Syndrome differentiation and treatment
The commonly-seen syndromes of acute suppurative ofitis media include the syndrome of wind and heat attacking the exterior as well as the syndrome of excessive fire of the liver and gallbladder, of which the latter is most commonly-seen. Excessive fire of the liver and gallbladder is marked by severer otalgia, or with fever, congestion of the tympanic membrane. Clearing away heat from the liver and purging fire are advisable in treatment. The syndrome of wind and heat attacking the exterior is characterized by milder otalgia, mild congestion of the tympanic membrane, or accompanied with the exterior syndrome of wind and heat. Dispelling wind and clearing away heat are advisable in treatment.

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. 
Therapeutic methods: Dispelling wind and clearing away heat, dispersing the lung and removing the obstruction of orifices.

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.
Therapeutic methods: Clearing away heat and purging fire from the liver and gallbladder, removing fire and obstruction of orifices.