（耳鸣 耳肿痛 耳疹 耳中痒 耳脓 耵聍 虫入耳中）
经云。肾气通于耳。肾和则耳能闻五音矣。 蒙招尤。目冥耳聋。下虚上实。过在足少阳厥
阴。甚则入肝。所谓耳鸣者。阳气万物盛上而跃。故耳鸣也。所谓浮为聋者。皆在气也。赵以德
曰。耳者肾之窍。足少阴经之所主。然心亦寄窍于耳。在十二经脉中。除足太阳。手厥阴外。其
余十经脉络。皆入于耳中。盖肾治内之阴。心治外之阳。合天地之道。精气无不变通。故清净精
明之气上走空窍。耳受之而听斯聪矣。灵枢云。肾气通于耳。肾和则耳闻五音矣。五脏不和。则
七窍不通。故凡一经一络。有虚实之气入于耳中者。皆足以乱主窍之精明。而兼至聋聩。此言暴
病者也。若夫久聋者。于肾亦有虚实之异。左肾为阴。主精。右肾为阳。主气。精不足。气有余。
则聋为虚。其人瘦而色黑。筋骨健壮。此精气俱有余。固藏闭塞。是聋为实。乃高寿之兆也。此
皆禀赋使然。不须治之。又有乍聋者。经云。不知调阴阳七损
八益之道。早丧之节也。其年五十体重。耳目不聪明矣。此亦无治也。惟暴聋之病。与阴阳隔绝之
未甚。经脉欲行而未通。冲击其中。鼓动听户。随其气之微甚而作嘈嘈风雨诸声者。则可随其邪
以为治。外此又有耳触风邪。与气相击。其声嘈嘈。眼如见火。谓之虚鸣。热气乘虚。随脉入耳。
聚热不散。脓汁出焉。谓之脓耳。人耳间有津液。轻则不能为害。若风热搏之。津液结硬。成核
塞耳。亦令暴聋。谓之耵耳。前是数者。肾脉可推。风则浮而盛。热则洪而实。虚则涩而濡风为
之疏散。热为之疏利。虚为之调养。邪气并退。然后以通脉调气安肾之剂治之。罗谦甫云。夫暴
聋者。由肾虚风邪所乘。搏于经络。随其血脉上入耳。正气与邪气相搏。故卒聋也。风虚耳聋。
排风汤、桂辛散。肾脏风虚。黄 丸。兼气虚。去附子加肉桂、人参。肝肾虚火。姜蝎散。风热
耳聋。犀角饮子。厥聋。经云。暴厥而聋。偏闭塞不通。内气暴薄也。复元通气散去白牵牛。加
全蝎、石菖蒲、川芎、生姜、葱白。吞养正丹凡治耳聋。皆当调气。肝气逆则头痛耳聋颊肿。四
物汤加肉桂吞龙荟丸降火。及复元通气散调气。耳聋有湿痰者。滚痰丸下之。耳聋面颊黑者。为
精脱肾虚。烧肾散。耳聋多恐者。为肝虚。温胆汤下养正丹。外治。用通神散、蓖麻丸。一方。
用地龙三枚。盐少许。同入葱管内。化水滴耳中。三五日效。一法。用磁石豆大一块。鲮鲤甲三
片。烧存性。绵裹塞耳中。口衔生铁少许。觉耳中如风雨声即愈。
耳鸣 经云。耳者。宗脉之所聚也。故胃中空则宗脉虚。虚则下溜。脉有所竭。故耳鸣。又
云。液脱者。脑髓消。筋酸耳数鸣。凡此皆耳鸣之属虚者也。经云。太阳所谓耳鸣者。阳气万物。
盛上而跃。故耳鸣也。又云。厥阴之脉。耳鸣头眩。又云。少阳所至为耳鸣。治以凉寒。凡此皆
耳鸣之属实者也。王汝明曰。耳鸣如蝉。或左或右。或时闭塞。世人多作肾
虚治不效。殊不知此是痰火上升。郁于耳中而鸣。郁甚则闭塞矣。若平昔饮酒浓味。上焦素有痰
火。清痰降火为主。大抵此证先因痰火在上。又感恼怒而得。怒则气上。少阳之火客于耳也。若
肾虚而鸣者。其鸣不甚。其人多欲。当见虚劳等证。喻嘉言曰。凡治高年肾气逆上而耳鸣。当以
磁石为主。以其重能达下。但性主下吸。不能制肝木之上吸。更以地黄、龟胶群阴之药辅之。五
味、山萸之酸以收之。令阴气自旺于本宫。不上触于阳窍。由是空旷无碍。岂更艰于远听哉。丹
溪取通圣散治饮酒过度而耳鸣。亦无确见。惟滚痰丸一方。少壮用之多效。以黄芩、大黄、沉香
之苦最能下气。礞石之重坠。大约与磁石相仿也。薛立斋云。若血虚有火。用四物加山栀、柴胡。
若中气虚弱。补中益气加山栀、丹皮。若因怒便聋。而或耳鸣。属肝胆气实。小柴胡加芎、归、
山栀。若午前甚者。阳气实热也。小柴胡加黄连、山栀。午后甚者。阴血虚也。四物加白术、茯
苓。若肾虚火动。耳中哄哄然。是无阴也。加减八味丸。肾虚耳中潮声蝉声。无休止时。妨害听
闻者。当坠气补肾。正元散下黑锡丹。间进安肾丸。肾脏虚风耳鸣。夜间睡着如擂战鼓。四肢掣
痛。耳内觉有风吹奇痒。黄 丸、四生散选用。
耳肿痛属少阳相火。犀角饮子加脑、麝为丸。经云。少阳之胜耳痛。治以辛寒是也。耳内痛
生疮。用鼠粘子、连翘、归、芍、芩、连、甘、桔、生地、桃仁、黄 、柴胡、草龙胆之类。耳
湿肿痛。用凉膈散加羌、防、荆芥。外用龙骨、黄丹等分。枯矾减半。加麝少许吹入。或龙骨、
黄丹、干胭脂为末亦佳。或用五倍子烧灰。同枯矾吹之。
耳疹 耳疹属少阳三焦。或足厥阴肝经血虚风热。或怒动肝火而致。若发热 痛。属三焦厥
阴风热。用柴胡清肝散、栀子清肝散之类。慎不可专治其外复伤气血也。有因肾虚风热作痒。挖
伤成疮者。六味丸加白蒺藜。
耳中痒。肾家有风。四生散。每作时服二三剂即瘥。
耳脓者湿热聚于耳中也。复元通气散如前加减。外以五倍子、全蝎、枯矾为末。入麝少许吹
入。或橘皮烧灰存性。入麝少许。先以绵拭耳内。脓净吹之。如壮盛之人。积热上攻。耳中出脓
水不瘥。凉膈散泻之。
耳中耵聍。耳鸣耳聋。内有污血。外用莱菔捣汁。研麝少许滴入。余法与耳聋相参治之。
虫入耳中。将生姜擦猫鼻。其尿即出。取尿滴耳中。虫即出。或用炒芝麻枕之。虫亦出。耳
中有物不可出。以弓弦或钱串绳。剪令头散蘸好胶着耳中。使其物粘之。徐徐引出效。薛立斋治
一男子。每交接。耳中痒痛或水出。以银簪探之。甚喜阴凉。此肾经虚火。用加减八味丸而愈。
又治一妇因怒发。每经行。两耳出脓。两太阳作痛。以手按之痛稍止。怒则胸胁乳房胀痛。
