耳疮属手少阳三焦经，或足厥阴肝经血虚风热，或肝经燥火风热，或肾经虚火等因。若
发热
热作痛，属肝经风热，用小柴胡汤，加山栀、川芎。若内热口干，属肾经虚火，用加味地黄
丸；如不应，用加减八味丸。余当随症治之。
治验
文选姚海山耳根赤肿，寒热作痛，此属三焦风热也。但中气素虚，以补中益气，加山栀
、炒黄芩、牛蒡子，治之而愈。
一儒者因怒，耳内作痛出水，或用祛风之剂，筋挛作痛，肢体如束，此肝火伤血也，
用六味丸料，数服而愈。
举人毛石峰子年二十，耳内出水，或作痛年余矣，脉洪数，左尺益甚，此属肝肾二经虚
热也，用加减八味丸料，一剂而愈。
一男子每入房，耳内或作痒，或出水，常以银簪探入，甚喜阴凉，此属肾经虚热也，用
加减八味丸而愈。
一妇人因怒发热，每经行即两耳出脓，两太阳作痛，以手按之，痛稍止。怒则胸胁乳房
胀肿，或寒热往来，或小便频数，或小腹胀闷，此皆属肝火血虚也。先用栀子清肝散二剂，又用
加味逍遥散数剂，诸症悉退；又以补中益气加五味而全愈。
一妇人经行后，因怒气劳役，发热寒热，耳内作痛，余以经行为血虚，用八珍汤加柴胡
。怒气为肝火，用加味逍遥散。劳役为气伤，用补中益气汤加山栀而愈。
一妇人耳内作痛，或肿 ，寒热发热，面色素青黄，经行则变赤。余以为怒气伤肝，郁
结伤脾。用加味归脾汤、加味逍遥散而愈。
一妇人耳内肿痛，寒热口苦，耳内出水， 连颈项，饮食少思，此肝火甚而伤脾也。用
小柴胡汤加山栀、牡丹皮稍愈，用加味逍遥散，及八珍汤加柴胡、山栀、丹皮，调补肝脾而
一孀妇，或耳内外作痛，或项侧结核，内热晡热，月经不调，唾痰少食，胸膈不利。余
以
太卿魏庄渠，癸卯仲冬，耳内作痛，左尺洪大而涩。余曰∶此肾水枯竭，不能生肝木，
当滋
明年季春十八日，复请治。昏愦不语，顺耳之分已有脓矣，且卵缩便数，方信余言，求治。
辞不克，用六味丸料一钟，阴茎舒出，
小便十减六七，神思顿醒。余曰∶若砭脓出，庶延数日，
为立嗣之计，否则脓从耳出，死立待矣，或谓不砭可
生者。余因辞归，翌日，果耳内出脓，至二十一日，己未火日而卒。
宪副姜时川，癸卯冬，右手寸口浮数而有痰，口内若有疮然。余曰∶此胃火传于肺也，
，慎起居，以御之。甲辰秋，尺脉洪数而无力。余曰∶此肺金不能生肾水，无根之火上炎也
。宜静调养，滋化源以治之。彼云∶今喉耳不时燥痛，肢体不时发热。果是无根之火，殒无
疑矣。后会刘古峡云∶姜公之病，已如尊料。遂拉同往视，喉果肿溃，脉愈洪大，又误以为
疮毒，而投苦寒之剂。卒于仲冬二十八日，乃药之促其亡也，否则尚能延至仲夏。
耳疮归属于手少阳三焦经，或由足厥阴肝经血虚风热所致，或由肝经燥火风热所致，或由肾经虚火等因素引起。如果发热且疼痛发作，属于肝经风热，使用小柴胡汤，加入山栀、川芎。如果内热口干，属于肾经虚火，使用加味地黄丸；如果无效，使用加减八味丸。其余情况应当根据症状进行治疗。
医案记录：
文选姚海山耳根红肿，寒热交替并疼痛，这属于三焦风热。但他中气素来虚弱，用补中益气汤，加入山栀、炒黄芩、牛蒡子治疗，痊愈了。
一位儒生因为发怒，耳内疼痛并流出液体，有人使用祛风的药剂，导致筋脉拘挛疼痛，肢体像被捆绑一样，这是肝火伤及血液，使用六味地黄丸料，服用几剂后痊愈。
举人毛石峰的儿子二十岁，耳内流液，有时疼痛一年多，脉象洪数，左尺脉尤其明显，这属于肝肾二经的虚热，使用加减八味丸料，一剂后痊愈。
一名男子每次行房事，耳内或发痒，或流出液体，常用银簪探入耳内，非常喜欢阴凉环境，这属于肾经虚热，使用加减八味丸而痊愈。
一名妇女因为发怒发热，每次月经来潮时双耳流脓，两侧太阳穴疼痛，用手按压，疼痛稍止。发怒时胸胁乳房胀肿，有时寒热往来，有时小便频数，或小腹胀闷，这些都属于肝火血虚。先用栀子清肝散两剂，又用加味逍遥散几剂，所有症状全部消退；再用补中益气汤加五味子完全治愈。
一名妇女在月经结束后，因为生气和劳累，出现发热恶寒，耳内疼痛，我认为月经期间是血虚，使用八珍汤加柴胡。生气是肝火，使用加味逍遥散。劳累是气伤，使用补中益气汤加山栀而痊愈。
一名妇女耳内疼痛，有时肿胀，寒热发热，面色素来青黄，月经来潮时变为红色。我认为这是怒气伤肝，郁结伤脾。使用加味归脾汤、加味逍遥散而痊愈。
一名妇女耳内肿痛，寒热口苦，耳内流液，牵连颈项，饮食减少思虑，这是肝火严重而伤及脾脏。使用小柴胡汤加山栀、牡丹皮稍微好转，使用加味逍遥散，以及八珍汤加柴胡、山栀、丹皮，调补肝脾而痊愈。
一位寡妇，有时耳内外疼痛，有时颈部侧面有结核，内热午后发热，月经不调，咳痰少食，胸膈不畅。我认为是……（原文此处似有缺漏或断句问题，依上下文推断为肝脾肾相关证候，但严格按原文提取实体，故仅翻译可见部分）太卿魏庄渠，癸卯年仲冬，耳内疼痛，左尺脉洪大而涩。我说：这是肾水枯竭，不能生养肝木，应当滋……（原文此处中断）
