谓目病不治，忍待自愈，或治失其宜，有犯禁戒，伤其脉络，遂致深入，又不治之，致搏夹不得
发散之故。或年之月、月之日，如花如潮，至期而发，至期而愈。久而不治，及因激发，遂成大害。
未发者，问其所发之时令，以别病本在何经位。已发者，当验其形证丝脉，以别其何部分，然后治之。
【耳】属足少阴肾经。（《中藏》曰∶肾者，精神之舍，性命之根，外通于耳。《素问》曰∶肾
在窍为耳，肾和则耳能闻五音矣。《灵枢·师传》曰∶肾者主为外，使之远听，视耳好恶，以知其
性。故耳好前居牙车者肾端正。注∶牙车即颊车穴也，在耳下曲颔端陷中。耳偏高者肾偏倾，耳高者
肾高，耳后陷者肾下，耳坚者肾坚，耳薄不坚者肾脆。《玄珠》曰∶耳薄而黑或白者，肾败也。又属
手少阴心经。《素问》曰∶南方赤色，入通于心，开窍于耳。又曰∶手少阴之络，会于耳中。）又属
手太阴肺经。（李东垣曰∶耳本主肾，而复能听声者，声为金，是耳中有肺水，土生于申也。
王太仆曰∶手太阴肺络，会于耳中，肺虚则少气不能报息而耳聋）。又属足厥阴肝经。（《素问》曰∶
肝病气逆则耳聋不聪。朱丹溪曰∶耳聋属热，少阳、厥阴热多）。又属手足少阳三焦胆，手太阳小肠
经之会。（《灵枢》曰∶少阳根于窍阴，结于窗龙，窗龙者，耳中也。《素问》曰∶一阳独啸，少阳
厥也，其终者耳聋。注∶啸，耳中鸣如啸聋也。胆及三焦脉皆入耳，故气逆上则耳中鸣。又曰∶少阳
主胆，其脉循胁络于耳，故伤寒三日少阳受之，则胸胁痛而耳聋，九日少阳病衰，耳聋微闻。《灵枢》
曰∶手太阳所生病者，耳聋，目黄）。又属手足阳明大肠胃经。（《素问》曰∶头痛耳鸣，九窍不利，
肠胃之所生也。《灵枢》曰∶聋而痛者，取手阳明。聋而不痛者，取足少阳。又曰∶耳者，宗脉之所
聚也。胃中空则宗脉虚，虚则下溜，脉有所竭者，故耳鸣）。又属足太阳膀胱经。（《素问》曰∶太
阳所谓耳鸣者，阳气万物盛上而跃，故耳鸣也）。又属手足少阴心肾，太阴肺脾，足阳明胃经之络。
（《素问》曰∶此五络皆属于耳中，上络左角，邪客之则病）。
【耳前】属手足少阳三焦胆，足阳明
胃经之会。（《素问》曰∶上部人，耳前之动脉。注∶在耳前陷者中，动应于手，手少阳脉气之所行
也）。
【耳后】属手足少阳三焦胆经之会。（李东垣曰∶少阳者，邪出于耳前后也。按此语并证上文）。
【耳下曲颊】属足少阳胆，阳明大肠经之会，又属手太阳小肠经。（《灵枢》曰∶手太阳当曲颊）。
【曲颊前】属足少阳胆，阳明大肠经之会。
【前寸许】属手阳明大肠经。
【曲颊后】属足少阳胆经。
（《灵枢》曰∶足少阳在耳下曲颊之后）。《保命集》云∶夫耳者，以窍言之水也，以声言之金也，
以经言
之手足少阳俱会其中也。有从内不能听者主也，有从外不能入者经也。有若钟鸣者，有若钟声者，有
若火 然者，各随经见之，其间虚实不可不察也。假令耳聋者，何谓治肺，肺主声，鼻塞者肺也。
何谓治心，心主臭。如推此法，皆从受气于始，肾受气于巳，心受气于亥，肝受气于申，肺受气于寅，
脾受气于四季，此治法皆生长之道也。赵以德曰∶耳者肾之窍，足少阴经之所主，然心亦寄窍于耳，
在身十二经脉中，除足太阳手厥阴外，其余十经脉络皆入耳中。盖肾治内之阴，心治外之阳，合天地
之道，精气无处而不交通，故清净精明之气上走空窍，耳受之而听斯聪矣，因此耳属二脏之窍也。于
是诸经禀其阴阳五行，精明者皆上入之，所以宫商角征羽之五音，从斯辨矣。经曰∶积阳为天，积阴
为地，清阳出上窍是也。若二气不调则交通不表，故阳气者闭塞，地气者冒明。而阳气之闭塞者，或
因烦劳，阴虚气浮；或因卫气不下，循脉积聚于上；或得于邪风与阳并盛；或因热淫之胜；或因三焦
之火独光，而耳中浑浑 ；或因经脏积热所致；或因大怒气上而不下。夫如是者，皆由心气虚实不
