验方 白龙骨研细吹耳内。
又方
人牙（ 存性，出火毒） 麝香（少许）
研细。每用少许吹耳内，即干。（又治小儿痘疮出现而靥者，酒调一字，服之即出。）
凡耳中策策痛者，是风入肾经也。不治则变，恶寒发热，脊强背直，如 之状，
曰黄耳伤寒。此不可作正伤寒治，宜小续命汤去附子，加僵蚕、天麻、羌、独，次
用荆防败毒散加细辛、白芷、蝉蜕、黄芩、赤芍、紫荆皮。
冯鲁瞻曰∶耳聋因于火者，或暴怒之乍乘，或情欲之自肆，或因有余之火，或
因不足之火，故耳聋及痛者。所主宜芩、连、归、芍之类。（《锦囊》）
又曰∶耳聋因于气闭者，有因怒伤及肝，痰因于火，或一时卒中，或久病气虚，
故耳聋及鸣者，所主宜舒郁调血，用导引宣通之法。
又曰∶更有风入于脑，停滞于手太阳之脉，则令气塞耳聋。
又曰∶若大病后而耳聋者，是血枯而气弱也，当服地黄丸。然在病后，则气血
俱虚，必诊两手之脉孰胜而为之治。若脉
大无力，或右手细小沉弱者，阳气大虚也，宜甘温之剂，仿阳生阴长之义，少加血药
佐之。若纯视为阴虚，而用滋阴降火之剂。则阳气愈弱，非惟耳聋不痊，反增恶心、胸
满、泄泻之患矣。
又曰∶耳聋皆属于热。左耳聋者，少阳火也，龙荟丸主之；右耳聋者，太阳火
也，六味丸主之；左右耳俱聋者，阳明之火也，通圣散、滚痰丸主之。凡有所忿怒
过度，则动少阳胆火从左起，故使左耳聋也；有所色欲过度则动，太阳膀胱相火从
右起，故使右耳聋也；有所醇酒浓味，过度则动，阳明胃火从中起，故使左右耳俱
聋也。妇人多左耳聋者，以其多忿怒也；男子多右耳聋者，以其多色欲也；膏梁之家，
多左右耳聋者，以其多肥甘也。
又曰∶经云∶耳聋少气嗌干者，肺也。又云∶头痛耳鸣，九窍不利，肠胃之所生
也。肠胃不足，故气弱不充，伤寒及大病之后，多有此证，以补中益气汤治之。耳
聋多恐者，肝虚也。经云∶肝虚则目KT KT 无所见，耳无所闻，善恐。治法用四物汤
加羌活、防风、柴胡、茯神、菖蒲主之。
又曰∶新聋多热，少阳、阳明火多故也；旧聋多虚，肾常不足故也。一宜清风
散热，一宜滋肾通窍。如大病后，又宜补阴降火。
陈远公曰∶人有耳中如针之触痛者，并无水出，止有水沸，人以为火邪作祟，殊
不知乃肾水耗也。夫肾开窍于耳，肾气不足则耳闭；耳闭之前，必非安然即闭也，必
先痛而后闭，何也？肾火冲之也。火冲不出，则火路塞不通，是火不再走于耳而成
聋也。此症宜速治，否则成聋难治矣。用益水准火汤主之∶熟地、生地、麦冬、玄
参各一两，菖蒲一钱，水煎服。一剂疼止，二剂响息，三剂全愈。此良法也。（此方补水之
剂，又能于水中泻火，且不损肾气。肾水既足则肾火自降，未成之聋，不可不治也。此方治
已聋者，尚有奇功，况治未聋之耳，有不取效之捷哉？）
又曰∶人有耳聋不闻雷声，又并不疼，此大病后或年老之人则有之。乃肾火闪闭
而气塞也，最难取效。法当内外兼治，必大补心肾。虽耳属肾，而非心气相通，则
心肾不交，反致阻塞，故必补肾。使肾液滋心，即用补心之剂，使心气降于肾火，肾
气交，自然上升通于耳矣。用启窍丹主之∶熟地二两，山萸肉、麦冬各一两，远志、茯
神、柏子仁、熟枣仁各三钱，北五味二钱，石菖蒲一钱，水煎服。四剂耳中必作响，此
欲开聋之兆也。又服十剂，外用龙骨一分，雄鼠胆汁一枚，麝香一厘，冰片三厘，研
末，为三丸，绵裹塞耳中，勿取出，一昼夜即通矣。神效之至。再用前方服一日，后
用六味丸为善后之计。否则恐不能久也。
经曰∶耳者，肾之窍也，肾主藏精者也。故精脱者，则颊黑而耳聋。耳者，宗
脉之所聚也。以窍言之，水也；以声言之，金也；以经言之，手足少阳俱会其中也。有
从内不能听者，主也；有从外而不能入者，经也。肾和则能闻五音矣。又曰∶有气逆
而聋者，所属有二∶凡手太阳气厥而耳聋者，其候聋而耳内气满也；手少阳气厥而
耳聋者，其候耳内浑浑 ，此皆气逆而聋也。治法宜四物汤加降火通气之药。然
