Auriculotherapy Oleson

'Terry Oleson1996, 1998
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Foreword
I haveknown Dr TerryOleson for anumber of years andI amverypleased tohave
been asked towritesome lines of introduction for thethirdedition of the
Auriculotherapy Manual: Chinese and Western Systems ofEar Acupuncture. I havevery
high regardfor theadvanced level of information contained inthisbook. Dr Oleson
states extremely well that therearetwoverydifferent approaches tounderstandabout
auriculotherapy. Oneapproach isOriental, theother one isOccidental. TheOriental
approach calls upon thebasic concepts of classical acupuncture. Most prominent are
theconcepts of yinandyang. InthisEasternapproach towardsauriculotherapy, the
notion of energy isomnipresent. Themetaphysical viewof theworld andof man isthe
primaryfocus, even moreprominent thanthedoctrines of physiology andanatomy.
TheWestern approach towardsauriculotherapy, thatwhich Paul Nogier first proposed,
rests upon thescientific method of observations, andtherepetition of such
observations. It isalso grounded upon thebasic foundations of anatomyand
physiology. IntheWestern approach, thereisnonotion of energy andnometaphysical
philosophy thatunderlies thistechnique. Infact, without going intodetails, the
external ear hasparticular diagnostic andtreatment properties because of its
innervationandbecause of thepresence of neuro-vascular complexes. These
complexes aresmall, actual entitiesconsisting of micro-hormones dispersed under the
skin of theexternal ear.
Thereareactually twojuxtaposed somatotopic systems which explain auriculotherapy
asit ispracticed today inEurope. Thefirst system isbased on nervous fibers distributed
throughout theauricleandispurely areflex. It iswiththissystem thatone uses
auriculotherapy toalleviatepain. Thesecond system rests upon theexistence of the
neuro-vascular complexes discovered bytheteamof Pr Senelar: OdileAuziech,
ClaudieTerral. On theexternal ear, thereexist cutaneous pointsof reduced electrical
resistance thatcorrespond tohistological microformations made upof anerve, a
lymphatic vessel, asmall artery, andaveinule. It isthese microformations that are
called neuro-vascular-complexes. Stimulationof these complexes by infrared light
modifies thetemperatureandthethermal regulation of internal body organs, thus
modifying their function.
Schematically, theexternal ear islikeacomputer keyboard which acts on thewhole
organismthrough theintermediaryof thecentral nervous system andtheauricular
micro-hormonal system. Thisauricular system hastwotypes of computer keys, one set
connected tothespinothalamic system that modulates painperception andanother set
which initiatestherelease of activehormonal substances which modify specific internal
organs. When looking at theear, one will obtainadifferent effect if aneedle isused, or
alaser light, or amagnetic field. As witheverythinginmedicine, great skill isrequired
tomaster thistechnique. Thecomputer keyboard on theear allowsclinicians to
effectively treatpain, functional disorders, addictive problems, andminor psychiatric
disorders.
It iswell known that Paul Nogier, myfather, discovered thesomatotopic properties of
theexternal ear. Therearejust afewfortunatepeople whonot only dream, but whoare
able tocarry out their dreams andbringthemintoreality. Paul Nogier wasat thesame
timeamanof innovativethoughts andaman of productive action. Hewasagifted
clinician of exceptional abilities whoattentivelylistened tohispatients, respected what
they had tosay, andthoroughly investigated their maladies. Tirelessly, heexamined
patientsfromMondaymorningtoSaturdayevening, tryingtounderstandandtocure
their illnesses. Onecannot understandthework of Paul Nogier without knowinghis
character. Hewasamanwhospent much of histimeproposing sometimes
contradictory newideas, themajorityof which fell bythewayside. Nevertheless, his
most original ideas remain: thesomatotopic representations on theear, thevascular
autonomic signal, andthetreatment effect of specific frequencies. It isfor these
discoveries that many students followed himso devotedly. At thesame time,
confronted withso much apparent inconstancy, much of theteachingbythisgreat
master wasnot understood or fell out of favor.
Foreword ix
Thisthirdedition of theAuriculotherapy Manual strives tobringcloser together
Western neurophysiological concepts andOriental energetic concepts asthey relateto
auriculotherapy. Dr Oleson livesinastateinthe USA which also assimilates Western
and Easterncultures. Perhapsonly inCaliforniacould onebeable todo thework that
hehas done. Inthethirdedition of thisbook, theorigins of auriculotherapy aretraced
tohistorical sources inthe West aswell asChina. The use of acupuncture pointson the
external ear hashadalong traditioninOriental medicine, which expanded ina
different direction withtheintroduction of thesomatotopic ear chartsdeveloped by
Paul Nogier. At thesame time, interest inauricular medicine brought greater attention
tothepractice of classical acupuncture inEurope.
Thisbook explores abroad rangeof theoretical perspectives that havebeen developed
tounderstandtheunderlyingbases of auriculotherapy. Thesomatotopic features of
multiplemicro-acupuncture systems, the relationship of ear acupuncture toother
concepts inOriental medicine, andholographic models areall described ina
comprehensive manner. Neurophysiological investigations of auricular acupuncture,
andtherole of hormonal substances such asendorphins, aresubstantiatedwith
numerous scientific studies. Artisticillustrationsrevealingtheanatomical regions of
theexternal ear facilitategreater comprehension of the correspondences between the
ear andthebody. Theauricular zone system developed by Dr Oleson provides
clinically useful reference guidelines for conducting auricular diagnosis and
auriculotherapy treatments. The predominant portion of thisbook presents several
hundredear acupuncture points organizedbymajor anatomical systems. Auricular
representation of themusculoskeletal system, visceral organs, endocrine glands, and
thenervous system aredifferentiated by their anatomical location andclinical
function.
Thetreatment plans presented at theendof thisbook integrateear acupuncture points
discovered intheWest aswell asinChina. InEuropean applications of auricular
medicine, greater emphasis isplaced upon palpationof thevascular autonomic signal
todetermine thereactivity of anear point anditsappropriateness for treatment. This
book isaveryimportant contribution tothefield of health care intheWest andthe
East. DrOlesons work issignificant. Evenif I ardentlydefend theWestern
conceptualizations of auricular acupuncture based upon theears uniquephysiology, I
wishthat hishook meets thesuccess which itwell deserves,
x
Lyon, July 2003
Foreword
Raphael Nogicr MD
Preface
When one hasbeen on ajourney for almost threedecades, itisnot uncommon to
wonder howthejourney first began. For me, theexploration of thefascinating field of
aurieulotherapy startedwithanafternoon lecture I heardwhilecompleting my
graduatestudies at theUniversity of Californiaat Irvine(UCI ). Thepresentation itself
had nothingtodo either withacupuncture or theexternal ear, but itstimulated my
mind tobedrawntoapath that continues toexcite mestill. The UCI Departmentof
Psychobiology sponsored aweekly guest lecturer series that brought invisitingfaculty
fromall over theUnitedStates, but thatdays presenter wasfromour neighboring
Californiacampus at UCLA. Dr J ohn Liebeskind mesmerized mewithhispioneering
research on aconcept that, in1972,wascompletely newtothefield of neuroscience.
Hislaboratory haddemonstrated thatelectrical stimulation of theperiaqueductal gray
of thebrainstemcould inhibit behavioral reflexes topainful stimuli. While thesensory
pathways that carry pain messages tothebrainhadbeen thoroughly investigated, the
laboratory of Dr Liebeskind provided thefirst scientific indication thatthebrain has
thecapability toturnoff pain aswell asrespond topain. It wasseveral years later that
subsequent studies would discover endorphins, themorphine-like substances that
serve asthebodys naturallyoccurring analgesic. What had made theLiebeskind
research so impressive wasthattheanalgesia produced byelectrical stimulationcould
beblocked bythechemical antagonist tomorphineknown asnaloxone. I wrote to
Dr Liebeskind after thelecture, met withhimat UCLA, andsoon submitted an
application for afederally funded postdoctoral scholarship workinginhislaboratory. As
mydoctoral dissertation examined thefiringpatternsof neurons inthesomatosensory
andauditorypathways duringPavlovianconditioning, mypostdoctoral grantsought to
examine neural firingpatternsinthebrainpathways related totheinhibitionof pain
sensations.
InJ ungianpsychology thereistheconcept of synchronicity, ameaningful coincidence
of separateevents thatdo not seem causally connected (J ung1964). J unghimself
noted that theclassical Chinese texts didnot ask, What causes anevent?, but instead,
What likes tooccur withwhat?Toooften, individualsfail tonotice such synchronistic
events, dismissing themasrandomcoincidences. I can often observe such events only
inretrospect. I began mywork inDr Liebeskinds labafter receiving myPhD in
Psychobiology in1973.It so happened thattheneuroscience laboratories at theUCLA
Departmentof Psychology wereinthebasement of an l l-storybuilding. After awalk
down along underground hallwayonearrivedat theUCLA Acupuncture Research
Clinic. What first drew metothatendof thebuildingwasastrangesmell which seemed
likemarijuana,but infact wastheChinese herb moxa. While I conducted animal
research experiments duringtheday, I began spending more of myfree timehours
interactingwiththedoctors investigatingtheeffects of acupuncture. In 1974,UCLA
wasone of only afew, major US universities toexplore themultipledimensions of
alternativemedicine. TheUCLA painclinic successfully treatedhundreds of chronic
pain patientswithacupuncture, biofeedback, hypnosis, guided imagery andnutritional
counseling. Thedirectors of theclinic, Dr DavidBresler andDr RichardKroening,
invitedmetotheir offices one afternoon andasked metobe their research director. It
waslikeaninvisibleforce pushed mefrombehind asI leaped at theopportunity. I did
not haveanyacupuncture skills, but asapsychologist I hadextensive trainingin
conducting research. And thusbegan theamazingjourney.
Thefirst research project thatweundertook wastoexamineauricular diagnosis, rather
thanconduct aclinical outcome study. At that time, themedical profession devalued
acupuncture assimply aplacebo, but adiagnostic study could not becontaminated bya
patientsdesire toplease their practitioner. It took several years todesign theresearch
andcollect thedata, but therewasanenergizingatmosphere affecting everyone
participatingintheclinic that made itagreat pleasure towork there. I wassurprised
myself when theresults werefinallyanalyzed andtherewassuch astrongstatistical
finding. Byjust examiningtheexternal ear, andblind toapatientsdiagnosis, a
physician could identify thepartsof thebody whereapatient hadreported
musculoskeletal pain. While I wasinitiallyonly ascientific observer of such
Preface xi
phenomena, I subsequently took numerous classes andseminars inauriculotherapy
andbody acupuncture. Therewerenot many US acupuncture schools at thattime, but
therewere plenty of teachers. While mostly unknowninthewhite, black andHispanic
partsof Los Angeles, therewere alargenumber of practitioners of Oriental medicine
intheAsian districts. Theywereverywillingtosharetheir knowledge of their ancient
andalmost mystical arts. Itwasonly after I presented theresults of theauricular
diagnosis research tothe I nternational Society for theStudy of Painthat I learned of
thewhole field of auricular medicine thatispracticed inEurope. American doctors
prefer theelectrical detection andtreatment of acupuncture pointsmore thanAsian
doctors, andseveral electronic equipment manufacturers sponsored seminars that
incorporated thework of European aswell asChinese acupuncturists. I had readabout
thepioneering auriculotherapy work of DrPaul Nogier, but I began studyingwith
physicians whohadactually studiedwithhiminFrance. Dr Tsun-NinLee sponsored a
presentation byNogier inSanFrancisco, anditwasthen thatI first had theopportunity
tomeet thisgreat man. Dr Nogier only spoke inFrench, so DrJ oseph Helms had to
translatethematerial intoEnglish. It isnot alwayseasy tolisten tolectures asthey are
translated, but DrNogier held theaudience enthralled. Hehad readof myresearch on
auricular diagnosis and made aspecial invitationtomeet withme, which I wasvery
glad toaccept. I had threemore opportunities tomeet withhimpersonally at
international congresses inEurope, andit alwaysseemed likeanhonor. I always
wished that I hadmore timetoupgrademyhigh school French so that I could converse
withhimmore fluently, but it isveryintriguingthat ameetingof minds can occur
beyond ones linguistic abilities. I feel veryfortunatetohavereceived individual
guidance on understandingtheunderlying mechanisms thatcan account for the
impressive benefits of auriculotherapy.
Dr RichardKroeninghad once told me that inmedical school, when learninganew
medical procedure, themotto issee one, do one, teach one. While not progressing
quitethatfast, I havenowhad theoccasion toteach courses inauriculotherapy at
colleges anduniversitiesacross theUnitedStates. Theadagethat one learnsfrom
ones students continues toapply even after 20years of teaching. Studentscome tome
andinformmeof patientsthey havetreatedwithauriculotherapy for unusual
conditions that I haveonly studied inbooks. While they tell methat they learned how
todo such treatmentsfrom earlier editions of myAuriculotherapy Manual, theclinical
contents of thismanual did not begin withme. Theworks of many acupuncture masters
inAsia, Europe, andAmerica inspired metocompile their teachings inameaningful
way. I also had thegood fortunetoconnect withDrJimShores whoco-sponsored the
I nternational Consensus Conference on Acupuncture, Auriculotherapy, andAuricular
Medicine in1999.It wasmycontinued efforts tounderstandthisunusual clinical
procedure thathas led tothismost recent edition. Thatstimulationof the external ear
can affect conditions inother partsof thebody does not seem intuitivelyobvious. Even
after treatinghundreds of patientswiththisapproach, it continues toamazemethat it
can work. Thepurpose of thisbook istoexplain both the theoretical basis andthe
clinical practice of auriculotherapy so thatothers mayknow of itsvalue.
I would liketoacknowledge TimMcCracken, Jan J ames, andSinuheAlberto Avalos
for their invaluableassistance inproducing thisbook. I wanttoalso thankDannyWatts
for hiswillingness toserve asthemodel for thehumanfigures used inthisbook.
xii
Los Angeles 2003
Preface
TerryOleson
Auricular microsystem points
Master points and landmarks
Musculoskeletal points
Ankle.C Toes.C
Chest
Arm
Elbow
Abdomen
SkinDisorder.E
SkinDisorder.C
...---Hand
__ Wrist
Shoulder
Neck
Master Shoulder
Occiput
TM]
Hip.C
Knee.C
Face Eye
CS;l..
Depthview ~
Auricular somatotopic map
on posterior of ear
Dental Analgesia
Forehead
Hip.E
Heel.E
Heel.C
Toes.E
Ankle.E
Knee.E
Inner Nose.C
Inner Ear.E
Cervical Spine.-"."
Temples
EyeDisorder 1
EyeDisorder 2
Sacral Spine
l.umbar Spine
Thoracic Spine
External Ear.C--+--...(
MuscleRelaxation
LM7
.Apex of Ear
/ Hepatitis.C
I __ t : ~ __ / Prostate.C
"Sciatic Nerve
Bladder
Kidney.C
/ Lesser Occipital Nerve
(WindStream.C)
Adrenal Gland.E
Small Intestines
/Spinal Cord
Heart.E
Pancreas
Spleen.E
Stomach
-Liver
ThyroidGland.E
Spleen.C
Lung1
------ThyroidGland.C
Heart.C
Brainstem.C
Antidepressant point
" "Brain.C
Asthma
".. -, Hippocampus (memory)
Gonadotropins (FSH, Ovaries.C)
Amygdala (aggressiveness)
Antihistamine
Internal organ and neuroendocrine points
Autonomic point
Omega 2
Hypertension -. \
Uterus.C
Kidney.E
Constipation
Psychosomatic
Reactions
ExternalGenitals.C
Uterus.E _____
Largeintestines
Diaphragm.C
Ovaries/Testes.E ~ __
ExternalGenitals.E
Mouth
Vitality point ---
Throat.C
Throat.E
Appetite Control
Adrenal Gland.C- ~ , ,
Lung2
San[iao >:",
ACTH/ /
Pineal Gland/
PituitaryGlancY
TSH/ /
Frontal Cortex/
LimbicSystem/
(Prostaglandin)
.C- Chinese ear reflex point
"E- European ear reflex point
e2003Elsevier Science Limited
Anatomical zones of the ear
Inverted fetusmap
AZ Auricular anatomy
HX Helix
AH Antihelix
LO Lobe
TG Tragus
AT Antitragus
IT Intertragic Notch
SF Scaphoid Fossa
TF Triangular Fossa
SC Superior Concha
IC Inferior Concha
CR Concha Ridge
CW Concha Wall
ST Subtragus
IH Internal Helix
PL Posterior Lobe
PG Posterior Groove
PT Posterior Triangle
PC Posterior Concha
PP Posterior Periphery
Depth view
Antihelix
TF 3 inferior
:;':'"'---.lL- crus
Antihelix
body
AMAH10
--I:r
C 8 ~
AH 8 Antihelix
tail
o SF 1
~ 1 J f ~
IC8. C':JI "e
Frequency zones
Posterior viewof auricular zones
if) 2003 Elsevier Science Limited
Surface viewof auricular zones
Hidden viewof auricular zones
II
Overview and history of
auriculotherapy
1.1 Introductiontoauriculotherapy
1.2 Health care practitioners using auriculotherapy
1.3 Historical overview of auriculotherapy
1.4 Earacupuncture developments inChina
1.5 Auriculotherapy and auricular medicine intheWest
1.6 Comparison of ear acupuncture to body acupuncture
1.1 Introduction to auriculotherapy
Auriculotherapyisahealthcaremodalityinwhichtheexternal surfaceof theear, orauricle, is
stimulatedtoalleviatepathologicalconditionsinotherpartsof thebody.Whileoriginallybased
upontheancientChinesepracticeofacupuncture,thesomatotopiccorrespondenceofspecific
partsof thebodytospecificpartsoftheear wasfirstdevelopedinmodernFrance.Itisthis
integratedsystemofChineseandWesternpracticesof auriculotherapythatisdescribedinthis
text.
1.2 Healthcare practitioners using auriculotherapy
Acupuncturists: Thepracticeofclassical acupunctureandTraditionalChineseMedicine(TCM)
includestheinsertionof needlesintoearacupointsaswell asbodyacupuncturepoints.Thesetwo
approachesofstimulatingacupuncturepointsonthebodyortheearcanbeusedinthesame
treatmentsessionorindifferentsessions. Someacupuncturistsstimulateearreflexpointsasthe
solemethodof theiracupuncturepractice,oftenfindingthatitismorerapidinrelievingpainand
moreeffectiveintreatingsubstanceabusethanbodyacupuncture.
Biofeedback therapists: Whereasbiofeedbackisveryuseful inteachingpatients
self-control techniquestoachievegeneral relaxationandstressmanagement,auriculotherapy
augmentsbiofeedbackproceduresbyproducingmoredirectandimmediatereliefof myofascial
painandvisceral discomfort.
Chiropractic doctors: Auriculotherapyhasbeenusedtofacilitatespinal manipulations,deep
tissuework, andmotorpointmassage. Stimulationof auricularpointsreducesresistancetothe
releaseof musclespasmsandthecorrectionofposturalpositionsbychiropracticadjustments.
Whenauriculotherapyisappliedafteramanipulativetreatment,ittendstostabilizepostural
realignmentsachievedbyachiropracticprocedure.
Dentists: Auriculotherapyhasbeenusedtoachievedentalanalgesiafor thereliefof acutepain
fromeitherdental drillingorteethcleaningprocedures.Forchronicproblems,suchasheadaches
and temporomandibularjoint(TMJ)dysfunction,auriculotherapycanbecombinedwithtrigger
pointinjections,dentalsplints, andocclusal work, thusfacilitatingmoresuccessful alleviationof
chronicheadandneckpain.
Medical doctors: Physiciansspecializinginanesthesiology, surgery, internalmedicine,andfamily
practicehaveemployedauriculotherapyfor themanagementofchronicpain, thetreatmentof
acutemusclesprains, andthereductionofunwantedsideeffects fromnarcoticmedications.
Whetherpracticedbythemselves, orbymedical assistantsworkingunderthem, auriculotherapy
hasbeenusedtoalleviateavarietyofsomaticcomplaintsseen instandardmedical practice.
Naturopathic doctors: Naturopathicpractitionersoftenincludeauriculotherapyalongwith
homeopathic,nutritionalandpreventivemodalities.Auriculardiagnosishasbeenusedto
Overviewandhistory 1
2
determinespecificallergiesandappropriateherbal recommendations.Auricularstimulationcan
relievedistressoriginatingfromdysfunctionalinternalorgans.
Nurses: Thestandardmedical careprovidedbynursescanbegreatlyassistedbytheapplication
of auriculotherapyforthesystematicreliefof painandpathologythatisnotadequatelyalleviated
byconventionalmedicationsorprocedures.
Osteopathicdoctors: Auriculotherapyhasbeenusedtofacilitatethecorrectionof misaligned
vertebrae,toreduceseveremusclespasms, andtoaugmentpainmanagementprocedures.
Physical therapists: Auriculotherapyisapowerful adjuncttotranscutaneouselectrical nerve
stimulation(TENS), traction,ultrasound,andtherapeuticexercisesfor thetreatmentof acute
whiplashinjuries,severe musclespasms, orchronicbackpain.
Psychotherapists: Psychiatristsandpsychologistshaveemployedauriculotherapyfor the
reductionof anxiety, depression,insomnia,alcoholism,andsubstanceabuse.
Reflexologists: Tactilemanipulationof reflexpointsontheearcanbecombinedwithpressure
appliedtotenderregionsof thefeet andhandsinordertorelievespecificbodyachesandinternal
organdisorders.
1.3 Historical overview of auriculotherapy
Ancient China: All recordedsystemsofclassical acupunctureareattributedtotheChinese
medical text, theYellowEmperorsclassic ofinternalmedicine(Veith 1972),compiledbetween206
BCE and220CEoInthistext, all sixyangmeridiansweresaidtobedirectlyconnectedtothe
auricle. Onlytheyangmeridianchannelstravel toorfromthehead,whereasthesixyinmeridians
weresaidtoconnecttotheearindirectlythroughtheircorrespondingyangmeridians.These
ancientChineseearacupuncturepoints,however, werenotarrangedinananatomicallyorganized
pattern.Theyweredepictedontheearasascatteredarrayof non-meridianpoints,withno
apparentlogical order.Reactiveearacupointsthatweretendertopalpationwerereferredtoas
yangalarmpoints.
Ancient Egypt,GreeceandRome: TheEgyptologistAlexandreVarillehasdocumentedthat
womeninancientEgyptwhodidnotwant anymorechildrensometimeshadtheirexternal ear
prickedwithaneedleorcauterizedwithheat. GoldearringswornbyMediterraneansailorswere
notjustusedasdecorations,butweresaidtoimprovevision. Hippocrates,thefatherof Greek
medicine, reportedthatdoctorsmadesmall openingsintheveinsbehindtheeartofacilitate
ejaculationandreduceimpotencyproblems.Cuttingof theveinssituatedbehindtheearwasalso
usedtotreatsciaticpains. TheGreekphysicianGalenintroducedHippocraticmedicinetothe
RomanempireinthesecondcenturyCE, andcommentedonthehealingvalueofbloodlettingat
theouterear.
Ancient Persia: After thefall of Rome, themedical recordsofEgyptian,Greek, andRoman
medicinewerebestpreservedinancientPersia. IncludedinthesePersianrecordswerespecific
referencestomedical treatmentsforsciaticpainproducedbycauterizationoftheexternal ear.
EuropeanMiddleAges: TheDutchEastIndiaCompanyactivelyengagedintradewithChina
fromthe1600sto1800s.Aswell assilk,porcelain,tea, andspices, Dutchmerchantsbrought
ChineseacupuncturepracticesbacktoEurope.Doctorsworkingwiththecompanyhadbecome
impressedbytheeffectivenessofneedlesandmoxafor relievingconditionssuchassciaticpainand
arthritisof thehip.Thispainreliefcouldbeobtainedbyneedlesinsertedintobodyacupoints,by
thecauterizationoftheexternal ear, orbycuttingtheveinsbehindtheears.
ModernEurope: In1957,DrPaul Nogier,aphysicianresidinginLyons, France,firstpresentedhis
observationsof thesomatotopiccorrespondencesoftheauricle. ConsideredtheFatherof
Auriculotherapy,DrNogieroriginatedtheconceptof aninvertedfetusmapontheexternal ear.
Hedevelopedthepropositionafternoticingscarsontheearsof patientswhohadbeensuccessfully
treatedfor sciaticpainbyalayhealer. NogiersresearchwasfirstpublishedbyaGerman
acupuncturesociety, wasthencirculatedtoacupuncturistsinJapan,andwasultimatelytranslated
intoChinese,for distributiontoacupuncturiststhroughoutChina.TheMedical StudiesGroupof
Lyons(GLEM)wascreatedtofurtherexploretheclinical benefitsof auricularmedicine.
AuriculotherapyManual
ModernChina: After learningabouttheNogierearchartsin1958,amassivestudywasinitiated
bytheNanjingArmy EarAcupunctureResearchTeam.ThisChinesemedical groupverifiedthe
clinical effectivenessof theNogierapproachtoauricularacupuncture.Theyassessed the
conditionsofover 2000clinical patients,recordingwhichearpointscorrespondedtospecific
diseases. Aspartof MaoTseTungseffortstode-WesternizeChinesemedicine,barefootdoctors
weretaughttheeasilylearnedtechniquesofear acupuncturetobringhealthcaretotheChinese
masses. Inthe1970s,theHongKongphysicianHLWenconductedthefirstclinical studiesonthe
useofear acupunctureforopiatedetoxification(Wen&Cheung1973;Wen1977;Wenetal. 1978,
1979).
ModernUnitedStates: Beginningin1973,clinical workbyDrMichael SmithatLincolnHospital
inNewYorkledtotheapplicationofauricularacupunctureforwithdrawingaddictsfromopiate
drugs, crackcocaine, alcohol, andnicotine(Patterson1974;Sacks1975;Smith1979).Thefirst
doubleblindevaluationof auriculardiagnosiswasconductedin1980,attheUniversityof
CaliforniaatLosAngeles (Olesonetal. 1980a).Thelocalizationof musculoskeletal painwas
establishedbyoneinvestigator,thenaseconddoctorexaminedtheauricleforspecificareasof
heightenedtendernessandincreasedelectrical conductance.Earpointsidentifiedasreactivewere
significantlycorrelatedwithspecificareasofthebodywheresomepainordysfunctionhadbeen
diagnosed.Trainingprogramsontheprotocolof usingfiveear acupuncturepointsforsubstance
abusetreatmentledtotheformationoftheNationalAcupunctureDetoxificationAssociation
(NADA) (Smith1990).Anotherorganization,theAmericanCollegeofAddictionologyand
CompulsiveDisorders(ACACD), hastrainedchiropracticandmedical doctorsinthetreatmentof
addictionwithauricularstimulation(Holderetal.2001).In1999,theInternationalConsensus
ConferenceonAcupuncture,Auriculotherapy,andAuricularMedicine(ICCAAAM) brought
togetherauricularmedicinepractitionersfromAsia, Europe,andAmericatoestablisha
consensusonthecurrentunderstandingofauricularacupunctureasitispracticedthroughoutthe
world.TheAuriculotherapyCertificationInstitute(ACI)wasestablishedin1999tocertify
practitionerswhohaveachievedahighlevel of masteryinthisfield.
Figure 1.1 AncientChinesechartsindicatinglocationofacupuncturemeridianchannelsinthreedifferentpresentations.
Overviewandhistory
3
4
World Health Organization (WHO): Internationalmeetingsof theWHOsoughttostandardize
theterminologyusedforauricularacupuncturenomenclature.Consensusconferenceswereheld
inChina,Korea, andthePhilippines,from1985to1989.At the1990WHOmeetinginLyons,
France, doctorsfromAsia, Europe,andAmericaagreedtofinalizethestandardizationof names
forauricularanatomy(Akerele1991;WHO1990a).Aconsensuswasarrivedatfor the
identificationofear pointsaccordingtoChineseandEuropeanearacupuncturecharts.
1.4 Ear acupuncture developments inChina
Classical acupuncturewasfirstdevelopedinChinaover 2000yearsago. Itshistorical rootshave
beenintriguinglydocumentedinUnschuldsMedicineinChina(1943),ChenshistoryofChinese
medicalscience (Hsu&Peacher 1977),EckmansInthefootstepsoftheYellowEmperor(1996),and
Huan&RosesWhocanridethedragon? (1999).Aswithprimitivemedical practiceinotherparts
oftheworld, Chineseshamanssoughttowardoffevil demonsthattheyperceivedasthesourceof
diseases; theyenlistedancestral spiritsfor assistanceinhealing.ThephilosophiesofTaoism
(Oaoism),Confucianism,andBuddhismeachinfluencedsubsequentmedical developmentsin
China.Mystical spiritualbeliefswerecombinedwithphysical observationsofclinicallyeffective
treatments.Metaphoricalreferencestolightanddark,sunandmoon,fireandearth,metal and
wood, all contributedtotheChineseunderstandingofdisease. Themicrocosmof mankindwas
relatedtothemacrocosmof theuniverse, withsystematiccorrespondencesbetweenthevisibleand
theinvisibleworlds.
Humanpainandpathologywereattributedtodisturbancesintheflowofqi (pronouncedchee)
alongdistinctenergychannelscalledmeridians.Thecirculationofthisvapor-like,invisibleenergy
throughholesintheskinwassaidtobefacilitatedbytheinsertionof needlesintospecific
acupuncturepoints.TheHuang-di-nei-jingtextattributedtotheYellowEmperorhadreferredto
360suchholesassuitablefor needling(Veith1972).TheemperorHuangDi purportedlycameto
power in2698BCE, andtheNei lingwaspresentedasadialoguebetweentheemperorandhis
healthminister.However, currentscholarssuggest thattheNei lingwasactuallywrittenmuch
later, inthesecondcenturyBCE. Thefirstrecordingof medical informationbycarvingsonflat
stones, turtleshells, andbambooslipsdidnotoccur until 400BCE, andpaperwasnotinventedin
Chinauntil 150CEoAcupunctureneedleswerefirstmadefrombonesandstones, andlaterfrom
bronzemetal. In1027CE, afull-sizedfigureofamanwascast inbronzetoguidemedical
practitioners.Over thesurfaceof thisbronzestatuewaslocatedaseriesof holesthatcorresponded
tothelocationsofacupuncturepoints.Orientalmedicinewasacompletetreatmentsystembased
upontheempirical findingsthatexaminedtheclinical efficacyof needlingacupuncturepoints.
OrGongSunChenoftheNanjingMedical University, hasreportedthattheNei lingincluded
numerousreferencestothetheoriesandexperiencesof usingauniqueear channel (Chen&Lu
1999).Theearwasnotconsideredanisolatedorgan,butwasintimatelyconnectedwithall organs
of thebody,thefiveviscera(liver, heart,spleen, lungs,kidneys), andthesixbowels(stomach,small
intestine,largeintestine,gall bladder,bladder,andsanjiaoor triplewarmer).Examinationsof the
earwereusedasameansfor predictingtheonsetofailmentsandtherecoveryfromdisease. Ear
acupuncturecouldtreatavarietyofdiseases, suchasheadaches, eyedisease, asthma,facial nerve
paralysis, andstomachaches.
AccordingtoHuang(1974),theNei lingfurtherstatedthatbloodandair(subsequentlytranslated
asbloodandqi)circulatethrough12meridiansandtheir365accessory pointstoinfiltratethefive
senseorgans, sevenorifices, andbrainmarrow.Huangfurthernotedthatthemeridianof the
lesser yangof thehandweresaidtoextendupwardstowardthebackof theear. Themeridianof
thegreatyangof thefootextendedtotheuppercornerof theear. Thecirculationof thesixyang
meridianspasseddirectlythroughtheear,whilethesixyinmeridiansjoinedwiththeir
correspondingyangmeridians.InspectionofancientandmodernChineseacupuncturecharts
demonstratesthatonlytheStomach,Small Intestines,Bladder,Gall BladderandSanJiao
meridianchannelscirculateinfrontofor aroundtheexternal ear, withtheLargeIntestines
channel runningnearby.
Thephrasemeridianchannelisactuallyredundant,butbothwordswill sometimesbeusedinthe
presenttexttohighlighttheOrientalmedicineapplicationof theseterms. Somemeridiansare
referredtoasfuchannelsthatcarryyangenergytostrengthentheprotectionof thebodyfrom
AuticulotherepyManual
external pathogenicfactorsandfromstress. Thezangmeridianchannels,whichcarryyinenergy,
originateorterminateintheinternalorgansof thechestandabdomen,buttheydonotprojectto
theheador ear. Byconnectingtotheircorrespondingfumeridianwhentheycametogetheratthe
handorfoot, thezangchannelswereabletointeractwithacupuncturepointsontheear. The
microcosmoftheearwassaidtohaveenergeticcorrespondencewiththemacrocosmof thewhole
body,andthemicrocosmofthewholebodywassaidtohavecosmiccorrespondencewiththe
macrocosmoftheuniverse. TheChineseperceivedhealthdisordersasafunctionofthe
relationshipsof theseenergeticsystems, ratherthanacausal effect ofspecificgermsproducing
specificdiseases.
VariouseartreatmentsforcuringdiseasesweretracedbyHuang(1974)tothe281CEChinesetext,
Prescriptionsforemergencies. Anotherancienttext,Thousandgoldremedieswrittenin581CE, stated
thatjaundiceandavarietyofepidemicswerereportedlycuredbyapplyingacupunctureand
moxibustiontotheupperridgeinthecenteroftheear. Thestudyofeightspecialmeridians,published
in1572,containedreportsthatanetworkconnectingall theyangmeridiansalsopassedthroughthe
headtoreachtheear. Theearwasthussaidtobetheconvergingplaceofthemainmeridians.Itwas
recordedinMysticalgate: pulsemeasurementthatair(qi)fromthekidneyisconnectedwiththeear. In
1602,Criteriaindiagnosisandtreatmentsuggestedthatwhenairinthelungsisinsufficient,theear
turnsdeaf. Thisworkstatedthat:
Lungcontrolsair(qi), whichspreadsall overthebodytoconvergeintheear. Theearisconnectedto
everypartofthebodybecauseoftheceaseless circulationofair(qi)andbloodthroughthese
meridiansandvessels. Theouterandinnerbranchvesselsservethefunctionofconnectingwiththe
outerlimbstoformtheharmoniousrelationshipbetweentheear, thefourlimbs,andahundred
bones.Theearjoinswiththebodytoformtheunified,inseparablewhole,atheorywhichformsthe
basisfordiagnosisandtreatment.
Also printedin1602,Thecompendiumofacupunctureandmoxibustionrecordedthatcataracts
couldbecuredbyapplyingmoxibustiontotheearapexpoint.Thisbookalsodescribedusingones
twohandstopull downtheearlobestocureheadaches.As lateas1888,duringtheQingdynasty,
thephysicianZhangZhendescribedinLi ZhenAnmoYaoShuhowtheposteriorauriclecouldbe
dividedintofiveregions, eachregionrelatedtooneofthefivezangorgans.Thecentral posterior
auriclewassaidtocorrespondtothelung, thelateral areatotheliver, themiddleareatothe
spleen,theupperareatotheheart,andthelower areatothekidney. Massagingtheearlobewas
usedtotreatthecommoncold, needlingthehelixcouldexpel windandrelievebackaches,while
stimulationoftheantihelixandantitraguswasusedtotreatheadachesduetowind-heatand
pathogenicfire.
Duringthemedieval periodinEurope,Westernphysicianscutopenmajorveinsonseriouslysick
patientsinordertoreleaseevil spiritsthatweresaidtocausedisease. Chinesedoctorsconducted
amuchlessbrutalformof bloodlettingbyprickingtheskinatacupointstoreleasejustafew
dropletsof blood. Oneof theprimaryloci usedforbloodlettingwastoprickthetopof theexternal
ear. Throughouttheirmedicine,Chinesedoctorssoughttobalancetheflowof qi andblood. By
drainingsurplusesof spirit, orbysupplementingdepletionsof subtleenergies, Orientalmedicine
providedhealthcaretotheChinesemasses throughouttheseveral thousandyearsoftheHan,Sui,
Tang,Song, Mongol,Ming,andManchudynasties. However,widespreaduseof acupuncturein
Chinadiminishedinthe1800s,whenChinabecamedominatedbyimperialistpowersfrom
Europe.In1822,theministerofhealthfor theChineseEmperorcommandedall hospitalstostop
practicingacupuncture,butitsusenonethelesscontinued.Whiletheapplicationof Western
medical proceduresbecameincreasinglyprominentinthelargecitiesof China,healthcare
practicesinruralChinachangedmuchmoreslowly.
TherewasasubsequenterosionoffaithintraditionalOrientalmedicinefollowingthedefeatof
ChinesemilitaryintheOpiumWarsofthe1840s.BritishmerchantswantedtopurchaseChinese
teaandsilk,buttheywereconcernedaboutthehugetradeimbalancecreatedwhentheChinese
didnotwant tobuyEuropeanproductsinreturn.Theirsolutionwasopium.Althoughtheemperor
forbadeitsimportation,smugglerswerehiredtosneakopiumintoChina.WhenChineseofficials
burnedawarehouseoftheBritishEastIndiaCompanystockedwithsmuggledopium,theBritish
parliamentclaimedanattackonBritishterritoryasjustificationfor thedeclarationofwar. The
ChineseshouldprobablyhaveimportedEuropeanweapons, for theyweresoundlydefeatedinthe
6
opiumwarswithGreatBritain.Theywereforced topaysubstantialsumsofcurrencyforthelost
Britishopiumandtosurrendertheterritoryof HongKong. Opiumhousesthenproliferatedand
theChineselostasenseofconfidenceinuniquelyOrientalmedical discoveries. Becausethe
Occidentaltradershadmorepowerful weaponsthantheChinese,itcametobebelievedthat
Westerndoctorshadmorepowerful medicine.TheChinesewereimpressedbyWesternscience
andbyEuropeanbiological discoveries. Antisepticpracticesthathadbeenintroducedfrom
Europegreatlyreducedpost-surgical infections.ThegermtheoryofWesternmedicinecameto
havegreaterrelevancefor healththantheenergetictheoryofqi.JesuitmissionariesinChina
utilizedthedisseminationofWesternmedicationsasamanifestationof thesuperiorityof their
Christianfaith. TheChinesegovernmentattemptedtosuppresstheteachingof Orientalmedicinc
asunscientific, issuingprohibitoryedictsin1914andagainin1929,yet thepracticeofacupuncture
continued.
Bythe1940s,however, EuropebecameembroiledinWorldWarII,andMarxismbecameamore
influentialWesternimporttoChinathanChristianity.After theCommunistrevolutionin1949,
MaoTseTungcalledfor arevitalizationof ancientChinesemethodsfor healthandhealing.
Acupuncturehaddeclinedinthelargecitiesof China,andthemainhospitalswereprimarilybased
onconventionalWesternmedicine.However, doctorsintheruralcountrysidesof Chinahad
maintainedtheancientwaysof healing. ItwasfromtheseruralroutesthatMaoderivedhis
militarypower, anditultimatelyledtoarenewedinterestinclassical Orientalpracticesof
acupuncture,moxibustion,andherbs. However, inadditiontoitscondemnationof bourgeois
Westernmedicine,Communistatheistsalsorejectedthemetaphysical,energeticprinciples
ofacupuncture.MaoistdogmaencouragedthedevelopmentofthemorescientificDialecticof
NatureandwhatisnowknownasTraditionalChineseMedicine(TCM).Nonetheless, theactual
practiceof acupuncturestill usedtheenergeticconceptsofyinandyang, thefiveelementsof
fire, earth,wood, water, andmetal, andtheeightprinciplesfor differentiatingmedical
syndromes.
Itwasfortuitousthatthediscoveriesof theearreflexchartsbyPaul NogierarrivedinChinain
1958,atthistimeof renewedinterestinclassical acupuncturetechniques.Theso-calledbarefoot
doctors,highschool graduatesgiven6monthsofmedical training,werealsotaughtthetechniques
of earacupuncture,andwereabletobringhealthcaretothelargepopulationsinurbanandrural
China. Withlittleplasticmodelsoftheinvertedfetusmappedontotheear, itwaseasy tolearnto
needlejust thepartof theearthatcorrespondtowherethepatientreportedpain.Althoughear
acupuncturewasusedacrossChinapriortolearningofNogierstreatiseonthesubject, itwasnot
practicedinthesamemanner.In1956,for example, hospitalsinShandongProvincereportedthat
theyhadtreatedacutetonsillitisbystimulatingthreepointsontheearhelixchosenaccordingto
folkexperience. GongSunChen(1995)hasconfirmedthatitwasonlyaftertheChineselearnedof
Nogiersinvertedfetuspictureof auricularpointsthatgreatchangesinthepracticeof ear
acupunctureoccurred.TheNanjingdivisionof themedical unitof Chinesemilitaryenlisted
acupuncturistsfromall over thecountrytoexamineandtotreatthousandsof patientswiththis
somatotopicauricularacupunctureprotocol.Theirreportonthesuccess of earacupuncturefor
several thousanddifferenttypesof patientsprovidedscientificreplicationof Nogiersworkandled
tobroadinclusionofthisapproachintraditionalChinesemedicine.
Anotherhistorianof Chinesemedicine, Huang(1974),alsostatedthat1958sawamassive
movementtostudyandapplyearacupunctureacrossthenation.Asaresult,general conclusions
weredrawnfromseveral hundredclinical cases, andthescopeof earacupuncturewasgreatly
enlarged.Shecontinues:however,certainindividualsbegantopromotetherevisionistlinein
medicineandhealth.Theyspreaderroneousideas, suchasChinesemedicineisunscientificand
insertionof theneedlecanonlykill painbutnotcuredisease. SincetheCulturalRevolution
dispelledtheseerroneousideas, earacupuncturehasbeenagainbroadlyappliedall over the
country.Huangobservedthat:
Themethodofear acupunctureisbasedonthefundamentalprincipleoftheunityofopposites. The
humanbeingisregardedasaunified, continuallymovingentity.Diseaseistheresultofstruggle
betweencontradictions.ByapplyingChairmanMaosbrilliantphilosophicalideas. wecan combine
therevolutionaryspiritofdaringtothinkanddaringtodowiththescientificmethodof
experimentationintheexplorationandapplicationofear acupuncture.
Tomodernreaders,itmightseemunusualthatCommunistpolitical rhetoricisintegratedwithina
medical text, butitmustberememberedthattheColdWar inthe1970sgreatlyisolatedChina
fromWesterninfluences. Huangalso includedmoremetaphysical influencesinChinesethought,
citingthetextMysticalgate: treatiseonmeridiansandvessels: theearisconnectedtoeverypartof
thebodybecauseof theceaseless circulationofenergyandbloodthroughthesemeridiansand
vessels. Theearjoinswiththebodytoformtheunified,inseparablewhole.
Medical researchinChinaintheyearssincetheintroductionof Nogierssomatotopic
auriculotherapydiscoverieshasfocusedontherelationshipofearacupuncturetoclassical
meridianchannels,theuseofearseedsaswell asneedlesfor thetreatmentofdifferentdiseases,
andtheuseof auriculardiagnosisasaguidefor recommendingChineseherbal remedies. Medical
conditionsweregroupedintothreecategories:
1. thosewhichcanbecuredbyauricularacupuncturealone
2. thosewhosesymptomscanbeatleast partiallyalleviatedbyauriculotherapy
3. thosewhereimprovementisseenonlyinindividualcases.
AuricularpointsinChinaareselectedaccordingtoseveral factors: thecorrespondingbodyregions
wherethereispainor pathology;theidentificationofpathologicallyreactiveearpointstenderto
touch;thebasicprinciplesof traditionalChinesemedicine;physiological understandingderived
frommodernWesternmedicine;andtheresultsofexperimentsandclinical observations.
Havingusedearacupuncturefor postoperativesymptoms,Wen&Cheung(1973)observedthat
opiateaddictedpatientsnolongerfelt acravingfor theirpreviouslypreferreddrug.TheShenMen
andLungearpointsusedfor acupunctureanalgesiaalsoaffecteddrugdetoxification.Wen
subsequentlystudiedalargersampleof opiumandheroinaddictswhoweregiven auricular
electroacupuncture.Bilateral,electrical stimulationbetweentheLungpointsintheconchaledto
completecessationof drugusein39of 40addicts. GiventhatitwasWesternmerchantswho
supportedwidespreadopiumabuseinChina,itisintriguingthataChineseauriculotherapy
treatmentfor drugaddictionisnowoneof themostwidelydisseminatedapplicationsof
acupunctureintheWest.
TherearedistinctdiscrepanciesbetweenOrientalandWesternearcharts.Distortionsmayhave
appearedinthetransmissionof earmapsfromFrancetoGermanytoJapantoChina.Inaccuracies
couldhavebeenduetomistranslationbetweenEuropeanandAsianlanguages. Moreover,
drawingsoftheconvolutedstructureof theauriclehavebeenthesourceofmanydiscrepancies
regardingtheanatomicalareasof theearbeingdescribed. TheChinese,however, maintainthat
theearacupuncturepointsusedintheirtreatmentplanshavebeenverifiedacrossthousandsof
patients.Chineseconferencescompletelydevotedtoresearchinvestigationsof earacupuncture
wereheldin1992,1995and1998,andtheChinesegovernmentauthorizedacommitteeto
standardizethenameandlocationof auricularpoints.Thiscommitteedesignatedthelocalization
of 91auricularpoints,standardizedalongguidelinesestablishedbytheWorldHealth
Organizationin1990(Zhou1995,1999).
1.5 Auriculotherapy and auricular medicine intheWest
AlthoughacupuncturewasmostlyunknownintheUnitedStatesuntilPresidentNixonvisited
Chinain1972,acupuncturehadbeenintroducedtoEuropeseveral hundredyearsearlier.A 16th
centuryphysicianworkingfor theDutchEastIndiaCompany,DrWillemTeRhyne,wasoneof the
first Westernpractitionerstodescribetheimpressivecurativepowersofacupuncture.Medical
interestinacupuncturewaxedandwanedinEuropeover thefollowingcenturies.Itwouldelicit
greatexcitement,thenbedismissedandgiven upasunreliablefolk medicine,yet subsequentlybe
rediscoveredasanewmethodof healing. Inthe19thcentury,theFrenchAcaderniedesSciences
appointedacommissiontostudyacupuncture.GustafLandgarenofSwedenconducted
acupunctureexperimentsonanimalsandonhumanvolunteersat theUniversityofUppsalain
1829.Sporadicreportsoftheuseof acupunctureneedleswereincludedinEuropeanmedical
writingsfor thenext several centuries.
Itwasintheearly1900sthatinterestinacupuncturewas onceagainrevivedinEurope.From1907
to1927,GeorgesSouliedeMorantservedastheFrenchconsul toChina.StationedinNanjingand
Shanghai,hebecamevery impressedbytheeffectiveness ofacupunctureintreatingacholera
Figure 1.2 Participantsatthe1990WorldHealthOrganizationmeetingonauricularacupuncturenomenclature, Lyons, France (A). The
enlargementbelow(8) showsDrPaul Nogieratthefar lejtofthefrontrow,hissonDrRaphael Nogiersecondfromtheright.DrFrank
Bahratthefarrightojthesecondrow,andDrTerry Olesonfourth[romtheleftofthesecondrow.
B
8 AuriculotherapyManual
epidemicandmanyotherdiseases. SouliedeMoranttranslatedtheNeiJingintoFrenchand
publishedLAcupuncturechinoise.HetaughtChinesemedical procedurestophysicians
throughoutFrance, Germany,andItalyandisconsideredtheFatherofAcupunctureinEurope.
Ofintriguinghistorical note,theFrenchJournal desconnaissancesmedico-chirurgicalesreported
back in18S0that13differentcases ofsciaticpainhadbeentreatedbycauterizationwithahotiron
appliedtotheear. Onlyoneof thepatientsfailedtodramaticallyimprove.Itwasnotuntil a
centurylater,however, thattheLyonsphysicianPaul Nogierrediscoveredthisremarkableear
treatment.
In19S0,Nogier(1972)wasintriguedbyastrangescarwhichcertainpatientshadintheexternal
ear. Hefoundthatthescarwasduetoatreatmentfor sciaticainvolvingcauterizationofthe
antihelixbyMmeBarrin,alaypractitionerlivinginMarseille, France. Thepatientswere
unanimousinstatingthattheyhadbeensuccessfully relievedofsciaticpainwithinhours,even
minutes,ofthisearcauterization.MmeBarrinhadlearnedof thisauricularprocedurefromher
father,who hadlearneditfromaChinesemandarin.Nogierstated: I thenproceededtocarryout
somecauterizationsmyself, whichprovedeffective, thentriedsomeother,lessbarbarous
processes. A simpledryjabwithaneedlealsoledtothereliefofsciaticaifgiventothesame
antihelixarea, anareaof theearwhichwaspainfultopressure. Nogierwasexperiencedintheuse
of acupunctureneedles, ashehadpreviouslystudiedtheworksof SouliedeMorant.Another
mentorfor NogierwastheSwisshomeopathicphysician,PierreSchmidt,whogavemassages,
spinal manipulations,andacupunctureaspartof hisnaturopathicpractice.Somecriticshave
contendedthatNogierdevelopedhisearmapsbasedontranslationofChinesewritings,butas
statedpreviously, theChinesethemselvesacknowledgethatitwasonlyaftertheylearnedof
Nogiersfindingsdidtheydeveloptheirownmodernearcharts.
A quotationattributedtothephysiologistClaudeBernardfurtherinspiredNogier:
Ithasoftenbeensaid,thatinordertodiscoverthings, onemustbeignorant. Itishettertoknow
nothingthantohavecertainfixedideasinonesmind,whicharebasedontheorieswhichone
constantlytriestoconfirm.Adiscoveryisusuallyanunexpectedconnection,whichisnotincludedin
sometheory.Adiscoveryisrarelylogicalandoftengoesagainsttheconceptionstheninfashion.
Nogierdiscussedhisantihelixcauterizationexperienceswithanotherphysician,ReneAmathieu,
whotoldhimtheproblemofsciaticaisaproblemofthesacrolumbarhinge.Nogierconjectured
thattheupperantihelixareausedtotreatsciaticacouldcorrespondtothelumbosacraljoint,and
A
Lower limb
B
Upper limb
Abdominal organs
Neck
Thoracic organs -+--\-"c:->"t1!
Head areas ~ - - ~ r - - -
Figure 1.3 Initialear chartsdevelopedbyNogiershowsomatotopiccorrespondencestoparticularauricular
regions (A) andtheinvertedfetuspatternrelatedtotheexternal ear (B). (ReproducedfromNogier1972. with
permission.)
Body
Spinal cord
Visceral organs
Brain
10
Figure 1.4 Nogierdiagramofinvertedmusculoskeletalbody,internalorgansandthe
nervoussystemrepresentedontheauricle. (ReproducedfromNogier1972, with
permission.)
thewholeantihelixcouldrepresenttheremainingspinalvertebrae, butupsidedown. Thehead
wouldhaveitscorrespondencelower ontheauricle. Theearcouldthusroughlyresemblean
upsidedownembryoinutero.Nogiersubsequentlyobtainedpainreliefforotherproblems.Using
electrical microcurrentsimperceptibletothepatient,Nogierconcludedthatthepainreliefwasnot
duetoanervousreactiontothepainfromneedleinsertion,butwasinfact causedbythe
stimulationofthatareaof theear.
Todiscover something,Nogierobserved, istoaccomplishonestageof thejourney.Topushonto
thebottomofthisdiscoveryistoaccomplishanother.In1955,Nogiermentionedhisdiscoveries
toDrJacquesNiboyet, theundisputedmasterof acupunctureinFrance. Niboyetwasstruckbythis
novel earreflexzone, whichhadnotbeendescribedbytheChinese. NiboyetencouragedNogierto
presenthisfindingstotheCongressoftheMediterraneanSocietyofAcupunctureinFebruary
1956.Oneof theattendeesof thismeeting,DrGerardBachmannof Munich,publishedNogiers
findingsinanacupuncturejournalin1957,whichhadworldwidecirculation,includingtheFar
East. FromthesetranslationsintoGerman,Nogiersearreflexsystemwassoonknownby
acupuncturistsinJapan,andwassubsequentlypublishedinChina,whereitbecameincorporated
intotheirearacupuncturecharts. Nogieracknowledgedinhisownwritingsthattheoriginsof
auriculotherapymighthavebeguninChinaorinPersia.Theprimarychangethathebroughtto
auricularacupuncturein1957wasthattheseearacupointswerenotjustascatteredarrayof
differentpointsfor differentconditions,butthattherewasasomatotopicinvertedfetuspatternof
auricularpointsthatcorrespondedtothepatternof theactual physical body.
Nogier (1972)limitedhisclassic Treatiseofauriculotherapytothespinal columnandthelimbs
becausethemusculoskeletal bodyisprojectedontotheexternal earinaclearandsimplemanner.
Thetherapeuticapplicationsarefreefromambiguityandoughttoallowthebeginnertoachieve
convincingresults. Itispossibletopalpatefortenderareasoftheearandreadilynoticehowthey
correspondtopainfulareasofthebody. Thefirststagesoflearningthemapoftheearconsistof
gettingtoknowthemorphologyoftheexternalear, itsreflexcartography, andhowtotreatsimple
painsoftraumaticorigin. Eachdoctorneedstobeconvincedoftheefficacyofthisearreflexmethod
bypersonalresultsthatheorsheisright. Theyareindeedfortunatepeoplewhocanconvince
themselvessimplybynotingtheimprovementofasymptomtheythemselveshaveexperienced.
After hetracedtheimageof thespineandthelimbs, Nogierexaminedthoracicorgans, abdominal
organs,andcentral nervoussystemprojectionsontotheear. Heneededafewyears, however, to
understandthattheearhadatripleinnervation,andthateachinnervationsupportedtheimageof
anembryological derivative: endoderm,mesoderm,andectoderm.
Theseembryological correspondencestotheearweredescribedbyNogier(1968) inanothertext,
Thehandbooktoauriculotherapy,withillustratedanatomicaldrawingsbyhisfriendandcolleague,
Dr ReneBourdiol.By1975,Nogierhadcreatedateachingstructurefor traininginauricular
medicine, establishingtheorganizationGroupLyonaiseEtudesMedicales(GLEM), translatedinto
EnglishastheMedical StudiesGroupofLyons. ThejournalAuriculo-medicinewasalsolaunched
in1975,providingaprofessional vehiclefor disseminatingclinical studiesonauricularmedicine.
Thatsameycar, Nogier, BourdiolandtheGermanphysicianFrankBahrcombinedtheireffortsto
publishaninformativewall chartonearlocalizations,Loci auriculo-medicinae.DrBahrwentonto
organizetheGermanAcademyofAuricularMedicine(Bahr1977),whichhasattractedover 10000
Germanphysicianstothepracticeof auricularmedicine. In1981,however, Bourdioldisassociated
himselffromNogier, partlybecausehewasnotcomfortablewithsomeof Nogiersmoreesoteric,
energeticexplanationsof healing. Consequently,Bourdiol(1982)wrotehisownbook,Elementsof
auriculotherapy. Thisworkremainsoneof themostanatomicallyprecisetextsof therelationshipof
theauricletothenervoussystemandincludesdetailedpicturesof theexternal earandits
representationof themusculoskeletal systemandvisceral organs.Theinnovativecollaborations
betweenNogierandBourdiol hadlastedfrom1965until 1981,buttheircollegial association
unfortunatelywasatanend.
Nogierturnedhiseffortsinadifferentdirectionwiththe1981publicationof
Delauriculotherapiealauricolomedecine,translatedintoEnglishasFromauriculotherapyto
auriculomedicinein1983.Inthiswork, Nogierpresentedhistheoryof threesomatotopicphaseson
theearandhediscussedhisconceptsofelectric, magnetic,andreticularenergies. Themost
prominentfeatureof thisauriculomedicinetext, though,featuredexpandeddescriptionof
Nogiers1966discoveryofanewpulse, therefiexeauriculocardiaque(RAC). Thispulsereaction
waslaterlabeledthevascular autonomicsignal (VAS), asitwasrelatedtoamoregeneral reactivity
of thevascular system. Inhonorof itsdiscoverer, thispulsereactionhasalsobeencalledtherefiexe
arteriel deNogierbyBourdiolandtheNogierreflexbyBahr. Forthepurposesof thistext, theNogier
vascular autonomicsignal will beabbreviatedasN-VAS, soasnottoconfuseitwithawell known
painassessment measure, thevisual analoguescaleor VAS. TheN-VASarterialwaveformchange
becomesdistinctinthepulseafewbeatsafterstimulationof theskinovertheear. Similar
autonomicreactionstotouchingsensitiveearpointshavealsobeenreportedfor changesinthe
electrodermalgalvanicskinresponseandinpupillaryconstriction.MonitoringthisN-VASradial
pulsereactionbecamethefundamentalbasisof auriculomedicine.Nogiersuggestedthateach
peripheralstimulationperceivedatthepulseisatfirstreceivedbythebrain,thentransmittedby
thearterial tree. Itseemedthattheearproducedasympatheticnervoussystemreflex, initiatinga
systoliccardiacwavethatreflectedoff thearterialwall, followedbyareturning,retrogradewave.
