Syndrome differentiation and treatment
 1. Syndrome of dampness intermingled with asthenia of the spleen
Main syndromes and signs: Pyorrhea inside the affected ear is mostly intermittent, profuse in quantity, thin in quality, white in colour and free from odour. The perforation of the tympanic membrane lies in the tense part and is larger. The mucosa of the tympanic cavity is reddish or pale. The patient has pale complexion, poor appetite, lassitude, fatigue and loose stool. The tongue is pale with white and greasy fur and the pulse is soft.
Therapeutic methods: Invigorating qi and strengthening the spleen, removing dampness and obstruction of orifices.

2. Syndrome of deficiency of the kidney
Main symptoms and signs: The pus discharge inside the ear is prolonged, sticky and thick, with odour, and is often intermingled with blood. There exists granulation or polyp inside the tympanic cavity. Tympanic membrane perforates in the marginal  part. There exists severer conduction deafness. X-ray film of the mastoid process sees the vague transparent area. The patient suffers from dizziness, fatigue and aching pain in loins and knees. The tongue is red with a bit of fur and the pulse is thready and rapid.  
Therapeutic methods: Strengthening the kidney, eliminating pathogenic factors and removing the obstruction of orifices.

3. Syndrome of hyperactivity of the liver due to asthenia of the kidney
Main symptoms and signs: Pyorrhea inside the ear is sometimes profuse and sometimes scanty. There exists the substance like bean dregs with special foul odour in the pus. The patient has severer conduction deafness or mixed deafness.  The  perforation  of  the  tympanic membrane lies in the flaccid portion, or posterosuperior part of the tense portion. Through the perforation, the examiner can see the squamous substance with grayish white colour and foul odour, or the indefinite-shaped substance like bean dregs. X-ray film of the mastoid process or CT scan of temporal bone can see the cholesteatomatous cavities of the upper tympanic cavity, antrum tympanicum or mastoid process.
Therapeutic methods: Strengthening the kidney,clearing away heat and purging fire from the liver.