明年季春十八日，再次请治。神志昏愦不语，顺着耳部经络已有脓液，而且睾丸收缩、小便频繁，这才相信我的话，请求治疗。推辞不过，使用六味地黄丸料一钟，阴茎舒展伸出，小便次数减少十分之六七，精神思维顿时清醒。我说：如果用砭石刺破排脓，或许能延长几天寿命，为了立嗣后的打算，否则脓从耳出，死亡就在眼前了，有人说不用砭石也可以生存。我于是辞别回家，第二天，果然耳内流出脓液，到二十一日，己未火日去世。
宪副姜时川，癸卯年冬天，右手寸口脉浮数且有痰，口腔内好像有疮一样。我说：这是胃火传于肺，注意起居作息，以抵御它。甲辰年秋天，尺脉洪数而无力。我说：这是肺金不能生肾水，无根之火上炎。应该静养调理，滋养化源来治疗。他说：现在喉咙耳朵不时干燥疼痛，肢体不时发热。果真是无根之火，死亡无疑了。后来会见刘古峡说：姜公的病，已经像您预料的那样。于是拉着我同去诊视，喉咙果然肿胀溃烂，脉象更加洪大，又误以为是疮毒，而投用苦寒的药剂。最终在仲冬二十八日去世，这是药物促使他死亡，否则还能延续到仲夏。
Auricular sores (Ear sores) belong to the Hand-Shaoyang Sanjiao Meridian, or may be caused by Blood deficiency with Wind-Heat in the Foot-Jueyin Liver Meridian, Dry-Fire and Wind-Heat in the Liver Meridian, or Deficient-Fire in the Kidney Meridian. If fever occurs accompanied by pain upon onset, it belongs to Wind-Heat in the Liver Meridian; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Gardenia (Gardeniae Fructus) and Ligusticum chuanxiong (Chuanxiong Rhizoma). If there is internal heat and dry mouth, it belongs to Deficient-Fire in the Kidney Meridian; use Jia Wei Di Huang Wan (Modified Rehmannia Pill); if ineffective, use Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill). Other cases should be treated according to symptoms.
Clinical Records:
Yao Haishan, a Literary Selection Compiler, had redness and swelling at the root of the ear, alternating chills and fever with pain. This belongs to Wind-Heat in the Sanjiao. However, his Middle Qi was inherently deficient. He was treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Gardenia, Stir-fried Scutellaria (Scutellariae Radix), and Arctium lappa (Arctii Fructus), and was cured.
A scholar suffered from pain and discharge in the ear due to anger. Someone used Wind-dispelling agents, resulting in tendon spasms and pain, with limbs feeling bound. This was Liver-Fire injuring Blood. He was treated with Liu Wei Di Huang Wan material (Six-Ingredient Pill with Rehmannia), and after several doses, he recovered.
