Tinnitus

=Tinnitus and Deafness (Ĕr Míng Ĕr Lóng)= Er Ming: “ear ringing” (e.g., cicadas, ocean tides) Er Long: “deafness; decline or loss of hearing”

Clinically, tinnitus and deafness may or may not present simultaneously. Although they have different manifestations, their pathogenesis in TCM terms is virtually identical, which is why they are discussed together.

=Tinnitus= Tinnitus is a ringing, buzzing, roaring, whistling or hissing that seems to originate in the ear or head. The noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both of your ears. It is not a single disease, but a symptom of an underlying condition. In many cases (though not all) it is not a serious problem, but rather a nuisance that eventually resolves. Nearly 36 million Americans suffer from this disorder. In almost all cases, only the patient can hear the noise.

Etiology
-Age-related (a.k.a. presbycusis) -Occupational/Noise-induced -Toxic (e.g., aminoglycoside antibiotics, aspirin) -Congenital (e.g., otosclerosis) -Infectious (e.g. otitis media) -Traumatic (e.g., injury to head and neck) -Cardiovascular (a.k.a. Pulsatile Tinnitus) -Atherosclerosis -Hypertension -Turbulent blood flow -Arteriovenous malformation -Head and neck tumors -Other (physical obstruction such as earwax, Meniere’s disease, acoustic neuroma)

Until fairly recently, most of the accounts of tinnitus in textbooks said it was all due to ear damage which couldn't be fixed. However, the most recent research suggests that, in the majority of cases of tinnitus, there’s “no there there.” Researchers using positron emission tomography [PET scanning] to view the brain activity of people with tinnitus have been able to show that these phantom auditory sensations originated somewhere in brain, not in the ear. It seems, therefore, tinnitus is something akin to phantom limb pain or focal dystonia, where symptoms result from aberrant neural activity in the brain.

For information regarding research into the neurological basis of tinnitus: []

Biomedical Tx
There are, as yet, no cures for tinnitus but there are several treatments currently used to produce relief: -Acoustic Therapy: the addition or enhancement of external sounds that can reduce the perception of tinnitus using any of the following: 1)sound generators that are worn in the ears; 2)hearing aids; 3)tapes, CDs, and bedside units that can help with sleep or concentration; 4)pillows embedded with small speakers that can plug into any tape, CD, or sound generation machine

-Medication: tricyclic antidepressants such as amitriptyline nortriptyline; gabapentin (Neurontin) and acamprosate (Campral) -Surgical Intervention -Diet and Lifestyle Changes -Counseling -Tinnitus Retraining Therapy (TRT) uses a combination of low level, broad-band noise and counseling to achieve the habituation of tinnitus, that is the patient is no longer aware of their tinnitus, except when they focus their attention on it, and even then tinnitus is not annoying or bothersome.

For information regarding Tinnitus Retraining Therapy: []

TCM Etiology and Pathogenesis
Tinnitus: Differentiating Repletion from Vacuity Repletion patterns characterized by sudden onset, loud and high-pitched ringing Vacuity patterns characterized by gradual onset and soft, low-pitched sounds Note: The pitch or loudness of tinnitus should not be taken as a sure indicator of repletion or excess; always corroborate these sx’s with patient’s other sx’s to determine the pathology and pattern.

Wind-Heat Invasion
Symptoms: common Wind-Heat symptoms including sore throat, fever, aversion to cold, headache, dry mouth, possible red tongue tip, thin, yellow tongue coating, floating and rapid pulse, with additional manifestation of distention and obstruction within the ears with possible earache leading to tinnitus and impairment of hearing Treatment Principles: Disperse Wind, clear Heat, open the orifices Herbal Treatment: Yin Qiao San Jin Yin Hua 10-30g Lian Qiao 10-30g Dan Dou Chi 10g Niu Bang Zi 10g Bo He 10g Jing Jie 10g Jie Geng 5g Lu Gen 10g Gan Cao 3g Note: children are less likely to complain of tinnitus or loss of hearing, but will complain of earache Wind-Heat Invasion

Liver and Gallbladder Fire
Main Symptoms: sudden onset of loud tinnitus or deafness with the tinnitus resembling ocean waves or claps of thunder; onset of symptoms or increase in severity of symptoms with anger or frustration; Additional Symptoms: headache, dizziness and vertigo, epistaxis, earache, distending sensation of the ears, flushed complexion, red eyes, dry mouth, bitter taste in mouth, irritability, irascibility, restlessness, insomnia, distention and pain of the chest and hypochondria, constipation, dark urine Tongue: red with yellow coating Pulse: rapid, wiry, forceful Liver and Gallbladder Fire Treatment Principles: Drain Liver and Gallbladder Fire, open the orifices Herbal Treatment for Liver and Gallbladder Fire: Long Dan Xie Gan Tang Long Dan Cao 10-15g Huang Qin 10g Shan Zhi Zi 10g Ze Xie 10g Mu Tong 6g Dang Gui 10g Che Qian Zi 10g Sheng Di Huang 10g Chai Hu 6g Gan Cao 6g Herbal Treatment for Liver Depression transforming to Heat (less pronounced Fire: Jia Wei Xiao Yao San Chai Hu 10g Bai Shao 10g Dang Gui 10g Bai Zu 10g Fu Ling 10g Zhi Gan Cao 6g Pao Jiang 6g Bo He 6g Zhi Zi 10g Mu Dan Pi 10g

Binding Depression of Phlegm-Fire
Main Symptoms: tinnitus and deafness accompanied by dizzy spells, sensation of heaviness of the head Additional Symptoms: oppression in the chest, profuse phlegm, bitter taste in the mouth, irregularity of urination and bowel movements Tongue: red with greasy, yellow coating Pulse: slippery, wiry or rapid, slippery pulse Treatment Principles: Drain Fire, transform Phlegm, open the orifices Herbal Treatment: Huang Lian Wen Dan Tang Jia Wei Zhu Ru 10g Zhi Shi 10g Ban Xia 10g Chen Pi 6g Fu Ling 10g Huang Lian 5g Gan Cao 6g Sheng Jiang 3pcs.