脏气逆而为厥聋，必有眩昏之证；风聋必有头痛之证；劳役伤其气血，色欲耗其精
元，昏昏愦愦是谓劳聋，必有虚损之证。其声嘈嘈，眼见黑花，此乃虚聋证也。
又曰∶凡耳聋，因湿热痰及气实者，并宜槟榔丸或神芎丸下之。
又曰∶耳者，虽足少阴之所主，然人身十二经络，除足太阳、手厥阴，其余十
经络，皆入于耳，惟肾开窍于耳，故治耳者以肾为主。然心亦开窍于耳，何也？盖
心窍本在舌，以舌无孔窍，因寄于耳。肾为耳窍之主，心为耳窍之客，肾治内之阴，
心治外之阳，清净精明之气上走空窍，而听斯聪矣。若二经不调，阴阳不和，皆令
暴聋。然五脏开于五部，分阴阳言之。在
肾、肝居阴，故耳、目二窍，阴精主者；在心、脾、肺居阳，故口、鼻、舌三窍，阳
精主之。是以五脏不和，则七窍不通。凡一经一络，有虚实之气入于耳者，皆足以
乱其聪明，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；若瘦而色黑，筋骨健壮，此精气俱有余，固藏
闭塞，是聋为实，乃高寿之兆，二者皆禀受所致也。若耳聋颊黑者，为脱精肾惫。用
安肾、八味、苁蓉等丸，选而用之；若肾经虚火、面赤口干，痰盛内热者，六味丸主
之。此论阴虚者也。至于阳虚者，亦有耳聋。经曰∶清阳出上窍。胃气者，清气元
气，春升之气，同出而异名也。今人饮食劳倦，脾胃之气一虚，不能上升而下流于
肾肝，故阳气闭塞，地气冒昧，邪害空窍，令人耳目不明，此阳虚耳聋。须用东垣补
中益气汤主之。有因心气虚实不调，虚则不能治其阳，下与阴交，实则恃阳强而与
阴绝。经曰∶至阴虚天气绝是也。宜以补心丸加减主之。更有地气冒昧者，或忧愁
不解，阴气闭塞，不与阳通；或内外湿饮，痞隔其气，不得升降，而耳中亦浑浑淳淳
者，宜以升阳除湿之剂主之。然以阴精阳气而论，则耳、目二窍，阴精主者；阴精
主者贵清凉而恶烦热，阳气主者贵温暖而恶寒凉。洁古老人尝有是论，信乎耳目之
不可以温补也。《仁斋直指》云∶肾通于耳，所主者精，精气调和，肾气充足，则耳得
听斯聪矣。故能调养得所，气血和平，则其聋渐轻；若不知自节，日就烦劳，不禁
欲，不戒性，不戒酒，及 炙浓味，虽服药，无效也。
验方：将白龙骨研磨成细粉，吹入耳内。
又一方：
人牙（煅存性，去除火毒）麝香（少量）
研磨成细粉。每次取少许吹入耳内，即可干燥结痂。（此方也治疗小儿痘疮已出但结痂迟缓的情况，用酒调服一字量，服用后痘疮即可顺利发出。）
凡是耳中感到像虫爬一样的刺痛，这是风邪侵入肾经所致。如果不治疗就会发生病变，出现恶寒发热、脊柱僵硬背部挺直，像僵直一样的症状，称为黄耳伤寒。这种情况不能当作普通伤寒来治，适宜用小续命汤去掉附子，加入僵蚕、天麻、羌活、独活；其次再用荆防败毒散加入细辛、白芷、蝉蜕、黄芩、赤芍、紫荆皮。
冯鲁瞻说：耳聋由火邪引起的，有的是因突然暴怒导致肝气上逆，有的是因情欲放纵，有的是因为实火有余，有的是因为虚火不足，所以导致耳聋及疼痛。主治宜用黄芩、黄连、当归、白芍之类的药物。（出自《锦囊》）
又说：耳聋由气机闭塞引起的，有因愤怒伤肝，痰随火生，或者一时卒中，或者久病气虚，所以导致耳聋及耳鸣的，主治宜疏解郁滞、调和气血，采用导引宣通的方法。
又说：更有风邪侵入脑部，停滞在手太阳经脉，就会导致气塞耳聋。
又说：如果在大病之后出现耳聋，这是血枯而气弱，应当服用地黄丸。然而在病后，气血都虚弱，必须诊察两手脉象哪一侧胜，从而进行治疗。如果脉象大而无力的，或者右手脉细小沉弱的，是阳气大虚，适宜用甘温的药剂，仿照阳生阴长的道理，少加补血药辅助。如果单纯视为阴虚，而使用滋阴降火的药剂，那么阳气会更弱，不仅耳聋不能痊愈，反而会增加恶心、胸满、泄泻的祸患。
