小儿肾气实,其热上冲于耳,使津液壅滞,化为稠脓,或为清汁,亦有沐浴水入耳
中,血气凝滞,渐生疳臭,久乃成聋。汤氏有五耳之名,其本则一,宜龙骨散吹之,外服化毒退热之剂。
胆气不舒,风邪乘袭,少火被郁,两耳肿痛,内流清水,久则变为脓血,身发寒热,
耳内如沸汤之响,此风火燥干胆汁之候,治宜舒胆汤。
耳中干耵,无脓无水,痛如针刺,久则焚槁成聋矣,速宜平火汤重剂服之,或以柴胡聪耳汤消息调之。
龙骨散
龙骨(研) 明矾( ,各三钱) 黄丹( ,二钱) 胭脂(一钱) 麝香(少许,同为末)
先捻去脓汁,次用鹅管吹入。
吴遇斋曰∶疮在耳外,用雄黄一钱,红枣一枚去核,包黄在内,火煨存性,取黄研
细,搽上即愈。疮在耳内,用鱼首石炼存性,碾细,加朱、麝各少许同碾,吹入自愈。
方鹿村曰∶耳后脓疮,用柿饼蒂七八个,
烧灰,将熄时,以碗覆之,冷定为末,入轻粉一钱,香油调涂即愈。
舒胆汤
当归 白芍 元参 花粉 炒山栀 柴胡 石菖蒲
平火汤
熟地 生地 麦冬 玄参 菖蒲
柴胡聪耳汤
柴胡(三钱) 连翘(四钱) 当归 甘草 人参(各一钱) 虻虫(三个,去翅足) 水蛭(五分) 麝香(少
许,三件另研) 生姜(一片)
各药煎好,去渣入三末,再煎一二沸,食少远,热服。
程庆其曰∶有虫入耳中,痛不可忍,极似干耵症,用生姜擦猫鼻,取尿滴耳中即出。
仇芑轩曰∶有耵燥暴聋者,用全蝎去毒为末,酒调滴耳中,闻水声即愈。
小儿肾气充盛,热气上冲至耳部,导致津液壅滞,化为浓稠的脓液,或成为清稀的汁液;也有因沐浴时水进入耳中,致使血气凝滞,逐渐产生疳疮恶臭,日久则形成耳聋。汤氏将耳病分为五种类型,但其根本病因一致,适宜使用龙骨散吹入耳中,同时外服具有解毒退热功效的药剂。
若胆气不舒,风邪乘虚侵袭,少火(相火)被郁遏,导致两耳肿痛,内部流出清水,日久则变为脓血,身体出现寒热交替的症状,耳内发出如沸水般的响声,这是风火燥干胆汁的表现,治疗应当使用舒胆汤。
若耳中干燥且有耵聍(耳垢),无脓无水,疼痛如针刺一般,日久则干枯焦灼而成聋,应立即重剂服用平火汤,或者斟酌情况使用柴胡聪耳汤调理。
龙骨散处方:龙骨(研碎)、明矾(各三钱)、黄丹(二钱)、胭脂(一钱)、麝香(少许,共同研为细末)。先捻去脓汁,然后用鹅毛管将药粉吹入耳中。
吴遇斋说:疮生在耳外,用雄黄一钱、红枣一枚去核,将雄黄包裹在枣内,用火煨至存性,取出雄黄研细,涂抹患处即可痊愈。疮生在耳内,用鱼首石煅烧存性,碾成细粉,加入朱砂、麝香各少许一同研磨,吹入耳中即可自愈。
方鹿村说:耳后脓疮,用柿饼蒂七八个,烧成灰,在火将熄灭时用碗覆盖,冷却后定形研为细末,加入轻粉一钱,用香油调和涂抹即可痊愈。
柴胡聪耳汤处方:柴胡(三钱)、连翘(四钱)、当归、甘草、人参(各一钱)、虻虫(三个,去除翅足)、水蛭(五分)、麝香(少许,三种另研)、生姜(一片)。将各药煎好,去渣后加入三种药末,再煮沸一二滚,饭后稍远时间热服。
The kidney qi of infants and children is robust, allowing heat to rush upward to the ears. This causes fluids to stagnate and transform into thick pus or clear fluid. In some cases, water enters the ear during bathing, causing blood and qi to stagnate, gradually leading to otomycosis with a foul odor, which may eventually result in deafness. Tang Shi classified ear diseases into five types, but their root cause is the same. It is advisable to use Longgu San (Dragon Bone Powder) insufflated into the ear, while externally administering decoctions that resolve toxicity and reduce fever.
