脉 眼病寸脉浮数。关脉弦数。为风热内障。寸关浮弦而涩。为风湿肿痒。寸脉弦而沉。为
气热痒痛。弦而滑。为痰火攻上。寸浮。关弦。尺涩。为血虚。火盛。水衰。眼目昏暗。
耳病 肾脉浮而盛。为风。浮而数为热。涩而濡为虚。右寸滑数。为肺经痰火上攻于耳。
口病 关脉洪数。脾气通于口。脾热则口臭。热甚则口縻。口疮。胃热则唇口生疮。口内腥
臭。 鼻病 右寸脉洪数。鼻乃肺之窍。鼻病皆肺热所致。肺伤风热。右寸浮数。而鼻塞不
闻香臭。 舌病 左寸脉滑数。盖舌乃心之苗。舌病皆心热所致。心脉系舌本。脾脉络于舌
傍。肝脉络舌本。心热盛。则舌生疮破裂。肝热盛。则血上涌。脾热则舌强。甚则滑而胎。
风寒所中。则舌卷缩而不能言。 牙病 属肾虚胃火。右关洪数。溢过寸口。兼浮者。为风
。兼沉者。为寒。濡细者。为湿。 咽喉 肿痛。两寸必浮洪而数。虽有数种之名率皆上焦
风热所致。
症 按东垣云∶十二经脉。三百六十五络。其清阳气上散于目。而为精。其气走于耳而为听
。若因心烦事冗。饮食失节。劳役过度。致脾胃虚弱。心火旺盛。则百脉沸腾。血脉逆行。
邪害空窍。犹天明而日月不明也。夫五脏六腑之精气。皆禀受于脾。上注于目。脾者诸阴之
首也。目者。血脉之宗也。脾虚。则五脏精气皆失所司。不能归于目矣。心者。君火也。主
人之精。宜静而安。相火化行其令。相火者，包络也。主百脉。皆营于目。既劳役运动。势
乃妄行。又因邪气所并。而损血脉。故诸病生焉。经曰。目得血而能视。血气盛。则精盛。
血气衰。则精弱。精弱则水虚。水虚则火动。火动则东方实。东方实则肝邪盛。而视
物不真矣。所以视植物为动物者。有之。视动物为植物者有之。然血有太过不及。皆能为痛
。太过则目壅塞而障痛。不及则无血养而枯痛。目之锐。皆少阳经也。血少气多。目之上纲
。太阳经也。血多气少。目之下纲。阳明经也。血气俱多。惟足厥阴经。连于目系而已。血
太过者。血得热而溢于上。所以作痛。治之之法。风热者。发以散之。血少神劳。肾虚者。
补血滋阴以调之。实者决之。虚者补之。辛以散之。凉以清之。随其病而药之。无不愈也。
按诸书论耳症不一。有气聋。热聋。阴虚聋。脓耳。 耳。气厥而聋。又挟风与劳损而聋
者。盖十二经脉。上络于耳。其阴诸经。适有交并。则脏气逆而厥。厥气抟入于耳。是为厥聋
。必兼眩运。况耳为宗脉之所附。若脉虚而风邪乘之。经气闭而不宣。谓之风聋。必兼头痛
。如瘦悴力怯。昏昏积积而暗暗然者。为劳聋。必兼虚怯等症。此好色肾虚者有之。有痰
火上升。郁于耳中而鸣。有热气乘虚。随脉入耳。结为脓汁。谓之脓耳。或耳有津液。风热
抟之。结硬成核塞耳。亦令暴聋。为 耳。大抵耳属足少阴之经。肾之寄窍也。肾气通于耳
。所主者精。精气充足。则耳闻而聪也。若劳伤气血。精脱肾败。则耳聋矣。治之之法。风
者散之。热者凉之。肾虚者补而养之。痰火者清而降之。各随其宜。不可不察也。 口臭生
疮。皆脾胃中有浊热所致。盖脾热则口干燥。胃热则唇破裂。又云∶五脏之气。皆通于口。
是以脾热则口甘。肝热则口酸。肾热则口咸。肺热则口辛。心热则口苦。胃热则口淡。胆热
则口酸苦。皆因谋虑不决而得。 丹溪云∶鼻乃肺之窍。因心肺上病而不利也。有寒有热。
寒邪伤于皮毛。气不利而壅塞。热壅清道。所以塞而不闻香臭矣。又有面鼻红紫黑。皆热伤血
而血热所致。盖面乃阳中之阳。鼻居面中。一身之血运到面鼻。皆为至清至精之血。多酒之
人。酒气熏蒸于上。面鼻得酒热之气。血为极热。血热复遇感冷。污浊凝结不行。面鼻紫黑
而肿。俗名酒 鼻是也。治宜清热。化滞血。生新血。或曰酒 鼻者。皆由肺经壅热所致。盖
肺气通于鼻。清气出入之道路。或因饮酒。气血壅滞上焦。邪热伏留不散。为鼻疮矣。或肺
经素有风热。虽不因酒。亦自生也。 鼻塞肉。亦由于此。 舌病。乃心肝脾壅热所致。说
见脉下。 牙齿肿痛。按东垣论云∶齿者肾之标。骨之余。上龈隶于脾土。足阳明胃之脉贯
络也。手阳明。恶寒饮而喜热。足阳明。喜寒饮而恶热。热甚则齿动龈脱。作痛不已。有恶
寒痛者。有恶热痛者。有恶寒恶热痛者。有恶热饮。少寒饮多痛者。有动摇痛者。有齿袒则
痛者。有齿龈为疳所蚀。血出而痛者。有 肿起而痛者。有脾胃中有风邪。但觉风而痛者。
有痛而臭不可近者。盖齿为关门。肾之荣。骨之余也。肾衰则齿豁。精固则齿坚。大肠虚。
则齿露。大肠壅。则齿浮。挟风则攻于头面。眼目疳 则HT 脱为痔。亦有气郁而致者。医者
诚能求其本而疗之。厥疾弗瘳者。未之有也。 喉痹。按子和云∶热气上行。搏于喉之两旁
。近外肿作。以其形似。是谓乳蛾。一为单。两为双也。比乳蛾差小者。名喉痹。热结于
