〔罗〕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。
暴聋皆是厥逆之气。经云∶暴厥而聋，偏塞闭不通，内气暴薄也。又云∶少阳之厥，暴聋是也。
〔罗〕蒲黄膏 治卒耳聋。
细辛 蒲黄（各二分） 曲末 杏仁（汤浸，去皮尖双仁。各三分）
上为末，研杏仁如膏，和捻如枣核大，绵裹塞耳中，日一易，以瘥为度。
又方龙脑膏
龙脑（半分，研） 椒目（半两，捣末） 杏仁（一分，汤浸，去皮）
上件捣研合匀，绵裹枣核大，塞耳中，日二易。
〔世〕蜀椒、巴豆、菖蒲、松脂，以蜡溶为筒子，纳耳中，抽肾虚气，耳中如风水之鸣，或如打钟鼓之声，
卒暴聋，一日一易，神效。
治耳暴聋。
雄黄（一钱） 巴豆（一个，去壳）
上研细，用葱涎和作一锭子，纸卷定塞耳中。
〔丹〕治耳暴聋。凌霄花叶，杵自然汁滴耳中，瘥。（《斗门》云∶本草凌霄活闭血淤血。丹溪云∶
补阴甚捷。）
〔《灵》〕暴聋气蒙，耳目不明，取天牖。（寒热病篇）
〔《甲》〕卒气聋，四渎主之。
（与耳聋相参用之）
〔丹〕冯宫人左耳鸣，此劳得之，法当补阴而镇坠之。
黄 人参（一两） 当归 陈皮 茯苓（七分） 升麻（五分） 酒柏（三钱） 防风（二钱半） 甘草（一钱
半） 芍药（酒制）
分十帖，食前热服，饮了，去眠一觉。
耳中哄哄然，是无阴者。
上阴虚耳鸣。经云∶液脱者脑髓消，胫酸耳数鸣是也。
〔罗〕治肾虚耳鸣，夜间睡着如打战鼓，觉耳内风吹，更四肢抽掣痛，黄 丸。
黄 （去芦，一两） 白蒺藜（炒，瓦擦捣细） 羌活（去芦。各半两） 黑附子（大者，一个）
羯羊肾（一对，焙干）
上细末，酒糊丸，桐子大。每服三四十丸，空心食前，煨葱盐汤下。
〔《素》〕太阳所谓耳鸣者，阳气万物盛上而跃，故耳鸣也。（脉解篇）
〔丹〕耳鸣因酒过者，用大剂通圣散，加枳壳、柴胡、大黄、甘草、南星、桔梗、青皮、荆芥。如不愈，
用四物汤。耳聋必龙荟丸食后服。气实人，槟榔神芎丸下之。（神芎丸方见前虚实法。）
〔垣〕柴胡聪耳汤 治耳中盯聍，耳鸣耳聋。
柴胡（三钱） 连翘（四钱） 甘草（一钱，炙） 虻虫（三个，去翅足） 水蛭（炒，五分，各另研）
麝香（少许，另研） 归身 人参（各一钱）
上除虻虫、蛭、麝另研外，用酒水煎熟，去渣，方下三末，再上火煎一二沸，稍热食后服。
运气耳鸣皆属风火。经云∶厥阴司天，风行太虚，云物摇动，目转耳鸣。三之气，天政布，风乃时举，
民病耳鸣。又云∶厥阴之脉，耳鸣头眩。又云∶少阳所至为耳鸣，治以凉寒是也。
〔丹〕耳鸣无昼夜。用乌头烧灰、菖蒲等分末之，包裹绵塞耳中，立效。（杨氏《产乳》）
〔《千》〕治耳鸣如流水声，耳痒，及风声，不治久则成聋。用生乌头一味，掘得乘湿削如枣核大，塞耳中，
日夜一易，不过三日愈。
〔《肘》〕治耳中常鸣。生地截塞耳，数易之，以瘥为度。
〔《灵》〕黄帝曰∶人之耳中鸣者，何气使然？岐伯曰∶耳者，宗脉之所聚也。故胃中空则宗脉虚，虚则下
溜，脉有所竭者，故耳鸣。补客主人，手大指爪甲上与肉交者也。（口问篇）
灸刺耳鸣补法有三，此其一也。又，经云∶上气不足，耳为之苦鸣，补足外踝下留之者二也。又云∶
脑为髓之海，其输上在百会，下在风府。髓海不足，则脑转耳鸣审守其输，调其虚实者也。
取法有二。经云∶耳鸣取耳前动脉者，一也。又云∶耳鸣取手中指爪甲上，左取右，右取左，先取手，后取
足者，二也。取谓视虚实调之也。
劫刺有一。经云∶手太阳之筋，其病肩髀引颈而痛，耳中鸣，其痛转筋者，治在燔针劫刺之，以知为度，
以痛为输者是也。
〔世〕耳虚鸣∶肾俞、太溪。
〔《甲》〕耳痛聋鸣，上关主之，刺不可深。耳聋鸣，下关及阳溪、关冲、掖门、阳谷主之。耳聋鸣，颈颔