Blood Stasis
Main Symptoms: persistent tinnitus and/or hearing loss, possibly associated with black discharge from the ear or dark matter mixed with ear wax; possible earache Additional Symptoms: dark complexion; possible HA Tongue: purple or purple spots with thin coat Pulse: wiry or choppy and thready Treatment Principles: Quicken the Blood, eliminate stasis, open the orifice Herbal Treatment: Tong Qiao Huo Xue Tang (best when stasis confined to head) Tao Ren 10g Hong Hua 10g Chi Shao Yao 10g Chuan Xiong 9g She Xiang 0.15g Cong Bai 3g Sheng Jiang 3 pcs Da Zao 7 pcs

OR

Xue Fu Zhu Yu Tang (selected when Blood stasis is more systemic) Tao Ren 12g Hong Hua 10g Chuan Niu Xi 10g Dang Gui 10g Chi Shao Yao 6g Chuan Xiong 6g Zhi Ke 6g Jie Geng 6g Chai Hu 6g Gan Cao 3g Note: this pattern usually follows upon some trauma to the head or injury to the ear, including exposure to loud noise or sudden pressure changes. It can also complicate other chronic patterns of tinnitus or hearing loss

Kidney Essence Depletion
Main Symptoms: gradual onset of tinnitus or hearing loss/deafness associated with aging or chronic illness; tinnitus resembles the buzzing of cicadas, may be intermittent and is often worse at night Additional Symptoms: dizziness and vertigo, insomnia, weak, aching low back and knees, seminal emission Tongue: red with scanty coating Pulse: thin or rapid, thin pulse Treatment Principles: Supplement the Kidneys, secure the Essence Herbal Treatment: Er Long Zuo Ci Wan Shu Di Huang 24g Shan Zhu Yu 12g Shan Yao 12g Mu Dan Pi 9g Ze Xie 9g Fu Ling 9g Shi Chang Pu 6g Wu Wei Zi 6g Ci Shi 30g

SP and ST Qi Vacuity(Center Qi Fall)
Symptoms: tinnitus and deafness aggravated by overwork, sensation of emptiness and coolness within the ears, accompanied by tiredness, fatigue, poor appetite, loose stools, epigastric distention after eating and a sallow, withered complexion, pale tongue with white coating, weak pulse Treatment Principles: Strengthen the Spleen and Stomach, boost Qi Herbal Treatment: Bu Zhong Yi Qi Tang Huang Qi 10-60g Dang Shen 10g Bai Zhu 10g Dang Gui 10g Chen Pi 10g Sheng Ma 5-15g Chai Hu 5g Zhi Gan Cao 3g

Excess Patterns
Modification Based on Pattern:
 * Primary Points:** TE 3, TE 17, TE 21, SI 19, GB 2, GB43
 * Wind-Heat:** TE 5, LI 4, LI 11
 * LV/GB Fire:** LV 2, LV 3, GB 34, GB 41
 * LV depression Heat:** LV 3, LI 4, PC 6, GB 20
 * Phlegm-Fire:** ST 40, PC 8
 * Blood Stasis:** LV 3, LI 4, SP 10, SP 6, BL 17

Vacuity Patterns
Modification Based on Pattern:
 * Primary Points:** TE 3, TE 17, TE 21, SI 19, GB 2
 * Kidney Essence Depletion:** BL 23, KI 3, SP 6, CV 4, GV 4
 * SP/ST Qi Vacuity:** BL 20, BL 21, ST 36, SP 6, CV 6

Kiiko Matsumoto Protocol:
Tinnitus can be one of the most difficult problems to treat, as such, tinnitus has been categorized as __resistant__ and __responsive__ tinnitus. __ Resistant tinnitus __ is hearing nerve damage or damage to the inner ear due to tumor, acoustic trauma, surgery, otosclerosis, cochlear and auditory nerve lesions __ Responsive tinnitus __ is broken down by etiology: stress, fatigue and idiopathic tinnitus - local/central or medication-induced Local problems are defined as ear wax blockage, Eustachian tube abnormality, severe ear infection, flow disturbances of the corotid artery or jugular vein, allergies, and cervical injury. Central problems include high or low blood pressure, lyme disease, diabetes, anemia Side-effects of medication (anti-inflammatories, sedatives, antidepressants, cancer treatment meds, aspirin, nicotine, antibiotics)

Effective points are those that relieve pp and/or swelling of the following areas: KD16 – adrenal exhaustion reflex – KD9 or KD6 with KD27 and TW9 plus SP21/GB22 area, add GB40 if applicable for ShaoYang tx. . . Adenoid reflex at the mastoid – treated w/LV13 Master Kuzome’s ear point – area between GB22 and SP21 – pp often ipsilateral to tinnitus s/sx Are of TW17 – behind earlobe at depression between mastoid process and mandible – usually not needled (pp reduced) Three points anterior to the tragus – TW21, SI19, GB2 – not needled, indication of reduced pp HJ of L2/L3 bilateral of T7 and C3

Insert 3 needles along Jiao Auditory Line (a 4.0 cm horizontal line, with the midpoint 1.5 cun directly above the apex of the ear; at about GB8). Needle the two end points and the middle point obliquely downward, angled towards the apex. With a thin copper wire (it cannot be too thick), start at one of the end needles, encircle it once, then encircle the middle needle once, and do the same with the last needle, making sure the wire is efficiently wrapped without much slack. Attach the wire around the middle of the handle and not at the top.
 * Auricular Acupuncture:** Subcortex, Endocrine, Liver, Kidney, Inner Ear, Shen Men
 * Scalp and Electroacupuncture Tx of Tinnitus and Deafness:**

Attach the negative lead to SI19 and the positive lead to the middle needle on auditory line, above the wire. Use intermittent wave with 1/2 or 1/3 frequency. Use your best judgement as to how strong, but not so much as to cause the patient any discomfort. Use this technique on both ears for 25 minutes and add supplemental points according to the pattern. This treatment protocol comes from Shandong University of TCM. Note: GB12 is often used in this hospital for head disorders of all sorts.