舌下。复生一小舌。名曰重舌。胀热。结于舌中肿起。名曰水舌。胀热结于咽喉。肿绕于外
。且麻且痒。肿而大者。名曰缠喉风。喉痹暴发暴死者。名曰走马喉痹。其名虽殊。火则
一也。夫少阴君火。心主之脉。手少阳。相火三焦之脉。二火皆主其脉。并络于喉。气热则
内结。结甚则肿胀。肿胀甚则闭。闭甚则不通而死矣。至于嗌干咽痛。颔肿舌本强。皆君火
之为也。惟喉痹急。连属相火也。经云∶甚者从之。又云∶龙火以火逐之。故古人疗喉痹等
症。用甘桔等汤治之。世医不达此旨。妄云大寒之剂。或至冷草药服之。 其气而不救者
。吾见多矣。其出血之法。最为紧要。但人畏针。委曲旁求。若病之急者。即闭而死。良可
痛哉。
治 河间云∶目疾在腑为表。当除风散热。在脏为里。当养血安神。如暴失明。昏涩翳膜。
眵泪斑疮。入眼暴散。皆表也。此风热所干。宜表散以去之。如昏弱不欲视物。内障见黑花
。瞳散睛背。久病。皆里也。此血少神劳。肾虚所致。宜养血补水安神。王节斋云∶眼痛亦
肿。古方用药。内外不同。在内汤药。则用苦寒辛凉之剂。以泻其火。在外点洗。则用辛热
辛凉之药。以散其邪。故点药莫要于冰片。而冰片大辛热。以其辛性急。故借以拔出火毒。
而散其热气。古方用烧酒洗眼者。皆此意也。大概火眼是火邪上攻于目。故内治用苦寒之药治
其本也。然火邪既客于目。从内出外。若外用寒凉以阻逆之。则郁火内攻。不得散矣。故点
药用辛热。而洗眼用热汤。是火抑则发。因而散之。从内达外法也。治法云∶久病目昏暗。
熟地黄、当归为君。防风、羌活、甘菊佐之。暴发赤肿。芩连、防风为君。以泻火
。四物为佐。以凉血养血。羌活、柴胡、甘菊为使。以疏风散热。血气壅盛而痛。四物、
加龙胆草、大黄以下之。肥人多是痰火。宜凉血清热行痰。痛人多是血少火盛。宜养血药
为主。少加风药佐之。 丹溪云∶耳聋。属少阳厥阴二经郁热多。有气闭者。有痰火上攻而
鸣。或聋。治宜开痰散风热。通圣散、滚痰丸之类。皆可用。大病后与阴虚火动而聋者。
宜滋阴降火。以四物汤，加知母、黄柏、耳鸣。宜当归龙会丸。饮酒浓味之人。宜木香槟榔
丸。王节斋云∶耳鸣一症。世人多作肾虚。治不效。殊不知此是痰火上升。郁于耳中而为鸣
。郁甚则壅闭矣。大抵此症。多因先有痰火在上。又感恼怒而得。怒则气上逆。而少阳之火
客于耳也。若肾虚而鸣者。其鸣不甚。治宜详之。 口病或疮。皆中上二焦积热。轻者泻黄
散。重者凉膈散主之。口病服凉药不愈者。此酒色过度。劳役不睡。或因忧思损伤中气。虚
火泛上无制。用理中汤。加附子、或官桂、冷服。一方、治口疮。以黄连六钱、官桂一钱、
为未。噙下。或调付疮上。甚效。口臭以黄连、生甘草、藿香、兰草、扁豆、砂仁为末。清
茶调下。 鼻塞不利。有肺热。或肺经素有火邪。久郁于内。遇寒便塞。宜清肺降火。而佐
以通气之剂。亦有感冒风寒而致。鼻塞声重。或流清涕者。作风寒治。宜表而散之。鼻或红
。及酒 鼻者。皆热伤肺经。以致血气壅滞。宜凉血化滞。清肺药主之。 舌肿舌疮。皆心
热所致。治宜泻心汤。甚者黄连解毒汤。舌胎者。治各有法。如伤寒舌胎。或黄或黑者。谅
轻重下之。详见本门。杂病舌胎。宜清之。黄连解毒汤。或凉膈散。选而用之。 王节斋云
、牙床肿痛。或齿动摇。或黑烂脱落。世人皆作肾虚治。殊不知此属阳明经湿热。盖齿虽属
肾。而生于牙床。上下牙床属阳明大肠与胃。犹木生于土也。肠胃伤于美酒浓味。膏粱粘滑
之物。致湿上攻。则牙床不清。而为肿为痛。或出血。或生虫。故齿不得安。而动摇黑烂脱
落矣。治宜泻阳明经之湿热。去肠胃中之伏火。则牙床清宁。而齿自安固矣。以防风通圣散
。去芒硝主之。 丹溪云∶喉痹之病。多属痰热。虽有数种之名。轻重之异。乃火之微甚故
也。微者以酸KT 之。甚者以辛散之。甚而急者。惟用针砭刺出血。最为上策。人火以凉治之
。龙火以火逐之。或用吐法尤妙。经云∶咽与喉。会厌与舌。同在一门。而用各异。喉以
候气。故通于天。会厌管乎其上。少司开阖。掩其厌。则食下不掩。其喉必错。必舌抵上
。则会厌能闭其喉矣。四者相交为用。缺一。则饮食废而死矣。
方 四物菊花汤治一切眼疾。清热。养血。疏风。
川芎（七分） 当归（酒浸一钱五分） 白芍药（一钱五分） 淮生地（一钱） 甘菊花（一钱五分）
防风（七分） 黄连（八分） 白扁豆（七分） 甘草（生用五分） 甘州枸杞子（八分）
上作一服。水一钟半。煎八分。食后服。兼有他症。根据后加减。
肝经壅热。加龙胆草（一钱）、黄芩（一钱）、赤芍药（八分）、青皮（五七分）、甚者。加大黄、
酒蒸过（三钱）、下之。
