第四节眼耳鼻喉科
牙衄
牙衄，亦称齿衄，因手足阳明经俱入齿中，所以医者多从阳叫火热立论，然若久久不愈者，又以此法治之多无效果。例如：患者赵×，男，6l岁。冠心病心绞痛，心律失常反复发作数年。近5个多月来，牙龈又见反复出血，早晨特别严重，经常满口是血。某院先以西药治之不效，后又配合中药数十剂仍无效。审视其证，除齿衄外，并见时时心烦心悸，胸满胸痛，腰酸腰痛，疲乏无力，舌苔薄白，脉沉细结代。再审其所用中药，大都为清胃泻火，滋阴降火之剂，然始终微效未见。因思脉证，腰酸腰痛者，肾虚也；脉沉细结代者，阳虚寒滞之脉也；心悸心烦时作者，肾水上泛之证也。前医所用清泻胃火，滋阴泻火之法不效者，乃仅治其火，而未温其阳也，法宜补肾温阳，引火归原。十味地黄汤加减：生地15克，山药9克，五味子9克，肉苁蓉9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参12克，麦冬12克，怀牛膝12克。某医视此方后，云：齿衄诸书皆曰火，火者当熄，然老师反以附、桂以助火势，火气怎降?答曰：龙雷之火者非温阳其火不熄，正如离照当空雷火自除耳。该医初疑信参半。后服药8剂，衄血停止。该医又云：余始知龙雷之火当如何治之也。
张××，女，成。牙龈流血，时轻时重十几年。先请某院口腔科、内科等以西药治之，不效，后又请某院中医以清胃泻火，滋阴降火之剂治之仍无效。审视其证，齿龈上有少量血，按压时有少量血液渗出，吃饭，刷牙均使出血加重，别无所苦，舌苔薄白，脉沉细尺大而弦。深思良久，云：尺脉者，属肾；弦脉者，主寒；阳虚火浮，非温阳不能熄，为拟温肾降火，增液汤加骨碎补。处方：元参15克，麦冬15克，生地15克，骨碎补15克。服药10剂，齿衄果然停止，但停药一个月后，齿衄又出现，但较从前轻微得多，为巩固效果，继服30剂愈。
暴骨与牙宣
王冰说：“肾主于骨，齿为骨余，肾气既衰，精无所养，故令发堕，齿复干枯。”沈金鳌说：“齿者，肾之标、骨之本也。齿又为手足阳明经所过，上齿隶坤土，足阳明胃脉贯络也……下齿属手阳明大肠脉络也。”所以“肾衰则齿豁，精固则齿坚，至其为病，则凡齿脆不坚，或易于动摇，或疏豁，或突而不实……必肾气之不足……是当以专补肾气为主。”
牙龈萎缩，牙齿浮动者，称为“暴骨”，“搜牙”。牙龈萎缩，牙根宣露，经常渗出血液或脓汁者，称为牙宣或龈宣。其发病原因以肾阴不足，虚火上炎及风火、湿热为多见。例如：耿××，男，15岁。牙齿动摇，隐隐作痛5年。某院诊为牙周炎。曾用中药清胃散和西药长期治疗不效。审其除两个臼齿外，全部牙齿均松动，牙龈萎缩微黑，舌苔黄白，脉滑稍数。证脉相参，诊为肾阴亏损，风火相煽之证。乃拟滋肾泻火佐以散风法。牢牙散加减：龙胆草9克、羌活1.5克、升麻1.5克、地骨皮30克、元参30克。药进10剂痛止而齿坚，继进一月虽吃饼干亦无害。高××，男，45岁。下门齿、犬齿及两个臼齿动摇，隐隐作痛8年多。某医院诊为慢性牙周炎。中西药久治不效。审其齿龈萎缩，齿浮动摇，不敢舌舐，也不敢吃硬、粘食物，舌苔白，脉沉弦尺大。证脉合参，诊为。肾阴亏损，虚火上炎，乃拟增液汤加味以滋阴降火。生地30克，麦冬30克，元参30克，肉桂6克。药进6剂牙齿稍坚，舌舐时已不动摇，继进10剂虽吃饼干亦不动摇，但牙龈不见明显恢复，乃继进30剂以善后。3个月后，患者来告云已愈。
某医问：两例症状全同，何用药不同耳?答曰：脉象不同，脏腑有别也。故前以泻火、后以补肾治之。
口疮
曾治患者张××，男，30岁。口疮数月，前医先以西药冶之不效，后以中药牛黄解毒丸、清胃散、外用冰硼散不效。审其口腔粘膜、舌尖有溃疡6处，大者如豆大，小者如高粱大，疼痛，大便正常，小便黄赤。综合脉证，诊为心胃火盛，冶宜导赤散加元参。处方：生地12克，木通10克，竹叶10觅，甘草10克，元参15克。药进2剂，溃疡消失，继进2剂而愈。某医云：余读《中医喉科学讲义》云：其治或以凉膈散，或以导赤散，然用之久久不愈者何也?答曰：李翰卿先生曾云：口疮、口糜，若大便秘结，或大便黄臭呈不消化状，或有粘液者，治宜通下；大便正常，小便黄赤者，宜利小便，使其火从小便而解；但下之不可太过，利之不可不及。又说：口疮、口糜，必须察其大小便，若胃脘有压痛，大便秘结或不秘结者，宜下。心火尿赤者，宜利小便。总之，或从心火以泻小肠，或从胃热以通腑。此证大便正常，亦无胃脘压痛，故应从泻心火论治，然其口腔粘膜有多处口疮，此胃中虚火所致也。故以导赤散中加元参以泻心胃之火。
程××，男，26岁。口腔溃疡反复发作两年，吃葱蒜则加重，吃冷食则腹痛。前医遍用西药及清胃散和芩、连、银、翘等不但无效，反见脘腹冷痛，腰困乏力。细察其证，除以上诸证外，并见舌苔薄白，脉沉细尺大稍弦。综合脉证，诊为肾气不足，虚火上炎，治宜十味地黄汤。处方：熟地15克，山药9克，五味子9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参15克，麦冬12克，白芍12克。服药4剂后，口疮大减，8剂后，口疮消失，因其腰痛仍在，加怀牛膝1O克，继服8剂而愈。某医云：为什么用十味地黄汤?答曰：李翰卿先生曾云：急性者，多实，但一两剂不愈者不可不注意虚；慢性久久不愈者多虚，但尤多兼实火；若火证为主者，不可仅注意火，因其多兼寒邪，故临证时必须审慎考虑。虚实夹杂者，以寒积不化，郁而化火，上热下寒者为多，此证往往具有胃脘、脐腹隐痛，压之则疼痛加剧，或吃肉、油腻以后加重，大便兼有粘液或不消化状的食物残渣，治宜理中大黄汤或理中承气合方，但攻下之时只可缓攻，不可大泻下，否则胃、腹疼痛加剧而口疮不除。脾肺俱虚，虚火上炎者，往往具有疲乏无力，胃脘痞满，脉象虚大或右大于左，治宜补中益气汤加元参、知母、黄柏；若寒热夹杂者，亦有脾肾之别，脾胃者，证见胃脘痞满，嘈杂或冷痛，两脉弦，治宜黄连汤加减；肾者，证见腰困腰冷，脉沉细尺大而弦，治宜十味地黄汤加减。本证腰困乏力，脉沉细尺大稍弦，为肾虚火炎，寒热并见之疾，故以十味地黄汤加减治之。
茧唇