If gallbladder qi fails to diffuse smoothly, wind pathogens invade, and Shaohuo (Ministerial Fire) becomes constrained, resulting in swelling and pain in both ears. Clear fluid flows internally, which over time turns into pus and blood. The body exhibits alternating chills and fever, and a sound like boiling water is heard within the ear. This presents as a syndrome where wind-fire dries up gallbladder juice; treatment should employ Shudan Tang (Gallbladder-Diffusing Decoction).
If the ear is dry with cerumen, without pus or fluid, and pain feels like needle pricks, prolonged neglect will lead to desiccation and deafness. One should promptly administer Pinghuo Tang (Fire-Calming Decoction) in a heavy dose, or adjust treatment using Chaihu Cong'er Tang (Bupleurum Ear-Opening Decoction) according to circumstances.
Longgu San (Dragon Bone Powder): Calcined Dragon Bone (ground), Alum (each 3 qian), Red Lead (2 qian), Carmine (1 qian), Musk (a small amount). All ingredients are ground together into powder. First, wipe away the pus, then insufflate the powder into the ear using a goose quill.
Wu Yu-zhai stated: For sores outside the ear, use 1 qian of Realgar and one red date pitted. Wrap the Realgar inside the date, roast it over fire until the carbonized nature remains, take out the Realgar, grind it finely, and apply it topically for immediate healing. For sores inside the ear, use processed Fish Head Stone calcined to retain its nature, grind it fine, add a small amount of Cinnabar and Musk, mix thoroughly, and insufflate into the ear for spontaneous recovery.
Fang Lu-cun stated: For abscesses behind the ear, use seven or eight persimmon stalks. Burn them to ash; when the fire is about to extinguish, cover them with a bowl to cool and solidify, then grind into powder. Add 1 qian of Calomel, mix with sesame oil, and apply topically for healing.
Shudan Tang (Gallbladder-Diffusing Decoction): Angelicae Radix (Danggui), Paeoniae Radix Alba (Baishao), Scrophulariae Radix (Yuanshen), Trichosanthis Radix (Huafen), Gardeniae Fructus (Chao Zhizi), Bupleuri Radix (Chaihu), Acori Tatarinowii Rhizoma (Shichangpu).
Pinghuo Tang (Fire-Calming Decoction): Rehmanniae Radix Praeparata (Shudi), Rehmanniae Radix Recens (Shengdi), Ophiopogonis Radix (Maidong), Scrophulariae Radix (Xuan Shen), Acori Tatarinowii Rhizoma (Changpu).
Chaihu Cong'er Tang (Bupleurum Ear-Opening Decoction): Bupleuri Radix (3 qian), Forsythiae Fructus (4 qian), Angelicae Radix, Glycyrrhizae Radix et Rhizoma (Gancao), Ginseng Radix (each 1 qian), Blatta Orientalis (Mengchong, 3 specimens, wings and feet removed), Hirudo (Shuizhi, 5 fen), Musk (a small amount, prepared separately), Zingiberis Rhizoma Recens (Shengjiang, 1 slice). Decoct the herbs, strain the residue, add the three prepared powders, boil for one or two more boils, and drink hot after meals with some distance taken.
Cheng Qing-qi stated: If an insect enters the ear, causing unbearable pain resembling dry cerumen syndrome, rub a cat's nose with fresh ginger, collect the urine, and drip it into the ear to expel the insect.
Qiu Xi-xuan stated: For sudden deafness caused by dry cerumen, use Scolopendra (Quanxie) detoxified and ground into powder. Mix with wine and drip into the ear; hearing the sound of water indicates recovery.