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EAR PAIN (EARACHE)

WIND-COLD

Clinical Manifestations	Painful ears A slight purplish or blue color to the ears Ear pain referring to the head Itching or tickling in the throat Cough with expectoration of thin, watery or frothy white sputum Chills with low grade fever Anhidrosis No thirst Headache Aversion to Wind Blocked and / or runny nose with clear, watery nasal discharge Sneezing General body aches Maybe asthma T: Pink C: Thin, white and moist P: Floating and tight or Floating and wiry
Treatment Principle	Expel Wind Dispel Cold Alleviate pain
Herb Formulas	Dang Gui Si Ni Tang Chinese Patent Medicine: Jing Fang Bai Du Pian
Points	Moxa or moxa needle GB-2, LI-4, SJ-5, SJ-17, needle GB-8, LU-7, UB-12 With spasms of the face: + ST-6, ST-7 With a headache and a stiff neck: + SI-3, UB-62 With a cough and expectoration of white Phlegm: + LU-1, UB-13 DU-16, GB-20, LI-4 + LU-7 or LI-4 + KI-7, LU-5, UB-12, UB-13

TAI YANG - YANG MING

Clinical Manifestations	Earache Nasal obstruction caused by Damp-Heat Stuffy nose Yellow and sticky nasal discharge Sneezing Headache Tendency to constipation May be fever Facial flushing Itchy nose and throat Decreased sense of smell Decreased energy Fatigue T: Tends to red C: May be yellow P: Full and rapid
Treatment Principle	Release the Exterior Clear Heat Resolve toxicity Unblock the nasal passages Dry Dampness in the head Dispel pus
Herb Formulas	Qing Bi Tang
Points

WIND-HEAT

Clinical Manifestations	Severe pain at the ears Redness and swelling of the ears Pain in the auditory canal occurs when there an early-stage sore in the ear Aggravation of the pain on speaking, chewing and yawning Yellow discharge from the ears Expectoration of yellow Phlegm Cough with thick, sticky, yellow sputum Sore, red, swollen throat Thirst with a desire to drink cold liquids Runny or blocked nose with thick, yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Maybe fatigue Maybe decreased hearing Maybe dyspnea with flared nostrils Maybe chest pain T: Red or Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Expel Wind Clear Heat Eliminate toxins Disperse swelling
Herb Formulas	Pu Ji Xiao Du Yin Yin Qiao San Jing Jie Lian Qiao Tang Qing Bi Tang Severe: Fang Feng Tong Sheng Tang With suppuration or exudate form the ears: Man Jing Zi San Chinese Patent Medicines: Yin Qiao Pian Yin Qiao Jie Du Pian Gan Mao Dan Huang Lian Shang Qing Pian Niu Huang Jie Du Pian
Points	GB-2, GB-20, GB-8, LI-4, SJ-3, SJ-17, SJ-21 With redness and swelling of the ear due to Toxic Heat: + LI-11, SJ-2 With yellow discharge from the ear due to Toxic Damp-Heat: + GB-34, SJ-6 With a fever: + DU-14 With a headache: + Taiyang For a cough with expectoration of yellow sputum: + LU-7, UB-13 DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13 LI-4, LI-11, SJ-5, bleed SJ-18, SJ-20 With a headache: + Taiyang With reduced auditory acuity: + SJ-21

LIVER QI STAGNATION

Clinical Manifestations	Pain in one or both ears which moves up and down Pain is aggravated by emotional upset Pain is alleviated by relaxation Headache Distention and pain in the sides or flanks Feeling of fullness in the chest and ears Tendency to sigh Melancholy Depression Nervousness Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Slightly purplish C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Clear Stagnation Relieve pain
Herb Formulas	Xiao Yao San modified Chinese Patent Medicines: Shu Gan Wan Xiao Yao Wan
Points	GB-8, GB-12, LI-4, LIV-3, SI-19, SJ-17, SJ-21 With severe ear pain: + GB-41, SJ-5 With aggravation of the ear pain by emotional upset: + GB-20, PC-6 With a headache: + Taiyang, Yintang With insomnia: + Anmian, HT-3 With depression and a feeling of fullness in the chest: + REN-17 With nausea or stomach pain during periods of nervousness: + REN-12, ST-34 With loose stools or diarrhea during periods of nervousness: + LIV-13, ST-25 With a bitter taste in the mouth ans a yellow, slightly greasy tongue coat: + GB-34