曾治患者杨××，女，29岁。一年多来上唇肿胀紫暗僵硬微痒。某院诊为唇癌?丹毒?因患者拒绝病理切片检查未确诊?先反复应用抗生素及中药清热解毒无效。审其上唇紫暗肿硬，舌苔白，脉沉细。综合脉证，诊为脾胃湿热为本，风邪为标：治以清胃泻火，除湿散风：升麻9克，防风9克，白芷9克．黄芩9克，生姜9克，藿香9克，枳壳9克，半夏6克，石斛9克，甘草6克，黄柏9克。2剂后，肿胀紫暗好转；10剂后，消退七八，但大便此时数日不行，加大黄4．5克，10剂而愈。病愈之后，一实习学生问：为什么前医用清胃散、甘露饮、玉女煎等久治不效，而你却用泻黄散取效呢?为什么同是泻脾胃火热之剂，一方取效若神，一方却寸效无见呢?答曰：东垣制升阳散火汤之治火在于解郁火，钱乙制泻黄散亦在于解郁火，郁火非散不解。清胃散之泻火在于一个泻，玉女煎、甘露饮之泻火在于一个养阴泻火。当泻之火，若予疏散，必使火邪炎炎而更炽，然若郁火徒用泻降，必使火邪更郁，而病难除。此方所以取效就在于散以解郁，而火邪得除耳。
又治患者王××，女，15岁。1岁时因地震在外露宿而发现上唇目中胀。医诊日光性皮炎?唇炎?治疗一个月后未见明显改善，后又去大同、北京等地医院住院治疗，前后住院10个多月，不但无效，反见日渐加重。14年来前后住院10次，服中药达干剂，西药不计其数，一直不效，特别是近一年来更加严重，上唇肿胀，麻木，微有痒痛。审其证，除口唇肿胀外，并见有少许鳞屑状物，间有少量黄色脓痂，鼻头及其周围少许丘疹，鼻头色红，舌苔白，脉弦缓。余始以清胃散、甘露饮加减治之，七日不效。思其证脉弦缓，此乃脾湿郁火之象。拟泻黄散：防风10克，甘草6克，栀子10克，藿香10克，白芷10克。服药4剂，痒痛略减，但肿胀不减；审其舌苔白润，脉濡缓，濡缓之脉者，湿热蕴结之象，又思湿热日久阴液必伤，故改予赤小豆当归散加减：赤小豆60克，防风5克，当归10克，石斛9克，元参9克，大黄1克。服药6剂，肿胀大减，麻木、痒痛消失七八，继服12剂，诸证消失，愈。某医问：赤小豆当归散仲景本用于近血和狐惑，你用于唇病者为何呢?曰：仲景用其治先血后便和狐惑目赤如鸠眼者，在于其能除湿热，而此病亦因湿热所致耳。
耳疳
慢性中耳炎、胆脂瘤，西医耳鼻喉科大都主张手术，然亦有反复治疗而数次复发者。此证之治，因其脓色黄，且时见热象，故多以清热之剂治之，然此病久久不愈，多致肾阳亏损，故用药多无显效。曾治患者李××，男，14岁。从l岁开始即有左耳流脓史，近一年来流脓不止，听力下降。一个月前突然寒战高热，剧烈头痛，不久即见左耳流出黄色脓汁，继而寒战高热消失，头痛顿消，但脓汁却日渐增多。最近赴某院耳鼻喉科检查：发现左耳后稍上方有5毫米x4毫米孔口，一直通向外耳道鼓膜前后上方，内口2毫米×3毫米，管道内有脓性分泌物。乳突照片：左侧慢性中耳炎、胆脂瘤。先用西药治疗不效，后予泻火之剂中药亦不效。邀治于予。思其病久肾阴亏损，改予滋阴降火之剂。滋阴降火汤加减：知母10克，黄柏10克，当归10克，赤芍10克，熟地10克，元参10克，花粉15克，旱莲草15克。连服15剂效果不著。再审脉象虚而兼缓，舌质淡暗，舌苔薄白。思之，舌、脉均为阴阳俱虚之象，但见脓汁即定其为火，恐不合拍。法当补肾益阳。处方：肉苁蓉15克，菟丝子18克，枸杞子12克，煅龙骨30克，煅牡蛎30克，石菖蒲6克，怀牛膝12克，白芍15克，白蒺藜3克，熟地30克，五味子9克，沙苑子9克。服药3剂果然诸证明显好转，脓汁减少，继服20剂而愈。
耳聋
链霉素中毒之耳聋临床所见甚多，要求中药治疗者不少，然治之多见无效，遍求古籍未见论及者，搜查今医之报道亦未见明确论及者。不得已，复求古训之理，《素问·阴阳应象大论》云：“在脏为肾，在窍为耳”，《金匮真言论》云：“人通于心，开窍于耳”，《灵枢‘邪气脏腑病形篇》云：“心脉微涩为耳呜”，张景岳云：“耳聋证总由气闭不通耳。”再思前医所用之方和个人所用之药，大多补。肾平肝，泻火散风之剂。细审所见之证均无肾虚肝火之证。乃悟：此证大多因秽浊之气蒙蔽耳窍耳，乃拟鳖甲、龙骨滋阴镇肝，远志、菖蒲开窍一方试之，果然效如桴鼓。例如：梁x×，女，18岁。一年前因病注射链霉素、青霉素后，发现耳聋。急诊入某院治疗。住院治疗2个多月无效，不得已，又转入某院耳鼻喉科住院治疗5个月，除西药外，并配针灸、中药等法，仍然无明显效果。邀余诊视。审其证，除完全耳聋外，并见轻度头晕耳鸣，舌苔薄白，脉弦而缓。查其方药，多为滋阴降火，滋阴平肝，补肾之品。证脉合参乃云：脏气厥逆之证耳。拟枕中丹：鳖甲30克，龙骨15克，远志15克，菖蒲30克。服药4剂竞耳聋微闻，16剂耳聋痊愈，耳鸣大减，30剂诸证消失而愈。自此之后，多用此方取效。
梅尼埃病之眩晕近人报道取效者甚多，梅尼埃病之耳聋报道者则甚少。余临证多年甚感棘手。曾治一例邮电职工，男．49岁，梅尼埃病4年，曾反复住院治疗，眩晕虽可暂时减轻，但耳呜耳聋却日渐加重，近一个月来眩晕又作，恶心呕吐，景物及自身颠倒，不敢睁眼，耳聋耳鸣，虽大声说话亦难听清，舌苔白，脉缓。综其脉证，诊为风痰上扰，蒙蔽清窍。为拟平肝疏风，化痰泻火。眩晕方加减：然又考虑风痰阻于窍隧者非全蝎、郁金不能开，乃拟：石决明15克，菊花10克，天麻10克，钩藤15克，薄荷4克，防风4克，半夏10克，陈皮10克，茯苓10克，甘草6克，生白术8克，黄芩10克，酒军3克，玉竹5克，郁金10克，全蝎4克。服药1剂眩晕耳鸣即减，服药6剂耳聋微闻，耳鸣、眩晕大减，继服6剂诸证消失。其后，因其痊愈甚速，急回单位告知其他有病职工来治，经治疗，亦不久痊愈。
第四节 眼耳鼻喉科
牙衄（牙龈出血）
牙衄，也称为齿衄。由于手阳明大肠经和足阳明胃经都进入牙齿中，所以医生多从阳热之火的角度立论治疗。然而，如果病情久久不愈，用这种方法治疗大多无效。例如：患者赵×，男，61岁。患有冠心病心绞痛、心律失常，反复发作数年。近5个多月来，牙龈又出现反复出血，早晨特别严重，经常满口是血。某医院先用西药治疗无效，后又配合服用中药数十剂仍然无效。审视其证候，除了齿衄外，还见到时时心烦心悸，胸满胸痛，腰酸腰痛，疲乏无力，舌苔薄白，脉象沉细且结代。再审查其所用的中药，大都是清胃泻火、滋阴降火的方剂，但始终微效未见。因此思考脉证，腰酸腰痛者，是肾虚；脉象沉细结代者，是阳虚寒滞的脉象；心悸心烦时常发作，是肾水上泛的证候。前医所用清泻胃火、滋阴泻火的方法之所以无效，是因为只治了火，而没有温补阳气，治法应当补肾温阳，引火归原。使用十味地黄汤加减：生地15克，山药9克，五味子9克，肉苁蓉9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参12克，麦冬12克，怀牛膝12克。另一位医生看到这个方子后说：“治疗齿衄的各种书籍都说这是火，火应当熄灭，但老师反而用附子、肉桂来助火势，火气怎么能降？”回答说：“龙雷之火（相火），如果不温阳则火不能熄灭，正如太阳当空，雷火自然消除一样。”该医生起初半信半疑。后来服药8剂，鼻衄/齿衄停止。该医生又说：“我现在才知道龙雷之火应当如何治疗了。”