或寒热往来。小便频数。或小腹胀闷。皆属肝火血虚。加味逍遥散十剂。诸证悉退。以补中益气
加五味而痊。
《内经》说：肾气通于耳。肾气调和，则耳能听见五音。若出现头晕目眩、视物模糊、耳聋，这是下虚上实的病机，病变在于足少阳胆经和足厥阴肝经，严重时病邪会传入肝脏。所谓耳鸣，是因为阳气像万物在盛长时向上跳跃一样，所以引起耳鸣。所谓听力减退为聋，都是由于气机失调所致。赵以德说：耳是肾的窍穴，由足少阴肾经所主。然而心也寄窍于耳，在十二经脉中，除了足太阳膀胱经和手厥阴心包经外，其余十条经脉的络脉都进入耳中。大概肾主管体内的阴，心主管体表的阳，这符合天地的道理，精气没有不变通的。所以清净精明的之气上行至空窍，耳受之而听觉灵敏。《灵枢》说：肾气通于耳，肾气调和则耳能闻五音。五脏不和，则七窍不通。所以凡是有一条经脉或络脉有虚实之气侵入耳中，都足以扰乱主宰窍穴的精明之气，从而导致耳聋失聪。这是指突发的疾病。至于久聋，肾脏也有虚实之分。左肾属阴，主藏精；右肾属阳，主司气。如果精不足而气有余，则耳聋属于虚证，患者身体消瘦且面色黑，但筋骨健壮，这是精气俱有余，固藏闭塞，这种耳聋属于实证，是高寿的征兆。这都是禀赋使然，不需要治疗。又有突然耳聋的情况，《内经》说：不懂得调和阴阳、运用“七损八益”的道理，就会过早丧失生育能力。到了五十岁，身体沉重，耳目不聪明。这也是无需治疗的常态。只有暴聋的病，与阴阳隔绝尚未严重，经脉欲行而未通，邪气冲击其中，鼓动听户，随着气的微甚而出现如风雨嘈杂之声，则可以随其邪气性质进行治疗。此外还有耳部触受风邪，与气相击，声音嘈杂，眼如见火，称为虚鸣。热气乘虚，随脉入耳，聚热不散，流出脓汁，称为脓耳。人耳间有津液，轻微时不能为害，若风热搏结，津液凝结变硬，形成核阻塞耳道，也会导致暴聋，称为耵耳。以上几种情况，可以通过推按肾脉来推断：风邪脉象浮而盛，热邪脉象洪而实，虚证脉象涩而濡。风邪用疏散法，热邪用疏利法，虚证用调养法。待邪气退去后，再用通脉调气安肾的方剂治疗。罗谦甫说：暴聋是由于肾虚风邪所乘，搏结于经络，随血脉上行入耳，正气与邪气相搏，所以突然耳聋。风虚耳聋，用排风汤、桂辛散。肾脏风虚，用黄[缺字]丸，兼气虚者，去附子加肉桂、人参。肝肾虚火，用姜蝎散。风热耳聋，用犀角饮子。厥聋，《内经》说：突然厥逆而聋，偏侧闭塞不通，是内气突然迫薄所致。用复元通气散去白牵牛，加全蝎、石菖蒲、川芎、生姜、葱白，吞服养正丹。凡治耳聋，都应当调气。肝气逆则头痛、耳聋、颊肿，用四物汤加肉桂，吞服龙荟丸以降火，及复元通气散调气。耳聋有湿痰者，用滚痰丸攻下。耳聋面颊黑者，为精脱肾虚，用烧肾散。耳聋多恐惧者，为肝虚，用温胆汤送服养正丹。外治法：用通神散、蓖麻丸。一方：用地龙三条，少许盐，同放入葱管内，化水滴入耳中，三五日见效。一法：用磁石豆大一块，鲮鲤甲三片，烧存性，绵裹塞入耳中，口衔生铁少许，感觉耳中如风雨声即愈。
耳鸣 《内经》说：耳是宗脉汇聚的地方。所以胃中空虚则宗脉虚，虚则下溜，脉有所竭，所以耳鸣。又说：津液脱失的人，脑髓消减，筋酸，耳数鸣。凡此皆属于耳鸣中的虚证。《内经》说：太阳经所谓耳鸣，是阳气像万物盛长时向上跳跃，所以耳鸣。又说：厥阴经的脉气，导致耳鸣头眩。又说：少阳经气至为耳鸣，治疗用凉寒之法。凡此皆属于耳鸣中的实证。王汝明说：耳鸣如蝉鸣，或左或右，或时而闭塞，世人多当作肾虚治疗无效，殊不知这是痰火上升，郁结于耳中而鸣，郁结甚则闭塞。若平素饮酒、吃浓味食物，上焦素有痰火，应以清痰降火为主。大抵此证先因痰火在上，又感恼怒而得，怒则气上，少阳之火客居于耳。若肾虚而鸣，其鸣声不甚，其人好色欲，当见虚劳等证。喻嘉言说：凡治老年人肾气逆上而耳鸣，当以磁石为主，因为磁石重能达下，但其性主下吸，不能制约肝木之上吸，更以地黄、龟胶等群阴之药辅助，五味子、山茱萸之酸以收敛之，令阴气自旺于本宫，不上触于阳窍，由此空旷无碍，难道还会难以远听吗？丹溪取防风通圣散治疗饮酒过度而耳鸣，也没有确切见解，只有滚痰丸一方，青壮年使用多有效，因为黄芩、大黄、沉香之苦最能下气，礞石之重坠，大约与磁石相似。薛立斋说：若血虚有火，用四物汤加山栀、柴胡。若中气虚弱，用补中益气汤加山栀、丹皮。若因怒便聋，或耳鸣，属肝胆气实，用小柴胡汤加川芎、当归、山栀。若午前甚者，是阳气实热，用小柴胡汤加黄连、山栀。午后甚者，是阴血虚，用四物汤加白术、茯苓。若肾虚火动，耳中哄哄然，是无阴的表现，用加减八味丸。肾虚耳中潮声蝉声，无休止时，妨害听闻者，当坠气补肾，正元散送服黑锡丹，间进安肾丸。肾脏虚风耳鸣，夜间睡着如擂战鼓，四肢掣痛，耳内觉有风吹奇痒，选用黄[缺字]丸、四生散。
耳肿痛属少阳相火，犀角饮子加冰片、麝香为丸。《内经》说：少阳之胜导致耳痛，治疗用辛寒之法是正确的。耳内痛生疮，用牛蒡子、连翘、当归、芍药、黄芩、黄连、甘草、桔梗、生地、桃仁、黄芪、柴胡、草龙胆之类。耳湿肿痛，用凉膈散加羌活、防风、荆芥。外用龙骨、黄丹等分，枯矾减半，加少许麝香吹入。或用龙骨、黄丹、干胭脂研末也佳。或用五倍子烧灰，同枯矾吹入。
耳疹 耳疹属少阳三焦，或足厥阴肝经血虚风热，或怒动肝火而致。若发热疼痛，属三焦厥阴风热，用柴胡清肝散、栀子清肝散之类。切不可专治其外而复伤气血。有因肾虚风热作痒，挖伤成疮者，用六味丸加白蒺藜。
