Ear diseaseEar disease

ZhangFu or Meridian theory related to Ear diseaseZhangFu or Meridian theory related to Ear disease

11. Organs:. Organs:

Kidney:Kidney:

Kidney in charge of the ear ‘s functionKidney in charge of the ear ‘s function

Heart:Heart:

Heart also open on the earHeart also open on the ear

Liver & GB:Liver & GB:

Liver & GB Qi connect with ear & easily goes up to earLiver & GB Qi connect with ear & easily goes up to ear

Spleen:Spleen:

Spleen Qi nourish the earSpleen Qi nourish the ear

2. Meridians2. Meridians

Foot Shao Yang GB MeridianFoot Shao Yang GB Meridian

Hand Shao Yang San Jiao MeridianHand Shao Yang San Jiao Meridian

Foot Yang Ming Stomach meridianFoot Yang Ming Stomach meridian

Hand Tai Yang Small Intestine MeridianHand Tai Yang Small Intestine Meridian

Foot Tai yang Bladder MeridiansFoot Tai yang Bladder Meridians

Etiology & PathologyEtiology & Pathology

1. Exterior evil poison ( wind-heat ) attack ear

2. Liver & GB. Damp heat

3. Heart fire rising up

4. Kidney essence deficient

5. Dampness due to Spleen def.Ear purulence or ear skin rankle

Diagnosis method

1.1. Ear acheEar ache

1.1. Wind-heat Wind-heat

2.2. Liver & Kidney def. or spleen def.Liver & Kidney def. or spleen def.

3.3. Liver & GB. FireLiver & GB. Fire

4.4. Excess Excess

2.2. Tinnitus & deafnessTinnitus & deafness

1.1. Liver & GB. Fire attackingLiver & GB. Fire attacking

2.2. Liver & kidney Yin def. or Qi & Blood def.Liver & kidney Yin def. or Qi & Blood def.

3.3. Wind, heat, or dampness accmulationWind, heat, or dampness accmulation

3.3. DizzinessDizziness

1.1. Liver Yang rising upLiver Yang rising up

2.2. Phlegm-dampness accmulationPhlegm-dampness accmulation

3.3. Qi & blood def.Qi & blood def.

4.4. Kidney essence def.Kidney essence def.

5.5. Dampness due to spleen def.Dampness due to spleen def.

4.4. Ear pusEar pus1.1. Liver & GB. FireLiver & GB. Fire

2.2. Damp-heatDamp-heat

Treatment method

1.1. Internal medicineInternal medicine

1.1. Expel wind & clear heatExpel wind & clear heat

2.2. Clear fire & toxinClear fire & toxin

3.3. Promote water & resolve dampnessPromote water & resolve dampness

4.4. Tonify kidney essenceTonify kidney essence

5.5. Expel pus Expel pus

6.6. Dispels & move the QiDispels & move the Qi

2.2. External medicineExternal medicine

1.1. Wash with clear heat & remove toxin herbsWash with clear heat & remove toxin herbs

2.2. Dripping drug into ear methodDripping drug into ear method

3.3. Blow powder into earBlow powder into ear

4.4. Spread & apply with clear heat toxin, resolve swollen herbsSpread & apply with clear heat toxin, resolve swollen herbs

3.3. Acupuncture Acupuncture

4.4. Others Others

• Pain EarsPain Ears• 1. Wind-heat type1. Wind-heat type

Main Sym: Main Sym: distention & blocked feeling distention & blocked feeling

Concurrent sym: tinntus, bad audition, reddish & swlloen eardrum, fever, aversion to cold, headache, blocked nose, sore thorat, dry mouth

Tongue:Tongue: red body with thin white coating red body with thin white coating

Pulse:Pulse: floating & rapid floating & rapid

Treatment principle: disperse wind-heat, open the earTreatment principle: disperse wind-heat, open the ear

FormulaFormula

Yin Qiao San plusYin Qiao San plus

Jing Yin Hua 12, Ju Hua 12, Lian Qiao 12, Xia Ku Cao 15, Jing Yin Hua 12, Ju Hua 12, Lian Qiao 12, Xia Ku Cao 15, Jing Jie 10, Fang Fen 10, Chan Tui 6, Gan Cao 6Jing Jie 10, Fang Fen 10, Chan Tui 6, Gan Cao 6