又说：耳聋都属于热证。左耳聋，是少阳火邪，主用龙胆泻肝丸；右耳聋，是太阳火邪，主用六味地黄丸；左右耳都聋，是阳明火邪，主用防风通圣散、滚痰丸。凡是有所忿怒过度，就会触动少阳胆火从左而起，所以使左耳聋；有所色欲过度就会触动太阳膀胱相火从右而起，所以使右耳聋；有所醇酒厚味过度就会触动阳明胃火从中而起，所以使左右耳都聋。妇人大多左耳聋，是因为她们多忿怒；男子大多右耳聋，是因为他们多色欲；富贵人家，大多左右耳都聋，是因为他们多吃肥甘厚味。
又说：医经说：耳聋伴有少气、咽喉干燥的，是肺的问题。又说：头痛耳鸣，九窍不通利，是肠胃产生的问题。肠胃不足，所以气弱不充盈，伤寒及大病之后，多有这种证候，用补中益气汤治疗。耳聋多伴有恐惧感的，是肝虚。医经说：肝虚则眼睛看不清东西，耳朵听不见声音，容易恐惧。治疗方法用四物汤加入羌活、防风、柴胡、茯神、石菖蒲主治。
又说：新发的耳聋多属热，是因为少阳、阳明火邪多的缘故；陈旧的耳聋多属虚，是因为肾常不足的缘故。一种适宜清风散热，一种适宜滋肾通窍。如大病后，又适宜补阴降火。
陈远公说：有人耳中像针扎一样痛，并没有水流出，只有感觉水沸腾，人们以为是火邪作祟，殊不知这是肾水耗损。肾开窍于耳，肾气不足则耳闭；在耳闭之前，必定不是安然直接闭上的，必定先痛而后闭，为什么呢？是肾火冲激的缘故。火冲不出去，则火路堵塞不通，火不再走于耳而成聋。此症适宜速治，否则成聋就难治了。用益水准火汤主治：熟地黄、生地黄、麦冬、玄参各一两，石菖蒲一钱，水煎服。一剂疼痛停止，二剂响声消失，三剂全愈。这是良法。（此方是补水之剂，又能于水中泻火，且不损伤肾气。肾水既充足则肾火自然下降，未成的耳聋，不可不治。此方治疗已经耳聋者，尚有奇功，何况治疗未聋的耳朵，没有见效快的呢？）
又说：有人耳聋听不到雷声，也并不疼痛，这在大病后或年老的人身上会有。这是肾火闪闭而气塞，最难取效。方法应当内外兼治，必须大补心肾。虽然耳属肾，但如果心气不相通，则心肾不交，反而导致阻塞，所以必须补肾，使肾液滋养心，即用补心的药剂，使心气降于肾火，肾气相交，自然上升通于耳了。用启窍丹主治：熟地黄二两，山茱萸肉、麦冬各一两，远志、茯神、柏子仁、炒酸枣仁各三钱，北五味子二钱，石菖蒲一钱，水煎服。四剂耳中必作响，这是想要开通耳聋的先兆。再服十剂，外用龙骨一分，雄鼠胆汁一枚，麝香一厘，冰片三厘，研磨成末，做成三丸，用棉包裹塞入耳中，不要取出，一昼夜就通了。神效至极。再用前方服药一日，后用六味地黄丸作为善后之计。否则恐怕不能持久。
医经说：耳，是肾的窍穴，肾主藏精。所以精脱的人，则脸颊发黑且耳聋。耳，是宗脉聚集的地方。从窍来说，属水；从声音来说，属金；从经络来说，手足少阳经都汇聚其中。有从内不能听的，主责在脏；有从外而不能入的，主责在经。肾气和顺则能听到五音了。又说：有气逆而聋的，所属有两种：凡是手太阳经气厥逆而耳聋的，其症状是耳聋且耳内气满；手少阳经气厥逆而耳聋的，其症状是耳内浑浑沉沉，这都是气逆而聋。治疗方法适宜用四物汤加入降火通气的药物。然而脏气逆而为厥聋，必有眩晕昏蒙的症状；风聋必有头痛的症状；劳役损伤气血，色欲耗损精元，昏昏愦愦这叫劳聋，必有虚损的症状。声音嘈杂，眼前见黑花，这是虚聋证。
又说：凡是耳聋，因湿热痰及气实的，都适宜用槟榔丸或神芎丸攻下。
又说：耳，虽然是足少阴肾所主，然而人身十二经络，除了足太阳、手厥阴，其余十条经络，都进入耳中，只有肾开窍于耳，所以治耳以肾为主。然而心也开窍于耳，为什么呢？因为心窍本在舌，因为舌无孔窍，所以寄居于耳。肾为耳窍之主，心为耳窍之客，肾治理内部的阴，心治理外部的阳，清净精明之气上行至空窍，听力才聪明了。如果这两经不调，阴阳不和，都会导致暴聋。然而五脏开窍于五部，分阴阳来说。在肾、肝居阴，所以耳、目二窍，由阴精主管；在心、脾、肺居阳，所以口、鼻、舌三窍，由阳精主管。因此五脏不和，则七窍不通。