经曰∶肾开窍于耳，耳为肾之外候。又曰∶肾者，作强之官，技巧出焉。又曰∶脱精者则耳
聋。又曰∶心通窍于耳，阳气上甚而跃，故耳鸣也。夫肾经寄窍于耳，所藏者精，所纳者气。精
气调和，肾经充足，则耳聪矣。若劳伤气血，耗损精髓；或酒醪浓味，痰火上升；或素多郁怒，
气逆于上；或大病后皆致耳鸣。设若精脱肾惫，则为聋矣。有厥、风、阴、热、气、劳诸聋，名
虽种种；感受无出肾虚所致。又有邪热乘虚随脉入耳，作耵耳、脓耳之证，亦皆热候。脉尺部洪
盛为火，濡涩而短为阴虚。治宜补肾，壮水制火。
主方 （肾虚耳鸣）黄柏（盐酒炒） 知母（盐酒炒） 当归 川芎 白芍 柴胡 生地（
各一钱） 麦冬 五味子（各七分）
上水煎，空心服。
疏肝清耳汤 治左耳鸣聋，恚怒气郁，肝火炎灼。
黄连 黄芩 栀子 当归 青皮 胆星（各一钱） 香附 龙胆草 玄参（各七分） 青黛
木香（各五分） 焦姜（三分）
上锉，加生姜三片，水煎服。
补肾养阴汤 治右耳鸣聋，属肾不足，命门火盛。
黄柏（酒炒） 知母（酒炒） 山药 山茱萸 牡丹皮 泽泻 白芍 白茯苓 石菖蒲 远志
当归 川芎（各八分） 熟地（一钱五分）
上锉水煎，空心温服。
清炎宁痛汤 治耳痛。
黄连 黄芩（酒炒） 连翘 玄参 蔓荆子 当归 白芍 山栀 防风 川芎 柴胡（等分）
上水煎服。
平肝清胃丸 治耳聋耳鸣。因于饮食浓味，挟怒气以动肝胃之火。
枯芩 黄连 白芍（俱酒炒） 生地（酒洗） 柴胡 半夏（各七钱） 人参（五钱） 青
皮（醋炒，五钱） 赤茯苓 蔓荆（各一两） 甘草（二钱）
上为末，葱汤浸，蒸饼为丸绿豆大。每服百丸，食远，姜、茶汤下。
补肾丸 治肾虚耳鸣、耳聋。
芍药 山茱萸 干姜（炮） 巴戟（去心） 泽泻 菟丝子（制饼） 桂心 远志（取肉）
黄 细辛 石斛 干地黄 附子（炮） 蛇床子（酒浸） 当归 牡丹皮 肉苁蓉（酒浸）
人参（各三两） 菖蒲 茯苓（各一两） 防风 甘草（各半两） 羊肾（二枚）
上为末，以羊肾研细，酒糊丸桐子大，每服五十丸，盐酒下。
益气聪明汤 治饮食不节，劳役形体，脾胃不足，得受内障、耳聋之患。服此令人精神过
倍，元气自益，轻身健体，耳目聪明。
黄柏（酒炒） 芍药（各五分） 蔓荆子 升麻 葛根 人参 黄 甘草（各一钱）
上水二盏，煎至一盏，临卧时服。
黍粘子汤 治耳痛生疮。
苏木 黍粘子 生甘草 昆布 龙胆草 连翘 蒲黄 黄芩 当归梢（各五分） 红花（少
许） 桔梗（一钱） 生地黄 柴胡 黄 （各四分） 黄连（三分） 桃仁（三粒，另研）
水煎，食后服。忌凉药。
两耳聋，脓耳、耵耳，上焦痰火，并宜凉膈散、神芎丸、当归龙荟丸（方见胁痛） 防风通
圣散（方见中风）；痰火，滚痰丸（方见痰门）诸方采用。
耳鸣、聋因火者，吴茱萸、草乌尖、大黄，三味为末，津调涂足底，引火下行。
耳鸣、耳塞，用石菖蒲、肥巴豆（一粒，去壳）、全蝎（一个），共为末，葱涎为丸。如枣
核，绵裹塞耳。或用生川乌为末，绵裹塞耳。或用磁石（能引针者，豆大），穿山甲（炒为末
各三分）；二味绵裹塞二耳，口含少生铁，觉耳内如风声、愈。
简便方 （治耳聋塞） 芥菜子捣烂，人乳调，绵裹塞。
又方 雄黄、硫黄研，绵裹塞；或蓖麻肉（五粒）、熟枣（一个），乳汁研丸，塞，日一换
（晒干易丸。）或大蒜（一瓣，剜孔），入巴豆（一粒），慢火炮熟，研丸塞。或骨碎补削成条，火
煨乘热塞；或鲜乌头削塞；或巴豆（一粒）、斑蝥（一个，去翅），研塞；或巴豆一个，针透眼
，塞耳中。
耳鸣及脓∶用香附为末，砂锅煎，萝卜种汤调二钱服。
耳大痛或有血水∶蛇蜕烧灰，用鹅毛管吹入耳。
耵耳出脓∶方见幼科耵耳门。
诸虫入耳∶香油滴入自出。或桃叶卷筒切齐塞（捣塞亦可；）或蒜汁滴入；或姜、韭、葱、
酱、醋汁皆可滴。
耳冻疮∶用橄榄核烧灰，清油调搽。耳痛，盐炒包熨。