--distention: Shi Chang Pu 10, Bai Ji Li 15, --distention: Shi Chang Pu 10, Bai Ji Li 15,

-- water secretion: Che qian Zi 10, Ze Xie 15, Sang Bai Pi 12-- water secretion: Che qian Zi 10, Ze Xie 15, Sang Bai Pi 12

• 2. Liver & GB fire2. Liver & GB fire

Main SymMain Sym: distent ear, inner ear ache radiated to : distent ear, inner ear ache radiated to the side of head, severe tinnitus, bad audience, the side of head, severe tinnitus, bad audience,

Concurrent symConcurrent sym: fever & headache, bitter mouth, : fever & headache, bitter mouth, dry thoratdry thorat

tonguetongue: red sides and tip of body with yellow : red sides and tip of body with yellow coating coating

Pulse: Pulse: wiry & rapidwiry & rapid

Treatment: Treatment: clear liver & GB. fire, open the earclear liver & GB. fire, open the ear

Formular:Formular: Long Dan Xie Gan Tang Plus Long Dan Xie Gan Tang Plus

Long Dan Cao 12, Huang Qin 12, Zhi Zi 12, Ju Hua Long Dan Cao 12, Huang Qin 12, Zhi Zi 12, Ju Hua 12, Chai Hu 12, Mu tong 12, Che Qian Zi 10, Ge Gen 30, 12, Chai Hu 12, Mu tong 12, Che Qian Zi 10, Ge Gen 30, Chan Tui 10, Gan Cao 6Chan Tui 10, Gan Cao 6

-- severe distention: Shi Chang Pu 12, Man Jing Zi -- severe distention: Shi Chang Pu 12, Man Jing Zi 12;12;

-- eardrum water accmulation: Fu Ling 15, Ze Xie -- eardrum water accmulation: Fu Ling 15, Ze Xie 1515

Tinnitus

• Etiology & PathologyEtiology & Pathology

Excess typeExcess type– Liver fire Liver fire – Phlegm firePhlegm fire– Exterior wind heat Exterior wind heat

Deficient TypeDeficient Type

- Liver & Kidney def.- Liver & Kidney def.

- Spleen & St. def.- Spleen & St. def.

- Heart Blood def.- Heart Blood def.

• Excess type :Excess type :• 1. Wind heat attacking1. Wind heat attacking

Main Sym: Main Sym: tinnitus with windy soundtinnitus with windy sound

Concurrent sym: exterior wind heat symptoms : headache, fever, sore throat,

Tongue:Tongue: thin white or yellow coating thin white or yellow coating

Pulse:Pulse: floating & rapid floating & rapid

Treatment principle: disperse wind-heat , open the Treatment principle: disperse wind-heat , open the earear

Formula : Yin Qiao San PlusFormula : Yin Qiao San Plus

• Excess typeExcess type

• 2. Liver Fire rising2. Liver Fire rising

Main Sym: Main Sym: suddent onset tinnitus, loud sound in suddent onset tinnitus, loud sound in the ear, severe sym. , worse in angrythe ear, severe sym. , worse in angry

Concurrent sym: emotional changing history, dizziness, headache, bitter mouth, dry throat & stools,

Tongue:Tongue: red body red body

Pulse:Pulse: wiry & rapid wiry & rapid

Treatment principle: Clear liver fire, opent the earTreatment principle: Clear liver fire, opent the ear

Formula : Long Dan Xie Gan Tang PlusFormula : Long Dan Xie Gan Tang Plus

• Excess TypeExcess Type

• 3. Phlegm Fire3. Phlegm Fire

Main Sym: Main Sym: tidal sound in the ear, blocked ear tidal sound in the ear, blocked ear feelingfeeling

Concurrent sym: heavy head, distent & opressed feeling in the chest & abdomen, sticky stool, heavy body type

Tongue:Tongue: red body with yellow geasy coating red body with yellow geasy coating

Pulse:Pulse: slippery & rapid slippery & rapid

Treatment principle: resolve dampness, clear fireTreatment principle: resolve dampness, clear fire

Formula : Formula :

• Deficient TypeDeficient Type

• 4. Spleen Qi Def.4. Spleen Qi Def.

