪止沸”的治疗方法。外用神塞丸塞入患处即可痊愈。
方剂：生地麦冬饮
组成：生地黄、麦冬（去心，各五钱）
用水二钟，煎至八分，饭后服用。
【方歌】生地麦冬饮治疗耳衄出血鲜红，其根源在于上焦血热，两药各用五钱煎煮，饭后服用，可清肺降火，保全平安。
又一方：神塞丸
组成：麝香（一分）、生白矾（一钱）、沉香（三分）、糯米（五十粒）
共同研成细末，用面糊制成丸药，大小如梧桐子。每丸用薄绵包裹，如果是左耳出血则塞右鼻，右耳出血则塞左鼻；如果是右鼻出血则塞右耳，左鼻出血则塞左耳（注：原文此处有重复及逻辑笔误，依古法通常指交叉或对应塞入）；如果双耳都出血则塞双鼻，双鼻都出血则塞双耳。
【方歌】神塞丸由麝香和生白矾组成，与沉香、糯米一同研末，用面糊制丸，大小如梧子，用薄绵包裹，塞入耳鼻可使衄血痊愈。
【方歌】耳痔、耳蕈、耳挺生于耳窍，由肝、肾、胃三经之火凝结而成。症状轻微肿胀、闷痛、皮肤破损，堵塞久了会导致听力严重下降。
【注】这三种病证都生长在耳内。耳痔形状像樱桃，也有形状像羊奶的；耳蕈形状像初生的麻菇，头大蒂小；耳挺形状像枣核，细长条状，突出于耳外。这些都由肝经怒火、肾经相火、胃经积火凝结而成。症状表现为轻微肿胀、闷痛、色红皮破，不应当触碰，偶然触碰到，疼痛会牵引至头顶。都适宜服用栀子清肝汤，外用硵砂散点涂，使病灶渐渐消散。
方剂：栀子清肝汤
组成：栀子（生研）、川芎、当归、柴胡、白芍（酒炒）、丹皮（各一钱）、甘草（生，五分）、石膏（煅）、牛蒡子（炒，研，各一钱）、黄芩、黄连（各五分）
用水二钟，煎至八分，饭后服用。
【方歌】栀子清肝汤治疗耳蕈、耳痔、耳挺，这些是由肾、肝、胃之火因愤怒而形成的。方中包含川芎、当归、柴胡、白芍、丹皮、甘草、石膏、牛蒡子、黄芩、黄连，使用均有功效。
又一方：硵砂散
组成：硵砂（一钱）、轻粉、雄黄（各三钱）、冰片（五厘）
共同研成细末，用水调成浓汁，用谷草细梗咬毛制成的工具蘸取药粉，点涂在痔上。
[Prescription Verse] Auricular hemorrhage (bleeding from the ear) is caused by blood heat in the Upper Jiao, with fresh blood intermittently flowing from the ear orifice. If due to Liver fire, Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver) may be used; if due to Stomach heat, Shengdi Maidong Yin (Rehmannia and Ophiopogon Drink) may be used.
[Annotation] This syndrome is caused by blood heat in the Upper Jiao, manifesting as intermittent flow of fresh blood from the ear orifice. If the Liver pulse is wiry and rapid, take Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver); if the Kidney pulse is deficient and rapid, treat primarily with Shengdi Maidong Yin (Rehmannia and Ophiopogon Drink). The general principle is to prioritize cooling blood, which is a method of "removing the firewood to stop the boiling" (addressing the root cause). Externally, apply Shen Sai Wan (Divine Plugging Pill) into the lesion for recovery.
Formula: Shengdi Maidong Yin (Rehmannia and Ophiopogon Drink)
Composition: Sheng Di Huang (Radix Rehmanniae Preparata), Mai Dong (Radix Ophiopogonis, heart removed, each 5 qian).
Decoct with two zhong of water until reduced to eight fen, taken after meals.
[Prescription Verse] Shengdi Maidong Yin treats auricular hemorrhage with bright red blood, its origin being blood heat in the Upper Jiao. Each herb is used in five qian amounts, decocted and taken after meals to clear Lung heat and descend fire, ensuring peace and safety.