凡是一经一络，有虚实之气进入耳中的，都足以扰乱其聪明，这是说暴病的。至于久聋，对于肾也有虚实之别。左肾为阴主精，右肾为阳主气，精不足气有余，则聋为虚；如果瘦而面色黑，筋骨健壮，这是精气俱有余，固藏闭塞，是聋为实，这是高寿的征兆，两者都是禀受所致。如果耳聋且脸颊发黑的，是脱精肾惫。用安肾丸、八味丸、苁蓉丸等，选择使用；如果肾经虚火、面赤口干，痰盛内热的，主用六味地黄丸。这是论述阴虚的。至于阳虚的，也有耳聋。医经说：清阳出于上窍。胃气，是清气元气，春升之气，同出而异名。现在人饮食劳倦，脾胃之气一虚，不能上升而下流于肾肝，所以阳气闭塞，地气冒昧，邪害空窍，令人耳目不明，这是阳虚耳聋。须用李东垣的补中益气汤主治。有因心气虚实不调，虚则不能治其阳，下与阴交，实则恃阳强而与阴绝。医经说：至阴虚天气绝就是这种情况。适宜用补心丸加减主治。更有地气冒昧的，或者忧愁不解，阴气闭塞，不与阳通；或者内外湿饮，痞隔其气，不得升降，而耳中也浑浑淳淳的，适宜用升阳除湿的药剂主治。然而以阴精阳气而论，则耳、目二窍，由阴精主管；阴精主管的贵清凉而厌恶烦热，阳气主管的贵温暖而厌恶寒凉。洁古老人曾经有这样的论述，确实耳目是不可以温补的。《仁斋直指》说：肾通于耳，所主的是精，精气调和，肾气充足，则耳得听斯聪明了。所以能调养得当，气血和平，则其聋逐渐减轻；如果不知自我节制，日渐烦劳，不禁欲，不戒怒，不戒酒，以及吃炙烤浓味食物，虽然服药，也无效。
Prescription: Grind Bai Long Gu (Fossilized Bones, *Os Draconis*) into fine powder and insufflate into the ear.
Another prescription:
Ren Ya (Human Tooth, calcined to retain efficacy, remove fire toxicity) She Xiang (Musk, *Moschus*) (a small amount)
Grind into fine powder. Use a small amount each time to insufflate into the ear, which will dry immediately. (This prescription also treats infantile smallpox that has erupted but fails to crust over; mix with wine and administer one "zi" [approx. 0.5-1g], after which the eruption will proceed smoothly.)
Whenever there is a prickling pain in the ear, it indicates Wind pathogen invading the Kidney Meridian. If untreated, it will transform into symptoms of aversion to cold, fever, stiffness of the spine and straightening of the back, resembling rigidity, known as Huang Er Shang Han (Yellow Ear Cold Damage). This condition should not be treated as ordinary Shang Han (Cold Damage); Xia Xu Ming Tang (Minor