“I have a buzzing in my left ear that never stops.”
A ringing that will not stop
Nine days of noise in one ear, in someone used to working surrounded by noise.
- Patient
- Man, 49
- Occupation
- Site foreman; noise and arguments daily
- Medication
- An antihypertensive for three years.
- History
- Controlled hypertension. No ear surgery.
- Habits
- Ten cigarettes a day. A glass of wine with lunch.
- Vitals
- BP 142/88 · afebrile
1 · The consultation
You have 22 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Patient update“«Another thing: since it started I hear noticeably less on that side. I have to take calls with my right ear. It started just as suddenly, nine days ago.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 4)
Case solved
Reasoned solution
Pattern: Liver and Gallbladder Fire. Supporting signs: Sudden onset, Loud, low buzzing, like an engine, Worse with anger, Bitter mouth and red eyes, Wiry, rapid pulse.
The deciding clue: Sudden onset: One Tuesday morning, between one argument and the next. Essence takes years to empty..
Safety: Sudden unilateral hearing loss has a window of days and needs ENT assessment as soon as possible. The Liver Fire reading was right and changes nothing.
Treatment: Drain Liver Fire, Clear the Gallbladder channel; Drain strongly. Points: LV2, GB43, TE17, GB20.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Liver and Gallbladder Fire. Supporting signs: Sudden onset, Loud, low buzzing, like an engine, Worse with anger, Bitter mouth and red eyes, Wiry, rapid pulse.
The deciding clue: Sudden onset: One Tuesday morning, between one argument and the next. Essence takes years to empty..
Safety: Sudden unilateral hearing loss has a window of days and needs ENT assessment as soon as possible. The Liver Fire reading was right and changes nothing.
Treatment: Drain Liver Fire, Clear the Gallbladder channel; Drain strongly. Points: LV2, GB43, TE17, GB20.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