LIVER QI STAGNATION TURNING TO HEAT WITH UNDERLYING QI AND BLOOD DEFICIENCY

Clinical Manifestations	Earache Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations Lower abdominal pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Spontaneous sweating or night sweats with fever Anxiety Dry eyes Hypochondriac pain Somnolence Insomnia Aching shoulders Five Sole Heat Premenstrual tension Hot flashes Fatigue Lassitude Depression Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis Irregular menstruation Heaviness in the lower abdomen T: Red or Red edges C: Thin and yellow P: Thready, rapid and wiry or Wiry and tight and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish the Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points

LIVER FIRE

Clinical Manifestations	Severe, unbearable pain in the ear Acute onset of ear pain or Chronic ear pain with acute aggravations Maybe discharge of yellow fluid from the ear Heat in the ear Redness and swelling of the skin of the ear A red eardrum Marked decrease in auditory acuity Maybe a fever Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irritability Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Nervousness Restlessness Constipation or dry stools Maybe rib pain Dark colored urine In severe cases: Mania Hemoptysis Hematemesis Epistaxis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Long Dan Xie Gan Tang Xie Qing Wan For chronic or recurrent cases: Tian Ma Gou Teng Yin Zhen Gan Xi Feng Tang Chinese Patent Medicines: Long Dan Xie Gan Wan Niu Huang Jie Du Wan
Points	GB-2, GB-8, GB-41, GB-43, LI-4, LIV-2, SJ-6 With redness and swelling of the ear: + LIV-8 With discharge of yellow liquid from the ear: + GB-34, SP-9 With pain in front of the ear: + GB-3 With nervousness, irritability and a headache: + DU-20, GB-20 With a bitter taste in the mouth: + GB-40 With hypochondriac pain: + LIV-14 GB-40, GB-42, LIV-2, SJ-17, SJ-21 With a bitter taste in the mouth: + GB-34 With reduced auditory acuity: + SJ-16

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Gradual onset of slight ear pain that is usually deep inside the ear The pain moves up and down Pain is aggravated when tired A feeling of slight fullness of the ear Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Hair loss Poor concentration Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Diminished hearing or Deafness Fatigue Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Spermatorrhea Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid or Deep and weak
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Liu Wei Di Huang Wan modified
Points	GB-2, KI-3, LIV-3, REN-6, SJ-21, SP-6, UB-18, UB-23 With severe ear pain: + SI-19, SJ-17 With tinnitus: + GB-10, SJ-18 With a feeling of slight fullness in the ear: + SI-4 With poor vision: + GB-37, ST-2 With aversion to Cold: + moxa or moxa needle REN-4 With edema: + REN-9, SP-9 With Heat in the body and night sweats: + HT-6, KI-2 With dizziness and a headache: + GB-20 With nervousness and irritability: + LIV-2 With discharge of yellow Phlegm form the ear: + GB-43, SJ-2

KIDNEY YIN DEFICIENCY WITH FIRE RISING

Clinical Manifestations	Ear pain Itching in the auditory canal which may be unbearable Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan
Points	GB-2, KI-3, KI-7, REN-4, SJ-17 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23

QI AND BLOOD STAGNATION

Clinical Manifestations	Ear pain that is radiating and unbearable Dizziness Tinnitus T: Dull purple C: White P: Thready and choppy
Treatment Principle	Clear Heat Drain Fire Unblock the Channels Open the Orifices
Herb Formulas	Long Dan Xie Gan Tang modified
Points	GB-2, GB-20, LI-4, LIV-2, SJ-17, SP-6

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Gradual onset of ear pain A feeling of slight fullness in the ear Diminished hearing Tinnitus Fatigue Loose stools Poor appetite Dizziness Pale face Weakness of the muscles and limbs Weak voice Shortness of breath Reluctance to speak Sweating with little or no exertion Palpitations Insomnia Dry skin Dry hair Hair loss Poor memory Paleness Scanty periods Loose stools T: Pale or Pale, thin and dry C: Thin and white P: Weak or Thin and choppy or Deep, thready and weak
Treatment Principle	Tonify Qi Nourish the Blood
Herb Formulas	Shi Quan Da Bu Tang modified Chinese Patent Medicines: Shi Quan Da Bu Wan Bu Zhong Yi Qi Wan
Points	Moxa or moxa needle DU-20, SP-3, ST-36, needle GB-2, SJ-21, SP-6, ST-7, ST-42 With severe ear pain: + GB-8, SJ-17 With chronic fatigue: + moxa or moxa needle REN-6 With shortness of breath: + LU-9 With a pale complexion, dizziness and scanty menstruation: + GB-39, UB-18 With a poor appetite and loose stools: + REN-12, SP-9