Herbs For Ear Disorders
Ci Shi Dong Chong Xia Cao Ge Gen He Shou Wu Long Dan Cao Mu Li Nu Zhen Zi Shan Zhu Yu

Homeopathic Remedies for Tinnitus
Cimicifuga 6c: for people sensitive to noise who tend toward depression Carbo Vegetabilis 6c: for tinnitus accompanied by vertigo and nausea Graphites 6c: for tinnitus with associated hearing loss Chinium Sulfuricum 30c: for tinnitus resulting from ingestion of quinine tablets (common among elderly for nighttime leg cramps) Homeopathic Remedies for Tinnitus Salicylic Acid 30c: for tinnitus resulting from ingestion of high dosage of aspirin Natrum Salicylicum 30c: may be beneficial if tinnitus present as a low, dull hum; loss of hearing and vertigo may also be present Lycopodium 6c: may be beneficial to tinnitus present as humming and roaring along with impaired hearing Supplements for Tinnitus and Hearing Loss Cobalamin (vitamin B12): patients with tinnitus and noise-induced hearing loss have demonstrated significant vitamin B-12 deficiency

Shemesh, Z., Attias, J., Ornan, M., Shapira, N., Shahar, A. (1993). Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced hearing loss. American Journal of Otolaryngology, 14, 94-99. Magnesium: low levels of magnesium are associated with noise-induced hearing loss; supplementation with magnesium has been shown to prevent noise-induced hearing loss

Attias, J., Weisz, G., Almog, S., Shahar, A., Wiener, M., Joachims, Z., Netzer, A., Ising, H., Rebentisch, E., Guenther, T. (1994). Oral magnesium intake reduces permanent hearing loss induced by noise exposure. American Journal of Otolaryngology, 15, 26-32. Supplements for Tinnitus and Hearing Loss Determination of vitamin B12 status in individuals with tinnitus and noise-induced hearing loss is warranted. If low, supplement with 2,000 mcg daily for 1 month, followed by 1,000 mcg daily thereafter (sublingual methylcobalamin is preferred form). Take with folic acid. 200 mg of magnesium daily (as magnesium aspartate) is safe and effective in preventing noise-induced hearing loss. Supplements for Tinnitus and Hearing Loss Vinpocetine, an extract of the Periwinkle plant, has shown possible benefit in the treatment of tinnitus. For more info.: [|http://www.bixby.org/faq/tinnitus/treatmnt.html#vinpocetine] []. htm

Phytotherapeutic Recommendations
-Vinca Minor (Periwinkle)


 * Other Tx Alternatives for Tinnitus**

Use of low-pitch sound to mask high-pitch tinnitus: [] low.htm

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Definition:
The perception of sound without external stimulus.

Etiology:
The sound the patient hears may be of several types, including ringing, roaring, buzzing, hissing, and whistling; or, the sound may be more involved or be different sounds at different times. Tinnitus may be constant or intermittent. It is sometimes associated with drug use, especially aspirin and antibiotics. It is often idiopathic, and although the pathophysiology of tinnitus is poorly understood, tinnitus is frequently associated with sensorineural or conductive hearing loss.

Nutrition:
eating principles: • low fat diet, low sugar, high complex carbohydrates • protein 12-15% diet • low cholesterol/cholesterol foods • vegetarian cleansing diet or short fasts » chronic: • elimination/rotation diet, rotation diet, rotation diet expanded

therapeutic foods » Kidney Xu (Deficiency) type: • foods that tonify the Kidney, Yang and foods that tonify the Yin • black sesame seeds, black beans, celery, oyster shells, pearl barley, adzuki beans, black jujube, yams, lotus seed, chestnuts, grapes

avoid: • stimulating foods, hot, spicy foods, rich foods, coffee, alcohol

therapeutic foods Liver Fire type: • Heat-clearing foods, soothe the Liver foods, tonify the Liver foods • liver-cleansing foods: beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root • chrysanthemum flowers and tea

avoid: • stimulating foods, hot, spicy foods, rich foods, coffee, alcohol

specific remedies • 3 oz. mussels, 8 oz. celery. Boil in 1 pt. water until reduced by half. Eat and drink 2-3x/week. (Butt and Bloomfield, p. 158) • 1 lb. catfish, 4 oz. mung beans, 1 1/4 oz. garlic. Boil in 3 pt. water until reduced by half. Drink 10 oz. twice daily 3x/week (Butt and Bloomfield, p. 158) • make tea from lotus seeds and chrysanthemums (Ni, p. l60) • drink juice form celery and grapes, 1 cup three times daily (Ni, p. 160) • cook adzuki beans and black beans with rice porridge and eat per day (Ni, p. 160) • boil Chinese black dates, walnuts, and lotus seeds with rice porridge and eat per day (Ni, p. 160) • take 15-30 g sunflower seed shells and 30 g sugar, cover with water and simmer for 30 minutes. Serve twice daily (Yin-fang and Cheng-jun, p. 113)

Botanicals
• Avena sativa: nerve tonic • Chenopodium ambrosioides (oil): an eighth tsp. three times daily (Bastyr College Black Book) • Cimicifuga racemosa: vertigo from auditory tinnitus (NCNM Botanicals; Smith) • Gelsemium sempervirens (toxic): associated with taking quinine (Ellingwood, p. 78) • Ginkgo biloba (standardized extract): use long term; tincture may have some benefit • Hydrastis canadensis: catarrhal deafness and tinnitus (British Herbal Pharmacopoeia, p. 114) • Hypericum perforatum: internally; oil, locally in the ear canal (Smith) • Nepeta hederacea: tinnitus aurium (British Herbal Pharmacopoeia, p. 149) • Pilocarpus jaborandi (toxic): contraindications: heart patients (Bastyr) • Podophyllum peltatum (toxic): with anorexia (Bastyr College Black Book) • Selenicereus grandiflorus (toxic): due to functional heart disease (Felter and Lloyd, p. 376) • Verbascum thapsus • Xanthoxylum americanum: circulatory stimulant