调。虚则不能治其阳下与阴交，实则恃阳强而与阴绝。经曰∶至阴虚，天气绝是也。而地气之冒明者，
或忧愁不解，阴气闭塞，不与阳通；或内外湿饮痞
隔，其气不得升降，则耳中亦浑浑 ；或肾精脱，若热病之精脱，二者尺脉绝则死；或耳中因二气
不和，结干耵聍塞之。夫如是，皆由肾气不和，虚则阴气微不能上交于阳，而阳是暴实，则阴气逆不
纳其阳也。《灵枢》曰∶肾气通于耳，肾和则能闻五音。五脏不和，则七窍不通。故凡一经一络有虚
实之气入于耳中者，皆足以乱二脏主窍之精明。至于聋聩，此言暴病者也。若夫久聋者，于肾亦有虚
实之异。左肾为阴主精，右肾为阳主气，精不足，气有余，则聋为虚。其人瘦而色黑，筋骨健壮，此
精气俱有余，固藏闭塞，是聋为实，乃高寿之兆也。二者皆禀赋使然，不须治之。又有乍聋者，经曰∶
不知调阴阳七损八益之道，早衰之节也。其年五十，体重，耳目不聪明矣，此亦无治也。唯暴聋之病，
与阴阳隔绝之未甚，经脉欲行而未通，冲击其中，鼓动听户，随其气之微甚而作嘈嘈风雨诸声者，则
可随其邪以为治，补不足，泻有余，务使阴阳和平，自然清净之气上走耳中而听斯聪矣。曰若子所表，
言水火同开此窍，何《原病式》之非温补耶。曰心在窍为舌，以舌非孔窍，因寄窍于耳，则是肾为耳
窍之主，心为耳窍之客。以五脏开窍于面部，分阴精阳气言之，在肾肝居阴，故耳目二窍阴精主之；
在心肺脾居阳，故口舌鼻三窍阳气主之。所以
阴精主者，贵清凉而恶烦热；阳气主者，贵温暖而恶寒凉。洁古老人尝有是论，信耳目之不可以温补
也。《仁齐直指》云∶肾通乎耳，所主者精，精气调和，肾气充足，则耳闻而聪。若劳伤气血，风邪
袭虚，使精脱肾惫，则耳转而聋。又有气厥而聋者，有挟风而聋者，有劳伤而聋者，盖十二经脉上络
于耳，其阴阳诸经适有交并，则脏气逆而为厥，厥气搏入于耳，是为厥聋，必有时乎眩晕之证。耳者，
宗脉之所附，脉虚而风邪乘之，风入于耳之脉，使经气否而不宣，是为风聋，必有时乎头痛之证。劳
役伤于血气，淫欲耗其精元，瘦悴力疲，昏昏愦溃，是为劳聋。有能将适得所，血气和平，则其聋暂
轻；其或日就劳伤，风邪停滞，则为久聋之证矣。外此又有耳触风邪，与气相击，其声嘈嘈，眼或见
火，谓之虚鸣。热气乘虚随脉入耳，聚热不散，脓汁出焉，谓之脓耳。人耳间有津液，轻则不能为害，
若风热搏之，津液结 成核塞耳，亦令暴聋，谓之耵耳。前是数者，肾脉可推，风则浮而盛，热则洪而
实，虚则涩而濡。风为之疏散，热为之清利，虚为之调养。邪气并退，然后以通耳调气安肾之剂主之。
风虚耳聋，排风汤、桂星散、羊肾羹、鱼脑膏、磁石丸、姜蝎散。风热耳聋，犀角饮子、芍药散、犀
角散、茯神散。耳聋皆属于热，少阳厥
阴热多，宜开痰散风热，通圣散、滚痰丸之类。耳因郁聋，以通圣散，内加大黄酒煨，再用酒炒三次，
后入，诸药通用酒炒。厥聋，和剂流气饮加石菖蒲，每服三钱，以生姜、葱白同煎，食后服。沉香降
气汤、或苏子降气汤、不换金正气散、指迷七气汤。轻者吞来复丹，重者吞养正丹。凡治耳聋，皆当
调气。气逆耳聋有三，肝与手太阳、少阳也。经云∶肝气逆则头痛，耳聋不聪，颊肿。又云∶太阳所
谓浮为聋者，皆在气也。罗谦甫云∶手太阳气厥而耳聋者，其候聋而耳内气满也。手少阳气厥而耳聋
者，其候耳内浑浑 ，此皆气逆而聋也。治法宜四物汤吞龙荟丸降火，及复元通气散调气是也。耳
聋有湿痰者，槟榔神芎丸下之。耳聋面颊黑者，为精脱肾虚。罗谦甫云∶经曰，精脱者则耳聋。夫肾
为足少阴之经，乃藏精而气通于耳，耳者宗脉之所聚也。若精气调和则肾脏强盛，耳闻五音，若劳伤
气血兼受风邪，损于肾藏而精脱者，则耳聋也。然五脏六腑十二经脉有络于耳者，其阴阳经气有相并