张××，女，成年。牙龈流血，时轻时重十几年。先请某医院口腔科、内科等用西药治疗，无效，后又请某医院中医用清胃泻火、滋阴降火的方剂治疗仍无效。审视其证候，齿龈上有少量血，按压时有少量血液渗出，吃饭、刷牙均使出血加重，别无所苦，舌苔薄白，脉象沉细尺部大而弦。深思良久，说：“尺脉属于肾；弦脉主寒；阳虚火浮，不温阳不能熄灭，为此拟定温肾降火，使用增液汤加骨碎补。处方：元参15克，麦冬15克，生地15克，骨碎补15克。服药10剂，齿衄果然停止，但停药一个月后，齿衄又出现，但较从前轻微得多，为了巩固效果，继续服用30剂痊愈。”
暴骨与牙宣
王冰说：“肾主骨，齿为骨之余，肾气既衰，精无所养，所以导致头发脱落，牙齿干枯。”沈金鳌说：“齿是肾的标象、骨的根本。齿又是手足阳明经所经过的地方，上齿隶属坤土，足阳明胃脉贯穿络属……下齿属手阳明大肠脉络。”所以“肾衰则牙齿豁落，精固则牙齿坚固，至于发病，凡是牙齿脆弱不坚，或易于动摇，或疏豁，或突出而不实……必定是肾气不足……这应当以专门补肾气为主。”
牙龈萎缩，牙齿浮动者，称为“暴骨”、“龋牙”（注：原文为搜牙，通龋牙或指牙龈病变，此处依文意译为牙龈相关病变）。牙龈萎缩，牙根宣露，经常渗出血液或脓汁者，称为牙宣或龈宣。其发病原因以肾阴不足、虚火上炎及风火、湿热为多见。例如：耿××，男，15岁。牙齿动摇，隐隐作痛5年。某医院诊断为牙周炎。曾用中药清胃散和西药长期治疗无效。审视除两个臼齿外，全部牙齿均松动，牙龈萎缩微黑，舌苔黄白，脉滑稍数。证候与脉象相参，诊断为肾阴亏损，风火相煽之证。于是拟定滋肾泻火佐以散风法。牢牙散加减：龙胆草9克、羌活1.5克、升麻1.5克、地骨皮30克、元参30克。药进10剂疼痛停止而牙齿坚固，继服一月即使吃饼干也无害。高××，男，45岁。下门齿、犬齿及两个臼齿动摇，隐隐作痛8年多。某医院诊断为慢性牙周炎。中西药久治不效。审视其齿龈萎缩，齿浮动摇，不敢用舌头舔，也不敢吃硬、粘食物，舌苔白，脉沉弦尺大。证候与脉象合参，诊断为肾阴亏损，虚火上炎，于是拟定增液汤加味以滋阴降火。生地30克，麦冬30克，元参30克，肉桂6克。药进6剂牙齿稍坚，舌头舔时已不动摇，继服10剂即使吃饼干也不动摇，但牙龈不见明显恢复，于是继服30剂善后。3个月后，患者来告知已痊愈。
某医生问：“两例症状完全相同，为什么用药不同？”回答说：“脉象不同，脏腑有别也。所以前者以泻火为主，后者以补肾为主。”
口疮
曾治疗患者张××，男，30岁。口疮数月，前医先用西药治疗无效，后用中药牛黄解毒丸、清胃散、外用冰硼散无效。审视其口腔粘膜、舌尖有溃疡6处，大的如豆大，小的如高粱粒大，疼痛，大便正常，小便黄赤。综合脉证，诊断为心胃火盛，治宜导赤散加元参。处方：生地12克，木通10克，竹叶10克，甘草10克，元参15克。药进2剂，溃疡消失，继进2剂而愈。某医生说：“我读《中医喉科学讲义》说：治疗或用凉膈散，或用导赤散，然而用之久久不愈的原因是什么？”回答说：“李翰卿先生曾说：口疮、口糜，如果大便秘结，或大便黄臭呈不消化状，或有粘液者，治宜通下；大便正常，小便黄赤者，宜利小便，使其火从小便而解；但下之不可太过，利之不可不及。又说：口疮、口糜，必须察其大小便，若胃脘有压痛，大便秘结或不秘结者，宜下。心火尿赤者，宜利小便。总之，或从心火以泻小肠，或从胃热以通腑。此证大便正常，亦无胃脘压痛，故应从泻心火论治，然而其口腔粘膜有多处口疮，这是胃中虚火所致也。故以导赤散中加元参以泻心胃之火。”
程××，男，26岁。口腔溃疡反复发作两年，吃葱蒜则加重，吃冷食则腹痛。前医遍用西药及清胃散和芩、连、银、翘等不但无效，反见脘腹冷痛，腰困乏力。细察其证，除以上诸证外，并见舌苔薄白，脉沉细尺大稍弦。综合脉证，诊断为肾气不足，虚火上炎，治宜十味地黄汤。处方：熟地15克，山药9克，五味子9克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，元参15克，麦冬12克，白芍12克。服药4剂后，口疮大减，8剂后，口疮消失，因其腰痛仍在，加怀牛膝10克，继服8剂而愈。某医生说：“为什么用十味地黄汤？”回答说：“李翰卿先生曾说：急性者，多实，但一两剂不愈者不可不注意虚；慢性久久不愈者多虚，但尤多兼实火；若火证为主者，不可仅注意火，因其多兼寒邪，故临证时必须审慎考虑。虚实夹杂者，以寒积不化，郁而化火，上热下寒者为多，此证往往具有胃脘、脐腹隐痛，压之则疼痛加剧，或吃肉、油腻以后加重，大便兼有粘液或不消化状的食物残渣，治宜理中大黄汤或理中承气合方，但攻下之时只可缓攻，不可大泻下，否则胃、腹疼痛加剧而口疮不除。脾肺俱虚，虚火上炎者，往往具有疲乏无力，胃脘痞满，脉象虚大或右大于左，治宜补中益气汤加元参、知母、黄柏；若寒热夹杂者，亦有脾肾之别，脾胃者，证见胃脘痞满，嘈杂或冷痛，两脉弦，治宜黄连汤加减；肾者，证见腰困腰冷，脉沉细尺大而弦，治宜十味地黄汤加减。本证腰困乏力，脉沉细尺大稍弦，为肾虚火炎，寒热并见之疾，故以十味地黄汤加减治之。”
茧唇
