天麻半夏与黄芩，橘皮柴胡草茯苓，风痰内作胸膈闷，头晕目黑自安宁。
天麻半夏汤（治头晕）
治风痰内作，胸膈不利，头旋目黑，兀兀欲吐，上热下寒，不得安卧
此皆虚风内外作，故以天麻为君。偏头痛，乃少阳也，非柴胡不能治。黄芩苦寒，酒制
炒锉，柴胡治上热，又为引用，故以为臣。橘皮苦辛温，甘草炙甘温，以治风痰，白茯苓甘
平利小便，导湿热，引而下行，故以为使。不数服而愈。
天麻一钱（为君） 黄芩（酒制）五分（为臣） 橘皮（去白）七分 柴胡七分 半夏
一钱 甘草五分（炙，为佐） 白茯苓五分（为使）以上锉如麻豆大，都作一服，水二姜三，
煎至一盏，去渣温服。
辨证
忿怒动胆火，左耳聋，宜龙荟丸。色欲动相火，右耳聋，宜地黄丸。醇酒浓味动胃火，
双耳聋，宜通圣散，滚痰丸。三者之中，由忿怒居多，色欲伤肾难治。丹溪曰∶厥阴少阳热，
当
龙荟丸 聪耳泻火。
龙胆草（酒洗） 当归（酒洗） 栀子仁（炒） 青皮 黄芩各一两 芦荟 柴胡 大
黄青黛各五钱 胆星三钱 木香二钱五分 麝香五分神曲糊丸如绿豆，姜汤下二十丸，日
进三服，七日后用针砂、酒以通其气。
通圣散 通圣防风将军芍，薄荷芎归草朴硝，栀翘芩梗并白术，荆芥麻黄滑石膏。
地黄丸（见补损） 滚痰丸（见痰饮）针砂酒 善通耳气。穿山甲（为末）一钱，针砂
一两，拌一昼夜，播去山甲，以酒一碗，浸三四日，口内噙酒，外用绵裹磁石一块塞耳，以
通为度。戒怒，戒色。
一方
用好磁石二块，锉如枣大，头略尖，上搽麝少许塞两耳，口噙生铁，一时两耳气通，
飒飒有声，勤用五七次即愈。
通明利气汤方 治虚火上升，痰郁热，或闭或鸣。
苍术（盐水炒） 白术（瓦焙） 香附（童便炒） 生地（姜汁浸） 槟榔各五分 抚
芎四分 木□二分半 甘草二分 贝母一钱半 陈皮一钱二分 栀子仁 黄柏 玄参各一钱
黄连 黄芩（同用酒浸，猪胆汁拌，炙干）各七分竹沥，生姜煎，食后服。
单方
治耳鸣、耳聋。黄柏（去皮）八两，人乳拌匀，晒干，再用盐水炒褐色，为末，丸如梧
子。每服百丸，空心盐汤下。治耳脓，先以绵杖榐净，剪猫嗑毛，烧灰存性掺入。
又方
明矾，发灰亦佳，治耳内忽大痛，或出血水，或如虫在内奔走，及干痛难忍 用蜕皮
烧灰存性，以鹅管吹入耳内。
余论
耳之重听，悉由于火，治之必用凉药，年少人不得不治，且能受凉剂，年高人苟非疼痛，
便可以不治，倘过用凉剂，恐坏脾胃。余见一医，用巴豆、斑蝥、麝香、葱汁为丸，绵裹入
耳，虽似暂开，旋又复重，而人之痛苦白受，若强用凉药，又岂止于痛苦已哉。谨识治耳臭，
用干胭脂、海螵蛸，共为末，吹入耳中，愈。
又方
用人发烧灰存性，每日分许，吹入耳愈。
治喉闭附方
用荔枝草数茎，加牛腾草或艾叶少许，捣汁，以人乳点之，或口鼻内灌入，立
可多用，用后，煎夏枯草汤饮之。
治耳
肾虚耳中作风水声。
椒目 巴豆 菖蒲 松脂各一钱共为末，以纸薄卷作筒塞耳，一日一换。一方，同以蜡
为丸，如枣核塞耳。一方，无松脂。
又方
麝香五分，全蝎十四个。薄荷十四叶，裹上二样瓦上焙干，共为细末，滴水，捏作小
塞耳内，极效。
又方
松香五钱，入铁锅内溶化，巴豆二十粒，为末，入松香内，用葱汁为丸，如莲子，用
绵裹塞过夜。左聋塞右，右聋塞左，左右俱聋，次第塞之，其效如神。
耳鸣风热上壅方 苍术一钱五分 防风一钱 荆芥一钱 蝉蜕一钱 川芎五分 僵蚕五
分陈皮五分 白茯苓五分 栝蒌仁五分 黄芩五分 细辛三分
水二钟，煎至七分，食前服。