耳脓者是湿热聚于耳中，用复元通气散如前加减。外用五倍子、全蝎、枯矾研末，入少许麝香吹入。或橘皮烧灰存性，入少许麝香，先用棉拭净耳内脓液后吹入。如体质壮盛之人，积热上攻，耳中出脓水不愈，用凉膈散泻之。
耳中耵聍，耳鸣耳聋，内有污血，外用莱菔捣汁，研少许麝香滴入。其余方法参照耳聋治疗。
虫入耳中，将生姜擦猫鼻，使其尿出，取尿滴入耳中，虫即出。或用炒芝麻枕之，虫亦出。耳中有物不可出，以弓弦或钱串绳，剪开头部散开蘸好胶着于耳中，使其物粘住，徐徐引出有效。薛立斋治一男子，每次交接，耳中痒痛或有水出，以银簪探之，甚喜阴凉，此为肾经虚火，用加减八味丸而愈。又治一妇人因怒气发作，每次月经来潮，两耳出脓，两太阳穴作痛，用手按压痛稍止，怒则胸胁乳房胀痛，或寒热往来，小便频数，或小腹胀闷，皆属肝火血虚，用加味逍遥散十剂，诸证悉退，后用补中益气汤加五味子而痊愈。
(Tinnitus, Ear Swelling and Pain, Ear Rash, Itching in the Ear, Otorrhea, Cerumen Impaction, Insect Entering the Ear)
The *Neijing* (Classic of Internal Medicine) states: Kidney Qi connects with the ears. When Kidney Qi is harmonious, the ears can hear the five tones. If dizziness and vertigo occur, vision becomes blurred, and deafness sets in, this indicates a pattern of deficiency below and excess above, with pathology involving the Foot Shaoyang Gallbladder Meridian and Foot Jueyin Liver Meridian; if severe, the pathogen may enter the Liver. The so-called tinnitus occurs because Yang Qi, like all things flourishing, surges upward and leaps, thus causing tinnitus. The so-called hearing loss (deafness) is entirely due to Qi dysfunction. Zhao Yi-de stated: The ear is the orifice of the Kidney, governed by the Foot Shaoyin Kidney Meridian. However, the Heart also has its orifice associated with the ear. Among the twelve meridians, except for the Foot Taiyang Bladder Meridian and Hand Jueyin Pericardium Meridian, the collateral branches of the remaining ten meridians all enter the ear. Generally, the Kidney governs the Yin within, and the Heart governs the Yang on the exterior, conforming to the Way of Heaven and Earth; Jing-Qi (Essence-Qi) undergoes transformation without obstruction. Thus, clear and bright Qi ascends to the orifices; when received by the ears, hearing becomes acute. The *Lingshu* (Spiritual Pivot) states: Kidney Qi connects with the ears. When Kidney Qi is harmonious, the ears can hear the five tones. If the Five Zang Organs are not harmonious, the seven orifices will be obstructed. Therefore, whenever there is an invasion of Deficiency or Excess Qi from any single meridian or collateral into the ear, it is sufficient to disturb the clarity of the orifice, leading to deafness. This refers to sudden onset diseases. As for chronic deafness, the Kidneys