曾治疗患者杨××，女，29岁。一年多来上唇肿胀紫暗僵硬微痒。某医院诊断为唇癌？丹毒？因患者拒绝病理切片检查未确诊。先反复应用抗生素及中药清热解毒无效。审视其上唇紫暗肿硬，舌苔白，脉沉细。综合脉证，诊断为脾胃湿热为本，风邪为标：治以清胃泻火，除湿散风：升麻9克，防风9克，白芷9克，黄芩9克，生姜9克，藿香9克，枳壳9克，半夏6克，石斛9克，甘草6克，黄柏9克。2剂后，肿胀紫暗好转；10剂后，消退七八，但大便此时数日不行，加大黄4.5克，10剂而愈。病愈之后，一实习学生问：“为什么前医用清胃散、甘露饮、玉女煎等久治不效，而你却用泻黄散取效呢？为什么同是泻脾胃火热之剂，一方取效若神，一方却寸效无见呢？”回答说：“东垣制升阳散火汤之治火在于解郁火，钱乙制泻黄散亦在于解郁火，郁火非散不解。清胃散之泻火在于一个泻，玉女煎、甘露饮之泻火在于一个养阴泻火。当泻之火，若予疏散，必使火邪炎炎而更炽，然若郁火徒用泻降，必使火邪更郁，而病难除。此方所以取效就在于散以解郁，而火邪得除耳。”
又治疗患者王××，女，15岁。1岁时因地震在外露宿而发现上唇目中胀（注：疑为‘目’字衍文或特定部位描述，依语境理解为局部肿胀）。医诊日光性皮炎？唇炎？治疗一个月后未见明显改善，后又去大同、北京等地医院住院治疗，前后住院10个多月，不但无效，反见日渐加重。14年来前后住院10次，服中药达千剂，西药不计其数，一直不效，特别是近一年来更加严重，上唇肿胀，麻木，微有痒痛。审视其证，除口唇肿胀外，并见有少许鳞屑状物，间有少量黄色脓痂，鼻头及其周围少许丘疹，鼻头色红，舌苔白，脉弦缓。余始以清胃散、甘露饮加减治之，七日不效。思其证脉弦缓，此乃脾湿郁火之象。拟泻黄散：防风10克，甘草6克，栀子10克，藿香10克，白芷10克。服药4剂，痒痛略减，但肿胀不减；审视其舌苔白润，脉濡缓，濡缓之脉者，湿热蕴结之象，又思湿热日久阴液必伤，故改予赤小豆当归散加减：赤小豆60克，防风5克，当归10克，石斛9克，元参9克，大黄1克。服药6剂，肿胀大减，麻木、痒痛消失七八，继服12剂，诸证消失，愈。某医生问：“赤小豆当归散仲景本用于近血和狐惑，你用于唇病者为何呢？”曰：“仲景用其治先血后便和狐惑目赤如鸠眼者，在于其能除湿热，而此病亦因湿热所致耳。”
耳疳
慢性中耳炎、胆脂瘤，西医耳鼻喉科大都主张手术，然亦有反复治疗而数次复发者。此证之治，因其脓色黄，且时见热象，故多以清热之剂治之，然此病久久不愈，多致肾阳亏损，故用药多无显效。曾治疗患者李××，男，14岁。从1岁开始即有左耳流脓史，近一年来流脓不止，听力下降。一个月前突然寒战高热，剧烈头痛，不久即见左耳流出黄色脓汁，继而寒战高热消失，头痛顿消，但脓汁却日渐增多。最近赴某院耳鼻喉科检查：发现左耳后稍上方有5毫米x4毫米孔口，一直通向外耳道鼓膜前后上方，内口2毫米×3毫米，管道内有脓性分泌物。乳突照片：左侧慢性中耳炎、胆脂瘤。先用西药治疗不效，后予泻火之剂中药亦不效。邀治于予。思其病久肾阴亏损，改予滋阴降火之剂。滋阴降火汤加减：知母10克，黄柏10克，当归10克，赤芍10克，熟地10克，元参10克，花粉15克，旱莲草15克。连服15剂效果不著。再审脉象虚而兼缓，舌质淡暗，舌苔薄白。思之，舌、脉均为阴阳俱虚之象，但见脓汁即定其为火，恐不合拍。法当补肾益阳。处方：肉苁蓉15克，菟丝子18克，枸杞子12克，煅龙骨30克，煅牡蛎30克，石菖蒲6克，怀牛膝12克，白芍15克，白蒺藜3克，熟地30克，五味子9克，沙苑子9克。服药3剂果然诸证明显好转，脓汁减少，继服20剂而愈。
耳聋
链霉素中毒之耳聋临床所见甚多，要求中药治疗者不少，然治之多见无效，遍求古籍未见论及者，搜查今医之报道亦未见明确论及者。不得已，复求古训之理，《素问·阴阳应象大论》云：“在脏为肾，在窍为耳”，《金匮真言论》云：“人通于心，开窍于耳”，《灵枢·邪气脏腑病形篇》云：“心脉微涩为耳鸣”，张景岳云：“耳聋证总由气闭不通耳。”再思前医所用之方和个人所用之药，大多补肾平肝，泻火散风之剂。细审所见之证均无肾虚肝火之证。乃悟：此证大多因秽浊之气蒙蔽耳窍耳，乃拟鳖甲、龙骨滋阴镇肝，远志、菖蒲开窍一方试之，果然效如桴鼓。例如：梁××，女，18岁。一年前因病注射链霉素、青霉素后，发现耳聋。急诊入某院治疗。住院治疗2个多月无效，不得已，又转入某院耳鼻喉科住院治疗5个月，除西药外，并配针灸、中药等法，仍然无明显效果。邀余诊视。审视其证，除完全耳聋外，并见轻度头晕耳鸣，舌苔薄白，脉弦而缓。查其方药，多为滋阴降火，滋阴平肝，补肾之品。证脉合参乃云：脏气厥逆之证耳。拟枕中丹：鳖甲30克，龙骨15克，远志15克，菖蒲30克。服药4剂竟耳聋微闻，16剂耳聋痊愈，耳鸣大减，30剂诸证消失而愈。自此之后，多用此方取效。
梅尼埃病之眩晕近人报道取效者甚多，梅尼埃病之耳聋报道者则甚少。余临证多年甚感棘手。曾治一例邮电职工，男，49岁，梅尼埃病4年，曾反复住院治疗，眩晕虽可暂时减轻，但耳鸣耳聋却日渐加重，近一个月来眩晕又作，恶心呕吐，景物及自身颠倒，不敢睁眼，耳聋耳鸣，虽大声说话亦难听清，舌苔白，脉缓。综其脉证，诊断为风痰上扰，蒙蔽清窍。为拟平肝疏风，化痰泻火。眩晕方加减：然又考虑风痰阻于窍隧者非全蝎、郁金不能开，乃拟：石决明15克，菊花10克，天麻10克，钩藤15克，薄荷4克，防风4克，半夏10克，陈皮10克，茯苓10克，甘草6克，生白术8克，黄芩10克，酒军3克，玉竹5克，郁金10克，全蝎4克。服药1剂眩晕耳鸣即减，服药6剂耳聋微闻，耳鸣、眩晕大减，继服6剂诸证消失。其后，因其痊愈甚速，急回单位告知其他有病职工来治，经治疗，亦不久痊愈。
Section 4: Ophthalmology, Otorhinolaryngology (ENT)
Gingival Bleeding (Ya Nu)