治耳内红肿痛极 连翘 黄芩 玄参 桔梗 栀子（炒） 生甘草 牛蒡子 龙胆草炒）
板蓝根（即靛子）
如感恼，加香附，煎服。外用蛇蜕（烧灰存性）吹耳。
治耳脓 枯矾 龙骨 黄丹 胭脂（烧灰）各一钱 麝香少许先以棉杖榐净，日日掺之，
以愈为度。
又方
用猫下嗑毛灰吹之。一方用发灰，一方用枯矾。
治气聋熏方（不拘年久） 蕲艾一两 磁石七钱（ ） 当门子二粒 珍珠七粒（铁锅
底上 ）以绵子铺热处，将黄蜡蜡之，分为数片，纸上摊艾，艾上掺药，卷作筒子，点火吹
灭，侧耳熏之，既通，用艾塞耳，不见风。
【头晕门】
天麻、半夏与黄芩，橘皮、柴胡、甘草、茯苓，风痰在体内发作导致胸膈部闷塞，头晕眼花的症状自然安宁。
天麻半夏汤（治疗头晕）
主治风痰在体内发作，胸膈气机不畅，头晕目眩，恶心欲吐，上热下寒，无法安稳躺卧。
这些症状都是因为虚风在内外作祟，所以用天麻作为君药。偏头痛属于少阳经病变，非柴胡不能治疗。黄芩味苦性寒，经过酒制炒锉后，配合柴胡治疗上部的热邪，并作为引经药，所以作为臣药。橘皮味辛苦性温，炙甘草味甘性温，用来治疗风痰；白茯苓味甘性平，能利小便，引导湿热下行，所以作为使药。服用几剂即可痊愈。
天麻一钱（作为君药），黄芩（酒制）五分（作为臣药），橘皮（去白）七分，柴胡七分，半夏一钱，甘草五分（炙，作为佐药），白茯苓五分（作为使药）。以上药材锉碎如麻豆大小，全部作为一服的量，加水二碗、生姜三片，煎煮至一碗，去渣滓后温服。
辨证论治：
因愤怒触动胆火导致的左耳耳聋，宜用龙荟丸。因房事过度触动相火导致的右耳耳聋，宜用地黄丸。因饮酒过多及食用厚味食物触动胃火导致的双耳耳聋，宜用通圣散或滚痰丸。这三种情况中，由愤怒引起的居多，而因色欲损伤肾脏导致的耳聋则难以治疗。朱丹溪说：厥阴和少阳的热证，应当使用龙荟丸来聪耳泻火。
龙胆草（酒洗），当归（酒洗），栀子仁（炒），青皮，黄芩各一两，芦荟，柴胡，大黄，青黛各五钱，胆南星三钱，木香二钱五分，麝香五分。用神曲糊制成绿豆大小的丸药，每次用姜汤送服二十丸，每天服用三次。七日后用针砂和酒来疏通气机。
通圣散歌诀：防风、将军（大黄）、芍药、薄荷、川芎、当归、甘草、朴硝，栀子、连翘、黄芩、桔梗并白术，荆芥、麻黄、滑石、石膏。
地黄丸（见补损章节），滚痰丸（见痰饮章节）。
针砂酒：善于疏通耳窍气机。穿山甲（研末）一钱，针砂一两，混合浸泡一昼夜，去掉穿山甲，用一碗酒浸泡三四日，含在口中，外用棉团包裹磁石一块塞入耳内，以通气为度。要戒除愤怒和色欲。
另一偏方：
用好磁石两块，锉成枣核大小，头部略尖，上面涂抹少许麝香，塞入双耳，口中含着生铁，片刻后双耳气机通畅，听到飒飒的声音，勤用五到七次即可痊愈。
通明利气汤方：治疗虚火上升，痰郁化热，导致耳窍闭塞或鸣响。
苍术（盐水炒），白术（瓦焙），香附（童便炒），生地（姜汁浸），槟榔各五分，抚芎四分，木香二分半，甘草二分，贝母一钱半，陈皮一钱二分，栀子仁，黄柏，玄参各一钱，黄连，黄芩（同用酒浸，猪胆汁拌，炙干）各七分。用竹沥、生姜煎汤，饭后服用。
【耳病门】
单方：
治疗耳鸣、耳聋。黄柏（去皮）八两，与人乳拌匀，晒干，再用盐水炒至褐色，研为细末，制成梧桐子大小的丸药。每服百丸，空腹时用盐汤送下。
治疗耳流脓，先用棉签棒清理干净，剪取猫咽喉处的毛，烧灰存性，掺入耳内。
又一方：
明矾，发灰也很好，治疗耳内突然剧烈疼痛，或出血水，或感觉像虫子在里面奔走，以及干燥疼痛难忍。用蛇蜕烧灰存性，用鹅管吹入耳内。
