耳聋，少气嗌干者，为肺虚。东垣曰∶脏气法时论云，肺虚则少气不能报息，耳聋嗌干。注云∶
肺之络，会于耳中故聋，此说非也。盖气虚必寒，盛则气血俱涩滞而不行也。耳者，宗气也，肺气不
行故聋也。宜生脉散嚼下蜡弹丸。耳聋多恐者为肝虚。经云∶肝虚则目KT KT 无所见，耳无所闻，善
恐。治法用四物汤加防风、羌活、柴胡、菖蒲、茯神等分煎汤，服二十余帖，却用姜蝎散开之。本草
云∶肝虚则生姜补之是也。劳聋，宜益气聪明汤。头目不清，清神散。气闭不通，通气散，秘传降气
汤加菖蒲。外治，通神散、通耳法、追风散、蓖麻丸、雄黄散、透耳筒、鲫鱼胆膏、蝎稍膏、鼠胆丸、
鸡卵方、灸方、驴脂方、醋附方、龟尿方、干地龙方、鱼脑膏。
【久聋】蓖麻子丸、天雄鸡子方、通
气散、水银方、大蒜方、胜金透关散。
【暴聋】蒲黄膏、龙脑膏，川椒、巴豆、菖蒲、松脂以蜡熔为
筒子，内耳中，一日一易。或用雄黄一钱，巴豆肉一个，研细，葱涎和作锭子，纸卷塞耳中。或用凌
霄花
叶，杵自然汁滴耳中。罗谦甫云∶夫卒耳聋者，由肾气虚为风邪所乘，搏于经络，随其血脉上入耳，
正气与邪气相搏，故令卒聋也。娄全善云∶暴聋皆是厥逆之气。经云，暴厥而聋，偏塞闭不通，内气
暴搏也。又云，少阳之厥，暴聋是也。宜于前厥聋条求其治法。运气耳聋有四∶一曰湿邪伤肾三焦聋。
经云∶太阴在泉，湿淫所胜，民病耳聋，浑浑 ，治以苦热是也。二曰燥邪伤肝聋。经云∶岁金太
过，燥气流行，肝木受邪，民病耳聋无所闻是也。三曰火邪伤肺聋。经云∶岁火太过，炎暑流行，肺
金受邪，民病耳聋是也。四曰风火炎扰于上聋。经云∶少阳司天之政，风热参布，云物沸腾，民病聋
瞑。三之气，炎暑至，民病热中，聋瞑，治以寒剂是也。
耳聋，伴有气短、咽喉干燥的，属于肺虚。李东垣说：《脏气法时论》记载，肺虚则气短，呼吸不能接续，出现耳聋、咽喉干燥。注解说：肺的络脉交会于耳中，所以导致耳聋，这种说法是不正确的。因为气虚必然伴随寒象，邪气盛则气血都涩滞而不运行。耳是宗气汇聚之处，肺气不运行所以导致耳聋。适宜用生脉散嚼服蜡弹丸。耳聋多伴有恐惧感的，属于肝虚。经书说：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防风、羌活、柴胡、石菖蒲、茯神等量煎汤，服用二十多帖后，再用姜蝎散来开通窍道。本草书籍说：肝虚则用生姜补益，正是这个意思。因劳累导致的耳聋（劳聋），适宜用益气聪明汤。头目不清爽，用清神散。气机闭塞不通，用通气散，或秘传降气汤加石菖蒲。外治法包括：通神散、通耳法、追风散、蓖麻丸、雄黄散、透耳筒、鲫鱼胆膏、蝎稍膏、鼠胆丸、鸡卵方、灸方、驴脂方、醋附方、龟尿方、干地龙方、鱼脑膏。
【久聋】（慢性耳聋）：蓖麻子丸、天雄鸡子方、通气散、水银方、大蒜方、胜金透关散。
【暴聋】（突发耳聋）：蒲黄膏、龙脑膏；或用川椒、巴豆、石菖蒲、松脂用蜡熔化做成筒状，塞入耳中，每天更换一次。或者用雄黄一钱，巴豆仁一个，研细，用葱汁调和做成锭子，用纸卷好塞入耳中。或者用凌霄花叶，捣取自然汁滴入耳中。罗谦甫说：突然耳聋，是由于肾气虚被风邪乘虚而入，搏结于经络，随着血脉上行进入耳中，正气与邪气相搏结，所以导致突然耳聋。娄全善说：突发耳聋都是厥逆之气所致。经书说，突然厥逆而耳聋，偏侧闭塞不通，是内部气机突然搏击所致。又说，少阳经的厥逆，表现为突发耳聋。应当在前面“厥聋”条目中寻求治疗方法。运气学说中的耳聋有四种：一是湿邪伤肾及三焦导致的耳聋。经书说：太阴在泉之年，湿气过盛，百姓患病耳聋，声音浑浊，治疗用苦热药物，正是此意。二是燥邪伤肝导致的耳聋。经书说：岁运金气太过，燥气流行，肝木受邪，百姓患病耳聋听不见声音，正是此意。三是火邪伤肺导致的耳聋。经书说：岁运火气太过，炎热暑气流行，肺金受邪，百姓患病耳聋，正是此意。四是风火炎上扰头目导致的耳聋。经书说：少阳司天之政，风热散布，云物沸腾，百姓患病耳聋目眩。在三之气阶段，炎热暑气到来，百姓患热中证，耳聋目眩，治疗用寒凉药剂，正是此意。
Deafness accompanied by shortness of breath and dryness of the throat indicates deficiency of Lung Qi (Lung Qi Deficiency). Li Dongyuan stated: The *Treatise on Zang-Qi Corresponding to Time* records that when Lung Qi is deficient, there is shortness of breath with inability to complete inhalation, along with deafness and dryness of the throat. The commentary claims that the collaterals of the Lung converge in the ear, thus causing deafness; this view is incorrect. In fact, Qi deficiency inevitably involves cold; when pathogenic factors are excessive, both Qi and Blood become stagnant and fail to circulate. The ear is the gathering place of Zong Qi (Pectoral Qi); when Lung Qi fails to circulate, deafness occurs. It is appropriate to administer Shengmai San (Generate the Pulse Powder) chewed with wax pills. Deafness accompanied by frequent fear indicates deficiency of Liver Blood (Liver Blood Deficiency). The classics state: When Liver Blood is deficient, vision becomes blurred, hearing is impaired, and one is prone to fear. The treatment method involves decocting Siwu Tang (Four Substances Decoction) with equal parts of Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Chaihu (Bupleurum Root), Shichangpu (Acorus Rhizome), and Fushen (Poria with Hostwood) in water. After taking more than twenty doses, follow up with Jiangxie San (Ginger and Scorpion Powder) to open the orifices. Materia Medica texts state that for Liver deficiency, Ginger tonifies it, which is correct. For deafness caused by overwork (Labor-induced Deafness), Yiqi Congming Tang (Qi-Boosting and Brightening Decoction) is appropriate. For cloudiness of the head and eyes, Qingshen San (Spirit-Clearing Powder) is used. For obstruction of Qi mechanism, Tongqi San (Unblocking Qi Powder) or the secret