Gingival bleeding, also known as dental bleeding (Chi Nu), occurs because both the Hand-Yangming Large Intestine Meridian and Foot-Yangming Stomach Meridian enter the teeth. Therefore, physicians often formulate treatment theories based on Yang heat-fire. However, if the condition persists for a long time without healing, this method is often ineffective. For example: Patient Zhao X, male, 61 years old. He has suffered from recurrent coronary heart disease angina pectoris and arrhythmia for several years. For the past five months, his gums have bled repeatedly, especially severely in the morning, often filling his mouth with blood. A certain hospital first treated him with Western medicine without effect, then combined it with dozens of doses of Chinese herbal medicine, still without effect. Examining his syndrome, besides gingival bleeding, he presented with frequent mental restlessness and palpitations, chest fullness and pain, soreness and pain in the lower back, fatigue and weakness, thin white tongue coating, and a deep, fine, knotted and intermittent pulse. Reviewing the Chinese medicines used previously, they were mostly formulas for clearing stomach fire and nourishing yin to subdue fire, yet they remained slightly effective. Considering the pulse and syndrome, soreness and pain in the lower back indicate Kidney deficiency; a deep, fine, knotted and intermittent pulse indicates Yang deficiency with cold stagnation; frequent palpitations and mental restlessness indicate flooding of Kidney water upward. The reason why the previous doctors' methods of clearing and purging stomach fire and nourishing yin to purge fire were ineffective is that they only treated the fire without warming the Yang. The treatment method should be to tonify the Kidney and warm Yang, guiding fire back to its source. Modified Shiwei Dihuang Tang (Ten-Ingredient Rehmannia Decoction): Sheng Di Huang (Rehmanniae Radix) 15g, Shan Yao (Dioscoreae Rhizoma) 9g, Wu Wei Zi (Schisandrae Fructus) 9g, Rou Cong Rong (Cistanches Herba) 9g, Fu Ling (Poria) 9g, Ze Xie (Alismatis Rhizoma) 9g, Dan Pi (Moutan Cortex) 9g, Fu Zi (Aconiti Lateralis Radix Praeparata) 9g, Rou Gui (Cinnamomi Cortex) 9g, Yuan Shen (Scrophulariae Radix) 12g, Mai Dong (Ophiopogonis Tuber) 12g, Huai Niu Xi (Achyranthis Bidentatae Radix) 12g. Another physician, seeing this prescription, said: "All books on treating gingival bleeding state it is due to fire, which should be extinguished. Yet the teacher uses Fu Zi and Rou Gui to assist the fire energy; how can the fire energy descend?" I replied: "Dragon and Thunder Fire (Ministerial Fire) cannot be extinguished without warming Yang, just as when the sun shines brightly, thunder fire naturally disappears." The physician was initially skeptical. After taking 8 doses, the bleeding stopped. The physician then said: "Now I know how to treat Dragon and Thunder Fire."