Thisreflex establishedastationaryvascularwave, whichcouldbeperceivedattheradial artery.
Palpationof theN-VASwasusedtodeterminechangesinpulseamplitudeor pulsewaveformthat
werenotrelatedtofluctuationsinpulserate.TheN-VAShasbeenattributedtoageneral
vascular-cutaneousreflex thatcanbeactivatedbytactile, electrical, or laserstimulationof many
bodyareas.
ConsiderableconfusionwasgeneratedwhensubsequentbooksontheNogierphasesonthecar
seemedtocontradictearlierwritings.Pointsreflexesauriculaires(Nogieret al. 1987)mappedsome
anatomicalstructuresontodifferentregionsof theexternal earthanthosedescribedinprevious
publicationsbyNogier.Themost detailedpresentationof thethreephaseswasdescribedby
Nogieret al. (1989) inComplementsdespointsreflexesauriculaires. Thistext continuedtoshowthat
inthesecondphase, themusculoskeletal systemshiftedfromtheantihelixtothecentralconcha,
whereasinthethirdphase, musculoskeletal pointswerelocatedonthetragus,antitragus,andear
lobe. However, Nogierreversedsomeof thedescriptionfromhispreviouswritings. Incontrastto
thepresentationof thephasesinthe1981bookDelauriculotherapiealauriculomedecine,in1989
heswitchedthelateral orientationof thesecondphasespineandthevertical orientationof the
thirdphasespine. AlthoughNogierhaddevelopedthethree-phasemodel asameansof
reconcilingthedifferencesbetweenhisfindingsandthatof theChinese,itwasadrasticdeparture
fromtheoriginal,invertedfetuspicturefor theear. Thesuggestionof differentsomatotopic
patternsonthesameauricularregionsbotheredmanyof Nogiersfollowers.
WidespreaddissensionwithintheEuropeanauriculomedicinemovementoccurredbythe1990s
(Nogier1999).First, thethreephasetheorywasnotwell acceptedbymanyauriculomedicine
practitionersinFranceandGermany.Second, Nogierdiscussedtheimportanceof reticular
energy, withoutspecificallydefiningwhat itwas. Heexploredthechakraenergycentersof
ayurvedicmedicine,whichseemedtosometobeunscientific.TheenergetictheoryofPaul Nogier
hadalsobeenadoptedbyanon-medical school thatusedNogiersnametodevelopmoreesoteric
philosophiesof auricularreflexotherapy,consequentlythreateningtheprofessional credibilityof
auricularmedicine. ManyacupuncturistsinEngland,Italy, andRussiafollowed theChinesecharts
describingthelocalizationof earreflexpoints,ratherthantheearchartsdevelopedbyNogier. A
verypersonal accountof thedevelopmentandprogressof auriculomedicineinEuropewas
presentedinthebookThemanintheear, writtenbyPaul NogierwithhissonRaphael Nogier
(1985).Also aphysician, Raphael NogierhasbecomeoneofEuropesmostprominentfiguresin
thecontinuedtrainingof doctorsinthepracticeof auricularmedicine.
PublicationsattheUCLAPainManagementCentersoughttointegratetheChineseearcharts
withNogierssystemsformappingthesomatotopicimageontheear(Oleson&Kroening1983a,
1983b).TheWorldHealthOrganizationheldits1990meetingonauricularacupuncture
nomenclatureinLyons, France, partlytohonorNogierspioneeringdiscoveries. After several
previousWHOsessionsthathadbeenheldinAsia, thisEuropeangatheringsoughttobring
togetherdifferentfactionsoftheacupuncturecommunity.At a1994internationalcongresson
auricularmedicineinLyons, NogierwasdescribedastheFatherofAuriculotherapy.Paul Nogier
diedin1996,leavinganamazingscientificinheritance.Hehadcontributedtheuniquediscoveryof
somatotopiccorrespondencestotheexternal ear, developedanewformof pulsediagnosis,and
expandedmedical appreciationofthecomplex, subtleenergiesof thebody.
12
Figure 1.5 Authorsdepictionofalternativeperspectivesofinvertedfetusimage(A) and
invertedsomatotopicpattern(B) ontheauricle.
AurkulotherepyManual
1.6 Comparison of ear acupuncture tobody acupuncture
Historicaldifferences: Bothearacupunctureandbodyacupuncturehadtheirhistorical originsin
ancientChina.However, bodyacupuncturehasremainedessentiallyunchangedinitsperspective
of specificmeridianchannels,whereasChineseearacupuncturewasgreatlymodifiedbythe
invertedfetusdiscoveriesof Paul NogierinEurope.Furtherresearchhasyieldedeven newer
developmentsinauricularmedicine.
Acupuncturemeridians: Bodyacupunctureisbaseduponasystemof 12meridians,sixyangorfu
meridiansandsixyinorzangmeridians,whichrunalongthesurfaceof thebodyaslinesof energy
forces. Earacupunctureissaidtodirectlyconnecttotheyangmeridians,butitisnotdependent
upontheseyangmeridianstofunction.Theearisaself-containedmicrosystemthatcanaffect the
wholebody. IntraditionalChinesemedicine,theheadismoreassociatedwithyangenergythan
arelower partsofthebody. TheLargeIntestines,Small Intestines,andSanJiaomeridiansrun
fromthearmtothehead,andtheStomach,Bladder,andGall Bladdermeridiansrunfromthe
headdownthebody.Yin meridians,however, donotconnectdirectlytothehead,thustheyhave
nophysical meanstolinktotheear.
Pathologicalcorrespondence: Themainprincipleinauriculotherapyisacorrespondence
betweenthecartographyof theexternal earandpathologicalconditionsinhomologouspartsof
thebody.Acupuncturepointsontheauricleonlyappearwhenthereissomephysical orfunctional
disorderinthepartofthebodyrepresentedbythatregionoftheear.Thereisnoevidenceof an
auricularpointifthecorrespondingpartofthebodyishealthy.Acupuncturepointsonthebody
canalmostalwaysbedetected,whetherthereisanimbalanceintherelatedmeridianchannel or
not.Whilebodyacupuncturecanbeveryeffective inrelievingavarietyofhealthproblems,the
organnamesof differentmeridianchannelsmaynotbenecessarilyrelatedtoanyknownpathology
inthatorgan.
Somatotopicinversion: Inbodyacupuncture,themeridianchannelsrunthroughoutthebody,
withnoapparentanatomical logicregardingtherelationshipof thatchannel tothebodyorgan
representedbythatmeridian.AcupointsontheLargeIntestinesmeridiansandtheKidney
meridiansoccurinlocationsfar removedfromthosespecificorgans. Inearacupuncture,however,
thereisanorderly,anatomical arrangementof points,basedupontheinvertedfetusperspectiveof
thebody.Theheadareasarerepresentedtowardthebottomoftheear, thefeet towardthetop,
andthebodyinbetween. Aswiththesomatotopicmapinthebrain,theauricularhomunculus
devotesaproportionallylargerareatotheheadandhandthantotheotherpartsof thebody.The
sizeof asomatotopicareaisrelatedtoitsfunctional importance,ratherthanitsactual physical
size.
Distinctacupuncturepoints: Theacupuncturepointsareanatomicallydefinedareasontheskin.
TheoriginalChinesepictographsforacupointsindicatedthattherewereholesintheskinthough
whichqi energycouldflow.Theyareset atafixed, specific locusinbodyacupuncture,andcan
almostalwaysbedetectedelectrically. Inearacupuncture,however, anacupuncturepointcanbe
detectedonlywhenthereissomepathologyinthecorrespondingpartof thebody,whichthatear
acupointrepresents.Adull, deep, achingfeelingcalleddeqi oftenaccompaniesthestimulation
ofbodyacupuncturepoints,butthissensationisnotusuallyobservedbystimulatingear
acupuncturepoints.Asharp,piercingfeelingmoreoftenaccompaniesauricularstimulation.The
exact locationoftheearpointmayshiftfromdaytoday, asitreflectsdifferentstagesofthe
progressionorhealingofadisorder.Aprominentdifferencebetweenthesystemsisthatbody
acupuncturepointslieinthetendonandmuscularregiondeepbelowtheskinsurface, whereasear
acupointsresideintheshallowdepthof theskinitself.
Increasedtenderness: Paul Nogierobservedthattherearesomecases of patientswithan
exceptional sensitivityinwhichmerepalpationofcertainpartsof theearprovokedapronounced
painsensationinthecorrespondingbodyregion. Thisobservationcanberepeatedseveral times
withoutthephenomenondiminishing,allowingthedistinctidentificationof theconnectionwhich
existsbetweensuchearpointsandtheperiphery.Thetendernessatanearacupointincreasesas
thedegreeofpathologyof thecorrespondingorganworsens, andthetendernessontheear
decreasesasthehealthconditionimproves.Thereisnotalwaysasmall, distinctacupoint,but
sometimesabroadareaof theearwherethereistenderness.
14
Decreased skinresistance: Inbothbodyandearacupuncture,theacupuncturepointsare
localizedregionsofloweredskinresistance, small areasoftheskinwherethereisadecreasein
oppositiontotheflowof electricity. Sometimeselectrodermalactivityisinverselystatedashigher
skinconductance,indicatingthatthereiseasy passageof electriccurrent.Thetechnologyof
recordingthiselectrical activityfromtheskinhasbeenusedinthefieldsof psychologyand
biofeedback,andwasoriginallydescribedasthegalvanicskinresponse(GSR). Electrical
resistanceandelectrical conductancemeasuretheexact sameelectrodermal phenomena,butthey
showitasoppositechanges, oneincreasingfrombaselineactivitywhiletheotherdecreases. When
pathologyof abodyorganisrepresentedatitscorrespondingauricularpoint,theelectrodermal
conductivityof thatearpointriseseven higherthannormal.Theconductanceintheflowof
electricityincreasesasthepathologyinthebodyincreases. Asthebodyorganbecomeshealthier,
theelectrodermalconductanceof thatearpointreturnstonormal levels. Electrodermal point
detectionisoneof themostreliablemethodsfor diagnosingthelocationof anauricularpoint.
Ipsilateral representation: Inbothbodyandearacupuncture,unilateral,pathological areasof the
bodyaremoregreatlyrepresentedbyacupuncturepointsonthesamesideof thebodyasthebody
organthanbypointsontheoppositesideof thebody.
Remote control sites: Earpointsarefoundataconsiderabledistancefromtheareaof thebody
wherethesymptomislocated,suchaspainproblemsintheankles, thehands,or thelower back.
Even thoughbodyacupuncturealsoincludesremotedistal acupoints,manybodyacupointsare
stimulateddirectlyover thesamebodyareaaswherethesymptomislocated.Auriculotherapycan
remotelystimulateapartof thebodythatistoopainful totreatdirectly. Whilethebodyacupoints
occurdirectlywithinameridianchannel,auricularacupointsserve asremotecontrolcenters. The
earpointscanremotelyaffect theflowofenergyinmeridianchannels.Inthisway, earpointscan
becomparedtothewayanelectronicremotecontrol unitisusedtooperateagaragedooror to
switchchannelsonatelevisionset. Althoughverysmall inphysical sizebecauseof theirmicrochip
circuitry,remotecontroldevicescanproducepronouncedchangesinmuchlargersystems. While
theauricleisalsoaphysicallysmall structure,itscontrolof thegrossanatomyof thebodycanbe
quiteimpressive.
Diagnostic efficacy: Earacupunctureprovidesamorescientificallyverifiedmeansof identifying
areasof painorpathologyinthebodythandosuchtraditionalChinesemedicineapproachesas
pulsediagnosisandtonguediagnosis. Inauriculardiagnosis, onecanidentifyspecificproblemsof
thebodybydetectingareasof thecarthataredarker,discoloredor flaky. Pathologicalearpoints
arenotablymoretenderor havehigherskinconductancethanotherareasof theauricle. The
subtlechangesinauriculardiagnosismayidentifyconditionsofwhichthepatientisonlymarginally
aware. Anewpractitionersconfidenceinauriculotherapyisstrengthenedbytherecognitionof
reactiveearpointsfor healthconditionsthatwerenotpreviouslyreportedbyapatient.
Therapeutic proof: Thesecondmostconvincingproceduretoverify theexistenceof the
correspondencebetweenthelocationof auricularpointsandaparticularpartof thebodyiswhen
specific regionsof painareimmediatelyrelievedbystimulationof theareaof theexternal ear
designatedbyestablishedwall charts.Therearesomepatientswhopresentwithvery unusual
disordersinaspecific regionof theiranatomy.Theseexceptional patientshavebeenfoundto
demonstratereactivepointsatpreciselythepredictedareaontheauricle. Oncetreatmentis
appliedtothatearpoint,thepatientsconditionisimmediatelyalleviated. At thesametime, many
patientshavediffusetypesof pathologythatdonotprovidesuchconvincingdemonstrationsof
selectivereactivity. Thelatterpatientshavemanybodyregionsinpain,contributingtobroad
regionsof theauriclewhicharesensitivetopressureor areelectricallyactive.
Pulse diagnosis: BothtraditionalOrientalmedicineandauricularmedicineutilizeaformof
diagnosisthatinvolvespalpationattheradial pulseonthewrist. Classical acupunctureprocedures
for examiningthepulserequiretheplacementof threemiddlefingersoverthewrist, assessingfor
subtlequalitiesinthedepth,fullness, andsubjectivequalitiesof thepulse.Thesetactilesensations
helptodetermineconditionsof heat,deficiency, stagnationor disordersassociatedwithspecific
zang-fuorgans.TheN-VASinvolvesplacementof onlythethumboverthewrist. Thepractitioner
discriminateschangesinthereactionof thepulsetoastimulusplacedontheear,whereasOriental
doctorsmonitortheongoing,steady-statequalitiesof therestingpulse.
Types of procedures: Bodyacupunctureandearacupunctureareoftenusedwitheach otherin
thesamesession, oreachprocedurecanbeeffectively appliedseparately. Bodyacupuncture
pointsandearacupuncturepointscanbothbestimulatedwiththeuseof acupressuremassage,
acupunctureneedlesandelectroacupuncture.Manypatientsareafraidof theinsertionof needles
intotheirskin, thustheyhaveastrongaversiontoanyformof needleacupuncture.Asan
alternative,earpointscanbeactivatedbytranscutaneouselectrical stimulation,laserstimulation,
orsmall metal orseed pelletstapedontotheauricle. Itisrecommendedthatbecauseauricular
acupuncturecanworkmorequicklythanbodyacupuncture,theearpointsshouldbetreatedfirst.
Clinical efficacy: Stimulationof earreflex pointsandbodyacupointsseemtobeequallyeffective
treatments.Each requiresonly20minutesof treatment,yet each canyieldclinical benefitswhich
lastfor daysandweeks. Bothbodyandearacupunctureareutilizedfor treatingabroadvarietyof
clinical disorders,includingheadaches, backpain, nausea, hypertension,asthmaanddental
disorders.Auriculotherapytendstorelievepainmorerapidlythanbodyacupuncture.Ear
acupunctureneedlingismoreoftenthetreatmentofchoicefor detoxificationfromsubstance
abusethanisbodyacupuncture.Earacupuncturehasbeenfoundtoquicklyrelievepostoperative
pain, inflammationfromjointsprains,painfrombonefracturesandthediscomfortfromgall
stones. Itreadilycanreduceinflammations,nausea, itchingandfever.
Application to many disorders: Sinceevery organof thebodyisrepresentedupontheexternal
ear, auriculotherapyisconsideredapotentialsourcefor alleviatinganydisease. Earacupunctureis
certainlynotlimitedtohearingdisordersoreven toproblemsaffectingthehead.At thesametime,
itcanbeveryeffectivefor treatinginnereardizzinessandfor alleviatingheadaches. Conditions
treatedbybothearandbodyacupunctureincludeappendicitis,tonsillitis,uterinebleeding,
dermatitis,allergicrhinitis,gastriculcers, hepatitis,hypertension,impotency,hypothyroidism,
sunburn,heatstroke,frozenshoulder,tenniselbow, torticollisandlowbackpain.
Healing. not just painrelief: Bothbodyacupunctureandearacupuncturedomorethanjust
reducetheexperienceof pain. Whilepainreliefisthemoreimmediateeffect, bothprocedures
alsofacilitatetheinternal healingprocessesof thebody.Acupunctureandauriculotherapytreat
thedeeper, underlyingcondition,notjustthesymptomaticrepresentationof theproblem.They
affect deeperphysiological changesbyfacilitatingthenaturalself-regulatinghomeostatic
mechanismsof thebody. Stimulatingagivenacupointcaneitherdiminishoveractivebodily
functionsor activatephysiological processesthatweredeficient.
Ease inmastery of skills: Becauseauricularreflexpointsareorganizedinthesamepatternasthe
grossanatomyof thebody, itispossibletolearnthebasicsof earacupunctureinjustafewdays. In
contrast,bodyacupuncturerequiresseveral yearsof intensivedidactictrainingandclinical
practice.Thepointsontheeararelabeledwiththeorganor theconditionthattheyareusedto
treat.Whilethereareover200earacupoints,thefewearpointsneededfor treatmentarereadily
identifiedbytheprincipleof somatotopiccorrespondenceandbytheirselectivereactivity.
Ease intreatment application: Earacupunctureisoftenmoreeconomical andconvenienttouse
thanbodyacupuncture,sincenodisrobingisrequiredof apatient.Theeariseasily availablefor
diagnosisandtreatmentwhilesomeoneissittinginachairor lyingdownintheirstreetclothes.
Insertionof needlesintotheearismoresimpletoapplythanistheuseof needlesatbody
acupoints.Theskinover theauricleisverysoft andthereislittledangerof damagingacritical
bloodvessel whenpuncturingtheearskinwithaneedle, aproblemthathasoccurredwith
insertionof needlesintobodyacupuncturepoints.
Side effects: Theprimarysideeffect of auriculotherapyisthepiercingsensationthatoccursat
thetimeneedlesareinsertedintotheearsurfaceorwhenintenseelectrical stimulationisapplied
toanearacupoint.For sensitivepatients,theauricleshouldbetreatedmoregently, andearpellets
orearseedsmaybeusedinsteadof needles. Ifthestimulationintensityisuncomfortable,itshould
bereduced.Theearitselfcansometimesbecometenderandinflamedafterthetreatment.This
post-treatmenttendernessusuallysubsideswithinashorttime. Aswithbodyacupuncture,some
patientsbecomeverydrowsyafteranauricularacupuncturetreatment.Theyshouldbeofferedthe
opportunitytorest for awhile. Thissedationeffect hasbeenattributedtothesystemicreleaseof
endorphins.
16
Equipment required: Well-trainedacupuncturistscandetectbodyacupuncturepointsjustby
theirpalpationof thesurfaceof thebodyor bytherotationofaninsertedneedle. Amusclespasm
reflexoftenseemstograbtheacupunctureneedleandholditinplacewhenthetipof theneedle
isontheappropriatepoint.Auriculardiagnosis, however, isbestachievedwithanelectrical point
finder. Furthermore,atranscutaneouselectrical stimulationdeviceusingmicrocurrentintensities
canoftenachieve profoundclinical effectswithouttheunwantedpainwhichaccompaniesneedle
insertion.Sincebodyacupointstypicallylieinthemuscleregiondeepbelowtheskinsurface,
electrical pointfindersareoftennotneededandarenotparticularlypractical for body
acupuncture.Theauricularskinsurface, however, isonlyafewmillimetersdeep, andreadily
availablefor detectionandtranscutaneoustreatment.Reactiveearreflex pointscanslightlyshift in
locationfromonedaytothenext, thustheuseof anelectrical pointfinderisimperativefor precise
determinationof pointlocalizationthatparticularday. Electrical stimulationofearacupoints,
eitherbyelectroacupuncturethroughinsertedneedlesor bytranscutaneousmetal probes,
producesmoreeffectivepainreliefthandoesneedlestimulationof theear.
Theoretical perspectives of
auriculotherapy
2.1 Micro-acupuncture systems
2.2 Traditional Oriental medicine and qi energy
2.3 Ayurvedic medicine, yoga and prana energy
2.4 Holographic model of microsystems
2.5 Neurophysiology of pain and pain inhibition
2.6 Endorphin release by auricular acupuncture
2.7 Embryological perspective of auriculotherapy
2.8 Nogier phases of auricular medicine
2.8.1 Auricular territories associated with the three embryological phases
2.8.2 Functional characteristics associated with different Nogier phases
2.8.3 Relationship of Nogier phases to traditional Chinese medicine
2.9 Integrating alternative perspectives of auriculotherapy
Theories concerning anyaspect of medicine aregenerally useful for providing aframework anda
structure which brings systematic order to diagnostic understanding and treatment applications.
With aprocedure asseemingly illogical asauriculotherapy, acomprehensive theory becomes
necessary tojustify whyauricular acupuncture should even beconsidered asavalid therapy. It does
not seem common sense that itispossible totreat problems inthe stomach or on the foot by
stimulating points on the external ear. While itisobservably evident that theear isanorgan for
hearing, it isnot at all obvious that theear could relate toanyother health conditions. Even when
shown repeated clinical examples of patients who have benefitted from auricular acupuncture, most
persons still remain skeptical, andauriculotherapy may seem more like magic than medicine. The
theories which arepresented inthissection arevaried, but they arenot mutually exclusive. It maybe
acombination of all of these theories which ultimately accounts for the clinical observations which
havebeen made. There isnopresent evidence which proves that oneof these theories ismore
correct than another, but there ismore empirical support for theneuroendocrine perspectives.
There may develop anew theoretical model which better accounts for the currently available data,
but theviewpoints described below areagood beginning tounderstanding thisfield.
2.1 Micro-acupuncture systems
Thefirst theory tobeconsidered isthe concept that auricular acupuncture isoneof several
microsystems throughout the human body, aself-contained system within thewhole system. In
Oriental thinking, there isasystematic correspondence of each part to thewhole. Themicrocosm
of each person isinterrelated tothe macrocosm of the world that surrounds them. Even inthe
West, medieval European philosophers described the relationship between organs of the
microcosm of man tothe planetary constellations inthemacrocosm of the heavens. Modern
medicine accepts that the microorganism of each cell within the body isinterrelated tothe
macroorganism of thewhole body. Just aseach cell has aprotective membrane, flowing fluids, and
aregulating center, so too does thewhole body have skin, blood, and thebrain. For thewhole of
the organism tobeinbalance, each smaller system within that organism must beinbalance.
Micro- versus macro-acupuncture systems: Dr Ralph Alan Dale(1976, 1985, 1999) of Miami,
Florida, was one of thefirst investigators tosuggest that not only the ear, but every part of thegross
anatomy can function asacomplete system for diagnosis and therapy. Dalehas spent several
Theoretical perspectives 17
18
decades accumulating clinical evidence from China, J apan, Europe andAmerica about these
multiple microsystems. Thetermmicro-acupuncture was introduced by Daleat the 1974Third
World Symposium on Acupuncture and Chinese Medicine. Micro-acupuncture istheexpression of
the entire bodys vital qi energy ineach major anatomical region. Helabeled them
micro-acupuncture systems to distinguish themfromthetraditional macro-acupuncture systems
that connect the acupoints distributed throughout themeridians of thebody. Every
micro-acupuncture system contains adistribution of acupoints that replicate theanatomy of the
whole organism. Micro-acupuncture systems have been identified byDaleon theear, foot, hand,
scalp, face, nose, iris, teeth, tongue, wrist, abdomen, back and on every long bone of the body. Each
region isafunctional microcosm of the traditional energetics of the whole body. Every part of the
body exhibits anenergetic microcosm through micro-acupoints and micro-channels that reiterate
the topology of the body. Figure 2.1depicts the microsystems that have been identified on the
scalp, the ear, the hand, themetacarpal andthe foot. Dalehas identified specific principles
regarding these micro-acupuncture systems that are presented below.
Remote reflex response: Every microsystem manifests neurological reflexes that areconnected with
partsof thebody remote from theanatomical location of that microsystem. These reflexes areboth
diagnostic and therapeutic. They maybeactivated bymassage, needle acupuncture, moxibustion,
heat, electrical stimulation, laser stimulation, magnets or anymethod used inmacro-acupuncture.
When pressure isapplied to areactive microsystem point, apronounced facial grimace or abehavioral
withdrawal reflex isevoked. Distinct verbalizations of discomfort indicate that thereactive ear point is
tender totouch. Thelocations of these distant tender spots arenot due to randomchance, but arein
fact related toaneurological reflex pattern that iscentrally mediated.
Somatotopic reiteration: Themicrosystem reflex mapof the body repeats the anatomical
arrangement of the whole body. Thetermsoma refers to theword body, andtopography refers
to the mapping of the terrain of anarea. Microsystems aresimilar to thesomatotopic responses in
the brain, where apicture of ahomunculus, alittleman, can beidentified bybrainmapping
studies. Figure 2.2shows thesomatotopic homunculus image that isrelated to different regions of
the brain. It isnot the actual bone or muscle which isrepresented on thebrain. Rather, it isthe
movement activity of that areaof the body which ismonitored bythe brain. Such isalso the case
with microsystem points, which indicate the pathological functioning of anorgan, not the
anatomical structure of that organ.
Somatotopic inversion: Insome microsystems, the reflex topology directly corresponds to the
upright position of the body, whereas inother microsystem maps, the body isconfigured inan
inverse order. Inthe auriculotherapy microsystem, the reflex pattern resembles the inverted fetus
inthe womb. With the hands pointed downwards and thetoes stretched out, thehandand foot
reflexology systems arealso inverted. Thescalp microsystem isalso represented upside down,
whereas the medial microsystems of the abdomen, back, face, nose andlips areall oriented inan
upright pattern. Thetongue and teeth microsystems arepresented horizontally.
Ipsilateral representation: Microsystems tend tohave bilateral effects, but they areusually more
reactive when themicro-acupoint and theareaof body pathology areipsilateral toeach other, on
thesame side of thebody. Only thescalp microsystem, which corresponds tothe underlying
somatosensory cerebral cortex, exhibits reactive acupoints on theside of thescalp that iscontralateral
totheside of body pathology. For theauricular microsystem, acondition on the right side of thebody
would berepresented on the right ear, whereas aproblem on theleft side of thebody would be
reflected on theleft ear. Actually, each region of thebody bilaterally projects toboth the right and left
ear. Auricular representation issimply stronger on the ipsilateral ear thanthecontralateral ear.
Bi-directional connections: Pathology inaspecific organ or part of thebody isindicated by
distinct changes inthe skin at the corresponding microsystem point, while stimulating that point
can produce changes inthecorresponding part of the body.
Organo-cutaneous reflexes: Inthistype of reflex, pathology inanorgan of thebody produces an
alteration inthecutaneous region where that corresponding organ isrepresented. Localized skin
changes may include increased tenderness on palpitation, altered blood flow, elevated temperature,
changes inelectrodermal activity, changes inskin color or alterations inskin texture. These skin
reactions arediagnostically useful for all the microsystems, but because of the risks involved with
treatment, the tongue, irisand pulse microsystems areused almost exclusively for diagnosis.
Auriculotherapy Manual
Scalp microsystem
Ear microsystem
3
J eg
//
~ _ Body
Arm
1"l"I I ".---Head
3 4
1
Foot reflexology microsystem
Zhangmetacarpal microsystem
Arm
Neck" //
Head/
Handreflexology microsystem
Leg-_
Abdomen---
Chest-
Chest -
Abdomen
Leg
Arm
--Chest
---- Neck
------ Head
1 1
Reflexology zone divisions
Figure 2.1 Microsystems that have heen identified on thescalp, ear, hand, metacarpal hone andfoot, andthefivezones ofthebody used
inreflexology. (From LifeARTS", Super Anatomy, 'Lippincott Williams & Wilkins, withpermission.)
A Sagittal view Body
Leg
Arm
Reticular
formation
Cerebral cortex
B Frontal view
Cerebral cortex
Reticular
formation
6
Leg
Body
Arm
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Leg
,-
I /
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I ,
I I
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---.... , I
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Figure 2.2 Somatotopic organization ofthecerebral cortex, thalamus andreticular formation ofthebrain viewed
sagittally (A) andfrontally (B). (From LijeART", Super Anatomy, 'Lippincott Williams & Wilkins, with
permission. )
20 Auriculotherapy Manual
Cutaneo-organic reflexes: Stimulating the skin at amicrosystem acupoint produces internal
homeostatic changes that lead tothe relief of painand the healing of the corresponding organ.
This cutaneous stimulation triggers nervous system messages to the spinal cord and brain,
activating bioenergetic changes, biochemical releases, and alterations of the electrical firingin
neuronal reflexes.
Interactions between systems: All of themicro-acupuncture system interact with the
macro-acupuncture systems. Treatment byonesystem will produce changes inthebodys
functional patterns asdiagnosed bythe other systems. Treatment of theoverall macrosystem
affects the functioning of the microsystems and treatment of anyof themicrosystems affects the
functioning of the macrosystem and of theother microsystems. For instance, stimulating anear
point can reduce the intensity of discomfort of atender trigger point on anacupuncture channel,
whereas anelectrically reactive ear point will become less conductive if the patient begins to heal
following abody acupuncture treatment.
Mu alarm points and shu transport points: Thefirst micro-acupuncture systems originated in
ancient China, but they were not consciously developed assuch. Thefront muand theback shu
channels are 12-point diagnostic and therapeutic systems (Dale1985). Each of the 12acupoints on
these midline meridians resonates with oneof 12principal organs, including the lung, heart, liver,
spleen, stomach, intestines, bladder andkidney (Figure 2.3). Thefront mu points and back shu
points aremore or less cutaneous projections from thevisceral organs that arefound deep beneath
theskin. These ancient systems may beseen asorgan-energy correspondences, whose acupoint loci
on thebody surface arereiterative of the underlying anatomy. Themu andshu points for theheart
arerespectively on the anterior chest and on theposterior spine at the level of the actual heart,
whereas the mu andshu points for theliver arerespectively on the anterior body and theposterior
body above theactual liver. Themu points alarmthebody about internal disorders and are
sensitive to painwhen thereisacute or chronic visceral distress. While the shu points that run along
theposterior spine can also beutilized for diagnostic discoveries, these acupoints on theback are
more often used for treatment of theunderlying organ disorder. Stimulating theback shu points is
said toconvey thevital qi energy tothecorresponding internal organ.
Microsystems along the body: In1913, Kurakishi Hirata, aJ apanese psychologist, postulated
seven micro-acupuncture zones: thehead, face, neck, abdomen, back, arms, and legs. Each of the
seven zones manifested 12horizontal sub-zones of organ-energy function: trachea-bronchi, lungs,
heart, liver, gall bladder, spleen-pancreas, stomach, kidneys, large intestines, small intestines,
urinarybladder and genitals. TheHirataZones were utilized both for diagnosis and for treatment.
Beginning in1973, aChinese researcher, Ying-Qing Zhang(1980,1992) from Shandong
University, published several books and articles, proposing atheory hecalled ECI WO (Embryo
Containing the Information of theWhole Organism). Zhangdelineated micro-acupuncture
systems for every long bone of thebody, which hepresented at theWorld Federation of
Acupuncture Societies andAssociations meeting in1990. Zhangparticularly emphasized aset of
microsystem points located outside the second metacarpal bone of thehand. Like Hirata, Zhang
identified 12divisions that correspond to 12body regions: head, neck, arm, lungs and heart, liver,
stomach, intestines, kidney, upper abdomen, lower abdomen, leg and foot. Bioholographic
systems arranged inasomatotopic pattern were described for all the primary bones of the body,
including the head, spine, upper arm, lower arm, hand, upper leg, lower leg, andfoot. Each of
these skeletal regions was said tocontain the 12different body regions and their underlying
internal organs.
Foot and hand reflexology: Twoof the oldest microsystems arethose of the foot and thehand,
both known inancient Chinaand ancient India. In1917, WilliamH Fitzgerald MD, of Hartford,
Connecticut, independently rediscovered the microsystem of the foot aswell asthe hand(Dale
1976). Fitzgerald called these systems Zone Therapy. Thetopology of Fitzgeralds microsystem
points was derived from the projections of fivedistinct zones that extended bilaterally upthe
entirelength of thebody, each zone originating from oneof the fivedigits of each handand each
foot. Several other Americans, including White, Bowers, Riley and Stopfel, developed this
procedure asreflexology, bywhich nameit iswidely known today. Inhandand foot reflexology, the
fingers and toes correspond to the head, whereas thebase of the handand the heel of the foot
represent the lower part of the body. Thethumb and large toe initiatezone I that runsalong the
midline of the body, whereas the index finger and second toe represent zone 2, the middle finger
A
B
Front mu points
Lungs
Pericardium
Heart
~ L i v e r
Gall Bladder
Stomach
Spleen
1------- Kidney
Large Intestines
------Smallintestines
i--- Sanjiao
------ Bladder
Back shu points
Lungs
Pericardium
Heart
Liver
Gall Bladder
Stomach
------- Spleen
Kidney
Large Intestines
---- Small Intestines
San[iao
Bladder
22
Figure 2.3 Mupoints (A) found ontheanterior torso that represent theinternal organs beneath themandthe
corresponding shu points (B) found ontheposterior torso ofthebody.
Auricu/otherapy Manual
and thirdtoe are found inzone 3, the ringfinger andfourth toe are located inzone 4, and thelittle
finger and littletoedemark zone 5(see Figure 2.1). Thislast zone connects all peripheral regions
of the body, including theleg, arm, and ear. Themidline of theback isinzone 1, whereas the hips
and shoulders occur along zone 5. On thehead, thenose isinzone 1, theeyes inzones 2and3, and
the ears areinzone 5. Thefoot reflexology micro system isshown inFigure 2.4, andthehand
reflexology microsystem inFigure 2.5.
Koryo hand therapy: TheKorean acupuncturist TaeWoo Yoo has described adifferent set of
correspondence points for the hand(Yoo 1993) (see Figure 2.6). Inthis Korean microsystem, the
midline of thebody isrepresented along themiddle finger and middle metacarpal, thearms are
represented on the second and fourth fingers, andthelegs are represented on thethumb and little
finger. Theposterior head, neck andback arefound on the dorsum of thehandandthe anterior
face, throat, chest and abdomen arerepresented on thepalmar side. Beyond correspondences to
the actual body, Koryo handtherapy also presents points for stimulating each of themeridian
acupuncture points that runover theactual body. Themacro-acupuncture points of each channel
are represented on the corresponding micro-acupuncture regions found on the hand.
Acupuncturists insert thin short needles just beneath theskin surface of these handpoints, usually
using aspecial metal device that holds thesmall needles. That this Korean somatotopic pattern on
thehandisso different from the American handreflexology pattern seems paradoxical,
particularly since practitioners of both systems claimvery high rates of clinical success. Since there
are also differences intheChinese and European locations for auricular points, abroader view is
that the somatotopic pathways may have multiple microsystem representations.
Face and nose microsystems: Chinese practitioners have identified microsystems on the face and
the nose that are oriented inanupright position (see Figure 2.7). Thehomunculus for the face
system places the head andneck inthe forehead, thelungs between theeyebrows, theheart
between theeyeballs, the liver andspleen on thebridge of the nose, andtheurogenital system in
the philtrumbetween the lips andnose. Thedigestive organs are located along themedial cheeks,
theupper limbs across theupper cheeks, and thelower limbs are represented on thelower jaw. In
the nose system, the midline points are at approximately thesame location asintheface system,
the digestive system isat thewings of the nose, andthe upper and lower extremities are inthe
crease alongside the nose.
Scalp microsystem: Scalp acupuncture was also known inancient Chinaand several modern
systems have subsequently evolved. Scalp micro-acupuncture has been shown to beparticularly
effective intreating strokes and cerebrovascular conditions. While there are two scalp
microsystems indicated by Dale(1976), theprincipal system divides thetemporal section of the
scalp intothree parts (see Figure 2.8). A diagonal line isextended laterally from the top of the
head to the areaof the temples above theear. Thelowest portion of thistemporal line relates to
the head, themiddle arearelates tothebody, arms, andhands, andtheuppermost region
represents thelegs andfeet. This inverted body pattern represented on thescalp activates reflexes
inthe ipsilateral cerebral cortex tothe contralateral side of the body.
Tongue and pulse microsystems: Tongue examination andpalpating theradial artery of thewrist
are two ancient Chinese diagnostic systems. While not initially intended assuch, thetongue and
pulse can also beviewed asmicrosystems. For pulse diagnosis, theacupuncture practitioner places
three middle fingers on thewrist of the patient. Thethree placements arecalled the cun or distal
position, the guan or middle position, andthechi or proximal position. Thedistal position (nearest
the hand) relates totheheart and lungs, themiddle position relates to thedigestive organs, and the
proximal position (toward the elbow) relates to the kidneys (see Figure 2.9). Thepractitioner
palpates thepulse to feel for such subtle qualities assuperficial versus deep, rapidversus slow, full
versus empty and strong versus weak. Inthetongue microsystem, theheart isfound at thevery tip
of thetongue, the lung inthefront, the spleen at thecenter, andthekidney at theback of the
tongue. Theliver islocated on the sides of the tongue. Tongue qualities include observations asto
whether itscoating isthick versus thin, thecolor of the coating iswhite or yellow, andwhether the
color of the tongue body ispale, red or purple.
Dental microsystem: A complete representation of all regions of thebody on the teeth has been
reported by Voll (1977), who associated specific teeth with specific organs. Theteeth themselves
can beidentified byoneof several nomenclature methods. Onesystem involves first dividing the
teeth intofour equal quadrants: right upper jaw, left upper jaw, right lower jawand left lower jaw.
A
Foot outstep
MidBack
Upper Back
Head ~ = - - - - - -
Shoulder
Upper Arm Elbow and
Forearm
Knee
Ovaries and Testes
Lower Leg
Foot
Hipand
Upper Leg
Dorsum of right foot Dorsum of left foot
Right Leg
B
Right Arm
Right Shoulder
Right Side
of Neck
Left Leg
Left Arm
Left Shoulder
Left Side
of Neck
c
Right plantar foot
Sinuses
Eyes
Ears
Right Lung
Liver
Adrenal Gland
Right Kidney
Gall Bladder
Large Intestines
Appendix
Sciatic Nerve
Brain
D
Left plantar foot
Eyes
Ears
Left Lung
Stomach
Spleen
Adrenal Gland
Left Kidney
Large Intestines
Cervical
Vertebrae
Foot instep
Sacral
Vertebrae
Uterus and
Prostate Gland
Figure 2.4 Thefoot reflexology system depicted on theoutside (A), dorsum (B), plantar surface (C) andinstep (D) ofthefoot.
Ear
Shoulder
Arm
Hip
Hand
C Right hand dorsum
Head
Lungs
Kidney
Spleen
Lumbar
Spine
Lower
Back
Pituitary Gland
Adrenal Gland
Thoracic
Spine
Pancreas
Large Intestines
Bladder
Ovary and Testis
Cervical
Spine
Uterus and Prostate
Head and
Skull
Small
Intestines
Appendix
Pancreas
Ovary
and Testis
Gall
Bladder
Bladder
Uterus
Liver
A Left palm
Heart
Large
Intestines
B Rightpalm
Lung
Thyroid
Kidney
Small Intestines
Figure 2.5 Thehandreflexology system depicted on thepalmar surface oftheleft hand (A), theright hand (B), andon thedorsal surface
oftheright hand (C).
Cervical Spine
Left Hand
Left Wrist -
Left Elbow
Left Shoulder
Left Foot
Left Ankle
Left Hip
A Dorsal hand
Forehead
B Palmar hand
Right Hand -
Right Foot
Right Lung
Liver ~ ~ ~ _
Gall Bladder
Right Kidney
Intestines
Genitals
Occiput
Right Hand
Right Wrist
Right Elbow
Right Foot
Right Ankle
Right Knee
Right Shoulder
Right Hip
<, Thoracic Spine
Lumbar Spine
Sacral Spine
Throat
Left Hand
Chest
Heart
Left Lung
Left Foot
- - ~ S p l e e n
Pancreas
Stomach
Left Kidney
Bladder
26
Figure 2.6 TheKorean handmicro-acupuncture system depicted on thedorsal (A) and palmar (B) sides ofthe
hand.
A Frontal view
Head-----
Neck ---
Lungs
Heart ->:
Liver.-------

Large Intestines >

Spleen
Bladder
Genitals
BSide view
Lungs
Heart ------
Liver ------
Spleen

Genitals/
Large Intestines
Kidney
Gall Bladder
Small Intestines
Shoulder

.i->
- Hand
Kidney
---- Hip
Leg
Knee
Foot
Gall Bladder
Small Intestines
- Shoulder
- Arm
>- Hand
- Hip
--- Leg
- Knee
__----Foot
Figure 2.7 Theface microsystems viewedfrom thefront (AJ and theside (B).
A Frontal view
BSide view
Thoracic
organs
Stomach
and Liver
Intestines
Thoracic Organs
Motor area
Stomach and Liver
Small and LargeIntestines
I ---Head
Somatosensory area
---Leg
28
Figure 2.8 Thescalp micro-acupuncture points related totheunderlying cerebral cortex viewed fromthefront (A)
andtheside (B).
A Tongue microsystem
Lower Jiao
Middle [lao
Upper Jiao
Kidney
Spleen
_--- Stomach
----Liver and Gall Bladder
----Lung
----Heart
B Pulse microsystem
Surface pulse Deep pulse
Bladder
~ e e , p pulse " S ~ .. rface pulse
Kidney
Liver
~ - - - - - - - - Small Intestines
----Heart
--_------ Gall Bladder
Pericardium
~ ~
Spleen _______
Stomach
San [lao
Lung-----
Large Intestines _--------:i
Figure 2.9 Internal organs represented on thetongue microsystem (A) arecontrasted with theacupuncture channels represented at the
radial pulse (B).
Table 2.1 Dental microsystem correspondences between teeth and body regions
Tooth position Right upper andlower jaw quadrants Left upper and lower jaw quadrants
I. Center incisor Right kidney, bladder, genitals, lumbosacral
vertebrae, right knee and ankle, sinus, ear
Left kidney, bladder, genitals, lumbosacral
vertebrae, left knee and ankle, sinus, ear
2. Lateral incisor Right kidney, bladder, genitals, lumbosacral Left kidney, bladder, genitals, lumbosacral
vertebrae, right knee and ankle, sinus vertebrae, left knee and ankle, sinus
3. Canine Liver, gall bladder, lower thoracic vertebrae, Liver, spleen, lower thoracic vertebrae,
right hip, right eye left hip, left eye
Left lung, large intestines, upper thoracic
vertebrae, left foot
Left lung, large intestines, upper thoracic
vertebrae, left foot
--- ----------
Spleen, stomach, left jaw, left shoulder,
left elbow, left hand
Pancreas, stomach, right jaw, right shoulder,
right elbow, right hand
Right lung, large intestines, upper thoracic
vertebrae, right foot
4. First bicuspid
6. First molar
5. Second bicuspid Right lung, large intestines, upper thoracic
vertebrae, right foot
-----
7. Second molar Pancreas, stomach, right jaw, right shoulder,
right elbow, right hand
--------
Spleen, stomach, left jaw, left shoulder,
left elbow, left hand
8. Wisdom tooth Heart, small intestines, inner ear, brainstem,
limbic brain, cerebrum, right shoulder,
elbow, hand
Heart, small intestines, inner ear,
brainstern, limbic brain, cerebrum,
left shoulder, elbow, hand
._--------------------_._--- -----_._--
The individual teeth arethen numbered from 1to8, beginning with the midline, front incisors at I,
then progressing laterally to thebicuspids, and continuing more posteriorly tothe molars at 7or 8.
Individuals who have had their wisdom teeth removed on aside of their jawwill only have seven
teeth inthat quadrant. Urogenital organs and the lower limbs arerepresented on the more central
teeth, whereas thoracic organs and theupper limbs arerepresented on the more peripheral molars
(see Table2.1).
2.2 Traditional Oriental medicine and qi energy
While theYellowEmperors classic ofinternal medicine (Veith 1972)andsubsequent Chinese medical
texts included avariety of acupuncture treatments applied totheexternal ear, itwasnot until thelate
1950sthat anauricular micro-acupuncture system wasfirst described. Some traditionalists contend
that ear acupuncture isnot apart of classical Chinese medicine. Nonetheless, both ancient and
modern acupuncture practitioners recorded theneedling of ear acupoints for therelief of many
health disorders. They also emphasized theimportance of selecting ear points based on the
fundamental principles of traditional Oriental medicine. The aspect of body acupuncture that is
most relevant totheapplication of auriculotherapy isthe use of distal acupuncture points. Needling
acupoints on thefeet or hands haslong been used for treatingconditions indistant partsof thebody.
There areothers who seek tomake auriculotherapy completely divorced from classical acupuncture,
suggesting that it isanentirely independent system of trigger point reflexes. Theclinical application
of certain points for ear acupuncture treatments, however, does not makeanysense without an
understanding of Oriental medicine. Thepopularity of the fiveear points used intheNADA
treatment protocol for addictions isonly comprehensible from theperspective of this ancient Asian
tradition that isvery different fromconventional Western thinking.
Influential English language texts on traditional Chinese medicine include Theweb that has no
weaver byTed Kaptchuk (1983), Modem techniques ofacupuncture: apractical scientific guide to
electro-acupuncture byJulian Kenyon (1983), Chinese acupuncture andmoxibustion from Foreign
Languages Press (1987), Thefoundations of Chinese medicine byGiovanni Maciocia (1989),
Between heaven andearth byBeinfeld & Korngold (1991),Acupuncture energetics byJ oseph Helms
(1995), Basics ofacupuncture byStux & Pomeranz (1998), and Understanding acupuncture byBirch
& Felt (1999). All of these books describe anenergetic system for healing that isrooted ina
uniquely Oriental viewpoint of thehuman body. While all energy isconceptualized asaform of qi,
there aredifferent manifestations of this basic energy substance, including the energy of yin and
yang, an energy differentiated byfivephases, and anenergy distinguished byeight principles for
categorizing pathological conditions. Everyday observations of nature, such asthe effects of wind,
fire, dampness and cold, areused asmetaphors for understanding how this qi energy affects the
internal conditions that lead todisease.
Qi: This basic energy refers to avital life force, aprimal power, andasubtle essence that sustains
all existence. TheChinese pictograph for qi refers tothenutrient-filled steam that appears while
cooking rice. Qi isthe distilled essence of the finest matter. Similar images for qi include the
undulatingvapors that rise from boiling tea, the swirling mists of fog that crawl over lowlands, the
flowing movement of agentle stream, or billowing cloud formations appearing over ahill. These
metaphorical pictures were all attempts todescribe thecirculation of this invisible energy.
Different manifestations of the images of qi are shown inFigure 2.10. However, qi was not just
Figure 2.10 TheChinese pictograph for qi energy isrelated totherising steam ofcooking rice (A). Other metaphors for qi include misty
clouds (B), rushing waterfalls (C) andflowing rivers (D). ((B) fun Ma, (C), (D)'Lita Singer, withpermission.)
Theoretical perspectives
31
considered ametaphor. Acupuncturists view qi asareal phenomenon, asreal asother invisible
forces, likegravity or magnetism. Qi isboth matter and the energy forces that move matter.
Comparable toWestern efforts toexplain light asunderstood inquantumphysics, qi isboth likea
particle and likeawave. Oi permeates everything, occurs everywhere, and isthe medium bywhich
all events arelinked toeach other inaninterweaving pattern. Thereisqi inthe sun, inmountains,
inrocks, inflowers, intrees, inswords, inbowls, inbirds, inhorses, and inall anatomical organs. Oi
invigorates theconsciousness andwillpower of ahuman being.
As things change inthe macrocosm of the heavens, the microcosm of theearth resonates with
corresponding vibrations, all related tothe movement and interconnectedness of qi. Certain types
of qi animatelivingorganisms, with thegreatest focus placed on defensive qi andon nutritiveqi.
Defensive qi (wei qi), also called protective qi, issaid to bethe exterior defense of thehuman body
and isactivated when the skin surface and muscles areinvaded byexogenous pathogens. Nutritive
qi (ying qi), also called nourishing qi, has thefunction of nourishing theinternal organs and is
closely related toblood. Prenatal qi istransmitted byparents to their children at conception and
affects that childs inherited constitution. Oi isobtained from the digestion of food and isextracted
from the air that webreathe. Rebellious qi occurs when energy flows inthewrong direction or in
conflicting, opposing patterns. Inbody acupuncture, health isthe harmonious movement of qi
throughout thebody, whereas illness isdue todisharmony inthe flow of qi. There can be
deficiency, excess, or stagnation of theflow of qi within the meridian channels or between different
organs. Theear hasconnections tothese channels, but it isnot apart of anyone of the classic
meridians.
Meridian channels: (lingLuo) The original English translations of the zigzag lines drawn on
Chinese acupuncture charts were described asmeridians, alluding tothelines of latitudewhich
circle theearth on geographic maps. Inacupuncture, meridians were thought tobeinvisible lines
of energy which allow circulation between specific sets of acupuncture points. Later translations
described these acupuncture lines aschannels, analogous to thewater canals that connected
different cities inancient China. As with channels of water, theflow of qi inacupuncture channels
could beexcessive, aswhen there isaflood; deficient, aswhen there isadrought; or stagnant, as
when water becomes foul from the lack of movement. Needles inserted into specific acupuncture
points were thought to reduce the flow of excessive qi, asindams which regulate the flow of water,
toincrease theflow of deficient qi, asinthe release of flood gates of water, or to clear areas of qi
stagnation, asinremoving the debris that can sometimes block water channels. Water has often
been used tosymbolize invisible energies, and isstill thought of inthe West asaconvenient way to
convey theproperties of electricity and the flow of electrical impulses along neurons. Acupoints
were thought tobeholes (xue) inthe liningof thebody through which qi could flow, likewater
through aseries of holes inasprinkler system.
Tao: Thephilosophy of Taoism guides one of theoldest religions of China. Itsbasic tenet isthat
thewhole cosmos iscomposed of two opposing and complementary qualities, yin andyang. The
Taoist symbol shown inFigure 2.11reveals acircle that isdivided intoawhite teardrop and ablack
teardrop. A white dot within theblack side represents theyang within yin, and the black dot within
Tao 3it
Yin Yang
32
Figure 2.11 TheTaoist symbol for theduality ofcomplementary opposites has ayin dark side andayang light
side. Each halfcontains an element oftheopposite side.
Figure 2.12 A depiction ofyang asthesunny sideandyin astheshadyside ofa hill. (Based onphotograph of
mountains byLita Singer, withpermission)
thewhite side reflects theyin within yang. TheChinese character for yang referred to the sunny
side of ahill that iswarmed bybright rays of sunlight, whereas the pictograph character for yin
referred to the darker, colder, shady side of ahill. Figure 2.12depicts such ascene. Light and dark,
day and night, hot andcold, male andfemale, areall examples of this basic dualism of the natural
world. Yin andyang are always relative rather thanabsolute qualities. Thefront of thebody issaid
tobeyin and theback of the body yang, yet the upper body ismore yang compared tothe lower
body. Theouter skin of thebody and the muscles are more yang, theinternal organs aremore yin.
34
Box 2.1 Taoist qualitiesof yangandyin
Yang qualities Yin qualities
Sunny side Shady side
Day Night
Sun Moon
Sky Earth
Fire Water
Hot Cold
Hard Soft
Order Chaos
Rigid Flexible
Active Passive
Strong Weak
Energetic Restful
Movement Stillness
Aggressive Nurturing
Rational I ntuitive
Intellect Emotions
Head Heart
Masculine Feminine
Father Mother
Disorders related tooveractivity aremore yang, diseases of weakness aremore yin. (Thedualistic
aspects of yin and yang aresummarized inBox 2.1.)
Thepsychologist Carl J ung (1964) and thehistorian J oseph Campbell (1988) have noted common
archetypal images inthe ancient cultures of China, India, Egypt, Persia, Europe and amongst
Native Americans. Inall these societies, the sky, thesun, and fire arereferred to asmasculine
qualities, whereas the earth, the moon, andwater areassociated with feminine qualities. Taoist
philosophers described this opposition of dualities inevery aspect of nature. There isatendency in
Western culture to place greater value on the masculine qualities of being strong, active, rational,
and orderly, and to devalue the feminine qualities of being passive, weak, or emotional. It is
understandable that most people tend to prefer being strong, but it isstill important for themto
acknowledge times when they feel weak. Taoism recognized the importance of balance and
emphasized the value of feminine qualities of nurturance and intuition aswell asthemasculine
traitsof strength and intelligence.
Yang qi: This energy islike thewarm, bright light of thesun. It issaid to bestrong, forceful,
vigorous, exciting, controls active movement, and isassociated with aggressive masculine
qualities. Yang meridian channels are thought tohave direct connections to ear acupuncture
points. Yang qi flows down the meridians on the back side of the body, pervading skin and muscles
and affecting defensive qi. Pathological conditions inthebody can be caused bythe excess or
stagnation of yang qi, producing symptoms of restlessness, hyperactivity, tremors, stress, anxiety
and insomnia. Tooverwork isto overindulge inyang qi, which usually leads to burnout of yin qi. In
addition to the application of acupuncture needles, moxibustion and herbal remedies, yang qi can
beactivated byvigorous physical exercise, athletic sports and the practice of martial artssuch as
kungfu or karate.
Yin qi: This energy islike the soft, gentle light of the moon that comes out duringthedarkness of
night. It issaid to beserene, quiet, restful, nurturing, andisassociated with passive, feminine
qualities. Yin isneeded to balance yang. Theyin meridians indirectly connect to theauricle
through their corresponding yang meridian. Yin qi flows up acupuncture meridians on the front
side of body and affects internal organs andnutritiveqi. Symptoms of sleepiness, lethargy,
depression and adesire to beimmobile may bedue to an excessive focus on craving yin qi.
Insufficient yin qi isthought tobeat the root of most illness, thus acupuncture and herbs are used
to restore this energy. Theflow of yin qi can beenhanced bymeditation, byrepeating the soothing
sound of amantra, byvisualization of aharmonious symbol, or bythepractice of such physical
exercises asqi gong, tai chi or yoga. TheChinese goddess Kuan Yin isthe manifestation of the
Buddha infemale form, usually portrayed asacaring, nurturing, ageless woman who isdressed in
long flowing robes.
Yang alarm reactions: A reactive ear reflex point issaid toshow ayang reaction on the ear tosignal a
stress reaction inthecorresponding areaof thebody. Inmodern times, anappropriate analogy would
beafirealarmsignal inabuilding, indicating thespecific hallwaywhere afireisburning. An alarmina
car can indicatewhen adoor isajar. Such alarms alert onetothespecific location of aproblem.
Elevation of yang energy manifests intheexternal ear asasmall areawhere there islocalized
activation of thesympathetic nervous system. Such sympathetic arousal leads toalocalized increase
inelectrodermal skin conductance that isdetectable byanelectrical point finder. Sympathetic
activation also induces localized regions of vasoconstriction intheskin of theauricle. Therestricted
blood supply causes anaccumulation of subdermal, toxic biochemicals, thus accounting for the
perception of tenderness andthesurface skin reactions often seen at ear reflex points.
Ashi points: Inaddition to the 12primary meridian channels that runalong the length of the
body, the Chinese also described extra-meridian acupoints located outside these channels. One
category of such acupoints was the ashi points. Ashi means Ouch! or Thereit is!, and there isa
strong reflex reaction when atender region of the skin ispalpated and apatient says Ouch, that
hurts!. Theexclamation point highlights thegreat emotional excitement vocalized at the time an
ashi point istouched. Sometimes needling of avery tender acupoint within one of the classic
meridian channels produces this same verbal outburst. While the natural inclination isto avoid
touching areas of the body that hurt, ancient acupuncturists and modern massage therapists have
observed that there ishealing value inactually puttingincreased pressure on these sensitive
regions. Theashi points have been suggested asthe origin of the trigger points which have been
described byJ anet Travell inher work on myofascial pain(Travell & Simons 1983). Inauricular
acupuncture, atender spot on the external ear isone of the definitive characteristics that indicate
such apoint should bestimulated, not avoided.