痛，耳门主之。耳鸣无闻，肩贞及完骨主之。耳中生风，耳鸣耳聋时不闻，商阳主之。耳鸣，百会及颔厌、颅
息、天窗、大凌、偏历、前谷、后溪主之。
心脉微涩，为耳鸣癫疾。（全文见治虚实法。）
[罗知悌] 突然耳聋，是由于肾气虚弱，风邪乘虚侵袭，搏结于经络，随着血脉上行进入耳部，正气与邪气相互搏击，从而导致突然失聪。
暴聋都是由于厥逆之气所致。《内经》说：突然厥逆而耳聋，偏侧闭塞不通，是因为体内之气突然迫击。又说：少阳经发生厥逆，就会出现突然耳聋的症状。
[罗知悌] 蒲黄膏：治疗突然耳聋。
细辛、蒲黄（各二分）、神曲末、杏仁（用热水浸泡，去皮尖及双仁的，各三分）。
以上药物研成细末，将杏仁研磨成膏状，调和后捏成如枣核大小的药丸，用棉布包裹塞入耳中，每天更换一次，以痊愈为度。
又一方：龙脑膏
龙脑（半分，研磨）、椒目（半两，捣成粉末）、杏仁（一分，热水浸泡，去皮）。
以上药物捣碎研磨混合均匀，用棉布包裹如枣核大小，塞入耳中，每天更换两次。
[世医] 蜀椒、巴豆、石菖蒲、松脂，用蜡熔化制成筒状，纳入耳中，可抽取肾虚之气。若耳中像风水流动的声音，或像敲钟打鼓的声音，突然暴聋，每天更换一次，效果神奇。
治疗耳朵突然失聪。
雄黄（一钱）、巴豆（一个，去壳）。
以上药物研细，用葱汁调和做成一个锭子，用纸卷好塞入耳中。
[朱丹溪] 治疗耳朵突然失聪。凌霄花叶，捣取自然汁滴入耳中，即可痊愈。（《斗门方》记载：本草认为凌霄花能活血祛瘀。丹溪说：它补阴非常迅速。）
[《灵枢》] 突然耳聋，气机蒙蔽，耳目不清明，取天牖穴。（出自《寒热病篇》）
[《甲乙经》] 突然因气导致的耳聋，由四渎穴主治。
（可与耳聋证互相参考使用）
[朱丹溪] 冯宫人左耳耳鸣，这是劳损所致，治法应当补阴并镇坠浮阳。
黄芪、人参（一两）、当归、陈皮、茯苓（七分）、升麻（五分）、酒炒黄柏（三钱）、防风（二钱半）、甘草（一钱半）、芍药（酒制）。
分为十帖，饭前热服，服后睡一觉。
耳中嗡嗡作响，是无阴的表现。
上述情况属于上阴虚引起的耳鸣。《内经》说：津液脱失则脑髓消减，小腿酸软且耳朵经常鸣响，说的就是这种情况。
[罗知悌] 治疗肾虚耳鸣，夜间睡着时感觉像打战鼓，醒来觉得耳内有风吹感，甚至四肢抽搐疼痛，用黄芪丸。
黄芪（去芦头，一两）、白蒺藜（炒，瓦器擦捣细）、羌活（去芦头，各半两）、黑附子（大的一个）、羯羊肾（一对，焙干）。
以上研成细末，用酒糊制作成梧桐子大小的丸剂。每次服用三四十丸，空腹饭前，用煨过的葱盐汤送服。
[《素问》] 《太阳脉解篇》所谓耳鸣，是因为阳气旺盛向上跳跃，所以耳鸣。（出自《脉解篇》）
[朱丹溪] 因饮酒过度引起的耳鸣，用大剂量通圣散，加枳壳、柴胡、大黄、甘草、南星、桔梗、青皮、荆芥。如果不好转，用四物汤。耳聋必须在饭后服用龙胆泻肝丸。气实的人，用槟榔神芎丸攻下。（神芎丸方见前面的虚实治法章节。）
[李东垣] 柴胡聪耳汤：治疗耳中耵聍（耳屎），耳鸣耳聋。
柴胡（三钱）、连翘（四钱）、甘草（一钱，炙）、虻虫（三个，去翅足）、水蛭（炒，五分，分别单独研磨）、麝香（少许，单独研磨）、当归身、人参（各一钱）。
除了虻虫、水蛭、麝香单独研磨外，其余药物用酒和水煎熟，去渣，然后加入那三种粉末，再上火煎一二沸，稍热后饭后服用。
运气学说中的耳鸣都属于风火。《内经》说：厥阴司天，风气流行于太虚，云物摇动，导致眼花耳鸣。第三步气运期间，天气政令发布，风气时常兴起，民众患病耳鸣。又说：厥阴经脉病变，会出现耳鸣头晕。又说：少阳经气到达时表现为耳鸣，治疗应用凉寒之法。