古籍记载：肾开窍于耳，耳是肾脏功能外在表现的窗口。又说：肾是负责强力工作的官职，技巧由此产生。又说：精气耗脱的人会出现耳聋。又说：心通过窍道与耳相通，阳气上亢过度而跳动，所以出现耳鸣。肾经寄居的窍道在耳，所贮藏的是精，所纳受的是气。精气调和，肾经充足，耳朵就能听觉灵敏。如果劳倦损伤气血，耗损精髓；或者嗜好浓烈酒水和厚味食物，导致痰火上升；或者平素多郁怒，气机逆乱向上；或者大病之后，都会导致耳鸣。假如精气耗脱、肾气疲惫，就会变成耳聋。有厥聋、风聋、阴聋、热聋、气聋、劳聋等多种类型，名称虽然繁多，但感受病因无外乎肾虚所致。又有邪热乘虚随经脉进入耳部，形成耵聍栓塞（耵耳）、化脓性中耳炎（脓耳）的病证，也都属于热证表现。脉象尺部洪盛为火邪，濡涩且短为阴虚。治疗应当补肾，壮水以制约火邪。
主方（针对肾虚耳鸣）：黄柏（用盐和酒炒制）、知母（用盐和酒炒制）、当归、川芎、白芍、柴胡、生地（各一钱）、麦冬、五味子（各七分）。以上药材用水煎煮，空腹服用。
疏肝清耳汤：治疗左耳鸣聋，因愤怒气郁，肝火炎灼所致。黄连、黄芩、栀子、当归、青皮、胆南星（各一钱）、香附、龙胆草、玄参（各七分）、青黛、木香（各五分）、焦姜（三分）。以上药材切碎，加生姜三片，用水煎服。
补肾养阴汤：治疗右耳鸣聋，属肾不足，命门火盛。黄柏（酒炒）、知母（酒炒）、山药、山茱萸、牡丹皮、泽泻、白芍、白茯苓、石菖蒲、远志、当归、川芎（各八分）、熟地（一钱五分）。以上药材切碎，用水煎煮，空腹温服。
清炎宁痛汤：治疗耳痛。黄连、黄芩（酒炒）、连翘、玄参、蔓荆子、当归、白芍、山栀、防风、川芎、柴胡（等量分配）。以上药材用水煎服。
平肝清胃丸：治疗耳聋耳鸣。因饮食浓味，挟带怒气而动肝胃之火。枯芩、黄连、白芍（均酒炒）、生地（酒洗）、柴胡、半夏（各七钱）、人参（五钱）、青皮（醋炒，五钱）、赤茯苓、蔓荆子（各一两）、甘草（二钱）。以上药材研为末，用葱汤浸泡，蒸饼制成如绿豆大小的丸剂。每次服用一百丸，饭后服用，用姜、茶送下。
补肾丸：治疗肾虚耳鸣、耳聋。芍药、山茱萸、干姜（炮制）、巴戟天（去心）、泽泻、菟丝子（制饼）、桂心、远志（取肉）、黄芪、细辛、石斛、干地黄、附子（炮制）、蛇床子（酒浸）、当归、牡丹皮、肉苁蓉（酒浸）、人参（各三两）、石菖蒲、茯苓（各一两）、防风、甘草（各半两）、羊肾（二枚）。以上药材研为末，将羊肾研细，用酒糊制成如梧桐子大小的丸剂。每次服用五十丸，用盐酒送下。
益气聪明汤：治疗饮食不节制，劳役形体，脾胃不足，从而患上内障、耳聋之患。服用此药使人精神加倍，元气自益，身体轻健，耳目聪明。黄柏（酒炒）、芍药（各五分）、蔓荆子、升麻、葛根、人参、黄芪、甘草（各一钱）。以上药材用两盏水，煎至一盏，临睡前服用。
黍粘子汤：治疗耳痛生疮。苏木、黍粘子、生甘草、昆布、龙胆草、连翘、蒲黄、黄芩、当归梢（各五分）、红花（少许）、桔梗（一钱）、生地黄、柴胡、黄芪（各四分）、黄连（三分）、桃仁（三粒，另研）。用水煎煮，饭后服用。忌服凉药。
双耳耳聋、脓耳、耵耳，以及上焦痰火，都适宜采用凉膈散、神芎丸、当归龙荟丸（方见胁痛篇）、防风通圣散（方见中风篇）；若是痰火，则采用滚痰丸（方见痰门篇）等方剂。
耳鸣、耳聋因火邪引起的，用吴茱萸、草乌尖、大黄，三味药研为末，用唾液调匀涂于足底，以引火下行。
耳鸣、耳塞，用石菖蒲、肥巴豆（一粒，去壳）、全蝎（一个），共研为末，用葱汁制成丸剂。如枣核大小，用棉包裹塞入耳中。或者用生川乌研为末，棉包裹塞入耳中。或者用磁石（能吸住针的，豆大）、穿山甲（炒为末，各三分）；这两味药用棉包裹塞入双耳，口中含少量生铁，感觉耳内如有风声，即可痊愈。
简便方（治疗耳聋塞）：芥菜子捣烂，用人乳调匀，棉包裹塞入耳中。
又一方：雄黄、硫黄研碎，棉包裹塞入；或者蓖麻肉（五粒）、熟枣（一个），乳汁研丸，塞入，每天更换一次（晒干后易丸）。或者大蒜（一瓣，挖孔），放入巴豆（一粒），慢火烤熟，研丸塞入。或者骨碎补削成条状，火煨后趁热塞入；或者鲜乌头削成条塞入；或者巴豆（一粒）、斑蝥（一个，去翅），研碎塞入；或者巴豆一个，针透眼，塞入耳中。
耵聍出脓：方法见儿科耵聍门。
诸虫入耳：滴入香油，虫子会自动出来。或者用桃叶卷筒切齐塞入（捣碎塞入也可以）；或者滴入蒜汁；或者姜、韭、葱、酱、醋汁都可以滴入。