Main Sym: Main Sym: tinnitus sound like cicada singing tinnitus sound like cicada singing

Concurrent sym: tiredness & weakness, bad appetite, worry during the whole day

Tongue:Tongue: pale color with enlarged body & pale color with enlarged body & toothmark toothmark

Pulse:Pulse: weak weak

Treatment principle: Tonify Spleen & open the earTreatment principle: Tonify Spleen & open the ear

Formula : Yi Qi Chong Ming TangFormula : Yi Qi Chong Ming Tang

Huang Qi, Ren Shen, Ge Geng, Man Jing Zi, Bai Huang Qi, Ren Shen, Ge Geng, Man Jing Zi, Bai Shao, Huang Bai, Sheng Ma, Gan CaoShao, Huang Bai, Sheng Ma, Gan Cao

• Deficient TypeDeficient Type

• 5. Heart Blood Def.5. Heart Blood Def.

Main Sym: Main Sym: tinnitus after long term illness or hard tinnitus after long term illness or hard working, repeatedly occuredworking, repeatedly occured

Concurrent sym: insominia, irrtability, nervious

Tongue:Tongue: pale body pale body

Pulse:Pulse: weak weak

Treatment principle: Nourish heart Blood, Open Treatment principle: Nourish heart Blood, Open the earthe ear

Formula : Gui Pi TangFormula : Gui Pi Tang

• Deficient TypeDeficient Type

• 6 Liver & Kidney Def.6 Liver & Kidney Def.

Main Sym: Main Sym: tinnitus & lack of sensitivity to sound, tinnitus & lack of sensitivity to sound, even deafness worse at nighteven deafness worse at night

Concurrent sym: dizziness & swimming, sore lower back

Tongue: Tongue:

Pulse:Pulse: weak weak

Treatment principle: Tonify Liver & Kidney, open Treatment principle: Tonify Liver & Kidney, open the earthe ear

Formula : Zuo Ci Wan or You Gui WanFormula : Zuo Ci Wan or You Gui Wan

Deafness

• Exterior wind or heat attacking

• Liver Qi Stagnation or Liver Fire attackingLiver Qi Stagnation or Liver Fire attacking

• Improper dietingImproper dieting

• Kidney essence def.Kidney essence def.

• Others: old age, genetic, drugs, Others: old age, genetic, drugs,

• 1 Wind-heat invasion1 Wind-heat invasion

Main Sym: Main Sym: sudden onset of deafness sudden onset of deafness

Concurrent sym: blocked nose, running nose, headache, distent ear, aversion to cold, fever

Tongue: Tongue: thin white coatingthin white coating

Pulse:Pulse: floating & rapid floating & rapid

Treatment principle: expel wind heat, open earTreatment principle: expel wind heat, open ear

Formula : Yin Qiao San PlusFormula : Yin Qiao San Plus

Jing Yin hua 16, Lian Qiao 12, Lu Gen 12, Bo He 7, Jing Yin hua 16, Lian Qiao 12, Lu Gen 12, Bo He 7, Niu Pang Zi 12, Jing Jie 7, Dan Dou Chi 12, Dan Zhu ye 12, Niu Pang Zi 12, Jing Jie 7, Dan Dou Chi 12, Dan Zhu ye 12, Shi Chang Pu 16, Ge Geng 16Shi Chang Pu 16, Ge Geng 16

• 2. Liver Fire rising2. Liver Fire rising

Main Sym: Main Sym: suddent onset deafness after emotion suddent onset deafness after emotion changingchanging

Concurrent sym: emotional changing history, dizziness, headache, bitter mouth, dry throat & stools,

Tongue:Tongue: red body red body

Pulse:Pulse: wiry & rapid wiry & rapid

Treatment principle: Clear liver fire, opent the earTreatment principle: Clear liver fire, opent the ear