肺经壅热。白睛红。加桑白皮、黄芩、山栀、麦门冬、石膏
（各等分）。
心经壅热。睛红内障。加赤茯苓、麦门冬、倍黄连、胆腑热。睛红肿痛。隐涩难开。加龙胆
草、柴胡（各一钱）、青皮（七分）。
胃中伏火上攻。赤肿胀痛。加连翘、黄芩、石膏（各一钱五分）、大黄（三钱）。
肝肾虚眼暗。加熟地黄、山药（各一钱二分）、黄柏（八分）、五味子（五分），去黄连。
翳膜遮睛。加草决明、密蒙花（各一钱）、木贼（八分）、外用点药。
能远视。不能近视。乃血盛气虚。加人参、白茯苓（各一钱）、石菖蒲（五分）。
能近视。不能远视。乃气盛血虚。倍当归，加熟地黄（一钱五分）。
风热火眼。加羌活、柴胡、黄芩（各一钱）、连翘、赤芍药（各八分）、大黄（三钱）。
目疾久服寒凉伤脾。致脾胃虚损。不能生血。反昏暗者。宜服清神益气汤。
又方 固本还睛丸（出医学正传） 治肝肾脾肺虚损。风热乘之。以致目暗不明。视物昏花。
或翳膜朦蔽。内外障痛。一切眼疾。并宜服之。
久服诚有奇效。非惟明目。且能滋养百骸。调和五脏。
天门冬（去心二两） 淮生地黄（二两） 人参（一两五钱） 麦冬（去心二两） 淮熟地黄（二两）
当归（一两五钱） 五味子（七钱） 青相子（一两） 石斛（一两五钱去根） 牛膝（酒洗一两）
犀角（一两炒） 川芎（一两） 枳壳（麸炒一两） 黄连（酒炒一两） 菟丝子（酒洗去土蒸熟
捣碎晒干一两五钱） 枸杞子（甘州者去梗一两五钱） 柏子仁（去壳净炒一两五钱） 决明子（
炒一两五） 杜仲（姜汁炒断丝一两） 羚羊角（白者一两） 黄柏（盐酒炒一两五钱）
上二十一味。除二冬二地酒煮捣膏。柏子仁另研。余药共为细末。炼蜜为丸。如梧桐子大。每服
九十丸。空心盐酒送下。忌煎炒五
辛发物。
又方 和气饮治耳鸣久聋。
川芎（一钱） 当归（一钱） 乌药（一钱五分） 陈皮（八分） 贝母（一钱） 黄芩（酒炒一钱）
山栀（八分） 桔梗（七分） 升麻（三分） 木通（八分） 木香（三分） 石菖蒲（一钱五分）
上作一服。姜三片。煎熟。加葱自然汁半盏。和服。
又方 加减凉膈散治口鼻舌诸病。皆由上焦壅热所致。
连翘 栀子 黄芩 石膏 大黄（各一钱五分） 防风 荆芥 薄荷（各八分） 甘草（四分）
当归 川芎 白芍药 生地黄 麦门冬（各一钱）
上作一服。水一钟半。煎。食后服。
口疮。加黄连（一钱二分）、桂（二分）、唇疮，加同上。
腮肿。加升麻（五分）、白芷（七分）、牛蒡子（一钱五分）、倍石膏。
舌肿胀。加白芍药、黄连（各一钱）、玄明粉（八分）。
舌疮。加黄连、青黛（各一钱）、舌胎。加同上。
牙缝舌根。无故出血。加牡丹皮、侧柏叶、槐实（各一钱）。
脉象与病症
眼病：寸脉浮数，为风热内障。寸关脉浮弦而涩，为风湿引起的肿胀瘙痒。寸脉弦而沉，为气热导致的瘙痒疼痛。脉弦滑，为痰火上攻所致。寸脉浮，关脉弦，尺脉涩，为血虚、火盛、水衰，导致眼目昏暗。
耳病：肾脉浮而盛大，为风邪；浮而数为热邪；涩而濡弱为虚证。右寸脉滑数，为肺经痰火上攻于耳。
口病：关脉洪数，脾气通于口，脾热则口臭，热甚则口糜（口腔黏膜溃烂）、口疮。胃热则唇口生疮，口内散发腥臭味。
鼻病：右寸脉洪数，鼻为肺之窍，鼻病皆由肺热所致。肺受风热侵袭，右寸脉浮数，导致鼻塞，闻不到香臭气味。
舌病：左寸脉滑数，舌为心之苗窍，舌病皆由心热所致。心脉系连舌本，脾脉络于舌旁，肝脉络于舌本。心热盛，则舌生疮破裂；肝热盛，则血液上涌；脾热则舌体僵硬，严重时舌面光滑无苔或生胎垢。若被风寒所中，则舌卷缩而不能言语。
牙病：属肾虚兼胃火。右关脉洪数，脉势溢过寸口，兼见浮脉为风邪，兼见沉脉为寒邪，脉濡细为湿邪。
咽喉：肿痛时，两寸脉必见浮洪而数。虽有多种名称，但大都由上焦风热所致。
症状分析：据李东垣所言：十二经脉，三百六十五络，其清阳之气上行散布于目，成为视觉之精；其气运行于耳，成为听觉。如果因心烦事多，饮食不节制，劳役过度，导致脾胃虚弱，心火旺盛，则百脉沸腾，血脉逆行，邪气侵害空窍，就像天日光明却日月不明一样。五脏六腑的精气，都禀受于脾，向上灌注于目。脾是诸阴之首，目是血脉的宗汇。脾虚，则五脏精气失去主宰，不能归于目。心为君火，主持人的精神，宜静而安；相火代行君火之令，相火即心包络，主持百脉，都营卫于目。既然经过劳役运动，相火之势便妄行，又因邪气侵并，损伤血脉，所以各种疾病产生。经书说：目得血而能视。血气盛，则精盛；血气衰，则精弱。精弱则水虚，水虚则火动，火动则东方（肝）实。东方实则肝邪盛，而视物不真。所以有看植物为动物，看动物为植物的情况。然而血有太过和不及，都能引起疼痛。太过则目窍壅塞而胀痛；不及则无血滋养而枯痛。目之锐眦（眼角），属于少阳经；血少气多，目之上纲（上眼睑），属于太阳经；血多气少，目之下纲（下眼睑），属于阳明经；血气俱多，只有足厥阴肝经，连系于目系而已。血太过者，血受热而溢于上部，所以作痛。治疗之法：风热者，用发散法疏散它；血少神劳、肾虚者，补血滋阴以调理它；实证用决泄法，虚证用补益法；辛味药以散之，凉性药以清之，根据病情用药，没有不愈的。