see: otitis media, otitis externa if associated with infection

Chinese Formulae
• Rehmannia Eight F. (Jin Gui Shen Qi Wan); Ge Jie Da Bu Wan (patent): Kidney Yin and Yang Xu (Deficiency), including drug-induced tinnitus (Rehmannia Eight: Hsu, 1980, p. 250; Yeung, p. 138; Dharmananda, 1986, p. 178; Bensky and Barolet, p. 275; Ge Jie: Zhu, p. 266) • Kwei Ling Chi (patent): Kidney Yang Xu (Deficiency) (Fratkin, p. 195) • Er Long Zuo Ci Wan; He Che Da Zao Wan (patent): Kidney Yin Xu (Deficiency) (Er Long: Yeung, p. 89; Bensky and Barolet, p. 265; He Che: Zhu, p. 286) • Scute C.; Tso Tzu Otic Pills (patent); Er Ming Zuo Ci Wan (patent): Kidney Yin Xu (Deficiency) with Empty Fire Blazing (Scute: Hsu, 1980, p. 271; Tso-Tzu: Fratkin, p. 209; Er Ming: Zhu, p. 304) • Shen Jing Shuai Ruo Wan (patent): Kidney Yin Xu (Deficiency) and Heart Yin Xu (Deficiency) (Zhu, p. 275) • Zhi Bao San Bian Wan (patent); Placenta Tablets (patent); Eleuthero 10+ (patent): Kidney Jing Xu (Essence Deficiency) (Zhi Bao: Zhu, p. 310; Placenta: Fratkin, p. 182; Eleuthero: Dharmananda, 1990, p. 14) • Pueraria C. (Ge Gen Tang): Wind-Heat, including excessive ear wax (Hsu, 1980, p. 51; Yeung, p. 105; Dharmananda, 1986, p. 125; Bensky and Barolet, p. 51) • Bupleurum and Rehmannia C. (Chai Hu Qing Gan Tang); Ji Gu Cao Wan (patent): Liver Yang Rising (Bupleurum: Hsu, 1980, p. 160; Dharmananda, 1986, p. 368; Bensky and Barolet, p. 98; Ji Gu Cao Wan: Zhu, p. 194; Gentiana: Dharmananda, 1990, p. 69; Long Dan: Fratkin, p. 82) • Gentiana C. (Long Dan Xie Gan Wan) (available as patent); Gentiana 12 (patent): Liver and Gall Bladder Invaded by Damp-Heat: constant, strong, high-pitched tinnitus. (Gentiana: Hsu, 1980, p. 181; Yeung, p. 154; Dharmananda, 1986, p. 229; Bensky and Barolet, p. 96; patent: Zhu, p. 172; Fratkin, p. 82; Gentiana 12: Dharmananda, 1990, p. 69) • Morus Fruit Tablets (patent): Xue (Blood) Heat (Dharmananda, 1990, p. ) • Dang Gui Su (patent): Liver Xue Xu (Blood Deficiency) (Zhu, p. 252) • Bupleurum and Dragon Bone C. (Chai Hu Jia Long Gu Mu Li Tang): Liver Wind Arising from Liver Yang Rising (Hsu, 1980, p. 340; Dharmananda, 1986, p. 154; Bensky and Barolet, p. 387)

Acupuncture
after assessing the person and palpating, consider these patterns: Kidney Qi and/or Yin Xu (Deficiency), which fails to ascend; Kidney Jing Xu (Essence Deficiency); Kidney and Heart not Communicating; Liver Yin Xu (Deficiency); Liver Wind Stirring; Liver and Gall Bladder Fire Blazing Upward, with uprising of Turbid Phlegm; Liver Yang Rising; dysfunction of the Yang Wei Mai (Yang Linking Vessel); Xue Yu (Blood Stasis) affecting channels

» therapeutic notes: • chronic tinnitus, esp. of gradual onset, can be very recalcitrant to treatment by acupuncture alone, esp. when Kidney Xu (Deficiency) is an important etiologic factor • consider distal points on Gall Bladder, Triple Warmer and/or Small Intestine channels if onset of the tinnitus followed an incident of physical trauma to such areas which may have left residual Xue Yu (Blood Stasis) and subsequently affected the channel(s) in its relationship to the ear (Bensky)

» illustrative combinations: • SI-19, TW-17, ting cong and ting xue for tinnitus (Shanghai, p. 161) • Kd-1 and GB-44; GB-20 and UB-10; GB-7, GB-8, GB-9, GB-18, GV-16 and GV-14 for tinnitus (Mann, p. 139) • Lv-4, SI-16, TW-17 and SI-19; Lu-11, LI-4, Kd-3 and St-36; TW-5, GB-2, TW-21, GV-20, GV-19 and TW-18; SI-3, SI-5, SI-19 and SI-16 for catarrhal tinnitus (Mann, p. 13) • GB-2, TW-17, TW-2, GB-40 and Kd-3 (ipsilateral) for Kidney Yin Xu (Deficiency) enabling the invasion of one ear by Wind and Damp-Heat from the Liver and Gall Bladder; note: case cited involved left ear (Jirui and Wang, p. 206) • GB-2, GB-20, GB-34 and Lv-3 for hearing loss and tinnitus due to Fire rising from the Liver and Gall Bladder (Jirui and Wang, p. 226) • GB-3, St-7, St-2, GV-20, TW-17, TW-21, GB-4, SI-16, LI-5, TW-1, TW-2 and TW-3 (also consider SI-17, SI-19 and GB-2) for deafness and tinnitus (Lee and Cheung, p. 350) • ting xue, yi long, ting cong and yi ming xia for tinnitus or deafness (Shanghai, p. 162); • TW-17, GB-20 and TW-3 for tinnitus and deafness; add Lv-2 and St-40 for Liver and Gall Bladder Fire Rising); and/or add UB-23 and Kd-3 for Kidney Qi Xu (Deficiency) (Lee and Cheung, p. 350; Shanghai, p. 688) • TW-5 and GB-41: open and regulate the Yang Wei Mai (Yang Linking Vessel) which circles the ear • UB-23, Kd-3 and Kd-6 (d. D): tonify Kidney for weakened patient (Eisen) • TW-21 and GB-2 open the ear; spread the Qi; benefit hearing (Flaws, 1989, p. 86; Finkelstein, p. 65) • GB-2, TW-21, SI-19 and GB-20 (-): clear Obstruction from the channels and ear orifices • UB-10, GB-20, GB-21, SI-13, SI-15 and hua tuo jia ji (-): relieve stiffness and tension in neck and shoulders • UB-63 and GB-2: "When cold damage alone sets both ears to ring, with UB-63 and GB-2 it will be gone with the wind" (Ellis, et al, 1988, p. 233)