Formula : Long Dan Xie Gan Tang PlusFormula : Long Dan Xie Gan Tang Plus

Long Dan Cao 12, Huang Qin 12, Dang Gui12, Chai Long Dan Cao 12, Huang Qin 12, Dang Gui12, Chai Hu 7, Ze Xie 12, Zhi Zi 12, Che Qian Zi 12, Shen Gan Cao Hu 7, Ze Xie 12, Zhi Zi 12, Che Qian Zi 12, Shen Gan Cao 12, Mu Tong 12, Shi Chang Pu 1612, Mu Tong 12, Shi Chang Pu 16

• 3. Phlegm fire accmulation3. Phlegm fire accmulation

Main Sym: Main Sym: suddent onset deafness with heavy suddent onset deafness with heavy head & dizzinesshead & dizziness

Concurrent sym: distent ear, oppressed feeling in the chest and abdomen, bad appetite

Tongue:Tongue: red body with yellow greasy coating red body with yellow greasy coating

Pulse:Pulse: slippery & rapid slippery & rapid

Treatment principle: Clear fire & resolve phlegm, Treatment principle: Clear fire & resolve phlegm, harmonize stomach & calm dwon the rebellion of Qi, harmonize stomach & calm dwon the rebellion of Qi, opent the earopent the ear

Formula : Weng Dan Tang PlusFormula : Weng Dan Tang Plus

Ban Xia 12, Chen Pi 12, Gan Cao 12, Zhi Shi 12, Zu Ban Xia 12, Chen Pi 12, Gan Cao 12, Zhi Shi 12, Zu Ru 12, Fu Ling 16, Sheng Jiang 5pieces, Ru 12, Fu Ling 16, Sheng Jiang 5pieces,

Greasy coating: Huo Xiang12 , Pei Lan 12, Cang Greasy coating: Huo Xiang12 , Pei Lan 12, Cang Zhu 12, Hou Pu 12Zhu 12, Hou Pu 12

• 4. Qi & Blood Def.4. Qi & Blood Def.

Main Sym: Main Sym: tinnitus & deafness reaptedly tinnitus & deafness reaptedly occurred, worse after workingoccurred, worse after working

Concurrent sym: weak body, & pale face color, bad appetite

Tongue:Tongue: thin white coating thin white coating

Pulse:Pulse: fine & Weak fine & Weak

Treatment principle: tonify Qi & Blood, open the Treatment principle: tonify Qi & Blood, open the earear

Formula : Ba Zheng Tang PlusFormula : Ba Zheng Tang Plus

Dang Shen 16, Bai Zhu 12, Fu Ling 12, Zhi Gan Cao 12, Dang Shen 16, Bai Zhu 12, Fu Ling 12, Zhi Gan Cao 12, Dang Gui 12, Shu Di 16, Bai Shao 12, Chuan Xiong 7, Chen Dang Gui 12, Shu Di 16, Bai Shao 12, Chuan Xiong 7, Chen Pi 12, Tai Zi Shen 16Pi 12, Tai Zi Shen 16

• 5. Kidney essence Def.5. Kidney essence Def.

Main Sym: Main Sym: long time deafness, tinnitus long time deafness, tinnitus

Concurrent sym: dizziness & swimming, sore lower back, weak knees,

Tongue:Tongue: red body with less coating red body with less coating

Pulse:Pulse: fine & rapid fine & rapid

Treatment principle: Nourish kidney essence, Treatment principle: Nourish kidney essence, open the earopen the ear

Formula : Qi Ju Di Huang Wan PlusFormula : Qi Ju Di Huang Wan Plus

Gou Qi Zi 12, Ju Hua 12, Shu Di 12, Shan Zhu Yu 12, Gou Qi Zi 12, Ju Hua 12, Shu Di 12, Shan Zhu Yu 12, Shan yao 16, Fu Ling 12, Ze Xie 12, Dan Pi 16, Shi Chang Shan yao 16, Fu Ling 12, Ze Xie 12, Dan Pi 16, Shi Chang Pu 12, Ci shi 16, He Shou Wu 16Pu 12, Ci shi 16, He Shou Wu 16

Insomnia: Yuan Zhi 12, Suan Zhao Ren 12Insomnia: Yuan Zhi 12, Suan Zhao Ren 12

def. fever: Di Gu pi 12def. fever: Di Gu pi 12

• 6. Blood stasis due to Qi stag.6. Blood stasis due to Qi stag.

