治血灌瞳仁，昏涩疼痛，及辘轳转关，外障。
麦门冬（去心，焙） 大黄（炒） 黄芩（去黑心） 桔梗（锉，炒） 玄参（各一两）
细辛（去苗） 芒硝（研，各半两）
上锉碎，每服五钱匕，水一盏半，煎至七分，去滓，下芒硝末少许，食后温服。
治眼血灌瞳仁，生障膜。
真珠 水晶 琥珀 马牙硝（各半两） 朱砂（一两） 龙脑（一分）
上同研如粉，以铜箸取如半小豆大点之。
河间云∶耳者盖非一也。以窍言之，是水也；以经言之，手足少阳俱会其中也。有从内
不能听者主也，有从外不能入者。经见有若蝉鸣者，有若钟声者，有若火 然者，各随经
也。之其间虚实，不可不察也。夫耳鸣有声，非妄闻也。耳为肾窍，交会手太阳少阳、足厥
阴少阴少阳之经。若水虚火实，而热气上甚，客其经络，冲于耳中，则鼓其听户，随其脉气
微甚而作诸音声也。经言阳气上甚而跃，故耳鸣也。夫耳聋者，由水衰火实，热郁于上而使
听户玄府壅塞，神气不得通泄也。其所验者，论曰∶属足少阴肾经，寄窍于耳而通之，所主
者精，精气调和，肾气充足，则耳目聪矣。且耳聋所感不一，有劳伤气血，风邪乘热，使精
脱肾惫而聋者；有挟风而聋者；有劳损而聋者。盖十二经脉，上络于耳，其诸经适有交并，
则脏气逆而为厥，厥气搏入于耳为厥聋。耳为厥聋，耳者宗脉之所附，脉虚而风邪乘之，风
入于耳，使经气否而不宽为风聋。劳役伤于血气，淫欲耗其精元，瘦悴力疲，昏昏愦愦为劳
聋。或人善调养，气血和平，不妄作劳，其证渐愈，或不能谨迎劳伤，精气神风邪停滞，则
为久聋之证。又有耳触风邪，热邪相持，其声嘈嘈，眼或见光为虚鸣，有热气乘热随脉入耳
，聚热不散，脓汁出焉，为脓耳。俗医多用剽悍燥烈之药制之，往往谓肾水虚冷故也。夫心
火本热，虚则寒矣；肾水本寒，衰则热矣。肾水既少，岂能反为病耶？故一法用酒浸针砂一
日，至晚去针砂，将酒含口中，用好瓷石一块，绵裹塞耳，在左塞左，在右塞右，欲导其气
而通泄也。或问曰∶聋既为热，或服干蝎生姜附子醇酒之类性热之物，而或愈者何也？答曰
∶欲以开发玄府，而令耳中郁滞通泄也。凡治聋者，适其所宜，若热证已退，而聋不已者，
当以辛热之剂发散，疾止即已，不可久服，恐热极而成他病尔。若聋有热证相兼者，宜以退
风散热调之，热退结散而愈。然聋甚闷绝，亦为难已，慎不可攻之，过极反伤正气。若非其
病，不可服其药，饮食同法，当所宜者，过度则反伤正气，病已即止，药欲求不病无损而已
矣。又言老人之气也，多病头目昏眩，耳鸣或聋上气等证，此皆阳实阴虚之证也。俗言老弱
为虚冷而无热也，纵有热证，或云少水不胜多火，而反言肾水虚则为寒，此乃举世受误之由
也，可不鉴哉！
治疗血灌瞳仁（眼底出血或充血导致瞳孔区浑浊）、眼睛昏涩疼痛，以及内障外障引起的视力障碍。
麦门冬（去除心部，焙干） 大黄（炒制） 黄芩（去除黑色腐坏部分） 桔梗（切碎，炒制） 玄参（各一两）
细辛（去除苗叶） 芒硝（研碎，各半两）
将上述药材切碎，每次服用五钱匕，加水一盏半，煎煮至七分满，滤去药渣，加入少许芒硝粉末，饭后温服。
治疗眼血灌瞳仁，生成障膜。
真珠 水晶 琥珀 马牙硝（各半两） 朱砂（一两） 龙脑（一分）
将上述药物共同研磨成粉，用铜筷取如半颗小豆大小的量点入眼中。
河间（刘完素）说：耳并非单一结构。从孔窍而言，它属水；从经络而言，手少阳经和足少阳经都汇聚于此。有因内部病变导致听力丧失的，也有因外部邪气侵入导致听力障碍的。临床上见到的耳鸣声像蝉鸣一样，有的像钟声，有的像火燃烧的声音，这都与受累的经络有关。其中的虚实情况，不可不仔细辨别。耳鸣有声，并非幻觉。耳为肾之窍，与手太阳、手少阳、足厥阴、足少阴、足少阳等经脉交会。如果肾水虚而心火实，热气上冲严重，客居于经络，冲击耳中，就会震动听户，随着脉气的强弱而产生各种声音。经文说阳气上冲剧烈而跳动，所以发生耳鸣。耳聋，是由于肾水衰退、心火亢盛，热气郁结于上部，使听户的玄府（汗孔，此处指细微的气机通道）壅塞，神气不能通畅宣泄所致。其验证依据是：属于足少阴肾经，寄居窍位于耳并与其相通，所主的是精。精气调和，肾气充足，则耳目聪明。而且引起耳聋的原因不一，有因劳损伤及气血，风邪乘热侵袭，导致精脱肾惫而聋的；有挟带风邪而聋的；有因过度劳累而聋的。大概十二经脉，上行联络于耳，各经在此处恰好交汇，如果脏气逆乱导致厥证，厥气搏入耳中，就形成厥聋。耳是宗脉（多条经脉）汇聚之处，脉虚而风邪乘虚而入，风邪进入耳中，使经气闭塞不通畅，形成风聋。