Continuation of Life Decoction) with Fu Zi (Aconite Root, *Radix Aconiti Lateralis Preparata*) removed, and Jiang Can (Silkworm, *Bombyx Batryticatus*), Tian Ma (Gastrodia Rhizome, *Gastrodiae Rhizoma*), Qiang Huo (Notopterygium Rhizome, *Notopterygii Rhizoma et Radix*, added, followed by Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Expel Toxins) with Xi Xin (Asarum Root, *Asari Radix et Rhizoma*), Bai Zhi (Angelica Dahurica Root, *Angelicae Dahuricae Radix*), Chan Tui (Cicada Slough, *Cicadae Periostracum*), Huang Qin (Scutellaria Root, *Scutellariae Radix*), Chi Shao (Red Peony Root, *Paeoniae Radix Rubra*), and Zi Jing Pi (Chinese Wisteria Bark, *Wisteriae Sinensis Cortex*) added.
Feng Luzhan stated: Deafness caused by Fire may result from sudden rage causing Liver Qi rebellion, indulgence in desires, excess of excess Fire, or deficiency of deficient Fire, thus leading to deafness and pain. The treatment should prioritize herbs such as Huang Qin (Scutellaria Root, *Scutellariae Radix*), Lian Zi (Lotus Plumule, *Nelumbinis Plumula* - note: text says Lian, likely Huang Lian), Dang Gui (Angelica Sinensis Root, *Angelicae Sinensis Radix*), and Bai Shao (White Peony Root, *Paeoniae Radix Alba*). (From *Jin Nang*)
He further stated: Deafness caused by Qi obstruction may arise from anger injuring the Liver, phlegm generated by Fire, sudden stroke, or chronic illness leading to Qi deficiency, resulting in deafness and tinnitus. The treatment should focus on resolving stagnation and harmonizing Blood, employing methods of guiding and unblocking.