Five Oriental elements: Also referred to asthe fivephases, this Chinese energetic system
organizes the universe intofivecategories: wood, fire, earth, metal and water. Theword element
issimilar to the four elements of naturedescribed inmedieval European texts, the elements of fire,
earth, air, andwater. Theword phase iscomparable to the phases of the moon, observed as
sequential shifts inthe pattern of sunlight that isreflected from the moon. I tisalso related tothe
phases of the sun asit rises at dawn, crosses overhead from morning to afternoon, sets at dusk, and
then hides duringthe darkness of night. Thephases of the seasons inChinese writings were said to
rotatefrom spring tosummer tolatesummer tofall towinter. These long-ago physicians found
observations of natural elements, such asthe heat from fireor the dampness of water, were useful
analogies asthey attempted todescribe themysterious invisible forces which affect health and
disease. Many complex metabolic actions inthe humanbody arestill not understood bymodern
Western medicine, even with the latest advances inblood chemical assays and magnetic resonance
imaging equipment.
Themetaphorical descriptions of fiveelement theory reflects thepoetry and rhythm of theChinese
language intheir attempts tounderstand each individual who isseeking relief from some ailment. At
thesame time, there arecertain aspects of thefivephases that seem likeanarbitraryattempt to
assign all things togroups of five. TheWestern approach of dividing the four seasons asthespring
equinox, summer solstice, fall equinox, andwinter solstice seem more aligned with naturethan the
Chinese notion of adding afifth season labeled latesummer. Moreover, theapplication of five
element theory totheenergetic aspects of anatomical organs often contradicts modern
understanding of thebiological function of those organs. I tisdifficult for Western minds toaccept
howtheelement metal logically relates tothelungorgan andthefeelings of sadness, whereas the
element wood issaid tobeassociated with theliver organ and theemotion of anger. At some point,
one must accept that these fivephases aresimply organizing principles tofacilitate clinical intuition
intheunderstanding of complex diseases. Insome respects, itmight have been better tohaveleft the
names of the meridian channels asChinese words rather than totranslate them intothe European
names of anatomical organs whose physiological functions were already known. Theconflicts between
theOriental energetic associations of anorgan andtheknown physiological effects of that organ can
lead toconfusion rather thancomprehension. I fone thinks of these zang-fu organs asforce fields
rather than organic structures, their associated function maybecome more understandable.
Zang-fu organs: Each of the fiveelements isrelated to two types of internal organs: thezang
organs aremore yin, thefu organs aremore yang. Theacupuncture channels arethe passages by
which thezang-fu organs connect with each other. Thezang meridians tend torun along the inner
side of the arms and legs and upthe front of the body. Thefu meridians run along the outer side of
the limbs and down theback of thebody. Thezang organs store vital substances, such asqi, blood,
essence, and body fluids, whereas thefu organs areconstantly filled andthen emptied. The
Chinese character for zang alluded to adepot storage facility, whereas the pictograph for fu
depicted ancient Chinese grain collection centers that were called palaces. Although Confucian
principles forbade official dissections of the humanbody, anatomical investigations probably still
occurred inancient China, asdidexamination of animals. Physical observations of gross internal
anatomy reveal that thefu organs were hollow tube-like structures that either carried food
(stomach, small and large intestines) or carried fluid (urinarybladder and gall bladder). In
contrast, the zang organs seemed essentially solid structures, particularly the liver, spleen and
kidneys. While the heart and lungs have respective passages for blood and air, onewould not
describe these two organs ashollow, but ashaving interconnecting chambers.
Thespecific characteristics of each zang-fu channel arepresented inTable2.2, which indicates the
internal organ for which each channel isnamed, the international abbreviation for that channel
Table 2.2 Differentiation of zang-fu meridian channels
Zang
fu
Organ
channels
WHO
code
Other
codes
Channel
location
Element Primary
acupoints
------
Lung LU Handtai yin Metal Zang LU I ,LU7,
LU9
LI 4, LI 11
ST36, ST44
Fu
Fu
Metal
Earth
Handyang ming
- - - - - - - - - - - ~
Foot yang ming
LI
ST
Large Intestines
Stomach
Fire
Earth Spleen SP Foot tai yin
Handshao yin
Zang
------
Zang
SP 6, SP 9
HT7
Handtai yang Fire Fu SI 3,SI I 8
Foot tai yang Water Fu BL23, BL40,
BL60
KI 3, KI 7
PC6
SJ 5
Fire
Fire
Water Zang
Zang
------
Fu
Foot shao yin
Handjueyin
-----
Handshao yang
P
TH,TE,
TW
PC
SJ
Pericardium
SanJ iao
(Triple Warmer)
- -- ------------
Gall Bladder GB Foot shao yang Wood Fu GB20, GB34,
GB40
Wood Liver
Conception
Vessel
LR
CV
Liv
Ren mai
Footjue yin
-------
Front-Mu yin
Zang
Governing
Vessel
GV Dumai Back-Shu yang GV 4, GV 14,
GV20
Energy issaid tocirculate through these zang-fu channels inthe order presented, from Lung to Large Intestines toStomach
toSpleen to Heart to Small Intestines toBladder to Kidney to Pericardium toSan J iao to Gall Bladder to Liver and back to
Lung. Tai refers togreater yin or yang. shao refers to lesser yin or yang, ming describes brightness, and jue yin indicates
absolute manifestation of yin.
according to theWorld Health Organization, alternative abbreviations which have been used in
various clinical texts, thelocation of each channel, and designation of theprimary element
associated with that channel. Theacupoints which aremost frequently used inacupuncture
treatments are also presented. Thesequential order of thechannels presented inTable 2.2
indicates thecirculation pattern inwhich energy issaid to flow. Thechannels are differentiated
intothreeyin meridians andthreeyang meridians on thehandand threeyin meridians and three
yang meridians on the foot. InTable2.3, thezang-fu channels areregrouped according tothose
meridians which aremore yang andthecorresponding channels which aremore yin. This tablealso
describes therelationship of theanatomical location of each meridian that isshown on
acupuncture charts ascompared tothe zone regions of thebody that areused infoot andhand
reflexology. Thezang channels tend torunalong theinside of thearms or legs, whereas the
corresponding fu channel typically runsalong theexternal side of thearms or legs.
As seen inFigures 2.13and2.14, when thearms areraised upwards toward thesun, yang energy
descends down theposterior side of the body along fu channels, whereas yin energy ascends the
anterior side of the body along zang channels. Only thefu Stomach channel descends along the
anterior side of the body. Since the fuchannels have acupuncture points located on thesurface of
the head, these yang meridians aresaid to be more directly connected to theear. TheLarge
Intestines channel crosses from theneck to the contralateral face, theStomach channel branches
across themedial cheeks andinfront ofthe ear, the Small Intestines channel projects across the
lateral cheek, theBladder meridian goes over themidline of thehead, andboth theSan Jiao and
theGall Bladder channels circle around the ear at theside of the head. Acupuncture points on the
zang channels only reach ashigh asthechest, so they have no physical means to connect totheear.
Another set of acupuncture channels, thefrontal Conception Vessel meridian (Ren mai) and the
dorsal Governing Vessel meridian (Dumai) both ascend themidline of thebody to reach the head,
asshown inFigure 2.15. Representation of the Conception Vessel andGoverning Vessel channels
upon the tragus region of theexternal ear isshown inFigure 6.8of Chapter 6.
TheChinese charts do not show how the external ear connects tothesix zangchannels. Dale
(1999) has hypothesized that all micro-acupuncture systems function through micro-meridians,
just asthemacro-energetic system functions through macro-acupuncture meridians. I tisfurther
postulated that the entire macro-micro channel complex forms anextensive energetic network,
Table2.3 Anatomical location of yang and yin meridian channels
Yang Location Reflex Corresponding Direction of Reflex
channels zones yin channels energy flow zones
Large External handto 1-2 Lung Inner chest to
Intestines armtoshoulder inner armand
andface hand
" - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - - -
SanJiao External handto 3-4 Pericardium Inner chest to 3
external armand inner armand
head hand
Small External handto 5 Heart Inner chest to 5
Intestines armtoshoulder inner armand
andface hand
-_._---_...-._.-
Stomach Facetoanterior 2-3 Spleen Foot toinner leg 1-2
bodytoanterior leg toanterior body
-_.,-_ ..,--_.__.._._-------------,._--
Gall Bladder External head to 5 Liver Foot toinner leg 1-2
external bodyandleg toanterior body
Bladder Posterior head to 1-2 Kidney Foot toinner leg 1-2
back toposterior leg toanterior body
Governing Midlineof buttocks Conception Midlineabdomen
Vessel tomidlineback Vessel tomidlinechest
(Dumai) tomidlinehead (Renmai) tomidlineface
-----------
5T 45
LR 14
KI 21
LR 13
KI 11
Figure 2.13 Thedescent ofyang qi from thehead tothefeet viewed on theposterior (A) andanterior (B) side ofthebody. Theascent or
yin qi from thefeet tothechest only occurs on theanterior side. Yangacupuncture channels along thebody include meridian acupointsfor
theBladder (BL), Call Bladder (CB) andStomach (ST). Yin acupuncture channels include meridian acupoints for theKidney (KI),
Spleen (SP) andLiver (LR).
38 Auriculotherapyfv1anual
PC9
PC6
PC1
A Hand yin meridians
B Hand yang meridians
SJ 15
SI 15
SI 19
SJ 1
SI 8
Figure 2.14 Yinqi flows from thechest distally toward thehandyin meridians (A), whileyang qi flows fromthehandyangmeridians
mediallv toward thehead (B). Theyin channels oftheinner arminclude theHeart (HT), Pericardium (PC) andLung(LV) meridians,
whereas theyang channels oftheexterior arminclude theLarge Intestines (L1), San Jiao (SJ) andSmall Intestines (51) meridians.
A Conception Vessel channel
B Governing Vessel channel
GV7
,.----GV1
: - - ~ ~ G V 1 4
--------Gv21
CV2 - ~ - - -
CV7 ~ - - - - - - =
CV14
CV21
CV24 ~ ~ ~ ~ - ~ ~ -
Figure2.15 TheConception Vessel meridian (Ren channel) isfound on themidlineoftheanterior torso (A), whereas theGoverning
Vessel meridian (Du channel) isfound along themidlineoftheposterior spine ofthebody (B).
perhaps similar tothewayveins, arteries and capillaries characterize thevascular network. Since
both macro-acupuncture channels and micro-acupuncture meridians carry invisible forces of
energy, theexact mechanisms remain mysterious.
Metal: Themetaphor of metal isrelated tothe Bronze Age technique of heating theminerals of
the earth to awhitehot intensity with fire, then cooling the object with water and shaping itwith
wood. While metal ismalleable when it iswarm, itbecomes hardandrigid when itcools and
contracts intoafixed shape. Theyin nourishing aspects of metal are represented by the ability to
cook rice inametal pot, whereas theyang aggressive aspects of metal are demonstrated bythe
creation of the sword andprotective suits of armor. Theacupuncture meridians related to metal
are theLungchannel that descends from thechest distally down theinner armand ends on the
palmside of the thumb, whereas theLarge Intestines channel isfound on the opposing side of the
hand, beginning at the external, dorsum side of the second finger andtraveling uptheexternal side
of the armtoward the body.
Earth: Theyellow earth isthestable foundation upon which crops aregrown andcities arecreated.
Thelatesummer qualities of earth allowone tobesolid andgrounded. Theacupuncture meridians
related toearth aretheSpleen channel that begins on thelarge toe and travels upthe inner leg andthe
Stomach channel that travels down theexternal body and external legtoend on thesecond toe.
Fire: Thered flames of afirebringwarmth andcomfort toacold day, allowing one tomove about
andfunction withgreater ease andspeed. Thesummer qualities of fire accompany atimewhen there
isgreat activity andagathering of crops. Theacupuncture meridians related tofireinclude theHeart
channel that descends from thechest distally down the inner armandends on the littlefinger,
whereas theSmall Intestines channel begins on thelittle finger and travels uptheexternal armtoward
thebody. Twoother channels also related tofirearethePericardium channel that travels distally
down the inner armand theSan Jiao channel that travels upthe outer armfrom thehand.
Yang meridians on right side of body
connect to microsystem points on right ear
Yang meridians
Large Intestines (L1)
Small Intestines (SI)
Stomach (ST)
Gall Bladder (GB)
Urinary Bladder (BL)
San [lao (SJ)
Corresponding yin meridians
Lung (LU)
Heart (HT)
Spleen (SP)
Liver (LR)
Kidney (KI)
Pericardium (PC)
Qi energy flow
Right ear relieves pain
on right side of body
Figure 2.16 Theflow ofqi along ayangacupuncture channel up thearmtoward ear reflex points on thehead has
theability to unblock theflow ofenergy along theispsilateral side ofbody. (From LifeART, Super Anatomy.
'Lippincott Williams & Wilkins, withpermission.}
A Surface view of zang organs B Posterior view of zang organs
Kidney Heart
Liver
Liver
Spleen
Spleen
Lung
Lung
Heart
Kidney
Figure 2.17 Localization ofthefivezangorgans represented on theanterior (A) andposterior (B) auricle.
Water: Therefreshing coolness of blue waters quenches ones thirst and provides thebody with
oneof itsmost necessary elements. Associated with winter, the qualities of water arestillness,
quietness, andatime for reflective meditation. Theacupuncture meridians related to water arethe
Kidney channel that begins on the littletoe and travels up the inner leg to theabdomen, whereas
theBladder channel begins on theforehead, crosses over the top of thehead to theback of the
head, runsdown the back of the neck, down the spine, anddown the back of the leg to the foot.
Wood: Theimage of wood isbest thought of asthe initial spring growth of new branches on a
tree, each limb sprouting bright green leaves. Wood isassociated with new beginnings, new growth,
and changing temperaments. Theacupuncture meridians related towood include theLiver
channel that begins on thelarge toe andtravels upthe inside of the leg to thechest, whereas the
Gall Bladder channel descends along theexternal side of the head andbody and down the external
leg to the littletoe.
Five zang organs: While all the internal organs aremore yin thanyang, apredominant focus in
Chinese medicine isgiven to the importance of thezangorgans, which areeven more yin thanthe
fu internal organs. Thefive principal zangorgans arethelung, heart, liver, spleen andkidney. The
energetic functions of zangorgans are utilized inclassical acupuncture more often than the
physiological functions of that organ. As previously noted, Western language translations of the
acupuncture meridians might have been better left asChinese pinyin terms. Thediscrepancies
between the anatomical function of these organs and their clinical use inOriental medicine has
often lead to skepticism rather than understanding byWestern doctors. Thezangorgans
represented on the external ear areshown inFigure 2.17.
Lung (fei): Thethoracic organ of the lung, inthe upper jiao, dominates the qi ofrespiration,
inhalingpureqi and exhaling toxic qi. I flung qi isweak, defensive qi will not reach theskin, thus
the body will bemore easily invaded bypathogenic factors, particularly cold. Besides itsinclusion
inthe treatment of respiratory disorders, the Lung point on the auricle isone of themost
frequently used ear points for the detoxification from addictive substances, such asopium, cocaine
and alcohol. Because the skin also connects to respiration and to the release of toxic substances
through sweating, the auricular Lungpoint isalso used for the treatment of skin disorders.
Heart (xin): This thoracic organ promotes blood circulation and supports vigorous heart qi.
Heart qi issaid to beessential for forming blood andalso houses themind, emotions andthe spirit.
In addition toitsapplication for coronary dysfunctions, the auricular Heart point isstimulated to
relieve nervous disorders, memory problems, sleep impairment and disturbing dreams.
Liver (gan): In Chinese thought, theliver issaid tostore blood and toincrease blood circulation
for vigorous movements bynourishing the sinews, ligaments and tendons that attach muscles to
bones. The liver isresponsible for unrestrained harmonious activity of all organs and maintains the
free flow of qi. Stagnation of liver qi isassociated with resentment, bitterness, irritability, repressed
anger, and mental depression, while excessive liver qi may cause headaches and insomnia. The
auricular Liver point isused for myofascial pain and muscle tension duetorepressed rage.
Spleen (pi): Of all thezang organs, the Chinese conceptualization of thespleen isprobably most
different from Western understanding of this organ. This abdominal organ reportedly governs the
transportation of blood and nourishes themuscles and thefour limbs. I fspleen qi isweak, the
muscles will beweak. Excessive mental work or worried thinking issaid toweaken spleen qi. In
Western anatomical texts, thespleen isconsidered apart of thelymphatic drainage system and has
littleeffect on muscles or on mental worry. Some of the digestive functions that theChinese
assigned to the spleen seem more appropriately delegated tothe nearby abdominal organs of the
stomach andthe pancreas. Nonetheless, theChinese Spleen point on the ear isoften used very
effectively for the treatment of muscle tension andgeneral nourishment.
Kidney (shen): Lower intheabdomen, the kidneys aresaid tostore thecongenital essence of the
physical body that people inherit from their parents. Thekidney also affects growth, development,
and reproduction. The kidneys dominate water metabolism andregulate thedistribution of body
fluid. The kidney isalso said to nourish the spinal cord and the brain, andto bethe residence of
willpower andvitality. Finally, the kidneys nourish hearing functions of theear.
Pericardium (xinbao): A sixth zang organ isthe pericardium, which refers to theprotective
membranes that surround the heart. This acupuncture channel has also been labeled theMaster of
the Heart or asthecirculation-sex channel. The Pericardium meridian functions very similar to
theHeart channel and runs along anadjacent region of the inside of the armasittravels distally
toward the hand. This zang organ isnot often utilized inauriculotherapy.
Six fu organs: Thefuorgans arenot asprominently discussed inOriental medicine asthezang
organs, but the acupuncture channels associated with each fuorgan arevery important in
acupuncture treatment plans. Twoof themost commonly used acupoints inall of Oriental
medicine are LI 4(hegu or hoku) on theLarge Intestines meridian andST 36(zusanli) on the
Stomach meridian. Stimulation of the Large Intestines channel can relieve pains inthe index
finger, wrist, elbow, shoulder, neck or jawthat occur along theLarge Intestines channel. Needling
theStomach channel can alleviate conditions intheface, neck, chest, abdomen, leg, knee or foot
that areall skeletal structures found along the Stomach meridian.
San Jiao: This termhas been translated asTripleWarmer, TripleHeater, TripleBurner andTriple
Energizer. Members of aninternational nomenclature committee of the World Health
Organization ultimately decided to keep the Chinese termfor this meridian, since San Jiao really
has nocorrespondence inWestern anatomical thinking. Theclassical division of thebody was
distinguished asthree regions: theupper jiao (thechest region that regulates circulatory and
respiratory functions), the middle jiao (theupper abdominal region which affects digestive
functions) and thelower jiao (the lower abdominal region which affects sexual and excretory
functions). Theupper burner of San Jiao islike avaporous mist intheregion of the heart and
lungs, the middle burner islikefoam inthe region of thestomach andspleen and the lower burner
islikeadense swamp inthe region of thekidneys, intestines and bladder. San Jiao refines the
subtle essence of qi thewayagranary refines flour or abrewery distills alcohol. Thephysiological
effects of San Jiao arepossibly related to thearousal actions of thesympathetic nervous system
andthe release of circulating hormones bythe endocrine system.
Spirit (shen): This substance serves asthe vitality behind the animation of qi, theflow of blood
and the instinctual processes related to individual essence (jing). Shen isassociated with human
consciousness and the force of human personality to think, feel, discriminate and choose. I tis
associated with aparticular behavioral style and it affects the choice of aparticular vocational
path inlife. Oneof the most widely used points inall of auriculotherapy isthe Shen Men point in
the triangular fossa. This Chinese ear point has aprofound effect on spirit, will andgeneral
wellbeing.
2.3 Ayurvedic medicine, yoga and prana energy
While theancestral source of Chinese medicine isnot fully known, many of theconcepts used in
acupuncture aresaid tocome from theVedic texts of ancient India. Theprinciples described inthe
Vedas were developed inIndiaby1500BeE andhavebeen presented inrecent evaluations of
complementary medicine for thedisciplines of yoga (Ross 2001) andayurvedic medicine (Manyam
2001). InSanskrit, ayu referred tolife, andveda referred toscience, thusayurveda denoted thescience
of life. TheVedas included ascientific understanding of body, mind andspirit. Ayurveda wasa
complete system of medicine, withseparate branches for surgery, internal medicine, toxicology,
pharmacology, neurology andpsychology. TheYoga Sutras of Pantanjali were written in200BCE. This
text wasone of thefirst documents todescribe thehealthcare practices of yoga. Pranayamas are
specific types of breathing, asanas aredisciplined postural movements, dyanas arepractices of
contemplative meditation, andsamadhi isblissful union withthesupreme existence of all things.
Prana: A fundamental principle of this Indiantradition isthat the body iscomposed of energy,
not just material substance. This energetic view of the human body isvery similar to Chinese
medicine. Illness wassaid tobedue totheblockage of energy. Through different yoga disciplines,
itwas possible toenhance thecirculation of energy inorder tofacilitate healing from adisease.
Ayurvedic practitioners refer totheprimal energy asprana, which also means breath. Hinduand
Buddhist teachings assert that the soul enters thebody with aninfantsfirst breath and the soul
leaves thebody with apersons last breath. Thesoul isthen ready for anew reincarnation, when
theprocess of lifethrough breath isrepeated. While incarnated on this earth, aperson is
challenged with many lessons for the souls evolution, including thechallenge of takingcareof the
physical body. Karma isnot punitive retribution for past sins, asit isoften thought of inthe West,
but isinstead aguide for educating the soul incorrecting previous mistakes inliving. I tisnot
necessary to believe inthereligious philosophies of Hinduismor Buddhism inorder tofind benefit
inthebreathing and postural practices of yoga or the herbs used byayurvedic practitioners. The
energetic perspectives of the human body, though, are afundamental component inunderstanding
how these spiritual traditions have been applied to ayurvedic clinical treatments.
Nadis: Similar tothe acupuncture meridians, Vedic writings described channels of energy
extending over the surface of thebody through which pranacan flow. InIndia, the channels were
called nadis. Said tobeaconduit between thegross anatomical body and the subtle etheric body,
thenetwork of 350000nadis resembles modern descriptions of nerves and nerve plexuses. Of the
different energy channels inayurvedic medicine, the three most important were thesushumna, the
ida and thepingala. Themainchannel was the sushumna, which rose from the tailbone upthe
spine. Theida and the pingala spiral upthespine on each side of the sushumna. These three
primary channels were depicted astwo coiled serpents spiraling upacentral staff, remarkably
similar tothe Egyptian, Greek and Roman caduceus symbol of healing. Thesushumna has been
said tocorrespond tothe central nervous system, the ida represents thesedative parasympathetic
nervous system, and thepingala affects the fight-or-flight-related sympathetic nervous system. The
location of the sushumna along the spine coincides with the midlinefront mu and back shu
meridian channels of Chinese acupuncture. Inboth the Vedic sushumna channel and Chinese
mu-shu channel, vital energy ascends the spine toward the head.
FiveVedic elements: Just astherewere fiveprincipal elements or phases inOriental medicine,
fiveprimary elements aredescribed inayurvedic medicine. Referred to asfivecategories of matter
(panchamahabhutas), these basic elements included earth (prthvi), water (ap), fire (tejas), air
(vayu) anduniversal etheric space (akasa). Theprimordial sound of ,Om was said to create air
from etheric space, which generated friction asit moved. This friction created fireandheat, which
ultimately cooled and manifested aswater, andfinally became earth. TheMateria medica of
ayurveda contained alist of several hundred botanical herbs that employ the principles of these five
elements inorder toheal various diseases, just asthemedical application of different Chinese
herbs used the principles of fivephases.
ThefiveVedic elements combined toform different constitutional types of mind-body
interactions. These body types areknown asthe threedoshas, which arevatha, pitta andkapha.
Figure 2.18 Images ofchakra motion arerepresented asachariot wheel (A), awagon wheel (B), thetop ofa whirlpool (C), awater
wheel (D), theside viewofawhirlpool (E), or theswirlingpattern oftornados (F). (Bfrom Cellox, Reedsburg, WI, withpermission;
D 'UtaSinger, withpermission; Ffrom NOAA/OAR/National Severe Storms Laboratory, Norman, OK.)
4S
A
7th
B
c
Figure 2.19 Theseven chakras found along thevertical axisofthebody viewed from thefront (A) andtheside (B). Thecaduceus symbol
(C), still used inmodern medicine, has ancestral roots inthenadis of Vedicscriptures which show thesushumna that rises upthespine
surrounded bythesnake-like undulations oftheida andthepingala nadis.
Vatha combines air with ether tocontrol the propagation of nerve impulses and the movement of
muscles. Pittautilizes the element of fire, thus affecting physiochemical activities of general
metabolism that produce heat and energy throughout the body. Kapha combines water and earth
tomaintaincohesiveness inthe body byproviding itwith afluid matrix. An excess of kapha,
however, can lead toslow metabolism, chronic lethargy, obesity or clinical depression. Thefive
Vedic elements and the three doshas facilitate anintuitiveunderstanding of personal constitution
and itseffects on health.
Seven chakras: Natural sources for facilitating the flow of pranawere the chakras (pronounced
shaw-kraws). Theword chakra refers to aspinning wheel, like the appearance of arapidly rotating,
multi-spoked wheel on acarriage asit moves along aroad (Motoyama 1981, Tansley 1984). They
areanalogous torotatingwater wheels andwindmills. Inmodern times, the rotatinggears of a
motor engine or therapid rotation of the propeller on anairplane might beequivalent analogies.
When viewed from the side, asopposed to afrontal perspective, the chakras appeared likea
whirlpool, awhirlwind, or atornado (see Figure 2.23). Each chakra isavortex of circling, spiraling,
swirling forces of invisible energy. These chakras arefound over specific regions of thebody, just as
the spinning pattern of hurricanes occurs over specific regions of the earth asseen from modern
satellites. Theswirling vortex of energy ascribed to the chakras isconsidered apossible explanation
for themanner inwhich energy circulates at acupuncture points. Thereareminor chakras at each
joint of the body, at the hands, thewrists, the elbows, theshoulders, the hips, the knees, the ankles
and the feet. Vedic texts also described secondary chakras at the ears. Most of the focus in
ayurvedic medicine, though, ison the seven primary chakras that ascend the midlineof the body.
Theaxial position of these chakras runs along the sushumna. Theida and thepingala undulateup
the spine inaspiral pattern, crossing each other at each chakra. All seven chakras areshown from
afrontal and asagittal perspective inFigure 2.19. Thefirst chakra resides at the base of the spine,
inthe region of themale genitals, and isthe initial source for the rise of thekundalini energy that is
essential for survival. Thesecond chakra islocated within the lower abdomen, the thirdchakra
within the upper abdomen, thefourth chakra within thechest and heart, the fifth chakra at the
lower throat, the sixth chakra between theeyebrows, and the seventh chakra at the top of the head.
Seen from the side, the chakras appear likefunnels, with the tipof these spinning cones of energy
at the posterior spine and thebroader circular base of the cone toward the anterior body. Ancient
texts pictured the chakras asmany-petaled lotus blossoms, with their stem toward the spine and
theblossom petals toward thefront of the body. Thechakras were not limited to these cone-like
configurations, but were actually broad fields of spiraling energy that could extend well beyond the
physical body.
Each of the seven primary chakras islocated next tothe anatomical position of anendocrine gland,
and the force field of each chakra produces functional changes that aresimilar tothe effects of the
hormone released bythat endocrine gland. Thefirst chakra isfound inthe scrotal region of the
male genital organ, the testis, whereas the second chakra occurs inthepelvic region of the female
genital organ, theovary. Testosterone produces afeeling of physical power, aggressive rage, and
sexual excitement. The estrogen released bythe ovary induces feminine sexual receptiveness while
the hormone progesterone facilitates maternal bonding. Thethirdchakra lies inthe region of the
abdominal adrenal gland. Theadrenal inand cortisol released bythe adrenals mobilizes the energy
todeal with stress andstrain. The primary endocrine gland found near the heart chakra isthe
thymus gland at thecenter of the chest and ispart of theimmunesystem. Thefifth chakra is
located at the base of the throat, near the thyroid and parathyroid glands. Thyroxin released bythe
thyroid gland enhances general metabolism when elevated, but asense of fatigue and lethargy
when diminished. Thesixth and seventh chakras that arecentered inthehead arefound inthe
location of the pineal gland and thepituitarygland. Thepineal releases the hormone melatonin
that regulates sleep-wake patterns, whereas thepituitaryreleases specific hormones that control
other endocrine glands.
The first chakra issaid totakethebase physical energy from the earth and transmute itsraw
substance to amore refined essence for the body to assimilate. Thehigher chakras transform the
energy of the lower chakras into even finer forms, similar to the Chinese descriptions of distillation
bythethree burners of San Jiao. Thefirst and second chakras arevery similar tothe urogenital
functions of the lower jiao, the thirdchakra tothe digestive functions of the middlejiao, and the
fourth andfifth chakras to the circulatory aspects of the upper jiao. When representing the front of
thechakras aslotus blossoms, the lower chakras areshown withjust afew petals andhigher
chakras aredepicted with progressively more petals. Specifically, the flowers for thefirst chakra
have four petals, the second chakra hassix petals, the thirdchakra has ten petals, the fourth chakra
has 12petals, the fifth chakra has 16petals, the sixth chakra has 96petals, and the seventh chakra
has 960petals. Thesixth chakra isoften pictured astwo large petals over the forehead region,
looking almost likethe left and the right cerebral hemispheres, while the seventh crown chakra is
referred to asthe thousand petaled lotus. These many-petaled lotus flowers metaphorically
suggest that the spinning wheels of the chakras rotatefaster asone ascends the spine.
Chakra colors: Inmetaphysical texts byBeasley (1978) and byBruyere (1989), the chakras are
represented bythe colors of the rainbow. Red isassociated with the first chakra, from which the
primordial energy of the kundalini begins itsascent up the spine. J ust asred isthe lowest frequency
inthevisible spectrum, the kundalini chakra has the lowest vibration rate. Progressively higher
frequencies of color that aredue to different wavelengths of light rays that are associated with
progressively higher chakras spinning at progressively higher frequencies of revolution. The
chakra colors progress from red at thebase chakra tothe slightly higher resonance rates of orange
at the second chakra. Thestill faster color of yellow isassociated with the thirdchakra, green with
thefourth chakra, blue with thefifth chakra, purple or indigo with the sixth chakra, and ultimately
white andviolet with the seventh chakra. Thehigher frequencies of the higher chakras aresaid to
represent higher planes of spiritual existence. This range of hues isactually anidealized version of
thewaythe chakra colors would appear inaperfectly healthy person, but arainbow pattern is
rarely thecolor spectrum seen on anactual person, particularly someone with anillness. Other
descriptions of thechakras allude to adifferent set of colors at each location, such asgreen at the
second chakra andyellow at the fourth chakra. Theauricular medicine perspectives that
developed inEurope also emphasized seven basic frequencies that affect the seven different types
of tissue inthebody. The lowest frequencies inauricular medicine characterized primitive
instinctual processes, whereas the higher frequencies areassociated with higher neurological
functioning.
Many Western investigators considered the chakras tobemore symbolic thanreal. However,
Western aswell asEastern physicians have reported that they can feel aswell assee these chakra
forces. TheCalifornia physician Brugh Joy (1979) described hisobservations of thesubtle energy
fields. Although hehad not read anyayurvedic writings, Joy could sense vibrational changes over a
patients body which precisely corresponded tothe locations of the seven Vedic chakras.
Electrophysiological research at UCLA byDr Valerie Huntfound that these chakra energy
Table 2.4 Relationship of seven chakras to different functions
Chakra name Location Gland Element Animal Lotus Color Function
traits petals
I. Base chakra Groin Testis Fire Serpent, 4 Red Survival instincts, rage,
(Muladhara) dragon vitality, physical power
2. Pelvic chakra Pelvis Ovary Water Fish 6 Orange Deep emotions, sexual
(Svahishthana) functioning
- - --- - --
3. Solar plexus Upper Adrenal Air Bird 10 Yellow Intellectual mind,
(Manipura) abdomen personal will
---------------
4. Heart chakra Chest Thymus Earth Mammal 12 Green Empathy, love,
(Anahata) compassion
- --- ----------------- ------- ------ -----------_._ ..__. __._. __. ~ .._.------
5. Throat chakra Throat Thyroid Ether Human 16 Blue Verbal expression,
(Viahuddua) speech, creativity
.-.- - - , , - ~ - - - - - . - ~ - _ . _ . _ -
6. Thirdeye Forehead Pineal Soul 96 Purple Intuition, psychic
(Ajna) vision
- ------------
7. Crown chakra Vertex of Pituitary Spirit 960 White and Worldly wisdom, spiritual
(Sahasrara ) head violet awareness
--,--_ .. - - " ' - " ~ . _ ' ...- .
48 Auriculotberepy Manual
patterns could bescientifically measured. Working with the aurareader and spiritual teacher
Rosalyn Bruyere (1989), Huntrecorded specific electrophysiological changes invery high
frequency waves of theelectromyogram (EMG). Surface EMG electrodes were placed over
specific chakra locations on thebodies of humanvolunteers. As the aurareader reported distinct
changes inthecolor and pattern of the auricenergy field at different chakras, the physiological
equipment indicated specific changes inelectrophysiological frequency andvoltage amplitude.
Thedifferent energy patterns reported bythe aurareader for each chakra position were found to
correspond tospecific EMGpatterns recorded bythe electrophysiological equipment. Noother
laboratory has attempted to replicate Huntsresearch, thus ascientific explanation for these
experiences remains tobedetermined.
Chakra acupuncture: TheGerman physician Gabriel Stux (1998) has described aprocedure
called chakra acupuncture asanexpansion of the practice of traditional Chinese acupuncture. The
chakra energy centers of ayurvedic medicine areactivated inamanner similar tostimulation of the
Chinese zang-fu channels. Traditional Chinese acupuncture seeks to harmonize the flow of qi by
dissolving the blockages inthechannels and organs, and there isasimilar aiminayurvedic
medicine. Conditions of excess or deficiency can bebalanced byharmonizing theyin andyang
forces of each of theseven chakra centers. Chakra acupuncture extends the traditional application
of acupuncture tothe Vedic chakra system for both diagnosis andtreatment. Inchakra
acupuncture, chakra points areneedled intheareaof theseven primary energy centers. Energy flow
stimulated bythisneedling isreferred toasopening of thechakras. Themost frequently used
chakra acupoints areGV 20toactivate theseventh chakra, GV 15tostimulate thesixth chakra, and
CV 17andGV 11tobalance thefourth chakra.
Besides needling thechakra points on the body, Stux asks the patient toconcentrate deliberately
on thebody areathat isbeing needled or electrically stimulated. After ashort time, the patient
usually feels aslight tingling sensation or adiscreet, warmflowing sensation inthis chakra area.
Thepractitioner focuses hisor her attention on this region too. When the flow through one energy
center isclearly perceptible tothe patient, treatment proceeds tothe next energy center. The
patient isasked tobreathe into thechakra area, to hold hisor her conscious awareness there, and
toimagine opening thechakra until heor she feels asensation of wideness, charge and flow inthat
region. Byattentively opening each energy center, the internal flow of lifeforce ispromoted. The
individual brings awareness or mental focus on achakra region, then the person identifies the
location, borders, size, temperature, color andemotions of that body area. The next step isto
release the blocked or stagnant energy, thus transforming the density of theblockage through
breathing consciously into that region.
Chakras andauricular acupuncture: The Dutchphysician Anthony Van Gelder (1999) has
suggested that thechakras arealso represented on the external ear. Thelocation of auricular areas
associated with each of the seven primary chakras coincides with certain ear acupoints known as
master points. Thefirst three chakras respectively correspond tothe auricular master points
referred to asthe Sympathetic Autonomic point, theear point Shen Men, and Point Zero. The
representation of theother chakra centers isnot so generally accepted, but inVanGelders work
they arelocalized at theroot of the helix of the ear. An alternative correspondence system for the
chakras correlates the upper chakras to theEuropean auricular points known asWonderful point,
Thalamus point, Endocrine point, andMaster Cerebral point. Different possible representations
of thechakras upon theexternal ear are indicated inFigure 2.20.
2.4 Holographic model of microsystems
InTheholographic universe, Michael Talbot (1991) describes how thetechnology ofthe hologram
can serve asamodel for many unexplained phenomena, including thesomatotopic microsystem
found on the external ear. A hologram iscreated when alaser light issplit into separate beams.
Angled mirrors areused tobounce the laser beamoff theobject being photographed. A second
laser beamisbounced off the reflected light of thefirst laser beam. Thecollision of these reflected
laser beams generates aninterference pattern on the holographic film. This interference pattern is
the areawhere the twolaser beams interact on thefilm. When thefilmisdeveloped, itlooks likea
meaningless swirl of light anddark images, composed of crisscrossing lines, concentric circles and
geometric shapes similar tosnowflakes. However, when the developed filmisilluminated by
another laser beam, athree-dimensional image of the original object appears. Onecould actually
A. Auricular Chakras described by Van Gelder
1st Chakra
5th Chakra
3rd Chakra
4th Chakra
2nd Chakra
B. Auricular Chakras described by Oleson
3rd Chakra
6th Chakra
7th Chakra
2nd Chakra
4th Chakra
so
Figure 2.20 (A) Fiveoftheseven chakras havebeen depicted by VanGelder as located intheupperexternal ear.
(B) All seven chakras areshown on theauricle fromadifferent perspective developed byOleson.
walk around this three dimensional image andview the hologram from different sides. For the
purpose of this discussion, themore intriguingaspect of holograms isthat each part of the
holographic filmcontains animage of thewhole object thatwas photographed. Instandard
photography of aman, for instance, one section of the photographic negative would just contain
theimage of the head and another section would just include the image of thefoot. Inholographic
photography, all sections of thefilmcontain all theimages of the head, thefoot, andtheentire
body inbetween. A diagramof holographic equipment isshown inFigure 2.21and aholographic
image of man isshown inFigure 2.22.
The respected Stanford University neurobiologist Karl Pribramused the model of the hologram to
explain research experiments demonstrating that memory can bestored inmany partsof the brain.
Pribramsuggested that individual neurons indifferent partsof the brainhave animage of what the
whole braincan remember. According to thismodel, memories areencoded not inneurons, or
even small groupings of neurons, but inpatterns of nerve impulses that crisscross theentirebrain.
Thisbrainmap issimilar to thewaythat interference patterns of laser light crisscross theentire
areaof apiece of holographic film. Theholographic theory also explains how the human brain can
store so many memories inso little space. I thasbeen estimated that the human brainhas the
capacity tomemorize something intheorder of 10billion bits of information duringthe average
human lifetime. Holograms also possess anastounding capacity for information storage. Simply by
changing the angle at which the two lasers strike apiece of photographic film, it ispossible to
record many different images on thesame surface. I thas been demonstrated that onecubic
centimeter of holographic filmcan hold asmany as10billion bits of information. Oneof the most
amazing aspects about the human thinkingprocess isthat every piece of information seems
instantly cross-correlated with every other piece of information, another feature intrinsic tothe
hologram. Just asahologram has atranslating device that isable toconvert anapparently
meaningless blur of freq uencies into acoherent image, Pribrampostulates that thebrainalso
employs holographic principles to mathematically convert the neurophysiological information it
receives from thesenses to theinner world of perceptions and thoughts.
TheBritish physicist David Bohm hypothesized that theenergy forces which regulate subatomic
particles could also beaccounted for bythe holographic model. In1982, aresearch teamled by
physicist Alain Aspect, at the University of Paris, discovered that one of twotwinphotons traveling
inopposite directions wasable tocorrelate theangle of itspolarization withthat of itstwin. Thetwo
photons seemed tobenon-locally connected. Thepaired particles were abletoinstantaneously
interact witheach other, regardless of thedistance separating them. I tdidnot seem to matter
whether the photons were amillimeter awayor 13meters apart. Somehow, each particle always
seemed toknow what theother wasdoing. Bohm suggested that thereason subatomic particles can
remain incontact withoneanother isnot because they aresending some sort of mysterious signal
back andforth. Rather, heargued that such particles arenot individual entities tobegin with, but
areactually extensions of thesame, subatomic substance. The electrons inone atom areconnected
tothesubatomic particles that comprise every other atom. Although human naturemay seek to
categorize andsubdivide thevarious phenomena of the universe, all such differentiations are
ultimately artificial. All of naturemaybelikeaseamless web of energy forces.
Talbot (1991) concluded from thework of these twonoted scientists that thecosmos, theworld, the
humanbrain, and each subatomic particle areall part of aholographic continuum: Ourbrains
mathematically construct objective reality byinterpreting frequencies that areultimately
projections from another dimension, adeeper order of existence that isbeyond both space and
time. Just aseach part of the holographic negative holds animage of thewhole picture, Talbot
further suggested that theauricular microsystem could hold animage of thewhole body. All
microsystems might function liketheecho resonance, waveform interference patterns ina
hologram, energy signals being transmitted from theskin tothe corresponding body organs.
Similar tophotographic hologram plates, each part of theauricle might integrate energetic signals
from all the partsof the human body. Ralph Alan Dale(1991,1999) inAmerica, Ying-Oing Zhang
(1980, 1992) inChina, and Vilhelm Schjelderup (1982) inEurope have all used this holograhic
paradigm to account for thesomatotopic pattern of acupoints found inevery micro-acupuncture
system they have examined.
The holographic model of microsystems isspeculative, but it iscongruent with the traditional
Chinese perspective that every organ inthebody isrelated tospecific acupoints on thesurface of
A Conventional photography
Object
Sunlight
Photographic film
Camera
Lens
B Holographic photography
Beam splitter Reference mirror
Lens
/\
,/
~
!"
/ "
/ "" !
I" \
- / " \
, , \
...................... ( ;A
Reference beam
Object
Lens
Laser beam
Object mirror
Laser source - coherent light
Holographic plate- interference pattern
Figure2.21 Conventional (A) and holographic (B) photographic equipment.
S2 Auriculotherapy Manual
A
D
B
E
Figure 2.22 In standardphotographic procedures, theoriginal object (A) isconverted toanegative imageonfilm(B). Whenitisdeveloped. a
small portionofthatnegative onlycontains onepart ofthepicture(C). In holographic photography, theoriginal object (D) isconverted toa
distorted imageofinteiference patterns (E). Aportion oftheholographic negative contains animageofthewholepicture(F).
53
54
thebody. Inhisbook TheWebthat has no weaver, Kaptchuk (1983) states thecosmos itself isan
integral whole, aweb of interrelated things andevents. Within thisweb of relationships and
change, anyentity can bedefined only byitsfunction, and significance only aspart of thewhole
pattern. Another Stanford scientist has also examined this perspective. Thephysicist William
Tiller (1997, 1999) contends that there are non-spatial, non-temporal energy waves functioning in
various bandsof avacuum. Hisresearch showed that itwas possible to focus human intention to
alter the physical properties of substances inasimple electronic device. Research participants ina
focused meditative statewere able to induce anincrease or decrease inthe pH level of water bythe
simple act of their intention. Therewas asmall but consistent alteration inthe pH level of water
electromagnetically isolated inside acontainer within aFaradaycage. ThepH level changed ina
-1.0negative direction when the meditators focused on lowering the pH andchanged ina+1.0
positive direction when themeditators focused on raising pH. According toTiller, theresults of
these experiments suggest that there isatransfer of unconventional information inpreviously
unknown frequency domains. This unconventional energy could serve asthe foundation for
auricular medicine andother holographic microsystems. Theresearch investigations byTiller
highlight the role of thehealing intention of the practitioner when working with apatient using any
healthcare modality.
Many inthe West are not comfortable with theconcept of anebulous, invisible energy matrix,
whether perceived from the orientation of Chinese medicine or from the speculations of quantum
physicists. That such energetic viewpoints would bethe primary foundation for auriculotherapy is
not reassuring tosuch individuals. A great split inthe European auricular medicine community
occurred when Paul Nogier expounded thenotion of reticular energy asanexplanation for the
clinical phenomena heobserved. Nogier proposed that reticular energy was avital force that
flowed inall livingtissue andthat itpropagated theexchange of cellular information. Any
stimulation of the smallest part of thebody bythis reticular energy was said tobeimmediately
transmitted toall other regions. When asurvey was taken of professionals at the 1999
International Consensus Conference on Acupuncture, Auriculotherapy, and Auricular Medicine,
most of the respondents indicated that they considered the holographic model more asauseful
analogy thananactual entity. Nonetheless, the notion that one part represents thewhole applies to
thebasic principles of microsystems aswell astothe phenomena of holograms.
2.5 Neurophysiology of pain and pain inhibition
Classical Chinese medicine did not really include the role of the nervous system ascurrently
conceived inWestern medical science. Even recent Chinese ear acupuncture charts contain just a
few auricular localizations for thebrain. Incontrast, the auriculotherapy texts byNogier (1972)
and Bourdiol (1982) predominantly focus on aneurological explanation for this auricular reflex
system. There have been many advances inthe field of neuroscience inthe last several decades
which have substantially altered basic understanding of pain pathways. I tisnow known that there
aremechanisms bywhich the nervous system perceives pain and nearby neural circuits bywhich
thebraincan suppress the pain experience. Neurophysiological research has also examined the
role of both ear acupuncture and body acupuncture inaltering these same neurobiological
processes of pain perception and pain modulation. Some investigators believe that all of the
energetic qualities described inChinese medicine can ultimately beaccounted for byobservable
electrophysiological and biochemical phenomena inthebrainand nervous system. Research
studies demonstrating the different regions of thebrainthat affect thebasic mechanisms of
acupuncture arereviewed inBirch &Felt (1999), Cho et al. (2001), Stux &Hammerschlag (200I)
andWeintraub (2001).
Neurons: Thefundamental units of the nervous system arethe individual neurons, long slender
threads of nerve tissue which areone of the few types of cells that can carry electrical signals. Body
acupuncture points occur at regions underneath the skin where there isanerve plexus or where a
nerve innervates amuscle. Onefeature of myelinated neurons isthat the speed of neural impulses
isincreased bythepresence of segments of high electrical resistance myelin separated bygaps of
lower electrical resistance nodes of Ranvier. This aspect of neurons corresponds to the
electrodermal feature of acupuncture points, aseries of low-skin-resistance gap junctions
separated byregions of high-skin-resistance non-acupuncture points.
Nociceptors: Although it isthecause of much unwanted suffering, painisnonetheless a
biological necessity. Painsensations trigger protective withdrawal reflexes essential for survival.
Theinitiation of pain signals begins with theactivation of microscopic neuron endings intheskin,
the muscles, thejoints, the blood vessels or theviscera. Since these sensory receptors areexcited by
noxious stimuli, capable of damaging cellular tissue, they havebeen called nociceptors. Electric
shock, intense heat, intense cold or pinching of theskin all lead toanincrease intheneuronal
firingrateof nociceptors. Thenatural stimuli for nociception, however, seem tobean array of
biochemicals released into theskin following injury to acell. Subdermal acidic chemicals that
activate peripheral nociceptors include prostaglandins, histamine, bradykinin and substance P. In
contrast, those sensory neurons specifically responsive tosoft touch arecalled mechanoreceptors
andthose skin receptors affected bychanges inheat or cold arecalled thermoreceptors. Insertion
of acupuncture needles seems toactivate nociceptors indeep muscles for body acupuncture and
the nociceptors intheskin for ear acupuncture.
Peripheral nerve pathways: Afferent sensory neuron fibers travel inbundles of nerves that
project from theperipheral skin surface or deep-lying muscles toward thecentral nervous system
at themidlineof the body. Each neuron iscapable of rapidly carrying electrical neural impulses
over long anatomical distances, such asfrom thefoot to thespine, or from the fingers tothe neck.
Theneurons from mechanoreceptors, thermoreceptors and nociceptors all travel along together,
liketheindividual copper wires inanextension cord. However, the type of neuron carrying each
type of message isdifferent. Thecategories of neurons aredistinguished bythe size and the
presence of myelin coating. Thethinnest neurons, which have nomyelin coating, arecalled TypeC
fibers andtend tocarry information about nociceptive pain. The next larger group of neurons are
called Type Bfibers, which arelarger and have some myelin coating. They typically carry
information about skin temperature or internal organ activity.
Neurons that have the thickest diameter arecalled TypeA fibers. TheTypeA neurons are
myelinated and large insize, making themmuch faster conductors thantheTypeBandTypeC
fibers. They arefurther subdivided intoTypeA betafibers, which carry information about light
touch stimuli activated bymechanoreceptors, andTypeA delta fibers, which arenot aslarge nor as
fast astheA beta fibers and carry information about nociceptive pain. TheA delta fibers arestill
faster thantheTypeCfibers, which also areactivated bynociceptors. When one ishurt, there is
initially the perception of first pain from information carried byA delta fibers and then the
perception of second paincarried byCfibers. First pain isimmediate, sharp, and brief, like apin
prick, whereas second painismore throbbing, aching, and enduring, aswhen one isburned or hits
ones handwith ahammer. Chronic painsensations seem more related toCfiber activity thanA
delta fiber activity, asCfiber firingcan summate over time rather thanhabituate. Thefastest
neurons areTypeA alpha fibers. These motor neurons carry electrical impulses from thespinal
cord tothe peripheral muscles, thus completing asensory-motor reflex arc. TypeA gamma motor
neurons areregulated byproprioceptive feedback from sensory organs inmuscle fibres that serve
to regulate muscle tone. Dsyfunctional neural firing inthisproprioceptive feedback seems tobe
thesource of the maintained muscle contractions which lead tochronic myofascial pain.
Spinal cord pathways: Thespinal cord isdivided into central gray matter surrounded bywhite
matter, so designated because the neurons inwhite matter aremore thickly coated withwhite fatty
myelin. When cut into cross sections, thegray matter looks like abutterfly, with aleft and aright
dorsal horn (posterior horn) and aleft and aright ventral horn (anterior horn). Sensory neurons
carrying nociceptive signals synapse inthefirst andfifth layers of the ipsilateral dorsal horn,
whereas messages concerning light touch synapse inthefourth layer of the dorsal horn. These
different messages about touch versus pain arethen sent up tothe brainintwoseparate sections of
thespinal white matter. Information about touch iscarried inthe dorsal columns of thespinal
cord, while information about nociceptive pain iscarried inthe anterolateral (ventrolateral) tract
of thespinal cord. Impulses along spinal neurons travel upthe respective regions of white matter
tocarry information about touch or about pain tohigher braincenters.
Higher brain processing centers: Theoverall organization of the brainisdivided into the lower
brain, the intermediate brain, and the higher brain. Spinal pathways connect to the brainstem at
themedulla, ascend tothepons andthen themidbrain. The reticular formation extends
throughout thecore of thelower brain, receiving tactile andnociceptive messages from thespinal
cord and activating higher braincenters toproduce general arousal. Theserotonergic raphenuclei
56
that facilitate sleep and sedation are also found inthe medulla, pons andmidbrain. The
intermediate brainconsists of the thalamus, the hypothalamus, the limbic system, andthe striatum
or basal ganglia. Thethalamus somatotopically projects sensory messages to the cortex and
modulates sensory information that ascends to consciousness. Thehypothalamus andthelimbic
system affect sympathetic arousal and theemotional qualities of pain. Thehigher braincenter
consists of the four lobes of the neocortex, the somatosensory parietal lobe, the visual occipital
lobe, the auditory temporal lobe, and themovement control centers inthe frontal lobe and
prefrontal lobe.
Gate control theory: Melzack & Wall (1965) proposed that inhibitory interneurons inthe dorsal
horn of thespinal cord aredifferentially affected byinput from A fiber and C fiber neurons. The
fast-conducting A betafibers, which carry information about light touch, excite inhibitory
interneurons tosuppress the experience of pain. Slow-conducting C fibers, which carry
information about pain, inhibit these same inhibitory interneurons. Theconsequence of inhibiting
aneuron which isitself inhibitory results inafurther increase inneural discharges that ascend
toward the braininthe spinal white matter. Thedorsal horn gating cells allow only brief neural
excitation following input from tactile A beta fibers, whereas they allow prolonged neural
excitation following activation of nociceptive C fibers. Theoccurrence of brief versus prolonged
bursts of neuronal firing accounts for differences intheperception of touch versus pain.
Supraspinal gating systems inthe brainwere theorized tosend descending input down to the spinal
inhibitory neurons, which thus allowed thebraintosuppress theincoming pain message.
Stimulation-produced analgesia: Empirical support for the existence of descending pain
inhibitory pathways occurred inthe 1970swith research investigations at UCLA by Liebeskind and
Mayer (Liebeskind et al. 1974; Mayer et al. 1971; Mayer & Liebeskind 1974). Electrical
stimulation of the midbrain periaqueductal grey (PAG) was found to suppress behavioral
responses to noxious heat or noxious electric shock. Oneof the most surprising findings was that
this stimulation-produced analgesia could be antagonized bytheopiate antagonist, naloxone
(Mayer et al. 1977). Although the periaqueductal grey was the most potent region to produce
analgesia inrats and cats, brainstimulation research inmonkeys (Oleson & Liebeskind 1978;
Oleson et al. 1980a) demonstrated that thethalamus was the most potent primatesite toyield
stimulation-produced analgesia. Examination of deep brainstimulation inhuman patients has
produced similar findings (Hosobuchi et al. 1979). Humanresearch has also confirmed that
nociceptive painmessages activate positron emission tomography (PET) scan activity inthe
periaqueductal grey, thalamus, hypothalamus, somatosensory cortex and prefrontal cortex of man
(Hseih et al. 1995). These arethe same brainstem and thalamic areas that areable to suppress pain
messages. While direct connections between auricular acupuncture points and these
antinociceptive brainpathways has not yet been investigated, neurophysiological investigations of
body acupuncture points suggest that theregions of thebrain related to pain inhibition arealso
affected bythe stimulation of acupoints (Kho & Robertson 1997).
Descending pain inhibitory systems: Themidbrain periaqueductal grey (PAG) was oneof the
first brainregions where stimulation-produced analgesia was demonstrated. Itwas subsequently
found also to beactivated bymicroinjections of morphine and to contain opiate receptors that
respond to the beta-endorphins. Neurons inthe dorsal raphe nuclei andraphe magnus can be
excited by PAG stimulation. These serotonergic raphe cells descend thespinal cord inthe dorsal
lateral funiculus and synapse on gating cells inlayer II of thedorsal horn. Basbaum & Fields
(1984) showed that lesions inthe descending, dorsolateral funiculus tract inthespinal cord
blocked behavioral analgesia from deep brainstimulation. Theraphe neurons release serotonin to
excite the spinal gating cells, which release enkephalin to inhibit afferent nociceptive neurons. A
different descending pathway carries impulses from thereticular formation, releasing the
neurotransmitter norepinephrine to activate the inhibitory gating cells inlayer III of thedorsal
horn. Curiously, there isalso adescending pain facilitation system inthe central nervous system.
Wei et al. (1999) have shown that destruction of descending, serotonergic pathways from the raphe
magnus anddescending noradrenergic pathways from the locus ceruleus both lead to an increase
inthe Fos protein activity of nociceptive spinal neurons. Conversely, destruction of descending
reticular gigantocellular pathways leads to adecrease inthe Fos protein activity of nociceptive
spinal neurons. Thepaininhibition system was selectively damaged bythe rapheandlocus
ceruleus lesions, whereas the painfacilitation system was disconnected bythereticular lesion.
Neural pathways of acupuncture analgesia: There aretwo major CNS pathways that lead to
acupuncture analgesia, an afferent sensory pathway andanefferent motor pathway. Stimulation of
acupuncture points activates the afferent pathway that travels from peripheral nerves intothe
spinal cord, and from the spinal cord up tothe brain. A specific circuit of brainnuclei connects the
afferent pathway tothe efferent pathway, which then sends descending neurons down the spinal
cord toinhibit the perception of pain andtosuppress nociceptive behavioral reflexes (Takeshige
et al. 1992). Thetwo braincircuits have been revealed byaseries of experiments conducted by
Takeshigi (2001) of J apan and Han(2001) inChinaandthe United States.
Afferent acupuncture pathway: This afferent pathway begins with stimulation of an acupuncture
point intheskin that sends neural impulses tothespinal cord. These signals then ascend through
the contralateral ventrolateral tract of thespinal cord to the reticular gigantocellular nucleus and
the raphe magnus inthe medulla. Thesignal next goes tothedorsal periaqueductal gray (PAG).