据各书记载，耳症论述不一，有气聋、热聋、阴虚聋、脓耳等。气厥而聋，又夹杂风邪与劳损而聋的，因为十二经脉上络于耳，其阴经恰好有交会，则脏气逆乱而厥，厥气聚结于耳，称为厥聋，必定兼有眩晕。况且耳为宗脉所依附，若脉虚而风邪乘之，经气闭塞而不宣通，称为风聋，必定兼有头痛。如形体消瘦憔悴、力气怯弱，昏昏沉沉、暗暗然不明的，为劳聋，必定兼有虚怯等症状，这是好色导致肾虚的人有的。有痰火上升，郁结于耳中而鸣响；有热气乘虚，随脉入耳，结为脓汁，称为脓耳。或者耳中有津液，风热搏结，凝结成硬块堵塞耳道，也导致暴聋，称为蠹耳（注：原文此处可能有缺字或异体字，指耳内结核堵塞）。大抵耳属足少阴肾经，是肾的外窍。肾气通于耳，所主的是精。精气充足，则耳闻声聪敏。若劳伤气血，精脱肾败，则耳聋了。治疗之法：风者散之，热者凉之，肾虚者补而养之，痰火者清而降之，各自依适宜之法，不可不仔细考察。
口臭生疮，都是脾胃中有浊热所致。脾热则口干燥，胃热则唇破裂。又说：五脏之气，都通于口，所以脾热则口甜，肝热则口酸，肾热则口咸，肺热则口辛，心热则口苦，胃热则口淡，胆热则口酸苦，都是因为谋虑不决而得的。
朱丹溪说：鼻是肺之窍，因心肺上部有病而不通利。有寒有热，寒邪伤于皮毛，气不利而壅塞；热壅塞清道，所以鼻塞闻不到香臭。又有面鼻红紫黑的，都是热伤血而血热所致。面乃阳中之阳，鼻居面部中央，一身之血运到面鼻，都是至清至精的血。多喝酒的人，酒气熏蒸于上，面鼻得到酒热之气，血变得极热，血热再遇感冷，污浊凝结不行，面鼻紫黑而肿，俗名酒齄鼻（注：原文“酒 鼻”应为酒齄鼻）。治疗宜清热，化滞血，生新血。有人说酒齄鼻，都是由肺经壅热所致。肺气通于鼻，是清气出入的道路，或因饮酒，气血壅滞上焦，邪热伏留不散，成为鼻疮。或者肺经素有风热，即使不因饮酒，也会自然发生。鼻塞息肉，也由于此。
舌病，乃心肝脾壅热所致，说法见脉象部分。牙齿肿痛，按李东垣论述：齿是肾之标，骨之余。上龈隶属于脾土，足阳明胃之脉贯络其中。手阳明大肠经，恶寒饮而喜热饮；足阳明胃经，喜寒饮而恶热饮。热甚则齿动龈脱，疼痛不止。有恶寒痛的，有恶热痛的，有恶寒恶热都痛的，有恶热饮、稍进寒饮则多痛的，有动摇时痛的，有齿露出牙龈则痛的，有齿龈被疳虫蚀破出血而痛的，有牙龈红肿起而痛的，有脾胃中有风邪，只觉风而痛的，有痛而臭不可近的。齿为关门，肾之荣华，骨之余。肾衰则齿豁（松动脱落），精固则齿坚。大肠虚，则齿露；大肠壅，则齿浮。挟风则攻于头面。眼目患疳疾则……（原文此处似有脱漏或错简，HT 脱为痔，语意不通，暂译为：眼目患疳疾则……脱落变为痔疮——*注：此处原文逻辑混乱，疑似传抄错误，通常眼疳与痔无关，但依原文直译*）。也有气郁而致的。医生如果能探求根本而治疗，久治不愈的情况，是没有的。
喉痹，按张子和说：热气上行，搏结于喉之两旁，近外肿胀发作，因其形状像乳头，称为乳蛾，单侧为单乳蛾，双侧为双乳蛾。比乳蛾稍小的，名为喉痹。热结于舌下，再生一小舌，名为重舌。胀热结于舌中肿起，名为水舌。胀热结于咽喉，肿胀环绕外部，且麻且痒，肿大者，名为缠喉风。喉痹暴发暴死的，名为走马喉痹。其名虽不同，火邪则是一样的。少阴君火，由心主之脉；手少阳相火，由三焦之脉。二火都主管其脉，并络于喉。气热则内结，结甚则肿胀，肿胀甚则闭塞，闭塞甚则不通而死。至于咽干咽痛，颔部肿胀，舌本强硬，都是君火造成的。只有喉痹急症，连属相火。经书说：甚者从之。又说：龙火以火逐之。所以古人治疗喉痹等症，用甘桔汤等方剂治疗。世医不懂这个旨意，胡乱说是大寒之剂，或者服用冷草药，导致气绝而不救的，我见过很多。其出血疗法，最为紧要。只是人们害怕针刺，委曲求全寻找其他方法，如果病情紧急，就会闭阻而死，实在令人痛心。
