The quote of the Heart opens to the ears is from Suwen, chapter four Jin Gui Zhen Yen Lun: “the color of the south is red, and enters into and communicate with the heart which opens into the orifice of the ears…” Wang Bing’s annotation was “the tongue is the official of the heart, the tongue is for speech, the tongue is not an orifice, and hence the ears are the orifice (of the heart)”. Zhang Jing Yue said “the root of the tongue belongs to the heart; but the ears belong to both heart and kidney.” They both agreed the relation between the heart and the ear orifices.
Because most yin channels do not travel to the head, the five viscera opening to the orifices on the face are in fact through their interior-exterior related yang channels. The kidney opening to the orifice ears is through the bladder channel which travels to and opens in the orifice ears. The heart channel, through its interior-exterior relation with the small intestine channel which enters into the ears, relates to the ears too.
There are quite a few ear disorders that are related to the heart. For example, the coronary heart groove on the earlobe is often used to assist the diagnosis of the coronary heart disease. Commonly seen tinnitus, and deafness are often related to the heart. For example, insomnia, hypertension, and anemia that accompany with tinnitus are more effectively treated if the heart is treated.
In Shang Han Lun, it says “Before the doctor feels the pulse, the patient presses his chest with interlaced fingers. When the doctor instructs him to cough, he fails to do it accordingly. He must be deaf. A great deficiency after profuse or repeatedly perspiration has caused the deafness.” It is effectively treated by Gui Zhi Gan Cao Tang which warms the heart yang. I often use modified Xiao Cai Hu Tang to treat ear disorders. One is because the gallbladder channel circulates and enters the ears; and another reason is based on the extraordinary connection of the heart and gallbladder. I also often select Fengshi (GB31) to treat the deafness, tinnitus and insomnia due to heart yang deficiency. The result is very good. The reason is also based on the extraordinary connection of the heart and gall bladder.
I also often prick the ear apex to bleed to treat profuse sweating. The result is very good as the heart governs the sweat. Pricking to bleed to treat insomnia is also very effective as the heart governs the spirit. Pricking to bleed to treat skin disorders is also very effective. As the urinary bladder travels to the ears, and the Taiyang governs the exterior; Shaoyang gallbladder channel circulates around the ears; and Shaoyang governs the wind, but so does the “all sores, pains, and itchiness belong to the heart”.