Low-frequency (2Hz) electrical stimulation of the muscles that underlie the acupoints LI 4(hegu
or hoku) and ST 36(zusanli) produce behavioral analgesia. Theintensity of electrical stimulation
at anacupoint must besufficient tocause muscle contraction, which thusleads to an increase inthe
latency for the animal tomove itstail away from ahot light. Stimulation of other muscle regions
does not produce this increase intail-flick latency. Brain potentials can beevoked specifically in
the periaqueductal central gray bystimulation of the muscles underlying the LI 4andST 36
acupoints, but not bystimulation of other muscles. These evoked potentials inthePAG were
blocked bycontralateral lesions of the anterolateral tract, byadministration of the antiserum to
met-en kephalin, bythe opiate antagonist naloxone, but not bythe administration of antagonists to
dynorphin. Moreover, lesions of the PAG abolished acupuncture analgesia, indicating that the
anatomical integrity of the PAG isnecessary for producing pain relief from acupuncture
stimulation. This afferent pathway projects from the PAG to the posterior hypothalamus, the
lateral hypothalamus, andthe centromedian nucleus of the thalamus. These neurons project
through thehypothalamic preoptic area tothepituitarygland, from which beta-endorphins are
secreted intothe blood.
Efferent acupuncture pathway: Thedescending pain inhibitory system begins inadifferent areaof
the midbrain periaqueductal gray, which projects to dopaminergic neurons inthe posterior
hypothalamic area and then totheventromedian nucleus of the hypothalamus. Thepathsplits into
aserotonergic system andanoradrenergic system that descends down the spinal cord. Brain
potentials inthe lateral PAG that are evoked bystimulation of non-acupoints areabolished by
antagonists to the opiate neurotransmitter dynorphin; incontrast, they are not abolished by
administration of antagonists toeither met-enkephalin or leu-enkephalin. Dynorphin isthus
believed to be the neurotransmitter of thespinal afferent pathway for non-acupuncture-produced
analgesia. Theafferent pathway for the efferent acupuncture system originates at non-acupoints
and ends inthe anterior part of the hypothalamic arcuate nucleus. Neurons from theventral
periaqueductal gray synapse inthe raphe magnus, which then travels down the spinal cord to
release the neurotransmitter serotonin on tospinal gating cells. An alternative efferent pathway
travels from the reticular paragigantocellularis nucleus down to spinal gating cells. Spinal
interneurons produce either presynaptic inhibition or postsynaptic inhibition on theneuron that
transmits pain messages to the brain, thusblocking thepain message.
Opiates inacupuncture analgesia: Theafferent acupuncture pathway produces atype of analgesia
that isnaloxone-reversible, disappears after hypophysectomy, persists long after stimulation of the
acupoint isterminated andexhibits individual variation ineffectiveness. Inthis first pathway,
electrical brainpotentials are evoked bystimulation of acupoints inthesame areas that produce
analgesia. Incontrast, stimulation of brainareas associated with theefferent acupuncture pathway
produces analgesia that isnot naloxone-reversible, isnot affected byhypophysectomy, and is
produced only duringthe period of electrical stimulation. Since hypophysectomy only disrupts the
activity of thefirst pathway, thesecond pathway can function without the presence of endorphin.
Microinjection of either beta-endorphin or morphine intothe hypothalamus produces analgesia in
adose-dependent manner, whereas microinjections of naloxone to thehypothalamic arcuate
nucleus antagonizes acupuncture analgesia inadose-dependent manner.
Neurotransmitters inacupuncture analgesia: Acupunctures painrelieving effects can be abolished
byconcurrent lesions of theraphe nucleus and thereticular paragigantocellular nucleus. These are
the known origins of the serotongergic andthenoradrenergic descending pain-inhibitory systems.
58
Synaptic transmission from thearcuate hypothalamus to theventromedian hypothalamus is
facilitated bydopamine agonists and isblocked bydopamine antagonists. Neurons inthe
ventromedian hypothalamus which respond toacupoint stimulation also respond to
microinjections of dopamine into that part of thebrain. Conversely, neurons inthe arcuate
hypothalamus which do not respond toacupoint stimulation also do not respond to
iontophoretically administered dopamine.
Adrenal activityandacupuncture analgesia: Acupuncture analgesia andstimulation-produced
analgesia areboth abolished after removal of the adrenal glands. Electroacupuncture produces
significant increases of beta-endorphin and adrenocorticotropic hormone (ACTH) released bythe
pituitarygland intotheperipheral blood stream. There isacontinual increase of both peptides for
more than 80minutes after termination of acupuncture stimulation, although this increase
gradually diminishes thereafter. Electroacupuncture applied toadonor rat wasable toinduce
behavioral analgesia inacrossed-circulated recipient rat. An increase of endorphins inthe
cerebrospinal fluid after electro acupuncture suggests that there may beacorrelation between
cerebral and peripheral beta-endorphin levels. Beta-endorphin andACTH areco-released from
thepituitarygland after ananimal isstressed. Endorphins aremost renowned for their pain
relieving qualities, whereas ACTH andcortisol aremore associated with neurobiological
responses tostress. They can reach levels high enough to activate long periods of stimulation of the
acupuncture analgesia pathways.
Electroacupuncture stimulation frequencies: The opiate peptides enkephalin and dynorphin, two
subfractions of thelarger polypeptide molecule beta-endorphin, areactivated bydifferent
frequencies of electroacupuncture. Analgesia produced bylowfrequency (2Hz)
electro acupuncture wasfound byHan (2001) tobeselectively attenuated byenkephalin
antibodies, but not bydynorphin antibodies. Incomparison, analgesia obtained byhigh frequency
(100Hz) electroacupuncture wasreduced byantibodies todynorphin, but not byantibodies to
enkephalin. Hanconcluded that 2-Hz electroacupuncture activates enkephalin synapses, whereas
100-Hzelectroacupuncture activates dynorphin synapses. Both forms of electroacupuncture
produced more pronounced analgesia thanneedle insertion alone.
Brainimaging and acupuncture stimulation: Themost direct evidence of the neurological effect
of acupuncture stimulation on the human brain hascome from Dr ZH Cho (Cho & Wong 1998;
Wong & Cho 1999;Cho et al. 2001) at the University of California at Irvine. Recording functional
magnetic resonance imaging (fMRI) of the human cerebral cortex, these investigators showed that
needles inserted into adistal acupuncture point on the leg used for visual disorders could activate
increased fMRI activity intheoccipital lobe visual cortex, whereas needling adifferent
acupuncture point on the leg that isstimulated torelieve auditory problems selectively activated
the temporal lobe auditory cortex. I fonly tactile nerves were relevant tostimulation of
acupuncture points intheskin, anincrease infMRI activity should have only been observed inthe
parietal lobe somatosensory cortex. Specificity of fMRI brainactivity toauricular stimulation has
been demonstrated byAlimi et al. (2002). Stimulation of the handareaof the auricle selectively
altered fMRI activity inthe handregion of thesomatosensory cortex, whereas stimulation of a
different areaof theexternal ear didnot produce this response. Similar correspondent changes
were obtained inbrainfMRI activity from stimulation of theelbow, knee, and foot regions of the
auricle. Stimulation of specific areas of theauricle led toselective changes inthefMRI responses
inthebrain(Alimi 2000).
Thalamic circuits for acupuncture: Tsun-nin Lee (1977,1994) has developed athalamic neuron
theory toaccount for reflex connections between acupuncture points and thebrain. According to
thistheory, pathological changes inperipheral tissue lead tomalfunctioning firingpatterns inthe
corresponding brain pathways. Thenatural organization of theconnections between peripheral
nerves and theCNSiscontrolled bysites inthesensory thalamus that arearranged like a
homunculus. The CNSinstitutes corrective measures intended to normalize the pathological
neural circuits, but strong environmental stressors or intense emotions maycause the CNS
circuitry to misfire. I fthe neurophysiological programs inthe neural circuits are impaired, the
peripheral disease becomes chronic. Painand disease are thus attributed tolearned maladaptive
dysfunctional programming of these neural circuits. Stimulation of acupuncture points on the body
or theear can serve toinduce afunctional reorganization of these pathological brainpathways.
Thespatial arrangement of these neuronal chains within the thalamic homunculus issaid to
account for the arrangement of acupuncture meridians inthe periphery. Theinvisible meridians
which purportedly run over the surface of the body may actually beduetonerve pathways
projected onto neuronal chains inthe thalamus. Theauricular acupuncture system ismore
noticeably arranged inasomatotopic pattern on the skin surface of theexternal ear (Chen 1993).
Nogier (1983) also proposed that for achronic illness to maintainitself, the disorder must be
accompanied byaltered neurological reflexes that transmit pathological messages to higher
nervous centers. Until this dysfunctional neural circuit iscorrected, somatic reflexes controlled by
thebrainwill remain dysfunctional. Stimulation of corresponding somatotopic points on the ear
sends messages tothebrainwhich facilitate the correction of this pathological brainactivity.
Somatotopic brain map: Research byPenfield & Rasmussen (1950) demonstrated that when the
brainof ahuman neurosurgery patient was electrically excited, stimulation of specific cortical
areas evoked verbal reports of sensations felt inspecific partsof the patients body. Stimulation of
the most superior and medial region of the somatosensory cortex elicited sensations from the feet;
stimulation of themore inferior and peripheral region of the cortex produced the perception of
tingling inthe head. Therest of thebody was represented inananatomically logical pattern. I fthe
right cortex was stimulated, the patient reported asensation on the left side of the body, whereas if
the left cortex was stimulated, thepatient felt asensation on the right side. Parallel research by
Mountcastle & Henneman (1952) and Woolsey (1958) showed that asimilar pattern existed for
animals. When electrical stimulation was applied tothefoot of ananimal, neurons inone region of
the contralateral somatosensory cortex began firing, whereas when the legwas stimulated, a
different but nearby region of thebrainwas activated. A systematic representation of the body has
been found for neurons inthe cerebral cortex, inthe subcortical thalamus, and inthe reticular
formation of thebrainstem (see Figure 2.1). This brainmap has the same overall pattern asthe
map on the ear, representing thebody inaninverted orientation.
Cerebral laterality: Thehigher braincenters aresplit into aleft cerebral cortex andaright
cerebral cortex, each side with afrontal lobe, aparietal lobe, atemporal lobe and anoccipital lobe.
A broad bandof neurons called the corpus callosum bridges thechasm between these two sides of
thebrain. Theleft side of the higher brainreceives signals from and sends messages out tocontrol
the right side of thebody, whereas the right side of the higher brainreceives signals from and sends
messages out to theleft side of thebody. Besides controlling the ability towritewith the right hand,
the left neocortex dominates our ability tounderstand language, toverbally articulatewords, to
solve mathematical problems, toanalyze details and to report on our states of consciousness. Even
left handed individuals tend toexhibit dominance for language on theleft side of thebrain.The right
side of thecerebral cortex regulates adifferent set of psychological functions. Besides controlling the
left hand, theright side of brainissuperior totheleft side of thebrain inrecognizing facial features, in
perceiving inflections and intonations, andinunderstanding therhythms that distinguish different
songs. Our recognition of negative emotional feelings ismore highly processed bytherelationship
oriented right brain than bythemore logically-oriented left brain. Box 2.2presents thedifferent
qualities of theleft andright cerebral hemispheres inaTaoist dualistic perspective: theleft side of the
brain ismore yang-like, whereas theright side of thebrain ismore yin-like.
Both mathematics and language involve asequential linear series of letters or numbers that must
becombined inalogical manner inorder toberationally understood. Theequation (5+4) x3=27
has adifferent result if thenumbers are rearranged to (3 +5) x4=32. Thephrase therays of
sunlight rise over the mountains inthe east can not belogically comprehended bythe left cerebral
cortex when thewords arerecombined to read theeast inthe rays rise of mountains over the
sunlight. However, the right cerebral cortex isreadily able to recognize apicture of sunlight rising
over some mountains, whether onefirst focuses on the mountains and then looks up at the sun, or
one first focuses on the sun and then lowers ones gaze tothe mountains. What isimportant to
right brainperception isthe overall relationship of the parts to thewhole. Themore conscious left
side of thebraintends tofocus on rationally solving problems, whereas the more emotionally
sensitive right side of thebrainallows for empathetic understanding of unconsciously motivated
feelings. Although information processed bythe left hemisphere isnecessary toremember
someones name, the right brainisessential to recall hisor her face. Dominance for language is
found in95%of the population, with only afew left handers exhibiting language dominance inthe
right cerebral cortex. I tshould benoted that both the left side and the right side of the brainare
actively used byeveryone, the two hemispheres constantly cross-referencing each other. However,
there can be certain learning disorders where the communication between the left cerebral cortex
Box 2.2 Taoist dualitiesintheleft andright cerebral hemispheres
Yangleft brainactivity
Logical
Rational
Thinking
Name recognition
Mathematical calculations
Analyzes details
Word recognition
Verbal meaning
Sequential
Linear
Literal
Abstract conce pts
Judgmental
Critical
Dominating
Language
Yinright brainactivity
I ntuitive
Emotional
Feeling
Facial recognition
Musical rhythms
Global impressions
Spatial relationships
Intonations and inflections
Simultaneous
Circular
Symbolic
Metaphorical images
Accepting
Compassionate
Supportive
Art
60
andtheright cerebral cortex creates confusion rather thanorder. An example would be dyslexia,
thereversal of numbers, letters, or words. Thiscondition is10times more likely to be found in
someone who isleft handed thaninsomeone who isright handed. In auricular medicine, problems
of left hemisphere andright hemisphere interactions arereferred to as laterality disorders.
Contralateral cortical criss-crossing: I tsometimes confuses beginning practitioners of
auriculotherapy that different body regions arerepresented contralaterally inthebrain, but are
represented ipsilaterally on theear. Theexplanation isthat nerves originating fromear reflex
points arecentrally projected to thecontralateral side of thebrain, which subsequently sends
descending projections back to theipsilateral corresponding organ. Signals from theleft ear cross
to theright side of thebrain. They then cross back from theright side of thebrainto theleft side of
thebody. Conversely, apoint on theright ear projects to theleft brain, which then processes the
information andactivates homeostatic regulating mechanisms that lead to corrective neural
impulses being sent to theright side of thephysical body. Thiscontralateral criss-crossing pattern
isrepresented inFigure 2.23.
Braincomputer model: A commonly cited analogy for understanding the brainistheexample of
modern computers. I fthe brainiscompared toacomputer, then theear can beviewed asacomputer
terminal, having peripheral access tothe bodys central microprocessor unit. Thisimage is
represented inFigure 2.24. Needle or electrical stimulation of ear acupoints would belike typing a
message on acomputer keyboard, whereas the computer screen would belike the appearance of
different diagnostic signs onthe auricle. Losing or damaging theear would not necessarily be
destructive tothe braincomputer, anymore thanlosing akeyboard would necessarily affect aphysical
computer. Havingaperipheral terminal onthe external ear allows more ready access to thecentral
braincomputer, thus facilitating cerebral reorganization of pathological reflex patterns.
Somatic control of muscle tension: There aretwo main divisions of theperipheral nervous
system, thesomatic nervous system andtheautonomic nervous system. Myofascial pain istypically
produced by theactivation of somatic nerves exciting thecontraction of muscle fibers to form
muscle spasms. These fixated muscle contractions will not release, nomatter what conscious
efforts areexerted. This myofascial tension isthemost common type of chronic pain, including
back pain, headaches, neck andshoulder pain, andjoint aches. A muscle will not initiatea
movement or maintain any action by itself. Themuscle must first be stimulated by amotor neuron
tocontract. I fone has rigidity andstiffness inalimb, neural reflexes arerequired to maintain that
postural pattern. Thequestion becomes what factor would cause thebrainto tell spinal motor
Right brain
Activation of
elbow area
represented on
right side of
cerebral cortex
ill
Contralateral crossing
of left ear
to right brain
Stimulation of
elbow point
on left ear
Contralateral crossing
of right brainto left side of body
Electrical impulses
along neurons
Left body
Treatment
of painin
left elbow
Figure 2.23 Contralateral cortical connections that cross fromtheleft external ear totherightbrainandfromtheright brainback tothe
left sideofthebody. (FromLifeART", Super Anatomy, 'Lippincott Williams& Wilkins, withpermission.)
Brain computer microprocessor
somatotopically monitors body
=Painor
pathology
Painrelieved
inbody by
neural output
frombrain
Brain computer
microprocessor
regulates body
Pathological areas of body
transmit information to brain

( ..... / . ".... .. \ . .. (\J..............J,.. / V
7
.
" I
4 ,I

G
Somatotopic ear
computer terminal
stimulated to
transmit information
to braincomputer
Activeear reflex points
respond to braininput,
actinglike computer monitor to
indicateareas of body pathology
B Auriculotherapy
A Auricular diagnosis
Figure 2.24 Braincomputer model indicatingperipheral connections fromthebodytothemicrochip circuitryofthebrain, represented
likeacomputer monitor (A). Stimulation oftheauricle islikesending messages onacomputer keyboard (B) tothebrain, which
subsequently regulates thebody.
62 Aur;culotherapyManual
neurons tosustain muscle contraction inapathological state. The thalamic neuron theory of Lee
andthewritings of Nogier suggest that such chronic painisdue toalearned pathological reflex
circuit established inthebrain. I tisthat maladaptive braincircuit which unconsciously maintains
chronic pain. Thepattern of neural firinginthese pathological braincircuits descends thespinal
cord and activates motor neurons tocontract the muscles inamanner that isdesigned tobe
protective against pain, but actually tends toexacerbate pain. Auriculotherapy can promote
homeostatic balancing of that pathological brain-somatic nerve circuit.
Sympathetic control of blood flow: Blood circulation andcontrol of other visceral organs is
regulated bytheautonomic nervous system. Sympathetic arousal leads toperipheral
vasoconstriction and areduction of blood flow tothearea. The localized skin surface changes
sometimes seen with auricular diagnosis, such aswhite flaky skin, can beattributed to
microvasoconstriction (Ionescu-Tirgoviste et al. 1991). Auriculotherapy stimulation produces
peripheral vasodilation, which patients often feel asasensation of heat inthe part of thebody
which corresponds tothe points being treated. This treatment can therefore beused for Raynauds
disease, arthritis, and muscle cramps due torestricted blood circulation.
Sympathetic control of sweat glands: Another system controlled bythe autonomic nervous
system isthe sympathetic control of sweat glands. Sweat isreleased more when it ishot outside, or
inresponse toanxiety or stress. An electrodermal discharge from sweat glands can be recorded
from skin surface electrodes. Selective changes intheelectrical activity on the auricular skin
surface can berecorded byanelectrical point finder. Such devices indicate localized increases in
skin conductance that are produced bythe sympathetic nervous system which innervates thesweat
glands (Hsieh 1998;Young & McCarthy 1998). Paradoxically, histological investigations of theskin
overlying the auricle do not reveal thepresence of sweat glands, indicating that some other process
must account for spatial differences inskin resistance at reactive ear reflex points. Stimulation of
reactive auricular points leads toareduction inskin conductance recorded inthepalm, thus
indicating reduced sympathetic arousal. Representation of theyang aspects of the sympathetic
nervous system and theyin aspects of the parasympathetic nervous system areshown inFigure 2.25
and Box 2.3.
Research on acupoint electrodermal activity: In 1980,Oleson and colleagues conducted thefirst
double blind assessment toscientifically validate thesomatotopic pattern of auricular reflex points
(Oleson et aI1980b). Forty patients with specific musculoskeletal pain problems were first
evaluated byadoctor or nurse todetermine theexact body location of their physical pain. A
second medical doctor who had extensive traininginauricular acupuncture procedures then
examined each patients ear. Thissecond doctor had no prior knowledge of thesubjects previously
established medical diagnosis andwasnot allowed tointeract verbally with the patient. Therewas
apositive correspondence between auricular points identified asreactive and the partsof thebody
where therewas musculoskeletal pain. Reactivity wasdefined asauricular points thatwere tender
topalpation and exhibited at least 50microamps (pA) of electrical conductivity. Non-reactive ear
points corresponded topartsof the body from which therewas noreported pain. Thestatistically
significant overall correct detection ratewas 75.2%. When the pain was located on only one side of
thebody, electrical conductivity was significantly greater at the somatotopic ear point on the
ipsilateral ear thanat the corresponding areaof thecontralateral ear. Another double blind
evaluation of auricular diagnosis didnot occur until adecade later. Ear reflex points related to
heart disorders were examined bySaku et al. (1993) inJapan. Reactive electropermeable points on
theear were defined asauricular skin areas that hadconductance of electrical current greater than
50microamps, indicating relatively lowskin resistance. Therewas asignificantly higher frequency
of reactive ear points at the Chinese Heart points intheinferior concha (84%) and on the tragus
(59%) for patients with myocardial infarctions and angina pain thanfor acontrol group of healthy
subjects (11%). Therewas nodifference between thecoronary heart disease group andthecontrol
group regarding theelectrical reactivity of auricular points that didnot represent the heart. The
frequency of electropermeable auricular points for the kidney (5%), stomach (6%), liver (10%),
elbow (11%) and eye (3%) was thesame for coronary patients asfor individuals without coronary
problems, highlighting the specificity of this phenomenon.
Observations that acupuncture points exhibited lower levels of skin resistance thansurrounding
skin surface areas were first reported inthe 1950sbyNakatani inJ apan andbyNiboyet inFrance
(Oleson & Kroening 1983c). Inthe 1970s, Matsumoto showed that 80%of acupuncture points
Taoist balance of autonomic nervous system
Yang reactions
Sympathetic activation
Rapid heart beats
Pupillary dilation
Elevated GSR
Rise inskin conductance
Yin reactions
Parasympathetic sedation
Slowheart beats
Pupillary constriction
Decreased GSR
Lowered skinconductance
Figure 2.25 Physiological activity intheautonomic nervous system iscompared tothecomplementary qualities ofyangandyin. Ytmg
likesympathetic arousal increases heart rate, pupillary dilation, andskin conductance, whereas parasympathetic sedation has the
opposite effects. (From LifeART", Super Anatomy, 'Lippincott Williams & Wilkins.)
Box 2.3 Taoist dualities of thesympathetic andparasympathetic nerves
Yin parasympathetic nervous system
Selective sedation
Conservation of energy
Slow deep breathing
Slow heart rate
Lowered blood pressure
Peripheral vasodilation
Warm hands
Dry hands
Reduced skin conductance
Pupillary constriction
Increased salivation
Improved digestion
Constipation
Facilitates muscle relaxation
could be detected aslow resistance points. Theelectrical resistance of acupuncture points was
found to range from 100to 900kilohms, whereas theelectrical resistance of non-acupuncture
points ranged from 1100to 11700kilohms. Reichmanis et al. (1975, 1976) further showed that
meridian acupuncture points exhibit even lower electrical resistance when there ispathology inthe
organ they represent. For instance, electrodermal resistance on the lungmeridian islower when
one has arespiratory disorder, whereas skin resistance on theliver meridian islower when one has
aliver disorder. Those acupuncture points that were ipsilateral to the site of body discomfort
exhibited alower electrical resistance thanthe corresponding meridian point on thecontralateral
side of the body. This work corroborated earlier findings (Bergsman & Hart 1973; Hyvarinen &
Karlsson 1977).
Subsequent research on thedifferential electrodermal activity of acupoints has continued toverify
these earlier studies. Xianglong et al. (1992) of Chinaexamined 68healthy adults for
computerized plotting of low skin resistance points. A silver electrode was continuously moved
over awhole areaof body surface, while areference electrode was fastened to thehand. Starting
from the distal ends of thefour limbs, investigators moved the electrode along the known
meridians. Theresistance of low skin impedance points (LSIP) was approximately 50kilohms,
whereas theimpedance at non-LSI P was typically 500kilohms. A total of 83.3% of LSIPs were
located within 3mmof achannel. Inonly afew cases could individual LSIPs befound in
non-channel areas. Thetopography of low skin resistance points (LSRP) inratswas examined by
Chiou et al. (1998). Specific LSRP loci were found tobe distributed symmetrically andbilaterally
over theshaved skin of theanimals ventral, dorsal, andlateral surface. Thearrangement of these
points corresponded to theacupuncture meridians found inhumans. TheLSRPs were
hypothesized to represent zones of autonomic concentration, thehigher electrical conductivity
due to higher neural andvascular elements beneath thepoints. TheLSRPs gradually disappeared
within 30minutes after theanimals death.
Skin and muscle tissue samples were obtained byChanet al. (1998) from four anesthetized dogs.
Acupuncture points, defined byregions of low skin resistance, were compared to control points,
which exhibited higher electrodermal resistance. Thepoints were marked for later histological
examination. Concentration of substance Pwas significantly higher at skin acupuncture points
(3.33nglg) than at control skin points (2.63ng/g) that did not exhibit low skin resistance.
Concentration of substance Pwas also significantly higher inskin tissue samples (3.33ng/g) thanin
the deeper, muscle tissue samples (1.8ng/g}, Substance P isknown to be aspinal neurotransmitter
found innociceptive afferent C-fibers (Kashiba & Veda 1991). I tplays arole inpaintransmission,
stimulates contractility of autonomic smooth muscle, induces subcutaneous liberation of
histamine, causes peripheral vasodilation, and leads to hypersensitivity of sensory neurons. This
66
neurotransmitter seems to activate asomato-autonornic reflex that could account for theclinical
observations of specific acupuncture points that areboth electrically active and tender to
palpation.
Experimentally induced changes inauricular reflex points inratswere examined by Kawakaita et
al. (1991). Thesubmucosal tissue of the stomach of anesthetized rats was exposed, then acetic acid
or saline was injected into the stomach tissue. Skin impedance of the auricular skin was measured
byconstant voltage, square wave pulses. A silver metal ball, the search electrode, was moved over
the surface of theratsear andaneedle was inserted intosubcutaneous tissue toserve asthe
reference electrode. Injection of acetic acid lead tothe gradual development of lowered skin
resistance points on central regions of the rats ears, auricular areas which correspond to the
gastrointestinal region of human ears. Innormal rats and inexperimental rats before the surgical
operation, lowimpedance points were rarely detected on the auricular skin. After experimentally
induced peritonitis, therewas asignificant increase inlow impedance points (0-100kilohms) and
moderate impedance points (100-500kilohms), but adecrease inhigh impedance points (greater
than 500kilohms). Histological investigation could not prove the existence of sweat glands inthe
rat auricular skin. The authors suggested that the lowimpedance points areinfact related to
sympathetic control of blood vessels.
Brainactivity related to auricular stimulation: Theareas of the brainwhich have been classically
related toweight control include two regions of the hypothalamus. Theventromedial
hypothalamus (VMH) has been referred to asasatiety center. When the VMH islesioned, animals
fail torestrict their food intake. Incontrast, the lateral hypothalamus (LH) isreferred to asa
feeding center, since stimulation of the LH induces animals tostart eatingfood. Asamoto &
Takeshige (1992) studied selective activation of the hypothalamic satiety center byauricular
acupuncture inrats. Electrical stimulation of inner regions of the rat ear, which correspond to
auricular representation of thegastrointestinal tract, produced evoked potentials inthe VMH
satiety center, but not inthe lateral hypothalamic feeding center. Stimulation of more peripheral
regions of the ear did not activate hypothalamic evoked potentials, indicating the selectivity of
auricular acupoint stimulation. Only the somatotopic auricular areas near the region representing
the stomach caused these specific brain responses. Thesame auricular acupuncture sites that led
to hypothalamic activity associated with satiety led to behavioral changes infood intake. Auricular
acupuncture had no effect on weight inadifferent set of ratswho hadreceived bilateral lesions of
VMH. These results provide acompelling connection between auricular acupuncture and apart of
thebrainassociated with neurophysiological regulation of feeding behavior.
Insupport of thisevoked potential research, Shiraishi et al. (1995) recorded single unit neuronal
discharge rates intheventromedial (VMH) and lateral hypothalamus (LH) of rats. Neurons were
recorded inthe hypothalamus following electrical stimulation of low resistance regions of the
inferior concha Stomach point. Auricular stimulation tended tofacilitate neuronal discharges in
the VMH and inhibit neural responses inthe LH. Out of 162neurons recorded inthe VMH,
44.4%exhibited increased neuronal discharge rates inresponse to auricular stimulations, 3.7%of
VMH neurons exhibited inhibition, and 51.9%showed no change. Of224neurons recorded inthe
LH feeding center of 21rats, 22.8%were inhibited byauricular stimulation, 7.1%were excited,
and70.1%were unaffected. When the analysis was limited to 12ratsclassified asbehaviorally
responding toauricular acupuncture stimulation, 49.5%of LH units were inhibited, 15.5%were
excited, and 35%were not affected byauricular stimulation. A different set of rats wasgiven
lesions of theventromedial hypothalamus, which led to significant weight gain. Inthese
hypothalamic obese rats, 53.2%of 111LH neurons were inhibited by auricular stimulation, 1.8%
showed increased activity, and 45%were unchanged. These neurophysiological findings suggest
that auricular acupuncture can selectively alter hypothalamic brainactivity and ismore likely to
produce sensations of VMH satiety thanreduction of LH appetite.
Fedoseeva et al. (1990) applied electrostimulation to the auricular lobe of rabbits, an area
corresponding to thejawand teeth inhumans. They measured behavioral reflexes and
cortical somatosensory evoked potentials inresponse to tooth pulp stimulation. Auricular
electro acupuncture produced asignificant decrease inboth behavioral reflexes andin
cortical evoked potentials to tooth pulp stimulation. Thesuppression of behavioral and
neurophysiological effects byauricular electroacupuncture at 15Hzwas abolished by
intravenous injection of the opiate antagonist naloxone, suggesting endorphinergic mechanisms.
Naloxone did not diminish the analgesic effect of 100Hz stimulation frequencies. Conversely,
injection of saralasin, an antagonist for angiotensin II, blocked the analgesic effect of 100Hz
auricular acupuncture, but not 15Hz stimulation. Theamplitude of cortical potentials evoked by
electrical stimulation of thehind limb was not attenuated bystimulation of theauricular areafor
the trigeminal nerve.
2.6 Endorphin release byauricular acupuncture
Thenatural pain relieving biochemicals known asendorphins areendogenous morphine
substances which arefound inthepituitarygland and partsof the central nervous system (CNS).
Enkephalin isasubfraction of endorphin, aneurotransmitter occurring inthebrainat the same
sites where opiate receptors have been found. Both body acupuncture and ear acupuncture have
been found toraise blood serum andcerebrospinal fluid (CSF) levels of endorphins and
enkephalins. As stated intheprevious section, naloxone isthe opiate antagonist which blocks
morphine, blocks endorphins, and also blocks the analgesia produced bythe stimulation of
auricular reflex points andbody acupuncture points. Thediscovery byWen & Cheung (1973) that
auricular acupuncture facilitates withdrawal from narcotic drugs has led to aplethora of studies
demonstrating the clinical use of this technique for substance abuse (Smith 1988, Dale1993).
Auricular electroacupuncture has also been shown to raise blood serum and cerebrospinal fluid
(CSF) levels of endorphins andenkephalins (Sjolund & Eriksson 1976; Sjolund et a1. 1977;
Wen et a1. 1978, 1979;Clement-Jones et a1. 1979) and beta-endorphin levels inmice withdrawn
from morphine (Hoet a1. 1978; Nget aI. 1975, 1981). Pomeranz (2001) has reviewed the extensive
research on the endorphinergic basis of acupuncture analgesia and has substantiated 17arguments
tojustify the conclusion that endorphins have ascientifically verifiable role inthe painrelieving
effects of acupuncture.
Mayer et a1. (1977) were thefirst investigators toprovide scientific evidence that there isa
neurophysiological and neurochemical basis for acupuncture inhumansubjects. Stimulation of the
body acupuncture point LI 4produced asignificant increase indental painthreshold. Acupuncture
treatment raised dental painthreshold by27.1%, whereas an untreated control group showed only
a6.9%increase indental painthreshold. A total of 20out of 35acupuncture subjects showed
increased painthresholds greater than20%, while only 5out of 40control subjects exhibited a20%
elevation of pain threshold. Statistically significant reversal of this elevated pain threshold was
achieved byintravenous administration of 0.8mgof naloxone, reducing the subjects pain
threshold to the same level asthat of acontrol group given saline. A double blind study byErnst &
Lee (1987) similarly found that therewas a27%increase inpain threshold after 30minutes of
electroacupuncture at LI 4. Theanalgesic effect induced byacupuncture inthat study was also
blocked bythe intravenous injection of 0.8mgof naloxone.
Contradictory findings with regard tothenaloxone reversibility of acupuncture analgesia have
been suggested byChapman et a1. (1983). Differences inexperimental design could account for
some of the discrepancies, but amore probable explanation for the contrasting findings may be
due tothe lowsample size employed inChapman et a1.sresearch. Their study examined only 7
subjects inthe experimental group given naloxone and 7inthe control group given saline. While
all 14subjects didexhibit significant analgesia with acupuncture stimulation at LI 4, they failed to
obtain astatistically significant reversal inpainthreshold by 1.2mgof intravenous naloxone. The
mean decrease intheelectrical current levels needed to evoke painwas 4.8/-LA after naloxone
administration, but only 0.4/-LA for the control group administered saline. While themean change
inpain threshold difference between groups was small, it might have reached statistical
significance with alarger sample size.
The aforementioned studies all obtained acupuncture analgesia with body acupoint LI 4. Simmons
& Oleson (1993) examined naloxone reversibility of auricular acupuncture analgesia to dental pain
induced inhuman subjects. UtilizingaStirn Flex 400transcutaneous electrical stimulation unit, 40
subjects were randomly assigned tobetreated at either 8auricular points specific for dental pain or
at 8placebo points, ear regions which have not been related to dental pain. All subjects were
assessed for tooth painthreshold byadental pulp tester at baseline, after auriculotherapy, and
then again after double blindinjection of 0.8mgof naloxone or placebo saline. Four treatment
groups consisted of trueauricular electrical stimulation (AES) followed byaninjection of
naloxone, trueAES followed byaninjection of saline, placebo stimulation of the auricle followed
68
byaninjection of naloxone, or placebo stimulation of the auricle followed byaninjection of saline.
Dental pain thresholds were significantly increased byAES conducted at appropriate auricular
points for dental pain, but were not altered bysham stimulation at inappropriate auricular points.
Naloxone produced aslight reduction indental pain threshold inthe subjects given trueAES,
whereas thetrueAES subjects then given saline showed afurther increase inpain threshold. The
minimal changes indental pain threshold shown bythe sham auriculotherapy group were not
significantly affected bysaline or bynaloxone. Research byOliveri et al. (1986) and Krause et al.
(1987) has also demonstrated statistically significant elevation of painthreshold bytranscutaneous
auricular stimulation, while Kitade & Hyodo (1979) and Lin (1984) found increased pain relief by
needles inserted into theauricle. These earlier investigations of auricular analgesia didnot test for
theeffects of naloxone.
Direct evidence of theendorphinergic basis of auriculotherapy was first provided bySjolund &
Eriksson (1976) andbyAbbate et al. (1980). Assaying plasma beta-endorphin concentrations in
subjects undergoing surgery, they observed asignificant increase inbeta-endorphins after
acupuncture stimulation wascombined with nitrous oxide inhalation, whereas control subjects
given nitrous oxide without acupuncture showed nosuch elevation of endorphins. Pert et al. (1981)
showed that 7-Hzelectrical stimulation through needles inserted into theconcha of the rat
produced anelevation of hot platethreshold, ananalgesic effect that was reversed bynaloxone.
Thebehavioral analgesia toauricular electroacupuncture was accompanied bya60%increase in
radioreceptor activity incerebrospinal fluid levels of endorphins. This auricular-induced elevation
inendorphin level wassignificantly greater thanwasfound inacontrol group of rats. Concomitant
withthese CSF changes, auricular electroacupuncture depleted beta-endorphin radioreceptor
activity intheventromedial hypothalamus andthe medial thalamus, but not theperiaqueductal
gray. Supportive findings inhuman back pain patients was obtained by Clement-Jones et al.
(1980). Low frequency electrical stimulation of theconcha led torelief of pain within 20minutes of
theonset of auricular electroacupuncture and anaccompanying elevation of radioassays for CSF
beta-endorphin activity inall 10subjects. Abbate et al. (1980) examined endorphin levels in6
patients undergoing thoracic surgery with 50%nitrous oxide and 50Hz auricular
electroacupuncture. They were compared to6control patients who underwent surgery with 70%
nitrous oxide but noacupuncture. The auricular acupuncture patients needed less nitrous oxide
than thecontrols and acupuncture led toasignificant increase inbeta-endorphin
immunoreactivity.
Extending thepioneering work of Wen & Cheung (1973) on thebenefits of auricular acupuncture
for opiate addicts, Kroening & Oleson (1985) examined auricular electro acupuncture inchronic
pain patients. Fourteen subjects were first switched from their original analgesic medication toan
equivalent dose of oral methadone, typically 80mgper day. An electrodermal point finder was
used todetermine areas of lowskin resistance for theLung point andthe Shen Men point. Needles
were bilaterally inserted into these two ear points and electrical stimulation was initiatedbetween
twopairs of needles. After 45minutes of electroacupuncture, thepatients were given periodic
injections of small doses of naloxone (0(l4mgevery 15minutes). All 14patients were withdrawn
from methadone within 2to7days, for amean of 4.5days. Only afew patients reported minimal
side effects, such asmild nausea or slight agitation. It was proposed that occupation of opiate
receptor sites bynarcotic drugs leads to theinhibition of the activity of natural endorphins,
whereas auricular acupuncture facilitates withdrawal from these drugs byactivating the release of
previously suppressed endorphins.
Other biochemical changes also accompany auricular acupuncture. Debrecini (1991) examined
changes inplasma ACTH andgrowth hormone (GH) levels after 20-Hz electrical stimulation
through needles inserted into theAdrenal point on the tragus of the ears of 20healthy females.
While GH secretions increased after electroacupunture, ACTH levels remained thesame. This
research supported earlier work byWen et al. (1978) that auricular acupuncture led toadecrease
inthe ACTH andcortisol levels associated with stress. Jaung-Geng et al. (1995) evaluated lactic
acid levels from pressure applied toear vaccaria seeds positioned over theLiver, Lung, San Jiao,
Endocrine, andThalamus (subcortex) points. Using awithin-subjects design, pressure applied to
ear points produced significantly lower levels of lactic acid obtained after physical exercise on a
treadmill test thanwhen ear seeds were placed over the same auricular points but not pressed.
Stimulation of auricular pressure points reduced the toxic build-up of lactic acid to agreater
Box 2.4 Taoist dualities of hormones andneurotransmitters
Yin sedating or nurturingneurochemicals
Endorphin
Melatonin
Parathormone
Estrogen and progesterone
GABA
Acetylcholine
Serotonin
Yang arousing neurochemicals
f------------=---------------:=------="-----------I
Adrenalin
Cortisol
Thyroxin
Testosterone
Glutamate
Norepinephrine
Dopamine
degree thanthecontrol condition. Thereduced lactic acid accumulation was attributed to
improved peripheral blood circulation.
As indicated inBox 2.4and Figure 2.25, the dualistic principles of Taoismcan beused to
distinguish the arousing and sedating qualities of different hormones and different
neurotransmitters. Thepituitary andtarget glands that release adrenalin, cortisol, thyroxin and
testosterone all induce general arousal and energy activation. Incontrast, the hormones
endorphin, growth hormone, parathormone, estrogen and progesterone all promote arelaxation
response. The neurotransmitter glutamate produces excitatory postsynaptic potentials (EPSPs)
throughout thebrain, while the neurotransmitter gamma-aminobutyric acid (GABA) produces
inhibitory postsynaptic potentials (IPSPs) throughout thebrain. Norepinephrine isreleased by
postganglionic fibers intheadrenergic sympathetic nervous system to activate general arousal,
while acetylcholine isreleased bypostganglionic fibers inthecholinergic parasympathetic nervous
system tofacilitate physiological relaxation. Inthebrain, dopamine tends toincrease motor
excitation and intensely pleasurable feelings, while serotonin facilitates calm, relaxing feelings that
facilitate sleep.
2.7 Embryological perspective of auriculotherapy
As part of his examination of the neurophysiological basis of auriculotherapy, Paul Nogier (1983)
proposed that nervous system innervations of theexternal ear correspond to the three primary
types of tissue found inthedeveloping embryo. Nogier theorized that the distribution of the three
cranial nerves which supply different auricular regions isrelated tothree embryological functions,
theectoderm, mesoderm, andendoderm. Leib (1999) has referred to Nogiers embryological
perspective asthree functional layers, each layer representing adifferent homeostatic system in
theorganism. Most health disorders arerelated todisturbances inall three functional layers.
Relationship of auricular regions to nerve pathways: There areactually four principal nerves,
which innervate the human ear. Figure 2.26shows thedistribution of different nerves todifferent
auricular regions. Since the entireauricle iscovered with athin skin layer containing extensively
branching nerves, all anatomical areas of theexternal ear areinpart related toectodermal tissue.
Somatic trigeminal nerve: Thefifth cranial nerve ispart of the somatic nervous system pathway
that processes sensations from theface and controls some facial movements. The mandibular
division of the trigeminal nerve isdistributed across theantihelix and thesurrounding auricular
areas of the antitragus, scaphoid fossa, triangular fossa andhelix. This auricular region represents
somatosensory nervous tissue associated withmesodermal organs.
Somatic facial nerve: The seventh cranial nerve isanexclusively motor division of the somatic
nervous system, controlling most facial movements. I tpredominately supplies the posterior
regions of the auricle that represent motor nerve control of mesodermal tissue.
Autonomic vagus nerve: The tenth cranial nerve isabranch of theparasympathetic division of the
autonomic nervous system. I tprocesses sensations from visceral organs inthe head, the thorax,
andtheabdomen and itcontrols thesmooth muscle activity of theinternal viscera. Vagus nerve
fibers spread throughout theconcha of the ear and represent neurons associated with endodermal
tissue.
A.
Vagus nerve
Cervical plexus
Nerve Connections to the Auricle
B.
Auriculo-temporalis
trigeminal nerve
D.
Minor occipitalis nerve
of cervical plexus
C.
Auricularis nerve complex of
vagus nerve, facial nerve,
and glossopharyngeal nerve
Figure 2.26 Cranial andcervical nervesaredistributed separately todifferent regions oftheexternal ear (A). Theauriculo-temporalis division
ofthetrigeminal nerveprojects totheantihelix, antitragus andsuperior helix(B), thevagusnerveprojects tothecentral concha (C), andthe
minor occipital nerveofthecervical plexusprojects totheear lobe(D). Thefacial andglossopharyngeal nervesalsoproject totheconcha, tragus
andmedial ear lobe. (Reproduced fromNogier 1972. withpennission.)
Cerebral cervical plexus nerves: Thisset of cervical nerves affects neuronal supply to the head,
neck and shoulder. Thelesser occipital nerve and thegreater auricular nerve of the cervical plexus
supply the ear lobe, tragus, andhelix tail regions of the auricle. These auricular regions correspond
toectodermal tissue.
Auricular representation of embryological tissue: All vertebrate organisms begin astheunion of
asingle egg and asingle sperm, but this one cell soon divides tobecome amulticellular organism as
shown inFigure 2.27. This developing ball of cells ultimately folds inon itself and differentiates
into the three different layers of embryological tissue. I tisfrom these three basic types of tissue
that all other organs areformed. Theorgans derived from these embryological layers areprojected
on todifferent regions of theauricle. Table2.5outlines these embryological divisions andthe
corresponding auricular regions.
Endodermal tissue: The endoderm becomes thegastrointestinal digestive tract, the respiratory
system and abdominal organs such asthe liver, pancreas, urethra and bladder. This portion of the
embryo also generates partsof theendocrine system, including the thyroid gland, parathyroid
gland, and thymus gland. Deep embryological tissue isrepresented intheconcha, thecentral valley
of theear. Stimulating this areaof theear affects metabolic activities and nutritivedisorders of the
internal organs that originate from theendoderm layer of theembryo. Disturbances ininternal
organs create anobstacle tothesuccess of medical treatments, so these metabolic disorders must
becorrected before complete healing can occur.
Egg and sperm union Dividing embryo Multicellular embryo
Embryo primary germ layers
Mesoderm
Endoderm - n ~ " ' "
Ectodermal
tissue
Endodermal ---f===\,--,--\-:--\
tissue
Mesodermal
tissue
Figure 2.27 Thedivision ofembryological cells leads toaball oftissue thatfolds inon itself tobecome thethree dermal layers ofthe
endoderm, mesoderm andectoderm. These embryological tissue layers arerepresented on three different regions oftheauricle. (From Life
AR1, Super Anatomy, 'Lippincott Williams & Wilkins, withpermission.)
Table 2.5 Auricular representation of embryological tissue layers
Endodermal tissue
Innerlayer
Mesodermal tissue
Middle layer
Ectodermal tissue
Outer layer
Viscera Skeletal bones Skin
Stomach Striatemuscles Hair
Tendons
Fascia andsinews Sweat glands
----------------------
Peripheral nerves Large intestines
Small intestines
Lungs
Tonsils
Ligaments
Hearts andcardiac muscle
Spinal cord
Brainstem
Liver Blood cells and blood vessels Thalamus and hypothalamus
Pancreas
Bladder
Lymphatic vessels
-----
Spleen
Limbic system and striatum
Cerebral cortex
~ - - - - - - --- ----- -------
Thyroid gland Kidneys Pineal gland
Parathyroid gland
Thymus gland
Gonads (ovaries and testes)
Adrenal cortex
Pituitarygland
Adrenal medulla
Ear lobe, helix tail andtragus
Outer ridge
Cervical plexus region
- - - - - -
Ear antihelix andantitragus
-----
Middle ridge
Trigeminal nerve region
Ear concha
Central valley
Vagus nerve region
-----
Mesodermal tissue: Themesoderm becomes skeletal muscles, cardiac muscles, smooth muscles,
connective tissue, joints, bones, blood cells from bone marrow, the circulatory system, the
lymphatic system, the adrenal cortex and urogenital organs. Musculoskeletal equilibration is
regulated bynegative feedback control of somatosensory reflexes. Middle embryological tissue is
represented on the antihelix, scaphoid fossa, triangular fossa and portions of the helix.
Mobilization of body defense mechanisms isonly possible if the region of the middle layer is
working normally.
Ectodermal tissue: Thesurface layer originates from theectoderm of theembryo. Theectoderm
becomes theouter skin, cornea, eye lens, nose epithelium, teeth, peripheral nerves, spinal cord,
brainand theendocrine glands of the pituitary, pineal andadrenal medulla. This embryological
tissue isrepresented on theear lobe and helix tail. Thesurface embryological layer affects the
capacity for adaptation andcontact totheenvironment. It reveals psychological resistance
reactions not only from theconscious mind, but also from the unconscious, deep psyche. This layer
integrates inborn instinctive information with individual learned experiences.
2.8 Nogier phases of auricular medicine
Insubsequent revisions of the somatotopic representation on the external ear, Paul Nogier
(Nogier 1983) has described different auricular maps thanthe inverted fetus pattern heoriginally
discovered. These alternative auricular microsystems varied considerably from ealier descriptions
of the correspondence between specific organs of thebody and the particular regions of the ear
where they were represented. Each anatomical areaof the external ear could thus represent more
thanone microsystem pattern. Nogier referred to these different representations asphases. The
use of this termisanalogous tothe phases of the moon, just asthe same surface of themoon
reflects different degrees of reflected light. A round, white ball of light isrevealed at the full moon,
asemicircle of light at the half moon, andadark round image at thenew moon. Thedifferent
auricular phases also allude tophase shifts inthe frequency of light asit passes through acrystal
prism tocreate different colored beams. Thesame whitebeamof light can besent at different
angles through aprism to reveal blue light, green light or red light on the same reflected surface
72 Aur;culotherapy Manual
Phase I pattern
Images of Nogier phases
Phase 1/ and1/1 patterns Phase IVpattern
Different phases of refracted light Inversion of image by optical lens
Bluelight
Green light
Red light
Original image
~ .
Inverted image
Figure 2.28 Somatotopic images ofthedifferent phases on theear arecharacterized byan upside down man in
Phase I, an upright maninPhase II, ahorizontal maninPhase III, andan inverted man on theposterior auricle in
Phase I VThedifferent phases can besymbolized byshifts inthefrequency ofwhite light as itpasses through a
crystal prism tocreate different colors ofrefracted light. Thefirst phase iscomparable totheinversion ofan image
byaconventional optical lens.
(Fig. 2.28). Different auricular regions revealed byspecific colored light filters were mapped using
the Nogier vascular autonomic signal (N-VAS). Changes inthe N-VAS pulse response to
stimulation of agiven region of theear were found to selectively vary withcolors of light.
Nogier proposed that differences between Chinese andEuropean charts may have originated from
this unrecognized existence of many reflex systems superimposed on the same areas of the auricle.
Theoccurrence of more thanone ear point that corresponds toagiven body organ mayseem to
contradict thegeneral proposition that there isasomatotopic pattern on theear. Precedence for
this phenomenon isfound bythepresence of multiple somatotopic maps that have already been
plotted inthebrainof different animal species. As depicted inFigure 2.29, there areat least two
somatosensory systems on thecerebral cortex of rats, cats andmonkeys: aprimary and asecondary
somatosensory cortex. There isalso athirdregion of theassociation cortex that interconnects
somatic, motor and multisensory input. Multiple projection systems arealso found for thevisual
andauditory cortex. These different cerebral cortex representations may not beresponsible for the
phases that Nogier has described for the external ear, but they do indicate that thebrainitself has
similar multiple microsystem arrangements.
2.8.1 Auricular territories associated with thethree embryological phases
A basic reason that Nogier emphasized theoccurrence of the phases isthat hebelieved that each
type of primary embryological tissue has acertain resonance frequency. The phase shifts in
Motor cortex Somatosensory cortex area 1
74
Somatosensory cortex area 2
Figure 2.29 Therearemultipleprojections ofthebodyto thesomatosensory cortex in
animals, possibly relatingtothedifferent somatotopic phases described byNogier.
different anatomical regions of theear arerelated todifferential activation of thefrequency
resonance of thecorresponding tissue of thebody. Tobetter indicate how theear microsystems
reflect these resonant phase shifts, theauricle isfirst divided into three territories (see Figure 2.30).
Thelocation of the three territories isbased upon their differential innervation bythree nerves.
Thetrigeminal nerve supplies Territory 1, thevagus nerve supplies Territory 2, and the cervical
plexus nerves supply Territory 3. InPhase I, Territory 1represents mesodermal and somatic
muscular actions, Territory 2represents endodermal and autonomic visceral effects, and Territory
3represents ectodermal and nervous system activity. Theembryological tissue represented byeach
territory shifts asone proceeds from Phase I to Phase II toPhase III, asshown inFigure 2.31. The
number of each phase corresponds tothe region that represents mesodermal tissue. There is
actually afourth territory and afourth phase, which has not yet been described. Thefacial nerve
supplies the posterior regions of the auricle, Territory 4, and it issaid to represent motor neuron
control of mesodermal somatic tissue. Theshifts of phase aresummarized inTable2.6.
2.8.2 Functional characteristics associated with different Nogier phases
The three primary colors of light are red, green and blue. These same three colors were used to
determine discordant resonance responses related to the three phases discovered byNogier. Red
#25Kodak-Wrattan filters elicited Nogier vascular autonomic signals (N-VAS) identified with the
first phase, green #58Kodak-Wrattan filters elicited N-VAS responses identified with thesecond
phase, and blue #44A Kodak-Wrattan filters elicited N-VAS responses identified with the third
phase. Nogier found that there areseveral reflex systems superimposed upon the auricle, but ear
points could react tovarying depths of pressure. I fanear point produced an N-VAS response with
firmpressure, greater than 120g/rnm-, itwas said tobelong tothe deep layer. Ear points reacting
toonly 5g/mm? were attributed tothe superficial layer, whereas ear points reacting to an
intermediate pressure of 60g/mm- belonged tothe middle layer. Thedeep layer indicates the
somatotopic region of theear that isthe most prominent reason for asymptom. The location of the
ear point can reveal if theproblem isdue to thesame body areawhere thepatient reports pain, if it
isdue toreferred pain, or if it isdue toanemotional problem, such asdepression. Nogier found
that ear points found at the deep layers were most related toPhase I, points discovered at the
superficial layer were most related toPhase II, and ear points discovered at the middle layer were
most related toPhase III.
PhaseI: Theinverted fetus pattern isused totreat the majority of medical conditions and ismost
inconcurrence with the Chinese ear reflex points. Phase I represents thetissues and organs of the
actual physical body. This phase istheprimary source for correcting somatic tissue disorganization
that istheprincipal manifestation of most medical conditions. FromaChinese medical
perspective, Phase I ear points indicate acute, yang excess reactions.
Territory1
f:J----r---E3LTerritory 2
Territory3
Figure 2.30 Nogier described threedifferent territories oftheauricle whicharerelated tothreedifferent phases that
correspond todifferent somatotopic representations.
Phase I
Embryological phase shifts on auricle
Phase /I Phase 11/
Mesodermal
Ectodermal
Endodermal

Ectodermal

Figure 2.31 Somatotopic correspondences shift withthethreeNogier phases between auricular Territory 1, Territory 2,and Territory 3.
Table2.6 Shifts of Nogier phase on the external ear
Territory 1 Territory 2 Territory 3 Dominant Depth of
Antihelix area Concha Lobeand tragus color ear point
Phase I Mesodermal Endodermal Ectodermal Red Deep layer
--------_...- ----------
Phase II Ectodermal Mesodermal Endodermal Green Superficial layer
Phase III Endodermal Ectodermal Mesodermal Blue Middle layer
76
Phase II: Theupright man pattern isused totreat more difficult chronic conditions that have not
responded successfully to treatment of the Phase I microsystem points. Phase II represents
psychosomatic reactions and neurophysiological connections tobodily organs. This phase isuseful
for correcting central nervous system dysfunctions and mental confusion that contribute to the
psychosomatic aspects of pain and pathology of chronic illnesses. Phase II points aresaid to be
related toyin degenerative conditions.
Phase III: Thehorizontal man pattern isused the least frequently, but it can bevery effective for
relieving unusual conditions or idiosyncratic reactions. Phase III affects basic cellular energy, and
can correct theenergy disorganization that affects cell tissue. I tproduces subtle changes inthe
electromagnetic energy fields which surround individual cells andwhole physical organs. Phase III
points aresaid toindicate prolonged, yang excess, inflammatory conditions.
Phase IV: Thesecond upside down manpattern isrepresented on the posterior side of the
external ear andisessentially thesame microsystem represented by Phase I. The Phase IV points
areused to treat muscle spasm aspects of acondition, whereas Phase I points indicate sensory
aspects of pain. Both Phase I andPhase IV relate toacute pain or ongoing pathological reactions,
whereas theother twophases appear with chronic pain. Phase IV ismost related to mesodermal
muscular tissue represented on Territory 4, theposterior side of theauricle.
2.8.3 Relationship of Nogier phases totraditional Chinese medicine
Nogier proposed histhree phases partly asanattempt toaccount for some of thediscrepancies
between the European and theChinese ear acupuncture charts. Practitioners of auricular
medicine suggest that thesomatotopic points described byNogier represent the actual physical
organs, whereas theChinese ear points may relate to neurological or energetic connections to
these organs. Thedifferent anatomical localizations on theear for theKidney, Spleen andHeart
points areanexample of thisview. Nogier placed these three mesoderm-derived organs on the
mesodermal region of the internal helix and theantihelix, whereas the Chinese ear charts show
these same three organs on theendodermal region of thesuperior and inferior concha. The
concept that the mesodermal organs shifted from theantihelix totheconcha was awayof
accounting for thisdivergent representation. Some of the uses of the Kidney point andtheHeart
point inChinese acupuncture areoften more related to their zang-fu energetic effect thantheir
biological function. Taoismdescribes theflow of qi energy from various states of yang energy and
yinenergy, which can becompared tothebinary code used incomputers and to the active and
resting states of aneuron. The Chinese symbolized yang asasolid lineandyin asabroken line:
various combinations of threesuch lines formwhat isknown asatrigram. Helms (1995) has cited
thework of theFrench acupuncturist Maurice Mussat inpresenting eight such trigrams rotating
around theyin-yang symbol. Theyang trigrams arediametrically opposite totheir corresponding
yin trigram. Each trigramcode reflects aspecific interaction of three basic components of the
universe: matter, movement andenergy. From atripartitephase perspective, Nogiers Phase I
represents solid matter, Phase II represents thecontrol of movement bythe nervous system, and
Phase III represents theecho reverberation of theenergy of thespirit. Disturbance of thedynamic
symmetry of composition of these three functional interactions can result inanimbalance of
energy. Dr Richard Feely of Chicago has suggested that these three energy states inChinese
philosophy can becompared toNogiers three microsystem phases. Sequential shifts in
interactions from theinitial yang reactions manifested inPhase I, tothechronic degenerative
states of Phase 11, tothe resonance reverberations of Phase III aredepicted inthetrigrampatterns
inFigure 2.32.