治疗原则：刘河间说：眼疾在腑为表，应当除风散热；在脏为里，应当养血安神。如突然失明，昏涩有翳膜，眼屎流泪斑疮，入眼暴散，都是表证。这是风热所干扰，宜用表散法去除。如昏弱不想看东西，内障见黑花，瞳仁散大，睛珠背晦，久病，都是里证。这是血少神劳、肾虚所致，宜养血补水安神。王节斋说：眼痛也伴有肿胀，古方用药，内外不同。在内服汤药，则用苦寒辛凉的药剂，以泻其火；在外点洗，则用辛热辛凉的药，以散其邪。所以点眼药没有比冰片更重要的，而冰片大辛大热，因其辛性急，所以借以拔出火毒，而散其热气。古方用烧酒洗眼的，都是这个意思。大概火眼是火邪上攻于目，所以内治用苦寒药治其本。然而火邪既客居于目，从内出外，若外用寒凉以阻逆它，则郁火内攻，不得散发了。所以点药用辛热，而洗眼用热汤，是火被抑制则发，因而散之，是从内达外的方法。治法说：久病目昏暗，以熟地黄、当归为君药，防风、羌活、甘菊为佐药。暴发赤肿，以黄芩、黄连、防风为君药，以泻火，四物汤为佐药，以凉血养血。羌活、柴胡、甘菊为使药，以疏风散热。血气壅盛而痛，用四物汤加龙胆草、大黄以下行之。肥人多多是痰火，宜凉血清热行痰。瘦人多是血少火盛，宜以养血药为主，少加风药佐之。
朱丹溪说：耳聋，属少阳、厥阴二经郁热多，有气闭的，有痰火上攻而鸣或聋的，治疗宜开痰散风热，通圣散、滚痰丸之类，都可以用。大病后与阴虚火动而聋的，宜滋阴降火，用四物汤加知母、黄柏。耳鸣，宜用当归龙荟丸。饮酒浓味之人，宜用木香槟榔丸。王节斋说：耳鸣一症，世人多当作肾虚治，治疗无效，殊不知这是痰火上升，郁于耳中而为鸣。郁甚则壅闭矣。大抵此症，多因先有痰火在上，又感恼怒而得。怒则气上逆，而少阳之火客于耳。若肾虚而鸣的，其鸣不甚，治疗应详细分辨。
口病或生疮，都是中上二焦积热，轻者用泻黄散，重者用凉膈散主治。口病服凉药不愈的，这是酒色过度，劳役不睡，或因忧思损伤中气，虚火泛上无制，用理中汤，加附子、或官桂，冷服。一方，治口疮，以黄连六钱、官桂一钱，研为末，噙化下，或调敷疮上，很有效。口臭以黄连、生甘草、藿香、兰草、扁豆、砂仁为末，清茶调下。
鼻塞不利，有肺热，或肺经素有火邪，久郁于内，遇寒便塞，宜清肺降火，而佐以通气之剂。也有感冒风寒而致，鼻塞声重，或流清涕的，作风寒治，宜表散。鼻或红，及酒齄鼻的，都是热伤肺经，以致血气壅滞，宜凉血化滞，以清肺药为主。
舌肿舌疮，都是心热所致，治疗宜用泻心汤，严重的用黄连解毒汤。舌苔者，治疗各有方法。如伤寒舌苔，或黄或黑的，斟酌轻重用下法，详见本门。杂病舌苔，宜清之，用黄连解毒汤，或凉膈散，选而用之。
王节斋说：牙床肿痛，或齿动摇，或黑烂脱落，世人皆当作肾虚治，殊不知这属阳明经湿热。盖齿虽属肾，而生于牙床，上下牙床属阳明大肠与胃，犹如木生于土。肠胃伤于美酒浓味、膏粱粘滑之物，致湿上攻，则牙床不清，而为肿为痛，或出血，或生虫，故齿不得安，而动摇黑烂脱落了。治疗宜泻阳明经之湿热，去肠胃中之伏火，则牙床清宁，而齿自安固了，以防风通圣散，去芒硝主治。
朱丹溪说：喉痹之病，多属痰热，虽有数种之名，轻重之异，乃是火之微甚的缘故。微者以酸味收敛之，甚者以辛味散之，甚而急的，惟用针砭刺出血，最为上策。人火以凉治之，龙火以火逐之，或用吐法尤其妙。经书说：咽与喉，会厌与舌，同在一门，而用法各异。喉以候气，故通于天，会厌管乎其上，少司开阖，掩其厌，则食下不掩，其喉必错（误），必舌抵上，则会厌能闭其喉矣。四者相交为用，缺一，则饮食废而死矣。
Pulse and Symptoms
Eye Diseases: The cun (inch) pulse is floating and rapid, indicating wind-heat internal obstruction. The cun and guan (middle) pulses are floating, wiry, and choppy, indicating swelling and itching caused by wind-dampness. The cun pulse is wiry and deep, indicating itching and pain caused by qi-heat. The pulse is wiry and slippery, indicating attack from phlegm-fire ascending. The cun pulse is floating, the guan pulse is wiry, and the chi (root) pulse is choppy, indicating blood deficiency, excessive fire, and declining water, leading to dim vision.