劳役损伤血气，淫欲耗损精元，身体消瘦憔悴、乏力疲倦，头昏脑胀，形成劳聋。如果人善于调养，气血平和，不妄自劳作，症状会逐渐痊愈；如果不能谨慎避免劳伤，精气神与风邪停滞，就会形成长期耳聋的病症。又有耳朵触受风邪，热邪相互持衡，声音嘈杂，或者眼前见光，这是虚鸣；有热气乘热随经脉进入耳中，聚热不散，流出脓汁，这是脓耳。俗医多用剽悍燥烈的药物治疗，往往认为是肾水虚冷所致。其实心火本性是热的，虚的时候才表现为寒；肾水本性是寒的，衰败的时候才表现为热。肾水既然已经减少，怎么能反而变成病态的寒呢？因此有一种方法是用酒浸泡针砂一天，到了晚上取出针砂，将酒含在口中，取一块好瓷石，用绵布包裹塞入耳中，左耳塞左边，右耳塞右边，目的是引导气机并使其通畅宣泄。有人问：既然耳聋是由热引起的，为什么有些人服用干蝎、生姜、附子、醇酒等性热的药物后却痊愈了呢？回答说：是想利用这些药物开发玄府，让耳中的郁滞得以通畅宣泄。凡是治疗耳聋，要适合病情。如果热证已退，但耳聋不止，应当用辛热药剂发散，病止即停，不可久服，恐怕热极会引发其他疾病。如果耳聋伴有热证，宜用疏散风热的方法调理，热退结散即可痊愈。然而耳聋非常严重甚至闷绝的，也难以治愈，千万不可攻伐太过，过度反而会伤害正气。如果不是相应的病症，不可服用相应的药物，饮食调理也是如此，适宜的要适度，过度则反伤正气，病愈即止，用药的目的是求得不生病且无损于身体罢了。又说老人的气机状况，多出现头目昏眩、耳鸣或耳聋、上气等症状，这些都是阳实阴虚的病症。世俗说法认为老弱就是虚冷而没有热证，即使有热证，也常说“少水不胜多火”，反而说肾水虚就会变寒，这正是举世被误导的原因啊，怎能不引以为鉴呢！
Treats blood flooding the pupil (hemorrhage or congestion in the pupillary area causing turbidity), dim and aching eyes, as well as internal and external obstructions affecting vision.
*Ophiopogonis Radix* (remove heart, baked) *Rhei Radix et Rhizoma* (stir-fried) *Scutellariae Radix* (remove blackened parts) *Platycodonis Radix* (cut into pieces, stir-fried) *Scrophulariae Radix* (each 1 liang)
*Asari Radix* (remove seedlings) *Natrii Sulfas* (crushed, each 0.5 liang)
Crush the above herbs finely. For each dose, take five qian bi (a small spoonful), add one dan and a half of water, decoct until reduced to seven-tenths, strain off the dregs, add a small amount of powdered *Natrii Sulfas*, and take warm after meals.
Treats blood flooding the pupil with the formation of ocular membranes (cataracts or pterygium).
*Margarita* *Quartz* *Amber* *Natrii Sulfas* (each 0.5 liang) *Cinnabaris* (1 liang) *Borneolum Syntheticum* (1 fen)
Grind the above substances together into powder. Use copper chopsticks to take an amount the size of half a small bean and instill into the eye.