2.9 Integrating alternative perspectives of auriculotherapy
Therehas been great interest bysome investigators of alternative andcomplementary medicine in
continued neurophysiological research that aims toprovide amore scientific basis for acupuncture
and auriculotherapy. Thediscovery of endorphins inthe1970sprovided abiochemical mechanism
which could account for the amazing observation that injecting theblood or cerebrospinal fluid
from one laboratory animal toanother could also transfer the analgesic benefits of acupuncture to
thesecond animal. Thesame neuroanatomical pathways that have nowbeen shown to underlie the
descending pain inhibitory systems producing opiate analgesia also affect acupuncture analgesia,
thereby providing aphysical foundation for acupuncture. ThefMRI studies of the human brain
Circular shifts in Chinese trigrams
Maximum yang
Yang symbol =
Yin symbol = __
Greater yang
Taiyang
--
Middle yang
Yang ming
--
--
--
Lesser yang
Shao yang
--
--
--
Maximum yin
Lesser yin
[ue yi n
--
Middle yin
Shao yin
--
--
--
--
Greater yin
Tai yin
Binary progression of trigrams
--
0 000 -- Maximum yin
001 Greater yin
--
2 010
-
Middle yin
3 011
-
Lesser yin
--
4 100
--
Lesser yang
--
5 101 Middle yang
6 110 Greater yang
7 111 Maximum yang
Counter-clockwise shifts in auricular phases
Upright man
~
Breath oflife
Phase I
Phase II
Horizontal man
Phase III
Phase IV
~
Invertedman
......I ------iI I E------1Phase III
Qi
~ Q i
Phase I
Inverted
fetus
Figure 2.32 Thecircular progression ofyin andyang
relationships of Chinese trigrams are compared tothe
different Nogier phases inauriculotherapy. The
numeric, binary progression oftrigrams islistedfrom
maximumyin tomaximumyang.
demonstrate neural changes that depend upon stimulation of aparticular acupoint on thebody or
on theear. At thesame time, many practitioners of the field of traditional Oriental medicine
maintain adeep belief intheenergetic principles thatwere developed inancient times. Whether
viewed asaself-contained micro-acupuncture system, aconduit to macro-acupuncture meridians,
ashi points, trigger points, chakra centers, or even the quantumphysical explanations of
holograms, there isreason tosuggest that anunconventional energy profoundly affects the healing
effect of auricular acupuncture aswell asbody acupuncture. Western scientists seem toprefer the
neurophysiological perspective, while those trained inOriental medicine more readily accept an
energetic viewpoint.
78
Thedifferences between the information processing styles of the left andright hemispheres of the
cerebral cortex allow for this yin-yang duality. TheWestern mind prefers the rational order of the
left side of the neocortex, with itsconscious ability to analyze details andcome to logical
conclusions, whereas the Oriental mind seems toaccept the holistic perspective of the right side of
theneocortex, which allows for the interactive relationship of all things. What isneeded to
comprehend auriculotherapy isacorpus callosum which can integrate both perspectives as
complementary viewpoints of avery complex system. This duality of Western and Chinese
perspectives has also altered the ear acupuncture charts that have developed inAsia and Europe.
After Nogier first discovered the inverted fetus map on the ear inthe 1950s, subsequent
investigations of the inverted auricular cartography took divergent paths inEurope and China.
While there isgreat overlap inthe corresponding points shown inthe Chinese and European
auricular maps, there arealso specific differences. There isatendency bymany individuals tofeel
the need tochoose one system over the other. Inmydiscussions on thesubject, I have promoted
the acceptance and integration of both systems asclinically valid and therapeutically useful.
I tseems paradoxical that two opposite observations could both becorrect, but such isthe naturein
many parts of life, including our current view of subatomic particles. I tisprobably thearrogance of
left brain thinking tosuggest that there isonly one truth. At the 1999meeting of the International
Consensus Conference on Acupuncture, Auriculotherapy, and Auricular Medicine (ICCAAAM),
I cited thework of agreat English author who hascommented on this paradox. Thefirst lineof
Rudyard Kiplings classic Theballad ofeast andwest iswell known, but the rest of theverse has
even greater relevance to the understanding of the different theoretical views of auriculotherapy.
Oh, East isEast, and West isWest, andnever thetwain shall meet,
Till Earth andSky stand presently at Gods great J udgment Seat;
But there isneither East nor West, nor Border, nor Breed, nor Birth,
When two strong menstandface toface, tho they come from theends oftheearth.
I I
Anatomy of theauricle
Aswithotherareas of humananatomy, therearespecific termsfor identifyingopposingdirections
of theear and for indicatingalternativeperspectives. Because othertexts onthetopicof auricular
acupuncturehaveused avariety of different termstodescribethesameregionsof theear, this
sectionwill define theanatomical termsused inthismanual. Takingthetimetolearn the
convoluted structureof theauriclefacilitates adeeper understandingof thecorresponding
connectionsbetweenspecific regionsof theear tospecific organsof thebody.
CONTENTS
3.1 Thespiral of life
3.2 Neuro-embryological innervations of the external ear
3.3 Anatomical views of the external ear
3.4 Depth view of the external ear
3.5 Anatomical regions of the external ear
3.6 Anatomical regions of the posterior ear
3.7 Curving contours of the antihelix and antitragus
3.8 Somatotopic correspondences to auricular regions
3.9 Determination of auricular landmarks
3.10 Anatomical relationships of auricular landmarks
3.11 Standard dimensions of auricular landmarks
3.1 Thespiral of life
Theear consistsof aseries of concentriccircles thatspiral fromthecenter of theauricletoaseries
of curving ridgesand deepvalleys thatspreadoutwardslikeanundulatingwave. This
configurationisvery similar totheringsof water waves thatradiateout fromasplash onapond.
Suchan image isdepictedinFigure3.1. Soundwaves aresimilar towaves onwater, consistingof
oscillatingincreases thendecreases inthecompression of air molecules. Theexternal ear isshaped
likeafunnel todirect thesesubtlemotionsof air into theear canal. Focusedsoundwaves then
vibrateagainst theeardrumlikeabatonpoundingagainst abass drum. After being amplifiedby
Figure 3.1 Concentricringsofwaterwavessymbolizetheoscillation ofsoundwavestowhich
theextemalearconformsinringsofridgesandcrevices. (Reproducedwithpermissionfrom
Reikifire, Calgary, Canada.)
Anatomyof theauricle 79
B
D
Figure 3.2 Spiral imagesinnaturethatreiterate theshapeoftheauricleincludethedoublehelixofDNAstrands(A),theswirl ofcloud
[ormationsinahurricane(B), thespiralingcochleaoftheinnerear (C) andthecircular shapeofthecurvingembryo(D). (Fig. 3.2C
reproducedfromSadler 2000Langman.IMedicalEmbryology8edn, withpermissionfromLippincottWilliams& Wilkins.)
theserial activation of theossicle bonesof themiddleear, thesoundsignal generatesatraveling
wave thatproducesdeflections inthebendingof membraneswithinthesnail-shapedinner ear.
Thebasic shapeof boththeinnerear andtheexternal ear reiteratesthespiral patternthatisa
commonarchetypal symbol. Differentexamples ofthisspiral imageareshown inFigure3.2, fromthe
doublehelixshapeof theDNAmolecule, totheswirl of cloud formations, tothecurvingembryo. The
Latinword for theshapeof aspiral ishelix.Just astherearetwospiralinghelices which formthe
structureof DNA, thereare twohelices for theauricle, anouter helixandan opposingantihelix. The
othercommonpatternwhich isrepresentedontheear isthatof aseashell, andthetermfor thedeep
central regionof theauricleistheconcha, which isLatinfor shell. Fromthedifferent sea shells
indicatedinFigure3.3, onecan recognizeabasic spiral shapecommontoall of them. InThespiral of
life,MichioKushi (1978) hassuggested thatthisspiralingpatternrelatestothecosmic orderof the
universeasseen fromOriental medicine, whereasfollowers of ayurvedic medicineemphasizethe
symbol of thecoiled serpent. Theundulatingimageof thetwocobrasrepresentstheriseof kundalini
forces of theidaand pingalaspiralingaroundthesushumnatoenergizetheseven primarychakras.
Figure 3.3 Seashellsthatrepeatthespiral patternoftheexternal ear. Thehelix-shaped, spiral tipsandtheconcha-shaped, central
crevices areIery distinctiveinthetwolarge conchshells,
Figure 3.4 Cellularbudsofthedevelopingembryotransformintotheexternal ear duringfetal development.Sixnodulesontheembryo
migrate10 sixdifferentpositionsthatbecometheauricle.
Anatomyoftheauricle 81
3.2 Neuro-embryological innervations of the external ear
Thebiological lifeof thehumanembryobegins astheunionof cells thatdivide and multiplyintoa
complex ball of embryonic tissue. Theauricleof theear resultsfromthecoalescence of sixbuds
which appear onthe40thdayof embryonicdevelopment. ShowninFigure3.4isarepresentation
of thecellular buds thattransforminto theexternal ear duringthefourthmonthof fetal
development. Thesefetal buds are theexpression of mesenchymal proliferationof thefirst two
branchial archesthatsubsequentlydevelop intothecranial nerves thatultimatelyinnervatethe
auricle. Thesuperior regionsof theauricleare innervatedbytheauricular-temporal branchof the
mandibular trigeminal nerve. Theconchaisinnervatedbytheauricular branchof thevagus nerve.
A thirdregionissuppliedbythelesser occipital nerve and thegreat auricular nerve, bothbranches
of thecervical plexus. Theseventhcranial nervewhich regulatesfacial muscles sendsneuronal
connectionstotheposterior sideof theauricle.
Bossy(1979) hassummarizedthestudieswhich delineatethethreeterritoriesof theauricle. The
superior somestheticregionisinnervatedbythetrigeminal and sympatheticnerves, acentral
visceral regionisinnervatedbytheparasympatheticvagus nerve, and alobular regionisinnervated
bythesuperficial cervical plexus. Thelobular areahas nopronouncedautonomicnerve
manifestation. Thedifferential dispersement of cranial nerves provides anembryological basis for
thefunctional divisions betweenspecific auricular regionsandcorrespondingpartsof thegross
anatomy. Thesomatosensorytrigeminal nerve innervatescutaneousand muscular regionsof the
actual face and also supplies theregionof theauricle thatcorrespondswith musculoskeletal
functions. Theautonomicvagus nerve innervatesthoracicand abdominal visceral organsand also
Anterior view
Superior
Midline
Superior
Rightear
t
I
t
Leftear
Rightear Leftear
Peripheral Central Central Peripheral
....-- -------.
....-- -------..
Lateral Lateral
....-- -------..
~
I nferior Medial Medial I nferior
------.. ....--
Superior Superior
Leftear
Posterior view
t
Rightear
Medial Medial
-------.. ....--
Peripheral Centra l Central Peripheral
....--
-------.. Leftear Rightear
....--
-------..
Lateral Lateral
+
I nferior
I nferior
Figure 3.5 Anatomicalperspectives oftheheadandtheexternal ear inanteriorandposteriorsurfaceviews. Thesuperior, inferior, central
andperipheral directionsoftheauricleareindicatedrelative toeach other.
supplies thecentral regionof theauricleassociated withinternal organs. Theconchaof theear is
theonlyregionof thebodywherethevagus nerve comestothesurface of theskin. Thecervical
plexus nerves regulatebloodsupply tothebrainandare associated withdiencephalicand
telencephalicbraincentersrepresentedontheinferior ear lobe.
Whileit seems logical thattheauricle ispart of theauditorypathway, examinationof otheranimal
species showsthattheexternal ear isnot onlyused for thefunctionof hearing. Bossy (2000) has
observed thattheears of animalsareused toprotectagainst theelementsand against predators.
Thedesert hare, desert foxanddesert mouseall havevery large auricles comparedtotheir non
desert relatives, thepurposeof whichistofacilitate heat lossthroughtheskinover theears.
Africanelephantsthatliveinthehot plains havelarger ears thanI ndianelephantsfor asimilar
purposeof heat exchange. Theseries of electroconductivepointsthathavebeenidentifiedonthe
shaved skin of rodentssuggest thattheoccurrenceof bodyacupointsandear pointsmayrelateto
thelateral linesystemoffish. Thissame systembywhichfishsense thesubtlemovementsof water
mayprovidetheevolutionaryfoundationfor acupuncturepointsonthebody andtheear.
3.3 Anatomical views of the external ear
Torefer toanyobject inthreedimensional space, theremust becertainpointsof reference. Asa
complex convoluted structure, theauriclemust beviewed fromdifferent angles andfromdifferent
depths. Specific termswill beused toindicatethesedifferent perspectives of theear which are
indicatedinFigure3.5.
Surfaceview: Thefront sideof theexternal ear iseasily available toview. Theauricleis
diagonally angled fromthesideof theskull such thatit extendsfromboththe
anterioraspects andthelateral sides of thehead.
Hiddenview: Vertical or underlyingsurfaces of theexternal ear are not easy toview, thusthe
auriclemust bepulledback byretractorsinorder toreveal thehiddenregions.
Posteriorview: Theback sideof theexternal ear faces themastoidbonebehindtheear.
External surface:
I nternal surface:
Superior side:
Inferiorside:
Central side:
Peripheral side:
Thehigher regionsof theexternal ear formtheexternal surfaceview.
Thevertical or underlyingsurface regionsof theear formthehiddenview.
Thetopof theear isdirectedtowardtheupper or dorsal position.
Thebottomof theear isdirectedtowardthelower or ventral position.
Themedial, proximal sideof theear isdirectedinward towardthemidlineof
thehead.
Thelateral, distal sideof theear isdirectedoutwardfromthemidlineof thehead.
3.4 Depth view of the external ear
Becausetwo-dimensional paper can not adequatelyrepresent thethree-dimensional depthof the
auricle, certainsymbols havebeendeveloped torepresent changesindepth. I fonewere tothinkof
therisingandfallingswells of awaveor theridges of ahill, thetopof thepeak isthehighest
position, indicatedbyanopencircle, thedescendingslopeisindicatedbyasquare, and thelowest
depthsareshown asafilled circle. InFigure3.6, thedeeper, central conchacontainsareas
representedbyfilledcircles, thesurroundingwall of theconchaisrepresentedbysquares, andthe
peaksof theantihelix and antitragusareshownwithopencircles.
Raisedear point: Regionsof theear which areelevated ridges or areflat surfaceprotrusions.
Representedbyopencircle symbols. 0
Deeper ear point: Regionswhich are lower intheear, likeagrooveor depression. Represented
bysolidcircle symbols.
Hiddenear point: Regions of theear which arehiddenfromviewbecause theyare
perpendicular tothedeeper, auricular, surface regionsor theyareonthe
internal, undersideof theauricle. Sometexts useabrokencircle symbol to
represent thesehiddenpoints. Representedbysolidsquaresymbols.
Posteriorear point: Regionsof theback sideof theear thatface towardthemastoidbone.
Representedbyopensquaresymbols. 0
Anatomyof theauricle
83
Surface view of left ear
Inferior
Raised
...... ...... ... . .. ... U.. ,.,.;..11;!//U//
Deeppoint-e .///
i .... tm
ii/
Superior
1
---+
Peripheral
External surface

surface
Hiddenview of left ear
Inferior
Superior
Peripheral
84
Figure3.6 A depthviewoftheear withthesymbolsusedtorepresent raisedregions(0), deepregions(e), and
hiddenregions (_) oftheauricle.
3.5 Anatomical regions of the external ear
Classic anatomical texts havepresentedspecific anatomical termsfor certainregionsof the
external ear. Thisappendageisalso knownas thepinnaor auricle. Latintermswereused to
describedesignatedregionsof theear aswell as specific termsthatweredeveloped at themeetings
of theWorldHealthOrganizationon acupuncturenomenclature. Someregionsof theexternal ear
aredescribed inauricular acupuncturetexts, but arenot discussed inconventional anatomybooks.
Theofficial termsfor theexternal ear thatweredescribed intheNominaanatomica (I nternational
Congressof Anatomists1977) included 112different termsfor theinternal ear (Aurisinterna), 97
termsfor middleear (Aurismedia), but only 30termsfor theexternal ear (Aurisexterna). The
nineprimaryauricular structuresthatwereidentifiedinWoerdemans(1955) classic anatomytext
includedthehelix, antihelix, tragus, antitragus, fossa triangularis, scapha, lobule, conchaand
Darwinstubercle. Therearetwo additional subdivisions for thelimbsof theantihelix, thesuperior
crus andtheinferior crus, andtwo subdivisions of theconcha, asuperior cymbaconchaandan
inferior cavumconcha. Delineationof theantitrago-helicinefissure, which separates the
antitragusfromtheantihelix, bringsthetotal to 14auricular termsfor thelateral view of the
auricle and 12additional termsfor themastoidview of theear. Subsequent anatomybooks, such as
Hilds(1974) Atlasofhumananatomyor Clementes(1997)Anatomy: aregional atlas ofthehuman
body, basically concur withtheseearlier designationsfor theexternal ear. Anatomistsinterestedin
auricular acupuncturehavethusconsideredsupplemental terminologyto delineatethestructures
of theauricle thatareused intheclinical practiceof auriculotherapy.
Theouter ridgeof theauricle isreferred toas thehelix, which istheLatintermfor aspiral pattern.
A middleridgewithinthisouter rimiscalled theantihelix. Thehelix issubdivided intoacentral
helix root, an archingsuperior helix, andtheoutermost helix tail. Thecauda, or tail, refers to a
long. trailinghindportion, like thetail of acomet. Thesubsections of theantihelixincludean
antihelix tail at thebottomof themiddleridge, an antihelixbodyinthecenter, andtwo limbsthat
extend fromtheantihelixbody, thesuperior crusandtheinferior crus. A fossa inLatinrefers toa
Auricu{otherapyManual
fissure, or groove. Betweenthetwolimbsof theantihelixlies aslopingvalley known asthe
triangular fossa, whereas thescaphoidfossa isalong, slender groove thatseparatesthehigher
ridges of theantihelix fromthehelixtail.
Adjacent tothefaceandoverlying theauditorycanal isaflat sectionof theear known asthe
tragus. Oppositetothetragusisanotherflap, labeled theantitragus. Thelatter isacurving
continuationof theantihelix, formingacircular ridgethatsurroundsthecentral valley of theear.
A prominentcreaseseparatestheantihelixfromtheantitragus. Belowtheantitragusisthesoft,
fleshyear lobe, and betweentheantitragusandthetragusisaV-shapedcurve known asthe
intertragicnotch. Thedeepest region of theear iscalled theconcha, indicatingitsshell-shaped
structure. Theconchaisfurther divided into aninferior conchabelow and asuperior concha
above. Whilemost anatomical texts(Clemente1997;Woerdeman1955) respectively refer tothese
Superior helix
Antihelix
superior crus
Antihelix
inferior crus
Antihelix
body
Helix tail
Helix root
Tragus
Antihelix
tail
I ntertragic
notch
I nferior
concha
I nternal helix
Figure 3.7 Termsusedfor specificanatomical regionsontheexternal ear: helix,antihelix,tragus, antitragus,
triangularfossa, scaphoidfossa, superiorconchaandinferiorconcha.
Anatomyoftheauricle
85
86
twoareas as thecymbaconchae and thecavumconchae, the 1990nomenclaturecommitteeof the
WorldHealthOrganization(WHO1990a) concluded thatsuperior conchaand inferior concha
were moreuseful designations. Thesetwo major divisions on theconchaare separatedbyaslight
mound. Thisprolongationof thehelixontotheconchafloor isidentifiedinthistext as theconcha
ridge. A vertical elevation thatsurroundsthewhole conchafloor has beendesignatedasthe
conchawall. Thishiddenwall areaof theauricle isnot identifiedinmost anatomical texts. Two
otherhiddenareas of theexternal ear includethesubtragusunderneaththetragusand theinternal
helixbeneaththehelixroot and superior helix.
Ontheback sideof theear isawhole surface referred toastheposterior sideof theauricle. It lies
across fromthemastoidboneof theskull. Thisregion issubdivided intoaposterior groovebehind
theantihelixridge, aposterior lobebehindtheear lobe, aposterior conchabehindthecentral
concha, aposterior trianglebehindthetriangular fossa, and theposterior peripherybehindthe
scaphoidfossa and helixtail. Takingthetimetovisually recognizeandtouchthesedifferent
contoursof theear assists practitionersof auriculotherapyinunderstandingthesomatotopic
correspondencesbetweentheexternal ear andspecific anatomical structures. Diagramsof specific
anatomical regionsof theauricleare shown inFigure3.7.
Earcanal (auditorymeatus): Thefunnel-shapedorificethatleads fromtheexternal ear tothe
middleear and innerear isanelliptical oval thatseparates theinferior conchafrom the
subtragus.
Helix: Thisoutermost, circular ridgeon theexternal ear provides afolded, cartilaginous rim
aroundtheauricle. I tlookslikeaquestionmark (?).
Helixroot: Theinitial segment of thehelix ascends fromthecenter of theear uptowardthe
face.
Superior helix: Thehighest sectionof thehelix isshapedlikeabroadarch.
Helixtail: Thefinal regionof thehelixdescendsvertically downwardalongthemost
peripheral aspect of theear.
Antihelix: ThisY-shapedridgeisanti or oppositetothehelix ridgeandforms an inner,
concentrichill thatsurroundsthecentral conchaof theauricle.
Superior crusof theantihelix: Theupper armandvertical extensionof theantihelix.
Inferior crus of theantihelix: Thelower armandhorizontal extension of theantihelix. This
flat-edgedridgeoverhangs thesuperior conchabelowit.
Antihelixbody: A broadsloping ridgeat thecentral thirdof theantihelix.
Antihelixtail: A narrowridge at theinferior thirdof theantihelix.
Tragus: Thetragusof theauricleisavertical, trapezoidshapedareajoiningthecar totheface,
projectingover theear canal.
Antitragus: Thisangledridge isanti (oppositeto) thetragusthatrises above thelowest portion
of theinferior concha. I thasadistinct groove thatseparates theantitragusfromtheantihelix
tail above it and aless distinct crevice wheretheantitragusmeetstheintertragicnotchbelow it.
I ntertragicnotch: ThisU-shapedcurve superior tothemedial ear lobeseparates thetragusfrom
theantitragus.
lobe: Thissoft, fleshy tissueisfoundat themost inferior part of theexternal ear.
Scaphoid fossa: A crescent-shaped, shallow valley separatingthehelix andtheantihelix. Fossa
refers to afissure, groove, or crevice, whereas scaphoid refers tothescaffolding used toform
theouter structureof aboat or buildingwhileit isunderconstruction.
Triangular fossa (navicular fossa): Thistriangular grooveseparates thesuperior crus and the
inferior crus of theantihelix. It isshapedlikean archonthewindowof aGothiccathedral.
Concha: A shell-shapedvalley at thevery center of theear, concharefers totheconchsea
shell.
Superior concha: Known asthecymbaconcha inclassical anatomical texts, theupper
hemiconchaisfoundimmediatelybelow theinferior crus of theantihelix.
Concha
Concha wall
Posterior concha
Cutawayviewofposterior ear
Antihelix
Posterior groove
Posterior
triangle
Posterior
groove
Posterior
lobe
I CLl-U----Posterior
concha
Posterior
periphery ~ ----"..
Figure 3.8 Termsusedtoidentifyspecificareasoftheposteriorregionsoftheexternal ear.
I nferior concha: Formallyknown as thecavumconcha inclassical anatomical texts, thelower
hemiconchaisfoundimmediatelyperipheral totheear canal.
Concha ridge: Thisraised ridge divides thesuperior conchafrom theinferior concha. I tisthe
anatomical prolongationof thehelix root ontotheconchafloor.
Concha wall: Thehidden, vertical regionof theear rises upfromtheconchafloor tothe
surroundingantihelixandantitragus. Theconchawall adjacent totheantihelixisacurving,
vertical surfacewhich rises fromthefloor of theconchaup totheantihelixridge. Theconcha
wall adjacent totheantitragusisavertical region underneaththeantitragusridgethatleans
over thelower inferior conchafloor.
Subtragus: Thisundersideof thetragusoverlies theear canal.
I nternal helix: Thishidden, undersideportionofthebrimof thehelix spirals fromthecenter of
thehelix to thetopof theear and aroundtothehelix tail.
3.6 Anatomical regions of the posterior ear (Figure3.8)
Posterior lobe: Thissoft fleshy regionbehindthelobe occurs at thebottomof theposterior
ear.
Posterior groove: A longvertical depression alongthewholeback of theposteriorearwhichlies
immediatelybehindtheY-shapedantihelixridgeonthefront sideof the
auricle.
Posterior triangle: Thesmall superior region on theposterior ear which lies betweenthetwo
armsof theY-shapedposterior groove.
Posterior concha: Thecentral region of theposteriorear foundimmediatelybehindtheconcha.
Posterior periphery: Theouter, curved regionof theposterior ear behindthehelix and the
scaphoidfossa. It lies peripheral totheposterior groove.
3.7 Curving contours of the antihelix and antitragus
Thecontoursof theear have different shapesat different levels of theantihelixand theantitragus
astheconchawall rises uptomeet them. Thesedifferences incontour areuseful indistinguishing
Depth view of auricle
Contours of theantihelix and antitragus
Antihelixinferior crus
Superior concha
Antihelixbody
Concha wall
Superior concha
Antihelixtail
I nferior concha
Triangular fossa
Scaphoid fossa
Antitragus
Concha ' l ~ ) \\
I nferior concha ~
88
Figure3.9 A depthviewshowschanges inthecurving contoursoftheantihelixdescendingfromtheinferior crus to
theantihelixbody, antihelixtail andantitragus.
different anatomical featuresontheear whichrelatetodifferent correspondencestobodyregions.
ThesedepthviewsarepresentedinFigure3.9.
Depth view of the inferior crus of antihelix: At thislevel of theantihelix, theconchawall exhibits
asharpoverhangbeforeit curves back underneathand thendescendsdown into thesuperior
concha. Theinferior crus itself issomewhat flat, beforegradually descendinginto thetriangular
fossa. Thetopsurfaceof thissectionof theantihelixcorrespondstothelumbosacral vertebrae,
whereas theconchawall belowit representsthesympatheticnerves affectingbloodsupply tothe
lower spine.
Depth view of the antihelix body: At thislevel of theantihelix, theconchawall exhibitsagradual
slope beforeit descendsdowninto thesuperior concha. Theantihelixbody islikeabroad, gentle
moundbeforeit curves down peripherallyintothescaphoidfossa. Theconchaside of this
sectionof theantihelixcorrespondsto thethoracicspine, whereas theconchawall belowthis
regionrepresentsthesympatheticnerves affectingbloodsupply totheupper back.
Depth view of the antihelix tail: At thislevel of theantihelix, theconchawall exhibitsasteep
slope beforeit descendsdownintotheinferior concha. Theantihelixtail islikealong narrow
ridgebeforeit curves down peripherallyinto thescaphoidfossa. Theconchasideof thisinferior
sectionof theantihelixcorrespondsto thecervical spine, whereas theconchawall belowthis
region representsthesympatheticnerves affectingbloodsupply totheneck.
Depth view of the antitragus: At thislevel of theantitragus, theconchawall forms an angled
vertical wall, whichcurves downwardfromtheantitragustotheinferior concha. Theantitragus
correspondstotheskull, whereas theconchawall representsthethalamusof thebrain.
3.8 Somatotopic correspondences to auricular regions
Inauriculotherapy, anactivereflexpointisonlydetectedwhenthereispathology, painor dysfunction
inthecorrespondingpartof thebody. I fthereisnobodilyproblem, thereisnoear reflexpoint. An
activereflexpoint isidentifiedasanareaof theear whichexhibitsincreased sensitivitytoapplied
pressureandincreased electrodermal skinconductivity. Theanatomical organ healthdisorders
commonlyassociated witheach part of theauriclearepresentedbelow(see Figures3.10and3.11).
Helix: Anti-inflammatorypointsandtreatmentof allergies and neuralgias.
Helix root: External genitals, sexual disorders, urogenital dysfunctions, diaphragm.
Superior helix: Allergies, arthritis, and anti-inflammatoryprocesses.
Helix tail: Representingthedorsal horn, sensory neuronsof thespinal cord and thepre
ganglionic sympatheticnervous system, thisregionisused for peripheral neuropathiesand
neuralgia.
Antihelix: Maintrunkandtorsoof thebody thatispart of themusculoskeletal system.
Superior crus: Lower extremitiesof legand foot.
I nferior crus: Lumbosacral spine, buttocks, sciatica, lowback pain.
Antihelix body: Thoracicspine, chest, abdomen, upper back pain.
Antihelix tail: Cervical spine, throatmuscles, neck pain.
Lobe: Cerebral cortex, lobes of thebrain, sensationoftheface, eye,jaw, and dental analgesia.
Theear lobe representsconditionedreflexes, psychological resistances and emotional blocks.
Tragus: Corpuscallosum, appetitecontrol, adrenal gland.
Antitragus: Skull, head, andtreatmentof frontal, temporal and occipital headaches.
I ntertragic notch: Pituitarygland, control of endocrineglands, hormonal disorders.
Scaphoid fossa: Upper extremities, such astheshoulder, arm, elbow, wrist, handandfingers.
Triangular fossa: Lower extremities, such asthehip, knee, ankle, foot, uterusandpelvic
organs.
Concha: Visceral organdisorders.
Superior concha: Abdominal organs, such asthespleen, pancreas, kidney and bladder.
Anatomyof theauricle 89
A
B
------Helix------
------Antihelix------
----Superior concha ----
-----Concharidge -----
.------I nferiorconcha -----
Intertragic notch ----
------Lobe ------
Darwins tubercle
Scaphoid fossa
Triangular fossa
Su perior crus
Internal helix
Inferior crus
Antihelix body
Antihelix tail
Tragus
Subtragus
Concha wall
Intertragic notch
Antitragus
Figure 3.10 Photographsoftheanteriorsurfaceoftheexternal ear showingthecircular ridges andcrevicesofdifferentanatomical areas.
A B c
Figure 3.11 Photographsoftheposteriorsurfaceoftheexternal ear highlighttheauricular regions behindthehelixandtheconchaofthe
leftear (A),therightear (B), andtheposteriorsurfacepulledback (C).
I nferior concha: Thoracicorgans, such astheheart andlungs, and also substanceabuse.
Concha ridge: Stomachandliver.
Concha wall: Thalamus, brain, sympatheticnerves, vascular circulation, general control of
pain.
Subtragus: Lateralityproblems, auditorynerve, internal nose, throat.
I nternal helix: I nternal genital organs, kidneys, allergies.
Posterior ear: Motorinvolvement withbodyproblems, such asmuscle spasms andmotor
paralysis.
Posterior lobe: Motorcortex, extrapyramidal system, limbicsystem.
Posterior groove: Motorcontrol of muscle spasms of paravertebral muscles.
Posterior triangle: Motorcontrol of legmovement, legmuscle spasms, andlegmotorweakness.
Posterior concha: Motorcontrol of internal organs.
Posterior periphery: Motorneuronsof spinal cord, motorcontrol of armand handmovements.
3.9 Determination of auricular landmarks
Oneprocedurefor identifying thesame region of theauriclefromonepersontothenext isto
examine theear for distinguishinglandmarks. Whilethesizeandshapeof theear maygreatly vary
betweendifferent individuals, theauricular landmarksarefairly consistent across most patients.
TheyaredepictedinFigure3.12, representedbyasolidtriangle. Theselandmarksare
distinguishedbythebeginningor theendof thedifferent subsectionsof theexternal ear. The
nameand numberingof the18landmarksbeginswithLM0becauseit isat thesame location asa
primarymaster pointontheauricle, PointZero. Thisfirst landmark, also called ear center, is
distinguishedasapronouncednotchwherethehelixroot rises upfromtheconcharidge. It is
found at thevery center of theear andisaprimaryreferencepoint tocomparetothelocationof
otherregionsof theauricle. Thesecond landmark, LM1, islocatedon thehelixrootwherethe
helixcrosses theinferior crus of theantihelixandwheretheauricleseparatesfromtheface.
92
LM7
Figure 3.12 Thelocationofauricular landmarksontheexternal ear arerepresented ina
surfaceviewandahiddenview.
Continuingupthehelixtothetopof theear isLM 2. Thenext twolandmarks, LM 3and LM4, are
twonotchesthatdefine theuppermost and lowermost boundariesof Darwinstubercle. Thisbulge
ontheouter helixisquitedistinctiveinsome persons, but it isbarely visible inothers. Following
theperipheral helixtail downwardstowardstheear lobe, LM5occurswherethehelixtakesa
curving turnand LM6isfound wherethecartilaginous helixmeetsthesoft fleshy lobe. The
bottomof theear, whichfollows astraight linefromLM 2, at theear apex, throughLM 0, hasbeen
designatedLM 7. Thejunctionof theear lobetothelower jawislabeled LM 8. Theintertragic
notchhasalready beendistinguishedas aseparateregionof theear andisidentifiedasLM9.
Higherontheauricle, therearetwoprominentprotrusionsor tubercleson thetragus, which have
beenlabeled LM 10and LM 11.Therearetwocomparableprotrusionsontheantitragus, referred
toasLM 12and LM 13.ThelandmarkLM 13isdistinguishedastheapex of theantitragus. Above
theantitragus-antihelixgroove thereisaprotrudingknob onthebaseof theantihelixtail which
hasbeenlabeled LM 14.Following thecentral sideof theantihelixtail uptotheantihelixbody,
thereisasharpanglewhich divides thetail andbodyof theantihelix, which islabeled LM 15.
Continuingupward, along thecurving central sideof theantihelixbody, adistinct notchisfound,
LM 16,which indicatesthebeginningof theflat, ledged-shapedinferior crus of theantihelix. The
final landmark, LM 17, occurs at anotchwhich divides theperipheral andcentral halves of the
antihelixinferior crus. Thisnotchrepresentsthesciatic nerveandistheauricular pointusedto
treat sciatica and lowback pain.
LM 0- Earcenter: A distinct notchisfoundat themost central positionof theear, wherethe
horizontal concharidgemeetsthevertically rising helix root. I tcan bedetectedeasily with a
fingernail or ametal probe. LM 0isthemost commonlandmarktoreferenceotheranatomical
regionsof theauricle. Reactiveear pointson theperipheral helix rimare oftenfoundat 30
angles fromalineconnectingLM 0totheauricular pointwhich correspondstotheareaof body
pathology. Thisregion of thehelixroot representstheautonomicsolar plexus andtheumbilical
cord, bringinganybody dysfunctions towardsabalanced state.
LM 1- Helixinsertion: Theregionof theear wherethehelixroot separatesfromtheface and
crosses over theinferior crus of theantihelix. Thehelix root, which extendsfromLM 0toLM 1,
representsthegenital organs. Theexternal genitaliaarefoundon theexternal surfaceof the
helixroot and internal genital organsarefoundalongthehiddensurface of theinternal helix
root.
LM 2- Apexof helix: Themost superior pointof theear iscalled theapex and lies alongaline
thatisvertically above LM O. Thispoint representsfunctional control of allergies and isthepoint
prickedfor blood-lettingtodispel toxic energy.
LM 3- Superior Darwinstubercle: Thenotchimmediatelysuperior totheauricular tubercle,
separatingDarwinstuberclefromthesuperior helix above it. Thisregion has pointsfor the
treatmentof anti-inflammatoryreactionsand tonsillitis.
LM 4-I nferiorDarwinstubercle: Thenotchimmediatelyinferior totheauricular tubercle,
dividing Darwinstuberclefromthehelix tail below it. Onthemoreperipheral surface of this
protrudinglandmark, thereisacrevice inthecartilagewhich separates thesuperior helixfrom
thehelixtail. Thehelix tail extendsfromLM 4down toLM 5, representingthespinal cord.
LM 5- Helixcurve: Thehelix tail curves centrally and inferiorly towardthelobe. Thisarea
representsthecervical spinal cord.
LM 6- Lobular-helixnotch: A subtlenotchwherecartilaginous tissueof theinferior helix tail
meetsthesoft, fleshy tissueof thelobe. Thisarearepresentsthebrainstemmedullaoblongata.
LM 7- Baseof lobe: Themost inferior pointof thelobeliesvertically below a
straight linepassingthroughLM 2, LM 0and LM 7. I trepresentsinflammatoryproblems.
LM 8- Lobular insertion: Themost inferior pointof thelobe thatattachestothejaw. The
positionof thislandmarkvaries considerably. Insomepeople, LM 8isinferior toLM 7, whereas
inotherindividuals, LM 8issuperior to LM 7. Thisregionrepresentsthelimbic system and
cerebral cortex. I taffects nervousness, worry, anxietyandneurasthenia.
LM 9-I ntertragicnotch: Thecurving notchwhich divides thetragusfromtheantitragus. I t
representspituitaryglandcontrol of hormonesreleased byotherendocrineglands.
LM 10-I nferiortragusprotrusion: Theprotrudingknobonthelower tragus, oppositethetopof
theantitragus. I trepresentsadrenal glandsandisused inthetreatmentof various stress related
disorders.
LM 11- Superior tragusprotrusion: Theprotrudingknobon theupper tragus, oppositetothe
helixroot. I taffects thirstandwater regulation.
LM 12-Antitragusprotrusion: Theprotrudingknob at thebaseof theI nverted~ of thecurving
ridgeof theantitragus, superior tothelobe. I trepresentstheforeheadof theskull and isused for
thetreatmentof headaches.
LM 13- Apexof antitragus: Theprotrudingknobat thetopof thecurvingridge of theantitragus,
oppositetoLM 12. I trepresentsthetemplesof theskull andisused for thetreatmentof
migraineheadachesandfor asthma.
LM 14- Baseof antihelix: A roundknobat thebase of theantihelixtail, rising above the
antitragal-antihelixgroove. Thisgroovedivides theperipheral antitragusfromtheantihelixtail.
Theknobat LM 14representstheupper cervical vertebraenear theskull. Theantihelixtail,
Anatomyof theauricle
93
94
which extendsfromLM 14upto LM 15,representsall seven cervical vertebrae andisused inthe
treatmentof neck pain.
LM 15-Antihelixcurve: A slight notchthatdivides thecentral antihelixbodyfrom theantihelix
tail. Thislandmarkislocatedabove theconcharidge, horizontallyacross fromLM 0, and divides
thelower cervical vertebraefromtheupper thoracicvertebrae. Theantihelixbody, which
extendsfromLM 15up toLM 16,representsall 12thoracicvertebrae and isused for treatment
of upper back pain.
LM 16-Antihelixnotch: A distinct notchwhich divides theflat curving ledge of theantihelix
inferior crus fromtheantihelixbody. Thisnotchdivides thesomatotopicrepresentationof the
lower thoracicvertebraefromtheupper lumbarvertebrae. Theperipheral inferior crus of the
antihelixisused for thetreatmentof lowback pain.
LM 17- Midpointof inferior crus: Thisnotchon thetopsurface of theinferior crusof the
antihelixdivides theinferior crus intotwohalves. Thisnotchseparates thelower lumbar
vertebraefromtheupper sacral vertebrae. Thislandmarkwas theear point used for the
treatmentof sciatica, first identifiedbyDr Nogier, thatled tothediscovery of theinvertedfetus
somatotopicmap ontheear.
3.10 Anatomical relationships of auricular landmarks
Auricular quadrants: Twointerconnectingstraight lines can bedrawnwhich formacross dividing
theear intofour equal quadrants, with LM 0at itscenter (Figure3.13A). A vertical linecan
connect landmarksLM 2, LM 0, LM 13and LM 7. A horizontal linecan connect thelandmarks
LM 11, LM 0, and LM 15.Theactual horizontal level of theear dependsuponthevertical
orientationof thepersonshead, which can beheld eitherslightly forward or bent slightly back.
For thepurposesof theseear diagrams, thehorizontal level isset relative toitsperpendicular
relationshiptothevertical linewhich runs from LM 2to LM 7.
Auricular gridcoordinates: Subdivisions of approximately onecentimetersquareallowfor the
linear divisionof thewholesurface of theexternal ear intoninecolumns, labeled 1-9, and 14rows,
labeled A-NinFigure3.13A. Thewidthandlengthof anaverage ear areshowninFigure3.13Bas
goingfrom0-45cmacross when progressingfrommedial toperipheral auricular regions andgoing
from0-70cmdownwhenprogressingfromsuperior toinferior areasof theexternal ear.
3.11 Standard dimensions of auricular landmarks
Tosubstantiatetherelative proportionsof thestandardizedear chart usedinthiswork, the
landmarklocationson theexternal earsof 134volunteerswere measured toestimatetherelative
distancesbetweenlandmarks. Volunteerswere recruitedbystudentsat twoacupunctureschools in
SouthernCalifornia. Eighteenlandmarkpointswere markedwith afelt penandmultiple
measurementswere madeof thedistancesbetweentwosets of landmarks(see Figures3.14, 3.15).
Themeans, standarddeviations and rangesof themeasurementswerethencomputed. Analyses of
variance andcorrelationcoefficients betweenthedistancesbetween specific landmarkswere also
performed. Inaddition, measurementsof thewidthandlengthof thehead, handand foot were
also recorded. Theheightof theheadwas measuredfromthechin tothetopof theforehead,
whereas thewidthof theheadwas designatedasthedistancebetweentheears. Thelengthof the
handwascomputedbetweenthewrist andthemiddlefinger, whilethewidthof thehandwas
measured betweenthethumband thelittlefinger. Thelengthof thefoot was assessed between the
heel and thelongest toe, and thewidthof thefoot was measuredbetweenthebigtoeand thelittle
toe. All of thesemeasurementswere used todeterminetheconsistency of usingtheauricular zone
systemdescribed inthispaper with actual persons.
Thesampleof 134volunteers containedequal numbersof male and female subjects, with amean
average ageof 39.7years (SD = 14). Theethnicfrequency of theseparticipantsconsistedof 96
Caucasians(71.6%),26 Asians(19.4%),7 Hispanics(5.2%), and5blacks (3.7%). Accordingtothe
U.S. CensusBureaufor 1999, therelative representationof theseethnicgroupsinCalifornia
would be49.9% Caucasian, 11.4%Asian, 31.6%Hispanic, and 6.7%black (Nelson& OReilly
2000). Theoverrepresentationof whitesand Asiansinthissampleprobably reflected thesocial
networkof studentsattendingacupuncturecolleges intheLosAngeles area, fromwhom
volunteers for thisstudywererecruited. I twas not intendedthattheexternal ears measured inthis
Auricu{otherapyManual
Auricular quadrants and
auricular grid coordinates
Average measurements of the ear
( in millimeters)
V
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05
10
15
20
25
30
35
40
45
50
55
60
65
70
05 10 15 20
LM7
25 30 35 40 45
Figure 3.13 Theexternal ear dividedintoquadrants andx-ygridcoordinates (A). Horizontal sectionsare numbered1to 9goingfrom
center toperiphery, whilevertical sectionsarelabeled A toNfromsuperior toinferior edges oftheear. Theaveraged value ofactual
measurement (inmillimeters) oftheexternal ears ofdifferentindividuals isalso shown (B).
studywere representativeof thegeneral population, onlythattherebealarge cross samplingof
theauricles of different individuals.
Earsfromtwosuch participantsareshown inFigure3.16, whereas theaccumulated meandata
fromthemultipleobservations of different auricles are presentedinBox3.1. Thisindicatesthe
relative meandistancesbetweeneach landmarkandthecentral landmarkLM0, andbetweeneach
landmarkand thesubsequent landmark. Theset of measurementsprovides anoverall indication
of theshapeandsizeof different ears. Acupuncturepractitionersandstudentsasked toidentify
the18landmarksonthese134participantswere readily abletodistinguisheachlandmarkoneach
subject, indicatingthattheseauricular demarcationsare reliably observed onmost individuals.
Therelatively lowstandarddeviationsfor thesemeasurementssuggests thatthelandmarks
examinedon manydifferent ears isareliableprocedurefor recognizingthespecific areas of the
auricle. A series of analyses of variance (ANOYA)computationscomparedauricular
measurementsbetweenmale andfemale participants. Correlationcoefficients werealso obtained
across all subjectsfor all measurements.
InhisTreatiseofauriculotherapy, Nogier (1972) reportedthatthevertical axisof theauricle varied
from60to65mmandthatthehorizontal axisvaried between30and35mm. Slightlylarger
measurementswere found inthepresent study. Themeanheight of theauricle, measuredbetween
thetopof theear apex at LM 2andthebottomof theear lobeat LM 7, was68.4mm. Themean
widthof theauricle, measured betweenthehelixroot asit leaves theface at LM 1andthemost
Anatomyoftheauricle
9S
LM2
LM 7
LM 1
LM 2
LM 7
A B
96
Figure 3.14 Specific linesofmeasurementbetween auricular landmarksindicatethebasis for data collectedji-O/11
participants intheear measurementstudy. ConnectionsbetweenLM0andperipheral landmarks (A); connections
betweenLM0andcentral landmarks, andbetweensuccessive pairs oflandmarks (B).
Figure 3.15 A millimeterruler wasused tomeasurethedistancebetween auricular landmarks.
A B
Figure 3.16 Photographsofexternal earsfromtwopeopleshowtheconsistentlocation ofauricular landmarksdespite variations inthe
actual pattern ofdifferent ears.
peripheral partof Darwinstubercleat LM 4,was33.8mm. Intheassessment of thelengthandwidth
of thehead, hand, andfoot, males were found tohavesignificantly larger measurementsthanfemales
(p <0.05). Thisresult wasnot surprising, sincemen aretypically larger thanwomen. Menalso have
significantly larger external ears thanwomen, andall ear measurement segmentswere larger in
males thaninfemales, withstatistically significant differences found for thedistancesof LM 1to
LM4and LM 2toLM7.Therelationshipof thesizeof different regionswasalso examined. Only
correlationcoefficients greater than0.40were consideredmeaningful. Thelengthof thefoot was
significantlycorrelatedwiththelengthofthehand(r =0.44) andthewidthof thehand(r =0.42).
Thewidthof thefoot was also correlatedwiththeheightof thehead(r =0.42). Curiously, thelength
of thesebodyareas wasnot ashighlycorrelatedwiththewidthof theirrespective body region. For
example, therewasonlyasmall correlation(r =0.39) betweenthelengthof thefoot andthewidthof
thefoot, even lessbetweenthelengthandwidthof thehand(r =0.34), andwaslowest betweenthe
heightandwidthof thehead(r =0.22). Ofall theauricular measurements, theonlydistancesto
correlatesignificantlywiththefoot, hand, or headwere thecorrelationsbetweenthewidthof the
head andthedistancebetweenLM0and LM 12(r =0.41) andthecorrelationof thewidthof the
headwiththedistancebetweenLM0and LM 17(r =0.42).
Theauricular measurementsthatcorrelatedbest witheach otherwereof thedistancesbetweenthe
centerof theauricle, LM0, tothemoreperipheral regions of theear, LM I toLM7.Significant
correlations thatrangedfromr =0.44to r =0.89werefoundfor themeasurementsof LM 0to
LM 1, LM 0toLM 2, LM 0to LM 3, LM 0to LM 4, LM 0to LM 5, LM0toLM6, LM 0toLM7,
LM0toLM8, andLM 0to LM 12. Thegreatest number of significant correlations between the
distances of two auricular landmarkswerefoundfor thedistancesof LM 0to LM 2, LM 0toLM
7, and LM 0toLM 12.Themorecentral landmarkson theear probablyhadfewer significant
correlationstootherauricular areas because theywere smaller inlengthandthusdid not vary as
98
Box 3.1 Measurements between auricular landmarks (LM)
Landmarks Mean SD Landmarks Mean SD
distance distance
inmm inmm
---
~ . __.,--
--- --------
LMO-LM1 22.6 5.3 LM1-LM2 22.6 5.5
LMO-LM2 32.5 5.0 LM2-LM4 26.7 6.8
LMO-LM3 27.9 4.8 LM4-LM5 28.6 6.3
LMO-LM4 25.1 5.2 LM5-LM6 9.2 3.8
LMO-LM5 23.0 4.2 LM6-LM 7 20.8 4.8
LMO-LM6 25.6 5.0 LM7-LM8 10.2 3.7
LMO-LM7 35.9 5.3 LM8-LM9 10.9 4.1
LMO-LM8 32.3 5.5 LM9-LM 10 12.2 4.6
LMO-LM9 23.9 4.9 LM10-LM 11 8.7 Z.7
LMO-LM10 14.1 2.7 LM12-LM 13 8.3 2.5
LMO-LM11 10.7 2.9 LM13-LM 14 6.5 2.4
LMO-LM12 19.5 3.5 LM14-LM 15 10.8 3.8
LMO-LM13 13.4 2.5 LM15-LM 16 14.0 4.2
LMO-LM14 12.3 2.8 LM16-LM 17 7.7 2.7
LMO-LM15 11.0 2.6
LMO-LM16 10.8 2.8
LMO-LM17 12.4 3.9
LM2-LM 7 68.4 10.2
LM1-LM4 33.8 6.3
Ear height 68.4 10.2
Earwidth 33.8 6.3
Head height 193.3 22.7
Head width 163.9 28.4
Hand length 171.8 27.9
Hand width 101.9 16.7
Foot length 235.8 30.8
Foot width 93.5 14.5
muchfromonepersonto thenext. Ofthedistancesbetweensequential auricular landmarks, only
thedistanceof LM2toLM4wassignificantly correlatedwithmorethanfour other
measurements. Thepurposeinobtainingtheseauricular measurementswas primarilyto
demonstratethatthesespecific landmarksontheexternal ear can bereliably observed onmany
individuals and are asconsistentlyfoundastherelationshipbetweenthefingers and base of the
handor betweenthetoes and heel of thefoot. Whiletheexternal ears dovary considerably from
onepersontothenext, thereisageneral consistency inthedistinctivepatternof theauricleand
therelative sizeof different anatomical sections.
AuticulothetepyManual
Auricular zones
4.1 Overviewof theauricular zonesystem
4.2 I nternational standardizationof auricular nomenclature
4.3 Anatomical identification of auricular zones
4.4 Somatotopiccorrespondences toauricular zones
4.5 Representationof Nogierphases inauricular zones
4.5.1 Auricularzonesfor different phases of mesodermal myofascial tissue
4.5.2 Auricularzonesfor different phases of internal organ tissue
4.5.3 Auricularzonesfor different phases of ectodermal neuroendocrinetissue
4.5.4 Nogierphases related toauricular master points
4.6 Microsystempointsrepresented inauricular zones
4.6.1 Helixzones
4.6.2 Antihelixzones
4.6.3 Internal helixzones
4.6.4 Lobezones
4.6.5 Scaphoidfossa zones
4.6.6 Triangularfossazones
4.6.7 Traguszones
4.6.8 Antitraguszones
4.6.9 Subtraguszones
4.6.10 Intertragicnotch zones
4.6.11 Inferiorconchazones
4.6.12 Concharidgezones
4.6.13 Superior conchazones
4.6.14 Conchawall zones
4.1 Overview of the auricular zone system
Inorder to provideasystematic methodfor locatingtheprecise positionof apointontheear, a
zonesystemwas developed whichuses theproportional subdivision of major anatomical regionsof
theauricle. A set of two lettersandanumberrepresent each ear zone, inconcurrencewith
guidelines established bytheWorldHealthOrganizationacupuncturenomenclaturecommittee
(Akerele 1991; WHO1990b). Thiszonesystemismodifiedfromtheauricular zonesystemfirst
developed in 1983at theUCLAPain ManagementCenter(Oleson& Kroening1983b). The
original zonesystemdeveloped at UCLAisshowninFigure4.1, whereinasingleletterwas used to
designateeach areaof theauricular anatomyandanumberdesignatedeachsubdivision of that
area. A different zonesystemthatwas suggested byPaul Nogier (1983) ispresentedinFigure4.2.
TheNogier zonesystem divided thewholeauricle intoarectangular gridpatternof rows and
columns. Thecapital lettersA to 0 identifiedthehorizontal axis, whereas thelower case lettersato
z indicatedthevertical axis. Whilesuch agridpatternissimpletouse onflat, two dimensional
paper, it isnoteasily adaptabletothethree-dimensional depthsof theauricle. Thecurving
contoursof theear do not conformwell to theconfigurationof basic squares andthereisno means
for indicatinghiddenor posterior regionsof theauricle. Moreover, as theear measurements
presentedin Chapter3indicated, therearemarkedvariations inthesize of different areas of the
auricle, even thoughtherelative proportionsremainthesame. Thedistancefromlandmark0tothe
ear apexat LM 2rangedfrom20mmto50mm, andthemeasuredlengthsof thesubjects ear lobes
Auricularzones 99
H Helix 0
I Inner rimof helix
A Antihelix 0
S Scaphoid fossa
F Triangular fossa
C Concha
T Tragus 0
R Subtragus
N Antitragus 0
G Wall of antitragus
W Wall of antihelix
L Lobule 0
Surface symbols
o Raised surface
Depressed surface
Vertical or hidden surface
H13
Figure 4.1 Theoriginal auricular zonesystemdevelopedinthe1980s at UCLAsubdividedeach anatomical region oftheexternal ear
referenced withasingleletter andanumber.
varied between 15mmand45mm. A gridwork of rows andcolumnsof fixed length can not easily
accommodatesuch discrepancies insize. Theauricular zonesystemdeveloped at UCLA
designatedeach sectionof theear basedupontheproportional sizeof theauricular regionof each
individual, not theabsolutesizeof thewhole ear. Therevised UCLAnomenclaturesystem(Oleson
1995) shown inFigure4.3provides aconsistent logical orderfor thenumberingof each anatomical
subdivision of theexternal ear. Thelowest numberscorrespondtothemost inferior and most
central zoneof thatanatomical part of theear. Thenumbersascendfrom1to2to3, etc.,
progressingfrominferior tosuperior zonesof thatanatomical areaand fromcentral toperipheral
zones. Ininternational communicationsabout thelocationof ear acupoints, theregionof theear
referred tocan belisted byitsanatomical zonedesignation, ratherthanitsorgancorrespondence.
4.2 I nternational standardization of auricular nomenclature
Thefirst concertedeffort tocreateastandardterminologyfor humananatomywas developed bya
groupof Germanscientistsin1895(I nternational Congressof Anatomists1977).TheBaslenomina
ONMLKJ I HGFEDCBA ABCDEFGHI JKLMNO
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Figure 4.2 Theauricular zonesystemfirstproposedbyDrPaul Nogier: arectangular gridreferencedwithcapital lettersfor thehorizontal
axisandlowercaselettersfor thevertical axis. (ReproducedfromNogier1983, withpermission.)
anatomica (RNA)wasfirst adoptedinGermany, Italy, USA, and later inGreatBritain. In1950, an
international congress of anatomistsmet inOxford, England,todiscuss revisions intheearlier
anatomical nomenclaturesystem. A newNominaanatomicawas acceptedbytheSixth
I nternational Congressof Anatomistsmeetingat Parisin1955. Most phraseswere adoptedfrom
theoriginal RNA,withall anatomical termsderived fromLatin, employingwordsthatwere simple,
informativeanddescriptive. ChangestoNominaanatomicawere madebysubsequent
nomenclaturecommitteesinanattempttosimplifyunnecessarily complexor unfamiliar terms.
Whileitwas thestrongopinionof theinternational nomenclaturecommitteethatonlyofficial
Latintermsshouldbeemployed inscientific publications, itwasalso recognized thatmany
scientific data-retrieval systems accept vernacular anatomical terms. Englishwords inparticular are
commonlyused incomputersearches sinceEnglishiscurrentlythemostwidely usedscientific
languageat international meetingsandontheinternet.
TheWorldHealthOrganization(WHO)sought toformaninternational consensus onthe
terminologyused for acupuncturepointsbyholdingaseries of international meetingsof
distinguishedacupuncturists. Dr Olayiwola Akerele(1991) presentedthefindingsbytheWHO
working groupthathadbeenconvenedtospecify thecriteriafor thestandardizationof
acupuncturenomenclature. Thefirst WHOworking groupmeetingon thistopicwas held in
Manila, Philippines, in1982,withgeneral acceptanceof astandardnomenclaturefor 361classical
acupuncturepoints. AcupunctureprogramsinAustralia, China,HongKong, Japan, Korea, New
Zealand, PhilippinesandVietnamadoptedthismeridianacupuncturesystem. Theconclusions of
theWHOregional workinggroupwere publishedin1984astheStandard acupuncture
nomenclature(Wang1984).
Auricularzones
101
Surface, hidden, and posterior auricular zones
Surface viewof
auricular zones
Posterior viewof
auricular zones
Posterior Lobe
Posterior Groove
Posterior Triangle
Posterior Concha
Posterior Periphery
Hiddenviewofauricular zones
Auricular zonecodes
HX Helix
AH Antihelix
LO Lobe
TG Tragus
AT Antitragus
IT I ntertragic Notch
SF Scaphoid Fossa
TF Triangular Fossa
SC Superior Concha
IC I nferior Concha
CR Concha Ridge
CW Concha Wall
ST Subtragus
IH I nternal Helix
102
Figure 4.3 Revisionsoftheauricular nomenclaturesystemoriginally developed byOleson were basedupon the
recommendationsofthe1990WHOnomenclaturecommittee. Differentzones arereferenced withtwolettersanda
numbet: Theprogression ofnumbersgoesfrombottomtotopandfromcenter toperiphery.