point analysis

» palpate and consider: • GV-20 (- and/or D): dispels Wind and Cold of head and opens Orifices; cools the body (D) (Finkelstein, p. 81); regulates and tonifies the Qi (D); adjusts Qi of the Du Mai (Governing Vessel); elevates the Clear Qi; spreads Liver Qi; extinguishes Liver Wind from upper body and pacifies Liver; Sea of Marrow point; Jiao Hui Intersecting point of the six Yang channels and the Du Mai (Governing Vessel) • GV-17 (=): dispels Wind and clears Heat; controlling point of the Sea of Marrow; Sea of Marrow point (with GV-1, GV-15, GV-16 and GV-28); sends vessels directly into the brain • GV-16 (-): calms the Shen and quiets the Soul; drains Fire; eliminates Yang Shi (Excess) from upper body and cleanses Yang which has been obscured by Phlegm; eliminates Liver Wind; Window of the Sky point; Sea of Marrow point • GV-4 (+ and/or D): strengthens the Kidney; replenishes the Kidney Yang and nourishes the Yuan (Original) Qi; relieves mental and physical exhaustion; reinforces and astringes the Jing (Essence); frees the channels and invigorates the collateral vessels; "Gate of Life Fire" • GB-12 (-): pacifies the Shen; stimulates the Brain; opens the sensory Orifices, esp. clears the ear; eliminates Wind and Cold; clears Heat; reduces upward disturbance of Fire of Liver/Gall Bladder • GB-20 (-): clears Heat and dissipates Wind; clears Obstruction from channels and ear Orifices; relieves stiffness and tension in neck and shoulders; pacifies Liver Wind and dissipates Internal Wind; reduces and relieves Heat; benefits the ears and sharpens the hearing; maintains function of inner ear; subdues Liver Yang and Fire to calm and regulate the Liver, esp. disperses and descends Liver Yang from the head; drains and disperses Fire of Gall Bladder; harmonizes Qi and Xue (Blood); frees the channels and invigorates the collateral vessels; Jiao Hui Intersecting point of Yang Wei Mai (Yang Linking Vessel) and Hand Xiao Yang (Triple Warmer) channels on the Foot Xiao Yang (Gall Bladder) channel • GB-21 (-): spreads Liver Qi; extinguishes Liver Wind; dissolves Phlegm; relieves stiffness and tension in neck and shoulders; clears and invigorates the channels; benefits tendons and muscles • cervical and upper thoracic hua tuo jia ji (-): relieve stiffness and tension in neck and shoulders • UB-10 (-): clears Fire; clears the head; opens the sensory Orifices; strengthens or relaxes the sinews and tendons; relieves stiffness and tension in neck and shoulders; Window of the Sky point; Sea of Qi general point • UB-15 (+ and/or d. D): strengthens the Heart and nourishes Heart Xue (Blood); regulates the Xue (Blood) and Qi; clears Heart Fire; Heart Shu Associated point • UB-17 (+): tonifies the Qi; nourishes and invigorates the Xue (Blood); enriches Yin; strengthens Xu (Deficient) conditions and increases stamina; Diaphragm Shu Associated point; Hui Reunion and Master point of the Xue (Blood) • UB-18 (=): pacifies the Shen; stimulates the Brain; drains the Liver and Gall Bladder; extinguishes Liver Wind and clears Liver Fire; moves Stagnant Qi; strengthens Xu (Deficiency) conditions; nourishes and regulates the Xue (Blood); nourishes Liver Yin; Liver Shu Associated point • UB-19 (=): regulates the Qi and calms the emotions; clears, cools and drains Heat from the Liver and Gall Bladder; nourishes Xue (Blood); Gall Bladder Shu Associated point • UB-23 (+ and/or d. D): tonifies and adjusts the Kidney; nourishes Yin, Xue (Blood) and Kidney Jing (Essence); strengthens the Brain and Marrow; prevents or relieves general stress fatigue or premature senility (Finkelstein, p. 44); benefits the ears and brightens the eyes; strengthens the Heart (Ross, 1985, p. 130); strengthens Kidney function of reception of Qi; spreads and clears Obstructed Kidney Qi; strengthens Yang and Qi Hai; counterbalances Liver Fire; esp. with a weakened patient; Kidney Shu Associated point • UB-47/52 (+): tonifies Kidney Qi, Kidney Yang, Kidney Yin, Jing (Essence) and Yuan (Original) Qi; spreads and clears Obstructed Kidney Qi; Kidney psychospiritual associated point • GB-2 (-): clears Heat and dissipates Wind; clarifies the senses; clears blockage and restores circulation of Qi in the Gall Bladder channel near the ear; opens the ear; invigorates the Liver and Gall Bladder; "Reunion of Hearing" • SI-13 (-): stimulates the flow of Qi and Xue (Blood); relaxes the muscles and sinews; relieves stiffness and tension in neck and shoulders • SI-15 (-): dissipates Heat; dissolves Phlegm; relieves stiffness and tension in neck and shoulders • SI-16 (-): pacifies the Shen and Heart; dispels Wind; nourishes the Heart; invigorates the channels and collateral vessels • SI-19 (-): clears Heat; loosens and regulates Qi of the ear; benefits the ear; Small Intestine Exit point; Jiao Hui Intersecting point of the Hand Xiao Yang (Triple Warmer) and Foot Xiao Yang (Gall Bladder) channels on the Hand Tai Yang (Small Intestine) channel • TW-21 (-): clears Obstruction from channels and ear Orifices; opens the ear; benefits hearing; disperses Heat; improves function of the Brain; "Ear's Gate" • TW-17 (-): clears Heat; frees the channels; benefits hearing and vision; opens the ears; Jiao Hui Intersecting point of the Foot Xiao Yang (Gall Bladder) channel on the Hand Xiao Yang (Triple Warmer) channel • TW-16 (-): clears Heat and dissipates Wind; clears the channels and invigorates the collateral vessels • yi dian (=): pacifies the Shen; benefits the ears; brightens the eyes; local point • yi long (=): calms the Shen; opens the ears and benefits hearing; local point • yi ming (-): pacifies the Shen; benefits the ears; brightens the eyes; local point • ting cong: opens the ears and benefits hearing; local point; 0.2 cun below GB-2 • ting ling: opens the ears and benefits hearing; local point; midway between ting xue and GB-2 • ting xue: opens the ears and benefits hearing; local point; midway between SI-19 and GB-2 • St-7 (-): clears Heat and dissipates Wind; removes Obstructions from the Stomach channel; benefits the ear; relaxes the jaw; Jiao Hui Intersecting point of the Foot Yang Ming (Stomach) and Foot Xiao Yang (Gall Bladder) channels • St-9 (=): regulates Qi and Xue (Blood); transforms Phlegm and moves the Xue (Blood); frees the channels and invigorates the collateral vessels; palpation: pulse at St-9 registers state of the Yang in the Upper Warmer; reflex for thyroid hormone imbalance (Matsumoto); tenderness or pain upon palpation indicates lack of adequate oxygenation (Matsumoto); Great Window of the Sky point; Exit point of the Sea of Qi; Jiao Hui Intersecting point of the Foot Yang Ming (Stomach) and Foot Xiao Yang (Gall Bladder) channels • CV-23 (=): clears Fire and Heat; transforms Phlegm; impels the downward flow of Phlegm; opens the ears; Jiao Hui Intersecting point of the Yin Wei Mai (Yin Linking Vessel) and Ren Mai (Conception Vessel); meeting point of the Kidney and Heart (Finkelstein, p. 93); directly linked to GV-16 • TW-7 (-): clears Heat and dissipates Wind, esp. from the Triple Warmer; expels Toxins; soothes the Liver; facilitates circulation of Qi; spreads Liver Qi Stagnation; treats geriatric senility (Finkelstein, p. 62); Triple Warmer Xi Cleft Accumulation point • TW-6 (-): dispels Wind; opens the sensory organs; clears Fire and Heat; transforms Phlegm; facilitates Qi flow and spreads the Qi; regulates the Triple Warmer and the Zang-Fu organs; frees the channels and invigorates the collateral vessels; disperses Obstruction; Triple Warmer Fire and Horary point • TW-5 (-): dissipates Wind; clears Heat, esp. from Triple Warmer channel; opens the Orifices (ears and anus) to influence hearing, treat tinnitus and relieve constipation; opens and moves the Yang Wei Mai (Yang Linking Vessel) and regulates the Dai Mai (Girdle Vessel); transforms Phlegm and dissolves Toxins; clears Xiao Yang (Gall Bladder) in the head and disperses Liver Yang Shi (Excess); tonifies Wei (Protective) Qi; frees the channels to facilitate the circulation of Qi in the channels; invigorates the collateral vessels; strengthens and relaxes the sinews and tendons; Triple Warmer Luo Connecting point; Master point of the Yang Wei Mai (Yang Linking Vessel); Couple point of the Dai Mai (Girdle Vessel) • TW-3 (-): facilitates the circulation of Qi; clears the head and benefits the ear; opens the sensory Orifices; Triple Warmer Wood and