时，并则脏气逆，名之曰厥，厥气相搏，入于耳之脉，则令聋。其肾病精脱耳聋者，其候颊颧色黑。
手少阳之脉动，则气厥逆而耳聋者，其候耳内浑浑 也。手太阳厥而耳聋者，其候聋而耳内气满也。
宜以烧肾散主之。烧肾散、益肾散、补肾丸、
苁蓉丸、肉苁蓉丸、桑螵蛸汤，肾虚有寒者宜之。《本事》地黄汤，肾虚有热者宜之。
【目】如果眼病不治疗，忍耐等待自愈，或者治疗不当，违反了禁忌，损伤了脉络，导致病情深入，又不进行治疗，致使邪气搏结夹杂，无法发散。或者在年、月、日的时间节点上，像花潮一样，到了那个时期就发作，到了那个时期就痊愈。时间久了不治疗，以及因为激发因素，最终造成大害。尚未发作时，询问其发作的时令，以辨别病本位于哪条经络的部位。已经发作时，应当查验其形态症状和丝脉（细微的脉象），以辨别病变在哪个部分，然后进行治疗。
【耳】归属于足少阴肾经。（《中藏经》说：肾是精神的居所，性命的根本，外部通连于耳。《素问》说：肾开窍于耳，肾气调和则耳能听到五音。《灵枢·师传》说：肾主司外部感知，使其能远听，观察耳朵的好坏，以此了解其本性。所以耳朵靠前且位于牙车穴位置的，说明肾位端正。注：牙车即颊车穴，位于耳下曲颌端的凹陷处。耳朵偏高说明肾位偏倾，耳朵高说明肾位高，耳后凹陷说明肾位低下，耳朵坚实说明肾体坚实，耳朵薄而不坚实说明肾体脆弱。《玄珠》说：耳朵薄而颜色黑或白的，是肾气败坏的表现。）又归属于手少阴心经。（《素问》说：南方赤色，内通于心，开窍于耳。又说：手少阴心经的络脉，会合于耳中。）又归属于手太阴肺经。（李东垣说：耳本来由肾主司，而又能听声音，声音属金，这是耳中有肺水，土生于申时。王太仆说：手太阴肺经的络脉，会合于耳中，肺气虚则气短不能深吸气而耳聋。）又归属于足厥阴肝经。（《素问》说：肝病气逆则耳聋不聪。朱丹溪说：耳聋属于热证，少阳、厥阴经的热证较多。）又归属于手足少阳三焦胆经、手太阳小肠经的会合处。（《灵枢》说：少阳经根于窍阴穴，结于窗笼穴，窗笼穴就是耳中。《素问》说：一阳独啸，是少阳经气厥逆，终末期会出现耳聋。注：啸，指耳中鸣响如啸声。胆及三焦经脉都进入耳中，所以气逆向上则耳中鸣响。又说：少阳主胆，其经脉循行胁肋联络于耳，所以伤寒三日少阳经受邪，则胸胁痛而耳聋，九日后少阳病衰退，耳聋轻微能听见。《灵枢》说：手太阳经所生的病症，包括耳聋、目黄。）又归属于手足阳明大肠胃经。（《素问》说：头痛耳鸣，九窍不利，是由肠胃产生的。《灵枢》说：聋而痛的，取手阳明经；聋而不痛的，取足少阳经。又说：耳是宗脉汇聚的地方。胃中空虚则宗脉虚弱，虚弱则向下流注，脉气有竭绝之处，所以耳鸣。）又归属于足太阳膀胱经。（《素问》说：太阳经所谓的耳鸣，是因为阳气像万物盛极向上跳跃，所以耳鸣。）又归属于手足少阴心肾、太阴肺脾、足阳明胃经的络脉。（《素问》说：这五条络脉都归属于耳中，上行联络左角，邪气客居于此则发病。）
【耳前】归属于手足少阳三焦胆经、足阳明胃经的会合处。（《素问》说：上部人部，耳前的动脉。注：在耳前凹陷处，跳动应于手，是手少阳经脉气运行的地方。）
【耳后】归属于手足少阳三焦胆经的会合处。（李东垣说：少阳经，邪气出于耳的前后。按此语并印证上文。）
【耳下曲颊】归属于足少阳胆经、阳明大肠经的会合处，又归属于手太阳小肠经。（《灵枢》说：手太阳经正当曲颊部位。）
【曲颊前】归属于足少阳胆经、阳明大肠经的会合处。
【前寸许】归属于手阳明大肠经。