Ear Diseases: The kidney pulse is floating and vigorous, indicating wind; floating and rapid indicates heat; choppy and soft indicates deficiency. The right cun pulse is slippery and rapid, indicating phlegm-fire of the lung meridian attacking the ear.
Mouth Diseases: The guan pulse is surging and rapid. The spleen qi connects to the mouth; spleen heat causes bad breath, and severe heat causes oral ulcers (stomatitis) and mouth sores. Stomach heat causes sores on the lips and mouth, with a fishy odor in the mouth.
Nose Diseases: The right cun pulse is surging and rapid. The nose is the orifice of the lung; nasal diseases are all caused by lung heat. Lung affected by wind-heat results in a floating and rapid right cun pulse, nasal congestion, and inability to smell fragrances or odors.
Tongue Diseases: The left cun pulse is slippery and rapid. The tongue is the sprout of the heart; tongue diseases are all caused by heart heat. The heart meridian connects to the root of the tongue, the spleen meridian runs along the sides of the tongue, and the liver meridian connects to the root of the tongue. Excessive heart heat causes sores and cracking on the tongue; excessive liver heat causes blood rushing upward; spleen heat causes tongue stiffness, and in severe cases, a smooth coating or thick fur. If struck by wind-cold, the tongue curls and contraction prevents speech.
Tooth Diseases: Belong to kidney deficiency combined with stomach fire. The right guan pulse is surging and rapid, overflowing past the cun position. Accompanied by a floating pulse indicates wind; accompanied by a deep pulse indicates cold; a soft and fine pulse indicates dampness.
Throat: Swelling and pain present when both cun pulses are floating, surging, and rapid. Although there are various names, they are mostly caused by upper jiao wind-heat.
Symptom Analysis: According to Li Dongyuan: The twelve meridians and three hundred sixty-five collaterals distribute their clear yang qi upward to the eyes, becoming the essence of vision; this qi travels to the ears, becoming hearing. If due to mental distress and busyness, irregular diet, and overexertion, leading to spleen-stomach weakness and excessive heart fire, then the hundred vessels boil, blood vessels reverse flow, and evil pathogens harm the orifices, just as the sun and moon are obscured despite the brightness of the sky. The essence and qi of the five zang and six fu organs are all received from the spleen and poured upward into the eyes. The spleen is the head of all yin meridians, and the eyes are the gathering place of blood vessels. When the spleen is weak, the essence and qi of the five zang organs lose their control and cannot return to the eyes. The heart is the ministerial fire, governing human spirit, which should be quiet and peaceful; the ministerial fire executes its orders. The ministerial fire is the pericardium, governing the hundred vessels, which all nourish the eyes. After exertion and movement, the force of the ministerial fire acts recklessly, and further damaged by evil pathogens invading the blood vessels, thus various diseases arise. The classics state: "The eyes see because of blood." When blood and qi are abundant, essence is abundant; when blood and qi decline, essence becomes weak. Weak essence leads to water deficiency, water deficiency leads to fire movement, fire movement leads to excess in the East (Liver). When the East is in excess, liver evil is strong, and vision is distorted. Thus, one may see plants as animals, or animals as plants. However, whether blood is excessive or insufficient, both can cause pain. Excess causes blockage in the eye orifices and distending pain; insufficiency causes lack of nourishment and withering pain. The outer canthus belongs to the Shaoyang meridian; the upper eyelid (blood scarce, qi abundant) belongs to the Taiyang meridian; the lower eyelid (blood abundant, qi scarce) belongs to the Yangming meridian; when both blood and qi are abundant, only the Foot Jueyin Liver meridian connects to the eye system. When blood is excessive, it overflows upward due to heat, causing pain. Treatment methods: For wind-heat, disperse it; for blood deficiency, spiritual fatigue, and kidney deficiency, tonify blood and nourish yin to regulate; for excess conditions, drain them; for deficiency conditions, tonify them; use acrid herbs to disperse, cool herbs to clear, and medicate according to the disease, without exception of cure.
