犀角(镑) 木通 石菖蒲 甘菊花(去蒂) 玄参 赤芍 赤小豆(炒)各二钱 甘
草(炙)
一钱
水二钟,煎至一钟,不拘时服。
磁石(制) 巴戟 川椒各一两(去闭口者) 石菖蒲 沉香各五钱
上为细末,每服二钱,用猪肾一只,细切,和以葱白小盐,并药湿纸十层裹,煨令香熟,
空
合论桂星散,犀角饮子、益肾散三方,治风虚、风热、肾气厥三者,皆属耳之暴聋,虽
各有
其
之
利
从
规
玄
寄
闭塞不聪,此即《经》言地气冒明也,由于肾经浊阴上逆,蒙蔽其阳,治以益肾散,辛热发
其阳,重坠镇其逆。然亦不可久服。河间、洁古二老论曰∶耳目不可以温补也。喻嘉言曰∶
凡治年高肾气逆上而耳不聪者,当以磁石镇之,但性主下吸,不能制肝木之上吸,须佐以地
黄、山药等群阴之药辅之,令阴气自王于本宫,不上触于阳窍,自然空旷无碍而能听矣,是
亦治肾虚耳聋之良图也。至于精髓告竭,宗脉耗损者,即有填补之方,终难复聪,不复多赘。
白芷一两 辛荑仁五钱 苍耳仁(炒去皮)二钱半 薄荷叶五钱
上为细末,每服一钱,葱汤或茶清调服。
《准绳》芷辛散,专治鼻渊。《三因方》易名苍耳散,又谓其统治鼻中之病。按《灵枢》
云
阴
则能入里托散鼻中之病矣。苍耳仁善通顶脑,去鼻中恶肉死肌,薄荷叶气味俱薄,能清至高
之风热。合而言之,风火在上,非辛散不能愈也。再按,《经》言∶胆移热于脑,则为鼻渊
,是胆热为病之本矣。余谓前方与黄芩、鲜生地、天麦冬同用,以清胆热,亦治本之理欤?
犀角(镑片) 木通 石菖蒲 甘菊花(去蒂) 玄参 赤芍 赤小豆(炒)各二钱 甘草(炙)一钱。水两碗,煎至一碗,不拘时候服用。
磁石(炮制) 巴戟天 川椒各一两(去除闭口者) 石菖蒲 沉香各五钱。以上药物研为细末,每次服用二钱,用猪肾一只,切细,与葱白、少量盐及药末混合,用湿纸十层包裹,煨烤至香熟,空腹时合论桂星散、犀角饮子、益肾散三方,治疗风虚、风热、肾气厥三种情况,都属于耳部突然失聪,虽然各有其利,但从规范来看,玄参寄于闭塞不聪,这就是《内经》所说的地气冒明,由于肾经浊阴上逆,蒙蔽其阳,治疗以益肾散,辛热发散其阳,重坠镇摄其逆。然而也不可久服。河间、洁古两位老医论述说:耳目不可以温补。喻嘉言说:凡是治疗年高肾气逆上而耳不聪的人,应当用磁石镇摄,但磁石性主下吸,不能制约肝木之上吸,必须佐以地黄、山药等群阴之药辅助,令阴气自然旺盛于本宫,不上触于阳窍,自然空旷无碍而能听矣,这也是治疗肾虚耳聋的良好方案。至于精髓枯竭,宗脉耗损的,即使有填补的方剂,终究难以恢复听力,不再多赘述。
白芷一两 辛荑仁五钱 苍耳仁(炒去皮)二钱半 薄荷叶五钱。以上药物研为细末,每次服用一钱,用葱汤或茶清调服。《准绳》中的芷辛散,专门治疗鼻渊。《三因方》改名为苍耳散,又说它统治鼻中的疾病。按《灵枢》所说,阴则能入里托散鼻中的疾病了。苍耳仁善于通顶脑,去除鼻中恶肉死肌,薄荷叶气味俱薄,能清至高之风热。合而言之,风火在上,非辛散不能痊愈。再按,《内经》说:胆移热于脑,则为鼻渊,是胆热为病的根本了。我认为前方与黄芩、鲜生地、天麦冬同用,以清胆热,也是治本的道理吗?
Rhino-cornu (sliced) Tongmu Shichangpu Ganjuhua (stalk removed) Xuanshen Chishao Chixiaodou (stir-fried) each 2 qian Gancao (roasted) 1 qian. With two bowls of water, decoct to one bowl, take at any time.
Cishi (processed) Bajitian Chuanjiao each 1 liang (remove closed-mouth ones) Shichangpu Chenxiang each 5 qian. The above are ground into fine powder, take 2 qian per dose, use one pig kidney, finely cut, mix with scallion white and a little salt, wrap in ten layers of wet paper with the medicine, roast until fragrant and cooked, take on an empty stomach. Discussing Guixing San, Xijiao Yinzi, Yishen San together, these three formulas treat wind deficiency, wind-heat, and kidney qi jue, all belonging to sudden deafness of the ear. Although each has its advantages, from the perspective of norms, Xuanshen is associated with blockage and lack of hearing, which is what the *Classic* calls "earth qi obscuring brightness," due to turbid yin of the kidney meridian reversing upward, covering its yang. Treat with Yishen San, using acrid-hot herbs to disperse its yang, and heavy-sinking herbs to suppress its reversal. However, it should not be taken for a long time. Hejian and Jiegu, two old masters, discussed: The ears and eyes cannot be tonified with warmth and tonification. Yu Jiayan said: For those of advanced age whose kidney qi reverses upward causing poor hearing, one should use Cishi to anchor it, but its nature is primarily downward absorption, unable to control the upward absorption of liver wood. It must be assisted by group-yin herbs such as Dihuang and Shanyao, allowing yin qi to naturally flourish in its home palace, not touching the yang orifices upward, naturally becoming spacious and unobstructed so that hearing can be restored. This is also a good plan for treating kidney deficiency deafness. As for those whose essence and marrow are exhausted and zong mai are damaged, even if there are filling formulas, it is ultimately difficult to restore hearing, so no more will be added.
Baizhi 1 liang Xinti Ren 5 qian Cang'er Ren (stir-fried, skin removed) 2.5 qian Boheye 5 qian. The above are ground into fine powder, take 1 qian per dose, mix with scallion soup or clear tea. *Zhunsheng*'s Zhixin San specifically treats biyuan (nasal sinusitis). *Sanyin Fang* changes the name to Cang'er San, and says it governs diseases of the nose. According to *Ling Shu*: Yin can enter the interior and disperse nasal diseases. Cang'er Ren is good at penetrating the top of the brain, removing evil flesh and dead muscle from the nose. Boheye has thin aroma and taste, able to clear wind-heat from the highest region. Combined, wind and fire are above, only acrid dispersal can cure them. Furthermore, the *Classic* states: Gallbladder transferring heat to the brain causes biyuan; thus gallbladder heat is the root of the disease. I believe the previous formula used with Huangqin, fresh Dihuang, Tian Maidong, and Mai Dong, to clear gallbladder heat, is also the principle of treating the root?