## Loud, or faint?
Ringing in the ears is one of the most common complaints we see, and one of the most frustrating to live with. A high whine in a quiet room. A hiss that is worst at night. A buzz like cicadas, or a low hum like a distant bell. Sometimes with hearing that has started to slip, sometimes with ears that feel full or blocked. It is usually called tinnitus and left there, often with the advice to get used to it.
The Donguibogam, the 1613 master text, gives the ear its own chapter, and it does not treat ringing as a single thing. It sorts it by the quality of the sound, by what came before it, and by what else is going on in the body. We translated it in full.
[→ The Ear — full translated chapter]
## The ear belongs to the Kidney
The chapter opens with the classical pairing: the ear is the orifice of the Kidney, and when the Kidney is in harmony, the ear can hear all five notes. It adds a second source: the Lung governs the Qi, and the whole body's Qi passes through the ear — which is why it can hear at all.
It also offers an image worth keeping. The ear and the eye, it says, are like the moon: they shine only when the sun's light reaches them. Hearing needs both Blood to receive and Yang Qi to arrive. When either is missing, the ear dims.
## The first question: loud, or faint?
The chapter's most practical sentence is one line long: where phlegm and fire are the cause, the ringing is loud; where the Kidney is depleted, the ringing is faint.
**Loud, insistent ringing** — often with a full or blocked feeling, irritability, a heavy head, or a red face. Read as phlegm and fire rising. The chapter notes it often comes with rich food, heavy drinking, and anger, and that it can flare with stress.
**A faint, constant hiss** — often worse when tired, with a weak low back, poor sleep, or a gradual slide in hearing. Read as Kidney depletion. The chapter is clear about who it tends to affect: people who have overworked or overindulged for years, people past middle age, and people recovering from a serious illness — the Kidney's water running low and its fire flaring up.
Many people have some of both. Telling them apart is most of the work.
## Other things that change the picture
**Did it begin after a cold, or with wind exposure?** — a buzzing that follows a chill is read as wind lodged in the ear, and treated by releasing it.
**Does it come with dizziness?** — the chapter quotes the Divine Pivot: when the sea of marrow is insufficient, the head spins and the ears ring. If yours does, read more here — [Vertigo & dizziness]
**Does it come with neck and shoulder tension?** — the Sinews chapter traces a sinew line that runs from the little finger up around the shoulder blade, along the neck, and into the ear; its listed diseases include pain around the shoulder blade drawing to the neck, and ringing in the ears. Modern clinicians call this somatic tinnitus, and it often changes when the neck is treated. More here — [Neck pain](https://www.raahacupuncture.com/neck-pain)
**Does it come with an empty stomach or poor appetite?** — the chapter quotes another passage that surprises patients: when the stomach is empty, the vessels that gather at the ear empty too, and the ear rings. Its advice for protecting the hearing is equally plain: keep yourself well fed.
**Is the ear blocked rather than ringing?** — the chapter notes that where heat has closed the ear, it does not ring. It also describes the ear's own fluid hardening into a plug that causes sudden deafness. Impacted ear wax is still the first thing to rule out.
## Ringing comes before deafness
The chapter's warning is direct: ringing in the ears is deafness approaching by degrees. Left untreated, it says, it gradually becomes deafness — "truly lamentable." The modern version is similar: new tinnitus is often the first sign of hearing loss, and it is worth having your hearing tested early rather than late.
## One thing to do every day
The chapter's section on cultivation gives a single practice: rub the rim of the ear with the hand, as many times as you like. It calls this "repairing the city walls" — strengthening the Kidney's Qi to guard against deafness. It costs nothing, and many patients find it calming at night when the ringing is loudest.
## What treatment looks like here
Acupuncture is the main tool. The chapter's points for ringing in the ears are concentrated around the ear itself and along the channels that reach it: TE21 Ermen and GB2 Tinghui in front of the ear, GB12 Wangu behind it, TE3 Zhongzhu and TE2 Yemen on the hand, SI3 Houxi and LI4 Hegu, and KI3 Taixi at the ankle for the Kidney. For hearing loss it adds SI19 Tinggong and TE5 Waiguan; for sudden deafness, TE16 Tianyou on the neck.
Herbal formulas follow the pattern. From the chapter:
[Yukmijihwang-hwan 六味地黃丸] — for faint ringing from Kidney depletion
[Bosin-hwan 補腎丸] — for ringing from depleted Yin with fire flaring
[Jasintongi-tang 滋腎通耳湯] — for Kidney depletion with ringing and early hearing loss
[Bokchong-tang 復聰湯] — for loud ringing from phlegm and fire
[Tongmyeongrigi-tang 通明利氣湯] — for a blocked, ringing ear with agitation
[Gungji-san 芎芷散] — for buzzing after wind exposure
[Bojungikgi-tang 補中益氣湯] — for ringing and dulled hearing from exhaustion
We are honest with patients about tinnitus. Recent ringing tends to respond better than ringing that has been there for years. For long-standing tinnitus, the realistic goal is often that it becomes quieter, less intrusive, and easier to sleep with, rather than gone. The chapter is honest too: it lists long-standing deafness with exhausted Kidney Qi as hard to treat.
## Please read this part
Some ear symptoms need a physician first, and not later.
**Get urgent evaluation if you have:** sudden hearing loss in one ear, even if it seems mild — treatment works best within the first few days; ringing with sudden weakness, numbness, facial drooping, or trouble speaking; ear pain with fever, discharge, or swelling behind the ear; or new ringing or hearing loss after a head injury.
**Get evaluated before starting here if you have:** ringing in one ear only, or hearing that is worse on one side; ringing that pulses in time with your heartbeat; episodes of spinning with ringing and a full ear; ringing that began with a new medication; or tinnitus you have never had checked with a hearing test.
The 1613 chapter draws the same distinctions. It sets sudden deafness apart as its own category, separate from gradual loss. It describes an ear that runs with pus as a different illness. And it lists the deafness that has gone on for years with the Kidney exhausted as hard to treat. Sudden, one-sided, or infected — these still deserve a proper look first.
**This approach may help if you're dealing with:** ringing, hissing, or buzzing in the ears · tinnitus that is worse at night or when tired · a full or blocked feeling in the ears · tinnitus with neck and shoulder tension · tinnitus with dizziness · tinnitus that flares with stress · gradual hearing loss with ringing, once evaluated · ear symptoms after a car accident, once medically cleared.
The Donguibogam translation project at formulas.raahacupuncture.com is researched and translated by Eui Young (Justin) Chung, L.Ac., Dipl. O.M. — the same clinician you'll see in the treatment room.