Hejian (Liu Wansu) stated: The ear is not a single entity. In terms of orifices, it belongs to Water; in terms of meridians, both the Hand Shaoyang and Foot Shaoyang meridians converge there. There are cases where hearing loss originates from within, and cases where it results from external invasion. Clinically, tinnitus may sound like cicadas, like bells, or like fire burning, each corresponding to specific meridians. One must carefully distinguish between deficiency and excess. Tinnitus with sound is not a hallucination. The ear is the orifice of the Kidney and intersects with the Hand Taiyang, Hand Shaoyang, Foot Jueyin, Foot Shaoyin, and Foot Shaoyang meridians. If Kidney Water is deficient and Heart Fire is excessive, with severe upward rushing of heat pathogen lodging in the meridians and striking the ear, it vibrates the auditory aperture, producing various sounds according to the strength of the meridian qi. The classics state that when Yang qi surges excessively and throbs, tinnitus occurs. Deafness arises from the decline of Water and excess of Fire, where heat stagnates superiorly, blocking the Xuanfu (micro-pores/energy gates) of the auditory aperture, preventing the smooth flow and discharge of Shen Qi (Spiritual Energy). The diagnostic basis is: this pertains to the Foot Shaoyin Kidney Meridian, which houses its orifice in the ear and connects through it, governing Jing (Essence). When Jing Qi is harmonious and Kidney Qi is sufficient, the ears and eyes are acute. Moreover, causes of deafness vary: some result from labor injuring Qi and Blood, allowing Wind pathogen to invade amidst Heat, leading to Essence depletion and Kidney exhaustion; some involve Wind complication; others stem from overexertion. Generally, the twelve meridians connect superiorly to the ear. Where these meridians intersect, if Zang Qi becomes rebellious leading to Jue syndrome, Jue Qi clashes into the ear, causing Jue Deafness. Since the ear is the attachment point for the Zong Mai (Gathering Vessels), when vessels are deficient and Wind pathogen invades, Wind enters the ear, obstructing meridian Qi flow, causing Wind Deafness. Labor injures Qi and Blood, lust consumes Essence and Yuan Qi, leading to emaciation, fatigue, dizziness, and confusion, causing Labor Deafness. If one manages health well, maintaining peaceful Qi and Blood without reckless exertion, symptoms gradually resolve. If one fails to avoid labor injury, allowing Essence, Spirit, and Wind pathogen to stagnate, chronic deafness ensues. Additionally, wind pathogen touching the ear combined with persistent heat causes noisy tinnitus or photopsia (seeing light), termed Deficient Tinnitus. If heat pathogen follows the meridions into the ear, gathering and failing to dissipate, discharging pus, it is called Purulent Ear Disease. Quack doctors often use harsh, drying, and hot medicines, mistakenly attributing it to Cold due to deficient Kidney Water. Actually, Heart Fire is inherently Hot, manifesting as Cold only when deficient; Kidney Water is inherently Cold, manifesting as Heat only when declining. If Kidney Water is already scant, how can it pathologically become Cold? Therefore, one method involves soaking *Chelae Limonitidis* (Needle Sand) in wine for a day. At night, remove the sand, hold the wine in the mouth, wrap a piece of good porcelain stone in cotton, and insert it into the ear (left for left, right for right), aiming to guide Qi and facilitate discharge. A question was raised: If deafness is caused by Heat, why do some recover after taking hot-natured substances like dried Scorpion, Ginger, Aconite, or strong wine? The answer is: These are used to open the Xuanfu and allow stagnation in the ear to drain. In treating deafness, one must match the treatment to the condition. If Heat signs have subsided but deafness persists, use acrid-warm agents to disperse; stop once the disease ceases, do not use long-term, lest extreme Heat cause other diseases. If deafness accompanies Heat signs, regulate with wind-dispersing and heat-clearing methods; recovery occurs when Heat retreats and knots dissolve. However, severe deafness with suffocation is difficult to cure; one must strictly avoid excessive attack, as it damages Righteous Qi. Do not take medicines for unrelated conditions; dietary regulation follows the same principle—moderation prevents damage to Righteous Qi. Stop medication when cured, seeking health preservation without harm. Furthermore, regarding the Qi of the elderly, they often suffer from dizziness, tinnitus or deafness, and ascending Qi, all of which are patterns of Excess Yang and Deficiency Yin. Folk belief holds that the old and weak are always Cold-Deficient without Heat. Even when Heat signs exist, it is wrongly claimed that "insufficient Water cannot overcome abundant Fire," asserting that Kidney Water deficiency leads to Cold. This is the source of universal misunderstanding; how can one fail to learn from this!