[朱丹溪] 耳鸣不分昼夜。用乌头烧成灰、石菖蒲等分研末，用棉布包裹塞入耳中，立即见效。（出自杨氏《产乳备要》）
[《千金方》] 治疗耳鸣像流水声，耳痒，以及风声，若不治疗久了会变成耳聋。用生乌头一味药，挖出后趁湿削成枣核大小，塞入耳中，日夜更换一次，不超过三天即可痊愈。
[《肘后备急方》] 治疗耳中经常鸣响。切生地塞入耳中，多次更换，以痊愈为度。
[《灵枢》] 黄帝问：人的耳中鸣响，是什么气造成的？岐伯答：耳朵是宗脉汇聚的地方。所以胃中空虚则宗脉虚弱，虚弱则气血下溜，脉气有所竭绝，所以耳鸣。补客主人穴，即手大拇指指甲角与肉交接处。（出自《口问篇》）
针灸治疗耳鸣的补法有三种，这是其中一种。另外，《内经》说：上气不足，耳朵会痛苦地鸣响，补足外踝下方的穴位（申脉），这是第二种。又说：脑是髓海，其输注穴位上面在百会，下面在风府。髓海不足，就会头晕耳鸣。审慎守住这些输注穴位，调节虚实，这是第三种取法。
取法还有两种。《内经》说：耳鸣取耳前动脉（听宫等穴），这是一法。又说：耳鸣取手中指指甲上方，左病取右，右病取左，先取手部穴位，后取足部穴位，这是二法。取穴是指观察虚实进行调理。
劫刺法有一种。《内经》说：手太阳筋脉的病，肩臂牵引颈部疼痛，耳中鸣响，疼痛转为筋挛者，治疗用燔针劫刺，以症状缓解为度，以痛点为腧穴，这就是这种方法。
[《甲乙经》] 耳痛聋鸣，上关穴主治，针刺不可深。耳聋鸣响，下关、阳溪、关冲、掖门、阳谷穴主治。耳聋鸣响，颈颔疼痛，耳门穴主治。耳鸣听不见声音，肩贞、完骨穴主治。耳中生风，耳鸣耳聋有时听不见，商阳穴主治。耳鸣，百会、颔厌、颅息、天窗、大陵、偏历、前谷、后溪穴主治。
[Luo Zhi] Sudden deafness is caused by deficiency of Kidney Qi, allowing Wind pathogen to invade. The pathogen combats with the meridians and collaterals, follows the blood vessels upward into the ear. When Righteous Qi (Zheng Qi) and Pathogenic Qi clash, sudden deafness occurs.
Sudden deafness is always due to Jue-Ni (reversal) Qi. The Classics state: "Sudden Jue-Ni with deafness, unilateral blockage and obstruction, is due to internal Qi suddenly pressing inward." It also states: "Jue-Ni of the Shaoyang channel manifests as sudden deafness."
[Luo Zhi] Puhuang Ointment: Treats sudden deafness.
Xixin (Asarum Herba), Puhuang (Tofu Setariae Pollen) (each 2 fen), Qu Mo (End of Fermented Wheat), Xingren (Prunus Armeniacae Semen) (soaked in hot water, skin and tips removed, double kernels removed; each 3 fen).
