Er Long Zuo Ci Wan — Tinnitus Left-Magnetite Pill

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Er Long Zuo Ci Wan — the “Tinnitus / Deafness Left Magnetite Pill” (er long literally means “ear deafness”) — is from Wei Yilin’s Yuan-dynasty Yi Yuan via Ye Tianshi’s later usage. It is Liu Wei Di Huang Wan with the addition of Magnetite (Ci Shi) for descending the Liver Yang that floats up to the ears, plus Chai Hu and Wu Wei Zi (in some versions) to settle the ascending Liver Qi. It is the foundational formula for tinnitus and hearing loss from Kidney Yin deficiency with mild Liver Yang rising.

I prescribe Er Long Zuo Ci Wan as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Er Long Zuo Ci Wan is prescribed for Kidney Yin deficiency with Liver Yang rising affecting the ears:

• Tinnitus — high-pitched, worse with stress or fatigue
• Gradual hearing loss
• Dizziness, light-headedness
• Lower back ache, weak knees
• Five-palm Heat, occasional flushes
• Insomnia, irritability
• Tongue — red with scant coat
• Pulse — thin, slightly rapid, possibly wiry

Key herbs

1. Shu Di Huang (Rx. Rehmanniae Preparata, 9–30g), Shan Zhu Yu (Fr. Corni, 6–12g), Shan Yao (Rz. Dioscoreae, 6–15g), Fu Ling (Poria, 6–9g), Ze Xie (Rz. Alismatis, 6–9g), Mu Dan Pi (Cx. Moutan, 6–9g) — Liu Wei Di Huang Wan core
2. Ci Shi (Magnetitum, 9–30g) — descends Liver Yang; anchors the floating Yang affecting the ears
3. Chai Hu (Rx. Bupleuri, 3–9g) — spreads Liver Qi; opens the ear channels
4. Wu Wei Zi (Fr. Schisandrae, 3–6g) — astringes Kidney; calms Shen

Formula actions

1. Tonifies Kidney Yin
2. Descends Liver Yang affecting the ears
3. Resolves tinnitus and slows progression of hearing loss

Conditions treated

1. Chronic tinnitus from Kidney Yin deficiency — see tinnitus
2. Age-related hearing loss (presbycusis) with Yin-deficient pattern
3. Ménière’s disease in the chronic phase with Yin deficiency
4. Tinnitus aggravated by stress and fatigue
5. Vertigo with tinnitus in older adults
6. Sudden sensorineural hearing loss recovery with Kidney Yin deficient background

Cautions

Not appropriate for tinnitus from Wind-Heat (acute onset with cold), Liver Fire (loud, sudden, irritable), Phlegm-Damp (muffled, foggy head) or Qi-Blood deficiency (faint, worse with exhaustion) — pattern differentiation is essential.

Sudden hearing loss requires urgent ENT assessment; this formula is for chronic / gradual cases.

Always consult a qualified Chinese herbalist registered with the RCHM.

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