AuricuiotherepyManual
Alphanumericcodes todesignatedifferent acupuncturepointswere labeledwithtwoletter
abbreviations (Helms1990). ThusLUwas used for theLungmeridianandLI for theLarge
I ntestinesmeridian. Someauthorsuseonlyoneletter torepresent ameridian, such asP for the
Pericardiummeridianinsteadof PC,or H for Heartmeridianinsteadof HT.Theleast agreedupon
EnglishdesignationwasthetermTripleEnergizeranditsabbreviation TE.TheHancharacter for
thismeridianisoftentranslatedasTripleWarmeror TripleHeater,butsomemembersof the
nomenclaturecommitteefelt thatthismeridianshouldhavebeenleft withitsChinesename, San
Jiao. Consequently, thismeridianchannel isnowabbreviated SJ. Representativesfromeach
countrywhowere at thismeetingwereencouraged tocommunicatetojournals, textbook
publishersand universities intheircountrytouseonlytheofficial WHOtwoletterdesignationsfor
zang-fumeridiansandfor acupuncturepoints.
ThesecondWHOworkinggroupwas heldinHongKong, in1985(WHO1985). Representatives
reportedgeneral acceptanceof theStandardAcupunctureNomenclaturefromnineAsian
countries. Revisions were suggestedfor standardizationof extrameridianpointsandfor new
points. Twodocumentswerepresentedat thisWHOmeetingtoguidestandardizationof ear
acupuncturenomenclature, thetextEar acupuncturebyHelenHuang(1974) andajournal article
writtenbymyself andDr RichardKroening(Oleson& Kroening1983a). However, all decisions
about auricular acupuncturenomenclaturewere deferredtoalater meeting. ThethirdWHO
WorkingGroupmet inSeoul, Korea (WHO1987). Havingalready arrived at aconsensus regarding
classical meridianpoints, thefinal areaof discord waswiththenomenclaturefor auricular points.
AsthemeetingwasorganizedbytheWHORegional Officefor theWesternPacific, mostof the
representativeswerefromAsia. OnlyDr Raphael Nogierof FrancerepresentedaEuropean
perspective. Standardnomenclaturewas adoptedfor 43auricular points, each point designatedby
oneor twolettersandbyanumber. Inadditiontothestandardnomenclatureacceptedfor 43
auricular pointsidentifiedasCategory1points, another36ear pointswere identifiedasCategory2
pointsthatneededfurtherstudyfor verification. All ear pointswere precededbythelettersMA to
designateMicrosystemAuricular. For example, MA-H1indicatedthelocationfor theEarCenter
pointonthehelixandMA-TF 1indicatedthelocationfor theShen Menpointinthetriangular
fossa. Theonlyotherapproveddesignationfor amicrosystemwasthedesignationMSfor
MicrosystemScalp. Noagreementwasmadeonthetwomainschools of auricular points, theone
initiatedbyPaul Nogierof FranceandtheotheroneutilizedbyChinesepractitionersfor ear
acupuncture.
Thefinal WHOGeneral WorkingGrouponAuricular AcupunctureNomenclaturemet inLyons,
France(WHO1990a). Themeetingwas ledbyRaphael NogierandJean Bossyof France, by
c.T. Tsiangof Australia, andbyOlayiwolaAkerelerepresentingtheWorldHealthOrganization.
I nternational participantsat thismeetingincludedrepresentatives fromAustralia, Austria, China
(PR), Columbia, Egypt, Finland, France, Germany, Italy, Japan, Korea(DPR),NewZealand,
Norway, Spain, Switzerland, VenezuelaandtheUSA. Hiroshi Nakajima, Director-Generalof the
WorldHealthOrganization,proclaimedtothegatheringthatauricular acupunctureisprobably
themost developed andbest documented, scientifically, of all themicrosystems of acupunctureand
isthemost practical andwidely used. Hefurther acknowledged that unlikeclassical acupuncture,
whichisalmost entirelyderived fromancient China, auricular acupunctureis, toalarge extent, a
morerecent development thathasreceived considerablecontributionsfromtheWest.
Inhispersonal addresstotheaudience, Paul Nogierobserved that:
thestudiesbyDrNiboyethaveprovedthattheearpoints, liketheacupuncturepoints, canbedetected
electrically. WealsoknowfromthestudiesbyProfessor DurinianoftheUSSRthattheauricle, by
virtueofitsshortnervelinkswiththebrain, permitsrapidtherapeuticactionthatcannot otherwisebe
explained. Thetimehascometoidentifyeachmajor reflexsiteintheauricle, andI knowthatsomeof
youarebusyonthis. Thisidentificationseemstometobeessential sothattherecanbeacommon
language inall countriesfor therecognitionoftheearpoints.
Threequalitieswere emphasized:
(1) ear pointsthathaveinternational andcommonnamesinuse;
(2) ear pointsthathaveprovenclinical efficacy;
(3) ear pointswhoselocalization intheauricular areaaregenerally accepted.
Auricularzones 103
Thegroupagreedthateach anatomical areaof theear should bedesignatedbytwoletters, not one,
toconformtothebodyacupuncturenomenclature. Theabbreviation for helixbecameHX rather
thanH and thedesignationfor lobebecameLOratherthanL.Terminologywasalso addedfor
pointsontheback of theear, each areatobeginwiththeinitial letter P, asinPP for posterior
periphery, andPL for posterior lobe. TheChinesehavealso developed arevised auricular zone
systembased upon therecommendationsof the1990WHOauricular nomenclaturecommittee
(Zhou1995,1999; seeFigure4.4).
Theprimarydifficultyat thisWHOnomenclatureconferencewas thediscrepancy betweenthe
Chineseand Europeanlocationsfor an ear point. For example, theKnee pointislocalized onthe
superior crus of theantihelixintheChinesesystemandinthetriangular fossa intheEuropean
system. Noconcurrent agreement onthisissuewasdetermined. Thegroupdidadopt a
standardizednomenclaturefor 39auricular points, but decidedthatanother36ear pointsdidnot
asyet meet thethreeworkingcriteria. TheCategory1and Category2ear pointsdescribed bythe
1987WorkingGroupfromtheWesternPacificDivision of theWHOarerespectively similar tothe
agreedupon andnotagreedupon auricular pointslistedbythe1990WHOmeeting. Thetwo
listsof ear pointsarerespectively presentedinTables4.1and4.2. Duringthecourseof discussions,
manydivergent pointsof viewemergedconcerningboththelocalization andterminologyof
auricular points. After afree exchangeof ideas andopinions, theWHOworkinggroupagreedthat
apriorityof futureactivity shouldbethedevelopment of astandardreferencechart of theear. This
chart shouldprovide acorrect anatomical illustrationof theear, an appropriateanatomical
mappingof topographical areas, consultationwithexpertsinanatomyand auricular acupuncture,
illustrationsof correct zones inrelationtoauricular acupuncture, and theactual delineationand
localization of ear points. A subsequent committeedirectedbyAkerele(WHO1990b) developed
specific anatomical drawings of theear and specific terminologyfor theauricle.

--(1i*)
----Ie

Figure 4.4 ThezonesystemdevelopedinChinaafter the1990WHOauricular nomenclaturemeetinghas beendescribed by
Dr Li-QunZhou(reproduced withpermission).
Table 4.1 WHO1990 standard nomenclature for auricular points, accepted points
Englishname Pinyin name
Ear Center Erzhong
Urethra Niaodao
External Genitals Waishengzhiqi
Anus Ganmen
-------
EarApex Erjian
Heel Gen
Ankle Huai
Knee Xi
PelvicGirdle TunKuan
-------
Sciaticnerve Zuogushenjing
Autonomicpoint Jiaogan
Cervical Vertebrae Jingzhui
ThoracicVertebrae Xiongzhui
Neck Jing
Thorax Xiong
Fingers Zhi
Wrist Wan
Elbow Zhou
Shoulder Girdle Jian
- - - ~ - - - - _ . _ - _ . - -------
EarShenMen Ershenmen
External Nose Waibi
Apexof Tragus Pingjian
PharynxandLarynx Yanhou
MA-HX4
MA-HX5
MA-AH3
MA-TG3
MA-AHI
----
MA-AH2
MA-SF I
MA-SF2
-------
MA-SF3
MA-SF4
---
MA-TFI
MA-TGI
MA-AH10
MA-TG2
----------------------------
Anatomical Alphanumeric
- - - - - - - - - - - - - - - - - - - - - - - - ~
Helix MA-HXI
MA-AH5
MA-AH4
MA-AH8
MA-AH9
MA-AH6
MA-AH7
Antihelix
MA-HX2
- - - - - - - - - - - - - ~
MA-HX3
----------
Scaphoid fossa
Triangular fossa
Tragus
Antitragus
Intertragic notch
Inferior concha
MA-AT
MA-I T
MA-I CI Lung Fei
Qiguan
----
Neifenmi
SanJiao
Kou
Trachea
Hypothalamic-PituitaryAxis
TripleEnergizer
Mouth
------------- ---------
MA-I C6 Esophagus Shidao
MA-I C7 Cardia Bennen
Superior concha MA-SCI
MA-SC2
MA-SC3
Duodenum
Small Intestines
Appendix
MA-SC4 LargeIntestines Dachang
MA-SC5 Liver Gan
MA-SC6
--- - - -
MA-SC7
MA-SC8
Pancreas-Gall bladder
Ureter
Yidan
Lobe MA-LOI Eye Mu
Auricularzones 105
Table4.2 WHO1990 standard nomenclature for auricular points. not yet considered
Pinyinname
Neishengzhiqi
Shangergen
- _ . _ . _ - - - - - - - - ~ . . -------_ ....... ,._-_._-----
Xiaergen
Ermigen
------------
Zuzhi
English name
MA-HX I nternal Genitals
MA-HX Upper ear root
Alphanumeric
---------------
MA-HX Lowerear root
._----
MA-HX Rootof ear vagus
MA-AH Toe Antihelix
Anatomical
Helix
MA-AH
MA-AH
Lumbosacral Spine
-----------
Abdomen
Yaodizhui
- ~
Fu
Pelvis
Scaphoid fossa
Triangular fossa
Tragus
Antitragus
WindStreamor Occipital Nerve
Middletriangular fossa
------
Superior triangular fossa
Adrenal Gland
Nie MA-AT
MA-AT Apexof Antitragus Duipingjian
--------=-- . - = - - - - - - ~
MA-AT Central Rimor Brain Yuanzhong
- - - - - - - - - - - - - - - - - - - - - - - - - - - _ . ~ . -
MA-AT Occiput Zhen
--------- - - - - - - - - - - - - - - - - - - - - - = - - - - - - - - - - - - - - - - - - - - ~ - - - - -
Temple
MA-AT Forehead E
Intertragic notch
- - - - - - - ~ ~ . _ - _ . _ - _ .._---
Inferior concha
MA-I T
MA-I C Heart Xin
MA-I C Spleen Pi
Superior concha
MA-I C
MA-SC
MA-SC
Stomach
Kidney
Angleof superior concha
Wei
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - -
Lobe MA-LO
MA-LO
MA-LO
Tooth
Tongue
Jaw
She
He
MA-LO Eye Yan
MA-LO
- ~ - ~ - _ .._-_._..._-_._---,._._,--_.__.. - - - - _ . _ " _ . _ - - " . - - - ~ -
MA-LO
MA-LO
I nternal ear
Cheek
Tonsil
Neier
Mianjia
-------------------
Biantaoui
Posterior lobe
MA-LO
MA-PL
AnteriorEar Lobe Chuiqian
Posterior peripheral MA-PP
Posterior intermediate
Posterior central
MA-PI
MA-PC
Grooveof posterior surface
Heartof posterior surface
MA-PC
MA-PC
Spleenof posterior surface
Liverof posterior surface
Erbeipi
----
Erbeigan
MA-PC
MA-PC
Lungof posterior surface
Kidneyof posterior surface
Erbeifei
Erbeishen
4.3 Anatomical identification of auricular zones
Eachauricular zoneisbasedupontheproportional subdivision of theprincipal anatomical regions,
such asthehelixandtheantitragus. Inconcurrencewiththesystemestablishedbythe1990WHO
auricular nomenclaturemeeting, eachzoneisidentifiedbyatwoletter abbreviation for each
anatomical region andanumberindicatingthatparticular subsectionof thatanatomical area.
Auricular zones ontheanterolateral and theposterior sides of theear areshown inFigure4.5. The
lowest numbersfor each auricular areabegin at themost inferior andmost central zoneof that
anatomical region. Thenumbersthenascend tohigher digitsasoneprogresses tosuperior and
morelateral sectionsof thatanatomical region. Theauricular landmarksare useful in
distinguishingwheresomezones endand thenext onebegins. A depthviewof thezonesisshown
inFigure4.6.
Thefirst zoneof thehelix, HX I,begins at landmarkLM0, thenproceedstohigher numbers, HX 2
andHX 3, asonerises tolandmarkLM 1higheronthehelixroot. Thesenumberscontinuefrom
HX 4toHX 7asonerises even higher totheapex of theauricle, LM 7. Thehelixnumbersprogress
higher asonedescendsfromthesuperior helixtothebottomof thehelixtail, endinginHX15.The
first zoneof theantihelix, AH 1,begins onthecentral sideof thebottomof theantihelixtail, LM
14, thenrises totheantihelixbodyat LM 15,curves aroundtotheinferior crus at LM 16,wherethe
antihelixnumberscontinuefromAH 5toAH 7. Theantihelixnumberscontinueagain onthe
peripheral sideof theantihelixtail, at AH 8, progressingtohigher numbersasoneascends higher
towardthesuperior crus, ultimatelytoAH18.Thedeeper valleys of thescaphoidfossa and the
triangular fossa aredivided intosixequal parts. Thezonesfor thescaphoidfossa risefromSF 1
near theear lobetoSF 6towardthetopof theear, whilethezonesfor thetriangular fossa increase
fromTF 1at thelower tipof thetriangular fossa toTF 6towardthetopof theear. A series of five
vertical zonesdivides thetragus, risingfromTG1near theintertragicnotchtoTG5, wherethe
tragusmeetsthehelixroot. ThelandmarkLM 10separatesTG2fromTG3,whilethelandmark
LM 11divides TG3fromTG4. Theantitragusisdivided intothreezones, beginningwithAT I at
theintertragicnotch, risinginnumberand inlocationat AT 2, andperipherallyat AT 3. Thereare
twozones for theintertragicnotch. ThezoneIT 1isfoundhigher towardthesurfaceof theauricle,
whereasthezoneIT 2occurs onthewall of theintertragicnotch, and isvertical toIT 1.
Thezones for theinferior conchabegin at IC 1and IC 2at theintertragicnotch. Thezonenumbers
thenriseon asecondconcharowthatbegins withIC 3andcontinuesperipherallyon theconcha
floor toIC5near theconchawall. Subsequent inferior conchasectionsarefoundon athirdrow
whichbegins at IC6belowthehelixroot andprogresses peripherallybelow theconcharidgetoIC
8. Thezonesfor thesuperior conchabegin withSC 1immediatelyabove thecentral concharidge
and ascend tohigherconcharegions at SC 4. Thesevalues for thesuperior conchazonesthencircle
back peripherallytoSC8, found above themoreperipheral concharidge. Theconcharidgeitself is
divided intotwozones, thecentral zoneCR 1andtheperipheral zoneCR 2. Thedifferent
auricular zonesof theposterior auricleeachbegin withtheletter P. Theyrisefromlower tohigher
numbersasanatomical subdivisions progressfromacentral toperipheral directionand froman
inferior tosuperior direction. Thereare different zonesfor theposterior lobe (PL), theposterior
concha(PC), andtheposterior periphery(PP), behindthehelixrimand thescaphoidfossa. The
most prominentzones arefor theposterior groove (PG),which isthedeepcrevice directlybehind
theantihelixridge.
Theintentioninprovidingsuch adetailedandcomplex auricular zonesystemistobeabletolabel
specific auricular reflex pointswiththeactual areaof theexternal ear onwhich anauricular pointis
found duringclinical detection. BothChineseand Europeanear chartslabel theauricular
acupointswiththesomatotopicbodyorganthattheyrepresent. Thestandardizationof zone
terminologyfor verbally designatingdifferent anatomical regionsof theear can provideauniversal
systemtofacilitateinternational communicationthatisbasedonear anatomy, not ear
correspondences. Whilephotographsand illustrationsof theauriclearevery useful indepicting
various regionsof theexternal ear, verbal descriptionsof thesepicturesareofteninadequatein
precisely determiningtheauricular areaindicated. Box4.1showstheauricular locationsof the
principal reflex pointsused inear acupuncturebythiszonecodingsystem, rather thanbypictures.
FurtherindicatedinBox4.1arethedifferences betweenthelocation of auricular pointsas
describedbyChineseauricular acupuncturists, denotedbythesuffixC,and theauricular zones
delineatedbyEuropeanpractitionersof auricular medicine, indicatedbythesuffixE.
Auricular zones 107
Somatotopic map on front side of ear
Somatotopic map on back side of ear
Auricular zones on front side of ear
Auricular zones on back side of ear
108
Figure 4.5 Auricular zonesseenfromanterior andposterior views oftheear, andtheir relationship tothe
somatotopicmapon theear.
Auricular zones
at antihelixtail
o L06
Auricular zones
at antitragus
Auricular zones
at tragus
Auricular zones
at helixroot
Auricular zonesat inferior crus
AH 5 TF1
Figure 4.6 A depthviewoftheauricular zones showingtheascent fromtheconchatotheconcha wall tothe
antihelix, andalso thelocation ofhiddenzones.
4.4 Somatotopic correspondences to auricular zones
Thesomatotopicrepresentationof thecervical spineissaid tobeinzonesAH 1and AH 2in
Europeancharts, but onthemoreperipheral zoneAH8inmanyChineseear charts. TheChinese
further report thattheLumbarSpineisfoundontheantihelixbody inzones AH11andAH12,
whiletheEuropeansmaintainthattheLumbarSpineislocatedontheinferior crus inzones AH 5
andAH6.A primarydifferencebetweentheEuropeanand Chineseauricular chartsisthelocation
of pointsfor theleg. Thekneeissaid tobefound onthesuperior crus zoneAH 15inChineseear
charts, but thekneeisrepresentedinthetriangular fossa zoneTF4inEuropeanear charts.
I nternal organsarealso foundindifferent auricular regionsinthesetwosystems. Forexample, the
uterusisfoundinthetriangular fossazoneTF6intheChinesesystem, but theuterusisfound
underneaththehelixroot intheEuropeansystem, inzoneIH 3.
Someear pointsaremoreeasily identifiedonceoneknows thisauricular zonesystem. Depicting
thelocationof theSympathetic(Autonomic) pointor theThalamus(Subcortex) pointisoften
confusingbecausethesetwoauricular pointsarehiddenfromaconventional viewof theear. The
SympatheticAutonomicpointisfoundinzoneIH 4, which isunderneaththehelixand near the
triangular fossa, whereas theThalamuspointisfound inzoneCW2,which isbehindtheantitragus
andnear theinferior concha. Thesezoneidentificationsdistinctly reveal thespecific localization of
thesetwoear pointsmoreclearly thanmanypicturesof thesepoints. It isalso possible toshowthe
Auricularzones 109
110
Box4.1 Primary auricular points represented indifferent auricular zones
Zone Auricular point Zone Auricular point Zone Auricular point
-----_._---_..,,-_.,---.- ...._------. _ . _ - - - - _ ~ _ - " - - _ ~ . _ .._-----_.--
AH1-2 Cervical Spine.E LO1 Master Cerebral IC1 Pituitary Gland
AH3-4 Thoracic Spine.E LO2 Aggressivity point IC2 Lung2
AH5-6 Lumbar Spine.E LO3 Master Sensorial IC3 Trachea, Larynx.E
AH7 Sacral Spine.E LO5 Trigeminal Nerve IC4 Heart.C, Lung1
AH8 Cervical Spine.C, L06 Antidepressant, IC5 Lung1
ThyroidGland.C Limbicsystem IC6 Mouth,Throat
AH9-10 Thoracic Spine.C LO7 Teeth, Lowerjaw IC7 Esophagus
AH11-12 LumbarSpine.C L08 TMj,Upper jaw IC8 Spleen.C
AH13 Hip.C HX1 Point Zero CR 1 Stomach
AH15 Knee.C HX2 Diaphragm.C CR2 Liver
AH17 Ankle.C, Foot.C HX3 Rectum.C SC 1 Duodenum
TF 1 Hip.E HX4 External Genitals.C SC 2 Small Intestines
TF2 Shen Men HX7 Apexof Ear SC 3 Large Intestines
TF 3-4 Knee.E, Leg.E HX12 LumbarSpinal Cord SC 4 Prostate.C
TF 5-6 Ankle.E, FootE HX13 Thoracic Spinal Cord SC 5 Bladder
SF 1-2 Shoulder HX14 Cervical Spinal Cord SC6 Kidney.C
SF 3-4 Elbow,Arm HX15 Brainstem.E SC 7 Pancreas
SF 5 Wrist,Hand IH1 Ovary/Testis.E SC 8 Spleen.E
SF 6 Fingers IH2 Prostate/Vagina.E IT2 Endocrine point
AT1 Forehead IH3 Uterus.E CW2 Thalamus point
AT2 Temples, Asthma I H4 Sympathetic Autonomic point CW3 Brain.C
A13 Occiput IH5-6 Kidney.E, Ureter.E CW4 Brainstem.C
TG 3 Adrenal Gland.C IH7 Allergypoint CW5 ThyroidGland.E
TG 2 Tranquilizer point IH11 WindStream CW6 ThymusGland.E
TG 1 Pineal Gland.E ST 2 Master Oscillation CW7 Adrenal Gland.E
S13 Larynx.C, Throat.C
differential locationof otherpointsfoundontheconchawall. TheChineseBrain point isfound in
zoneCW3andtheBrainsteminCW4. TheEuropeanlocationsfor theThyroidGlandare
localized inzoneCW4/CW5, theThymusGlandinCW6, andtheAdrenal GlandinzoneCW7.
Understandinghowthecontoursandlandmarksontheear can assist theidentificationand
comparisonof suchear pointsisanattainablegoal.
4.5 Representation of Nogier phases inauricular zones
Insubsequent revisions of thesomatotopicrepresentationof thebodyontheexternal ear, Paul
Nogier haspostulatedtwoadditional auricular microsystems thatare distinct fromtheoriginal
invertedfetus pattern. Eachanatomical region of theexternal ear can represent morethanone
microsystempoint. AsnotedinChapter2, thethreedifferent Nogier phasesrepresent
embryological tissueinthreedifferent territoriesontheauricle. Territory1consists of theantihelix.
theantitragus, andareas adjacent totheantihelix, such asthescaphoidfossa, triangular fossa and
helix. Territory2consists of theconcha, includingthesuperior concha, theinferior concha, the
concharidgeandtheconchawall. Territory3consists of thelobe, thetragus, theintertragicnotch
andthemost inferior region of thehelixtail. Thephasenumberfor representationof mesodermal
tissueconcurswiththenumberfor each territory. PhaseI mesodermal tissue isrepresentedin
Territory1, PhaseII mesodermal tissueisrepresentedinTerritory2, and PhaseIII mesodermal tissue
isrepresentedinTerritory3. Theendodermal tissuefor different phasesshiftsfromTerritory2in
PhaseI, toTerritory3inPhaseII, toTerritoryI inPhaseIII.Theectodermal tissuefor different
phasesshiftsfromTerritory3inPhaseI, toTerritory1inPhaseII, toTerritory3inPhaseIII.
Functionally, PhaseI pointsaremoreassociated withrepresentationof acutesomaticreactionsand
PhaseII pointsaremorereflective of chronic, degenerativeconditions. PhaseIII pointsseemto
reflect subacutesyndromes thatarenotas serious aspathological statesrepresentedinPhaseII,
but arethemost salient pointsinpatientswith underlyingobstacles totreatmentsuccess.
4.5.1 Auricular zones for different phases of mesodermal myofascial tissue
Vertebral column: ForboththeChinesesystem and theNogier PhaseI system, thevertebral
columnisfoundinTerritory1, alongthemedial sideof theantihelix. TheChinesestateintheir
texts thatthewholevertebral columnislimitedtothebodyand tail of theantihelix. Nogier has
indicatedthatthePhaseI Cervical Vertebraearefoundontheantihelixtail, theThoracic
Vertebraearefoundon theantihelixbody, and theLumbosacral Vertebraeextendontothe
inferior crusof theantihelix. TheChinesechartsdoshowtheButtocksand Sciaticpointson the
inferior crus, but do not includethelower vertebraethere. InNogiersPhaseII, theLumbosacral
Vertebraearefoundonthehelix root, whereas theThoracicandCervical Vertebraeextend
peripherally ontotheconcharidge, inTerritory2. InPhaseIII, TheCervical, Thoracic, and
Lumbosacral Vertebraeoccur alongthesurfaceof thetragusinTerritory3.
Upper and lower limbs: TheChineseplaced theHip, Knee, and Footon thesuperior crus of the
antihelixof Territory1. Nogier placed thePhaseI lower limb pointsinthenearbytriangular fossa
Table4.3 Mesodermal tissuefor different phasesfound inauricular zones
No. Anatomical region Chinese PhaseI PhaseII PhaseIII PhaseIV
10 Cervical Spine AHI AH1-2 CR2 TGI -2 PG1-2
11 ThoracicSpine AH2-3 AH3-4 CRI TG2-3 PG3-4
12 Lumbosacral Spine AH4 AH5-6 HXI TG4-5 PG5-6
18 ChestandRibs AHIO AHIO SCI TG3 PG3
19 Abdomen AHI I AH11 IH1 TG4 PG4
~ - - - - - - - - ~ -
21 HipandButtocks AH13 TFI IC1-2 AH I ,AT3 PT I
- - - - _ . - - " - - - ' ~ - - - ' ~ - - - - - - - - - ~ - ~ ~ - - " - - - " ' - ' . _ . _ .._._-
23 KneeandThigh AH 15 TF4 IC2/4 AT2 PT2
--- ----_.._---------_._---------_._---_._-".
25 AnkleandCalf AHI 7 TF5 IC5 AT1 PT3
- - ' - - - ' - ' - ' - ' - ' - ~
26 Foot,Heel,Toes AHI 7 TF5-6 IC8 IT1 PT3
30 HandandFingers SF6 SF6 SC8 L01 PP9-10
------_.._--------
32 WristandForearm SF5 SF5 SC7 L03 PP7-8
34 ElbowandArm SF4 SF4 SC5-6 L05 PP5-6
36 Shoulder SF2 SF2 SC4 L07, SF1 PP3-4
-" ---_........__._.__.
38 HeadandScalp AT1-3 I H7-9 SC3 L04 PL4
49 Tongue L04 HX8-11 IC7 L02 PL5
53 Skin SF6 HX12-15 SC4 L04
69 Heart IC4 AH3,11 SC7 L08 PP5
76 Diaphragm HX2 AH11 SC2 TG4
--------_ ..- ---- -----------
81 Spleen IC8 CW9 SC8 L08 PC3
84 KidneyandUreter SC6 I H5,6 IC7-8 AHl,8 PP10
88 Prostate SC4 I H3-4 ICI L02
.---------
89 Uterus TF5/6 I H3-4 IC2 L02
-_.._,.,-----
91 OvarieslTestes CWI IH1-2 I C4-5 L04
92 Adrenal Gland TG2/3 HX2-7 I C3,6 L06 PG5
Auricular zones 111
38.F3 Head
49.Fl Tongue
40.C Forehead
38.C Occiput
39.C Temples
49.C Tongue
10.C Cervical Spine
18.C & 18.Fl Chest
53.C Skin
Chinese earpoints
and Phase III points
ThoracicSpine
13.C
Sacral Spine
19.C & 19.Fl
Abdomen
7i:.....L_\--..-t----Ji12.CLumbar Spine
53.Fl Skin
10.F3
Cervical
Spine
53.F3Skin
39. Temples
11. Thoracic
Spine
13. Sacral
\ Spine
14. Buttocks
___ 38. Occiput
Phase I and Phase /I points Phase IVpoints
13. Fl
Sacral Spine
38. F2_---....--;
Head
12.F2_---ror:
Lumbar Spine
11.F2
Thoracic Spine
10. F2
Cervical Spine
18.F2
Chest
11.Fl
Thoracic
Spine
18.Fl
Chest
10.Fl
Cervical
Spine
18. F4
Chest
38. F4
Occiput
39.F4
Temples
40.F4
Forehead
49.F4
Tongue
Figure 4.7 Phases for mesodermal vertebral spineandheadpoints.
Chineseearpoints,PhaseI arm,andPhase/IIpoints
25.F3
Ankle
21.F3
Hip
32.( & .F1
Wrist
23.F3
Knee
31.C & .F1
Hand & Fingers
28.C
Toes
r.J-f-+-- 36.C & .F1
Shoulder
PhaseIVpoints
26.C
Heel
25.C
Ankle
27.F3
Foot
25. Ankle
23.C1
34. Elbow
Knee
34.C & .F1
21. Hip Elbow
21.(
32. Wrist
Hip
_++-_ 36. Shoulder
..__ 23. Knee
PhaseI legandPhase" points
Fingers
23.F4 Knee
31.F4
Hand
34.F4 -+--\1
Elbow
36. F4 --;-----+-1
Shoulder
23.F1
Knee
31.F2
Hand
25.F1
Ankle
36.F3
Shoulder
27.F3
Foot
34.F3
Elbow
23.F3
Knee 32.F3
31.F3
Wrist
Hand
27.F1
Foot
25.F2
Ankle

Elbow
Figure 4.8 Phases for mesodermal upper limbandlower limbpoints.
Auricular zones 113
of Territory1.InboththeChinesesystemand Phase I of Nogierssystem, theShoulder, Elbow, and
Handarefoundinidentical areas of thescaphoidfossa. InNogiersPhaseII, theupper limbsshift
totheinferior conchaand thelower limbsarefound inthesuperior concha. Bothlimbs are thus
locatedinTerritory2. InPhaseIII, theear pointsfor theupper andlower limbsshift tothelobe and
antihelixof Territory3.
Faceandskull: Theauricular pointsfor headareas liketheSkull, Jaw, Eye, and Eararefoundon
theantitragusof Territory1. InPhaseII, thepointsfor theheadarefoundwithother
musculoskeletal pointsontheconchawall of Territory2. InPhaseIII, theheadisfoundat themost
inferior level of thetragusinTerritory3.
4.5.2 Auricular zonesfor different phasesof internal organtissue
Endodermal internal organs: Almost all ear reflex pointsfor theendodermal internal organsarc
found intheconchaof Territory2for boththeChinesesystemand for PhaseI of Nogierssystem.
ThePhase I internal organpointsincludeear reflex pointsfor thedigestive system, such asthe
Stomachand I ntestines, respiratorypointssuch astheLungsand Bronchi, abdominal organssuch
astheBladder, Gall Bladder, Pancreas, and Liver, and theendocrineglands such astheThymus,
theThyroid, andtheParathyroid. All of theseendodermal pointsshift tothelobe and thetragusof
Territory3inPhaseII, and tothehelixand antihelixareasof Territory1inPhaseIII.
Mesodermal internal organs: Whilemost cellswhich develop fromthemesodermal layer of the
embryo becomepart of themusculoskeletal system, some mesodermal tissue differentiatesinto
visceral organs. Thesemesodermal internal organsincludetheHeart,theSpleen, theKidneys, the
Ureter, theAdrenal Glands, andGenital organs, such astheVagina, theUterus, theProstate, the
Ovariesand theTestes. IntheNogier phases, thisset of internal organsisfound inthesame
territoriesthatthemusculoskeletal tissue isfound. InPhaseI thesepointsare foundinTerritoryI,
inPhaseII theyarefoundinTerritory2, and inPhaseIII theyarefoundinTerritory3.
Table4.4 Endodermal tissuefor different phasesfound inauricular zones
64 Duodenum
65 Small I ntestines
No. Anatomical region PhaseII PhaseIII PhaseIV
LO1 HX1 PC2
..-.. - ~ - - - - - _ . -
L03 HX2-5 PC2
L05 TF4 PC3
---_._._.... _.._"----------
L04 I H3-9 PC3
ATl-3 HX10-14 PC4
--_._----_._-----
I TI HXI 5 PC4
_ .. --_.-,,_.--_._-.---.-_._-_._--
CWI -3 CW9-10 PG2-5
L08 SF 2-3 PC2
L07 SF 1 PC2
L08 AH4 PC2
I C3
I C4,5
CW4-8
STI
SC3,4
I H3
I C4
I C6
ST4
SC3
._------------
HX3
- ~ _ . _ ~ ~ - - ~ ~ - - - - _ . _ - - - - - - - - - - - - - -
Chinese PhaseI
I C7 I C6
.. _ - ~ - - - - _ ..__.
CRI I C7,CR1
------
SC1 SC1
SC2 SC 1-2
Bronchi
Larynx
Lungs
CirculatorySystem
LargeIntestines
Rectum
74
67
66
68
70
71
61 Esophagus
63 Stomach
L07 SF4,5 PC3
L02 AH 13, 14 PC3
LO1 TF3,4,5 PC3
LOI ,L03 SF6 PC3
AHI 8
- -----------_.._-------
L01 TF6 PC3
L05 HX6-8 PG4
AH1,8 AH2 PG3
HX 15 AHI PG I
I C2
--------
IC1
SC4
I C8
SC7
SC5-6
CR2,SC8
SC8
HX4
AH8
CR2
SC8
SC7
-----------
SC5
Liver
Bladder
Urethra
ThymusGland
Gall Bladder
ThyroidGland
ParathyroidGland 97
94
87
96
79
82
83 Pancreas
---
86
114 Aur;culotherapyManual
79.F2
Liver
64.F2
Duodenum
94.F2 ThymusGland
>+-"'-';="'r/-- 96.(
ThyroidGland
96.F2
ThyroidGland
70.F2
Lung
71.F2
Bronchi
NogierPhase/Iear points
Chineseear pointsand
NogierPhaseI earpoints
83.( & .F1Pancreas
82.( & .F1Gall Bladder
63.( and.F1Stomach
86.F2
Bladder
67.(
Rectum
82.F3
Gall
Bladder
82.F2
Gall Bladder
79.F3
Liver
67.F3
Rectum
66.F3
Large
Intestines
70B
Lungs
:--1-+--1--1---79.c& .F1Liver
94.F3
Thymus
64.F3
Duodenum
86.F3
Bladder
86.( & .F1
Bladder
83.F3
Pancreas
97.F1
Parathyroid
74.F1
Larynx
71.F1
Bronchi
96.F3
Thyroid
87.F3
Urethra
63.F3
Stomach
65.F3
Small
Intestines
61.F3
Esophagus
97.F3
Parathyroid
74.F3Larynx .....
Figure 4.9 Phases for theendodennal internal organs.
Auricularzones 115
81.F4
Spleen
81.F3
Spleen
92.F3
Adrenal
Gland
81.C
Spleen
69.F3
Heart
Chinese ear points
and Phase III points
84.F4
Kidney
'/\Jr-...T-----I'--_ 84.F3
Kidney
69.C
n Heart
69.F1
Heart
76.F1
Diaphragm
76.F2
Diaphragm
69.F2
Heart
89.C
Uterus
91.C
Ovaries
or Testes
91.F3
Ovaries
or Testes
91.F2
Ovaries
or Testes
92.F1
Adrenal Gland
88.C 84.C
Prostate Kidney
76. C
Diaphragm
76.F3
Diaphragm
92.C -----"I ---i
Adrenal Gland
89.F3 Uterus
88.F3 Prostate
81.
Spleen
Nogier Phase I and Phase /I points
89.
Uterus
84.F1
Kidney
91.F1
Ovaries
or Testes
89.F2 Uterus
88.F2 Prostate
Figure 4.10 Phasesfor themesodermal internal organs.
4.5.3 Auricular zones for different phases of ectodermal neuroendocrine tissue
Chinese neuroendocrine points: TheChinesehave identifiedonlyafewneuroendocrinesystem
pointsontheconchawall of Territory2,whereastheEuropeanauricular chartshave indicated
manyareasof theauriclewhich represent thebrainand spinal cord. Thereisconcurrencebetween
theOriental andWesternsystems for thosefewear pointstheChinesehave recognized. The
master pointthatNogier and hiscolleagues first identifiedastheThalamuspointwas labeled the
SubcortexpointbytheChinese. WhiletheChineseear chartsdodescribethelocationof the
PituitaryGlandinasimilar locationastheEuropeanear charts, theChinesedonotgointoas
muchdetail regardingtheperipheral endocrineglands thatare regulatedbythepituitarygland.
Table 4.5 Ectodermal tissue for different phases found inauricular zones
No. Anatomical region Chinese Phase I Phase II Phase III Phase IV
54 Eye L04 L04 AHll I C3 PL4
59 External Ear TG5 L01 TG5 SC6
95
98
99
109
110
113 VagusNerve
AH10
IC 1
I H4
L01
TG1
IT 2, IC I
CW2
CW3
CW1
HX7-9
HX1
AH 15-18
HX 13-14
HX15
HX12
IC1
SC5
CW1
CRl-2
CR2
CR1
PG3
PC1
PG3-6
PG7
PG1
124 Spinal Cord AH8,SF1 AH8,9
SF 1, 2
I C5 PP2,4,6
BrainstemMedullaOblongata
Reticular Formation
CW4 L07
L08
HXl-3
AH 10, 12
SF 3-4
SC1
I C8
PP2
PL6
133
134
RedNucleus
SubstantiaNigra
L06
L06
CWlO
IH1
I C6
I C7
PL4
PL4
135 Striatum(Basal Ganglia) L04,AT1 HX9-11 I C3,4 PL4
PL2
PG1
PL2
PL2
I C4
CWl-3
I C6
I C7
AH3
AHll
CW9
CW8
L06
AT2-3
L02
LO2, IT 1
CW2
Hypothalamus
Thalamus(Subcortex, Brain)
Hippocampus
Amygdala
-------------------------------------
137
138
140
141
143
145
CingulateGyrus
Cerebellum
IT 1
AT3,AH1
CW7
HX4-6
I C6
SC8
PL2
PP 1
147 Occipital Cortex L07 SF4
AH12
SC7 PL4
---------------------------
148
149
Temporal Cortex
Parietal Cortex
L05
L05
SF5
AH14
SF6
AH 16, 18
SC6
SC6
PL4
PL3
150 Frontal Cortex L03 TF 1-2
AH13
SC5 PL2
151 Prefrontal Cortex LO1 TF3-4
AH 15-17
SC4 PL1
Auricularzones 117
95.C
Mammary
Gland
124.Fl
SpinalCord
13Ul
Reticular
Formation
127.Fl
Medulla
Oblongata
134.F1
SubstantiaNigra
133.Fl
Red Nucleus
135.F1
Striatum
127.C
Brainstem
110.Fl
Parasympathetic Nerves
109.Fl
Sympathetic Nerves
113.Fl
VagusNerve
143.F1
u--_-
CingulateGyrus
140.Fl
Hippocampus
95.Fl
MammaryGland
141.F1Amygdala
145.Fl
Cerebellum
147.F1
Occipital Cortex
149.Fl
Parietal Cortex
148.Fl
TemporalCortex
54.Fl Eye
150.Fl
Frontal Cortex
138.C
Brain
138.Fl
Thalamus
137.Fl
Hypothalamus
98.Fl
PinealGland
99.Fl
PituitaryGland
59.Fl
ExternalEar
151.Fl
Prefrontal
Cortex
118
Figure 4.1 1 PhaseI neuroendocrineandChineseearpoints.
145.F2
Cerebellum
127.F2
Medulla
Oblongata
59.F2 _--f'-J
External Ear
98.F2
Pineal Gland
131.F2
Reticular
Formation
99.F2
PituitaryGland
151.F2
PrefrontalCortex
150.F2
Frontal Cortex
133.F2
Red Nucleus
140.F2---''<I''
Hippocampus
141.F2
Amygdala
143.F2
CingulateGyrus
134.F2
SubstantiaNigra
Figure 4.12 PhaseIl neuroendocrineearpoints.
Auricularzones
95.F2
MammaryGland
135.F2
Striatum
54.F2
Eye
110.F2
ParasympatheticNerves
109.F2
SympatheticNerves
113.F2
VagusNerve
124.F2
SpinalCord
148.F2
TemporalCortex
147.F2
OccipitalCortex
138.F2
Thalamus
. I ! . ~ d - - - 137.F2
Hypothalamus
119
59.F3
External Ear
127.F3
Medulla
98.F3
Oblongata
Pineal Gland
109.F3
Sympathetic
113.F3
Vagus Nerve
Nerves
110B
140B
Parasympathetic
Hippocampus
Nerves
141.F3
131.F3
Amygdala
Reticular
143.F3
Formation
Cingulate Gyrus
134.F3
54.F3
Substantia Nigra
Eye
124.F3
95.F3
Spinal Cord
Mammary Gland
145.F3 --++-1-+
Cerebellum
137.F3 __- + = ~ ~ ! I . -
Hypothalamus
138.F3
Thalamus
151.F3
Prefrontal
Cortex
~
150B
Frontal Cortex
~ __ 149.F3
Parietal Cortex
148.F3
Temporal Cortex
147.F3
Occipital Cortex
135.F3
Striatum
99.F3
Pituitary Gland
Figure 4.13 PhaseIII neuroendocrineearpoints.
120 Aur;culotherapyf\1anual
Phase I neuroendocrine points: Thenervoussystem and theendocrinesystem arefirst represented
onthelobe of Territory3inPhaseI of Nogierssystem. Inall threephases, theNogiersystem allows
for different auricular localizations for pituitarycontrol of endocrinehormones, ascontrastedwith
theactual placement of theperipheral endocrineglanditself. TheThalamusand Hypothalamusare
foundontheexternal surfaceof theantitragus, whereas theywere previously described onthe
conchawall and inferior concha. TheCerebral Cortexisstill representedontheear lobe
Phase II neuroendocrine points: Theectodermal neuroendocrinesystems shift tothehelix, the
antihelix, andthetriangular fossa regionsof Territory1inPhaseII. ThePituitarypointfor genital
control inPhaseII islocated inthetriangularfossa region, near theChineseUteruspoint. The
Frontal CortexinPhaseII correspondstotheauricular locationfor theChinesemaster point Shen
Men.TheCerebral CortexinPhaseII isfoundalong thesuperior helix, leadingtotheSpinal Cord
locatedonthehelix tail.
Phase IIIneuroendocrine points: Theneuroendocrinesystems shift totheconchainTerritory2in
PhaseIII. Thecortical areas arelocated inthesuperior conchaand thesubcortical areas inthe
inferior concha. Thelocationof thePhaseIII AnteriorHypothalamusand PosteriorHypothalamus
intheinferior conchacoincideswith thelocationof theChineseLungpointsusedinthetreatment
of narcoticdetoxification anddrugabuse.
4.5.4 Nogierphases relatedtoauricular master points
Thereare certainpointson theauricle usedinbothChineseear acupunctureandEuropean
auricular medicinethatdo not relatetoonespecific anatomical organbut affect abroadrangeof
physiological functions. Theseear pointsarereferredto asmaster points, thetwoprincipal
examples beingtheChineseear pointShenMenandtheNogier auricular locus identifiedasPoint
Zero. Thesetwofunctional pointsdocorrespondtospecific anatomical organswhenviewed from
theperspectiveof theNogier phases.
Frank(1999) has notedthatShenMenisidentifiedat theauricular locationsconsistentwith the
PhaseI Spleen projection, thePhaseII Thalamusprojection, and PhaseIII Liver projection. The
spleen dealswith inflammatorycellular elementsand isthusreasonably seen inmanyinflammatory
conditions. Thethalamusisasignificant central nervous systemstructureinvolved inthe
modulationof painsignals fromthespinal cordtothecerebral cortex. I tisreasonable, therefore, to
findthiszonereactivewithchronic, degenerative, painful conditions. Theliver isassociated with
hepatobiliaryphysiology andthereforethiszonewouldreasonably beactive insubacuteor chronic
painor dysfunctional problems.
PointZerolies inthehelixroot areainnervatedbythevagus nerve thatsuppliestheendodermal
organstructuresrepresentedinPhaseI at thesuperior and inferior concha. Vagusnerveactivity is
commonlyseenwithphysiologic stress and painful experiences. PhaseII locationat theregionwhere
Point Zeroisfoundisconsistentwithlocationof theCerebellum. Specific cerebellar functions
includecoordinationof somaticmotoractivity, regulationof muscle tone, and thebalancing
mechanismsof equilibrium. Withsuch significant impact onthebodyscoordinationfunctions, it is
not surprisingthatthispointisreactiveinmanychronicdegenerativePhaseII conditions. ThePhase
III pointfor theCorpusCallosumislocatedat theanatomical positionof PointZero. Thisneural
bridgebetweentheleft andright cerebral cortexisacritical relay for properneurophysiologic
function. PhaseIII disturbancesat thispointmaymanifest asattentiondeficit disorder, stuttering,
dyslexia, confusionwithdirectionsandvisual and auditoryprocessingdisturbances.
4.6 Microsystem points represented inauricular zones
Eachanatomical partof thehumanbody and each healthconditionarerepresentedintheauricular
microsystemcodes byanear reflex pointdesignatedbyanumber andaletterextension. The
numberscontinuefrom0.0toover 200.0, each numberdesignatingadifferent partof human
anatomy. Theletterextensionsfollowing thedecimal pointshown inBox4.2indicatewhetherthat
ear reflex pointbelongstotheChineseear acupuncturemicrosystem, .C, theEuropean
auriculotherapymicrosystem, .E,or whetherit isauniversally acceptedlocation. Insomecases,
thereismorethanoneChineseor Europeanear reflex pointfor agiven bodyarea. Inthose
instances, therecan beseveral extensions, such as.Cl, .C2, and .C3. Box4.2also shows howthe
Nogier PhasesI -I I I areindicatedby.Fl-.F3and .F4for thefourthphaseontheposterior sideof
theear.
Auricularzones
121
4.6.1 Helixzones
HX1 Point 0, Point of Support, Solar Plexus, Umbilical Cord, External Genitals.E, Penis or
Clitoris, Sexual Desire.
HX2 Diaphragm.C.
HX3 Rectum.C,Anus, Urethra.C, Weather point.
HX4 External Genitals.C.
HX5 Psychosomatic point, Psychotherapeutic point, Reactional point (Point R).
HX6 Omega 2.
HX7 Allergy point, Apex of Ear.
HXB
HX9 Tonsil 1.
HX10 LiverYang 1.
HX11 Darwins point, LiverYang 2,Helix 1.
HX12 Lumbosacral Spinal Cord,Alertness.
HX13 Thoracic Spinal Cord, Helix2.
HX14 Cervical Spinal Cord,Tonsil 2, Helix3.
HX15 Medulla Oblongata, Tonsil 3, Helix4, Sexual Compulsion.
Helix auricular zones
Box 4.2 Auricular microsystem
codes
.0
.C
.E
.F1
.F2
.F3
.F4
Universal ear reflex point
Chinese ear reflex point
European ear reflex point
Nogier Phase I point
Nogier Phase IIpoint
Nogier Phase IIIpoint
Nogier Phase IVpoint
188.E
Omega 2
183.E2
Psychosomatic
Point
90.C
External
Genitals.C
198.E
Weather
87.C
Urethra.C
67.C
Rectum.C
76.C
Diaphragm
90.E
External
Genitals.E
184.E
Sexual Desire
179.C
Apex of ear 75.C1
Tonsil 1
80.C1
LiverYang 1
200.E
Darwins Point
180.C1
Helix1
\ .....-<---_ 80.C2
Liveryang 2
194.E
Alertness
124.E
Lumbosacral
Spinal Cord
125.E
Thoracic Spinal Cord
75.C2
Tonsil 2
126.E
Cervical Spinal Cord
185.E
Sexual Compulsion
127.E
MedullaOblongata
75.C3
Tonsil 3
122
Figure 4.14 Helixzonesandcorrespondingauricular points.
4.6.2
AH1
AH2
AH3
AH4
AHS
AH6
AH7
AH8
AH9
AH10
AH11
AH12
AH13
AH14
AH1S
Antihelixzones
Upper Cervical Vertebrae, Cerebellum.
LowerCervical Vertebrae, Torticollis.
UpperThoracic Vertebrae, Heart.E, Mammary Gland.C.
LowerThoracicVertebrae. LumbarVertebrae.C,Abdomen.
Upper LumbarVertebrae, Buttocks.
Lower LumbarVertebrae. Sciatic Nerve, Sciatica, Ischium.
Sacral Vertebrae, Autonomic point, Sympathetic point.
Upper Anterior Neck Muscles, Torticollis.Cervical Spine.c.
LowerAnterior Neck muscles, Clavicle.E, Thoracic Spine.C, Scapula.E, ThyroidGland.C.
Chest and Ribs, Thorax, Pectoral Muscles, Breast, Mammary Gland.C, Lumbar Spine.C.
Abdomen, Lumbago (lumbodynia) point, Heat point.
Abdomen. AH16 Thumb.E.
Hip.C. AH17 Heel.C,Ankle.C.
Knee joint.C2. AH18 Toes.C.
Knee.C1.
Antihelix auricular zones
168.C
Heatpoint
14.0
Buttocks
13.E
Sacral Spine
107.0
SciaticNerve
12.E
LumbarSpine
HE
ThoracicSpine
69.E
HeartE
95.C
MammaryGland.C
10.E
Cervical Spine
145.E
Cerebellum
26.C
Heel.C
28.C
Toes.C
25.C
Ankle.C
23.Cl
Knee.Cl
29.E
Thumb
21.C
Hip.C
23.C2
Knee.C2
158.Cl
Lumbago
19.0
Abdomen
18.0
Chest
17.0
Breast
16.E
Clavicle.E
96.C
ThyroidGland.C
15.0
Neck
Figure 4.15 Antihelixzonesandcorrespondingauricular points.
Auricularzones 123
4.6.3
IH1
I H2
I H3
I H4
IHS
I H6
I H7
IH11
IH12
Internal helix zones
Ovaries orTestes.E.
Vagina or Prostate.E.
Uterus.E.
Sympathetic Autonomic point, Ureter.E.
Kidney.E, Hemorrhoids.C 1.
Kidney.E.
Allergypoint.
WindStream, Lesser Occipital Nerve.
Lumbar Sympathetic Preganglionic Nerves.
174.C
Hemorrhoids
8S.E
Ureter.E
2.0
Sympathetic
Autonomic
point
89.E
Uterus.E
88.E
Vagina or Prostate.E
124
Figure 4.16 Internalhelixzonesandcorrespondingauricular points.
L03
L04
4.6.4 lobe zones
LO1 Master Cerebral point, Master Omega point, Nervousness, Neurasthenia, Fear, Worry,
Psychosomatic point, Prefrontal Lobe, Optic Nerve, Analgesic point, DentalAnalgesia 2(Tooth
extraction anesthesia, lower teeth), LimbicSystem 1, Prostaglandin point 1.
LO2 External Nose.E, Frontal Cortex, LimbicSystem 2, Rhinencephalon, Septal Nucleus, Nucleus
Accumbens, Olfactory Bulb, Olfactory Nerve, Amygdala, Aggressivity point, I rritabilitypoint,
DentalAnalgesia 1(Toothextraction anesthesia, upper teeth).
Face, Cheeks, Lips, Tonsil 4, Helix6, Parietal Cortex.
Master Sensorial, Eye, Frontal Sinus, Tongue.C, Palate.c.
LO5 Internal Ear.C, Tongue.E, MidbrainTegmentum, Trigeminal Nerve, Helix5.
LO6 Upper jaw, Maxilla,Vertex, Hippocampus, Temporal Cortex,Auditory Line, Parietal Cortex.
LO7 Lowerjaw, Mandible, Chin, Pons.
LO8 TMj,Teeth, Antidepressant point, Sneezing point, Salivary Gland(parotid gland).
140.E
Hippocampus
148.E
Temporal Cortex
49.C
Tongue.C
41.E
Frontal Sinus
182.E
Aggressivity
139.E2
Limbic System 2
47.C1
Dental Analgesia 1
57.E
External Nose.E
47.C2
Dental Analgesia 2
9.0
Master Cerebral
86.E
Master Omega
139.E1
Limbic System1
150.E
Frontal Cortex
50.E
8 0 Lips
Master 54.0 18q.C6
Sensorial Eye Helix6
Tonsil 4
42.C
Vertex
43.E
TMJ
190.E
Antidepressant
51.E

46.0
Teeth
44.0
Lower Jaw
45.0
Upper Jaw
180.C5
Helix5
49.E
Tongue.E
58.C
I nternal Ear.C
149.E
Parietal Cortex
Figure 4.17 Lobezonesandcorrespondingauricular points.
Auricularzones 125
126
4.6.5 Scaphoid fossa zones
SF 1 Master Shoulder, Clavicle.C, Appendix Disorder 3.
SF 2 Shoulder, Chinese Shoulder joint.
SF 3 Upper Arm,Chinese Shoulder, Appendix Disorder 2.
SF 4 Elbow, Forearm.
SF 5 Wrist, Hand,Skin Disorder.C, Urticaria point.
SF 6 Fingers, Appendix Disorder 1.
78.C1 Appendix Disorder 1
30.0
Fingers
31.0
Hand
53.C
Skin Disorder.C
(Urticariapoint)
~ - - l - - __ 32.0
Wrist
195.E1
Insomnia 1
33.0
Forearm
34.0
Elbow
78.C2
Appendix Disorder 2
35.0
Arm
36.0
Shoulder
195.E2
Insomnia 2
37.E
Master Shoulder
16.C
Clavicle.C
78.C3
Appendix Disorder 3
Figure 4.18 Scaphoidfossa zonesandcorrespondingauricular points.
4.6.6 Triangular fossa zones
TF1 Hip.E, Pelvic Girdle.
TF2 Shen Men(SpiritGate, DivineGate).
TF3 Thigh, Constipation,Antihistamine.
TF4 Knee.E, Hepatitis 1.
TF5 Heel.E, Calf.E,Ankte.E, Uterus.c.
TF6 Toes.E, Hypertension 1(Depressing point).
28.E
Toes.E
27.E
FootE
25.E
Ankle.E
26.E __I--
Heel.E,......_...
24.E
Calf.E
154.C
Constipation
156.C1
Hypertension 1
89.C
Uterus.C
155.C1
Hepatitis 1
153.C
Antihistamine
1.C
Shen Men
20.0
Pelvic girdle
Figure 4.19 Triangular fossazonesandcorrespondingauricular points.
Auricular zones 127
4.6.7 Tragus zones
TG1 Pineal Gland, Epiphysis, Point E, Eye Disorder 1(Mu1).
TG2 Tranquilizer point, Hypertension 2(HighBloodPressure point), ValiumAnalog, Relaxation point.
Maniapoint, Nicotine point. Corpus Callosum.
TG3 External Nose.C,Appetite Control (Hunger point),Adrenal Gland.C (Suprarenal Gland),
Stress Control point, Corpus Callosum.
TG4 Vitalitypoint. Viscera, Thirstpoint, Corpus Callosum.
TG5 External Ear.C,Apex ofTragus, Heart.C2(Cardiac point).
4.6.8 Antitragus zones
AT1 Forehead. Thyrotropin (TSH), Eye Disorder 2(Mu2).
AT2 Temples, Asthma (PingChuan),Apex of Antitragus.
AT3 Occiput. Atlas, Occipital Cortex.
146.E
Corpus
Callosum
92.C
Adrenal Gland
192.E
NicotinePoint
191.E
Mania Point
~ - - I - - __178.C
Apex of
Antitragus
38.0
Occiput
147.E
Occipital Cortex
152.C
Asthma
39.0
Temple
59.0
External Ear.O
69.C2
Heart.C2
177.E
Apex of Tragus
193.E
VitalityPoint
162.C
ThirstPoint
57.C
External Nose.C
161.C
Appetite Control
7.0
Tranquilizer Point
55.C1
Eye Disorder 1
98.E
Pineal Gland
143.E
Cingulate Gyrus
157.C
Hypotension
40.0
55.C2 Forehead
Eye Disorder 2
Figure 4.20 Tragusandantitraguszonesandcorrespondingauricular points.
4.6.9 Subtragus zones
ST1 Adrenocorticotropin (ACTH),Surrenalian point.