He also stated: Furthermore, if Wind enters the brain and stagnates in the Hand Taiyang Meridian, it causes Qi blockage and deafness.
He further stated: If deafness occurs after a severe illness, it indicates exhaustion of Blood and weakness of Qi, and Di Huang Wan (Rehmannia Pill) should be taken. However, post-illness involves deficiency of both Qi and Blood; one must diagnose the pulse of both hands to determine superiority and guide treatment. If the pulse is large but forceless, or the right-hand pulse is fine, thin, deep, and weak, it indicates severe Yang deficiency. A sweet-warm formula should be used, following the principle of Yang generating Yin, with a small addition of Blood-nourishing herbs. If mistakenly viewed solely as Yin deficiency and treated with Yin-nourishing and Fire-descending formulas, Yang will become even weaker. Not only will deafness not resolve, but nausea, chest fullness, and diarrhea may worsen.
He further stated: Deafness generally belongs to Heat. Left-sided deafness is due to Shaoyang Fire, treated primarily with Long Dan Xie Gan Wan (Gentian Liver-Draining Pill); right-sided deafness is due to Taiyang Fire, treated primarily with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill); bilateral deafness is due to Yangming Fire, treated primarily with Fang Feng Tong Sheng San (Saposhnikovia Universal Relief Powder) or Gun Tan Wan (Rolling Phlegm Pill). Excessive anger stirs Shaoyang Gallbladder Fire rising from the left, causing left deafness; excessive sexual desire stirs Taiyang Bladder Ministerial Fire rising from the right, causing right deafness; excessive consumption of rich alcohol and food stirs Yangming Stomach Fire rising from the center, causing bilateral deafness. Women often suffer left deafness due to frequent anger; men often suffer right deafness due to frequent sexual indulgence; wealthy families often suffer bilateral deafness due to excessive rich and greasy foods.
He further stated: The Classics state: Deafness accompanied by shortness of breath and dry throat relates to the Lung. It also states: Headache, tinnitus, and dysfunction of the nine orifices originate from the Intestines and Stomach. Insufficiency of the Intestines and Stomach leads to weak Qi failing to fill the orifices. This pattern often follows Shang Han (Cold Damage) or severe illness and is treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Deafness accompanied by fear indicates Liver deficiency. The Classics state: Liver deficiency leads to blurred vision, hearing loss, and timidity. The treatment uses Si Wu Tang (Four Substances Decoction) plus Qiang Huo (Notopterygium Rhizome, *Notopterygii Rhizoma et Radix*), Fang Feng (Saposhnikovia Root, *Saposhnikoviae Radix*), Chai Hu (Bupleurum Root, *Bupleuri Radix*), Fu Shen (Poria with Hostwood, *Poria*), and Shi Chang Pu (Acorus Rhizome, *Acori Tatarinowii Rhizoma*).
He further stated: New-onset deafness is mostly Heat, due to abundance of Shaoyang and Yangming Fire; chronic deafness is mostly Deficiency, due to chronic Kidney insufficiency. One requires clearing Wind and dissipating Heat; the other requires nourishing the Kidney and opening the orifices. Post-severe illness requires nourishing Yin and descending Fire.
Chen Yuan Gong stated: Some experience needle-like pain in the ear without discharge, only a sensation of boiling water. People attribute this to Fire pathogen, unaware it is actually depletion of Kidney Water. The Kidney opens into the ears; insufficient Kidney Qi causes ear closure. Before closure, it does not happen peacefully but involves pain preceding closure, due to Kidney Fire rushing upward. If the Fire cannot escape, the pathway becomes blocked, preventing Fire from exiting via the ear, leading to deafness. This condition requires rapid treatment; otherwise, established deafness is difficult to cure. Treat with Yi Shui Ping Huo Tang (Water-Balancing Fire-Calming Decoction): Shu Di Huang (Prepared Rehmannia Root, *Rehmanniae Radix Praeparata*), Sheng Di Huang (Raw Rehmannia Root, *Rehmanniae Radix*), Mai Dong (Ophiopogon Tuber, *Ophiopogonis Tuber*), Xuan Shen (Scrophularia Root, *Scrophulariae Radix*) each 1 liang, Shi Chang Pu (Acorus Rhizome, *Acori Tatarinowii Rhizoma*) 1 qian. Decoct and take orally. Pain stops after one dose, tinnitus ceases after two doses, full recovery after three doses. This is an excellent method. (This formula nourishes Water while draining Fire within Water, without damaging Kidney Qi. Once Kidney Water is sufficient, Kidney Fire naturally descends. Preventive treatment for impending deafness is essential. Even for established deafness, this formula yields miraculous results, let alone for pre-deafness ear conditions.)