Zhang XX, female, adult. Gingival bleeding, fluctuating in severity for over ten years. First treated at a certain hospital's stomatology and internal medicine departments with Western medicine without effect, then treated by a TCM doctor at another hospital with formulas for clearing stomach fire and nourishing yin to subdue fire, still without effect. Examining her syndrome, there was a small amount of blood on the gingiva, with slight oozing upon pressure; eating and brushing teeth aggravated the bleeding, with no other discomforts. Tongue coating was thin and white; pulse was deep, fine, large at the Chi position, and wiry. After deep thought, I said: "The Chi pulse belongs to the Kidney; the wiry pulse governs cold; Yang deficiency with floating fire cannot be extinguished without warming Yang. Therefore, I prescribe warming the Kidney and descending fire, using Zengye Tang (Increase Fluids Decoction) plus Gu Sui Bu." Prescription: Yuan Shen 15g, Mai Dong 15g, Sheng Di Huang 15g, Gu Sui Bu (Drynariae Rhizoma) 15g. After 10 doses, gingival bleeding indeed stopped. However, one month after stopping medication, the bleeding recurred, though much milder than before. To consolidate the effect, she continued taking 30 doses and recovered.
Baogu (Exposure of Bones) and Yaxuan (Gum Suppuration)
Wang Bing said: "The Kidney governs bones, and teeth are the surplus of bones. When Kidney Qi declines and essence lacks nourishment, hair falls out and teeth become dry and withered." Shen Jin'ao said: "Teeth are the manifestation of the Kidney and the root of bones. Teeth are also passed through by the Hand and Foot Yangming meridians. Upper teeth belong to Kun Earth, connected to the Foot-Yangming Stomach Meridian... Lower teeth belong to the Hand-Yangming Large Intestine Meridian." Thus, "When Kidney declines, teeth become loose; when essence is secure, teeth are firm. Regarding pathology, any case of fragile teeth, easy mobility, looseness, or protrusion without solidity... must be due to insufficiency of Kidney Qi... Treatment should focus primarily on tonifying Kidney Qi."
Gingival atrophy with tooth mobility is called "Baogu" or "Sou Ya". Gingival atrophy with exposed tooth roots, frequently oozing blood or pus, is called Yaxuan or Yin Xuan. Its pathogenesis is mostly due to Kidney Yin deficiency with deficient fire flaming upward, as well as wind-fire and damp-heat. For example: Geng XX, male, 15 years old. Tooth mobility and dull pain for 5 years. Diagnosed with periodontitis at a certain hospital. Long-term treatment with Qingwei San (Clear Stomach Powder) and Western medicine was ineffective. Examining him, all teeth except two molars were loose, gingiva was atrophic and slightly black, tongue coating yellowish-white, pulse slippery and slightly rapid. Correlating syndrome and pulse, diagnosed as Kidney Yin deficiency with wind-fire stirring internally. Prescribed nourishing Kidney and purging fire assisted by dispersing wind. Laoya San (Stabilize Teeth Powder) modified: Long Dan Cao (Gentianae Radix) 9g, Qiang Huo (Notopterygii Rhizoma et Radix) 1.5g, Sheng Ma (Cimicifugae Rhizoma) 1.5g, Di Gu Pi (Lycii Cortex) 30g, Yuan Shen 30g. After 10 doses, pain ceased and teeth became firm. Continuing for one month, even eating biscuits caused no harm. Gao XX, male, 45 years old. Mobility and dull pain of lower incisors, canines, and two molars for over 8 years. Diagnosed with chronic periodontitis at a certain hospital. Long-term treatment with Chinese and Western medicine was ineffective. Examining him, gingiva was atrophic, teeth were mobile, afraid to lick with tongue, afraid to eat hard or sticky foods, tongue coating white, pulse deep, wiry, large at Chi position. Correlating syndrome and pulse, diagnosed as Kidney Yin deficiency with deficient fire flaming upward. Prescribed Zengye Tang modified to nourish Yin and descend fire. Sheng Di Huang 30g, Mai Dong 30g, Yuan Shen 30g, Rou Gui 6g. After 6 doses, teeth became slightly firm, no longer mobile when licked. After continuing for 10 doses, even eating biscuits did not cause mobility, but gingiva showed no obvious recovery. Continued for 30 doses for follow-up care. Three months later, the patient reported complete recovery.
A physician asked: "The symptoms of these two cases are identical, why different medications?" I replied: "The pulses are different, indicating different organ involvement. Hence, the former was treated by purging fire, the latter by tonifying Kidney."
Oral Ulcers (Kou Chuang)
I once treated patient Zhang XX, male, 30 years old. Oral ulcers for several months. Previous doctors first tried Western medicine without effect, then Chinese medicine Niuhuang Jiedu Wan (Calculus Bovis Detoxification Pill), Qingwei San, and topical Bingpeng San without effect. Examining him, there were 6 ulcers on the oral mucosa and tongue tip, the largest like a bean, the smallest like a sorghum grain, painful. Bowel movements were normal, urine was yellow and red. Synthesizing pulse and syndrome, diagnosed as excess fire in Heart and Stomach. Treatment suitable: Daochi San (Guide Out Red Powder) plus Yuan Shen. Prescription: Sheng Di Huang 12g, Mu Tong (Akebiae Caulis) 10g, Zhu Ye (Bambusae Folium) 10g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 10g, Yuan Shen 15g. After 2 doses, ulcers disappeared; after continuing 2 doses, recovered. A physician said: "Reading 'Lecture Notes on TCM Laryngology', it says treatment may use Liangge San (Cool the Diaphragm Powder) or Daochi San. Why does long-term use fail?" I replied: "Mr. Li Hanqing once said: For oral ulcers and aphthous stomatitis, if stool is constipated, or yellow/foul/smelly resembling undigested food, or contains mucus, treatment should promote purgation; if stool is normal and urine is yellow/red, treatment should promote diuresis to resolve fire via urination; however, purgation must not be excessive, and diuresis must not be insufficient. Also, for oral ulcers and aphthous stomatitis, one must observe bowel and bladder movements. If there is tenderness in the epigastrium, whether constipated or not, purgation is indicated. If Heart fire causes red urine, diuresis is indicated. In summary, either clear Heart fire to drain Small Intestine, or clear Stomach heat to unblock the fu organs. This case had normal stool and no epigastric tenderness, so treatment should focus on clearing Heart fire. However, multiple ulcers on oral mucosa indicate deficient fire in the Stomach. Thus, adding Yuan Shen to Daochi San clears Heart and Stomach fire."