Tonification point • TW-2 (-): drains Fire in the head; clears and drains Heat, esp. pathogenic Heat in the San Jiao (Triple Warmer); dispels Wind; facilitates flow of Qi; disperses Stagnation; frees the channels and invigorates the collateral vessels; Triple Warmer Water point • TW-1 (-): drains Fire; opens the ears; eliminates Toxins; frees the channels and invigorates the collateral vessels; Triple Warmer Jing Well, Metal and Entry point • SI-5 (-): clears the Brain; opens the ears; transforms Phlegm; regulates Qi of the Small Intestine channel; Small Intestine Fire and Horary point • SI-4 (-): regulates and removes Obstruction from the Small Intestine channel in aural region; invigorates Tai Yang (Small Intestine and Bladder); disperses Damp-Heat from the Small Intestine; relaxes the sinews and muscles; relaxes spasms; reduces swelling; Small Intestine Yuan Source point • SI-3 (-): opens the ears; opens the Du Mai (Governing Vessel) and regulates the Yang Qiao Mai (Yang Motility Vessel); dispels Dampness and Internal Heat; tonifies the Small Intestine; invigorates the channels; Small Intestine Wood and Tonification point; Master point of the Du Mai (Governing Vessel); Couple point of the Yang Qiao Mai (Yang Motility Vessel) • SI-2 (-): opens the ears; regulates and removes Obstruction from the Small Intestine channel in aural region; Small Intestine Water point • SI-1 (-): disperses Wind; clears Heart Fire; opens the sensory Orifices; clears Obstruction from the channels; Small Intestine Jing Well, Metal and Entry point • Ht-7 (=): calms the Heart; lowers blood pressure and reduces irritability of cortex (Finkelstein, p. 33); assists sleep; general sedative and regulating effect on the inner organs; tonifies and nourishes Heart Yin and Xue (Blood); Heart Yuan Source, Earth and Dispersion point • LI-6 (-): dissipates Heat and Fire; benefits the ear and treats deafness; tonifies Kidney Yin by directing the Yang Qi of the Exterior toward the internal duct of the Triple Warmer (Finkelstein, p. 8); Large Intestine Luo Connecting point • LI-5 (-): expels Wind and drains Fire; Large Intestine Fire point • LI-4 (-): dispels Stagnation and facilitates flow of Qi in the head; regulates Qi and Xue (Blood); elevates Clear Qi and descends Turbid Qi; clears Toxins; frees the channels and invigorates the collateral vessels; Large Intestine Yuan Source and Entry point; Command point of the face and mouth • LI-1 (-): opens the ears; tonifies Wei (Protective) Qi via the internal duct of the Triple Warmer; cools the Lung; esp. appropriate with Wind, Phlegm and high fever and/or combination of deafness and tinnitus; Large intestine Jing Well, Metal and Horary point • Kd-16 (+): benefits the Heart; regulates the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel); tonifies the Kidney • CV-6 (+): strengthens and regulates the Qi, esp. in the Lower Warmer; reduces Fire of Liver and Gall Bladder; tonifies the Kidney and Yuan (Original) Qi; nourishes Kidney Yang; warms Ming Men (Life Gate Fire) (esp. with D); reinforces the Jing (Essence); Dan Tien (Elixir of Long Life), with CV-5: important point for concentration of Qi in the body • CV-4 (+): regulates the Qi and benefits Yuan (Original) Qi; nourishes Xue (Blood) and Yin; separates the Clear and the Turbid; nourishes and stabilizes the Kidney; strengthens and replenishes the Kidney Qi; resolves Damp-Heat; Small Intestine Mu Alarm point • St-36 (+): dispels Cold and expels Wind; facilitates the Lung and regulates Wei (Protective) Qi so as to resist External invasion; disperses noxious Yang and brings down fever; regulates and strengthens Qi and Xue (Blood); supports Lung Qi and transforms Phlegm; disperses Stagnation in the Upper Warmer; strengthens weak and Xu (Deficient) conditions; strengthens the Spleen and eliminates Dampness; spreads Liver Qi and benefits the Gall Bladder; nourishes the Kidney, Liver and Spleen; tonifies Kidney Yin; clears Heat from the Yang organs and drains Shi (Excess) from the Yang channels; regulates ascension of the Clear and descension of the Turbid (-), esp. by the Intestines; frees the channels and invigorates the collateral vessels; Stomach He Sea Lower Uniting, Earth and Horary point; Sea of Nourishment point • St-40 (-): dispels Wind; strengthens the Spleen and circulates Qi of the Stomach and Spleen; transforms, dissolves and eliminates Phlegm and Dampness; descends the Turbid; strengthens Kidney Yin and drains Liver Yang; invigorates the channels; Stomach Luo Connecting point • Sp-6 (=): nourishes Yin, esp. of the Spleen, Liver and Kidney; clears Fire due to Xu (Deficiency); strengthens the Spleen and tonifies the Qi; frees Qi Stagnation; spreads Liver Qi and suppresses Liver Heat; regulates the Gall Bladder; warms the Middle and Lower Warmers; tonifies the Kidney; transforms Dampness and Heat; Jiao Hui Intersecting point of the three Foot Yin channels • Lv-8 (+): drains Liver Fire; nourishes Liver Xue (Blood) and Yin; clears and cools Damp-Heat; Liver He Sea Uniting, Water and Tonification point • Lv-3 (-): adjusts and harmonizes the Liver and Gall Bladder; promotes smooth flow of Qi and Xue (Blood); disperses and eliminates Liver Qi Stagnation; cools, clears and drains Heat and Fire from the Liver and Gall Bladder; subdues Liver Yang; calms and extinguishes Liver Wind; tonifies Liver Xue (Blood); opens the channels; Liver Yuan Source and Earth point • Lv-2 (-): disperses Stagnant Liver Qi; clears and drains Fire of the Liver and Gall Bladder; subdues Yang Shi (Excess); soothes and loosens the Liver to release Liver Qi and remove Qi Depression; eliminates Interior Wind; Liver Fire and Dispersion point • GB-34 (-): clears Gall Bladder Fire; benefits the Liver and Gall Bladder; extinguishes Liver Wind; subdues Liver Yang; tonifies the Spleen and dissolves Phlegm; clears and cools Dampness and Heat; eliminates Phlegm-Fire in the Stomach; Gall Bladder He Sea Uniting and Earth point • GB-40 (-): clears and drains Fire from the Liver and Gall Bladder; spreads the Liver Qi; benefits Gall Bladder; softens hard masses; transforms Damp-Heat; treats external trauma, esp. below the waist; benefits the joints; frees the channels; Gall Bladder Yuan Source point • GB-41 (-): removes Fire; dissolves Phlegm; harmonizes and regulates the Liver and Gall Bladder; removes Stagnancy of Liver Qi; dispels Damp-Heat; Gall Bladder Wood and Horary point; Master point of the Dai Mai (Girdle Vessel); Couple point of the Yang Wei Mai (Yang Linking Vessel) • GB-42 (-): drains the Gall Bladder and clears the Liver; sharpens the hearing; dissipates Dampness; reduces swelling • GB-43 (-): disperses Heat; extinguishes Wind; treats ear conditions; reduces inflammation; Gall Bladder Water and Tonification point • GB-44 (-): opens the ears; clears Heat; drains Fire, esp. from the Gall Bladder; extinguishes Wind; removes Liver Qi Stagnation; Gall Bladder Jing Well and Metal point • Kd-7 (+): strengthens Wei (Protective) Qi; clears Heat and nourishes Yin; strengthens the Spleen; tonifies Yuan (Original) Qi and regulates Kidney Qi; strengthens and enriches the Kidney; tonifies the Liver via the mother/child relationship; cools and clears Damp-Heat; Kidney Metal and Tonification point • Kd-6 (d. D): nourishes the Heart; cools and clears Heat; clears Xu (Deficiency) Fire; tonifies the Kidney (especially Yin); dispels Dampness; frees the channels and invigorates the collateral vessels; Master point and Entry point of the Yin Qiao Mai (Yin Motility Vessel); Couple point of Ren Mai (Conception Vessel) • Kd-3 (d. D): tonifies the Kidney, Yuan (Original) Qi, Xue (Blood) and Jing (Essence); nourishes and enriches Kidney Yin, supplies Liver Yin, and tonifies Yin of the entire body; cools and descends Heat; pacifies Xu (Deficiency) Fire; benefits the ears; treats thyroid imbalance (Matsumoto); tonifies Kidney Yang and Ming Men Fire (D); reinforces Kidney Qi; Kidney Yuan Source and Earth point • UB-62 (+): dispels Wind and Cold; cools and clears Fire and Heat; regulates the Du Mai (Governing Vessel) and benefits Du Mai (Governing Vessel) disorders; Master point of the Yang Qiao Mai (Yang Motility Vessel); Couple point of the Du Mai (Governing Vessel) • UB-63 (-): dispels Wind and Cold; clears Heat; opens the ears; invigorates the collateral vessels; Bladder Xi Cleft Accumulation point; Entry point of the Yang Wei Mai (Yang Linking Vessel)