also present patterns of Deficiency and Excess. The Left Kidney belongs to Yin and governs Essence; the Right Kidney belongs to Yang and governs Qi. If Essence is insufficient while Qi is excessive, deafness is classified as Deficiency; the patient is emaciated with dark complexion but strong sinews and bones, indicating that both Essence and Qi are abundant yet stored and blocked; this type of deafness is Excess and is a sign of longevity. These are due to innate constitution and require no treatment. There is also sudden deafness. The *Neijing* states: Those who do not understand the way of harmonizing Yin and Yang and applying the "Seven Losses and Eight Benefits" will lose their reproductive capacity prematurely. By age fifty, the body feels heavy, and the ears and eyes lose their acuity. This too is a normal state requiring no treatment. Only in cases of sudden deafness, where the separation of Yin and Yang is not yet severe, and the meridians desire flow but are not yet unobstructed, pathogenic factors surge within, drumming against the auditory passageways. Depending on the severity of the Qi disturbance, sounds such as wind and rain may be heard. Treatment should follow the nature of the pathogen. Additionally, there is exposure to Wind Pathogen affecting the ear, clashing with Qi, producing noisy sounds, with eyes perceiving fire, termed "Empty Tinnitus." Heat Pathogen takes advantage of deficiency, enters the ear via the meridians, accumulates heat without dissipating, and discharges pus, termed "Pus Ear" (Otitis Media). Human ears contain fluids; if mild, they cause no harm. If Wind-Heat binds them, the fluids harden into nodules blocking the ear, causing sudden deafness, termed "Cerumen Impaction." For the aforementioned conditions, the Kidney pulse can be palpated: Wind presents as floating and vigorous; Heat as洪 (Surging) and full; Deficiency as choppy and soft. Wind is treated with dispersing methods; Heat with draining methods; Deficiency with nourishing methods. After the pathogenic factors recede, formulas that unblock meridians, regulate Qi, and calm the Kidney are used. Luo Qianfu stated: Sudden deafness arises from Kidney Deficiency allowing Wind Pathogen to invade, binding