According to various texts, ear symptoms are discussed differently, including Qi deafness, Heat deafness, Yin-deficiency deafness, and suppurative otitis. Deafness due to Qi syncope, compounded by wind and damage from overwork, occurs because the twelve meridians connect to the ear, and when yin meridians intersect, organ qi reverses and synopsizes, with synoptic qi gathering in the ear, called Synoptic Deafness, necessarily accompanied by vertigo. Moreover, the ear is attached to the master vessel; if the vessel is weak and wind evil attacks, meridian qi closes and does not circulate, called Wind Deafness, necessarily accompanied by headache. If emaciated, weak, and feeling dizzy and dim, it is Fatigue Deafness, necessarily accompanied by deficiency symptoms, common in those with kidney deficiency due to excessive sexual activity. Phlegm-fire ascending and stagnating in the ear causes tinnitus; heat qi entering the ear through deficiency and condensing into pus is called Suppurative Otitis. Or, if fluid in the ear combines with wind-heat to form hard nodules blocking the ear, it also causes sudden deafness, called Ear Mite Disease (or similar obstruction). Generally, the ear belongs to the Foot Shaoyin Kidney meridian, the external orifice of the kidney. Kidney qi connects to the ear, governing essence. When essence and qi are sufficient, hearing is acute. If blood and qi are damaged by overwork, essence escapes, and kidney fails, deafness occurs. Treatment: Disperse wind, cool heat, tonify and nourish kidney deficiency, clear and descend phlegm-fire, each according to suitability, requiring careful examination.
Bad breath and sores are caused by turbid heat in the spleen and stomach. Spleen heat causes dry mouth; stomach heat causes cracked lips. Furthermore, the qi of the five zang organs connects to the mouth. Thus, spleen heat causes sweet taste, liver heat causes sour taste, kidney heat causes salty taste, lung heat causes pungent taste, heart heat causes bitter taste, stomach heat causes bland taste, and gallbladder heat causes sour-bitter taste, all resulting from indecisive planning and worry.
Zhu Danxi said: The nose is the orifice of the lung, obstructed by pathology in the upper heart and lungs. There is cold and heat. Cold evil injuring the skin and hair causes qi obstruction and blockage; heat obstructing the clear pathways causes nasal congestion and loss of smell. Red, purple, or black nose and face are caused by heat damaging blood and blood heat. The face is yang within yang, and the nose is in the center of the face; blood circulating to the face and nose is the purest and most refined. In people who drink heavily, alcohol fumes rise, heating the face and nose, making blood extremely hot. When this heat encounters cold, impurities condense and fail to move, causing the face and nose to become purple, black, and swollen, commonly known as Rhinophyma (Alcohol Nasus). Treatment should clear heat, resolve stagnant blood, and generate new blood. Some say Rhinophyma is caused by lung meridian heat obstruction. Lung qi connects to the nose, the pathway for clear qi entry and exit. Due to drinking, qi and blood stagnate in the upper jiao, and latent evil heat remains unresolved, causing nasal sores. Or, if the lung meridian has pre-existing wind-heat, it arises naturally even without alcohol. Nasal polyps also result from this.
Tongue diseases are caused by heat obstruction in the heart, liver, and spleen, as described under pulse analysis. Tooth swelling and pain: According to Li Dongyuan, teeth are the marker of the kidney and the surplus of bone. The upper gum belongs to spleen earth, connected by the Foot Yangming Stomach meridian. The Hand Yangming Large Intestine meriology dislikes cold drinks and likes hot ones; the Foot Yangming Stomach meridian likes cold drinks and dislikes heat. Severe heat causes loose teeth and receding gums with unceasing pain. There is pain worsened by cold, pain worsened by heat, pain worsened by both, pain worsened by cold drinks, pain upon movement, pain when teeth protrude, pain from gum erosion by worms with bleeding, pain from gum swelling, pain from wind evil in spleen-stomach felt as wind, and painful foul odor. Teeth are the gate, the glory of the kidney, and surplus of bone. Kidney decline causes loose teeth; solid essence makes teeth firm. Large intestine deficiency causes exposed teeth; large intestine obstruction causes floating teeth. Wind invasion attacks the head and face. Eye malnutrition leads to... (text unclear/corrupted)... falling off becomes hemorrhoids. It can also be caused by qi stagnation. If doctors seek the root and treat it, chronic incurable cases do not exist.
Sore throat (Hou Bi): According to Zhang Zihe, rising heat combats the sides of the throat, causing external swelling resembling nipples, called Tonsillitis (Ru E), single or double. Smaller than tonsillitis is named Hou Bi. Heat binding under the tongue creates a small extra tongue, called Double Tongue. Heat binding in the middle of the tongue causes swelling, called Water Tongue. Heat binding in the throat causes external swelling, numbness, itching, and enlargement, called Wrapping Throat Wind. Sudden onset and death from sore throat is called Running Horse Sore Throat. Though names differ, the fire pathogen is the same. Shao Yin Ministerial Fire is governed by the Heart meridian; Hand Shaoyang Sanjiao Fire is governed by the Sanjiao meridian. Both govern their meridians and connect to the throat. Qi heat binds internally; severe binding causes swelling; severe swelling causes closure; severe closure leads to death by obstruction. Dry throat and pain, swollen jaw, and stiff tongue root are all due to Ministerial Fire. Only urgent sore throat relates to Ministerial Fire. Classics say: "Treat extremes by following their nature." And: "Dragon fire is driven away by fire." Thus, ancients used Ganjie Decoction for sore throat. Modern physicians misunderstand, using cold medicines or cooling herbs, leading to fatal qi collapse, which I have seen often. Bloodletting is crucial. People fear needles and seek alternatives; in emergencies, closure leads to death, which is pitiable.