【曲颊后】归属于足少阳胆经。（《灵枢》说：足少阳经在耳下曲颊之后。）《保命集》说：耳，从孔窍来说属水，从声音来说属金，从经络来说手足少阳经都汇聚其中。有从内部不能听的，主责于脏；有从外部不能入的，主责于经。有的像钟鸣，有的像钟声，有的像火燃，各随所见经络而定，其中的虚实不可不察。假如耳聋，为什么说治肺？肺主声，鼻塞也是肺的问题。为什么说治心？心主嗅觉。如果推演这种方法，都是从受气的初始阶段开始，肾受气于巳时，心受气于亥时，肝受气于申时，肺受气于寅时，脾受气于四季，这些治法都是生长之道。赵以德说：耳是肾之窍，由足少阴经主司，然而心也寄窍于耳，在身体十二经脉中，除了足太阳经和手厥阴经外，其余十条经脉络都进入耳中。大概肾治理内部的阴，心治理外部的阳，符合天地之道，精气无处不交通，所以清净精明的之气上行走空窍，耳接受它而听力聪慧，因此耳属于心和肾两脏的窍。于是各经禀受阴阳五行，精明的都上行进入耳中，所以宫商角徵羽的五音，由此得以分辨。经说：积阳为天，积阴为地，清阳出上窍正是如此。如果二气不调则交通受阻，所以阳气闭塞，地气冒蔽清明。而阳气闭塞的原因，或因烦劳，阴虚气浮；或因卫气不下行，循脉积聚于上；或因邪风与阳并盛；或因热邪淫胜；或因三焦之火独旺，而耳中浑浑作响；或因经脏积热所致；或因大怒气上而不降。像这样的情况，都是由心气虚实不调引起的。虚则不能治理阳气下行与阴交合，实则依仗阳气强盛而与阴隔绝。经说：至阴虚，天气绝正是如此。而地气冒蔽明亮的情况，或因忧愁不解，阴气闭塞，不与阳相通；或因内外湿饮痞隔，气不得升降，则耳中也浑浑作响；或因肾精脱失，若热病的精脱，二者尺脉绝则死；或因耳中因二气不和，结聚成耵聍堵塞。像这样，皆由肾气不和引起，虚则阴气微弱不能上交于阳，而阳气突然实盛，则阴气逆乱不能接纳阳气。《灵枢》说：肾气通于耳，肾和则能闻五音。五脏不和，则七窍不通。所以凡一经一络有虚实之气进入耳中的，都足以扰乱两脏主窍的精明。至于聋聩，这里说的是暴病。如果是久聋，对于肾也有虚实之别。左肾为阴主精，右肾为阳主气，精不足，气有余，则聋为虚证。其人瘦而色黑，筋骨健壮，这是精气俱有余，固藏闭塞，这种聋为实证，是高寿的征兆。两者都是禀赋使然，不需要治疗。又有突然耳聋者，经说：不知道调阴阳、七损八益的道理，是早衰的节律。其年五十，体重，耳目不聪明，这也是无需治疗的。只有暴聋的病，与阴阳隔绝尚不严重，经脉欲行而未通，冲击其中，鼓动听户，随着气的微甚而发出嘈嘈风雨等声音的，则可以随其邪气进行治疗，补不足，泻有余，务必使阴阳平和，自然清净之气上行走耳中而听力聪慧。如果说您刚才表述的，言水火同开此窍，为什么《原病式》主张非温补呢？回答说：心在窍为舌，因为舌不是孔窍，所以寄窍于耳，那么肾就是耳窍之主，心就是耳窍之客。以五脏开窍于面部，分阴精阳气来说，在肾肝居阴，所以耳目二窍由阴精主司；在心肺脾居阳，所以口舌鼻三窍由阳气主司。所以阴精主司的，贵在清凉而厌恶烦热；阳气主司的，贵在温暖而厌恶寒凉。洁古老人曾有这样的论述，确实认为耳目不可以温补。《仁齐直指》说：肾通乎耳，所主的是精，精气调和，肾气充足，则耳闻而聪。如果劳伤气血，风邪袭虚，使精脱肾惫，则耳转而聋。又有气厥而聋者，有挟风而聋者，有劳伤而聋者，大概十二经脉上络于耳，其阴阳诸经恰好有交并，则脏气逆而为厥，厥气搏入于耳，是为厥聋，必然有时伴有眩晕的症状。耳是宗脉所依附的地方，脉虚而风邪乘之，风进入耳之脉，使经气否塞而不宣通，是为风聋，必然有时伴有头痛的症状。劳役伤于血气，淫欲耗其精元，瘦悴力疲，昏昏愦溃，是为劳聋。如果能将养得当，血气和平，则其聋暂时减轻；如果日益劳伤，风邪停滞，则为久聋的证候了。除此之外又有耳触风邪，与气相击，其声嘈嘈，眼或见火，谓之虚鸣。热气乘虚随脉入耳，聚热不散，脓汁出焉，谓之脓耳。人耳间有津液，轻则不能为害，若风热搏结，津液结成核堵塞耳道，亦令暴聋，谓之耵耳。