As stated in ancient texts: The Kidney opens into the ears, and the ears are the external manifestation of the Kidney. It is also said: The Kidney is the official responsible for strength and vigor, and skills emerge from it. It is further stated: Those who suffer from depletion of essence will experience deafness. It is also said: The Heart connects to the ears through orifices; when Yang Qi ascends excessively and throbs, tinnitus occurs. The Kidney Meridian resides in the ear orifice, storing Essence (Jing) and receiving Qi. When Essence and Qi are harmonious and the Kidney Meridian is sufficient, hearing becomes acute. However, if labor and fatigue damage Qi and Blood, depleting Marrow and Essence; or if one indulges in strong wines and rich flavors, causing Phlegm-Fire to ascend; or if one is prone to depression and anger, leading to rebellious Qi moving upward; or after a major illness, all these can lead to tinnitus. If Essence is depleted and the Kidney is exhausted, deafness ensues. There are various types of deafness such as Jue Deafness, Wind Deafness, Yin Deafness, Heat Deafness, Qi Deafness, and Labor Deafness. Although names vary, the pathogenic factors essentially stem from Kidney Deficiency. Additionally, Pathogenic Heat may enter the ear via meridians due to deficiency, resulting in conditions like Aural Cerumen Impaction (Ding Er) and Otorrhea/Otitis Media (Nong Er), which are also manifestations of Heat syndromes. A full and vigorous pulse at the Chi position indicates Fire, while a soggy, choppy, and short pulse indicates Yin Deficiency. Treatment should focus on tonifying the Kidney and strengthening Water to control Fire.
