Click Heart Medicine Young Doctor↑ Accompanying You to Grow TogetherAuthor｜Jia Dailin (WeChat ID: tcmjdl) Source｜Heart Medicine Young Doctor (WeChat Official Account)Record of the “Kengqiang TCM Exchange” January 2022 Salon
【Abstract】
This article is an excerpt from the sharing session of Teacher Jia Haizhong in the January 2022 “Kengqiang TCM Exchange” audio recording. The sharing mainly includes Teacher Jia’s insights on the relationship between the ear and the physiology and pathology of the five internal organs, as well as how to treat ear diseases and the connection between ear and internal injury diseases.
Image from previous on-site exchange
Audio recording of Teacher Jia Haizhong’s experience sharing
Today, we continue to discuss the relationship between the five senses and the internal organs online, the correlation between otolaryngological diseases and complex internal organ diseases, and share some clinical treatment experiences. The relationship between the ear, hearing, ear orifice, and the five internal organs, and how to treat otolaryngological diseases by adjusting the five internal organs. How to understand internal injury diseases through observing the ear, analyzing the subtle signs of complex internal organ diseases.
Now, I will talk about my understanding of the relationship between ear diseases and the whole body. First of all, as mentioned by the teacher earlier, do not underestimate the ear; it is a pathway to the whole body. Any small orifice can connect to the entire world. In our human body, the ear orifice can connect to the whole body. For example, when someone experiences dizziness, their eyes may close, and you can observe eye tremors, nausea, and vomiting, indicating instability. Therefore, if there is a problem with one ear, it can affect the entire body.
Conversely, the ear must be normal, which requires the health of the whole body as a foundation. This is the holistic concept emphasized in TCM, which must not be overlooked in otolaryngology. In clinical practice, how do I recognize and approach this? First, when a patient comes to see an ear disease, we need to determine whether it is a purely localized ear condition or a combined ear condition with systemic issues. This distinction is crucial because if it is a purely ear disease, whether it is ear fullness, pain, ringing, deafness, or dizziness, in most cases, it is caused by localized lesions. This localized lesion, according to TCM, is related to the external environment, where external pathogens invade and cause changes around the ear. For instance, if a patient reports ear fullness and sounds inside the ear, we need to ask whether it is one ear or both ears.
If it is one ear, it is more likely a localized lesion; if it is both ears, it may indicate a systemic condition combined with a localized issue. Therefore, in clinical practice, we must first make this distinction. For example, if the patient feels ear fullness, we must ask if they have nasal congestion, as it may indicate a problem with the Eustachian tube, which connects to the nasal cavity. We should consider that it might be a localized inflammation causing the infection. In this case, treating the lung can resolve the nasal orifice issue, thus alleviating the ear fullness. We can further differentiate the syndrome to identify the pathogenic factor, and then this issue can be resolved. The same analysis applies to pain; if it is localized, we analyze it similarly; if it is low-frequency tinnitus, we also consider it this way. All local and systemic, unilateral and bilateral conditions must be distinguished in clinical syndrome differentiation.
Localized issues are generally caused by the invasion of external pathogens. Some diseases are relatively mild, with the pathogenic factor being latent; others may have progressed to a severe stage, resulting in residual issues, which are also latent pathogens. These latent pathogens in the local area generally produce pathological changes such as qi stagnation, blood stasis, water retention, and pathogen accumulation. “Pathogen accumulation” refers to the accumulation formed by external pathogens lurking within. The formation of these pathological changes leads to local symptoms, and clarifying the nature of the pathogenic factor can resolve the issue. Most ear diseases belong to heat pathogens or wind-heat, and there are also wind-cold cases, often invading from the nose. This is mainly to address localized symptoms, including unilateral acoustic neuroma, which we must consider as caused by latent pathogens, meaning external pathogens have lurked inside, leading to conditions like otitis media.
