人身有九窍，阳七窍，眼耳口鼻是也；阴二窍，前后便溺所出是也。清阳走上窍，而下
入于阴
位，则有溺溲腹鸣之候；浊阴走下窍，而上入于阳位，则有窒塞耳鸣之候。故人年五十以外
，肾气渐衰于下，每每从阳上逆，而耳之窍职失聪，耳之聪司于肾，肾主闭藏，不欲外泄，
因肝木为子疏泄母气而散于外，是以谋虑郁怒之火一动，阴气从之上逆，耳窍窒塞不清，故
能近听不碍，而听远不无少碍。高年之体、大率类然。较之聋病，一天一渊。聋病者，其窍
中另有一膜庶蔽，外气不得内入，故以开窍为主，而方所用石菖蒲、麝香等药，及外填内攻
等法者，皆为此而设。至于高年不自收摄阴气，致越出上窍之理，从无一人言及，反以治少
壮耳聋药，及发表散气药，兼带阴虚不治。是以百无一效，不知阴气至于上窍，亦隔一膜。
不能超出窍外，止于窍中，汨汨有声，如蛙鼓蚊雷，鼓吹不已，以故外入之声，为其内声所
混，听之不清，若气少不逆上，则听少清；气全不逆上，则听全清矣。故凡治高年逆上之气
，大法宜以磁石为主，取其重能达下，性主下吸，又能制肝木之上吸故也；次用地黄、龟胶
群阴之药以补之；更用五味、山萸之酸以收之，令阴气自至于本宫，不上触于阳窍。由是空
旷无塞，耳之于声，似谷之受响，万籁之音，尚可细聆，岂更与人声相混，艰于远听耶？
此实至理所在。但医术浅薄之辈，不能知之，试观人之收视而视益明，反听而听愈聪者，亦
可恍然悟矣！
人体有九个孔窍，其中七个阳窍，即眼、耳、口、鼻；两个阴窍，即前阴和后阴（大小便排泄之处）。清阳之气上升走窜于上部的阳窍，若下行进入下部的阴位，则会出现小便、排尿及腹部鸣响的症状；浊阴之气下降走窜于下部的阴窍，若上行进入上部的阳位，则会出现鼻塞、耳鸣等症状。因此，人到了五十岁以后，肾气在下方逐渐衰退，往往伴随阳气从下向上逆乱，导致耳窍失去听觉功能。耳朵的听觉功能由肾脏主管，肾脏主闭藏精气，不希望其外泄。由于肝木（肝脏）作为肾水之子，疏泄母脏（肾脏）的气机使其散失于外，所以当谋虑过度或郁怒引发的火气一动，阴气便随之向上逆乱，导致耳窍堵塞不清。因此，近距离听声音没有障碍，但远距离听声音则略有困难。老年人的体质，大体上都属于这种情况。这与聋病相比，有着天壤之别。聋病患者，其耳窍中另有一层膜遮蔽，外界的声音无法进入内部，所以治疗以开通耳窍为主，所用方剂中的石菖蒲、麝香等药物，以及外敷内服等方法，都是为此类病症而设。至于老年人不能自我收敛阴气，导致阴气越出而上行于上部阳窍的道理，从未有人提及过，反而用治疗青壮年耳聋的药物，以及发表散气的药物，兼带阴虚的治疗，结果百无一效。他们不知道阴气上行至耳窍，也隔着一层膜，不能超出窍外，只停留在窍中，发出汩汩的声音，如同蛙鼓蚊雷，不停地鼓吹，因此外界传入的声音被内部的杂声所混淆，导致听不清楚。如果气机稍微不向上逆乱，听力就会稍微清晰；如果气机完全不向上逆乱，听力就能完全清晰。所以，凡是治疗老年人气机上逆的大法，适宜以磁石为主药，取其质地沉重能达于下焦，药性主向下吸引，又能制约肝木之气向上吸拔的作用；其次用地黄、龟胶等群阴类药物来滋补；再用五味子、山茱萸的酸味来收敛，使阴气自然回归到本宫（肾脏），不再冲击上部的阳窍。由此耳窍空旷无堵塞，耳朵对声音的反应，就像山谷接受回声一样，各种细微的声音都可以仔细聆听，怎么会再与人声相混淆，难以听清远处的声音呢？这确实是至理所在。只是医术浅薄的人，不能理解这个道理。试看人们闭目凝神观看时视力更加明亮，反听（集中注意力倾听）时听力更加灵敏的例子，也可以恍然大悟了！
The human body has nine orifices: seven yang orifices, namely the eyes, ears, mouth, and nose; and two yin orifices, through which urine and feces are excreted. Clear yang qi ascends to the upper yang orifices; if it descends into the lower yin positions, symptoms such as urination, defecation, and abdominal borborygmus occur. Turbid yin qi descends to the lower yin orifices; if it ascends into the upper yang positions, symptoms such as nasal obstruction and tinnitus occur. Therefore, after the age of fifty, kidney qi gradually declines in the lower body. Often, yang qi rebels upward from below, causing the ear orifice to lose its hearing function. Hearing is governed by the Kidney (Shen), which governs storage and does not desire leakage. Since Liver Wood (Gan) acts as the child of Kidney Water and drains the mother organ's qi, scattering it outward, when fire generated by excessive planning or anger moves, yin qi rebels upward along with it. This causes blockage and turbidity in the ear orifice. Consequently, near hearing remains unimpeded, but far hearing is slightly hindered. The constitution of elderly people generally resembles this state. Compared to deafness (longbing), there is a world of difference. In cases of deafness, a membrane within the orifice blocks external air from entering, so treatment focuses on opening the orifice. Medicines such as Rhizoma Acori Tatarinowii (Shichangpu) and Moschus (Shexiang), as well as methods of external application and internal attack, are all designed for this condition. However, the principle that elderly individuals fail to self-restrain yin qi, causing it to escape upward to the yang orifices, has never been mentioned. Instead, medicines used for treating deafness in young and strong adults, along with diaphoretic and qi-scattering medicines, are often applied, neglecting yin deficiency. Thus, there is rarely any efficacy. They do not realize that yin qi reaching the upper orifice is also separated by a membrane; it cannot exceed the outside of the orifice but stays within it, producing gurgling sounds like frog drums or mosquito thunder, blowing incessantly. As a result, incoming external sounds are confused by internal noises, leading to unclear hearing. If the qi rebels upward less, hearing becomes clearer; if the qi does not rebel upward at all, hearing becomes completely clear. Therefore, the general method for treating upward-rebelling qi in the elderly should primarily use Magnetitum (Cishi). Its heavy nature allows it to reach the lower jiao, its property directs downward attraction, and it can restrain the upward suction of Liver Wood. Secondly, yin-nourishing herbs such as Radix Rehmanniae Preparata (Shudihuang) and Carapax et Plastrum Testudinis (Guijiao) should be used to tonify. Furthermore, sour herbs like Fructus Schisandrae (Wuweizi) and Fructus Corni (Shanzhuyu) should be used to astringe, allowing yin qi to return naturally to its home palace (Kidney) without touching the upper yang orifices. Consequently, the orifice becomes spacious and unblocked. The ear's reception of sound becomes like a valley receiving echoes; various subtle sounds can still be carefully listened to. How could they be confused with human speech, making distant hearing difficult? This is indeed the profound truth. Only those with shallow medical skills fail to understand this. Observe how people see more clearly when focusing their gaze inward, and hear more sharply when concentrating their listening; one can then suddenly comprehend!