Phlegm-fire: Tinnitus and Hearing Loss

Tinnitus and hearing loss can either be a short-term or a long-term condition. In the short term, it is often caused by an excess of phlegm and dampness in the ear, which can be triggered by changes in diet, emotions, or the presence of an external pathogen. In the long term, the symptoms may be less noticeable, but the condition can persist for extended periods. People who consume a diet high in fatty, sweet, or phlegm-inducing foods, those with a tendency to constricted qi, and those with weak Spleen and Stomach function are more prone to phlegm accumulation.

Chronic phlegm and dampness can lead to stagnation and generate heat. There is a connection between the movement of qi and phlegm in the ears, as phlegm can enter the ear through the distribution of Liver qi through the Gallbladder channel. This suggests that there may be an emotional component to phlegm patterns, and resolving the condition may involve addressing qi movement.

Short-term episodes of phlegm and fire are often treated with antibiotics, which can weaken the Spleen and increase the risk of long-term tinnitus or hearing loss due to Spleen qi deficiency. Phlegm and fire can also be complicated by Liver fire.

Signs and symptoms

  • Sudden decrease in hearing, with or without tinnitus, in one or both ears
  • Tinnitus, if present, is typically low-pitched, loud, and similar to the sound of cicadas
  • Possible feelings of blockage or pressure in the ears, and in some cases a yellow discharge from one ear
  • Heaviness or fullness in the head, foggy head
  • Stifling sensation in the chest
  • Irritability, restlessness, insomnia
  • Repeated throat clearing or coughing with yellow sputum
  • Tongue is red with a thick, greasy, yellow coating
  • Pulse is wiry and slippery or slippery and rapid

Healing approach 

Clear heat, regulate qi, and transform phlegm. Disperse accumulation and unblock the ears.

Base Formula


  • Liver fire or ascendant yangm add one or two of the following: Uncariae Ramulus cum Uncis (9-12g), Haliotidis Concha (15-30g), and Magnetitum (15-30g), or Chrysanthemi Flos (9-12g)
  • Sticky, yellow discharge, add Isatidis Folium (12-15g) and Isatidis/Baphicacanthis Radix (12-15g)