in the meridians and ascending via blood vessels into the ear. Zheng Qi (Upright Qi) clashes with Xie Qi (Pathogenic Qi), resulting in sudden deafness. For Wind-Deficiency Deafness, use Paifeng Tang (Wind-Expelling Decoction) or Guixin San (Cinnamon Twig and Asarum Powder). For Kidney Wind-Deficiency, use Huang [missing character] Wan; if accompanied by Qi Deficiency, remove Fuzi (Aconite Root) and add Rougui (Cinnamon Bark) and Renshen (Ginseng). For Liver-Kidney Deficient Fire, use Jiangxie San (Ginger and Scorpion Powder). For Wind-Heat Deafness, use Xijiao Yinzi (Rhinoceros Horn Drink). For Jue Deafness, the *Neijing* states: Sudden Jue with deafness and unilateral blockage is due to internal Qi suddenly pressing inward. Use Fuyuan Tongqi San removing Baiqianniu (White Morning Glory Seed), adding Quanxie (Scorpion), Shichangpu (Acorus), Chuanxiong (Sichuan Lovage Rhizome), Shengjiang (Fresh Ginger), and Congbai (Green Onion White), swallowed with Yangzheng Dan (Nourishing Upright Pill). In treating all deafness, Qi must be regulated. Liver Qi rebellion causes headache, deafness, and cheek swelling; treat with Siwu Tang (Four Substances Decoction) plus Rougui (Cinnamon Bark), swallowing Longhui Wan (Dragon Bile Pill) to descend Fire, along with Fuyuan Tongqi San to regulate Qi. For deafness with Damp-Phlegm, use Guntan Wan (Rolling Phlegm Pill) to purge. For deafness with black cheeks, indicating Essence depletion and Kidney Deficiency, use Shao Shen San (Burning Kidney Powder). For deafness with excessive fear, indicating Liver Deficiency, use Wendan Tang (Warm Gallbladder Decoction) swallowing Yangzheng Dan. External treatments include Tongshen San (Unblocking Spirit Powder) and Bimawan (Castor Bean Pill). One prescription: Use three earthworms (Dilong) and a little salt, placed inside a green onion tube, melted, and dripped into the ear; effective within three to five days. Another method: Use a piece of Magnetite (Cishi) the size of a bean and three scales of Pangolin (Linqiji), calcined until charred but retaining essence, wrapped in cotton and inserted into the ear, while holding a small piece of raw iron in the mouth; healing occurs when a wind-and-rain sound is felt in the ear.