Main Sym: Main Sym: deafness sometime worse sometime deafness sometime worse sometime better with tinnitusbetter with tinnitus

Concurrent sym:

Tongue:Tongue: purple color purple color

Pulse:Pulse:

Treatment principle: Move blood resolve blood Treatment principle: Move blood resolve blood stasis, moving qi to open the earstasis, moving qi to open the ear

Formula : Tong Qiao Huo Xue Tang PlusFormula : Tong Qiao Huo Xue Tang Plus

Tao Ren 12, Hong Hua 12, Di Long 12, Chuan Xiong 12, Tao Ren 12, Hong Hua 12, Di Long 12, Chuan Xiong 12, Chi Shao 12, She Xiang 5, Cong Bai 5 Sheng Jiang 5 p, Da Chi Shao 12, She Xiang 5, Cong Bai 5 Sheng Jiang 5 p, Da Zhao 5p; Xuan Hu Suo 12, Yu Jing 12Zhao 5p; Xuan Hu Suo 12, Yu Jing 12

Meniere’s disease

• Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear, and fluctuating hearing loss.

• An acute attack of Meniere's disease is generally believed to result from fluctuating pressure of the fluid within the inner ear.

• TCM Pathology & Etiology

1.Phlegm block the ear orifices

Bad food digestion, fatigue, Over thinking or chronic disease -> damage the spleen function -> dampness accumulation -> Turn into phlegm -> Block the Yang Qi & orifice -> cause dizziness

2. Liver Yang rising

emotion changing-> Liver Qi stag. -> liver yang rising or liver fire attacking

3. Kidney essence deficiency

• 1. Phlegm blocks the orifice.1. Phlegm blocks the orifice.

Main Sym: Main Sym: severe dizziness, tinnitus, deafness, severe dizziness, tinnitus, deafness,

Concurrent sym: heavy head, chest fullness & heavy head, chest fullness & distention, vomiting & nausea, lots phlegm & saliva, poor distention, vomiting & nausea, lots phlegm & saliva, poor digestion, fatigue, thirsty but no desire of drinking waterdigestion, fatigue, thirsty but no desire of drinking water

Tongue:Tongue: thick greasy coating thick greasy coating

Pulse:Pulse: soft & slippery soft & slippery

Treatment principle: Strengthen the Spleen, Expel Treatment principle: Strengthen the Spleen, Expel the phlegm, open the orificethe phlegm, open the orifice

Formula : Ban Xia Bai Zhu Tian Ma TangFormula : Ban Xia Bai Zhu Tian Ma Tang

Ban Xia 9g, Bai Zhu 9g, Tian Ma 9g, Fu Ling 15g, Ju Hong Ban Xia 9g, Bai Zhu 9g, Tian Ma 9g, Fu Ling 15g, Ju Hong 9g, Gan Cao 6g, Sheng Jiang 3 slices, Da Zao 5 pieces 9g, Gan Cao 6g, Sheng Jiang 3 slices, Da Zao 5 pieces

• 2. Liver Yang rising.2. Liver Yang rising.

Main Sym: Main Sym: suddenly occurred dizziness, tinnitus, suddenly occurred dizziness, tinnitus, deafness, deafness,

Concurrent sym: nausea & vomiting, worse with nausea & vomiting, worse with emotional changing, red eyes, dry throat, bitter mouth, pain rib emotional changing, red eyes, dry throat, bitter mouth, pain rib area, area,

Tongue:Tongue: red body with yellow coating red body with yellow coating

Pulse:Pulse: rapid & wiry rapid & wiry

Treatment principle: Nourish liver Yin, Calms the Treatment principle: Nourish liver Yin, Calms the liver Yang or expel the liver wind liver Yang or expel the liver wind

Formula : Tian Ma Gou Teng YinFormula : Tian Ma Gou Teng Yin

Tian Ma 9g, Gou Teng 9g, Shi Jue Ming 24g, Zhi Zi 9g, Tian Ma 9g, Gou Teng 9g, Shi Jue Ming 24g, Zhi Zi 9g, Huang Qin 9g, Chuan Niu Xi 9g, Du Zhong 9g, Sang Ji Huang Qin 9g, Chuan Niu Xi 9g, Du Zhong 9g, Sang Ji Sheng 9g, Fu Shen 12g, Ye Jiao Teng 12g, Chai Hu 9gSheng 9g, Fu Shen 12g, Ye Jiao Teng 12g, Chai Hu 9g

• 3. Kidney essence deficiency.3. Kidney essence deficiency.

