[总诀]耳虽肾窍辨声音,绕耳游行是胆经。时辈不知清木火,漫将滋肾诩高明。耳鸣耳聋,或兼口苦寒热
者,少阳经风热也。宜仲景柴胡汤。
柴胡(三钱) 人参(二钱) 黄芩(三钱) 半夏(三钱) 甘草(一钱) 生姜(三片) 大枣
(二枚)
歌曰∶耳鸣寒热或兼聋,枣草参苓姜夏同。
风中少阳柴作引,方原仲景妙无穷。
(伯未按∶耳暴聋,木香研末,酒浸一宿,以酒滴耳中。)
耳鸣耳聋,或兼胁痛善怒者,肝经之火郁也。宜加味泻肝汤。
当归(三钱) 生地(三钱) 柴胡(三钱) 黄芩(三钱) 栀子(三钱) 泽泻(三钱) 木通(二
钱) 胆草(三钱) 车前子(三钱) 牡蛎(三钱) 青皮(一钱) 甘草(一钱)
歌曰∶耳鸣胁痛泻肝汤,龙胆车前牡蛎匡。
通泽栀芩柴地用,青皮归草合成方。
(伯未按∶夏枯花五钱,浓煎服之,极简效。)
耳鸣耳聋,并无障碍壅闭者,肾虚阴气逆也。宜加味磁朱丸。
磁石(三钱) 朱砂(一钱) 熟地(四钱) 山药(三钱) 云苓(三钱) 泽泻(三钱) 丹皮(三
钱) 山茱萸(三钱) 五味子(五分) 菖蒲(一钱)
歌曰∶肾虚亦使耳聋鸣,磁石朱砂研要精。
苓泽山丹蒲味具,山萸熟地使阴生。
【总诀】耳朵虽然是肾的外窍,负责辨别声音,但环绕耳朵循行的是胆经。世俗之人不懂得清泻肝胆之火,却随意将滋补肾阴标榜为高明之法。耳鸣耳聋,如果兼有口苦、寒热往来症状的,属于少阳经受风热侵袭。适宜使用张仲景的柴胡汤。
柴胡(三钱) 人参(二钱) 黄芩(三钱) 半夏(三钱) 甘草(一钱) 生姜(三片) 大枣(二枚)
歌诀说:耳鸣伴有寒热或兼耳聋,用到大枣、甘草、人参、茯苓、生姜、半夏。(注:此处歌诀中“参苓”实指人参与茯苓,但原方列表中为人参,无茯苓,且后文加味泻肝汤及磁朱丸亦无茯苓,结合语境及常见配伍,此处歌诀可能泛指或存在传抄差异,但依原文翻译即保留字面意思,同时指出原方组成)。
风中少阳经,以柴胡为引药,此方源自张仲景,奥妙无穷。
(伯未按语:突然暴聋,可用木香研成粉末,用酒浸泡一夜,取酒滴入耳中。)
耳鸣耳聋,如果兼有胁肋疼痛、容易发怒症状的,属于肝经火气郁结。适宜使用加味泻肝汤。
当归(三钱) 生地(三钱) 柴胡(三钱) 黄芩(三钱) 栀子(三钱) 泽泻(三钱) 木通(二钱) 胆草(三钱) 车前子(三钱) 牡蛎(三钱) 青皮(一钱) 甘草(一钱)
歌诀说:治疗耳鸣胁痛的泻肝汤,龙胆草、车前子、牡蛎起匡扶作用。
木通、泽泻、栀子、黄芩、柴胡、生地配合使用,加上青皮、当归、甘草合成一方。
(伯未按语:夏枯花五钱,浓煎服用,效果极简且显著。)
耳鸣耳聋,并没有障碍壅闭感觉的,属于肾虚导致阴气上逆。适宜使用加味磁朱丸。
磁石(三钱) 朱砂(一钱) 熟地(四钱) 山药(三钱) 云苓(三钱) 泽泻(三钱) 丹皮(三钱) 山茱萸(三钱) 五味子(五分) 菖蒲(一钱)
歌诀说:肾虚也会导致耳聋耳鸣,磁石和朱砂研磨要精细。
茯苓、泽泻、山药、丹皮、菖蒲、五味子都具备,山茱萸和熟地能使阴气滋生。
[General Principle] Although the ears are the orifice of the Kidney (Shen) and responsible for distinguishing sounds, the Gallbladder Meridian (Dan Jing) circulates around the ears. Contemporary practitioners often fail to understand how to clear Wood and Fire pathogens, instead indiscriminately claiming that nourishing the Kidney is a superior method. Tinnitus and deafness accompanied by bitter taste in the mouth and alternating chills and fever indicate Wind-Heat affecting the Shaoyang Meridian (Shaoyang Jing). The appropriate prescription is Chaihu Tang (Bupleurum Decoction) from Zhang Zhongjing.
Chai Hu (San Qian) Ren Shen (Er Qian) Huang Qin (San Qian) Ban Xia (San Qian) Gan Cao (Yi Qian) Sheng Jiang (San Pian) Da Zao (Er Mei)
The song states: Tinnitus with chills and fever or accompanied by deafness, combined with dates, licorice, ginseng, poria, ginger, and pinellia.
When Wind affects the Shaoyang, Chai Hu serves as the guiding herb; this formula originates from Zhang Zhongjing and its efficacy is boundless.
(Commentary by Bowei: For sudden acute deafness, grind Mu Xiang (Costus Root) into powder, soak it in wine overnight, and drip the wine into the ear.)
Tinnitus and deafness accompanied by hypochondriac pain and irritability indicate Fire stagnation in the Liver Meridian (Gan Jing). The appropriate prescription is Jiawei Xiegan Tang (Modified Draining Liver Decoction).
Dang Gui (San Qian) Sheng Di (San Qian) Chai Hu (San Qian) Huang Qin (San Qian) Zhi Zi (San Qian) Ze Xie (San Qian) Mu Tong (Er Qian) Dan Cao (San Qian) Che Qian Zi (San Qian) Mu Li (San Qian) Qing Pi (Yi Qian) Gan Cao (Yi Qian)
The song states: For tinnitus and hypochondriac pain, use Xiegan Tang, supported by Long Dan, Che Qian, and Mu Li.
Mu Tong, Ze Xie, Zhi Zi, Huang Qin, Chai Hu, and Sheng Di are used, combined with Qing Pi, Dang Gui, and Gan Cao to form the prescription.
(Commentary by Bowei: Boil Wu Kui Hua (Prunella Vulgaris Flower) five qian in concentrated decoction and take it; it is extremely simple and effective.)
Tinnitus and deafness without any sensation of obstruction or blockage indicate reversal of Yin Qi due to Kidney Deficiency (Shen Xu). The appropriate prescription is Jiawei Cizhu Wan (Modified Magnetite and Cinnabar Pill).
Ci Shi (San Qian) Zhu Sha (Yi Qian) Shu Di (Si Qian) Shan Yao (San Qian) Yun Ling (San Qian) Ze Xie (San Qian) Dan Pi (San Qian) Shan Zhu Yu (San Qian) Wu Wei Zi (Wu Fen) Chang Pu (Yi Qian)
The song states: Kidney deficiency also causes tinnitus and deafness; Ci Shi and Zhu Sha must be ground finely.
Yun Ling, Ze Xie, Shan Yao, Dan Pi, Chang Pu, and Wu Wei Zi are all included; Shan Zhu Yu and Shu Di promote the generation of Yin.