前述几种情况，可通过肾脉推断，风脉则浮而盛，热脉则洪而实，虚脉则涩而濡。风邪为之疏散，热邪为之清利，虚证为之调养。邪气并退后，然后用通耳调气安肾的方剂主治。风虚耳聋，用排风汤、桂星散、羊肾羹、鱼脑膏、磁石丸、姜蝎散。风热耳聋，用犀角饮子、芍药散、犀角散、茯神散。耳聋皆属于热，少阳厥阴热多，宜开痰散风热，用通圣散、滚痰丸之类。耳因郁怒致聋，用通圣散，内加大黄酒煨，再用酒炒三次，后入，诸药通用酒炒。厥聋，用和剂流气饮加石菖蒲，每服三钱，以生姜、葱白同煎，食后服。沉香降气汤、或苏子降气汤、不换金正气散、指迷七气汤。轻者吞服来复丹，重者吞服养正丹。凡是治疗耳聋，都应当调气。气逆耳聋有三种，涉及肝与手太阳、少阳经。经云：肝气逆则头痛，耳聋不聪，颊肿。又说：太阳经所谓的浮为聋者，都在气方面。罗谦甫说：手太阳经气厥而耳聋者，其表现为聋而耳内气满。手少阳经气厥而耳聋者，其表现为耳内浑浑作响，这都是气逆而聋。治法宜四物汤吞服龙荟丸降火，以及复元通气散调气。耳聋有湿痰者，用槟榔神芎丸攻下。耳聋面颊黑者，为精脱肾虚。罗谦甫说：经说，精脱者则耳聋。肾为足少阴之经，乃藏精而气通于耳，耳是宗脉汇聚的地方。如果精气调和则肾脏强盛，耳闻五音，如果劳伤气血兼受风邪，损于肾藏而精脱者，则耳聋也。然而五脏六腑十二经脉有络于耳者，其阴阳经气有相并时，并则脏气逆，名之曰厥，厥气相搏，入于耳之脉，则令聋。其肾病精脱耳聋者，其表现为颊颧色黑。手少阳之脉动，则气厥逆而耳聋者，其表现为耳内浑浑作响。手太阳厥而耳聋者，其表现为聋而耳内气满。宜以烧肾散主治。烧肾散、益肾散、补肾丸、苁蓉丸、肉苁蓉丸、桑螵蛸汤，肾虚有寒者适宜。《本事方》地黄汤，肾虚有热者适宜。
[Eye] If eye disease is not treated, enduring it in the hope of spontaneous recovery, or if treatment is inappropriate, violating contraindications, damaging the meridians and collaterals, leading to deep penetration, and further left untreated, causing pathogenic factors to knot and mix without being able to disperse. Or, at specific times of the year, month, or day, like flowers blooming or tides rising, symptoms manifest when the time comes and resolve when the time passes. Long-term neglect, combined with triggering factors, can lead to severe harm. Before onset, inquire about the timing of attacks to distinguish which meridian and location the root pathology resides in. After onset, examine the clinical manifestations and subtle pulse characteristics to identify the affected part, then proceed with treatment.