Another Formula: Shen Sai Wan (Divine Plugging Pill)
Composition: She Xiang (Moschus, 1 fen), Sheng Bai Fan (Alumen Crude, 1 qian), Chen Xiang (Aquilaria Lignum, 3 fen), Nuo Mi (Oryza Sativa Glutinosa, 50 grains).
Grind together into fine powder, bind with wheat paste to form pills the size of Sophora japonica seeds. Wrap each pill in thin cotton. If the left ear bleeds, plug the right nostril; if the right ear bleeds, plug the left nostril; if the right nostril bleeds, plug the right ear; if the left nostril bleeds, plug the left ear (Note: Original text contains repetition/ambiguity, traditionally implying cross-plugging or corresponding plugging); if both ears bleed, plug both nostrils; if both nostrils bleed, plug both ears.
[Prescription Verse] Shen Sai Wan consists of Moschus and Alumen Crude, ground with Aquilaria Lignum and Oryza Sativa Glutinosa, bound with wheat paste into pills the size of Sophora japonica seeds, wrapped in thin cotton, and plugged into the nose or ear to cure hemorrhage.
Another Formula: Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver) (See previous section on Temporal Furuncle).
[Prescription Verse] Ear Mole (Er Zhi), Ear Mushroom (Er Xun), and Ear Projection (Er Ting) arise in the ear orifice, formed by the condensation of Fire from the Liver, Kidney, and Stomach meridians. Symptoms include slight swelling, dull pain, skin erosion; prolonged obstruction leads to severe hearing loss.
[Annotation] These three conditions all grow within the ear. Er Zhi (Ear Mole) resembles a cherry, or sometimes a sheep's teat; Er Xun (Ear Mushroom) resembles a newly sprouted mushroom, with a large head and small stalk; Er Ting (Ear Projection) resembles a jujube pit, slender and long, protruding outside the ear. All are caused by the condensation of furious fire from the Liver meridian, ministerial fire from the Kidney meridian, and accumulated fire from the Stomach meridian. Symptoms present as slight swelling, dull pain, redness, and broken skin. They should not be touched; accidental contact causes pain radiating to the vertex of the head. All are suitable for internal administration of Zhizi Qinggan Tang (Gardenia Decoction to Clear the Liver) and external application of Qisha San (Realgar Powder) to gradually dissipate the lesions.
Formula: Zhizi Qinggan Tang (Gardenia Decoction to Clear the Liver)
Composition: Zhi Zi (Fructus Gardeniae, raw and ground), Chuan Xiong (Rhizoma Chuanxiong), Dang Gui (Radix Angelicae Sinensis), Chai Hu (Radix Bupleuri), Bai Shao (Radix Paeoniae Alba, wine-fried), Dan Pi (Cortex Moutan, each 1 qian), Gan Cao (Radix Glycyrrhizae, raw, 5 fen), Shi Gao (Gypsum Fibrosum, calcined), Niu Bang Zi (Fructus Arctii, fried and ground, each 1 qian), Huang Qin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis, each 5 fen).
Decoct with two zhong of water until reduced to eight fen, taken after meals.
[Prescription Verse] Zhizi Qinggan Tang treats Ear Mushroom, Ear Mole, and Ear Projection, which are formed by Fire from the Kidney, Liver, and Stomach due to anger. The formula includes Chuan Xiong, Dang Gui, Chai Hu, Bai Shao, Dan Pi, Gan Cao, Shi Gao, Niu Bang Zi, Huang Qin, and Huang Lian, all of which contribute efficacy.
Another Formula: Qisha San (Realgar Powder)
Composition: Qisha (Arsenical Orpiment, 1 qian), Qing Fen (Calomel), Xiong Huang (Realgar, each 3 qian), Bing Pian (Borneolum Syntheticum, 5 li).
Grind together into fine powder, mix with water to form a thick paste. Use a fine stalk of millet grass bitten to create bristles, dip into the powder, and apply to the mole.
[Prescription Verse] Qisha San indeed has miraculous effects for moles, mushrooms, and projections growing in the ear. Calomel, Borneolum Syntheticum, Arsenical Orpiment, and Realgar are ground into powder, mixed with water, and applied to the lesion to reduce and shrink it.