• ear: occiput, inner ear, (outer) ear, kidney

Homeopathy
• Antipyrinum: pains and buzzing; nervous anxiety; hallucinations of sight and hearing • Cannabis indica: throbbing, buzzing and ringing; noise like boiling water; extreme sensitiveness to noise; intense exaltation of mind • Carboneum sulphuratum: hearing impaired; buzzing and singing noises like a harp; tinnitus aurium; Meniere's disease • Causticum: echoes and re-echoes; hears his own voice echoing; ringing and roaring and pulsating with deafness • Chenopodium: torpor of auditory nerve, hearing better high-pitched sounds; comparative deafness to sound of voice, but great sensitiveness to sound, as of passing cars; shrinking from low tones; buzzing in ears; aural vertigo • Chininum sulphuricum: buzzing, roaring, singing or hissing with deafness • Cinchona: ringing in ears; hearing sensitive to noise; general debility from exhausting discharges; loss of vital fluids with nervous exhaustion; associated with deafness and sometimes with headache and vertigo • Hydrastis canadensis: after recent catarrh of eustachian tube; roaring and high-pitched voice • Kali iodatum: singing and hissing • Kali muriaticum: sounds like a moving train; voices of birds, snapping and noises in the ears • Lachesis: noises are most pronounced on waking • Ledum: sounds like ringing of bells or like a wind storm • Lycopodium: otorrhea with or without tinnitus; humming and roaring with hardness of hearing; every voice causes peculiar echo in ear • Petroleum: noises of a whizzing nature, as of a breeze; noise unbearable, esp. from several people talking together; ringing and cracking; diminished hearing • Phosphoricum acidum: associated with debility, weakness and vertigo; roaring with difficult hearing • Phosphorus: hearing difficult, esp. to human voice; re-echoing of sounds • Pulsatilla: noises < upper respiratory catarrh; hearing difficult, as if ear were stuffed; diminished acuteness of hearing • Salicylicum acidum: roaring and ringing in ears; deafness with vertigo; Meniere's disease • Spigelia: with neuralgic pains in the ears, intermittent rather than continuous • Sulphur: noises < at night; whizzing in ears; deafness preceded by exceedingly sensitive hearing • Viscum album: noises with catarrhal deafness

