exposure to loud sounds is also considered to be of the Full type and is treated as such. Empty
types of tinnitus are due to not enough Qi (intended in a broad sense) reaching the head and ears.
This may be Kidney-Qi, Kidney-Essence, Lung-Qi or Heart-Blood.

From a diagnostic point of view, tinnitus with a sudden onset and a loud sound is of the Full
type. It is also aggravated by cupping one's hands over the ears. Tinnitus with a gradual onset
and a low sound is of the Empty type. It is improved by cupping one's hands over the ears.

Differentiation and Treatment

The patterns discussed will be:

EXCESS TYPE

Rising of Liver and Gall-Bladder Fire

Phlegm-Fire Flaring Upwards

DEFICIENCY TYPE

Kidney-Essence Deficiency

Upper Burner Qi Weak

Heart-Blood Deficiency

Excess Type

Rising of Liver and Gall-Bladder Fire

Clinical Manifestations

Tinnitus with a sudden onset and loud sound and clearly related to emotional strain, headache,
irritability, a bitter taste, thirst, red face, dizziness, constipation.

Tongue: Red with redder sides, yellow coating.

Pulse: Wiry and Rapid.

Treatment Principle

Drain Liver-Fire, ease the ears, calm the Mind and settle the Ethereal Soul.