Tinnitus The *Neijing* states: The ear is the gathering place of the Zong Mai (Grand Vessels). Therefore, when the Stomach is empty, the Zong Mai become deficient; deficiency leads to downward sinking, and the vessels become exhausted, causing tinnitus. It also states: When Body Fluids are depleted, the brain marrow diminishes, sinews ache, and the ears ring frequently. All these belong to Deficiency patterns of tinnitus. The *Neijing* states: Regarding the Taiyang channel, tinnitus occurs because Yang Qi, like all things flourishing, surges upward and leaps. It also states: The Jueyin channel's Qi causes tinnitus and vertigo. It further states: The arrival of Shaoyang Qi manifests as tinnitus, treated with cooling and cold methods. All these belong to Excess patterns of tinnitus. Wang Ruming stated: Tinnitus sounding like cicadas, occurring on either side or intermittently blocking the ear, is often mistakenly treated as Kidney Deficiency with poor results. In fact, this is Phlegm-Fire rising and stagnating in the ear, causing ringing; severe stagnation leads to blockage. If one usually drinks alcohol and eats rich flavors, creating Phlegm-Fire in the Upper Jiao, the primary treatment should be clearing Phlegm and descending Fire. Generally, this condition first arises from Phlegm-Fire in the upper region, combined with emotional anger; anger causes Qi to rise, and Shaoyang Fire lodges in the ear. If tinnitus is due to Kidney Deficiency, the sound is not intense, the person is prone to sexual indulgence, and signs of Consumption (Xu Lao) appear. Yu Jiayan stated: In treating elderly patients with Kidney Qi rebelling upward causing tinnitus, Magnetite (Cishi) should be the main herb because its heaviness reaches downward. However, its nature primarily draws downward and cannot control the upward suction of Liver Wood. It should be assisted by Yin-nourishing herbs such as Dihuang (Rehmannia Root) and Guijiao (Donkey-hide Gelatin), and astringents like Wuweizi (Schisandra Berry) and Shanzhuyu (Cornus Fruit) to consolidate, allowing Yin Qi to flourish in its home palace without touching the Yang orifices. Thus, the space becomes clear, and distant hearing is restored. Danxi used Fangfeng Tongsheng San (Wind-Protecting Universal Rescue Powder) for tinnitus caused by excessive drinking, but this lacks definitive insight. Only Guntan Wan (Rolling Phlegm Pill) is effective for young and robust individuals, as Huangqin (Scutellaria Root), Dahuang (Rhubarb Root), and Chenxiang (Agarwood) are bitter and best at descending Qi, while Mengshi (Calamine) is heavy and sinking, similar to Magnetite. Xue Lizhai stated: If Blood Deficiency with Fire, use Siwu Tang (Four Substances Decoction) plus Zhizi (Gardenia Fruit) and Chaihu (Bupleurum Root). If Middle Qi is weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Zhizi (Gardenia Fruit) and Danpi (Moutan Cortex). If deafness or tinnitus occurs after anger, belonging to Liver-Gallbladder Qi Excess, use Xiaochaihu Tang (Minor Bupleurum Decoction) plus Chuanxiong (Sichuan Lovage Rhizome), Danggui (Angelica Sinensis), and Zhizi (Gardenia Fruit). If worse in the morning, it is Yang Qi Excess-Heat; use Xiaochaihu Tang plus Huanglian (Coptis Rhizome) and Zhizi (Gardenia Fruit). If worse in the afternoon, it is Yin-Blood Deficiency; use Siwu Tang (Four Substances Decoction) plus Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria). If Kidney Deficiency with Fire stirring, causing a humming sound in the ears, indicating lack of Yin, use Jiajian Bawei Wan (Modified Eight-Ingredient Pill). For Kidney Deficiency with tidal or cicada-like sounds in the ears, incessant and interfering with hearing, Qi must be anchored and the Kidney tonified; Zhengyuan San (Upright Origin Powder) swallowing Heixi Dan (Black Tin Pill), with Anshen Wan (Calming Kidney Pill) administered intermittently. For Kidney Organ Wind-Deficiency Tinnitus, where sleeping at night sounds like war drums, with limb twitching and pain, and a sensation of wind blowing with extreme itching in the ear, select Huang [missing character] Wan or Sisheng San (Four Living Herbs Powder).
