Also ringing in the ears; sound of cicadas in the ear. Unreal ringing, buzzing, or rushing sounds heard in the ears. Distinction is made between repletion and vacuity. Repletion patterns are attributed to liver fire or phlegm-fire ascending counterflow. Vacuity patterns are attributed to depletion of kidney yīn or center qì fall. In repletion patterns, tinnitus is of rapid onset and is characterized by the sound of frogs or of the tide. In vacuity patterns, it is like the sound of cicadas or a flute or pipe.
Patterns
Liver fire (肝火 gān huǒ) tinnitus is attended by headache, red eyes, dry mouth with bitter taste, vexation and agitation, irascibility, constipation, yellow tongue fur, and a rapid stringlike pulse.
Medicinal therapy: Clear and discharge liver fire using formulas such as Gentian Liver-Draining Decoction (龙胆泻肝汤lóng dǎn xiè gān tāng).
Acumoxatherapy: for the treatment of repletion patterns, base treatment mainly on TB, GB, and SI, selecting TB-17 (Wind Screen, 翳风 yì fēng), TB-3 (Central Islet, 中渚 zhōng zhǔ), GB-2 (Auditory Convergence, 听会 tīng huì), SI-19 (Auditory Palace, 听宫 tīng gōng), and GB-43 (Pinched Ravine, 侠溪 xiá xī) as the main points. For liver fire, combine these with LR-3 (Supreme Surge, 太冲 tài chōng), LR-2 (Moving Between, 行间 xíng jiān), GB-34 (Yang Mound Spring, 阳陵泉 yáng líng quán), and KI-3 (Great Ravine, 太溪 tài xī); needle with drainage.
Phlegm-fire (痰火 phlegm-fire) tinnitus is accompanied by oppression in the chest, copious phlegm, inhibited stool and urination, yellow slimy tongue fur, and a rapid stringlike pulse.
Medicinal therapy: Treat with Gallbladder-Warming Decoction (温胆汤wēn dǎn tāng) plus coptis (Coptidis Rhizoma, 黄连huáng lián) and trichosanthes (Trichosanthis Fructus, 栝楼guā lóu).
Acumoxatherapy: Use the basic points for repletion combined with ST-40 (Bountiful Bulge, 丰隆 fēng lóng), CV-17 (Chest Center, 膻中 shān zhōng), ST-44 (Inner Court, 内庭 nèi tíng), LI-4 (Union Valley, 合谷 hé gǔ), and LU-5 (Cubit Marsh, 尺泽 chǐ zé); needle with drainage.
Kidney vacuity (肾虚 shèn xū) tinnitus, observed in vacuity patients and the elderly, takes the form of a fine thread-like sound that occurs frequently and is accompanied by limp aching lumbus and knees, enuresis, seminal emission, and a fine weak pulse that is forceless at the cubit chǐ.
Medicinal therapy: Enrich yīn and supplement the kidney with Six-Ingredient Rehmannia Pill (六味地黄丸liù wèi dì huáng wán), and if there is also hyperactivity of yáng with dizziness, loadstone (Magnetitum, 磁石cí shí), tortoise shell (Testudinis Carapax et Plastrum, 龟版guī bǎn), schisandra (Schisandrae Fructus, 五味子wǔ wèi zǐ), and achyranthes (Achyranthis Bidentatae Radix, 牛膝niú xī) should be added to subdue yáng.
Acumoxatherapy: for the treatment of vacuity patterns, base treatment mainly on TB and SI, selecting TB-17 (Wind Screen, 翳风 yì fēng), SI-19 (Auditory Palace, 听宫 tīng gōng), TB-3 (Central Islet, 中渚 zhōng zhǔ), and TB-21 (Ear Gate, 耳门 ěr mén) as the main points. To address the kidney yīn vacuity, further needle with supplementation at BL-23 (Kidney Transport, 肾俞 shèn shù), CV-4 (Pass Head, 关元 guān yuán), and KI-3 (Great Ravine, 太溪 tài xī). For kidney vacuity with yáng hyperactivity, supplement KI-6 (Shining Sea, 照海 zhào hǎi), KI-2 (Blazing Valley, 然谷 rán gǔ), and KI-3 (Great Ravine, 太溪 tài xī); drain LR-3 (Supreme Surge, 太冲 tài chōng), LR-2 (Moving Between, 行间 xíng jiān), and HT-7 (Spirit Gate, 神门 shén mén).
Qì vacuity (气虚 qì xū) tinnitus is accompanied by fatigued limbs, reduced food intake, and sloppy stool.
Medicinal therapy: Supplement the center and boost qì with Center-Supplementing Qì-Boosting Decoction (补中益气汤bǔ zhōng yì qì tāng) plus cuscuta (Cuscutae Semen, 菟丝子tù sī zǐ).
Acumoxatherapy: Use the basic points for vacuity patterns combined with GV-20 (Hundred Convergences, 百会 bǎi huì), CV-6 (Sea of Qì, 气海 qì hǎi), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), and KI-3 (Great Ravine, 太溪 tài xī); needle with supplementation and add moxa if appropriate.