BLOOD STAGNATION

Clinical Manifestations	Stabbing pain in the ears Pain is worse at night Headache A purplish color of the ears Pain that is fixed, stabbing and /or severe Pain is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Regulate Qi Break up Stagnation Alleviate pain
Herb Formulas	Tong Qiao Huo Xue Tang Xue Fu Zhu Yu Tang Chinese Patent Medicine: Yan Hu Suo Zhi Tong Pian
Points	GB-2, GB-8, LI-4, LIV-3, SI-19, SJ-21, SP-6 With severe ear pain: + UB-17 With Qi Stagnation: + PC-6, REN-17 With a headache: + GB-20, SI-3

TOXIC HEAT OR INSECT BITES

Clinical Manifestations	Sudden swelling and pain of the ear Mostly on one side Itching Redness A hot or burning sensation Restlessness Fever Thirst Constipation T: Red C: Yellow P: Wiry and rapid
Treatment Principle	Clear Heat Remove toxin Reduce swelling Relieve pain
Herb Formulas	Wu Wei Xiao Du Yin Jing Jie Lian Qiao Tang Chinese Patent Medicines: Niu Huang Jie Du Pian Huang Lian Shang Qing Wan
Points	DU-10, GB-3, LI-2, LI-4, SJ-6, SJ-21, UB-17 With obvious redness and swelling of the ear: + GB-43, SJ-2 With a fever: + DU-14, LI-11 With a headache: + Taiyang With restlessness and insomnia: + HT-3

TOXIC HEAT WITH BLOCKAGE OF THE PERICARDIUM

Clinical Manifestations	Gradual onset of ear pain with sudden aggravation Profuse discharge of yellow pus from the ear High fever Restlessness Severe headache Nausea Vomiting Delirium Maybe semiconsciouness Thirst Constipation T: Deep red C: Thick, yellow and greasy P: Rapid and forceful
Treatment Principle	Clear Heat Remove Toxin Reduce fever Relieve blockage
Herb Formulas	Huang Lian Jie Du Tang modified Chinese Patent Medicines: Niu Huang Jie Du Pian An Gong Niu Huang Wan
Points	DU-10, HT-3, LI-2, LI-4, LI-11, SJ-6, SJ-21, ST-44 With severe redness and swelling of the ear: + GB-43, SJ-2 With a high fever: + DU-14 With a headache: + Taiyang With restlessness and insomnia: + HT-7 With semiconsciousness: + DU-26 With expectoration of profuse yellow Phlegm: + LU-5, ST-40 With nausea and vomiting: + PC-6, REN-12 With constipation: + ST-25

PHLEGM-HEAT (FIRE)

Clinical Manifestations	Ear pain Tinnitus in both ears like the sound of cicadas There may be a feeling of blockage or pressure in the ears This condition often is long term with gradual loss of hearing Maybe yellow, purulent discharge from one ear associated with an earache Fullness and heaviness of the head Foggy-headedness Recurrent clearing of the throat Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Maybe restless fever Sore throat Fullness in the chest and epigastrium Loose or sluggish stools or Constipation Dry stools Shortness of breath Anorexia A poor sense of taste or A bitter taste in the mouth Dyspnea Nausea Vomiting Pain in the ribs T: Scarlet C: Yellow or Yellow and greasy or Yellow and smooth P: Rapid and smooth or Slippery and rapid or Wiry and slippery
Treatment Principle	Clear Heat Resolve Phlegm
Herb Formulas	Wen Dan Tang modified For severe cases or cases with vertigo, a thick, yellow tongue coat, impairment of consciousness or constipation: Gun Tan Wan Following resolution of the Heat signs or between episodes: Er Chen Tang modified With dizziness and a headache of foggy-headedness: Ban Xia Bai Zhu Tian Ma Tang With Spleen Qi Deficiency: Liu Jun Zi Tang Chinese Patent Medicines: Qing Qi Hua Tan Wan Huang Lian Jie Du Tang Chuan Xin Lian Kang Yan Pian
Points	LI-11, LU-5, ST-40, UB-13 Choose one or two of the following: GB-2, SI-19, SJ-17, SJ-21 + two or three of the following: GB-20. LI-4, LU-7, PC-5, SJ-3, SP-4, SP-9, ST-40