If there are symptoms observable throughout the body, or multiple symptoms beyond the ear, such as cough, dizziness, diarrhea, frequent urination, etc., it may indicate the presence of systemic or multiple other organ lesions, and we often need to consider the internal organs, as the spleen, stomach, kidney, lung, heart, and liver can all have an impact. As mentioned earlier by various teachers, especially Liu Ning’s report, it has been clearly stated. In this category of diseases, after further identifying the internal organs, we must differentiate whether it is a deficiency of essence, qi, blood, or semen, or whether it is due to qi and blood stagnation, water retention, or the invasion of external pathogens leading to the accumulation of external pathogens in a specific organ. Generally, this approach yields better therapeutic effects for ear diseases compared to purely Western medical treatments. If we elaborate on ear disease treatment, there is too much content; I will briefly mention a few points that were not covered earlier.
One is that in the “Huangdi Neijing” (Yellow Emperor’s Inner Canon), there is a method for treating deafness called the “Famen Method”, which Liu Ning mentioned earlier. The Famen Method is rarely reported for its efficacy in treating deafness and tinnitus, but I have clinically verified that the Famen Method is effective for both tinnitus and deafness, especially for acute sudden deafness, the Famen Method is quite useful, but it must be performed according to the requirements in the “Huangdi Neijing”. Everyone can check whether this method is effective; I believe a significant portion of patients will find it effective.
Additionally, there is the issue of ear stone syndrome. Ear stone syndrome is mostly a localized manifestation of a systemic disease. The Western medical repositioning therapy for ear stones treats the symptoms but not the root cause, as it does not fundamentally resolve the issue of ear stones; it merely relocates them, which does not count as curing the disease. Therefore, the treatment of ear stone syndrome cannot rely on Western medicine’s so-called “repositioning”; it is actually “relocation”. It is essential to adjust the whole body to change the internal environment of the inner ear, allowing it to gradually improve on its own. In clinical practice, we have treated many patients with ear stone syndrome, and indeed, traditional Chinese medicine has a fundamentally good effect.
Another effective remedy is that for any cause of dizziness, we often select the “Dizziness and Hearing Area” for acupuncture. In scalp acupuncture, the Dizziness and Hearing Area corresponds to the Jingming (GB1) point, and generally, after needling, it can quickly improve dizziness symptoms. This is an acupuncture experience. We usually select one acupoint and do not choose too many.
Furthermore, in terms of herbal differentiation and medication for dizziness, regardless of the cause, as long as it is a deficiency syndrome, Xianhecao (Agrimonia eupatoria) is very effective. You can also check the literature on Xianhecao, which has been reported since the Cultural Revolution. I have repeatedly verified in clinical practice that this herb is very effective. For patients with deficiency syndromes, especially those with cerebral ischemia and inner ear ischemia, the efficacy is definite.
Another herb with confirmed efficacy is a formula by Teacher Shi Laoshi, called Yunke Ping. Yunke Ping is composed of Banxia (Pinellia ternata), Cheqian Cao (Plantago asiatica), Sheng Danzhi (raw red clay), and Xiakucao (selfheal). It is used to treat Meniere’s disease, and was first formulated during the Cultural Revolution when Teacher Shi was young, with articles published demonstrating its good efficacy. This formula is now also available as a patent medicine produced by Nantong Jinhua Pharmaceutical. The key ingredient in this formula is Sheng Danzhi, which is very effective for treating dizziness. If there is qi deficiency, it can be combined with Xianhecao, Huangqi (Astragalus membranaceus), or Ren Shen (Ginseng) for synergy. If there are heat symptoms, Yunke Ping can be used directly, or selected based on syndrome differentiation. I will just add these points briefly; everyone has spoken very well and systematically, and I believe those attending the lecture today have gained a lot.
Teacher Zhao Jinxie: Thank you, Teacher Jia, for sharing very specific experiences in selecting formulas, medications, and acupoints. Many students prefer methods that are effective and can be applied immediately. Teacher Jia has provided a great experience sharing. In fact, there used to be a magnetic bead pill that was also quite good for treating dizziness and tinnitus, which had certain efficacy. However, it seems that this medicine is hard to find now. There are at most two questions. Who has a question? Please hurry up. Let’s see if any students have questions.
Li Zeyu: Teacher Zhao, I have a question I would like to ask. Thank you. I want to ask Teacher Jia a question. Just now, I heard you mention the Famen Method in the Inner Canon, and I also did a simple search and found that the original text mentions that this needling must be done at noon, needling the Tinggong (SI19) point. I also saw articles using the Famen Method combined with the Ziwuliuzhu (Clock and Meridian) needling method to treat neurogenic tinnitus, and it mentions that the Famen Method and the timing are related. I want to ask, is the timing of acupuncture really very important?