Cheng XX, male, 26 years old. Recurrent oral ulcers for two years, aggravated by eating green onions/garlic, abdominal pain from cold food. Previous doctors used various Western medicines and Qingwei San plus Huang Qin, Huang Lian, Yin Hua, Jin Ying Qiao etc., not only without effect, but causing cold pain in epigastrium/abdomen and waist fatigue/weakness. Carefully examining the syndrome, besides the above, tongue coating was thin white, pulse deep, fine, large at Chi position, slightly wiry. Synthesizing pulse and syndrome, diagnosed as Kidney Qi insufficiency with deficient fire flaming upward. Treatment suitable: Shiwei Dihuang Tang. Prescription: Shu Di Huang (Prepared Rehmanniae Radix) 15g, Shan Yao 9g, Wu Wei Zi 9g, Fu Ling 9g, Ze Xie 9g, Dan Pi 9g, Fu Zi 9g, Rou Gui 9g, Yuan Shen 15g, Mai Dong 12g, Bai Shao (Paeoniae Radix Alba) 12g. After 4 doses, ulcers greatly reduced; after 8 doses, ulcers disappeared. Since lower back pain persisted, added Huai Niu Xi 10g, continued for 8 doses and recovered. A physician asked: "Why use Shiwei Dihuang Tang?" I replied: "Mr. Li Hanqing once said: Acute cases are mostly excess, but if not resolved in 1-2 doses, one must pay attention to deficiency; chronic cases persisting for a long time are mostly deficiency, but often accompanied by excess fire; if fire syndrome is dominant, do not only focus on fire, as it is often accompanied by cold pathogens, so clinical consideration must be prudent. Mixed excess and deficiency cases often involve cold accumulation failing to transform, stagnating into fire, with upper heat and lower cold. These cases often present with dull pain in epigastrium/umbilical abdomen, worsened by pressure or eating meat/greasy food, stool containing mucus or undigested food residues. Treatment suitable: Lizhong Dahuang Tang or combination of Lizhong Chengqi Tang. However, during purgation, only gentle attack is allowed, not drastic purgation, otherwise gastric/abdominal pain will worsen and ulcers will not be removed. Spleen and Lung both deficient with deficient fire flaming upward often present with fatigue/weakness, epigastric fullness/stuffiness, pulse deficiency-large or right larger than left. Treatment suitable: Buzhong Yiqi Tang plus Yuan Shen, Zhi Mu, Huang Bo. If mixed cold and heat, there is distinction between Spleen/Stomach and Kidney. Spleen/Stomach cases present with epigastric fullness/stuffiness, acid regurgitation/cold pain, wiry pulses bilaterally. Treatment suitable: Huanglian Tang modified. Kidney cases present with waist fatigue/cold, deep fine large wiry Chi pulse. Treatment suitable: Shiwei Dihuang Tang modified. This case had waist fatigue/weakness, deep fine large slightly wiry Chi pulse, indicating Kidney deficiency with fire flaming, a disease with simultaneous cold and heat. Thus, modified Shiwei Dihuang Tang was used."
Silkworm Lip (Jian Chun)
I once treated patient Yang XX, female, 29 years old. For over a year, upper lip swelling, purple-dark, stiff, slightly itchy. Diagnosed at a certain hospital as lip cancer? Erysipelas? Diagnosis undetermined because patient refused pathological biopsy. Repeated application of antibiotics and Chinese medicine for clearing heat and detoxifying was ineffective. Examining her, upper lip was purple-dark, swollen, hard, tongue coating white, pulse deep and fine. Synthesizing pulse and syndrome, diagnosed as Spleen/Stomach damp-heat as root, Wind pathogen as branch. Treatment: Clear Stomach and purge fire, remove dampness and disperse wind. Sheng Ma 9g, Fang Feng 9g, Bai Zhi 9g, Huang Qin 9g, Sheng Jiang 9g, Huo Xiang 9g, Zhi Ke 9g, Ban Xia 6g, Shi Hu 9g, Gan Cao 6g, Huang Bo 9g. After 2 doses, purple-dark swelling improved; after 10 doses, 70-80% resolved. However, stool had not moved for several days. Added Da Huang 4.5g, cured after 10 doses. After recovery, an intern student asked: "Why did previous doctors' long-term use of Qingwei San, Ganlu Yin, Yv Nu Jian fail, while you succeeded with Xiehuang San? Why does one formula work miraculously while the other has no effect, given both clear Stomach/Spleen fire?" I replied: "Li Dongyuan's Shengyang Sanhuo Tang treats fire by resolving stagnant fire; Qian Yi's Xiehuang San also resolves stagnant fire. Stagnant fire cannot be resolved without dispersion. Qingwei San purges fire through 'purging'; Yv Nu Jian and Ganlu Yin purge fire through 'nourishing yin and purging fire'. For fire that should be purged, if dispersed, fire pathogen will blaze more fiercely; however, for stagnant fire, if only purging/descending is used, fire pathogen will stagnate further, making disease difficult to remove. This formula succeeds because dispersion resolves stagnation, allowing fire pathogen to be removed."
Another patient Wang XX, female, 15 years old. Discovered upper lip swelling after sleeping outdoors during an earthquake at age 1. Diagnosed as solar dermatitis? Cheilitis? One month of treatment showed no obvious improvement. Later hospitalized in Datong, Beijing, etc., totaling over 10 months hospitalization, not only ineffective but progressively worsening. Over 14 years, hospitalized 10 times, took thousands of doses of Chinese medicine, countless Western medicines, always ineffective. Especially in the past year, worse: upper lip swelling, numbness, slight itching/pain. Examining syndrome, besides lip swelling, slight scaly matter, occasional small yellow crusts, few papules around nose tip, red nose tip, tongue coating white, pulse string-slow. I initially treated with modified Qingwei San and Ganlu Yin, ineffective after 7 days. Considering syndrome and string-slow pulse, this is Spleen dampness with stagnant fire. Prescribed Xiehuang San: Fang Feng 10g, Gan Cao 6g, Zhi Zi 10g, Huo Xiang 10g, Bai Zhi 10g. After 4 doses, itching/pain slightly reduced, but swelling unchanged. Examining tongue coating white-moist, pulse soggy-slow, soggy-slow pulse indicates damp-heat accumulation. Considering long-standing damp-heat must injure Yin fluids, changed to modified Chixiaodou Danggui San (Adzuki Bean and Angelica Decoction): Chixiaodou 60g, Fang Feng 5g, Dang Gui 10g, Shi Hu 9g, Yuan Shen 9g, Da Huang 1g. After 6 doses, swelling greatly reduced, numbness/itching/pain disappeared 70-80%. Continued 12 doses, all symptoms disappeared, cured. A physician asked: "Zhongjing originally used Chixiaodou Danggui San for distal blood and Huhu disease. Why use it for lip disease?" I said: "Zhongjing used it for blood preceding stool and Huhu disease with eyes red like turtledove eyes, because it removes damp-heat. This disease is also caused by damp-heat."