Main Formula (for Kidney Deficiency Tinnitus): Huangbai (Phellodendri Cortex, stir-fried with salt and wine), Zhimu (Anemarrhenae Rhizoma, stir-fried with salt and wine), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix), Shengdi (Rehmanniae Radix) (each 1 qian); Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus) (each 7 fen). Decoct with water and take on an empty stomach.
Shugan Qing'er Tang (Liver-Soothing and Ear-Clearing Decoction): Treats left-sided tinnitus and deafness caused by anger and qi stagnation, with Liver Fire blazing. Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Danningxing (Arisaematis Cum Bile), Xiangfu (Cyperi Rhizoma), Longdancao (Gentianae Radix), Xuanshen (Scrophulariae Radix) (each 1 qian); Qingdai (Indigo Naturalis), Muxiang (Aucklandiae Radix) (each 5 fen); Jiaojang (Zingiberis Rhizoma Carbonisatum) (3 fen). Chop the herbs, add three slices of fresh ginger, decoct with water, and take orally.
Bushen Yangyin Tang (Kidney-Tonifying and Yin-Nourishing Decoction): Treats right-sided tinnitus and deafness due to Kidney insufficiency and hyperactivity of Mingmen Fire. Huangbai (Phellodendri Cortex, wine-fried), Zhimu (Anemarrhenae Rhizoma, wine-fried), Shanyao (Dioscoreae Rhizoma), Shanzhuyu (Corni Fructus), Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), Baishao (Paeoniae Radix Alba), Bai Fuling (Poria), Shichangpu (Acori Tatarinowii Rhizoma), Yuanzhi (Polygalae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 8 fen); Shudi (Rehmanniae Radix Preparata) (1.5 qian). Chop the herbs, decoct with water, and take warm on an empty stomach.
Qingyan Ningtong Tang (Heat-Clearing and Pain-Calming Decoction): Treats otalgia. Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix, wine-fried), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Manjingzi (Viticis Semen), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shanzhi (Gardeniae Fructus), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix) (equal parts). Decoct with water and take orally.
Pinggan Qingwei Wan (Liver-Pacifying and Stomach-Clearing Pill): Treats deafness and tinnitus caused by rich dietary intake combined with anger stirring up Liver and Stomach Fire. Kuqing (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Baishao (Paeoniae Radix Alba, all wine-fried), Shengdi (Rehmanniae Radix, wine-washed), Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma) (each 7 qian); Renshen (Ginseng Radix et Rhizoma) (5 qian); Qingpi (Citri Reticulatae Pericarpium Viride, vinegar-fried, 5 qian); Chi Fuling (Poria with Red Host), Manjingzi (Viticis Semen) (each 1 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian). Grind into powder, soak in scallion juice, steam, and form pills the size of mung beans. Take 100 pills per dose after meals, washed down with ginger and tea.
Bushen Wan (Kidney-Tonifying Pill): Treats Kidney Deficiency tinnitus and deafness. Shaoyao (Paeoniae Radix), Shanzhuyu (Corni Fructus), Ganjiang (Zingiberis Rhizoma, processed), Bajitian (Morindae Officinalis Radix, heart removed), Zexie (Alismatis Rhizoma), Tusizi (Cuscutae Semen, prepared as cake), Guixin (Cinnamomi Ramulus), Yuanzhi (Polygalae Radix, flesh taken), Huangqi (Astragali Radix), Xixin (Asari Radix et Rhizoma), Shihu (Dendrobii Caulis), Gadihuang (Rehmanniae Radix), Fuzi (Aconiti Lateralis Radix Praeparata, processed), Chuangzi (Cnidii Fructus, soaked in wine), Danggui (Angelicae Sinensis Radix), Mudanpi (Moutan Cortex), Rongshunrong (Cynomorchii Herba, soaked in wine), Renshen (Ginseng Radix et Rhizoma) (each 3 liang); Changpu (Acori Tatarinowii Rhizoma), Fuling (Poria) (each 1 liang); Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each half liang); Yangshen (Ovis Testis) (2 pieces). Grind into powder, finely grind the sheep kidneys, mix with rice paste made from wine, and form pills the size of paulownia seeds. Take 50 pills per dose, washed down with salted wine.
Yiqi Congming Tang (Qi-Replenishing and Acuity-Enhancing Decoction): Treats internal obstruction and deafness caused by irregular diet, physical overwork, and Spleen-Stomach insufficiency. Taking this formula doubles mental energy, benefits primal Qi, lightens the body, strengthens the physique, and enhances hearing and vision. Huangbai (Phellodendri Cortex, wine-fried), Shaoyao (Paeoniae Radix) (each 5 fen); Manjingzi (Viticis Semen), Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian). Use two cups of water, decoct until one cup remains, and take before retiring.