Grind all into powder. Grind Xingren into a paste, mix well, and shape into pills the size of a jujube pit. Wrap in cotton and insert into the ear. Change once daily until cured.
Another formula: Longnao Ointment
Longnao (Borneolum Syntheticum) (0.5 fen, ground), Jiaomu (Zanthoxyli Fructus Seed) (0.5 liang, pounded into powder), Xingren (Prunus Armeniacae Semen) (1 fen, soaked in hot water, skin removed).
Pound and grind the above ingredients together until uniform. Wrap in cotton to the size of a jujube pit and insert into the ear. Change twice daily.
[Shi Yi (World Physicians)] Shujiao (Sichuan Pepper), Badou (Crotonis Fructus), Changpu (Acori Tatarinowii Rhizoma), Songzhi (Pinis Resina). Melt with wax to form a tube, insert into the ear to draw out Kidney deficiency Qi. If there is a sound like wind and water flowing, or like beating bells and drums, causing sudden deafness, change once daily for miraculous effect.
Treating sudden deafness.
Xionghuang (Realgar) (1 qian), Badou (Crotonis Fructus) (one fruit, shell removed).
Grind finely, mix with scallion juice to form one tablet. Roll in paper and insert into the ear.
[Zhu Danxi] Treating sudden deafness. Lingxiao flower leaves, pound to extract natural juice, drip into the ear until cured. (*Doumen Fang* states: Materia Medica says Lingxiao activates blood and resolves stasis. Danxi says: It supplements Yin very swiftly.)
*[Ling Shu]* Sudden deafness with Qi obstruction, unclear hearing and vision, select Tianyou point. (From *Han Re Bing Pian*)
*[Jia Yi Jing]* Sudden Qi-induced deafness is primarily treated by Sidu point.
(To be used in conjunction with Deafness protocols)
[Zhu Danxi] Palace Woman Feng suffered from tinnitus in the left ear, caused by overwork. The method should be to supplement Yin and anchor/descend floating Yang.
Huangqi (Astragali Radix), Renshen (Ginseng Radix) (1 liang), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Shengma (Cimicifugae Rhizoma) (5 fen), Jiubaie (Phellodendri Cortex prepared with wine) (3 qian), Fangfeng (Saposhnikoviae Radix) (2.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1.5 qian), Shaoyao (Paeoniae Radix Alba) (prepared with wine).
Divide into ten doses. Take hot before meals. After drinking, sleep for a while.
Buzzing in the ears indicates lack of Yin.
The above describes upper Yin deficiency causing tinnitus. The Classics state: "When body fluids are depleted, brain marrow diminishes; calves ache and ears ring frequently." This refers to that condition.
[Luo Zhi] Treating Kidney deficiency tinnitus: sleeping at night feels like beating war drums, waking up feels like wind blowing in the ear, accompanied by spasms and pain in the four limbs. Use Huangqi Pill.
Huangqi (Astragali Radix) (remove root tufts, 1 liang), Bajieli (Tribuli Fructus) (stir-fried, ground fine on tile), Qianghuo (Notopterygii Rhizoma et Radix) (remove root tufts; each 0.5 liang), Heifuzi (Aconiti Lateralis Radix Preparata) (one large one), Jieyangshen (Caprae Hircus Kidney) (one pair, dried by baking).
Grind into fine powder, make pills with wine paste, size of paulownia seeds. Take 30-40 pills per dose, empty stomach before meals, wash down with warm scallion and salt soup.
*[Su Wen]* What the Taiyang chapter calls tinnitus is because Yang Qi is abundant and leaps upward, hence tinnitus. (From *Mai Jie Pian*)
[Zhu Danxi] Tinnitus caused by excessive alcohol consumption: use a large dose of Tongsheng San, add Zhike (Aurantii Fructus), Chaihu (Bupleuri Radix), Dahuang (Rhei Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Nanting (Arisaematis Rhizoma), Jiegeng (Platycodonis Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Jingjie (Schizonepetae Herba). If not cured, use Siwu Tang. For deafness, take Longdan Xiegan Wan after meals. For individuals with excess Qi, use Binglang Shenxiong Wan to purge. (Shenxiong Wan formula seen earlier in Deficiency/Excess methods.)
[Li Dongyuan] Chaihu Conger Tang: Treating cerumen (earwax), tinnitus, and deafness.
