【方歌】黑疔暗藏耳窍生，色黑根深椒目形，痛如锥刺引腮脑，
破流血水火毒攻。
【注】此证生于耳窍暗藏之处，由肾经火毒所发，亦有因服丹
石热药，积毒而成者。色黑根深，形如椒目，疼如锥刺
，痛引腮脑，破流血水，急服蟾酥丸汗之。再用蟾酥丸
水调浓，滴于耳窍内，立效。毒甚者以黄连消毒饮疏解
之，黄连解毒汤清之即瘥。
方剂：黄连解毒汤
组成：黄连 黄芩
黄柏 生栀子（研，各一钱五分）
水煎热服。
【方歌】黄连解毒焮痛疮，诸般疔毒烦躁狂，黄连芩柏生栀子，
四味煎服保安康。
又方：蟾酥丸（见疔疮门）
黄连消毒饮（见头部百会疽）
【方歌】耳疳时出黑臭脓，青震白缠黄色聤，胃湿相兼肝经火，
红风偏肝血热成。
【注】此证耳内闷肿出脓，因脓色不一，而名亦各殊。如出黑
色臭脓者，名耳疳；出青脓者，名震耳；出白脓者，名
缠耳；出黄脓者，名聤耳，俱由胃湿与肝火相兼而成。
宜柴胡清肝汤主之。气实火盛者，以龙胆泻肝汤服之。
惟风耳则出红脓，偏于肝经血热，宜用四物汤加丹皮、
石菖蒲服之。外俱用酱茄内里然油滴之，俟脓净换滴耳
油，时时滴入，肿消生肌自愈。
方剂：滴耳油
组成：核桃仁研烂，拧油去渣，得油一钱，兑冰片二分。每用
少许，滴于耳内。
【方歌】滴耳油治耳疳证，脓净滴之效更深，核桃拧油消肿痛，
冰片发散热通神。
又方：柴胡清肝汤（见前鬓疽）
龙胆泻肝汤（见腰部缠腰火丹）
四物汤（见疮疡门）
【方歌】黑疔暗藏于耳窍深处生成，颜色发黑、根深蒂固，形状如同花椒籽，疼痛如锥子刺入并牵引至腮部和脑部，破溃后流出血液和脓水，这是由火毒攻冲所致。
【注】此证生于耳窍隐蔽之处，由肾经的火毒引发，也有因服用丹石类热性药物，导致积毒而形成的。症状表现为色黑根深，形状像花椒籽，疼痛如锥刺，痛感牵连腮部和脑部，破溃后流出血水，需紧急服用蟾酥丸使其发汗。再用蟾酥丸用水调成浓汁，滴入耳窍内，立即见效。毒邪严重者，用黄连消毒饮来疏解，用黄连解毒汤来清热，即可痊愈。
方剂：黄连解毒汤
组成：黄连 黄芩 黄柏 生栀子（研碎，各一钱五分）
加水煎煮，热服。
【方歌】黄连解毒汤治疗红肿疼痛的疮疡，以及各类疔毒引起的烦躁狂乱，由黄连、黄芩、黄柏、生栀子四味药煎服，可保平安健康。
又一方：蟾酥丸（见疔疮门章节）
黄连消毒饮（见头部百会疽章节）
【方歌】耳疳时常流出黑色且恶臭的脓液，青色脓液称为震耳，白色脓液称为缠耳，黄色脓液称为聤耳，红色脓液则多因肝经血热形成风证。
【注】此证表现为耳内闷胀肿痛并出脓，因为脓液颜色不同，名称也各不相同。如流出黑色臭脓的，名为耳疳；流出青色脓液的，名为震耳；流出白色脓液的，名为缠耳；流出黄色脓液的，名为聤耳，这些病症都是由胃湿与肝火相互兼夹而成。适宜用柴胡清肝汤为主进行治疗。体质壮实、火势旺盛者，服用龙胆泻肝汤。只有风耳流出红色脓液，偏向于肝经血热，适宜用四物汤加入牡丹皮、石菖蒲服用。外部均使用酱茄子内部烧油后滴入，待脓液排净后更换滴入耳油，经常滴入，肿胀消退、肌肉生长后即可自愈。
方剂：滴耳油
组成：核桃仁研烂，拧取油液去渣，得到油一钱，兑入冰片二分。每次用少许，滴入耳内。
【方歌】滴耳油治疗耳疳证，脓液排净后滴入疗效更深，核桃拧油可消肿止痛，冰片发散热量疏通神窍。
又一方：柴胡清肝汤（见前鬓疽章节）
龙胆泻肝汤（见腰部缠腰火丹章节）
四物汤（见疮疡门章节）
[Formula Song] Heiding (Black Carbuncle) secretly arises in the ear canal, with a black color and deep roots, shaped like a pepper seed. The pain is like a needle piercing, radiating to the cheek and brain. Upon rupture, it bleeds and discharges fluid, caused by the attack of fire-toxin.