The son of Mao Shifeng, a Jinshi degree holder, was twenty years old. He had ear discharge and intermittent pain for over a year. His pulse was surging and rapid, especially in the left Chi position. This belongs to Deficient-Heat in the Liver and Kidney meridians. He was treated with Jia Jian Ba Wei Wan material, and recovered after one dose.
A man experienced itching or discharge in the ear after intercourse. He often inserted a silver hairpin into the ear and preferred cool environments. This belongs to Deficient-Heat in the Kidney Meridian. He was cured using Jia Jian Ba Wei Wan.
A woman developed fever due to anger. Every time her menstruation occurred, pus discharged from both ears, and pain occurred in both temporal regions, which subsided slightly upon pressure. Anger caused distension and swelling in the chest, hypochondrium, and breasts; sometimes there were alternating chills and fever, frequent urination, or lower abdominal fullness. All these belong to Liver-Fire and Blood deficiency. She first took Zhi Zi Qing Gan San (Gardenia Clearing the Liver Powder) for two doses, then Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for several doses, after which all symptoms receded. Finally, she took Bu Zhong Yi Qi Tang with Wu Wei Zi (Schisandra Berry) and was fully cured.
After menstruation, a woman suffered from fever and chills, and ear pain due to anger and overwork. I considered menstruation as Blood deficiency and used Ba Zhen Tang (Eight-Treasure Decoction) with Chai Hu (Bupleuri Radix). Anger represents Liver-Fire, treated with Jia Wei Xiao Yao San. Overwork injures Qi, treated with Bu Zhong Yi Qi Tang plus Gardenia, and she recovered.
A woman had ear pain and occasional swelling, with fever and chills. Her complexion was usually greenish-yellow, turning red during menstruation. I attributed this to anger injuring the Liver and stagnation injuring the Spleen. She was cured using Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) and Jia Wei Xiao Yao San.
A woman had painful swelling in the ear, alternating chills and fever, bitter taste, ear discharge extending to the neck, and poor appetite. This indicates severe Liver-Fire injuring the Spleen. She improved slightly with Xiao Chai Hu Tang plus Gardenia and Moutan Cortex (Moutan Radicis Cortex). She was then treated with Jia Wei Xiao Yao San, and Ba Zhen Tang plus Chai Hu, Gardenia, and Dan Pi to regulate and tonify the Liver and Spleen, leading to recovery.
A widow experienced pain inside and outside the ears, or nodules on the side of the neck, internal heat with afternoon fever, irregular menstruation, expectoration of phlegm, poor appetite, and chest diaphragm discomfort. [Text fragment missing]. Wei Zhuangqu, Grand Secretary, in mid-winter of the Gui-Mao year, had ear pain with a surging, large, and choppy pulse in the left Chi position. I said: This is exhaustion of Kidney Water, unable to nourish Liver Wood; it requires nourishing... [Text fragment missing].
On the 18th day of late spring the following year, treatment was requested again. The patient was confused and mute. Pus had formed along the ear meridian distribution, and the testicles were retracted with frequent urination. Only then did he believe my words and seek treatment. Unable to refuse, I administered one cup of Liu Wei Di Huang Wan material. The penis extended, urination decreased by six or seven tenths, and mental clarity returned suddenly. I said: If the pus were drained by scarification, life might be prolonged for a few days. For the sake of establishing an heir, otherwise, with pus discharging from the ear, death is imminent. Some said survival was possible without scarification. I declined and returned home. The next day, pus indeed discharged from the ear. On the 21st day, the Ji-Wei Fire day, he died.
Jiang Shichuan, Vice Commissioner, in winter of the Gui-Mao year, had a floating and rapid pulse at the right Cun Kou position with phlegm, and oral lesions resembling sores. I said: This is Stomach Fire transmitting to the Lung. Attend carefully to daily routine to resist it. In autumn of the Jia-Chen year, the Chi pulse was surging, rapid, and powerless. I said: This is Lung Metal unable to generate Kidney Water, with Rootless Fire flaming upward. It requires quiet recuperation and nourishing the source of transformation. He said: Now my throat and ears are occasionally dry and painful, and my limbs occasionally feel hot. Indeed, this is Rootless Fire; death is inevitable. Later, meeting Liu Guxia, he said: Lord Jiang's illness has proceeded exactly as you predicted. We went together to examine him. The throat was indeed swollen and ulcerated, and the pulse became even more surging and large. Mistakenly diagnosed as toxic sores, bitter-cold agents were administered. He died on the 28th day of mid-winter. This medication hastened his death; otherwise, he could have survived until mid-summer.