Subtle Support
• notes: A#, B, C, D#, E, G, G#

• chords: diminished 8th, C Major, D# Major, G# Major (Gimbel, p. 116)

Mind/Body
• Refusal to listen; not hearing the inner voice; stubbornness. (Hay, 1984, p. 186) • Our capacity for hearing is a bodily expression of how obedient and submissive we are. Those who are hard of hearing are people who will not listen, they simply fail to hear what they do not want to hear. It shows a certain egocentricity and lack of submissiveness. (Dethlefsen, p. 153)

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; provides the "Fire of Life" through its Yang functions; provides the nourishing and stabilizing qualities of Yin and Water that balance the Yang and the Fiery qualities; relates particularly to chronic conditions because it carries the constitutional endowment from the parents; manifests through the ears; and displays the effects of sexual dissipation (especially excessive ejaculation), overwork, aging, chronic debilitation, and extreme stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. As always, chronic Yin Xu (Deficiency) predisposes to Empty Heat and/or acute inflammation. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).
 * Chinese psychophysiology:**

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); expresses itself in the nervous system; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Yin Xu (Deficiency) predisposes to the Shi (Excess) conditions of Liver Wind, Liver Yang Rising, and Liver Fire Blazing. » Liver Shi (Excess) signs include discontent; anger; pain in lumbar region and genitals (Seem, p. 28); muscular tension; excessive sex drive; insomnia; moodiness; excitability; genital diseases; red, tearing eyes; compulsive energy; and bitter taste in the mouth. Chronically suppressed anger can implode and give rise to Fire in the Liver and Gall Bladder with symptoms of tinnitus, irritability, bitter taste, headaches, etc., and a tendency to "invade" the Stomach, Spleen, and Intestines. » Liver Wind derives from Liver Yin Xu (Deficiency) and/or Liver Xue Xu (Blood Deficiency) and their subsequent inability to embrace the Yang, and can manifest as joint stiffness, dizziness, tremor, paralysis, convulsions, rashes, itching, and neurological problems. Wind can also be internalized after exposure to inclement, especially windy, weather and any concomitant influences of Damp, Cold, and/or Heat.

• Small Intestine ~ Xiao Chang receives and transforms food by separating the Clear (Pure) from the Turbid (Impure), with the Clear becoming bodily fluids and the Turbid becoming urine - this function also operates on the emotional, mental, and spiritual levels. » Healthy expressions are love, joy, and the ability to discriminate; and, as the Princely Fire, warmth, vitality, and excitement. » The Small Intestine is affected by sadness which grips a person and destroys the mental clarity and capacity of sound judgment for which this organ is responsible. (Maciocia, p. 273) Weakness, dysfunction, and illness are associated with cruelty, hate, indiscretion, and impatience. » Small Intestine Deficiency signs include bluish lips with white border, emaciation, profuse sweating (Seem, p. 29); swellings of nodules; hemicrania; tinnitus; pain around the ear; pain depressing the abdomen. » Mental signs of Small Intestine channel disorders include poor mental assimilation, a feeling of mental deficiency due to inability to assimilate ideas, and insecurity. (Seem, p. 27).

Integrative Therapies
Tinnitus is a condition in which sounds are heard without any outside cause. It is often referred to as "ringing in the ears," but the sound may be more like buzzing, whistling, roaring, or hissing. The sounds usually seem louder at night, and there may be an accompanying loss of hearing.

Tinnitus appears as a symptom of nearly all the disorders of the ear. It may also indicate anemia, syphilis, tumors, auditory hallucinations, or an overdose of toxic chemicals or medications (even aspirin). Exposure to hazardous chemicals or suspected adverse drug reactions should be investigated, and the problematic substance should be avoided if possible. The basic cause of tinnitus is unknown, but it may be from irritation of the nerve endings in the ear.

The sudden appearance of tinnitus can point to a quite serious condition. It is necessary to be examined by a physician to find the condition that underlies its development. If you suffer from Meniere's disease (which has the symptoms of tinnitus, hearing loss, and dizzines), you can refer to that topic:

THE FOLLOWING SUPPLEMENTS CAN BE TAKEN UNTIL SYMPTOMS IMPROVE: 1. Calcium – 200 to 500 milligrams per day. 2. Pancreatic enzymes – 2 tablets with meals. 3. Potassium – 3 to 5 grams per day. Be cautious. High levels of Potassium can be dangerous. Use it only under a physician's supervision. 4. Glandular extracts of thyroid, pituitary, or adrenal are recommended. Take according to product label directions. 5. A multvitamin and mineral supplement – taken daily, according to the product label. Choose a brand that is free of sugar, yeast, and artificial ingredients.

AN HERB USED FOR TINNITUS IS: • Gingko, one of the most commonly prescribed medicines in Europe. This can be very effective in treating tinnitus. Take 40 milligrams, 3 times a day. It may take 3 months or more of continued use to bring results.

HOMEOPATHY: From the following homeopathic remedies, choose the one that best matches your symptoms. Dissolve 3 pellets under the tongue. • Chininum sulphuricum 12C: For roaring, ringing, or buzzing in the ears with hearing loss. Take twice daily for 3 weeks. • Natrum salicylicum 12C: For low-pitched sounds or when tinnitus is caused by taking aspirin. Take twice daily for 3 weeks.

Note: A wide range of homeopathic medicines can be helpful for individuals with tinnitus. Consultation with a health care professional trained in homeopathic prescribing will usually be the best way to select the correct medicine.