[Note] This condition arises in the hidden parts of the ear canal, triggered by fire-toxin from the Kidney Meridian. It may also result from the accumulation of toxins due to the ingestion of hot medicinal stones (Dan Shi). The symptoms include a black color, deep roots, and a shape resembling a pepper seed. The pain feels like a needle piercing, radiating to the cheeks and brain, with bleeding and discharge upon rupture. Urgently administer Chansu Wan (Toad Venom Pill) to induce sweating. Then, mix Chansu Wan with water to form a thick paste and drip it into the ear canal for immediate effect. For severe toxicity, use Huanglian Xiaodu Yin (Coptis Decoction for Detoxification) to dissipate and resolve it, and Huanglian Jiedu Tang (Coptis Decoction for Clearing Heat and Resolving Toxin) to clear heat; recovery will follow.
Formula: Huanglian Jiedu Tang (Coptis Decoction for Clearing Heat and Resolving Toxin)
Composition: Huanglian (Rhizoma Coptidis), Huangqin (Radix Scutellariae), Huangbai (Cortex Phellodendri), Sheng Zhizi (Fructus Gardeniae, raw, crushed, each 1.5 qian).
Decoct in water and take warm.
[Formula Song] Huanglian Jiedu Tang treats carbuncles with redness, swelling, and pain, as well as various types of Ding poison causing irritability and madness. Decocting the four ingredients—Huanglian, Huangqin, Huangbai, and Sheng Zhiji—ensures safety and health.
Another Formula: Chansu Wan (see section on Ding Sores)
Huanglian Xiaodu Yin (see section on Baihui Ju of the Head)
[Formula Song] Er'gan (Ear Fungus) frequently discharges black, foul-smelling pus. Green pus is called Zhen'er, white pus is called Chan'er, yellow pus is called Ting'er. Red pus is often formed by wind due to blood-heat in the Liver Meridian.
[Note] This condition presents with stuffiness, swelling, pain in the ear, and pus discharge. Due to the different colors of the pus, the names vary. Black, foul-smelling pus is named Er'gan; green pus is named Zhen'er; white pus is named Chan'er; yellow pus is named Ting'er. All these conditions are caused by the combination of Stomach Dampness and Liver Fire. Chaihu Qinggan Tang (Bupleurum Decoction for Clearing the Liver) should be used as the primary treatment. For those with excess constitution and vigorous fire, Longdan Xiegan Tang (Gentian Decoction for Draining the Liver) should be taken. Only Feng'er (Wind Ear) discharges red pus, which leans towards blood-heat in the Liver Meridian; Siwu Tang (Four Substances Decoction) added with Mudanpi (Cortex Moutan) and Shichangpu (Rhizoma Acori Tatarinowii) should be used. Externally, apply oil extracted from roasted pickled eggplant to the ear. Once the pus is cleared, switch to dripping Ear Oil. Drip frequently until swelling subsides and flesh regenerates, leading to self-healing.
Formula: Di'er You (Ear-Dropping Oil)
Composition: Crush Walnut Kernel (Semen Juglandis), press to extract oil and remove dregs to obtain one qian of oil, mixed with two fen of Bingpian (Borneolum Syntheticum). Use a small amount per application, dripping into the ear.
[Formula Song] Di'er You treats Er'gan syndrome; dripping it after pus clearance yields deeper efficacy. Walnut oil reduces swelling and relieves pain, while Borneol disperses heat and unblocks the spirit.
Another Formula: Chaihu Qinggan Tang (see section on Bianju of the Temple)
Longdan Xiegan Tang (see section on Waist-Binding Fire Snake of the Waist)
Siwu Tang (see section on Chuangyang Men/Sores and Ulcers)