formula Jiangqi Tang (Descending Qi Decoction) added with Shichangpu (Acorus Rhizome) is indicated. External treatments include: Tongshen San (Spirit-Unblocking Powder), Tong'er Fa (Ear-Unblocking Method), Zhuifeng San (Wind-Chasing Powder), Bimawan (Castor Bean Pill), Xionghuang San (Realgar Powder), Tou'er Tong (Ear-Penetrating Tube), Jiyu Dan Gao (Crucian Carp Gall Bladder Ointment), Xiexiao Gao (Scorpion Tip Ointment), Shudan Wan (Rat Gall Bladder Pill), Ji'uan Fang (Chicken Egg Formula), Moxibustion Formula, Lvzi Fang (Donkey Fat Formula), Cu Fu Fang (Vinegar-Processed Aconite Formula), Gui Niao Fang (Turtle Urine Formula), Gan Dilong Fang (Dried Earthworm Formula), and Yunaogan (Fish Brain Ointment).
[Chronic Deafness]: Bimazi Wan (Castor Seed Pill), Tianxiong Jizi Fang (Aconite and Chicken Egg Formula), Tongqi San (Unblocking Qi Powder), Shuiyin Fang (Mercury Formula), Dasuan Fang (Garlic Formula), Shengjin Touguan San (Golden-Success Orifice-Penetrating Powder).
[Sudden Deafness]: Puhuang Gao (Polygonatum Pollen Ointment), Longnao Gao (Borneol Ointment); or use Sichuan Pepper, Croton Seed, Acorus Rhizome, and Pine Resin melted with wax into a tube shape, inserted into the ear, changed once daily. Alternatively, use 1 qian of Realgar and one kernel of Croton Seed, ground finely, mixed with green onion juice to form a pellet, wrapped in paper, and inserted into the ear. Or use leaves and flowers of Campsis grandiflora, pounded to extract natural juice, and dripped into the ear. Luo Qianfu stated: Sudden deafness arises from Kidney Qi deficiency allowing Wind Pathogens to invade, binding to the collaterals and ascending via blood vessels into the ear. The Righteous Qi clashes with the Pathogenic Qi, resulting in sudden deafness. Lou Quanshan stated: All cases of sudden deafness are due to Jue Ni (Rebellious Qi). The classics state: Sudden Jue syndrome with deafness, characterized by unilateral blockage and obstruction, results from violent internal Qi agitation. It also states: Jue of the Shaoyang channel manifests as sudden deafness. One should seek treatment methods under the previous "Jue Deafness" section. According to the theory of Six Qi transformations, there are four types of deafness: First, Dampness Pathogen injuring the Kidney and Sanjiao (Triple Burner) causing deafness. The classics state: When Taiyin is in the泉 (subterranean position), excessive Dampness causes people to suffer from deafness with muffled hearing; treatment uses bitter-hot herbs, which corresponds to this. Second, Dryness Pathogen injuring the Liver causing deafness. The classics state: When Metal Qi is excessive in the year, Dryness prevails, injuring Wood of the Liver, causing people to suffer from deafness and inability to hear, which corresponds to this. Third, Fire Pathogen injuring the Lung causing deafness. The classics state: When Fire Qi is excessive in the year, intense heat prevails, injuring Metal of the Lung, causing people to suffer from deafness, which corresponds to this. Fourth, Wind and Fire flaming upward disturbing the head causing deafness. The classics state: When Shaoyang governs the Heavenly Qi, Wind and Heat are distributed, clouds and phenomena boil; people suffer from deafness and dizziness. During the third Qi phase, intense heat arrives, causing people to suffer from interior heat syndrome, deafness, and dizziness; treatment uses cold-natured agents, which corresponds to this.