余论：
耳朵听力下降，全由于火邪所致，治疗必须使用凉药。年轻人不得不治，且能承受凉药；老年人如果不是因为疼痛，就可以不治，如果过度使用凉药，恐怕会损伤脾胃。我见过一位医生，用巴豆、斑蝥、麝香、葱汁制成丸药，用棉裹住塞入耳内，虽然暂时开通，但很快又恢复重听，让人白白受苦。如果强行使用凉药，痛苦岂止于此？谨此记录治疗耳臭的方法：用干胭脂、海螵蛸，共同研为细末，吹入耳中，可愈。
又一方：
用人发烧灰存性，每日少许，吹入耳中可愈。
【治喉闭附方】
用荔枝草数茎，加入牛膝草或艾叶少许，捣汁，用人乳点之，或灌入口鼻内，立即见效。多用之后，煎夏枯草汤饮用。
【治耳】
肾虚导致耳中有风水声。
椒目，巴豆，石菖蒲，松脂各一钱，共为细末，用纸薄卷成筒状塞入耳内，一日更换一次。另一方，同样用蜡做成丸药，如枣核大小塞入耳内。另一方，不用松脂。
又一方：
麝香五分，全蝎十四个，薄荷十四叶，将前两种药放在瓦上焙干，共研为细末，滴水调和，捏成小丸塞入耳内，极有效。
又一方：
松香五钱，放入铁锅内溶化，加入巴豆二十粒研成的末，混入松香中，用葱汁制成丸药，如莲子大小，用棉裹住塞过夜。左耳聋塞右耳，右耳聋塞左耳，左右都聋则依次塞入，其效如神。
耳鸣风热上壅方：
苍术一钱五分，防风一钱，荆芥一钱，蝉蜕一钱，川芎五分，僵蚕五分，陈皮五分，白茯苓五分，栝蒌仁五分，黄芩五分，细辛三分。
加水二钟，煎至七分，饭前服用。
治疗耳内红肿痛极：
连翘，黄芩，玄参，桔梗，栀子（炒），生甘草，牛蒡子，龙胆草（炒），板蓝根（即靛子）。
如果伴有恼怒情绪，加香附，煎服。外用蛇蜕（烧灰存性）吹入耳内。
治疗耳脓：
枯矾，龙骨，黄丹，胭脂（烧灰）各一钱，麝香少许。先用棉签棒清理干净，日日掺药，以痊愈为度。
治疗气聋熏方（不拘年限长短）：
蕲艾一两，磁石七钱（煅），当门子（麝香）二粒，珍珠七粒（在铁锅底上煅）。用绵纸铺在热处，用黄蜡涂之，分为数片，纸上摊开艾绒，艾绒上撒药，卷成筒状，点火吹灭，侧耳熏之。既已通气，用艾绒塞耳，避免受风。
[Chapter on Dizziness]
Gastrodia (Tianma), Pinellia (Banxia) and Scutellaria (Huangqin), Citrus reticulata peel (Chenpi), Bupleurum (Chaihu), Licorice (Gancao), and Poria (Fuling). When Wind-Phlegm acts internally causing chest and diaphragm stuffiness, dizziness and blurred vision will naturally subside.
Gastrodia and Pinellia Decoction (Treating Dizziness)
Indicated for Wind-Phlegm acting internally, obstruction of the chest and diaphragm, vertigo and blurred vision, nausea with a desire to vomit, upper heat and lower cold, and inability to lie down comfortably.