Er Geng (Ear Fungus/Otitis)
Chronic otitis media, cholesteatoma: Western ENT departments mostly advocate surgery, yet some recur repeatedly despite repeated treatments. Treatment for this syndrome, because pus is yellow and heat signs appear occasionally, is mostly treated with heat-clearing agents. However, this disease persisting for a long time often leads to Kidney Yang deficiency, so medication often lacks obvious effect. I once treated patient Li XX, male, 14 years old. History of left ear suppuration since age 1. For the past year, continuous suppuration, hearing loss. One month ago, sudden chills and high fever, severe headache. Soon after, yellow pus flowed from left ear. Subsequently, chills/high fever disappeared, headache vanished instantly, but pus increased daily. Recent ENT exam at a certain hospital: Found a 5mm x 4mm opening slightly above posterior left ear, leading directly to anterior-posterior superior external auditory canal tympanic membrane, inner opening 2mm x 3mm, purulent secretion in the tract. Mastoid X-ray: Left chronic otitis media, cholesteatoma. Western medicine treatment ineffective, then heat-purging Chinese medicine also ineffective. Invited me to treat. Considering long-standing disease causing Kidney Yin deficiency, changed to nourishing Yin and descending fire agent. Ziyin Jianghuo Tang (Nourish Yin Descend Fire Decoction) modified: Zhi Mu 10g, Huang Bo 10g, Dang Gui 10g, Chi Shao 10g, Shu Di Huang 10g, Yuan Shen 10g, Hua Fen 15g, Han Lian Cao 15g. Taken continuously for 15 doses, effect not significant. Re-examined pulse: deficiency with slowness; tongue body pale-dark, coating thin white. Considering tongue and pulse both indicate Yin-Yang dual deficiency, but defining it as fire solely based on pus might be inaccurate. Method should be tonifying Kidney and benefiting Yang. Prescription: Rou Cong Rong 15g, Tu Si Zi 18g, Gou Qi Zi 12g, Duan Long Gu 30g, Duan Mu Li 30g, Shi Chang Pu 6g, Huai Niu Xi 12g, Bai Shao 15g, Bai Ji Li 3g, Shu Di Huang 30g, Wu Wei Zi 9g, Sha Yuan Zi 9g. After 3 doses, symptoms obviously improved, pus decreased. Continued 20 doses and cured.
Deafness (Er Long)
Streptomycin-induced deafness is commonly seen clinically, many request Chinese medicine treatment, yet most treatments are ineffective. Searching ancient texts reveals no discussion; searching modern medical reports also finds no clear mention. Reluctantly, seeking principles from ancient teachings: Suwen - Yin Yang Ying Xiang Da Lun states: "In zang organs it is Kidney, in orifices it is Ear"; Jingui Zhenyan Lun states: "Man connects with Heart, opens to orifice at Ear"; Lingnan - Xieqi Zangfu Bingxing Pian states: "Heart pulse slightly choppy indicates tinnitus"; Zhang Jingyue states: "Deafness syndromes are generally due to Qi blockage and non-circulation." Reflecting on formulas used by previous doctors and my own medications, mostly Kidney-tonifying Liver-calming, fire-purging wind-dispersing agents. Carefully examining observed syndromes, none showed Kidney deficiency or Liver fire. Then realized: This syndrome is mostly due to turbid qi obscuring ear orifices. Prescribed Bie Jia, Long Gu to nourish Yin and calm Liver, Yuan Zhi, Chang Pu to open orifices. Tested this formula, indeed effective as striking a drum. For example: Liang XX, female, 18 years old. Discovered deafness after injecting streptomycin/penicillin for illness one year ago. Emergency admission to a certain hospital. Hospitalized over 2 months ineffective. Reluctantly transferred to ENT department of another hospital, hospitalized 5 months. Besides Western medicine, combined with acupuncture, Chinese medicine, etc., still no obvious effect. Invited me to examine. Examining syndrome, besides total deafness, mild dizziness/tinnitus, tongue coating thin white, pulse string-slow. Checking prescriptions, mostly nourishing Yin descending fire, nourishing Yin calming Liver, Kidney-tonifying items. Correlating syndrome and pulse, I said: "This is Zang Qi reversal syndrome." Prescribed Zhongzhuang Dan (Pillow Treasure Pill): Bie Jia 30g, Long Gu 15g, Yuan Zhi 15g, Chang Pu 30g. After 4 doses, could faintly hear deafness; after 16 doses, deafness cured, tinnitus greatly reduced; after 30 doses, all symptoms disappeared, cured. Since then, mostly used this formula with success.
Meniere's Disease Vertigo: Recent reports show many successes, but Meniere's deafness reports are rare. I have felt very troubled by this in years of clinical practice. Once treated a postal worker, male, 49 years old, Meniere's disease for 4 years. Repeated hospitalizations; vertigo temporarily relieved, but tinnitus/deafness progressively worsened. For the past month, vertigo recurred, nausea/vomiting, objects/self upside down, dare not open eyes, deafness/tinnitus, difficult to hear clearly even loud speech, tongue coating white, pulse slow. Synthesizing pulse and syndrome, diagnosed as Wind-Phlegm disturbing upward, obscuring clear orifices. Prescribed Liver-calming wind-dispersing, phlegm-resolving fire-purging. Modified Xuan Yun Fang (Vertigo Formula): However, considering wind-phlegm blocking orifice tunnels requires Quan Xie, Yu Jin to open. So prescribed: Shi Jue Ming 15g, Ju Hua 10g, Tian Ma 10g, Gou Teng 15g, Bo He 4g, Fang Feng 4g, Ban Xia 10g, Chen Pi 10g, Fu Ling 10g, Gan Cao 6g, Sheng Bai Zhu 8g, Huang Qin 10g, Jiu Jun 3g, Yu Zhu 5g, Yu Jin 10g, Quan Xie 4g. After 1 dose, vertigo/tinnitus reduced; after 6 doses, deafness faintly heard, tinnitus/vertigo greatly reduced; continued 6 doses, all symptoms disappeared. Afterwards, due to rapid recovery, hurried back to unit to inform other sick employees to come for treatment. After treatment, also recovered shortly.