1.  Syndrome of wind and heat attacking the exterior
Main symptoms and signs: Gradually worsening swelling with fullness and pain inside the ear, hypoacusis, tinnitus like hearing wind, red tympanic membrane, conduction deafness found by audiometry, accompanying symptoms like fever, aversion to cold, body pain, nasal obstruction and nasal discharge, red lingual margin and
tip, floating and rapid pulse.

2. Syndrome of excessive fire of the liver and gallbladder
Main symptoms and signs: Otalgia is severe like being punctured by an awl.  It manifests as cry and restlessness in children. Hypoacusis is even more obvious. Examination shows deep red tympanic membrane with evagination, or small yellow spots which is the premonitory sign of perforation of the tympanic membrane. Or there exists the small hole on the tympanic membrane. But profuse pus still exists without being discharged. The tongue is red with yellowish fur. The pulse is taut and rapid.