[Ear] The ear is associated with the Foot-Shaoyin Kidney Meridian. (The *Zhongzang Jing* states: "The kidney is the residence of spirit and the root of life, externally connecting to the ear." The *Suwen* states: "The kidney opens into the ear; when kidney qi is harmonious, the ear can hear the five tones." The *Lingshu·Shichuan* states: "The kidney governs external perception, enabling distant hearing. Observing the condition of the ears reveals its nature. Thus, ears positioned forward near the Jiache acupoint indicate a properly positioned kidney. Note: Jiache refers to the Jiache acupoint, located in the depression at the end of the curved jaw below the ear. Ears positioned high indicate a tilted kidney; high ears indicate a high kidney; depressed posterior ears indicate a low kidney; firm ears indicate a solid kidney; thin and unfirm ears indicate a fragile kidney." The *Xuanzhu* states: "Thin ears that are black or white indicate kidney failure.") It is also associated with the Hand-Shaoyin Heart Meridian. (The *Suwen* states: "Southern red color internally connects to the heart, opening into the ear." It further states: "The collateral of the Hand-Shaoyin meridian converges in the ear.") It is also associated with the Hand-Taiyin Lung Meridian. (Li Dongyuan stated: "Although the ear is primarily governed by the kidney, its ability to hear sound relates to Metal; this implies lung water exists within the ear, as Earth generates at Shen hour." Wang Taipu stated: "The collateral of the Hand-Taiyin Lung meridian converges in the ear; lung deficiency leads to shortness of breath and inability to take deep breaths, resulting in deafness.") It is also associated with the Foot-Jueyin Liver Meridian. (The *Suwen* states: "Liver qi rebellion causes deafness and poor hearing." Zhu Danxi stated: "Deafness belongs to Heat; Shaoyang and Jueyin meridians often have excessive heat.") It is also the convergence point of the Hand-Foot Shaoyang Sanjiao and Gallbladder Meridians, and the Hand-Taiyin Small Intestine Meridian. (The *Lingshu* states: "Shaoyang roots at Qiaoyin and knots at Chuanglong; Chuanglong refers to the ear." The *Suwen* states: "A solitary whistle from One Yang indicates Shaoyang rebellion; the terminal stage involves deafness. Note: 'Whistle' refers to tinnitus sounding like a whistle. Both Gallbladder and Sanjiao meridians enter the ear, so rebellious qi causes tinnitus." It further states: "Shaoyang governs the Gallbladder; its meridian circulates along the hypochondrium and connects to the ear. Thus, after three days of Cold Damage affecting Shaoyang, there is hypochondriac pain and deafness. After nine days, as Shaoyang disease declines, hearing slightly returns." The *Lingshu* states: "Diseases generated by the Hand-Taiyin meridian include deafness and yellow eyes.") It is also the convergence point of the Hand-Foot Yangming Large Intestine and Stomach Meridians. (The *Suwen* states: "Headache, tinnitus, and dysfunction of the nine orifices arise from the stomach and intestines." The *Lingshu* states: "For deafness with pain, select the Hand-Yangming meridian; for deafness without pain, select the Foot-Shaoyang meridian." It further states: "The ear is the gathering place of the Zong vessels. When the stomach is empty, the Zong vessels become deficient; deficiency leads to downward flow, and where vessel qi exhausts, tinnitus occurs.") It is also associated with the Foot-Taiyang Bladder Meridian. (The *Suwen* states: "Tinnitus attributed to Taiyang occurs because yang qi, like flourishing things, surges upward, causing tinnitus.") It is also associated with the collaterals of the Hand-Foot Shaoyin Heart-Kidney, Hand-Foot Taiyin Lung-Spleen, and Foot-Yangming Stomach Meridians. (The *Suwen* states: "These five collaterals all belong to the center of the ear, ascending to connect with the left corner of the head; if evil Qi lodges here, disease occurs.")
[Preauricular Area] Convergence of the Hand-Foot Shaoyang Sanjiao-Gallbladder Meridians and Foot-Yangming Stomach Meridian. (The *Suwen* states: "Upper Human region, the arterial pulse before the ear. Note: Located in the depression before the ear, pulsating under the hand, this is where the Qi of the Hand-Shaoyang meridian flows.")
[Retroauricular Area] Convergence of the Hand-Foot Shaoyang Sanjiao-Gallbladder Meridians. (Li Dongyuan stated: "Shaoyang, evil exits from the front and back of the ear. This comment corroborates the preceding text.")
[Lower Curved Jaw] Convergence of the Foot-Shaoyang Gallbladder Meridian and Yangming Large Intestine Meridian, also associated with the Hand-Taiyin Small Intestine Meridian. (The *Lingshu* states: "Hand-Taiyin corresponds to the curved jaw.")
[Anterior to Curved Jaw] Convergence of the Foot-Shaoyang Gallbladder Meridian and Yangming Large Intestine Meridian.
[One Cun Anteriorly] Associated with the Hand-Yangming Large Intestine Meridian.