Chaihu (Bupleuri Radix) (3 qian), Lianqiao (Forsythiae Fructus) (4 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian, honey-fried), Mengchong (Blatta Orientalis), Shizhi (Hirudo) (stir-fried, 5 fen, each ground separately), Shexiang (Musk) (a little, ground separately), Guishen (Angelicae Sinensis Radix), Renshen (Ginseng Radix) (each 1 qian).
Except for Mengchong, Shizhi, and Shexiang which are ground separately, decoct the rest in wine and water until cooked. Strain dregs, then add the three powders. Boil again for one or two boils. Take slightly warm after meals.
In the theory of Six Qi, tinnitus belongs to Wind-Fire. The Classics state: "When Jueyin governs the year, Wind moves through the Great Void, clouds and objects shake, causing dizziness and tinnitus." During the third Qi period, Heaven's administration spreads, Wind rises timely, people suffer tinnitus. Also: "Jueyin channel disease involves tinnitus and vertigo." Also: "Shaoyang arrival manifests as tinnitus, treated with cooling/cold methods."
[Zhu Danxi] Tinnitus without day or night distinction. Use Wutou (Aconiti Radix) burnt to ash, Changpu (Acori Tatarinowii Rhizoma) in equal parts, powdered, wrapped in cotton and inserted into the ear for immediate effect. (From Yang Shi *Chan Ru*)
*[Qian Jin Fang]* Treating tinnitus sounding like flowing water, itchy ears, and wind sounds. If untreated for long, it becomes deafness. Use raw Wutou (Aconiti Radix) alone. Dig it up, peel while wet to the size of a jujube pit, insert into the ear. Change day and night once. Cured within three days.
*[Zhou Hou Bei Ji Fang]* Treating constant ringing in the ears. Cut fresh Dihuang (Rehmanniae Radix) to plug the ear. Change multiple times until cured.
*[Ling Shu]* Yellow Emperor asked: What Qi causes ringing in the ears? Qibo answered: The ear is the gathering place of Zong Mai (Grand Vessels). Therefore, when the Stomach is empty, Zong Mai becomes deficient. Deficiency leads to downward flow, and where vessels exhaust, tinnitus occurs. Tonify Keyuren (ST7) point, located at the junction of the nail and flesh on the thumb. (From *Kou Wen Pian*)
There are three tonification methods for acupuncture/moxibustion in treating tinnitus, this is the first. Furthermore, the Classics state: "When Upper Qi is insufficient, the ears suffer ringing; tonify the point below the outer ankle (Shenmai BL62) and retain needle," this is the second. Also: "The Brain is the Sea of Marrow. Its transport points are above at Baihui (GV20) and below at Fengfu (GV16). When the Sea of Marrow is insufficient, there is dizziness and tinnitus. Carefully observe these transport points to regulate deficiency and excess," this is the third method of selection.
There are two more selection methods. The Classics state: "For tinnitus, select the arterial pulse in front of the ear," this is one. Also: "For tinnitus, select above the nail of the middle finger; left affected, treat right; right affected, treat left. Treat hand points first, then foot points," this is two. Selection means observing deficiency/excess to regulate.
There is one Jie Ci (plunder puncture) method. The Classics state: "Disease of Hand-Taiyang sinews: shoulder and arm pain radiating to the neck, tinnitus, pain turning into spasm. Treat with burning needle Jie Ci, until sensation changes, using the painful spot as the Shu point." This is the method.
[Shi Yi] Ear deficiency ringing: Shenshu (BL23), Taixi (KI3).
*[Jia Yi Jing]* Ear pain, deafness, tinnitus: Shangguan (ST7) primarily treats. Do not needle deeply. Deafness, tinnitus: Xiaguan (ST7), Yangxi (LI5), Guanchong (SJ1), Yemen (not standard, likely typo for Yamen GB10 or similar, but text says Yemen), Yanggu (SI4) primarily treat. Deafness, tinnitus, neck/jaw pain: Ermen (TE21) primarily treats. Tinnitus with hearing loss: Jianzhen (SI9), Wanggu (GB12) primarily treat. Wind in ear, tinnitus/deafness intermittent: Shangyang (LI1) primarily treats. Tinnitus: Baihui (GV20), Hanyan (GB8), Luxi (TB19), Tianchuang (SI16), Daling (PC7), Pianli (LI6), Qiangu (SI3), Houxi (SI3) primarily treat.
Heart pulse micro-choppy indicates tinnitus and epilepsy. (Full text see Treating Deficiency/Excess methods.)