Note: The following
text is selected from A Practical English-Chinese Library
of Traditional Chinese Medicine by
Prof.Dr. Enqin Zhang(Engin CAN), he was the chief
editor&author of the books, now lecturing and practising
Chinese medicine at The Asante Academy of Chinese
Medicine in the Middlesex University Archway Campus, 2-10
Highgate Hill, N19 5LW, London, U.K.For more information,
Tel:0044 7804709475;
E-mail:prof.engincan@yahoo.com.tr
Chronic suppurative otitis media is in most cases the result of
inappropriate treatment of acute suppurative otitis media. It is
a chronic inflammation of the mucous membrane, periost and even
osseous tissue of the middle ear. The disease has the following
clinical features: a long period of recurrent otopyorrea which
is very difficult to get cured, hypoacusis and perforation of
the tympanic membrane. This disease falls into the category of
tympanic membrane. This disease falls into the category of what
the TCM calls "nong er", that is, otitis media suppurativa.
Main
Points of Diagnosis
1. There is intermittent or continuous pyorrhea
in the ear. The pus may be either thin and clear or thick and
sticky. The otopyorrhea will not come to and end within a short
period of time.
2. Mild or moderate sound-conductive hypoacusis may occur.
3. The perforation is mostly in the membrana tensa, seldom at
its rim or Shrapnell's membrane, accompanied by the formation of
granulation or polyp.
4. There may be retroauricular pyorrhea, facial paralysis and
vertigo.
5. Mastoid x-ray photographing may be helpful to the diagnosis.
Differentiation and Treatment of Common Syndromes
1. Internal Treatment
1) The Type of Sticky Pus due to Heat in the Lung
Main Symptoms and Signs: The patient has intermittent
otopyorrhea which may be recurrent due to a cold. The pus is
white and as sticky as nasal mucus. Deafness is sometimes
serious and sometimes mild. Perforation of membrana tensa
occurs. The pus from it looks like sticky silk thread if
smeared. These symptoms may be accompanied with stuffy nose and
rhinorrhea. The fur of the tongue is thin and white and the
pulse is slippery.
Therapeutic Principle: Purging lung-heat, removing turbidity and
promoting the flow of qi to clear away obstruction from the
upper orifices.
Recipe: Magnolia Decoction for Purging Lung-Heat with additional
herbs
magnolia flower
scutellaria root
rhizome of anemarrhena
cimicifuga rhizome
xanthium
capejasmine fruit
ophiopogon root
white tribulus fruit
lily bulb
loquat leaf
gypsum
dahurian angelica root
licorice root
All the above herbs are to be decocted in water for oral
administration.
2) The Type of the Dampness Retention due to Hypo-Function of
the Spleen
Main Symptoms and Signs: There is continuous pyorrhea flowing
out from the ear. The discharge is thin and clear. A big
perforation of membrana tensa and hypoacusis occur, accompanied
by dizziness, a heavy sensation in the head and poor appetite.
The fur of the tongue is thin and white and the pulse soft and
moderate.
Therapeutic Principle: Invigorating the function of the spleen
to remove pathogenic dampness and reinforcing qi and blood to
discharge pus.
Recipe: Powder of Ginseng, Poria and White Atractylodes
ginseng
white atractylodes rhizome
pulp of lotus seed
poria
licorice root
amomum fruit
platycodon root
Chinese yam
coix seed
white hyacinth bean
All the above herbs are to be decocted in water for oral
administration.
3) The Type of the Deficiency of the Kidneys
Main Symptoms and Signs: There is a little but continuous
otopyorrhea which is dirty and smells stinking. Hearing is
distinctively worsened. Perforation of membrana tensa or
Shrapnel's membrane occurs and granulation may be seen,
accompanied by soreness of waist, dizziness, insomnia and
palpitation, red tongue, with thin and white fur and thready and
rapid pulse.
Therapeutic Principle: Reinforcing the kidney and purging
pathogenic fire to eliminate pus.
Recipe: Pill of Anemarrhena, Phellodendron and Rehmannia with
additional ingredients
anemarrhena
yellow corktree bark
pulp of dogwood fruit
prepared rehmannia root
poria
oriental water plantain rhizome
moutan bark
prunella spike
Chinese yam
All the above herbs are to be decocted in water for oral
administration.
For those with yellow and thick pus, add 9 grams of scutellaria
root, 6 grams of coptis root and 9 grams of bupleurum root. For
those with thin pus, add 15 grams of plantain seed which is to
be wrapped in a piece of cloth ,and 15 grams of coix seed. For
those who have lot of pus which comes out continuously, add 9
grams of flavescent sophora root, 9 grams of xanthium and 9
grams of dahurian angelica root.
2. External Treatment
1) Clean the external auditory canal. Do this whit white vinegar
solution (white vinegar mixed with the same amount of water for
injection), three times a day.
2) Drip ear drops into the ear. Do this with Ear Drops of Coptis
(the same as used for acute suppurative otitis media), three
times a day.
3) Other treatments. If there is granulation in the ear, it can
be removed with snare. When otopyorrhea ceases to come out and
inflammation is healed, and operation to restore hearing can be
considered. If x-ray photograph indicates any destruction of the
bones, and operational treatment should be carried out.
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