These symptoms are all caused by deficient Wind acting from both inside and outside; therefore, Gastrodia is used as the Sovereign drug (Jun). Migraine belongs to the Shaoyang channel, which cannot be treated without Bupleurum. Scutellaria is bitter and cold; after being processed with wine and stir-fried, it is combined with Bupleurum to treat upper heat and serves as an guiding herb (Yin Jing Yao), thus serving as the Minister drug (Chen). Citrus reticulata peel is bitter, pungent, and warm; roasted Licorice is sweet and warm, used together to treat Wind-Phlegm; White Poria is sweet and neutral, promotes urination, guides damp-heat downward, thus serving as the Envoy drug (Shi). Recovery occurs after a few doses.
Gastrodia 1 qian (Sovereign), Scutellaria 0.5 qian (wine-processed, Minister), Citrus reticulata peel 0.7 qian (peel removed), Bupleurum 0.7 qian, Pinellia 1 qian, Licorice 0.5 qian (roasted, Assistant), White Poria 0.5 qian (Envoy). The above herbs are crushed to the size of hemp seeds, combined as one dose, with two bowls of water and three slices of ginger, decocted to one bowl, strained, and taken warm.
Differentiation:
Left ear deafness triggered by anger moving Gallbladder Fire should be treated with Longhui Wan. Right ear deafness triggered by sexual excess moving Minister Fire should be treated with Dihuang Wan. Bilateral ear deafness triggered by excessive alcohol and rich foods moving Stomach Fire should be treated with Tongsheng San or Guntan Wan. Among these three, those caused by anger are most common, while those caused by sexual injury to the Kidney are difficult to treat. Zhu Danxi said: Heat in Jueyin and Shaoyang should be treated with Longhui Wan to brighten the ears and drain fire.
Gentian root (wine-washed), Angelica sinensis (wine-washed), Gardenia seed (stir-fried), Green tangerine peel, Scutellaria each 1 liang; Aloe, Bupleurum, Rhubarb, Indigo naturalis each 5 qian; Areca catechu stem (Danxing) 3 qian; Costus root 2.5 qian; Musk 0.5 fen. Form pills the size of mung beans using dough made from Medicated Leaven (Shenqu). Take 20 pills with Ginger Decoction, three times a day. After seven days, use Magnetite (Zhensha) and wine to unblock Qi.
Tongsheng San Verse: Fangfeng, Jiangjun (Rhubarb), Shaoyao, Bohe, Xiong, Guizhi, Gancao, Xiaoyao, Zhizi, Qiao, Huangqin, Jiegeng, Baizhu, Jingjie, Mahuang, Huashi, Shigao.
Dihuang Wan (See Bu Sun Chapter), Guntan Wan (See Tan Yin Chapter).
Zhensha Wine: Good at unblocking Qi in the ears. Pangolin scales (powdered) 1 qian, Magnetite 1 liang, mixed and soaked for one day and night, remove pangolin scales, soak in one bowl of wine for three to four days. Hold the wine in the mouth, and externally wrap a piece of Magnetite in cotton and insert into the ear until Qi flows. Avoid anger and sexual excess.
Another prescription:
Use two good pieces of Magnetite, crushed to the size of a jujube, slightly pointed at the head, apply a little Musk on top, and insert into both ears. Hold raw iron in the mouth. After a moment, Qi in both ears will flow, producing a rustling sound. Use diligently five to seven times for recovery.
Tongming Liqi Tang Formula: Treats rising Deficient Fire, Phlegm stagnation transforming into Heat, causing ear blockage or tinnitus.
Atractylodes lancea (salt-water fried), Atractylodes macrocephala (baked on tile), Cyperus rotundus (fried in child's urine), Rehmannia glutinosa (soaked in ginger juice), Areca nut each 0.5 qian; Chuanxiong 0.4 qian; Costus root 0.25 qian; Licorice 0.2 qian; Fritillaria 1.5 qian; Chenpi 1.2 qian; Gardenia seed, Phellodendron, Scrophularia each 1 qian; Coptis, Scutellaria (soaked in wine, mixed with pig bile, roasted dry) each 0.7 qian. Decoct with Bamboo sap and Ginger, take after meals.
