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OTORRHEA (OTOPYORRHEA)

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas	Tuo Li Xiao Du Yin
Points

WIND-HEAT

Clinical Manifestations	Sudden, mild, unilateral tinnitus or hearing loss Painful distention and oppression of the ears Throbbing pain which is alleviated by discharge of pus Pus is usually yellow Hearing may be compromised Fullness, distention, blockage or persistent itching of the ear Maybe pain of the ears or mastoid process radiating to the jaw Possible purulent or bloody discharge from the ear Headache Fever Head sores with secretion of pus and scabs Red pimples on face, neck, armpits and external genitalia Earache Swelling, inflammation and infection of the ears and nose Cough Muscle and joint aches Thirst Aversion to Wind Nasal congestion A painful, dry throat Abdominal rigidity Constipation Dark brown discoloration of the skin Perspiration and an oiling feeling on the palms and soles Abdominal tension Rhinitis T: Normal C: White or yellow P:Floating and rapid
Treatment Principle	Dispels Wind Disperses Stagnation Clears Heat Removes Toxins Suppresses Suppuration Open the ears
Herb Formulas	Jing Jie Lian Qiao Tang Man Jing Zi San Fang Feng Tong Sheng San Yin Qiao San modified
Points	GB-2, SI-17, SI-19, SJ-21 choose one or two DU-23, GB-20, GB-39, LI-4, LI-5, LI-11, SI-4, SJ-5, SJ-17 choose two or three depending on tenderness With Internal Heat: + LIV-2, SJ-2 GB-20, LI-4, LU-11, SI-19, SJ-5, SJ-17 With a headache: +DU-23, Taiyang

SPLEEN QI DEFICIENCY

Clinical Manifestations	Chronic or enduring discharge of thin, white, odorless pus Fluids flowing from the auditory canal with no pain or inflammation Pale, sallow complexion Fatigue Anorexia Four limbs feel cold, tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and deficient
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Huang Qi Jian Zhong Tang
Points	REN-6, SJ-17, SJ-21, ST-36, UB-20, UB-21 LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

LIVER FIRE FLARING UP

Clinical Manifestations	Otorrhea Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis 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 For Liver Yin Deficiency with Yang Rising: Tian Ma Gou Teng Yin Zhen Gan Xi Feng Tang
Points	GB-20, GB-34, GB-40, LI-5, LIV-2, LIV-3, SJ-3, SJ-5, SJ-17 For Liver Yin Deficiency with Yang Rising: + KI-1, KI-3, UB-18, UB-23

DAMP-HEAT IN THE LIVER AND GALLBLADDER

Clinical Manifestations	Abrupt onset of yellow, thick, profuse pus severe pain which lessens after draining of the pus Fever Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth A dry throat Headache Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Dry stools Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Long Dan Xie Gan Tang
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	On again off again discharge of pus from the ear Thin, clear, odorless pus 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 Irritability 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 If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan Zi Shen Tong Qi Tang
Points	KI-3, REN-4, SI-19, SJ-19 For thirst and irritability: + KI-7 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: + HT-7, PC-7, UB-15 If Liver Yang also Rises: + LIV-3, UB-18

PHLEGM-HEAT

Clinical Manifestations	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

DAMP-HEAT IN THE SAN JIAO

Clinical Manifestations	Ear discharge Impotence Inability to get or maintain a full erection Erection may be painful Maybe excessive sweating around the scrotum and groin Testicles cold Itching or pain in the genitals Maybe mucopurulent discharge from the urethra Maybe a history of genital herpes Lethargy Heaviness or aching in the lower limbs Maybe poor sperm count or Low sperm motility and anti-sperm antibodies thick or congealed ejaculate with retarded liquification Afternoon fatigue Hypochondriac pain Headache Dizziness Red sore eyes Hearing loss Swelling in the ears Bitter taste in the mouth Irritability Short temper Difficult and painful urination with a heat sensation in the urethra Swollen and itchy genitalia Vertigo Nausea and vomiting Insomnia Dream-disturbed sleep with unusual dreams Palpitations Anxiety Profuse white foamy sputum Restlessness Timidity Indecisiveness Indeterminate gnawing hunger Seizures accompanied by copious sputum Flushing up Chest distention Expectoration of yellow Phlegm Bitter taste in the mouth Chills and fever Abdominal distention Frequent dark, scanty and painful urination Irritability Depression Slight thirst Anorexia after serious illness Yellow urine Chest pain Loose stools or Alternating constipation and diarrhea Turbid, foul-smelling urine Dry throat Hematuria Pain in the armpits Sweating in the groin T: Pink or Red tip or Red or Red edges C: Yellow or Yellow and greasy, especially at the root P: Deep and slippery or Soft, slippery and rapid or Slippery and rapid or Wiry and rapid or Wiry, Excess and rapid
Treatment Principle	Clear Damp-Heat from the San Jiao
Herb Formulas	Bei Xie Tang Liang Ge San
Points