ST2 Reticular Formation, Vigilance, Postural Tonus, Inner Nose.C (Nasal cavity).
ST3 Master Oscillation point, Auditory Nerve, Deafness, Inner Ear.E, Mutism(Dumb).
Reticular Formation point.
ST4 Larynx and Pharynx.C, Skin Master point.
4.6.10 Intertragic notch zones
IT1 Eye Disorder 1(Mu1). CingulateGyrus, Hypotension point.
IT2 Endocrine point. Internal Secretion. Thyrotropins, ThyroidStimulating hormone (TSH),
Parathyrotropin.
5.0
Endocrine point
(I nternal Secretion)
114.E
AuditoryNerve.E
56.C
I nternal Nose.C
55.C1
EyeDisorder 1
143.E
Cingulate Gyrus
102.E
Thyrotropins (TSH)
157.C
Hypotension
Figure 4.21 Subtragusandintertragic notchzonesandcorrespondingauricular points.
Auricularzones 129
4.6.11 Inferior concha zones
IC1 Anterior Pituitary, Adeno-Hypophysis, San Jiao (TripleWarmer), Prolactin.
IC2 Lung2, Ipsilateral Lung,Anterior Hypothalamus.
IC3 Posterior Pituitary, Neuro-Hypophysis, Trachea, Larynxand Pharynx.E, Vagus Nerve, Bronchi.
IC4 Lung, Heart.C, Bronchi, Tuberculosis point.
IC5 Lung1,Contralateral Lung, Posterior Hypothalamus, Toothache 3.
IC6 Mouth,Throat, Parasympathetic Sacral Nerves, Eye Disorder 3.
IC7 Esophagus, Eye Disorder 3(new Eye point), Cardiac Orifice.
IC8 Spleen.C (left ear), MuscleRelaxation point.
62.0
Cardiac
Orifice
137.E
Posterior
Hypothalamus
159.C
Muscle
Relaxation
'--J:..---- 81.C
Spleen.C
~ ' - - - 70.01
Lung 1
46.C3
Toothache 3
72.0
Trachea
60.0
Mouth
73.0
Throat
71.C
Bronchi
113.E
Vagus Nerve --+--
100.E
Posterior
Pituitary
69.C
99.0 Heart.C
Anterior
Pituitary
70.02
136.E Lung 2
Anterior
Hypothalamus
Figure 4.22 Inferior conchazonesandcorrespondingauricular points.
4.6.12 Concha ridge zones
eR 1 Stomach.
eR 2 Liver, Cirrhosis, Hepatitis.
4.6.13 Superior concha zones
se1 Duodenum,Appendix.
se2 Small Intestines, Appendix, Omega 1,Alcoholic point.
se3 Large Intestines, Colon, Hypogastric Nerve.
se4 Prostate Gland.C, Urethra.E, Hemorrhoids.C2.
se5 Urethra.E, Bladder.
se6 Kidney.C, Ureter.c.
se7 Pancreas, Ascites point.
se8 Gall Bladder (right ear), Spleen.E (left ear).
67.E
Rectum.E
77.0
Appendix
65.0
Small I ntestines
r-,,_......
163.C
Alcoholic point
64.0
Duodenum
Figure 4.23 Superior conchaandconcharidgezones andauricular points.
Auricularzones
86.0
Bladder
85.C
Ureter.C
84.C
Kidney.C
172.C
Ascites
8U
L-+--Spleen.E
131
4.6.14 Concha wall zones
ew1 Gonadotropins (FSH. LH),Ovaries or Testes.c.
ew2 Thalamus point, Subcortex (Dermis), Thalamic Nuclei. Excitement point, Salivary Gland.
ew3 Brain (Diencephalon), Central Rim, Dizziness, Vertigo.Toothache 2.
ew4 Parathyroid Gland, Brainstem, Superior and MiddleCervical Sympathetic Ganglia.
ew5 ThyroidGland.E, Wonderful point, Inferior Cervical Sympathetic Ganglia.
ew6 Mammary Gland.E, Thoracic Sympathetic Ganglia.
ew7 ThymusGland, Thoracic Sympathetic Ganglia.
ew8 Adrenal Gland, Lumbar Sympathetic Ganglia.
ew9 LumbarSympathetic Ganglia.
ew10 Sacral Sympathetic Ganglia.
109.E
Sympathetic
Postganglionic
Nerves
3.0
Thalamus
(Subcortex)
46.C 2
Toothache 2
lOU
Gonadotropins
91.C
Ovaries or Testes
165.C
106.C Excitement
Salivary Gland
94.E
Thymus Gland
95.E
Mammary
Gland
iiiSf:::::::=--- 79.0
Liver
68.E
--1---_Circulatory
System
96.E
Thyroid Gland
97.E
Parathyroid Gland
127.C
Brainstem
176.C
Central Rim
130.C
Brain
132
Figure 4.24 Conchawall zonesandcorrespondingauricular points.
Auriculotherepy fvlanual
12.F4
Lumbar Spine
84.F4
Kidney
27.F4
Foot
23.F4
Knee
13.F4
Sacral Spine
86.F4
Bladder
66.F4
LargeIntestines
83.F4
Pancreas
65.F4
Small Intestines
81.F4
n.----+----Spleen
63.F4
Stomach
79.F4
Liver
60.F4
Mouth
70.F4
Lung
38.F4
Occiput
39.F4
Temples
40.F4
Forehead
45.F4
Upper Jaw
36.F4 --+--u
Shoulder
31.F4
Hand
32.F4
Wrist
21.F4
Hip
43.F4 ----t--l,J
TMJ
44.F4
LowerJaw
10.F4
Cervical Spine
34.F4
Elbow
69.F4 --\------lc---n
Heart
11.F4
Thoracic Spine
49.F4
Tongue
Figure 4.25 Posterior auricular zonesfor thesomatotopicbody.
Auricular zones 133
LM2
LM 1
134
LM 7
LM Al LM Al LM Al
LM 0 HX 1/ CR1 LM 6 HX 15/ LO7 LM 12 AT 1/ AT 2
LM 1 HX 4 / HX5 LM 7 LO1 / LO3 LM 13 AT 2 / AT 3
LM 2 HX 7 / HX8 LM 8 LO1 / Face LM 14 AT 3 / AH 1
LM 3 HX 10 / HX 11 LM 9 IT 1 / TG 1 LM 15 AH 2 / AH 3
LM 4 HX 11 / HX 12 LM 10 TG2 / TG3 LM 16 AH 4/ AH 5
LM 5 HX15 LM 11 TG4 / TG5 LM 17 AH 6 / AH 7
Figure 4.26 Relationshipofauricular landmarks toauricular zones.
Auricular diagnosis
procedures
5.1 Visual observation of skin surface changes
5.2 Tactile palpation of auricular tenderness
5.3 Electrical detection of ear reflex points
504 Nogier vascular autonomic signal (N-VAS)
5.5 Auricular diagnosis guidelines
5.6 Assessment of oscillation and laterality disorders
5.6.1 Physical tests for the presence of laterality disorders
5.6.2 Scoring laterality tests
5.7 Obstructions from toxic scars and dental foci
5.8 Scientific investigations of auricular diagnosis
5.1 Visual observation of skin surface changes
Just asclassical acupuncturistshaveobserved distinct changesinthecolor andshapeof thetongue
andinthesubtlequalitiesof theradial pulse, practitionersof ear acupuncturehaveemphasizedthe
diagnosticvalue of visually examiningtheexternal ear (Kvirchishvili 1974, Romoli & Vettoni 1982).
Thoughnot asroutinelyobserved asotherdiagnostic indicatorsof reactive ear points, prominent
physical attributesof theauricular skinsurface havebeenassociated withspecific clinical conditions.
Thisvisual inspectionof theauricle shouldbeconductedbeforetheear surface iscleanedor
manipulatedfor otherauricular procedures.
Dark colored spots: Shinyred, purpleorbrownspots at distinct regionson theear surface usually
indicateacuteinflammations. Bright redtendstoindicateanacutereactionthatispainful,
whereas dark red isseenwith patientswho have along historyof disease. Darkgrey or darkbrown
can indicatetissue dedifferentiationor tumorscouldbefoundinthecorrespondingorgan. These
colored spotsare not tobeconfusedwith ordinaryfreckles thatdo notnecessarily indicatea
diagnosticcondition. If pressureisappliedtothesecoloredregionsof theauricle, thatspot isoften
painful totouch. Absenceof thesespots doesnot indicatetheabsenceof anymedical problem, but
theoccurrenceof colored regionson theear doessuggest thehighprobabilityof sometypeof
pathologyinthecorrespondingpart of thebody. Thesecolored spotsonlygradually goaway when
thehealthof therelatedbody areaimproves.
White skin: Whiteflakes, crusty scales, peelingskin, sheddingand dandruff-likeareas of
desquamationalways indicateachroniccondition. Whitenesssurroundedbyrednessintheheart
regionindicatesrheumaticheart disease. A close inspectionof theear of many patientsindicates
thatthereisadryness onlocalized regionsof theskin. I ftheauricleiscleaned, thewhiteflaky
regionswill reappear withinseveral days unless thecorrespondingconditionistreated. I fa
treatmentiseffective for healingagiven condition, flaky regions donotreappear.
Physical protrusions: Specific areas of theauricular skin surfacecanexhibit spot-likeprotrusions,
slight depressions, roughthickenedskin or blister-likepapulesprotrudingabove thesurface. The
papules aresmall, circumscribed solid elevations of skin thatcouldbecolored red, whiteor awhite
papulesurroundedbyredness. Sometimesthereisadarkgrey papule.
Ear lobe creases: Diagonal folds intheskinover theear lobehave beencorrelatedwithcertain
types of healthdisorders. Lichsteinet al. (1974) andMehta& Hornby(1974) bothpublished
Diagnosis procedures 135
Groove of
tinnitus --"""";111
Groove of
hypertension ---......,
Tumor-specific
area I by Huang
---Tumor specific
area II by Huang
~ .........,.----Groove of coronary
heart disease
Figure 5.1 Photograph ofan ear lobecrease related to
coronary problems.
Figure 5.2 Representationoffunctional regions on theear identifiedby
DrLi ChunHuangthat havebeen associated withtumorsandcardiovascular
disorders.
136
studiesintheNewEnglandJournal ofMedicinethatdemonstratedsignificant correspondences
betweenear lobecreases and coronaryproblems. Thesedoubleblindclinical studiesshowed that
thepresenceof acrease runningdiagonally fromtheintertragicnotchtothebottomof thelobe
was morepredictiveof theoccurrenceof acoronaryproblemthaneitherbloodpressurelevel or
serumcholesterol level. Huang(1996, 1999) hasreportedthatother ear lobecreases are
associated with theincidenceof cancer.
5.2 Tactile palpation of auricular tenderness
Themost readily available techniquefor determiningthereactivity of auricular reflex pointsisto
apply localized pressuretospecific areas of theauricle. Patientsare oftenvery surprisedthat
palpationof oneareaof theexternal ear issomuch morepainful thanidentical pressureapplied to
anearbyauricular region. Even moreamazingishowthespecific areaof theear hadbeen
previously recognized onear reflex chartsasindicativeof pathological problemsthatthepatient is
experienci ng.
General reactivity: Checkbroadregionsof theexternal ear byusing longstrokingmovements
withyour fingers and byapplyinggeneralized pinchingpressuretogiven regionsof theauricle.
Determineareas of increased ear sensitivity of thepatient toappliedpalpationwith thethumbon
thefront of theear and theindex finger on theposterior sideof theauricle. Ask if thepatient
noticeswhetheroneregionismoretender thananother. Monitorfacial grimaces inresponseto
your tactilepressure. Gentlypinch thetwosides of theauricleat different areas. It isimportantto
develop tactileawareness of thedifferent contoursof thecartilaginous antihelixandthecurving
ridges aroundthehelix. Oneshouldpull downon thefleshy ear lobe and feel throughoutthe
depthsof theconcha. Noteareas of skin surface thatmay berough, bumpy, scaly, waxy, dry, oily,
cold or warm. Especially sensitive patientsexperience tendernessfromeven light touchingof
broadareas of theauricle, and it isimportanttoproceedslowly and gentlywith that individual. For
less sensitive patients, moreselective palpationcan beappliedwithafingernail.
Auriculotherapyfv1anual
Specific tenderness: Localized tenderareas ontheexternal ear are investigatedwith alongmetal
probewitharound, blunt smoothtipapproximately 1.5mmindiameter. Such probesare available
fromacupuncture, medical or dental equipmentsuppliers. Someart supply storesoffer similarly
effective tools for usebygraphicartists, spring-loadedmetal devices with asmall, spherical tip.
Firmlystretchout theauriclewithonehand, whileholdingtheprobewiththeotherhand. Slowly
glidetheprobeover theear surface, stoppingonsmall regions thatthepatientstatesare sensitive
tolightlyappliedpressure. Palpateauricular areas thatyou suspect of beingreactive bytheir
correspondencetothepartsof thebodywherethepatient hasreportedpainor pathology. I f
several pointson theear arefound tobetender, selectively examineeachpointtodeterminewhich
isthemost painful of thegroup. Thedegreeof tendernessusually relatestotheseverity of the
condition. Themoresensitive thepoint, themoreserious thedisorder. Tendernessappearswithin
12hoursafter ahealthproblemoccurs, becomes moresensitive if theconditionworsens, and
disappearswithin7days after theproblemiscorrected. Thereisalearnedclinical skill inknowing
thelevel of pressureneededtodiscriminatethemost accuratepoint thatexhibits thehighest
intensityof tenderness. Avoid overly stressingthepatientwithunnecessarily severe discomfort
whileconductingatactileexaminationoftheauricle.
Behavioral monitoring: Thepractitionershouldask thepatienttoratethedegreeof sensitivity
thatisfelt at each pointon theauriclewhen pressureisapplied. Liketheashi pointsinbody
acupuncture, onecould simply have thepatientsayeither Ouchor Therewhen aregionis
especially tender. Alternatively, onecan usearangeof numerical or verbal responses toindicate
thedegreeoftenderness. A value ofT or Slight couldindicatelowlevel tenderness, 2 or
Moderatecould indicatemiddlelevel tenderness, 3 or Strong couldindicatehighlevel
tenderness, and 4 or Very Strong couldindicateextremely highlevel tenderness. Spontaneous,
facial grimacereactionsor behavioral flinches inresponsetoappliedpressureshouldalso be
noted. A noticeablewincebythepatientwhen you palpateaspecific pointontheear maynot be
comfortablefor thepatient, but it isoneof thebest predictorsthatyou are onan active reflex point
thatisappropriatefor treatment. Nogier referredtothecontractionof face muscles inresponseto
auricular palpationasthesign of thegrimace, themost reliable indicationthatareal ear reflex
point hasbeenlocated. TheChinesehave developed asimilar gradingsystemwherethedegreeof
facial grimaces andverbal expressions isratedasfollows: (-) for nopain, (+)for flinchingor
sayingOuch, (++)for frowning, (+++)for wincing, and (++++)for dodgingaway or saying
thepain isunbearable.
5.3 Electrical detection of ear reflex points
Ofall themethodsfor conductingauricular diagnosis, examinationof theauriclewith anelectrical
pointfinder isthemost reliableandleast aversive. Even small changesinelectrodermal skin
resistancecan bedeterminedbyelectrical detectionprocedures. Formany practitioners, themain
considerationsareeither thecost of aqualitypointfinder or theextratimetakentofirst determine
themost reactive points. Whilebothof theseobjections have theirvalidity, theincreaseinaccuracy
of discovering themost appropriateear point for diagnosis and treatmentof thatclient isworththe
expenseand effort. Familiarityallows even inexpensive but less sophisticatedequipmenttobeused
inaneffective manner.
Clean skin: Toexaminetheear withanelectrical pointfinder, first clean theear with alcohol to
removesources of electrodermal skinresistance. Highelectrical resistanceimpairstheelectrical
pointfindersability todiscriminateactive ear reflex pointsfromnormal regionsof theauricle.
Sourcesof such unwantedskinresistancecould includeearwax, flaky skin, dust fromtheair,
make-upfromtheface, or hairsprayingredients.
Point finder: Use anelectrical point finder designedfor theear bybothitssizeand itselectrical
amperage. Someprobesdesignedfor thebodyare inappropriatefor theear because theyaretoo
bigor usetoohighanelectrical detectingvoltage. Earpointsare smaller, closer tothesurface and
havelower electrodermal skin resistance than dobody acupoints. Thepointfinder shouldbea
spring-loaded, constant pressurerodwith asmall ball at theend. Evenmoreselective are
concentricbipolar probeswith asmall rod inthemiddleand anouter barrel. Bipolar detecting
probesusedifferential amplificationof thevoltage differencebetweenthetwoadjacent
electrodes. Thisprocedureallows for maximumdiscriminationof thedifferenceinelectrodermal
A B
c D
Figure 5.3 Pressurepalpation devices thatare used on theauricle areshownon Point Zero(A) andtheSympatheticAutonomicpoint
(R). A triangular stylus can beusedtodiscern theindentationat landmarkzero (C), andaspring-loadedstylus can maintainconstant
pressure whiledetectingreactive ear points(D).
skin resistancebetweenadjacent skin areas. Theauricular probeisappliedtotheear bythe
therapist, whileanotherlead isheld inthepatientshand.
Electrodermal measurement: Thepractitionermonitorsdecreased skin resistance, or inversely
stated, increased skinconductance, astheprobeisglidedover theskinwithonehandwhilethe
otherhandstretchesout theauricle. Electrodermal activity hasalso beendesignatedasthe
galvanic skin response(GSR), ameasureof thedegreeof electrical current thatflows throughthe
skinfromthedetectingprobetothehandheld neutral probe. Electricitymust always flowbetween
twopoints, thusfor somepointfinders thatdo not utilize ahandheld probe, it isimperativethat
thepractitioner touch theskinof thepatientat theear. Usually alight or asoundfromthepoint
finder indicatesachangeinskinconductance. Dependingontheequipmentsdesign, achangein
theelectrodermal measurementsleads toachangeinauditoryor visual signals toindicatethe
occurrenceof reactive auricular points.
Threshold settings: Someequipmentrequiresanindividual thresholdtobeset for each patient
beforeassessing otherear points. Toset thethreshold, place theprobeon theShen Menpoint or
PointZero, increase thedetectionsensitivityuntil thesound, lightsor visual meterontheequipment
indicatethatthereishighelectrical conductance. Next, slightlyreducethesensitivityuntil theShen
Menpointor PointZeroisonlybarely detected. Itshouldbepossible tofindthesetwomaster points
inall personsexamined, andtheyareusually reactive becausetheyindicatetheeffects of everyday
stress inapersonslife. ShenMenandPoint Zeromaynot bethemost electrically activepointsona
patientsear, but theyarethetwopointsmost consistentlyidentifiedinmost people.
Probe procedures: Slowlyglidetheear probeacross all regionsof theauricletodetermine
localized areas of increased skinconductance(decreased skin resistance). Movingtheprobetoo
quickly can easily missareactiveear point. Applyingtoomuch pressurewith theprobecan create
false ear pointsmerely because of theincreased electrical contactwith theskin. Holdtheauricular
probeperpendicular tothestretchedsurface of theear, andgently glide theprobeover theear,
A B
Figure 5.4 Differentelectrical pointfinder devices havebeen developedin China(A) andinEurope(B). Astheproheglides over the
surface of/heear, changes inelectrodermal skinconductanceareshownbyavariation in therateofaflickeringlight or inthefrequencyof
soundfeedback:
140
usingfirmbut not overly strongpressure. Donot lift and pokewiththeprobe. Theotherhand
supportstheback of thepatientsear. It isimportanttofollowthecontoursof theauriclewhile
applying theprobe, checkingbothhiddenand posterior surfaces aswell asthefront external
surfaceof theauricle. Theback of theear isoftenless electrically sensitivethanthefront of the
auricle, but theposterior sideof theear isusually moretendertoappliedpressurethanisthefront.
Tomorereadily findanear pointontheposterior surface, first detect thepointon thefront of the
auricle, thenputafinger on thatspot andbendtheear over. I tisnoweasier tosearch theback of
theear for theidentical regionontheanterior andtheposterior surface.
5.4 Nogier vascular autonomic signal (N-VAS)
Theauricular cardiac reflexwasfirst describedbyPaul Nogier(1972), andwasonlylater renamedthe
Nogier vascular autonomicsignal (N-VAS).Thepractitionertouchescertainpartsof theexternal ear
whilemonitoringtheradial pulsefor eitheradecreaseor anincreaseinpulseamplitude. Thepulse
mayseemtodiminishandcollapse, or itmayseemtobecomesharper andmorevibrant. The
modificationof thepulsecan occur anywhere fromthesecondpulsebeat uptothetenthpulsebeat
followingauricular stimulation. ThischangeintheN-VAScanlast for 2to4pulsebeats. Thestimulus
couldbetactilepressuretotheskin, but itcould alsobeprovidedbyholdingamagnetover theear
surface, bypulsed laser stimulation, byplacingacoloredplasticfilter over theauricle, or byusinga
slidethatcontainsaspecific chemical substance. Theart of thistechniqueisinlearningtofeel the
subjective subtletiesof theradial pulse. Classical pulsediagnosis aspracticedinOriental medicine
usesthethreemiddlefingerslightlyplaced ontheradial arteryat thewrist (seeFigure5.5A). The
Nogier pulsetechniquerequiresplacement of onlythethumbover theradial artery(see Figure5.5B,
5.5C). Ratherthanfeelingfor steadystatequalities of thepulse, N-VASisachangeinpulse
amplitudeandpulsevolume thatoccurs inresponsetostimulationof theauricle. Masteryof this
techniquerequiresmanypracticesessions withsomeonealreadyskilled intheprocedure.
Ackerman (1999) hasproposedthatN-VASexists asaspecific autonomicbiophysical response
systemconstitutingoneof theprincipal coordinatingandintegratingsystems of thebody. At the
sametime, N-VASisapathwaybywhich thecentral nervous systemreceives informationand
modulatessympatheticoutflowfor precisemodulationof thebloodvascular system. N-VASis
thoughttooccur inevery arteryof thebody and isexpressed throughchangesinsmoothmuscle
toneandbloodinflux. Thisvascular systemiscontrolledbyendothelium-derivedfactors, mainly by
thevasodilator nitricoxide (NO).NOacts directlyonvascular smoothmuscle cells toregulate
vascular tone. Thereleaseof NOismodulatedbywall shear stress, frequency of pulsatileflow, and
amplitudeof pulsatileflow.
Fromthestandpointof informationtheory, theautonomiccontrolledbloodvascular supply could
berepresentedasan analogsystem, contrarytotheneuronsthatoperateasadigital system
consistingof on-or-offneural impulses. Asananalogsystem, thevascular systemisregulatedby
thestrengthof flow, wavelength variations initsstrengthand thedirectionof flow. Theadaptive
capabilityof thevascular systemresultsfrommechanical stimuli such aswall shear stressand
transmural pressurethat ismodulatedbyvascular muscle tone.
5.5 Auricular diagnosis guidelines
Ear as finaL guide: Theauricular chartsdepictingdifferent organsof thebodyaresomatotopic
maps thatindicatethegeneral areainwhich aparticular ear reflex pointcouldbefound. However,
itisthemeasuredreactivity of specific sites ontheauriclewhich serves asthebest determinantof
theexact locationof an appropriateear point. Bymonitoringtheheightenedtendernesstoapplied
pressureand theincreased electrical conductanceat aspecific locus, oneisable toselect themost
relevant ear pointsthatrepresent bodypathology. Theear chartsindicateaterritoryof theauricle
wherethecorrect pointmaybefound, but thereareseveral possiblespotswithin thatregion to
choosefrom. Onlythemost reactiveear pointsdefinitelyrepresent theactual locationof the
somatotopicsite. I fthereisnoreactive ear point inaregionof theauricle, thereisno body
pathologyindicatedfor treatment.I fthereisnopathologyinthecorrespondingbody area, there
will benotendernessor electrical activity at therelatedmicrosystempointon theear. When
choosingbetweendifferent ear pointsto treat, whether it isintheChinesesystemor theEuropean
system, whetherit isintheNogierfirst phaseor secondphase, thisfundamental principle, thatthe
ear itself isthefinal guide, shouldalways befollowed.
Aur;culotherapyManual
A
B
Diagnosisprocedures
c
Figure 5.5 InOriental pulsediagnosis (A), three
fingers areplaced on each wrist todetect differencesin
theposition, depth andqualities ofthesteady pulse.
Practitioners ofauricular medicinein Europeholdthe
wrist at onlyoneposition (B) andfeel for changes in
theamplitudeandwaveformoftheradial pulsein
responsetostimulationoftheear bylightpassing
through afilter (C).
141
142
Alternativepointswithinanarea: Theactual auricular pointconsists of asmall sitewithina
general areaof theauricleindicatedbythesomatotopicauricular map. Theear reflex point
representingaparticular part of thebodycan befoundinoneof several possible locationswithin
thisarea. Insomeindividuals, theear pointwill befoundinoneauricular location, whereas in
otherpersons, itwill befoundinanearbybut different auricular location. Thelocationof apoint
maychangefromoneday tothenext, thusit isessential thatonechecks for theear point that
exhibitsthehighest degreeof reactivity at thetimesomeoneisexamined.
I psilateral ear reactivity: In80-90%of individuals, reactive ear reflex pointsarefoundon the
sameear as thesideof bodywherethereispainor pathology. Intheremaining10-20%of cases,
therepresentationiscontralateral, andthemost active ear point isfoundon theoppositeside of
thebody. Since most clinical problemshave abilateral representation, it iscommontotreat both
theright and theleft ears on apatient. I ftreatingjust oneear of apatient, it isusually best to
stimulatetheear which isipsilateral tothesideof thebodywith thegreatest degreeof discomfort.
Thosefewpersonswho exhibit contralateral auricular representationof abodyproblemare
referredto aslateralizers or oscillators, and needspecial consideration.
5.6 Assessment of oscillation and laterality disorders
Personswhohavedifficulties withneural communicationbetweentheleft and theright sides of the
brain arereferredtoashavingproblemswithlateralityor oscillation intheEuropeanschool of
auriculotherapy. Thiscrossed-lateralityconditionissometimesidentifiedasswitched or cross-wired
incertainAmericanchiropracticschools. It isasif thetwocerebral hemispheresarecompetingfor
control of thebodyrather thanworking inacomplementaryfashion. Lateralityproblemsaretypically
found inthe10-20%of thepopulationwhichexhibits higherelectrically conductivityat ear reflex
pointsonthecontralateral ear thanontheipsilateral ear. Usually thesepatientsshowhighelectrical
conductanceat theMasterOscillationpoint,but not everyonewhohasanactive MasterOscillation
point isanoscillator. Oscillationcan also beduetosevere stress or dental foci. TheMasterOscillation
pointinpatientswithlateralitydisordersneedstobecorrectedwithacupressure, needlingor
electricationstimulationbeforethat patientcan receive satisfactory medical treatment.
It isbelieved thatmanyfunctional disordersareduetodysfunctionsintheinterhemispheric
connectionsthroughthecorpuscallosum, theanteriorcommisureandthereticular formationof the
brain. Thereisinappropriateinterferenceof onesideof thebrainbytheothersideof thebrain.
Global relationshipsthatshouldbeprocessed bytheright cerebral hemisphereare analyzed bythe
left cerebral cortex. Verbal informationthatshouldbeprocessed bytheleft cerebral hemisphereis
processed bytheright cerebral cortex. Such individuals frequentlyexhibit dyslexia, learning
disabilities, problemswithorientationinspace and aresusceptibletoimmunesystemdisorders.
Peoplewith lateralityproblemsreport thattheyoftenhadproblemsinelementaryschool withpoor
concentration, stuttering, spelling mistakes, attentiondeficit, andfeeling different fromothers. As
adolescents, theyexperienced frequent anxiety, hyperactivity, gastrointestinal dysfunctions andthey
oftenmisgauged distancesor trippedover things. Oneway apersonmay recognizethattheyare an
oscillator isthattheyhaveoverly sensitive or ratherunusual reactionstoprescription medications.
Dysfunctionsof lateralityandoscillation arefound moreofteninleft-handedor inambidextrous
persons. Theproportionof dyslexia andotherlearningdisordersissignificantly higherinleft
handersthaninright-handers. Lateralityproblemsare rarely noticeablebeforetheageof two, but
cerebral organizationbegins tobedefinitelylateralized bytheageof seven, theageof reason. I tis
fromthisagethatdisordersof lateralitymayfirst appear.
5.6.1 Physical testsfor thepresence of lateralitydisorders
Handwriting: Haveapersonwritesomething. Whichhanddid theyuse, theright handor theleft
hand? Manyindividualsweretrainedtowritewith theirright handwhentheywerechildren, even
thoughtheywere naturallyleft handed. Forthatreason, someof thefollowing testsmay beamore
authenticappraisal of their actual lateralitypreference.
Handclap: Haveapersonclap their handsas if theyweregivingpoliteapplauseat asocial
function, with onehandon topof theotherhand. Whichhandisontop?
Handclasp: Haveapersonclasp their hands, withthefingers interlocked. Whichthumbisontop?
Armfold: Haveapersonfold their arms, withonearmon top of theother. Whicharmison top?
Thehandthattouchesthecrease at theoppositeelbowisconsidered thearmthatison top.
Foot kick: Haveapersonpretendtokick afootball. Whichfoot do they kickwith, theright or the
left foot?
Eye gaze: Haveapersonopenbotheyes and thenline uptheraised thumbof their outstretched
handtowardasmall point on theoppositewall. Alternatively, have thepersonmakeacircular hole
bypinchingtheir middlefinger totheirthumb, thenlook at thespot throughthehole. Ineither
case, next have themclose first oneeye, openagain, thenclose theothereye. Closingoneeye
producesagreater shift inalignmentwith theobject on theoppositewall thanclosing theother
eye. I ftheobject shifts moreonclosing theright eye, thentheright eye isdominant; if thepoint
shiftsmoreonclosing theleft eye, thentheleft eye isdominant. Alternatively havesomeonenotice
which eyetheywould leave openandwhich theywould close if theyweretoimagineshootinga
target with arifle. Theeye used for aimingtheriflewould bethedominanteye.
5.6.2 Scoring laterality tests
Eachof theabovebehavioral assessments isscored aseitherrightor left. I fapersonscores 4or moreon
theleft side, that individual islikelytohavealateralitydysfunction. Theymight alsohaveproblemswith
spatial orientation,dyslexia, learningdifficulties, allergies, immunesystemdisorders andunusual
medical reactions. Lateralitydoesnot necessarily produceamedical problem, asmanyindividualslearn
tocompensatefor thisimbalanceover thecourseof their lifetime.At thesametime, theymayhave
certainvulnerabilities thatconventional medicinedoesnot allowfor. Thedosageandincidenceof side
effectsof Westernmedications arebasedontheaverage responsebyalargegroupof people, but donot
takeintoaccount theidiosyncraticreactions of unusual individuals. Personswithlaterality dysfunctions
must beverycareful about thetreatmentsthat theyaregivenbecause of their highlevel of sensitivity.
5.7 Obstructions from toxic scars and dental foci
Inadditiontoidiosyncratic problemsattributabletolateralitydisorders, otherfactors mayalso
interferewithsubsequent pathologiesthathave alongstandingnature. Thefailure tocompletely
heal fromoneconditionmayact asasourceof disequilibriumthatblocks thealleviation of newer
healthproblems. Twosuch sources of obstructionare (1) toxic scars fromoldwoundsor previous
surgeries, and(2) damagedtissue frominvasive dental procedures. Toxicscars couldoccur on the
skin surface or indeeper structures, creatingaregion of cellular disorganizationthatemits
abnormal electrical charges. Thispathological tissuegeneratesadisharmoniousresonancecausing
chronicstress and interferencewithgeneral homeostaticbalance. Abnormal sensations, such as
itching, numbness, pain or soreness, oftenoccur intheregionof toxic scars. Besides checkingthe
regionof theexternal ear thatcorrespondstoabody areathatwas previously injured, also examine
theskin disorder regionof theexternal ear. Dental procedures, such as removingdecayed teethor
drilling aroot canal, are beneficial for dental care, but they mayalso leave adental focus that
interfereswith general healthmaintenance. Dental foci mayfollow dental surgery, berelatedto
bacterial foci under afilling, or result fromanabscess or gumdisease. Theremay also be
pathogenicresponses tomercuryfillings. Patientsthemselves are oftenunawareof having such a
disorder, since theconsequenceof theseprevious scars may not necessarily beexperienced at a
conscious level. Thesepathological regionsmaybeelectrically detectedat theauricular areathat
correspondstothesiteof thetoxic scar or dental focus. Theymayalso bediscovered bymonitoring
theN-VASresponsetostimulationof theaffected regionof thebody. Onlywhen thistoxic scar
regionissuccessfully treatedcan otherhealthcareproceduresbeeffective.
Sometimesonesownpersonal experienceisthemost impressive sourceof confirmationfor accepting
anewconcept inhealthcare. WhenI wasanadolescent, I dislocatedmyright shoulder duringa
skateboardaccident. I also hadmywisdomteethremovedbyanoral surgeon. AsI becameanadult,
thechronicstress of everyday livingwasmost stronglymanifest asdiscomfortingshoulder aches, but I
never experienced jawpain. Frequentmassages, chiropracticadjustments, acupuncturesessions and
auriculotherapytreatmentsall producedtemporaryrelief of theshoulder pain, but therewasnostable
resolution. Myearswere recently examinedbyaGermanphysicianwhopractices auricular medicine.
DrBeateStrittmatterrevealed atoxicscar at thelocationof thewisdomtoothat theleft lower jaw.
Theinsertionof aneedleat apointontheleft ear lobewhichcorrespondedtotheleft mandiblewas
addedtostimulationof theShoulderpointontheright auricle. Thistreatmentof thedental
obstructionaswell asthecorrespondingShoulderpointontheauricle ledtoanimmediatecorrection
of ashoulder conditionthathadbeenaproblemfor years.
144
5.8 Scientific investigations of auricular diagnosis
Auricular diagnosis ismostly used for detectionof active pointson theear which needtobe
treated, rather thanasaprimarymeansof diagnosingapatient. Nonetheless, findings from
auricular diagnosis can reveal aclinical problemmissedbyothermedical examinationprocedures,
or verify aproblemonlysuspectedfromotherdiagnostictests. Physical auricular reactionsmay
appear beforethebodysymptomsappear or reveal apermanentreactive markof pathologyinthe
correspondingbodyorgan. Theauricular pointschangewith thevarious stagesof an illness or
injury, includingtheinitial occurrence, continueddevelopment, and ultimateresolution. Reactive
auricular pointsreflect theongoinginformationabout adisease, not onlythehealthcondition
occurringinthepresent. I tcan indicatethestateof an illness or injury inthepast or inthenear
future. Positiveauricular pointsmayhave adifferent appearanceindifferent stagesof adiseases
and indicatewhenapathologyiscompletely healed.
At the1995I nternationalSymposiumonAuricular MedicineinBeijing, China, several scientific
studies indicatedthat auricular diagnosis hasbeen used todetect malignanttumors, coronaryheart
disease andpulmonarytuberculosis. Onestudyfoundthat36of 79cases of colon cancer showed dark
redcapillaries inthesuperior concha, 54of 78cases of lungcancer revealed brown pinpoint
depressionsscatteredinpatchesintheinferior concha, and 16of 31cases of uterinecancer showed
spotteddepressionsintheinternal genitals areaof theconchawall. Nosuchchangesinthecolor or
themorphologyof correspondingear pointswerefound innormal control subjects. Another
investigation showedthat 116patientsoutof 1263hospitalizedpatientshadreactive Liver pointson
theear. Furtherexaminationof these 116patientsrevealed 80cases of hepatitis. Still anotherstudy
found that of 84cases diagnosedwithultrasoundtohavegall bladder disease, 81%showed adark red
region inthegall bladder areaof theauricle. In93%of cases of chronicgastritis, thestomachand
duodenumauricular regions appearedwhite, shinyandbulgywhentherewasnoacuteinfection. In
contrast, thesetwopointsappeareddeepredwhentherewasanacutegastric disorder. Theresults of
usingpressureor electronicdetectionwereessentially thesameasvisual observation.
Dr Michel Marignan(1999), of Marseilles, France, reportedon hisinvestigationswith digital
thermographyof theear at theI nternational ConsensusConferenceon Acupuncture,
Auriculotheraphy, andAuricular Medicine(I CCAAAM).Skintemperatureradiationsfromthe
auricular surfacewere measuredwithan infraredcamera. Thephotographyequipmentwas cooled
with liquid nitrogenand acomputerwas especially adaptedfor thisprocedure. Thetemperature
variationsof radiationacross thehumanear changedinresponseto stimulationof various areas of
theear pavilion. Marignansuggested thatreactive auricular pointsareduetomicroscopic thermal
regulation. Theevidence of correspondencebetweenanatomical localization and theauricular
thermal reactionprovidedascientific basis for auriculotherapy. At thesameI CCAAAM
conference, EdwardDvorkin(1999) of I srael examined active auricular pointsfromskinsamples
obtainedinhumansundergoingsurgery. Someskinsamplescorrespondtoear pointsthatwere
detectedbeforesurgery bymonitoringtheNogiervascular autonomicsignal andbyelectrical
detection. Small piecesof skinwere takenfromhealthytissueat thesurgical edgesof auricular
regionscorrespondingtotheThalamuspoint, theAllergy point, theAntidepressantpoint and the
Aggressivity point. A neutral part of theauricular skin of each patientwas also takenfor
comparisonexamination. Electronmicroscopy examinationof ultrathinsectionsof all thestudied
zones revealed thefollowing findings:
thick nervebundleswith myelinated aswell asnon-myelinatednervefibres;
solitarythinbundlesof non-myelinatednerve fibres;
mast cells relatedtobloodvessels andnerves;
numerousveins withoutinnervation;
solitary arterieswithoutinnervation.
However, nospecific ultrastructureor morphological substratumwas foundinDvorkinsstudy for
active ear reflex pointscomparedtoneutral ear points. Thedistinctivecharacteristics of active
auricular pointsmust thusbebased onphysiological ratherthananatomical structural differences.
Theresearch byMarignansuggests thatperipheral sympatheticnervecontrol of bloodvessels
supplying theauriclecan betteraccount for active auricular points.
I I
Auriculotherapy treatment procedures
6.1 Auricular acupressure
6.2 Earacupuncture needling techniques
6.3 Auricular electroacupuncture stimulation (AES)
6.4 Transcutaneous auricular stimulation (TAS)
6.5 Auricular medicine
6.6 Seven frequency zones
6.7 Semipermanent auricular procedures
6.8 Selection of auricular acupoints for treatment
6.9 Tonification and sedation inauriculotherapy
6.10 Relationship of yin organs to ear acupoints
6.11 Geometric ear points
6.12 Inverse and contrary relationships of the ear and body
6.13 Precautions associated withauriculotherapy
6.14 Hindrances to treatment success
6.15 Overall guidelines for auriculotherapy treatments
6.1 Auricular acupressure
I. General massage: Strokebroadregionsof theexternal ear byrubbingthethumbagainst the
front of theauricle, whilethetipor lengthof theindexfinger isheldagainst theposterior sideof
theear for support. First strokedownthetraguswiththethumb, thenspreadthestrokesacross the
ear lobe toinduceageneral calming effect. Next, strokefromthebeginningof thehelix root at
landmarkzeroand riseupand aroundthecurving helix, endingat thebase of thehelixtail.
Proceedbystrokingacross theantihelixtail, beginningat thebase, thenwork uptheantihelix. In
eachcase massage across theinnerridge of theantihelixoutwardtowardthescaphoidfossa and
helixrim. Endwithgentlestrokesthroughoutthesuperior concha, concharidge, and inferior
concha. I fpatientsaretaughttodothisprocedureonthemselves, their indexfinger isusedonfront
of theear and their thumbisplacedontheback of theear.
2. Specificmassage: Applyametal styluswithasmall ball at theend(see Figure6.1) totheauricle.
Palpatethemost reactive ear pointdeterminedduringauricular diagnosis. Youcould also usethe
eraser endof apencil or afingertip. Holdtheauricle tautwiththeoppositehand. Micromassageof
anear pointmayfirst lead toanincrease inpainat that point,but thetendernesscangradually
diminishanddisappear asthemassage iscontinued. Thedirectionof massage canvary. Adoptthe
onethat isleast tenderandmost tolerablefor thepatient. For neck, back andshoulder tension, apply
firmbut gentlepressureontheantihelixtail, antihelixbody, inferior crus andscaphoidfossa. For
headaches, specific pressureisappliedtotheantitragusandantihelix tail. Visceral dysfunctions are
treatedwiththestylusprobepressedagainst specific regions of theconcha.
3. Auriculopressuretechniques: Massageeachtenderear pointfor 1to2minutes, repeatingthe
process once or twicedaily. Apply massagewithacircling motion, first noticingwhich direction
producestheleast discomfort. A morelongitudinal massage along theouterhelixor antihelix
reduces muscle tensionand sympathomimeticexcess excitation. Descendinglongitudinal strokes
tendtotonify muscles and excite sympatheticactivity, while ascendinglongitudinal strokestend to
relax muscles and enhanceparasympathetictone. A radial centrifugal massage away from
landmarkzeroacross theconchaenhancesparasympatheticsedationandvisceral relaxation.
Treatmentprocedures 145
146
Figure 6.1 Ear acupressure massagecanbeactivatedwithametal stylusappliedtospecificpartsoftheauricle
whiletheopposinghandprovidesbackpressure.
Massagingthetragusdownwardand outward, fromsuperior toinferior, can augment cellular
reactionsandinterhemisphericcommunication, whereas massaging thetragusupwardand inward,
frominferior tosuperior, tendstoslowdown metabolismand calminterhemispheric
communicationbetween thetwosides of thebrain.
6.2 Ear acupuncture needling techniques
1. CLean ear: After conductinganyvisual inspection necessary for auricular diagnosis, clean the
ear with alcohol. Thissterilizes theskin and removeswax, oils, sweat, grease, make-upand
hairspray. Besides itsantisepticvalue, removingoilysubstances fromtheskin surface of theear
improves theability todetect auricular pointswith electrical pointfinders.
2. Prepare needLes: Unpackat least 5sterilized0.5inch(15mm) needles, tobeinsertedipsilaterally
or bilaterally. Shorterneedlesarepreferred, sincelonger needlestendtofall out tooeasily. Thicker
needlediametersizesof30gauge(0.30mm), 32gauge(0.25mm) or 34gauge (0.22mm) arepreferred
for theear, sincethinnerneedlestendtobendoninsertion. Stainless steel needlesareappropriatefor
most clinical purposes, althoughbetterresults aresometimesobtainedbyusinggoldneedlesonone
ear andsilver needles ontheoppositeear. Knowledgeof theNogier vascular autonomicsignal is
necessary todeterminewhethergoldor silver needlesaremoreappropriatefor whichear.
3. Determine treatment pLan: Examinethespecific treatmentplanslisted inthelast section of
thistext toselect theauricular pointswhich are most appropriatefor theconditionbeing treated.
A typical treatmentincludes thecorrespondinganatomicpoints, selective master pointsand
supportivepointslisted for thatcondition. Youshouldnot treat all of theear pointslisted, only
thosewhich are themost tenderand showthehighest electrical conductance.
4. SeLect ear points: Detect2to6pointsoneach ear with anelectrical pointfinder, selectingonly
themost reactive points. Thepointfinder shouldbespring-loadedandwill leave abrief
AuriculotherapyNanual
Figure 6.2 Needleinsertion techniquesdemonstratedon arubber modelear.
indentationat theear point if stronger pressureisappliedwhen areactiveear point isdetected.
Usethatindentationfor identificationof theregion of theauriclewheretheneedleshouldbe
inserted. Theorder inwhich auricular pointsare needleddependsmoreon thepractical
convenienceof their locationthanonthepriorityof theirimportancefor treatingthatspecific
condition. Needlesarefirst insertedinto ear pointswhich arelocated inmorecentral or hidden
regions of theauricle because needlesinmoreperipheral areas of theear would get intheway.
5. Needle insertion: First stretchout theauricle withonehandwhileusingtheotherhandto
holdtheneedleover theappropriateear point(see Figure6.2). Avoid doingone-handedear
acupuncture, onlyusingthehandholdingtheneedle. I nserttheneedlewithaquick jabandatwist
toadepthof 1to2mm. Theneedleshouldjust barely penetratetheskin, but it isacceptable if it
touchesthecartilage. Theneedleshould beinserteddeepenoughtohold firmly, but not sodeep
thatit pierces throughtotheotherside(see Figure6.3). Becareful not tolet theneedlepiercethe
handthatisstabilizing thepatientsear.
I tisusually morecomfortablefor thepatientif theneedleisinsertedon thepatientsinhalation
breath. Thepatientmaygasp or chokewhen aneedleisinsertedintoaparticularlysensitive
region. Eventhoughtheneedlemayproduceintensediscomfort onfirst insertion, thisadverse
effect isshort lived andthepainquickly subsides. Theintensityof painat anauricular pointis
usually asign that thepointisappropriatefor treatment. Guidetubesthatareoftenused toinsert
needlesintobodyacupuncturepointsare not neededbecauseof theshallow depthof ear points. I t
isbettertolocatetheneedlebysight precisely over anear point previously identifiedbyskin
surface indentationfromapointfinder. I nsert all theneedlesyou plantouseat onetimeandleave
theminplace. Youmayperiodically twirl theneedlestomaintainafirmconnectionand tofurther
stimulatethatauricular point. Bleedingmayoccur when aneedleiswithdrawnfromtheear, but
gentle pressureappliedtothepointusually stopsthebleedingwithinafewseconds.
6. Treatment duration: Leaveall theinsertedneedles inplacefor 10-30minutes, thenremoveand
placetheusedneedles inanapproved container. Someneedlesfall out beforethesession isover,
whichtendstoindicatethat theparticular needleinsertionpoint hadreceived sufficient stimulation.
148
Figure6.3 Half-inchneedles insertedintotheauricular acupointsShenMen, Point Zero, and Thalamuspoint.
7. Numberof sessions: Treat 1-3timesaweek for 2-10weeks, thengradually spaceout the
treatmentsessions. A given conditionmay requireas few as 2or as manyas 12sessions, depending
on thechronicityandseverity of theproblemandon thepatientsenergylevel. If after 3sessions
thereisno improvement inthecondition, either use adifferent set of ear pointsor tryanother
formof therapy.
6.3 Auricular electroacupuncture stimulation (AES)
1. Earneedlingtechniques: For electroacupuncture, first use needlingtechniquesdescribed in
theprevious section to detect theappropriateear pointsandto insert theneedles.
2. Tapeneedles: Inorder to holdtheinsertedneedles securely inplace, tapetheneedlesacross
theear withmedical adhesive tape. Attachingthestimulatingelectrodeswill tendto pull out the
needles, unless theyarefirst fastenedwithprotectivetape.
3. Attachelectrodes: Usemicrogator clips to connect theinsertedneedles to theelectrodeleads
of an electrical stimulator (seeFigure6.4). Because thesemoveable clips may pull out theinserted
needleswhenattached, makesurethat theneedles arefirst securely tapedinplace. I tisalso wise to
fasten theelectrodewires to asecureanchor so thatthewireswill not dragontheneedlesandpull
themout.
4. Electrodepairs: It isalways necessary tostimulatebetween two needles, as electricity flows
fromapositive to anegativepole. It doesnot usually matterwhichpoleof thestimulator is
attachedto which ear point, but if thepatient reportsany increaseinpain, tryswitchingthe
electrodeleadsto theoppositepolarity.
5. Frequencyparameters: Preset theelectrical frequency rateto either aslow 2Hzor 10Hz
frequency, or to aparameter known as dense-disperse, where2Hzfrequencies arealternated
with 100Hzfrequencies (see Figure6.5). Lower frequencies, 10Hzor less, affect enkephalins,
endorphins, andvisceral andsomaticdisorders, whereas higher frequencies, 100Hz or higher,
affect dynorphinsandneurological dysfunctions.
A
B
Figure 6.4 Alligatorclipelectrodes attachedtoneedlesinsertedintotheShenMenandLungpointsoftheauricle(A).Electroacupuncture
stimulationequipmentisshownwithelectrodewiresleadingtoneedlesinarubberearmodel (B).Needlesinthisfigurearenotshowntapedto
theear toallowgoodvisualizationoftheattachmentofelectrodes to theacupunctureneedles, huttheywouldtypically hetapedsecurely in
place.
Hz
5 Hz frequency
20 llA current intensity
1.0 s stimulus duration
10 Hzfrequency
40 llA current intensity
2.0 s stimulus duration
1.0 s
Figure 6.5 Thestimulationparameters used inactivatingauricular acupoints can vary byfrequencyincycles per second, byintensityin
current amplitude, andbyduration inthenumberofsecondsapointisstimulated.
6. Currentintensity: Graduallyraise theelectrical current intensitytoaperceptiblelevel and
thenreduceit toasubpainthreshold. Theelectrical stimulationintensityshouldnotbepainful.
7. Treatmentsessions: Aswith auricular acupuncturewithoutelectrical stimulation, leave the
needlesinplace andmaintainthestimulationcurrentfor 10-30minutes. Treatthepatientonceto
threetimesaweek, for 2to10weeks. Whilemorecumbersometoapply thanneedleinsertionalone,
electroacupunctureistypically morepowerful and moresuccessful inrelieving pain and alleviating
theproblemsof addiction.
6.4 Transcutaneous auricular stimulation (TAS)
I. Overview: Inthistreatmentmethod, thetherapist detectsandstimulateseachear pointwith
thesameelectrical probe. Theauricular pointisdetectedand thenimmediatelytreatedwith
microcurrent stimulationbeforemovingontothenext ear point. It isaformof transcutaneous
electrical nervestimulation(TENS)or neurostimulationand can be medically billed assuch.
Beforebeginningauriculotherapy, it isbest tohave thepatientrepeat thosemovements, or
maintainthosepostures, which most aggravate hisor her condition. It isalso useful for the
practitionertoputphysical pressureon thosebody areaswhich arepainful. Onecan thusestablish
abehavioral baselinefromwhich therecan beseen achangeasaresult of thetreatment.Thesame
movements, postures, or appliedpressures arerepeatedfollowing thetreatment.Thispractice
tendstoeliminatedoubtsabout theprocedurewhich oftenoccur whenonly subjective impressions
are elicited. A facial grimacebythepatientduringmovements, or inresponsetopressure, ismuch
moreconvincingthanverbal assessments thatit hurts.
2. Cleanear: Cleantheexternal ear with alcohol toeliminateskin oil andsurfaceflakiness.
Havingaclean auricular surface isvery importantfor determiningtheaccuracy of reactiveear
pointsthatwill betreatedwith transcutaneousauricular stimulation.
3. Determinetreatmentplan: Aswith otherauricular procedures, consult thespecific treatment
planslistedinlast section of thistext toselect theauricular pointswhichseemmost appropriatefor
theconditionbeingtreated. First treat local anatomicpointscorrespondingtospecific body
symptoms. I fthereismorethanonelocal point, only treat themost tenderand most electrically
conductivelocal points. Next treat master pointsand supportivepoints.
A
B
Figure 6.6 Transcutaneousstimulationoftheskin surface ofan auricular acupoint andthehandheldreferenceprobe(A). StimFlex
equipmentthatprovides aprobefor bothauricular detectionandauricular stimulation(B), oneofseveral possible electrical stimulation
devices.
152
4. Threshold setting: Someinstrumentsrequirethepractitioner tofirst set athresholdlevel by
raising thesensitivity of theunit toallow electrical detectionof theShenMenpointor PointZero.
Mostreactivecorrespondingpointsare typically moreelectrically conductivethanShenMenor
PointZero, but thesetwo master pointsaremoreconsistentlyactive inamajorityof clients.
Sometimes, byfirst stimulatingoneof thesetwomaster points, otherauricular pointsbecome
moreidentifiablefor detection. Thisprocess iscalled lightingup theear.
5. Auricular probe: Applytheauricular detectingandstimulatingprobetotheexternal ear,
stretchingtheskin tightly toreveal different surfaces of theear. Thepractitionersotherhand
supportstheback of theear sothatbothit and theprobearesteady. Gentlyglide theauricular
probeover theear, holdingtheprobeperpendicular totheear surface. Donot pick up theprobe
andjab at different areas of theear. Thepatient usually holdsacommonlead inoneof their hands
inorder tocompleteafull electrical circuit. Electriccurrent flowsfromthestimulatingequipment
totheelectrodeleads totheear probeheldtothepatientsauricle. Currentthenpasses through
thepatientsbody tothepatientshandtothemetal commonlead. Finally, thecurrent goes
throughthereturnelectrodewires and back totheelectronicequipment. I fthereissomeproblem
withstimulation, besurethatall partsof thecircuit arecomplete. Therecould beabreak in
electrodewires or thepatientmayfail tocontinueholdingthecommonlead.
6. Detection mode: Diagnosisof reactive ear pointsisachieved with lowlevel direct current
(DC).Themicrocurrent levels used for detectionareusually only 2microampsinstrength. The
detectingcycle isusually indicatedbyachangeinacontinuoustoneor byalight thatflashes when
areactive point isdetected.
7. Stimulation mode: Reactive ear pointsdiscovered duringauricular diagnosis aretreatedwith
alternatingcurrent (AC). Themicrocurrent levels used for treatmentaretypically 10-80microamps
instrength. Thetreatmentcycle isusually indicatedbyapulsatingtoneor aflickering light. It is
usually necessary topressabuttonontheauricular probewhile it isheldinplaceat areactive ear
point. Detectand stimulateoneear pointbeforeproceedingtothenext ear point.
8. Stimulation frequency: Preset thefrequency rateof stimulation, measuredincycles per
secondor Hertz(Hz),bythespecific zoneof theear tobestimulatedor bythetype of body tissue
tobetreated. AlthoughAsianelectronicequipmentisoftensuppliedwithonly onefrequency,
usually 2Hzor 10Hz,Americanand Europeanelectronicequipmentcomeswith arangeof
frequency ratestochoosefrom. Thespecific frequencies developed byNogier areas follows:
2.5Hzfor thesubtragus, 5Hzfor theconcha, 10Hzfor theantihelix, antitragusandsuperior helix,
20Hzfor thetragusand intertragicnotch, 40Hzfor thehelix tail, 80Hzfor theperipheral ear
lobe, and 160Hzfor themedial ear lobe. Thetypeof organtissue beingtreatedisalso afactor,
with5Hzusedfor visceral disorders, 10Hzfor musculoskeletal disorders, 40Hzfor neuralgias,
80Hzfor subcortical dysfunctions and 160Hzfor cerebral dysfunctions.
9. Stimulation intensity: Set theintensityof stimulationbythepatientspaintolerance, usually
rangingfrom10-80microamps. Lower thecurrent intensityif thepatientcomplainsof painfrom
theauricular stimulation. I feven thelowest intensityisexperienced as painful, thenonly auricular
acupressure shouldbeused at thatear point. A major problemwithelectrical stimulatorsthatarc
designedfor treatingthebody aswell astheear isthat theskin surfaceon thebody has amuch
higher resistancethandoes theear. Consequently, electrical current levels thataresufficient to
activatebody acupointsaretoo intensefor stimulatingauricular points. Practitionersshouldbe
clear not toconfusestimulationfrequency withstimulationintensity. Frequencyrefers tothe
number of pulses of current inaperiodof time, whereas intensityrefers totheamplitudeor
strengthof theelectric current. Onlyintensityisrelatedtoperceived pain, whereas frequency is
relatedtothepatternof electric pulses.
10. Stimulation duration: Treat each ear pointfor 8-30seconds, sometimestreatingfor aslongas
2minutesinchronicconditions, addictionsor very severe symptoms. Anatomicpointsare usually
treatedfor over 20seconds, whereasmaster pointsmayonlyrequire10secondsof stimulation.
11. Number of ear points: Treat5to15pointsper ear, using asfewauricular pointsaspossible.
Usually treat theexternal ear ipsilateral tothecorrespondingbody areawherethereispathology.
12. Bilateral stimulation: After treatingall thepointson theipsilateral ear, stimulatepointson
theoppositeear if theproblemisbilateral, i.e. inmost healthproblems. Evenwhen theproblemis
localized on onesideof thebody, it isoftenuseful totreat themaster pointsonbothears.
13. Tenderness ratings: Thepreciseear pointsdetectedand thelevel of stimulationintensity
used dependspartlyonthedegreeof tendernessexperienced bythepatient. Ratingsof tenderness
couldbeaverbal descriptor or couldbenumbersonascale of 1to10or 0, 1,2,3 levels of
increasingdiscomfort. Ask thepatient tomonitortheareaof bodily discomfort whileyou stimulate
theear. Continuetreatinganear point longer if thesymptomstartstodiminish, or ifthepatient
noticessensationsof warmthintheareaof thebodywherethesymptomislocated. I fnosymptom
changesare noticedwithin30seconds, stimulateanotherpoint.