[Chapter on Ear Diseases]
Single Herb Prescription:
For tinnitus and deafness. Phellodendron bark (peeled) 8 liang, mixed with human milk, dried, then fried with salt water until brown, powdered, and formed into pills the size of Chinese wolfberry seeds. Take 100 pills per dose, with salt water on an empty stomach.
For otorrhea (ear pus), first clean thoroughly with a cotton swab, cut cat throat hair, burn to ash preserving its nature, and sprinkle into the ear.
Another prescription:
Alum or hair ash is also good for treating sudden severe pain in the ear, bleeding or discharge, sensation of insects running inside, or unbearable dry pain. Burn snake skin to ash preserving its nature, and blow into the ear using a goose quill.
Additional Remarks:
Deafness is entirely due to Fire; treatment must use cooling medicines. Young people must be treated and can tolerate cold medicines; elderly people need not be treated unless there is pain, as overuse of cold medicines may damage the Spleen and Stomach. I once saw a doctor who made pills from Croton seed, Mustard beetle, Musk, and green onion juice, wrapped in cotton and inserted into the ear. Although temporarily effective, hearing quickly returned to poor condition, causing unnecessary suffering. If cold medicines were forced upon them, would the suffering not be even greater? Record this method for treating foul-smelling ears: mix dried Carmine and Cuttlebone powder, blow into the ear for cure.
Another prescription:
Burn human hair to ash preserving its nature, sprinkle a small amount daily into the ear for cure.
[Appendix on Treating Throat Bi]
Use several stems of Plantago asiatica, add a little Achyranthes bidentata or Mugwort, crush to extract juice, apply with human milk, or instill into mouth and nose for immediate effect. Afterward, drink Prunella vulgaris Decoction.
[Ear Treatment]
Kidney Deficiency causing wind and water sounds in the ears.
Zanthoxylum seed, Croton seed, Acorus tatarinowii, Pine resin each 1 qian. Powder together, roll thinly in paper into a tube, insert into ear, change once a day. Another method: form into pills the size of a jujube pit with wax and insert into ear. Another method: omit pine resin.
Another prescription:
Musk 0.5 fen, Scorpio 14 pieces, Mint leaves 14. Roast the first two items on a tile until dry, powder together with mint, mix with drops of water, form into small pills, and insert into ear. Very effective.
Another prescription:
Pine rosin 5 qian, melt in an iron pot, add 20 Croton seeds powdered, mix into rosin, form into pills the size of lotus seeds with green onion juice, wrap in cotton and insert overnight. For left-sided deafness, insert into right ear; for right-sided deafness, insert into left ear; for bilateral deafness, insert sequentially. Effect is miraculous.
Prescription for Tinnitus due to Wind-Heat Obstruction:
Atractylodes lancea 1.5 qian, Saposhnikovia 1 qian, Schizonepeta 1 qian, Cicada slough 1 qian, Chuanxiong 0.5 qian, Bombyx batryticatus 0.5 qian, Chenpi 0.5 qian, Poria 0.5 qian, Trichosanthes kernel 0.5 qian, Scutellaria 0.5 qian, Asarum 0.3 qian.
Decoct two zhong of water to 0.7 zhong, take before meals.
Treating Severe Redness, Swelling, and Pain in Ear:
Forsythia, Scutellaria, Scrophularia, Platycodon, Gardenia (stir-fried), Raw Licorice, Arctium seed, Gentian root (stir-fried), Isatis root (Indigo naturalis).
If accompanied by irritability, add Cyperus rotundus, decoct and take. Externally, blow Snake slough (burned to ash preserving its nature) into the ear.
Treating Otorrhea:
Alum, Dragon bone, Litharge, Carmine (burned to ash) each 1 qian, a little Musk. First clean with cotton swab, sprinkle medicine daily until healed.
Another prescription:
Blow Cat throat hair ash. Another uses Hair ash, another uses Alum.
Smoking Method for Qi Deafness (Regardless of Duration):
Qiai (Ai Ye) 1 liang, Magnetite 7 qian (calcined), Musk 2 grains, Pearl 7 grains (calcined on iron pot bottom). Spread cotton on a hot surface, coat with yellow wax, divide into several pieces. Spread mugwort on paper, sprinkle medicine on mugwort, roll into a tube. Ignite, blow out flame, smoke into the ear while tilting head. Once unblocked, plug ear with mugwort, avoid wind.