Teacher Jia Haizhong: Well, this is a very good question. In fact, the ancients summarized this experience, but whether it is effective outside that time point also needs clinical verification. Because in clinical practice, we cannot only see patients at that specific time; patients come to see the doctor at any time. Therefore, we use this method randomly; as long as the patient comes, we apply this method. However, it is essential to strictly follow the operational methods. The timing is not limited.
Tang Ying: I want to ask Teacher Jia, you emphasized that the treatment of ear stone syndrome should be based on overall differentiation. Are there any unique characteristics in the differentiation of ear stone syndrome? Or besides differentiating based on the patient, are there any other unique aspects? Thank you, Teacher.
Teacher Jia Haizhong: In fact, the so-called ear stones in ear stone syndrome are not necessarily stones; they are just some tangible substances in the fluid that, when they touch the cilia, cause various balance disorders. This is its clinical feature. The diagnosis of this disease is based on its characteristics, which is that the symptoms are extremely brief, occurring in a specific position, and then resolving when the position changes. As mentioned by the previous teachers, I believe you have heard this. However, the specific treatment must be based on the patient’s specific situation. For example, if it is a long-term diarrhea patient with spleen deficiency, you must tonify the spleen to improve the internal environment. Then, the so-called ear stones can gradually dissolve, be absorbed, and metabolized away. This is the principle from a holistic perspective. For instance, if there is lung disease causing systemic changes, and it is combined with this condition, treating the lung disease will also resolve the ear issue. Therefore, the diagnosis of ear stone syndrome can be made based on the characteristics mentioned earlier, which are extremely brief and position-related. However, the treatment must be tailored to the specific patient; there is no one-size-fits-all approach. However, the most common cause of ear stone syndrome in clinical practice is abnormal spleen and stomach function, which is caused by gastrointestinal diseases. Therefore, in TCM, this is considered phlegm-dampness, and the basic formulas are Zexie Tang (Alisma Decoction) and Zexie San (Alisma Powder), which consist of Zexie (Alisma orientalis) and Bai Zhu (Atractylodes macrocephala). These two herbs are excellent for regulating the gastrointestinal tract and are very effective for infectious and deficiency diseases of the gastrointestinal tract. This has been discussed in the “Jinkui Yaolue” (Essentials of Jinkui). Of course, in clinical practice, we must consider the specific patient. If we elaborate on this, there is too much to discuss. Just understand this principle.
Note: The formulas, herbs, specific dosages, and treatment methods mentioned in this article are for the reference of clinical practitioners only.
Introduction to the “Kengqiang TCM Academic Salon”:
Supported by relevant departments of Beijing University of Chinese Medicine and Dongzhimen Hospital, the “Kengqiang TCM Academic Salon” was jointly initiated by Professors Zhao Jinxie and Jia Haizhong as a purely public welfare TCM academic salon. The term “Kengqiang” signifies a loud and passionate voice for TCM, with an intention for academic debate, and also symbolizes the rapid development of TCM. The “Kengqiang TCM Exchange” is held monthly, discussing important, hot, and misunderstood academic topics in TCM. Through exchanges and discussions among experts, some popular but incorrect viewpoints in TCM are clarified, and in-depth discussions on various issues in TCM education, research, and clinical practice are conducted. To ensure the salon closely integrates with clinical efficacy, most invited experts are TCM practitioners working on the front lines. The original intention of the “Kengqiang TCM Exchange” is to cultivate excellent TCM clinical talents, with each discussion naturally revolving around the central theme of “improving TCM clinical efficacy”. After each “Kengqiang TCM Exchange” event, Zhao Jinxie arranges for graduate students to transcribe the recordings into written documents. The “Global TCM” magazine has a special column to publish the discussion manuscripts. At the end of 2017, the “Kengqiang TCM Exchange” column in the “Global TCM” magazine was selected as an excellent promotional work by the National Health and Family Planning Commission’s publishing unit in 2017.
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