[Posterior to Curved Jaw] Associated with the Foot-Shaoyang Gallbladder Meridian. (The *Lingshu* states: "Foot-Shaoyang is behind the lower curved jaw.") The *Baoming Ji* states: "Regarding the ear, as an orifice it belongs to Water, regarding sound it belongs to Metal, and regarding meridians, both Hand and Foot Shaoyang converge within it. Deafness from internal inability to hear is governed by the Zang organs; inability to receive sound from outside is governed by the meridians. Sounds may resemble bell ringing, chimes, or fire crackling, each corresponding to observed meridians; their deficiency or excess must be carefully examined. For example, why treat the Lung for deafness? The Lung governs sound, and nasal congestion is also a Lung issue. Why treat the Heart? The Heart governs smell. Extending this logic, treatment begins from the origin of receiving Qi: Kidney receives Qi at Si hour, Heart at Hai hour, Liver at Shen hour, Lung at Yin hour, Spleen at the four seasons. These treatments follow the Dao of growth. Zhao Yi-de stated: 'The ear is the orifice of the Kidney, governed by the Foot-Shaoyin meridian, yet the Heart also寄 (lodges) its orifice in the ear. Among the twelve meridians, excluding Foot-Taiyang and Hand-Jueyin, the remaining ten collaterals enter the ear. Roughly, the Kidney governs internal Yin, and the Heart governs external Yang, conforming to the Way of Heaven and Earth. Essence and Qi communicate everywhere, so clear and bright Qi ascends to the orifices; the ear receives it, granting acute hearing. Thus, the ear is the orifice of these two Zang organs.' Consequently, all meridians imbibe Yin-Yang and Five Elements; clarity ascends into the ear, allowing discrimination of the five tones (Gong, Shang, Jue, Zhi, Yu). The Classics state: 'Accumulated Yang becomes Heaven, accumulated Yin becomes Earth; clear Yang emerges from the upper orifices.' If the two Qi do not harmonize, communication fails, leading to obstruction of Yang Qi and obscuration by Earth Qi. Obstruction of Yang Qi may result from: fatigue causing Yin deficiency and floating Qi; Wei Qi failing to descend and accumulating above; pathogenic wind combining with excessive Yang; excessive Heat; independent flare-up of Sanjiao Fire causing muffled hearing; accumulation of Heat in meridians and Zang organs; or anger causing Qi to rise without descending. All such cases stem from imbalance of Heart Qi deficiency/excess. Deficiency prevents Yang from descending to interact with Yin; excess relies on strong Yang to sever connection with Yin. The Classics state: 'Extreme Yin deficiency leads to cutoff of Heavenly Qi.' Obscuration by Earth Qi may result from: unresolved sorrow causing Yin obstruction preventing Yang communication; internal/external dampness/phlegm blocking Qi ascent/descent, causing muffled hearing; exhaustion of Kidney essence (if due to febrile disease, cutoff of Chi pulse indicates death); or blockage by cerumen due to disharmony of the two Qi. All such cases stem from Kidney Qi disharmony. Deficiency means weak Yin cannot ascend to interact with Yang, while sudden Yang excess causes rebellious Yin to reject Yang. The *Lingshu* states: 'Kidney Qi connects to the ear; harmony allows hearing the five tones. Disharmony of the Five Zang leads to obstruction of the seven orifices.' Thus, any deficiency or excess Qi entering the ear via meridians/collaterals disrupts the clarity governed by the two Zang organs. Sudden deafness refers to acute illness. Chronic deafness varies by Kidney deficiency/excess. Left Kidney (Yin) governs Essence; Right Kidney (Yang) governs Qi. Insufficient Essence and excess Qi indicate deficiency-type deafness. A thin, dark-complexioned person with strong bones/muscles has excess Essence/Qi and blocked storage, indicating excess-type deafness, a sign of longevity. Both are constitutional and require no treatment. Sudden deafness: The Classics state, 'Failure to regulate Yin-Yang and the Seven Losses/Eight Benefits leads to premature aging.' At age fifty, heaviness and dull senses occur, also requiring no treatment. Only acute deafness, where Yin-Yang separation is not severe, meridians desire flow but are blocked, impacting the interior and drumming the auditory canal, producing roaring/windy sounds proportional to Qi intensity, can be treated by expelling evil, tonifying