Main Sym: Main Sym: Frequently occurred dizziness, Frequently occurred dizziness, tinnitus, Bad hearing tinnitus, Bad hearing

Concurrent sym: sore & weak lower back & knees, sore & weak lower back & knees, poor memory, hot sensation in five palms. poor memory, hot sensation in five palms.

Tongue:Tongue: red body with less coating red body with less coating

Pulse:Pulse: rapid & fine rapid & fine

Treatment principle: Tonify Kidney essenceTreatment principle: Tonify Kidney essence

Formula : Qi Ju Di Huang WanFormula : Qi Ju Di Huang Wan

Sheng Di Huang 12g, Shan Yao 15g, Shan Yu Rou 15g, Sheng Di Huang 12g, Shan Yao 15g, Shan Yu Rou 15g, Gou Qi Zi 9g, Ju Hua 9g, Shi Jue Ming 15g, Bai Shao 12g, Gou Qi Zi 9g, Ju Hua 9g, Shi Jue Ming 15g, Bai Shao 12g, Shou Wu 12g, Gui Ban Jiao 10g, Lu Jiao Jiao 10g, Mu Li Shou Wu 12g, Gui Ban Jiao 10g, Lu Jiao Jiao 10g, Mu Li 15g, 15g,

–Case 1–Main complain: right ear ringing for one year

Continually ear ringing for one year, high pitch but low volume; Especially feel irritability when hear the noise from outside. Symptoms get worse after hard working. Right side ear ringing is worse than left side. With headache recently too.

Tongue: thin white coating & slightly red tongue body

Pulse: even

TCM diagnosis:

Excess heart fire attacking the ear orifice

Treatment: Clear heart fire

Sheng Di Huang 10g; Dan Zhu Ye 10g; Bai Mao Gen 10g; Deng Xing 3g;

Dang Gui 10g; Dan Shen 10g; Ju Hua 10g; Bai Zi Ren 10g; Yi Mu Cao 10g

Case 2

Female 48 y

Main complain: tinnitus & deafness

8 years ago, suddenly occurred tinnitus & deafness. After treated by hyperbaric oxygenation; tinnitus stopped, but deafness is still. And the deafness is getting even worse clearly in this year. Accompanied with distending feeling in the ear, dry throat. Also whole body very itching sometime, but with no any rashes or eczema; itching could be cured by drinking expel wind herb formula.

tongue: thin coating Pulse: fine

TCM diagnosis: Blood & Yin deficiency

Treatment: Nourish the blood & Yin

Shu Di Huang10g; Shan Yao 10g; Fu Ling 10g; Lu Dou Yi 10g;

Ze Lan 6g; Mu Dan Pi 6g; Dang Gui 10g; Xuan Shen 10g; Ge Gen 6g;

Case 3

Female 47 Y

Main complain: Acute deafness for 4 m

Suddenly occurred deafness in the middle of the June. After treatment, deafness is little better, but the ear ringing started, continually, high pitch and very loud volume, none stopping in the whole day & whole night. Couldn’t fall asleep due to its big noise. Dizziness, heavy head feeling but very light on the feet. Very sensitive to the noisy from outside.

Tongue: thin coating Pulse: slippery & wiry

TCM diagnosis: Phlegm fire block the ear orifice.

Treatment: Clear fire & resolve the phlegm

Long Dan Cao 3g; Dan Nan Xing 3g; Chen Pi 6g; BanXia 6g;

Tian Zhu Huang6g; Zhi Zi10g; Zhi Shi6g; Shi Chang Pu 3g;

Xia Ku Cao 10g; Ju Hua10g