He further stated: Some suffer deafness unable to hear thunder, without pain, occurring after severe illness or in the elderly. This is due to Kidney Fire flashing shut and Qi obstruction, making it difficult to treat. Treatment must combine internal and external approaches, strongly tonifying Heart and Kidney. Although the ear belongs to the Kidney, if Heart Qi does not communicate, Heart and Kidney fail to interact, causing blockage. Thus, one must tonify the Kidney to allow Kidney Fluid to nourish the Heart, using Heart-tonifying agents to descend Heart Qi to Kidney Fire. When Kidney Qi interacts, it naturally rises to open the ear. Treat with Qi Qiao Dan (Orifice-Opening Pill): Shu Di Huang (Prepared Rehmannia Root, *Rehmanniae Radix Praeparata*) 2 liang, Shan Yu Rou (Cornus Fruit, *Corni Fructus*), Mai Dong (Ophiopogon Tuber, *Ophiopogonis Tuber*) each 1 liang, Yuan Zhi (Polygala Root, *Polygalae Radix*), Fu Shen (Poria with Hostwood, *Poria*), Bai Zi Ren (Biota Seed, *Platycladi Semen*), Shu Zao Ren (Processed Sour Jujube Seed, *Ziziphi Spinosae Semen Praeparatum*) each 3 qian, Bei Wu Wei Zi (Schisandra Berry, *Schisandrae Chinensis Fructus*) 2 qian, Shi Chang Pu (Acorus Rhizome, *Acori Tatarinowii Rhizoma*) 1 qian. Decoct and take orally. After four doses, ringing in the ears should occur, signaling impending opening of deafness. Take ten more doses. Externally, grind Long Gu (Fossilized Bones, *Os Draconis*) 1 fen, Male Rat Gallbladder Juice 1 piece, She Xiang (Musk, *Moschus*) 1 li, Bing Pian (Borneol, *Borneolum Syntheticum*) 3 li into powder, form three pills, wrap in cotton, insert into the ear, do not remove for 24 hours, then hearing will clear. Extremely effective. Continue the internal formula for one day, then use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) for maintenance. Otherwise, effects may not last.
The Classics state: The ear is the orifice of the Kidney, which stores Essence. Loss of Essence leads to dark cheeks and deafness. The ear is the gathering place of the Zong (Grand) Vessels. In terms of orifices, it corresponds to Water; in terms of sound, to Metal; in terms of meridians, the Hand and Foot Shaoyang meridians converge here. Deafness arising from internal inability to hear relates to the Zang organs; deafness arising from external inability to enter relates to the meridians. Harmonious Kidney Qi allows hearing the five tones. Furthermore, deafness due to Qi rebellion has two types: Hand Taiyang Qi reversal causes deafness with fullness in the ear; Hand Shaoyang Qi reversal causes deafness with muffled hearing. Both are deafness due to Qi rebellion. Treatment uses Si Wu Tang (Four Substances Decoction) plus herbs that descend Fire and promote Qi flow. However, Zang Qi reversal causing Jue (Reversal) deafness presents with dizziness and fainting; Wind deafness presents with headache; fatigue damaging Qi and Blood, and sexual indulgence depleting Essence, causing confusion and dullness, is called Labor Deafness, presenting with deficiency signs. Noisy tinnitus and seeing black spots indicate Deficiency Deafness.