deficiency, and draining excess, ensuring Yin-Yang harmony so clear Qi ascends to the ear, restoring hearing. You asked: If Water and Fire share this orifice, why does *Yuanbing Shi* oppose warming/tonification? Answer: The Heart's orifice is the tongue; since the tongue is not a cavity, it lodges in the ear. Thus, Kidney is the master of the ear orifice, Heart is the guest. Regarding Five Zang orifices on the face, divided by Yin Essence/Yang Qi: Kidney/Liver are Yin, governing Eye/Ear (Yin Essence); Heart/Lung/Spleen are Yang, governing Mouth/Tongue/Nose (Yang Qi). Yin Essence governance values coolness and dislikes heat; Yang Qi governance values warmth and dislikes cold. Jiegu Laoren argued that Eyes/Ears should not be warmed/tonified. *Renqi Zhizhi* states: 'Kidney communicates with the ear, governing Essence. Harmonized Essence and sufficient Kidney Qi grant acute hearing. Labor/injury to Qi/Blood, wind attacking deficiency, causing Essence depletion and Kidney exhaustion, leads to deafness.' There is also Qi-Rebellion Deafness (Jue Long), Wind-Clasping Deafness (Feng Long), and Labor-Injury Deafness (Lao Long). Since twelve meridians connect to the ear, if Yin-Yang meridians intersect, Zang Qi rebels causing Jue; Jue Qi clashes into ear meridians, causing Jue Long, often accompanied by vertigo. Ear is attached to Zong vessels; vessel deficiency allows wind invasion, blocking meridian Qi, causing Feng Long, often with headache. Labor injures Qi/Blood, lust depletes Essence, leading to emaciation and weakness, causing Lao Long. Proper care restores balance, temporarily alleviating deafness; chronic labor/wind stagnation causes chronic deafness. Additionally, wind striking the ear clashing with Qi causes roaring tinnitus (Xu Ming), sometimes with visual fire. Heat invading via vessels, accumulating without dispersing, discharging pus, is Nong Er (Pus Ear). Fluids in the ear are harmless unless wind-heat binds them into kernels blocking the ear, causing sudden deafness, called Ding Er (Cerumen). These conditions are diagnosed via Kidney pulse: Wind is Floating/Excessive, Heat is洪 (Surging)/Solid, Deficiency is Se/Ruo (Choppy/Soft). Treat Wind by dispersing, Heat by clearing/draining, Deficiency by nourishing. After evil retreats, use formulas to open the ear, regulate Qi, and calm the Kidney. Wind-Deficiency Deafness: Paifeng Tang, Guixing San, Sheep Kidney Soup, Fish Brain Ointment, Cishi Wan, Jiangxie San. Wind-Heat Deafness: Xijiao Yinzi, Shaoyao San, Xijiao San, Fushen San. Deafness generally belongs to Heat, especially Shaoyang/Jueyin Heat; use Tongsheng San, Gutan Wan to resolve phlegm and scatter wind-heat. Deafness due to Depression: Tongsheng San with Rhubarb (wine-fried three times, added last); other herbs wine-fried. Jue Long: Heji Liuqi Yin with Shichangpu, 3 qian per dose, decocted with Ginger/Green Onion, taken post-meal. Chenxiang Jiangqi Tang, Suzi Jiangqi Tang, Buhuanjin Zhengqi San, Zhimi Qiqi Tang. Mild cases: Laifu Dan; severe cases: Yangzheng Dan. Treating deafness always requires regulating Qi. Qi-Rebellion Deafness involves Liver, Hand-Taiyang, Hand-Shaoyang. Classics: 'Liver Qi rebellion causes headache, deafness, cheek swelling.' 'Taiyang floating deafness is Qi-related.' Luo Qianfu: Hand-Taiandon Qi rebellion causes deafness with fullness; Hand-Shaoyang Qi rebellion causes muffled hearing. Treat with Siwu Tang + Longhui Wan to descend Fire, plus Fuyuan Tongqi San to regulate Qi. Deafness with Damp-Phlegm: Binglang Shenxiong Wan to purge. Deafness with dark cheeks: Essence depletion/Kidney deficiency. Luo Qianfu: 'Classics say Essence depletion causes deafness. Kidney is Foot-Shaoyin, storing Essence, connecting to ear. Harmonized Essence strengthens Kidney, enabling hearing. Labor/Wind damaging Kidney/Essence causes deafness.' When Yin-Yang Qi merges in meridians connected to the ear, Zang Qi rebels (Jue), clashing into ear meridians causing deafness. Kidney Essence depletion deafness presents with dark zygomatic color. Hand-Shaoyang pulse movement indicates Qi rebellion deafness (muffled hearing). Hand-Taiyang rebellion deafness presents with fullness. Use Shao Shen San. Shao Shen San, Yishen San, Bushen Wan, Congrong Wan, Rong Rong Wan, Sangpiaoxiao Tang are for Kidney Deficiency with Cold. *Benshi Fang* Dihuang Tang is for Kidney Deficiency with Heat.