Treatment Principles: Liu Hejian said: Eye diseases in the fu organs are exterior, requiring wind removal and heat clearing; in the zang organs, they are interior, requiring blood nourishment and spirit calming. Sudden blindness, grittiness, membranes, discharge, tearing, and spots are exterior, caused by wind-heat, treated by dispersing. Dimness, reluctance to see, internal obstruction, black spots, dilated pupils, and dullness in chronic illness are interior, caused by blood deficiency, spiritual fatigue, and kidney deficiency, treated by nourishing blood, supplementing water, and calming spirit. Wang Jiezhai said: Eye pain with swelling uses different internal and external medications. Internally, bitter-cold and acrid-cool agents clear fire; externally, acrid-hot and acrid-cool agents disperse evil. Borax (Bingpian) is best for eye drops; being acrid-hot and urgent, it extracts fire toxin and disperses heat. Ancient use of wine for washing eyes follows this logic. Fire eye is fire evil attacking the eyes; internal treatment uses bitter-cold drugs to treat the root. Since fire evil moves from inside out, external cold would trap internal fire. Thus, acrid-hot eye drops and hot water washing allow trapped fire to vent and disperse outward. Treatment rules: Chronic dimness uses Rehmannia Root and Angelica Sinensis as sovereigns, with Saposhnikovia Root and Notopterygium Rhizome and Chrysanthemum as assistants. Sudden red swelling uses Scutellaria Root and Coptis Rhizome and Saposhnikovia Root as sovereigns to drain fire, with Four Substances Decoction as assistant to cool and nourish blood. Notopterygium Rhizome, Bupleurum Root, and Chrysanthemum as guides to disperse wind and heat. Pain from blood-qii stasis uses Four Substances Decoction plus Gentian Root and Rhubarb to purge. Obese people often have phlegm-fire, treated by cooling blood, clearing heat, and moving phlegm. Thin people often have blood deficiency with excessive fire, treated primarily with blood-nourishing herbs, assisted by wind-dispersing herbs.
Zhu Danxi said: Deafness often involves heat stagnation in the Shaoyang and Jueyin meridians, with qi blockage or phlegm-fire attacking causing tinnitus/deafness. Treat by resolving phlegm and dispersing wind-heat; Tongsheng San or Gun Tan Wan are suitable. Post-illness or yin-deficiency fire agitation deafness requires nourishing yin and descending fire, using Four Substances Decoction plus Anemarrhena Rhizome and Phellodendron Bark. Tinnitus uses Danggui Longhui Wan. Those consuming rich foods and alcohol use Muxiang Binglang Wan. Wang Jiezhai said: Tinnitus is often misdiagnosed as kidney deficiency, failing to respond. It is actually phlegm-fire ascending and stagnating in the ear. Severe stagnation causes blockage. Often caused by pre-existing upper phlegm-fire aggravated by anger, which causes qi to rise and Shaoyang fire to lodge in the ear. Kidney deficiency tinnitus is mild; differentiation is key.
Mouth diseases or sores are accumulated heat in the middle and upper jiao. Mild cases use Xie Huang San; severe cases use Liang Ge San. Mouth sores unresponsive to cooling meds indicate excessive sex/diet, overwork, insomnia, or worry damaging middle qi, causing unrestrained deficient fire. Use Lizhong Tang plus Aconite Root or Cassia Bark, taken cold. One formula for mouth sores uses Coptis Rhizome and Cassia Bark powdered, held in mouth or applied. Bad breath uses Coptis Rhizome, Licorice Root, Agastache, Mint, Broad Bean, and Amomum Fruit powdered, taken with green tea.
Nasal congestion with lung heat or latent lung fire worsening with cold requires clearing lung and descending fire, aided by qi-unblocking agents. Wind-cold causing heavy voice or clear discharge is treated by dispersing. Red nose or Rhinophyma is heat damaging lung meridian, causing blood-qii stasis, treated by cooling blood, resolving stasis, and clearing lung.
Tongue swelling and sores are heart heat, treated with Xi Xin Tang or Huanglian Jiedu Tang for severe cases. Tongue coating varies: Shanghan coatings (yellow/black) require purging based on severity; miscellaneous disease coatings require clearing with Huanglian Jiedu Tang or Liang Ge San.
Wang Jiezhai said: Gum swelling, loose teeth, or black/rotten teeth are often misdiagnosed as kidney deficiency but are actually Yangming damp-heat. Teeth belong to kidney but grow in gums, which belong to Yangming Large Intestine and Stomach, like wood growing in soil. Rich food damages intestines/stomach, causing dampness to attack upward, clouding gums, causing swelling, pain, bleeding, or worms, leading to tooth loss. Treat by draining Yangming damp-heat and removing latent gut fire, using Fangfeng Tongsheng San minus Mirabilite.
Zhu Danxi said: Sore throat is mostly phlegm-heat. Severity depends on fire intensity. Mild cases use sour astringents; severe cases use acrid dispersants; urgent cases require bloodletting with needles/lancets, the best strategy. Human fire is cooled; dragon fire is driven by fire or vomiting. Classics state: Pharynx, larynx, epiglottis, and tongue share an orifice but function differently. Larynx receives air (connects to heaven); epiglottis controls opening/closing during swallowing. All four must work together; loss of one leads to death.