He further stated: For deafness caused by Damp-Heat, Phlegm, or Excess Qi, Bing Lang Wan (Areca Nut Pill) or Shen Xiong Wan (Divine Celery Pill) should be used to purge.
He further stated: Although the ear is primarily governed by the Foot Shaoyin (Kidney), among the twelve meridians, except for Foot Taiyang and Hand Jueyin, the remaining ten meridians enter the ear. Since the Kidney opens into the ear, treatment focuses on the Kidney. However, the Heart also opens into the ear. Why? Because the Heart's orifice is originally the tongue; since the tongue lacks pores, the orifice resides in the ear. The Kidney is the master of the ear orifice, the Heart is the guest. The Kidney governs internal Yin, the Heart governs external Yang. Clear, pure, and bright Qi ascends to the orifices, enabling acute hearing. Disharmony between these two meridians and imbalance of Yin and Yang cause sudden deafness. The Five Zang organs open into five regions. Differentiating by Yin/Yang: Kidney and Liver reside in Yin, governing the Yin Essence of the ear and eye orifices; Heart, Spleen, and Lung reside in Yang, governing the Yang Essence of the mouth, nose, and tongue orifices. Therefore, disharmony of the Five Zang blocks the seven orifices. Any meridian or collateral carrying Excess or Deficient Qi into the ear disrupts hearing, referring to acute disease. Chronic deafness differs in Kidney Excess or Deficiency. Left Kidney (Yin) governs Essence; Right Kidney (Yang) governs Qi. Insufficient Essence and Excess Qi cause Deficiency Deafness. Thin body, dark complexion, strong bones and muscles indicate Excess Essence and Qi, solid storage and blockage, causing Excess Deafness, a sign of longevity. Both result from congenital endowment. Dark cheeks with deafness indicate Essence depletion and Kidney exhaustion. Use An Shen Wan (Calming Kidney Pill), Ba Wei Wan (Eight-Ingredient Pill), or Cong Rong Wan (Cistanche Pill) as appropriate. Kidney Meridian Deficient Fire with red face, dry mouth, abundant phlegm, and internal heat is treated with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), addressing Yin Deficiency. Yang Deficiency also causes deafness. The Classics state: Clear Yang emerges from the upper orifices. Stomach Qi is Clear Qi, Original Qi, Spring Ascending Qi—same origin, different names. Modern people suffer dietary irregularities and fatigue, weakening Spleen-Stomach Qi. Unable to ascend, it flows downward to Kidney and Liver, blocking Yang Qi. Earthly Qi obscures, pathogens harm the orifices, blinding eyes and deafening ears—this is Yang Deficiency Deafness. Treat with Li Dongyuan's Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Heart Qi imbalance, where deficiency fails to control Yang, allowing it to join Yin, or excess relies on Yang to sever connection with Yin, reflects the Classic: "Extreme Yin deficiency leads to cessation of Heavenly Qi." Treat with modified Bu Xin Wan (Tonify Heart Pill). Earthly Qi obscuring due to unresolved sorrow, blocking Yin from communicating with Yang; or internal/external Damp-Fluids obstructing Qi, preventing ascending/descending, causing muffled hearing, should be treated with Yang-Raising and Damp-Resolving formulas. Regarding Yin Essence and Yang Qi: Ear and Eye are governed by Yin Essence, favoring coolness and disliking irritant heat; Mouth, Nose, Tongue are governed by Yang Qi, favoring warmth and disliking cold. Master Jiegu once argued that eyes and ears should not be tonified with warm herbs. *Ren Zhai Zhi Zhi* states: Kidney connects to the ear, governing Essence. Harmonious Essence and Qi, sufficient Kidney Qi, enable acute hearing. Proper regulation harmonizes Qi and Blood, gradually lightening deafness. Without self-restraint, daily fatigue, unrestrained desire, anger, alcohol, and rich/greasy foods render medication ineffective.