Shuniuzi Tang (Arnebiae Semen Decoction): Treats otalgia with sores. Sumu (Sappan Lignum), Shuniuzi (Arnebiae Semen), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Kunbu (Laminariae Thallus), Longdancao (Gentianae Radix), Lianqiao (Forsythiae Fructus), Puhuang (Typhae Pollen), Huangqin (Scutellariae Radix), Danggui Shao (Angelicae Sinensis Radix Tip) (each 5 fen); Honghua (Carthami Flos, a small amount); Jiegeng (Platycodonis Radix) (1 qian); Sheng Dihuang (Raw Rehmanniae Radix), Chaihu (Bupleuri Radix), Huangqi (Astragali Radix) (each 4 fen); Huanglian (Coptidis Rhizoma) (3 fen); Taoren (Persicae Semen, 3 grains, ground separately). Decoct with water and take after meals. Avoid cold-natured medicines.
For bilateral deafness, otorrhea, aural cerumen impaction, and upper jiao Phlegm-Fire, suitable formulas include Liangge San (Cool the Diaphragm Powder), Shenxiong Wan (Divine Celery Pill), Danggui Longhui Wan (Angelica Gentian Pill) (see Hypochondriac Pain section), Fangfeng Tongsheng San (Saposhnikovia Releasing the Exterior and Generating Strength Powder) (see Stroke section); for Phlegm-Fire, use Tun Tan Wan (Rolling Phlegm Pill) (see Phlegm Section).
For tinnitus and deafness caused by Fire, use Wuzhuyu (Evodiae Fructus), Caowujian (Aconiti Kusnezoffii Radix Tip), and Dahuang (Rhei Radix et Rhizoma). Grind into powder, mix with saliva, apply to the sole of the foot to guide Fire downward.
For tinnitus and ear blockage, use Shichangpu (Acori Tatarinowii Rhizoma), Fei Badou (Fat Crotonis Semen, 1 grain, shell removed), and Quanxie (Scorpio). Grind into powder, mix with scallion juice to form pills. Size of a date pit, wrap in cotton, and insert into the ear. Alternatively, use raw Chuanwu (Aconiti Radix) powder wrapped in cotton and inserted into the ear. Or use Cishi (Magnetitum, capable of attracting needles, bean-sized) and Chanshunjia (Manis Squama, fried and powdered, each 3 fen); wrap both in cotton and insert into both ears, while holding a small piece of raw iron in the mouth. Hearing improvement is indicated by a sensation of wind in the ears.
Simple Prescription (for ear blockage/deafness): Crush Mustard Seed (Jiecaizi), mix with human milk, wrap in cotton, and insert into the ear.
Another Method: Grind Xionghuang (Realgar) and Liuhuang (Sulfur), wrap in cotton, and insert. Or mix Hemp Seed (Bimaren Rou, 5 grains) with a ripe Jujube (one), grind with milk to form pills, insert, and change once daily (dry and reform if necessary). Or take Garlic (one clove, hollowed), insert Badou (one grain), roast slowly until cooked, grind into pills, and insert. Or carve Gusuibu (Drynariae Rhizoma) into strips, roast over fire, and insert while hot. Or carve fresh Wutou (Aconiti Radix) and insert. Or mix Badou (one grain) with Banmao (Mylabris, one, wings removed), grind, and insert. Or pierce a hole through one Badou grain and insert into the ear.
For tinnitus and purulent discharge: Grind Xiangfu (Cyperi Rhizoma) into powder, decoct in a clay pot, and take 2 qian mixed with radish seed soup.
For severe ear pain or bloody discharge: Burn Snake Skin (Shetui) to ash, and blow into the ear using a goose feather tube.
For aural cerumen with pus: See Pediatric Section on Aural Cerumen.
For insects entering the ear: Drip sesame oil; the insect will exit naturally. Or roll peach leaves into a tube, cut evenly, and insert (crushed insertion is also acceptable). Or drip garlic juice. Or juices from ginger, leek, scallion, soy sauce, or vinegar can be dripped in.
For frostbite of the ear: Burn olive pits to ash, mix with clear oil, and apply. For ear pain, stir-fry salt, wrap in cloth, and apply as a warm compress.