Ear Swelling and Pain Belong to Shaoyang Ministerial Fire; treat with Xijiao Yinzi (Rhinoceros Horn Drink) plus Bingpian (Borneol) and Shexiang (Musk) made into pills. The *Neijing* states: Excess of Shaoyang causes ear pain, treated with pungent-cold methods, which is correct. For pain and sores inside the ear, use Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Danggui (Angelica Sinensis), Shaoyao (Peony Root), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Gancao (Licorice Root), Jiegeng (Platycodon Root), Shengdi (Rehmanniae Radix), Taoren (Prunus Semen), Huangqi (Astragali Radix), Chaihu (Bupleurum Root), and Caolongdan (Gentiana Scabra Root). For damp-swollen painful ears, use Liangge San (Cooling the Diaphragm Powder) plus Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Jingjie (Schizonepetae Spica). Externally, use equal parts Longgu (Fossilized Bones) and Huangdan (Lead Monoxide), with half amount of Kufan (Alum), plus a little Musk blown into the ear. Alternatively, use Longgu (Fossilized Bones), Huangdan (Lead Monoxide), and Ganyanzi (Dried Pomegranate Flower) powdered together. Or burn Wubeizi (Chinese Gall) to ash, mix with Alum, and blow into the ear.
Ear Rash Ear rash belongs to the Shaoyang Sanjiao, or Foot Jueyin Liver Meridian Blood Deficiency with Wind-Heat, or induced by anger stirring Liver Fire. If accompanied by fever and pain, it belongs to Sanjiao-Jueyin Wind-Heat; use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) or Zhizi Qinggan San (Gardenia Liver-Clearing Powder). Do not exclusively treat externally at the expense of damaging Qi and Blood. For itching caused by Kidney Deficiency with Wind-Heat, scratched into sores, use Liuwei Wan (Six-Ingredient Pill) plus Baijili (Tribulus Fruit).
Itching in the Ear Indicates Wind in the Kidney Home; use Sisheng San (Four Living Herbs Powder). Take two or three doses each time it occurs for recovery.
Otorrhea Results from Damp-Heat accumulating in the ear. Use Fuyuan Tongqi San (Restoring Vitality and Unblocking Qi Powder) with modifications as before. Externally, powder Wubeizi (Chinese Gall), Quanxie (Scorpion), and Kufan (Alum), add a little Musk, and blow into the ear. Or burn Jupi (Citrus Peel) until charred but retaining essence, add a little Musk, first wipe the ear clean with cotton to remove pus, then apply. For robust individuals with accumulated Heat attacking upward, where otorrhea persists, use Liangge San (Cooling the Diaphragm Powder) to purge.
Cerumen Impaction With Tinnitus/Deafness and Internal Stagnant Blood: Externally, crush Radish (Laifu) to extract juice, mix with a little ground Musk, and drip into the ear. Other methods refer to the treatment of deafness.
Insect Entering the Ear: Rub cat's nose with fresh ginger to induce urination; take the urine and drip into the ear to expel the insect. Or sleep on fried sesame seeds to expel the insect. If an object is stuck and cannot be removed, cut the end of a bowstring or coin string to fray it, dip in good glue, attach to the object in the ear, and slowly pull out for effectiveness. Xue Lizhai treated a man who experienced ear itching/pain or discharge during intercourse, preferring coolness, probing with a silver needle; this was Kidney Channel Deficient Fire, cured with Jiajian Bawei Wan (Modified Eight-Ingredient Pill). He also treated a woman whose anger flared up, causing bilateral otorrhea and temporal headache upon menstruation, relieved by pressure, with chest/hypochondriac/breast distension/pain upon anger, alternating chills/fever, frequent urination, or lower abdominal fullness; all belonged to Liver Fire and Blood Deficiency. Ten doses of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) resolved all symptoms, followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wuweizi (Schisandra Berry) for complete recovery.