14. Number of sessions: Twototenauriculotherapysessions areusually requiredtocompletely
relieve acondition,but significant improvementcanbenoticedwithinthefirst twosessions. By
monitoringperceived painlevel inabodyregion, andbydeterminingtherangeof movementof
musculoskeletal areas, onecanmoreeasilydeterminetheprogress of theauriculotherapytreatments.
Thesebehavioral assessments shouldbeconductedbeforeandafter anauriculotherapysession. For
internal organs andneuroendocrinedisorders, thereisoftennospecific symptomtonotice, soone
mustwait toobserve achangeinthepatientscondition. Evenfor musculoskeletal problems, there
maynot beamarkedrelief of painfor several hours, sothepatientshould continuetomonitortheir
symptomsfor thenext 24hoursafter asession.
15. Laser stimulation: Theexact proceduresdescribed above can beappliedtolaser stimulation
aswell astoelectrical stimulation. Bothlaser stimulationand transcutaneouselectrical stimulation
are non-invasiveproceduresand theyseemtoyield similar results. However, at thepresent time,
theUSFoodand DrugAdministration(FDA)hasnot approved theuse of laser stimulationfor
auriculotherapyintheUnitedStates. Surfaceelectrical stimulationof theexternal ear isFDA
approved as aformof transcutaneouselectrical nerve stimulation.
16. Medical billing: Tobill for auriculotherapyasTENS,assign theCPTCode64550for peripheral
nerveneurostimulationor CPTCode97032for electrical stimulationwithconstanttherapist
attendance. CPTCode97781for acupuncturewithelectrical stimulationcan alsobeused.
17. Stimulation equipment: Various American, EuropeanandAsianmanufacturersproduce
electronicequipmentdesignedfor auricular stimulation, ranginginpricefrom$80to$8000(US).
Amongtheunitsavailable intheUnitedStatesare theAcuscope, Acumatic, Alpha-Stim,Stim
Flex400, Hibiki 7, Neuroprobeand PointerPlus. Addressesand telephonenumbersfor these
manufacturersarefound at theback of thisbook.
6.5 Auricular medicine
EuropeandoctorswhomonitortheNogiervascular autonomicsignal (N-VAS)todeterminewhich
ear pointstostimulaterefer tothisclinical procedureas aurieular medicinerather than
auriculotherapy. Thesomatotopiccartographyof theauricleisverified byapositive or anegative
changeinradial pulse amplitudefollowing tactilepressureat specific pointson theauricle. N-VAS
can also beactivated bythepositive or negativepoles of amagnet. Differentsides of atwo-prong
polarizedprobeare used toelicit thechangeinpulse qualitieswhich indicatethereactivity of
specific areas of theear. Needlesare theninsertedinto theidentifiedear points, or sometimesthey
aretreatedwith laser stimulation. Asthefocus of thisbook isthedescriptionof auriculotherapy
procedures, ratherthanauricular medicine, further explanationof thismoreadvanced technique
isomittedhere.
6.6 Seven frequency zones
Nogier identifiedseven specific regionsof thebody thatresonatedwith seven basic frequencies.
Thespecific frequency associated witheachbodyregionwas determinedbyholdingdifferent
coloredtransparencyslides over theauricleandnotingwhetherthatcolor couldbalance
disturbancesof N-VASresponse. Alternatively, Nogier would stimulatetheear or thebodywith
different frequencies of aflashingwhitestrobelight. Thebody regionswere differentiatedwith
lettersA throughG (see Figure6.7). Eachletter also indicatedcertaintypes of healthconditions
thatwere relatedtothetypeof tissueof thatorganregion. Thecolor and numberof aKodak
Wrattenfilter thatrelates toeach frequency zoneof thebody ispresentedinthesecondand third
columnsof Table6.1. I ndividual colors have different frequencies of oscillatingphotonsof light,
progressingfromthelowest frequency of red toprogressively higher frequencies inarainbowor
prism. Nogierdeterminedthattheeffects of progressively shorterwavelengths of different colored
Internalorgans
zoneB
5Hz
Musculoskeletal body
zoneC
10 Hz
Frequencyrates for bodyregions
Cerebral cortex
zoneG
160 Hz
Subcortical brain
zoneF
80 Hz
Intercellular core
zoneA
2.5 Hz
Frequencyrates for auricleregions
Corpuscallosum
zoneD
20 Hz
Antihelix
zoneC
10 Hz
Concha
zoneB
5Hz
Subtragus
zoneA
2.5 Hz
Tragus
zoneD
20 Hz
Helixtail
,.""__---zoneE
40 Hz
Peripheral lobe
~ I - f ' : r - - - - - - - - zoneF
80 Hz
Centrallobe
zoneG
160 Hz
Figure6.7 Sevenfrequencyzones ofthebodyaredesignatedbythelettersA for 2.5Hz, Bfor5Hz, Cfor 10Hz, Dfor 20Hz, for40Hz,
F[or 80Hz,andGfor 160Hz. Thesesamefrequencies arerelated todifferentregions oftheauricle anddifferent typesofsomatictissue.
Table6.1 Color, electrical and laser stimulation frequencies
Zone Color Wratten Electrical Exact Laser Correspondingauricularareas
filter frequency rate frequency
(Hz) (Hz) (Hz)
A Orange #22 2.5 2.28 292 Subtragus
B Red #25 5.0 4.56 584 Concha
C Yellow #4 10.0 9.12 1168 Antihelix, Antitragus, Helix
D Red Orange #23 20.0 18.25 2336 Tragus, I ntertragicnotch
-- , - _ . ~ - " . _ .._._"... ~ _ .. -
E Green #44 40.0 36.50 4672 Helixtail
F Blue #98 80.0 73.00 9334 Peripheral ear lobe
G Purple #30 160.0 146.00 18688* Medial ear lobe
"Inclinical practice, theharmonicresonancefrequency of 146HZisusedforlaserstimulationbecausesucharapid
frequency rateof 18kHztendstooverheatthelaserequipment.
light filtersonbodytissuecould also befound withprogressively higher frequencies of flashing
light, faster frequencies of electrical pulses, or higherfrequencies of laser stimulation.
Theelectrical frequencies for eachzoneof thebody arepresentedincolumn4of Table6.1and
theexact body resonanceratesare presentedincolumn5. Eachrateistwicetherateof the
frequency below it. Conchaandvisceral disorders are stimulatedat 5Hz, antihelixand
musculoskeletal disordersare stimulatedat 10Hz, andthehighest frequencies of 160Hzrelate
tocerebral and learningdisorders. Thecorrespondingfrequencies for laser stimulationare
presentedincolumn6, with thelast columnreserved for theareas of auricular anatomyrelated
toeach frequency zone. Somepractitionersof auricular medicinehave suggested thatthese
seven resonant frequencies are relatedto theenergies of theseven primarychakrasof ayurvedic
medicine. Insomeenergeticsystems, each chakraisassociated with thedifferent colors of the
spectrum, fromred toorangetoyellow togreen tobluetoviolet towhitelight.
Anatomical zones and energy expressions of different frequencies
ZoneA- Cellular vitality: Thiszonerunsupthemidlineof thephysical bodyliketheacupuncture
channelsof theConceptionVessel andGoverningVessel inOriental medicineandlikethe
sushumnanadi of ayurvedic medicine. Theauricular areafor this2.5-Hzzoneisthesubtragus. I t
affects primitivereticular energy andtheprimordial forces thataffect cellular organization. This
frequency oftenoccurs at thesiteof scars andtissuedisturbanceand relatestotheembryonic
organizationof cellular tissue. I tisused totreatcellular hyperactivity, cellular proliferation,
inflammatoryprocesses, neoplasticcancers, tumorsor tissue dedifferentiation.
ZoneB- Nutritional metabolism: Thiszoneaffects internal organs. Thefrequency of 5Hzisthe
optimal ratefor stimulatingpointsintheconchaof theauricle. Affectingvagal nerve projectionsto
visceral organs, the5Hzfrequency isused totreat nutritional disorders, assimilation disorders,
tissuemalnutrition,neurovegetative dysfunctions, organicallergies, constitutional dysfunctions
andparasympatheticimbalance. Whentreatingendodermal visceral organpointsrelatedtothe
Nogiersecondandthirdphase, the5Hzfrequency moves withtheterritoryrelatedtothatphase.
ZoneC- Kinetic movements: Thiszone affects proprioception, kineticmovementsandthe
musculoskeletal body. Theresonant frequency for thezoneis10Hz,which isthefrequency used to
treat auricular pointsontheantihelix andthesurroundingareas of theauricle, such asthe
scaphoidfossa andtriangular fossa. Thiszoneaffects myofascial pain, sympatheticnervoussystem
arousal, somatizationdisorders, cutaneousallergies, motorspasms, muscle pathologyandany
disorder aggravated bykinetic movement. Whentreatingmesodermal musculoskeletal points
relatedtotheNogiersecondandthirdphase, the10Hzfrequency moves withtheterritoryrelated
tothat phase.
ZoneD- Global coordination: This20-Hzzonerepresentsthecorpuscallosumand theanterior
commissurewhichcoordinateassociations betweenthetwosides of thebrain. It isrepresentedon
Treatmentprocedures
155
Acupuncture microsystems on zone 0 of tragus
Right ear
Conception
Vessel
Governing
Vessel
Leftear
Right ear
I nternal Musculoskeletal
organs body
Genitals Coccyx
Bladder Sacral Spine
Intestines LumbarSpine
Stomach ThoracicSpine
Heart ThoracicSpine
Lungs Cervical Spine
Throat Cervical Spine
Mouth Head
Figure 6.8 TheConceptionVessel channel isfoundonthetragus oftherightauricle, whereastheGoverningVessel meridianisfoundOil
thetragus oftheleftear. Similarly, theinternal organsrepresentedbythefrontmupointsarefoundonthetragusoftherightear, whilerear
shupointsareshownall thetragus oftheleftear.
theexternal tragusof theauricle that liesimmediatelyabove thesubtragal zoneA. I tcorrespondsto
crossed-lateralitydysfunctions, problemsof cerebral symmetryversus divergence, incoordinationof
thetwosidesof thebody, symmetrically bilateral dysfunctions or midlinepainproblems. This
frequency affects symmetrically bilateral pain problemsandstrictlymedianpainproblems. Inaright
handedperson, therighttraguscorrespondstotheanteriorsideof thebodyConceptionVessel and
theleft tragus correspondstotheposterior bodyGoverningVessel (see Figure6.8). For aleft-handed
personor an oscillator, theoppositeisthecase. Theleft traguscorrespondstotheanteriorsideof
thebodyand theright traguscorrespondstotheposterior sideof thebody. Ineach case, thebodyis
represented upsidedown, withtheupper bodytowardtheinferior tragusand thelower body
towardthesuperior tragus.
Zone E- Neurological interactions: Thiszone representsthespinal cordand peripheral nerves
andcorrespondstothehelix tail of theauricle. The40Hzfrequency isused for spinal disorders,
skin disorders, dermatitis, skinscars, neuropathies, neuralgias and herpeszoster.
Zone F- Emotional reactions: This80-Hzzonerepresentsthebrainstem, thalamus, limbic
system, and striatumand isrepresentedon theperipheral lobe of theauricle. I tcorrespondsto
problemsrelatedtounconsciouspostures, conditionedreflexes, tics, muscular spasms,
stammering, headaches, facial pain, overly sensitive sensations, clinical depression and emotional
disturbances. Whentreatingectodermal neuroendocrinepointsrelatedtotheNogier secondand
thirdphase, the80Hzfrequency moves with theterritoryrelatedtothatphase.
Zone G -I ntellectual organization: Thiszonerepresentspsychological functionsaffected bythe
frontal cortexthatare representedonthemedial lobeof theauricle. The160Hzstimulation
frequency isused for pyramidal systemdysfunctions, memorydisorders, intellectual dysfunctions,
psychosomatic reactions, obsessive nervousness, chronicworry, malfunctioningconditioned
reflexes anddeep-seatedpsychopathology. Whentreatingectodermal cerebral cortexpoints
relatedtotheNogiersecondand thirdphase, the160Hzfrequency moves withtheterritory
relatedtothatphase.
Theplacement of colored filters or theselection of electrical or laser stimulationfrequencies is
basedonthetypeof disorder andtheregionof theear thatcorrespondtoeachzone(see Box6.1).
Box 6.1 Stimulation frequencies for specific auricular points
Auricular point
Master Oscillation point
Point Zero
Shen Men
Sympathetic Autonomic point
Allergy point
Endocrine point
Tranquilizer point
Thalamus point
Master Sensorial point
Master Cerebral point
Muscle Relaxation point
WindStream
San Jiao (triplewarmer)
Appetite Control point
Vitalitypoint
Antidepressant point
Aggressivity point
Psychosomatic point
Treatmentprocedures
Stimulation
frequency (Hz)
2.5
10
10
10
10
20
20
80
160
160
5
10
20
20
20
80
80
160
Auricular point
Gastrointestinal Organs
Lungand Respiratory Organs
Abdominal Organs
UrogentialOrgans
Heart Muscle Activity
Musculoskeletal Spine
Musculoskeletal Limbs
Musculoskeletal Head
Sensory Organs
Endocrine Glands
Peripheral Nerves
Spinal Cord
Brainstem
Thalamus and Hypothalamus
LimbicSystem and Striatum
Corpus Callosum
Cerebral Cortex
Stimulation
frequency (HZ)
5
5
5
10
10
10
10
10
10
20
40
40
80
80
80
20
160
157
158
Theriseinresonancefrequencies goingfromzoneA tozoneGreflects theincreasingevolutionary
complexity of organictissue organization. Asoneascends frombasic cellular metabolismto
visceral organstomusculoskeletal tissue toperipheral nerves tosubcortical brainstructurestothe
hierarchical structureof thecerebral cortex, thefrequencies thatrelatetoeach successive zone
becomeprogressively faster. Thisriseinfrequencies whengoingfromprimitivetissuetomore
recentlyevolved neurological tissuecorrespondstotheincreasingly faster rotationof chakra
vortices described inChapter2.3.
6.7 Semipermanent auricular procedures
Ear pellets: Small stainless steel ballsor small seeds soakedinanherbal solutioncan beplaced ona
specificear point andheldtherebyanadhesive strip. Earacupointpellets arealsocalled ear seeds, ion
spheres, semen vaccaria grains, otoacupointbeads or magrainpellets. Thesmall adhesive stripsused
toholdtheseeds arebest placedwithforceps or tweezers indifficult-to-reachareas of theear. In
Chineseear acupuncture, theripeseeds fromthevaccaria plant havebecomeapopular replacement
for ear needles, andarenowusedasthesolemethodof auricular stimulation. Theseeds canbeas
effectiveasneedles andhavelesschanceof leadingtoinfections. Evenafter needleinsertion
treatments,ear pellets areleft inplaceat reactive ear pointsinordertosustain thebenefits of
auricular acupuncture. Theyshouldnot beleft ontheauricle for longer thanaweek. Spontaneous
sweatingontheear surface anddailybathingmaymakeitdifficult for ear pellets tostayattached.
Whilepatientsareoftenencouragedtoperiodically press onthepellets duringtheweek, thisadded
procedurerunstheriskof knockingthepellet out of place.
Ear magnets: Thesemagnetsappear similar totheacupoint pellets, but consist of small magnets
held ontotheauricular surfacewithan adhesive strip.
Press needles and ear tacks: Thesearesmall, semipermanentneedlesor indwellingthintacks
thatare insertedintotheear tobeleft inplace for several days. Thesetypes of needleprovide
stronger stimulationthanear pellets.
Staple puncture: A surgical staplegun isused toapply stapleneedles intotheskin at specific ear
points. Thisprocedurehasbeenmost commonlyused for thetreatmentof weight loss byastaple
insertedinto theStomachandEsophaguspoints.
Aqua puncture: Novocaine, saline, vitaminsor anherbsolutioncan besubcutaneously injected
intoaspecific region of theear. Thesubdermal pressureaswell astheingredientsof theinjected
solutionprovides prolongedstimulationof anear point.
6.8 Selection of auricular acupoints for treatment
Theselection of ear pointsfor treatmentisbasedonthefollowing criteria:
I. Byreferencetothecorrespondingareaonthebodywhichexhibitspainor pathology.
2. Selective reactivity, asindicatedbyabnormal color or shape, tendernessor increased
electrodermal responseat theear.
3. Reactivity based onchangesintheN-VASpulse.
4. Differentiationsof zang-fusyndromesrelatedtoTCMtheoryandtheflowof qi inacupuncture
channels.
5. Modernphysiological understandingof theneurobiological mechanismsunderlyingamedical
disorder.
6. Thefunctionof anear pointasbased uponclinical writings and scientific studies.
7. Presentingclinical symptoms, requiringageneral medical diagnosisof thepatientto
differentiatesuperficial complaintsfromunderlyingpathology.
8. Personal clinical experience.
Someauricular loci arefoundtoelicit therapeuticeffects for acertaindiseasethatseemtohave
nothingtodowitheither conventional Westernmedicineor traditional Chinesemedicine.
6.9 Tonification and sedation in auriculotherapy
Positive gold tonification: TheChineserefer totonificationastheactivation or augmentationof
areaswithweak energy. Usebrief (6-10seconds duration) positive electrical polarityfor activating
weak functions. Masterpointsand functional pointsareoftentonifiedwiththisbrief stimulation.
A B
c o
Figure 6.9 Earpelletsappliedtotheauricular skinsurfacetapedontotheauricularlow backregion (A),andtheauricular neckregion (C).
Asmall goldhall canheappliedtothetragus withforceps(B), whereas semipermanentneedlesareshowninsertedintotheear lobe(D).
160
Inauricular acupunctureneedling, tonifybyinsertinggold needles intotheear ipsilateral tothe
problem, turningtheneedleinaclockwise rotation. Goldactivates thesympatheticnervous
system, sotonificationproceduresareusedtotreatparasympatheticdisorders, hyporeactionsand
energeticvacuums. It isusual totreat thedominantsideof thebody. Anycomplaintwhich is
aggravated byrest will oftenindicatetheneedfor agold needle.
Negative silver sedation: TheChineserefer tosedationas thedispersion of excessive energy to
diminishitsoveractivity. Use negativeelectrical polarity, of 12-30seconds duration, todiminish
overactive organsor excessive reactions duetostress or tension. Onetypically sedates local
pointsrepresentingaspecific areaof thebody bytreatingthemwith moreprolonged
stimulation, from10secondstoseveral minutes. Inauricular acupuncture, one may sedateby
insertingsilver needles intothereactive ear point, turningtheneedleinacounterclockwise
rotation. Silver activates theparasympatheticnervous system. Mostreactive pointson theear
requiresedative procedures, since they represent muscle tension, sympatheticarousal, stressful
reactions, and excessive energyuse. For some individuals, it may also benecessary totreat the
ear contralateral totheareaof thebody wherethereisaproblem, thenon-dominantside. A
painwhich isaggravated bymovement or exercise suggests theneedfor asilver needle. Onecan
stimulateapointwith astrongstimulusover ashort periodof timeor aweak stimulusover a
prolongedperiodof time.
6.10 Relationship of yin organs to ear acupoints
Theprincipal organsused tobalancetheacupuncturechannelsinOriental medicinecan also be
activated bystimulationof thecorrespondingauricular points. Recent revisions of theChineseear
acupuncturechartshaveemphasizedtherepresentationof theLung, Heart,Liver, Spleenand
Kidneypointsontheposterior surface of theauricle aswell asintheconchaof theanterolateral
surface (see Figure2.17).
I. Lung point: Affects respiratorydisorders, drugdetoxification andskindiseases.
2. Heart point: Producesmental calming, relieves nervousness, and improves memory.
3. Liver point: Affects blood, muscles, tendons, inflammations, sprains, andeyediseases.
4. Spleen point: Affects digestion, reduces muscle tensions, andfacilitates physical
relaxation.
5. Kidney point: Affects urinarydisorders, bonefractures, back pain, and hearingdisorders.
6.11 Geometric ear points
Nogier andhiscolleagues discovered that after treatingcorrespondingear pointsindicatedby
somatotopicmaps, it was also possibleto discern aseries of reactive auricular pointsthat
occurred alongan imaginarystraight line. Theselines werereferred toas geometricbecause
they occurred at 30angles toeach other (see Figure6.10). Thepractitionerwould first
configurean imaginary line that extendedfromPointZeroto thecorrespondingauricular
point. Thelinewas thencontinuedoutwardtotheperipheral helix that intersectedwith that
line. Stimulationof any reactive ear pointsfound alongthislinewerefoundto augment the
treatmenteffects seen with auriculotherapy. Inadditionto treatingthehelix point itself,
30angles extendingfromthishelix locationwereused tocreateadditional imaginary lines
which werealso stimulated. TheseconfigurationsaredepictedinFigure6.10. Theapplication
of these30angles hasbeensuggested byBahr (1977) to account for theChineseear
acupuncturepointsusedfor AppendixdisordersfoundintheScaphoidFossaandTonsil points
foundon thehelix. Thereisalso a30anglebetweentheChineseHypertensionpoint inthe
triangular fossa, asecond Hypertensionpoint on thetragus, and theEuropeanMarvelous
point, which isalso used totreat highbloodpressure. Thecomplexity of thisgeometric
procedure, however, limits itsusefulness to thoseclinical cases which do not respondtomore
straightforwardapplicationsof auriculotherapy. Dr Bahr has also described alinear
relationshipof importantfunctional ear pointshedescribed as theOmegapoints. Figure6.11
shows thevertical alignment of theMaster Omegapoint, Omega1, andOmega2along the
medial aspects of theauricle.
A Geometric ear points
C Chinese Appendix ear points
Helixextension
of Elbow point
Elbow point
B
D
Chinese helix ear points
Ear apex
Helix6
Chinese Tonsil ear points
Tonsil 1
Appendix 2
Tonsil 4
Figure 6.10 Geometricear pointsoccur at .10anglesfromalinethatextendsfromPoint Zero tothehelix (A). Chineseear acupuncture
pointsalsofoundat 30angles arelocated on thehelix (8), for AppendixDisorder acupoints inthescaphoidfossa (C) andTonsilpoints
on thehelix(D).
Omega points
Master
Omega
Figure 6.11 Omegapointsformavertical linealong themedial aspects oftheexternal eat; includingMaster
Omega, Omega1, andOmega2points.
6.12 Inverse and contrary relationships of the ear and body
Whentreatingthemuscles attachedtothespinal vertebrae and theperipheral limbs, it hasbeen
foundinbothauriculotherapy and manipulativetherapiesthat it ispossible totreat opposing
regionsof themusculoskeletal body. Thistechniquecan beused tostimulatereactive pointson the
Box 6.2 Opposing relationships between inverse and contrary body regions
162
Upper spine region
Cervical spine 1
Cervical spine 2
Cervical spine 3
Cervical spine 4
Cervical spine 5
Cervical spine 6
Cervical spine 7
Thoracic spine 1
Thoracic spine 2
Thoracic spine 3
Thoracic spine 4
Thoracic spine 5
Thoracic spine 6
Thoracic spine 7
Thoracic spine 8
Inverse region
of lower spine
Sacral spine 5
Sacral spine 4
Sacral spine 3
Sacral spine 2
Sacral spine 1
Lumbar spine 5
Lumbar spine 4
Lumbar spine 3
Lumbar spine 2
Lumbar spine 1
Thoracicspine 12
Thoracicspine 11
Thoracicspine 10
Thoracicspine 9
Thoracicspine 8
Right side of body
Righthand
Rightwrist
Rightelbow
Rightshoulder
Righthip
Rightknee
Rightankle
Rightfoot
Contrary side of
opposing body
Leftfoot
Left ankle
Leftknee
Left hip
Leftshoulder
Left elbow
Leftwrist
Left hand
cervical spinetorelieve aconditioninthelumbosacral spineor totreat thefoot toprovidepain
relief intheshoulder. Thesespecific relationshipsarepresentedinBox6.2. For example, one
would look for areactive pointonthepart of theauriclewhichrepresentsthesixthcervical
vertebratoaffect thefifthlumbarvertebraandonewould treat thefirst lumbar vertebratoaffect
thethirdthoracicvertebra. Onecould treat theregionof theauriclerepresentingtheright wrist in
order toalleviate adysfunction intheleft ankle or treat theear point representingtheleft hipto
relieve tensionintheright shoulder.
6.13 Precautions associated with auriculotherapy
Donot treat anypain neededtodiagnosean underlyingproblem.
Donot relieve anypain thatwarns apatientagainst engagingininappropriatephysical activity
thatcould aggravate thecondition.
Becautiouswhen treatingpregnantwomen. Thisprecautionismostly requiredfor malpractice
reasons, ratherthananyknownclinical evidence regardingpossibleharmful effects of
auriculotherapyupon afetus or pregnantwoman. Nonetheless, Chinesestudieshavesuggested
thatstrongstimulationof theUterusand Ovarypointsontheexternal ear can possibly induce
anabortion.
Donot useonpatientswithacardiac pacemaker, even thoughtheelectrical microcurrentsusedin
auriculotherapyaredelivered at extremely small intensitylevels.
Donot useaggressive stimulationwithchildrenor elderly patientswhomaybeparticularly
sensitive tostrongauriculotherapytreatments.
Avoidtreatingpatientswhen theyare excessively weak, anemic, tired, fasting, hypoglycemic or
havejust eatenaheavy meal. Thetreatmentwill not beaseffective.
Allownervous, anxious, weak or hypertensivepatientssometimefor arest after thetreatment.
I tishelpful tooffer patientswarmteawhiletheyrecover.
I nformthepatientnot tousealcohol or drugsbeforetheauriculotherapytreatment.
Somepatientsmaybecomesleepy or dizzyafter atreatmentandthey mayneedtoliedownfor a
while. Thissedationeffect hasbeenattributedtothereleaseof endorphins.
Themost commonadverse sideeffect fromauriculotherapyisthattheear becomesred and
tenderafter thetreatment. Informthepatientthatthistendernessisonlytemporary.
Treat patientwithantibioticsif theear becomesinfected.
6.14 Hindrances to treatment success
I fapatientsdisorder persists after auriculotherapytreatmentof thecorrespondingear points,
theremaybeatherapeuticblockage duetoatoxicscar or dental focus. I nquireabout thepatients
medical historyandprevious accidentsor surgeries. Sometimesahindrancetotreatmentisdueto
anallergy, which isanexcess of energy. At othertimes, thereisanobstacletothetransmissionof
thecellular informationbecauseof aregionof energy deficiency. Thelossof energy maybe
attributabletotheafter-effectsof anaccident or surgery whichcaused atoxicscar and ashort
circuit inthepatientsenergy. A different typeof toxicscar isadental focus relatedtocontinued
inflammationfromaprior dental procedure. Mercuryamalgamintoothfillingsor chronic
infectionof thegingivacan also produceadental focus.
Accept thatsomemedical problemspresentedbyapatient can not beeffectively treatedby
auriculotherapybecause thereis(1) astructural imbalancethat needs tobecorrectedbysome
physical therapyprocedure, or (2) apsychological dysfunction that needstobeaddressed by
sometype of psychotherapeutic intervention. Nogier oftencombinedauriculotherapywith
ostepathicmanipulationsinorder toprovidestructural integrationto theneuromuscular
changes thatcould beachieved with auriculotherapy. Whentheobstacle isdue to an
unresolved emotional state, stimulationof PointZerocan bringbalancetothepsychosomatic
resistance.
Whilepsychosomatic disordersareoftendismissed byphysicians and patientsalike, thereisample
evidence tosuggest thatpsychological factors haveaprofoundimpact onmanyphysical
conditions. Until emotional issues relatedtoanxiety, depression, loneliness andshameare
satisfactorily resolved, apatientsunconscious motivationsmaydefeat themost skilled clinician.
Evenwhen patientsstrongly vocalize thattheywant toberelieved of theirphysical suffering, they
maynot beconsciously aware of theirownthoughts,attitudesand behaviors thathave theopposite
164
effect. Gentlebut firmconfrontationregardingthepossibility thatsuch psychological barriersexist
isoftennecessary beforeproceedingfurtherwithanymedical treatment. Manypractitionersare
not comfortableaddressingsuch issues with resistant patients, but such confrontationsare often
very necessary for theeventual improvement of thatpersonshealthproblems.
6.15 Overall guidelines for auriculotherapy treatments
1 Treat asfewear pointsaspossible.
2 Onlytreat ear pointsthataretendertopalpationor areelectrically conductive.
3 Treat amaximumof threeproblemsat atime, treatingtheprimaryproblemfirst.
4 Treat ipsilateral ear reflex pointsfor unilateral problemsand treatbothearsfor bilateral
conditions.
5 I fthepatientexhibits alateralityor oscillation disorder, theMasterOscillationpointshouldbe
treatedfirst, thencorrespondingpointsonbothauricles shouldbestimulated.
6 Treat thefront of theexternal ear for relieving thesensationsof pain, thentreat theback of the
ear for relieving muscle spasms whichproducemuscle tensionand limit rangeof motion.
7 After treatingtheanatomicpointsthatcorrespondtotheareaof thebodily symptom, next
treat themaster points, and lastlytreat supportivefunctional points.
Themost commonlyused master pointsare PointZero, Shen Men, SympatheticAutonomic
point, Thalamuspoint and MasterCerebral point.
Anatomicpointsthatareoftenusedassupportivepointstoalleviate otherdisordersinclude
ear pointsfor theOcciput, theChineseAdrenal Gland, theChineseKidney, theChinese
Heart,theLung, theLiver andtheStomach.
Themost commonlyused Chinesefunctional pointsare Muscle Relaxation point, Appetite
Control point, Brain(Central Rim), WindStream(Lesser Occipital nerve), and San Jiao
(TripleWarmer).
Themost frequently used Europeanfunctional pointsare Vitality point, Antidepressant
point, Aggressivity point and Psychosomatic point.
8 Treat Nogier PhaseII and Phase1II pointsif successful results arenot obtainedwithPhaseI
pointsor withChineseear points. PhaseII pointsareindicatedfor chronicdeficiencyconditions,
whereasPhaseIII ear pointsareindicatedfor chronicexcess conditions.
9 Evaluatethepatient for thepresenceof physical hindrancesor psychological obstacles that
could interferewiththetreatment.Onemight also noticeif treatingreactive pointsontheear
relatedtogeometric, inverse, or contraryrelationshipsimproves theclinical effectiveness of
theauriculotherapytreatment.
i 0 Auriculotherapyworksverywell withothertreatmentmodalities. Itisquitecommontocombine
ear acupunctureandbodyacupunctureinthesametreatmentsession.
Chineseherbs, moxibustion, homeopathicmedicinesand acupressure massage can be
effectively integratedwithauriculotherapyaswell asbody acupuncture.
Postural adjustmentswithosteopathicor chiropracticmanipulationsserve tofacilitate the
reductionof muscle spasms attainedwithauricular stimulation.
Biofeedback, hypnosis, meditationandyoga all serve toaugment thegeneral relaxation
effect seen withauricuiotherapy.
Patientswithpsychosomatic disturbanceswould probablybenefit frompsychotherapeutic
interventionsif theycouldaccept theperspectivethatunconscious emotional conflicts could
beacontributingfactor totheir physical healthproblem.
Anyprocedureusedasstandardmedical practicefor theconditionbeingtreatedcan be
further enhancedbytheuseof auricuiotherapy.
Somatotopic representations
ontheear
7.1 Master points on the ear
7.2 Auricular representation of the musculoskeletal system
7.2.1 Vertebral spine and anterior body represented on the antihelix
7.2.2 Legand foot represented on the superior crus and triangular fossa
7.2.3 Armand hand represented on the scaphoid fossa
7.2.4 Head, skull and face represented on the antitragus and lobe
7.2.5 Sensory organs represented on the lobe, tragus and subtragus
7.2.6 Auricular landmarks near musculoskeletal points
7.3 Auricular representation of internal visceral organs
7.3.1 Digestive system represented inthe concha region around the helix root
7.3.2 Thoracic organs represented on the inferior concha
7.3.3 Abdominal organs represented on the superior concha and helix
7.3.4 Urogenital organs represented on the superior concha and internal helix
7.4 Auricular representation of endocrine glands
7.4.1 Peripheral endocrine glands represented along the concha wall
7.4.2 Cranial endocrine glands represented at the intertragic notch
7.5 Auricular representation of the nervous system
7.5.1 Nogier phase representation of the nervous system
7.5.2 Peripheral nervous system represented on the ear
7.5.3 Spinal cord and brainstem represented on the helix tail and lobe
7.5.4 Subcortical brain nuclei represented on the concha wall and lobe
7.5.5 Cerebral cortex represented on the ear lobe
7.6 Auricular representation of functional conditions
7.6.1 Primary Chinese functional points represented on the ear
7.6.2 Secondary Chinese functional points represented on the ear
7.6.3 Primary European functional points represented on the ear
7.6.4 Secondary European functional points represented on the ear
Over 20booksonauricular acupuncturehavebeenconsultedtodeterminetheanatomical locationand
somatotopicfunction of specific regions of theear. Textswhichfocus ontheidentificationof Chinese
ear acupuncturepointsinclude: Huang(1974), Wexu(1975), Nahemkis& Smith(1975), Lu(1975),
VanGelder(1985), Grobglas& Levy(1986), Chen& Cui (1991), Zhaohaoet a1. (1991), Konig &
Wancura(1993), Shanet al. (1996) andHuang(1996). Journal articles andconferencepresentationsby
Zhou(1995, 1999)haveaddressedthemost recent Chinesepublicationsfor thestandardizationof
auricular points. A Europeanperspectiveon thecorrespondingrepresentationsof thegross anatomy
ontheexternal ear beginswiththepioneeringwork of Paul Nogier(1972,1983,1987,1989). Thelatter
textspresent thethreephasesof theauricular microsystemasdelineatedbyNogier. Otherbookswhich
havedescribed thesomatotopiclocalization of auricular pointsintheEuropeanschools of
auriculotherapyandauricular medicineincludethefollowing: Bahr (1977), Bourdiol (1982), Kropej
(1984), VanGelder(1992), Bucek (1994), Pesikov& Rybalko (1994), Strittmatter(1998,2001) and
Rubach(2001). I nformationfromall of thesetextswascombinedtodeterminethelocationand
function of theauricular pointsdescribedbytheChineseandtheEuropeanschools of auriculotherapy.
Ingeneral, thereismorecongruencethandisparitybetweentheChineseandEuropean
somatotopicmapsfor theauricle. Evenwhentherearenoticeabledifferences betweenthetwo
systems, thecorrespondingpointsareoftenlocated on adjacent regionsof theexternal ear. The
lower extremities are locatedon theantihelixsuperior crus intheChineseear charts, but thelegs
are localized tothetriangular fossa intheEuropeancartography. Thesetwo auricular areas lie
Somatotopicrepresentations 165
Overview of auricular microsystem somatotopic maps
Masterpoints Representedthroughoutauricle
- - - - - - ~ ----
Sensory Organs
Auricular representation of the musculoskeletal system and sensory systems
-----
Spinal VertebraeandAnteriorBody Representedonantihelix _
LegandFoot Representedontriangular fossa andsuperior crus
ArmandHand Representedonscaphoidfossa
HeadandSkull Representedonantitragus
Face, Jaw, TeethandTongue Representedonlobe
..--..._---------
Representedonlobe, tragus, andsubtragus
Representedoninferior concha
. _ - - - - ~ - - - - ~ - - - - - - -
Representedonsuperior conchaandconcharidge
-------------
Representedonsuperior conchaandinternal helix
Representedonconchawall
Urogenital Organs
EndocrineGlands
Abdominal Organs
Auricular representation of internal organs
- - - - - - - ~ - - - - ~ ~ - - - - - - - ~ ~ -
Representedonconchaaroundhelixroot Digestive Organs
ThoracicOrgans
- - - ~ - - - - - -
Auricular representation of the nervous system
Somatic peripheral nerves Representedonantihelix
---------
Sympatheticperipheral nerves Representedonconchawall
Spinal CordandBrainstem Representedonhelixtail andlobe
Subcortical Brain Nuclei Representedonantitragusandconchawall
-_._--------
Cerebral Cortex Representedonlobe
~ ~ .... _ - - - ~ - ~ - - - - - - - - - - - - - - - -
Auricular representation of functional conditions
-----------
Chineseprimaryfunctional points
----------------
Chinesesecondaryfunctional points
Europeanprimaryfunctional points
Europeansecondaryfunctional points
next toeachother, andineach case thehipisfound towardtheinferior tipof thetriangular fossa
andthefeet arefound towardthetopof theear. TheChineseassert thatthekidney isfound inthe
superior conchaandthespleen intheinferior concha, whereas Europeantexts maintainthatthe
kidneyislocatedunderneaththehelixroot andthespleen isfound above theconcharidge. Ineach
case, though, thekidney isfound towardtheupper regionsof theauriclewherebothschools locate
thebladder andthespleenisfound oneach sideof theLiver point,which isalso inthesame areaof
theconchainbothschools. A general impression isthattheEuropeanear pointsdelineatethe
musculoskeletal pointsand neuroendocrinepointsmoreprecisely, whereas theChinesecharts
seemtoindicatethelocationof theinternal organsmoreaccurately. Thatsomuch of Oriental
medicineisfocused ontheconstitutional factors establishedbytheinternal organs, andthateach
acupuncturechannel isnamedfor aninternal organ, mayprovidegood reasonfor thisdifference.
Europeanapproachestoauriculotherapyhaveplacedgreater emphasisontheneurophysiological
control of themusculoskeletal systemandtherelationshipof each organtotheembryological
tissuefromwhichit originates. TheNogier systemof threedifferent phasesrelatedtothree
different territoriesontheauricle mayat first seemoverly complex andconfusing, but theclinical
applicability of thesephasesbecomeseasier withcontinuedpractice.
7.1 Master points on the ear
Themaster pointsareso identifiedbecause theyaretypically active inmost patientsandtheyare
useful for thetreatmentof avariety of healthdisorders. Thepractitionershouldfirst stimulatethe
appropriatecorrespondingpointsfor agiven anatomical organ, and thenstimulatethemaster
pointsalso indicatedfor thatmedical condition.
Eachauricular pointpresentedinthistext isidentifiedwithanumber, thepointsprincipal name,
alternativenames, andtheauricular zone (AZ)whereit isfound. I fanauricular zonelocation
includes aslash (I), theear pointoccurs at thejunctionof twozones. Thelocationof each ear
point isdescribedwithregardtoaspecific region of auricular anatomyandthenearest auricular
landmark(LM). Thephysiological functionof thecorrespondingorganor thehealthdisorders
affected byaparticular ear pointarepresentedafter thelocationof thatear point.
Musculoskeletal bodyrepresentedon theear I nternal organs representedon theear
Spinal vertebrae
and anterior
Legand Foot
Armand Hand
Urogenital
Organs__+
Digestive
System -----,<L
Thoracic
Organs ----1h
Pituitary
Gland
Abdominal
Organs
Nervoussystem
representedon theear Territoriesof theear
Spinal Cord
Territory
Territory2 .....
Cerebral Cortex
e:
Subcortical Nuclei Territory3---I ++H+++t-.l
Figure7.1 Overviewofthemusculoskeletal body, internal organs andthenervous systemrepresented on theexternal ear. Alsoindicated
are thethreeprimaryterritoriesoftheauricle.
Somatotopicrepresentations
167
No.
0.0
AuricuLar microsystem point (Alternativename)
Point Zero (Ear Center, PointofSupport, Umbilical Cord, Solar Plexus)
[Auricular zone]
[HX1/CR1]
Location: Notchon thehelix root at LM 0, just as thevertically ascendinghelix rises from themorehorizontal concha
ridge.
Function: Thismaster point isthegeometrical and physiological center of thewhole auricle. It bringsthewholebody
towardshomeostasis, producingabalanceof energy, hormonesand brainactivity. I tsupportstheactionsof other
auricular pointsand returnsthebody to theidealized statewhich was present inthewomb. Ontheauricular somatotopic
map, PointZeroislocatedwheretheumbilical cordwould risefromtheabdomenof theinvertedfetus patternfoundon
theear. Asthesolar plexus point, Point Zeroserves as theautonomicbrain thatcontrolsvisceral organsthrough
peripheral nerveganglia.
1.C Shen Men(SpiritGate, DivineGate) [TF 2]
Location: Superior and central tothetipof thetriangular fossa, between thejunctionof thesuperior crusand the
inferior crus of theantihelix. It isnot at thetipof thetriangular fossa, but slightly inwardand slightly upwardfromwhere
thetriangular fossa descends fromthesuperior crus towarddeeper regionsof thetriangular fossa.
Function: Thepurposeof Shen Men istotranquilizethemind and toallow aharmoniousconnectionto essential spirit.
Thismaster point alleviates stress, pain, tension, anxiety, depression, insomnia, restlessness, and excessive sensitivity.
TheChinesebelieve thatShenMenaffects excitation and inhibitionof thecerebral cortex, which issimilar infunction to
NogierssecondphaseThalamuspointlocalized tothesamearea of theear. Utilizedinalmost all treatmentplans,
includingauricular acupunctureanalgesiafor surgery. Shen Menwasoneof thefirst pointsemphasizedfor the
detoxification fromdrugs andthetreatmentof alcoholismand substanceabuse. It isalso used toreducecoughs, fever,
inflammatorydiseases, epilepsy and highbloodpressure. Whenit isdifficult tofindtenderor electrically active car
points, stimulationof eitherShen Menor Point Zeroincreases thereactivity of otherauricular points, makingiteasier to
detect them.
2.0 Sympathetic Autonomic point [IH4/AH 7]
Location: Junctionof themorevertically rising internal helix and themorehorizontal inferior crus, directly below
LM I. I tiscovered bythebrimof thehelix root above it, thusmakingthisear point difficult toview directly fromthe
external surface of thecar. I tcan befoundon thevertically rising internal helixwall, on theflat ledge of theinferior crus
or at thejunctionwherethetwomeet.
Function: Thismaster pointbalances sympatheticnervous system activationwith parasympatheticsedation. Thispoint
istheprimaryear locus for diagnosingvisceral pain and for inducingsedationeffects duringacupuncture. I timproves
bloodcirculation byfacilitatingvasodilation, corrects irregular or rapid heartbeats, reduces anginapain, alleviates
Raynauds disease, reducesvisceral painfrominternal organs, calms smoothmusclespasms and reduces
neurovegetative disequilibrium. It isalso used for thetreatmentof kidneystones, gall stones, gastric ulcers, abdominal
distension, asthmaand dysfunctions of theautonomicnervous system.
3.0 Allergy point [IH7or HX7]
Location: I nternal and external sides of theapex of theear, below or at LM 2.
Function: Thismaster point leads toageneral reductionininflammatoryreactionsrelatedtoallergies, rheumatoid
arthritisand asthma. I tisused for theeliminationof toxic substances, theexcretion of metabolicwastes and treatmentof
anaphylactic shock. InOriental medicine, thetop surfaceof theAllergy point isprickedwith aneedleto reduceexcess qi
or it ispinchedtodiminishallergic reactions.
4.0 ThaLamus point (Subcortex, Brain, Pain Control point) [CW2/IC 4]
168
Location: Base of theconchawall which lies behindtheantitragus. Todetect thispoint, follow avertical ridgewhich
descends down theconchawall fromtheapex of theantitragus(LM 13). I tislocatedon theinternal surfacebehindthe
antitragus, wheretheconchawall meetsthefloor of theinferior concha.
Function: Thismaster point representsthewholediencephalon, includingthethalamusand thehypothalamus. Itaffects
thalamicrelay connectionstothecerebral cortex andhypothalamicregulationof autonomicnerves andendocrineglands.
Thethalamusislikeapreamplifier for signals sent tothecerebral cortex, refining theneural message andeliminating
meaninglessbackgroundnoise. Thethalamusisthehighest level of thesupraspinal gatecontrol system, and soisused for
AurlculotherspyManual
No. Auricular microsystem point (Alternativename) [Auricular zone]
[ITZ]
[ST 3]
[TG Z]
6.0
6.E
7.0
most paindisorders, acuteandchronic, andisfrequently used for auricular acupunctureanalgesia. I talso reduces
neurasthenia, anxiety, depression, schizophrenia, over-excitement, sweating, swelling, shock, hypertension, coronary
disorders, cardiac arrhythmias, Raynaudsdisease, gastritis, nausea, vomiting, diarrhea, constipation, liver disordersandgall
bladder dysfunctions. InTCM,theThalamusSubcortex point tonifiesthebrainandcalms themind. IntheNogier phase
system, thePhaseII Thalamusislocated intheregionof ShenMenandPhaseIII Thalamusislocated intheregionof the
Lung.Thesethreepoints, Thalamus, Shcn MenandLung, areall usedfor drugdetoxification.
Endocrine point (Internal Secretion, PituitaryGland)
Location: Wallof theintertragicnotch, belowLM 9.
Function: Thismaster point brings endocrinehormonestotheir appropriatehomeostaticlevels, either raising or
lowering glandular secretions. I tfunctionsbyactivatingthepituitaryglandbelowthebrain. Thepituitaryisthemaster
gland controllingall otherendocrineglands. I trelieves hypersensitivity, rheumatism, hyperthyroidism, diabetes
mellitus, irregular menstruation, sexual dysfunction and urogenital disorders. I thasantiallergic, antirheumatic, and
anti-inflammatoryeffects. InTCMtreatments, it reduces dampnessand relieves swelling andedema.
Master Oscillation point (Lateralitypoint,Switchingpoint)
Location: Undersideof thesubtragus, internal totheinferior tragusprotrusion, LM 10.
Function: Thismaster pointbalances lateralitydisorders relatedtotheleft and right cerebral hemispheres.
Anatomicallyit representsthecorpuscallosumand theanteriorcommissure. Thepoint isactive inthosepersonswho
areleft handedor mixed dominantinhandedness. Whereas80%of individuals showipsilateral representationof body
organs, 20%of patientsexhibit contralateral representationof bodyorgans. Theseindividuals areviewed asoscillators
intheEuropeanschool of auriculotherapy, and thislateralitydysfunction islabeled switched insomechiropractic
schools. Stimulationof thisauricular point inoscillators isoftennecessary beforeanyotherauriculotherapytreatment
can beeffective. After stimulationof theMasterOscillationpoint, auricular pointsthatwere initially moreelectrically
activeon thecontralateral ear maybecomemore conductiveon theipsilateral ear. Thispoint isused toalleviate
dyslexia, learningdisabilities andattentiondeficit disorder. Peoplewho have unusual or hypersensitive reactions to
prescriptionmedicationsor autoimmuneproblemsoftenneedtobetreatedfor oscillation.
- ----------------------
Tranquilizer point (ValiumAnalogpoint,Hypertensivepoint)
Location: I nferior tragusasitjoins theface, lyinghalfway between LM9and LM 10.
Function: Thismaster pointproducesageneral sedationeffect, facilitatingoverall relaxation and relieving generalized
anxiety. I talso reduces highbloodpressureandchronicstress.
8.E Master Sensorial point (Eyepoint) [L04]
[LO1] 9.0
Location: Middleof thelobe, vertically inferior toLM 13andvertically superior toLM 7. I tisfoundat thesame siteas
theEyepoint.
Function: Thismaster point controlsthesensory cerebral cortexareas of theparietal lobe, thetemporal lobe, and the
occipital lobe. I tisused toreduceanyunpleasant or excessive sensation, such astactileparesthesia, ringing intheears
and blurredvision.
Master Cerebral point (fvfaster Omega,Nervousness, Neurasthenia, Worry)
Location: Wherethemedial ear lobemeetstheface. I tliesvertically inferior totheintertragicnotch.
Function: Thismaster point representstheprefrontal lobeof thebrain, thepart of thecerebral cortexwhich makes
decisions andinitiatesconscious action. Stimulationof thisauricular point diminishesnervous anxiety, fear, worry,
lassitude, dream-disturbedsleep, poor memory, obsessive-compulsive disorders, psychosomatic disorders, and the
negative pessimistic thinkingwhichoftenaccompanieschronicpain problems.
Superior helix
1.(
Shen Men
(SpiritGate)
0.0
Point Zero
4.0
Thalamus point
(Subcortex)
Antitragus Conchawall
~
Internal ridge
~
behindconcha
wall
T atamus point
In erior concha
3.0
Allergy point
8.E
Master Sensorial point
Helixroot
----2.0
Sympathetic
Autonomic point
Tragus
f-------6.E
Master Oscillation point
--------- 5.0
Endocrine point
(Internal Secretion)
9.0
Figure 7,2 Hiddenviewofauricular master points. TheTranquilizer point is not shownin Figure 7.2because thispoint on theexternal
tragus isonlyvisiblefromaSurface View,as indicatedin Figure7.3.
170 Auriculotherapyfvlanual
8.E Master Sensorial point
~ ~ /
. , \
! \
c l - ' - ~ >
4.0 Thalamus point
(Subcortex)
3.0
Allergy point
9.0
1.0
Shen Men
(Spirit Gate)
7.0
Tranquilizer
point
6.E
Master Oscillation
point
2.0
Sympathetic
Autonomic point
5.0
Endocrine point
(Internal Secretion)
Figure 7.3 Surfaceviewofauricular masterpoints.
A B
c
D
Figure 7.4 Photographsofthemasterpoints:PointZero(A),ShenMen(B),SympatheticAutonomicpoint(C),AllergypointandThalamus
point(D).
172 AurieulotherapyManual
A
B
c D
Figure 7.5 Photographsofthemusterpoints: Endocrinepoint (A), Master Oscillation point (B), Tranquilizer point (C), Master Sensorial
pointandMaster Cerehral point (D).
174
7.2 Auricular representation of themusculoskeletal system
Theanatomical locationof all auricular pointspresentedinthistext aredescribedverbally andare
also indicatedbytheirzonelocation. I fdifferent auricular regionsrepresent asingle
correspondingpart of thebody, asseen inChineseand Europeanear points, or differences inthe
Nogier phaselocationof apoint, thefunctionof thatear pointispresentedwiththefirst citationof
that point. Thenomenclaturesystemdescribed inChapter4will beused witheach auricular
microsystem point. Chineseear pointswill berepresentedbytheextension .C,Europeanear
pointsby.E, andear pointsthatarethesame inbothsystems by.0.Thethreephasesof theNogier
(French) systemwill bedesignatedbytheextensions .FI , .F2, and .F3. Eachanatomical areaof the
bodyandeach functional conditionisdesignatedbyadifferent Arabicnumber. Whetherthe
musculoskeletal point isfound inTerritoryI inPhaseI, Territory2inPhaseII,or Territory3in
PhaseIII, theoptimal electrical stimulationfor thatear pointwill be10Hz.
Musculoskeletal auricular pointsrepresent theskin, muscles, tendons, ligamentsand skeletal bone
structuresof thecorrespondingbodyarea, aswell asbloodvessel circulationtothat area. These
ear reflex pointsrepresent somaticnervous systemreflexes controllinglimbandpostural
movementsandautonomicsympatheticreflexes affectingvascular supply toabody region.
Most pain problemsareduetomyofascial pain relatedtochronicrestimulationof sensory neuron
feedback. A muscleinspasmreactivates interneuronsinthespinal cord torestimulatemotor
neuronexcitation, whichleads tomoreneural impulsesgoingtothemuscle, causingthemuscle to
stayinspasm. Musclesdo not stayinspasmwithout aneuroncausing themtocontract and
auricular stimulationserves todisrupt thefeedback loop betweensensory neuronandmotor
neuron.
Clinical problemstreatedbyear reflex pointsincluderelief of muscle tension, muscle strains,
muscletremors, muscleweakness, tendonitis, sprainedligaments, bonefractures, bonespurs,
peripheral neuralgias, swollen joints, arthritis, shingles, sunburns, skin irritationsand skinlesions.
For all ear reflex points, theanteriorsurfaceof theear isused totreat thesensory neuronaspects
of nociceptivepainsensation, whereas theposterior surfaceof theear isused totreat themotor
neuronaspects of muscular spasm.
Theconsensusfor theChineselocationof thevertebral columnisnot clear. SomeChinesecharts
concur withEuropeanmaps thatthespineislocatedontheconchasideof theantihelixridge,
whereas otherChinesechartsput itonthescaphoidfossa sideof theantihelixridge. ThePhaseI
locationof ear pointsfor thecervical, thoracicandlumbarvertebrae, designated.FI , are most
similar totheChineseidentificationof theregions of theauriclewhich correspondtothespine.
ThePhaseIV locationfor thevertebrae andfor othermusculoskeletal tissue isfoundonthe
posterior regionof theauricle immediatelybehindthePhaseI location. For thespine, thesepoints
arelocatedontheposterior groove.
15.
Neck
17.
Breast
19.
Abdomen
39.
Temporal muscles
10.
Cervical muscles
11.
Thoracicmuscles
36.
Shouldermuscles
Sacral muscles
14.
Buttocks
22.
Thigh
___ 24.
Calf
39.
Temple
Pelvic
girdle
23.
Knee
25.
Ankle
rM"..fooiI1--- 11.
Thoracic
spine
Antihelix
Anterior
Posterior muscles
40.
Forehead
muscles
10.
Cervical
muscles
Concha
17.
Breast
11.
Thoracicmuscles
19.
Abdomen
13.
Sacral muscles
14.
20. Buttocks
Pelvic
23.
muscles
Knee
24.
Calf
25.
Ankle
Figure 7.6 Overviewofthemuscular andskeletal systems.
7.2.1 Vertebral spine and anterior body represented onthe antihelix
No.
10.C
Auricular microsystem point (Alternative name)
Cervical Spine.C
Location: Ridge and scaphoidfossa sideof theantihelixtail.
Function: Relieves neck strain, neck pain, torticollis, headaches, TMJ.
[Auricular zone]
[AHB]
1OJ 1 Cervical Spine.F1 (CervicalVertebrae, PosteriorNeckmuscles) [AH1,AH2, PG 2]
Location: Conchasideof theantihelixtail, betweenLM 14and LM IS. TheCl vertebralies central to the
antitragus-antihelixgroove and runs along thenarrowridgeof theantihelixtail up toC7above theconcharidge.
Function: I mprovesrangeof motionof tight muscles along theneck, increasingflexibility and circulation.
10.F2
10.F3
11.C
Cervical Spine.F2
Location: Peripheral concharidgebelow LM IS,wheretheconchafloor lies next totheconchawall.
Cervical Spine.F3
Location: I nferior region of thetragus, between LM 9and LM 10. Locatedat theTranquilizer point.
Thoracic Spine.C
Location: Ridge andscaphoidfossa sideof theantihelixbody.
Function: Relieves upper back pain, lowback pain, shoulder pain, arthritis.
[CR 2]
[TG 2]
[AH9,AH 10]
11.F1 Thoracic Spine.F1 (Upper Back, Dorsal Spine, Thoracic Vertebrae) [AH3,AH4, PG 3, PG 4]
Location: Conchasideof theantihelixbody, between LM 15and LM 16.TheTl vertebralies above theconcharidge,
across fromLMD. Theotherthoracicvertebraeare sequentially found along theslopingantihelixas itcurves upward
and medially towardtheinferior crus.
11.F2
11.F3
Thoracic Spine.F2
Location: Medial concharidge, just peripheral toLM O.
Thoracic Spine.F3
Location: Middleregionof thetragus, between LM 10and LM 11.
[CR 1]
[TG 3,TG4]
12.C Lumbar Spine.C (LowerBack, LumbarVertebrae, Sacroiliac) [AH11]
Location: Upper region of theantihelixbody.
Function: Representingsacroiliac muscles and ligaments, thispointrelieves lowback pain, sciatica pain, peripheral
neuralgia, back strainand discdegeneration.
12J1 Lumbar Spine.F1 [AH5,AH6, PG 5, PG 6]
Location: Topsurface of theantihelixinferior crus, between LM 16and LM 17.TheL1vertebraoccurs at LM 16,
where theinferior crus begins, and proceedsalong theflat ledge of theinferior crus to L5at LM 17.
12.F2
12.F3
176
Lumbar Spine.F2
Location: Rising helix root, above LM D.
Lumbar Spine.F3
Location: Superior region of thetragus, above LM 10.
[HX 1]
[TG 5]
13.Fl Sacral Spine.F1 (Coccyx) [AH 7,PG 7)
Location: Topsurface of theantihelix inferior crus, betweenLM 17and LM 1. TheS1vertebraoccurs at themidpoint
of theinferior crus, at LM 17,whileS5isfound belowtheLungpoint.
Function: Relieves lowback pain, sciatica pain.
14.0
15.0
Buttocks (Gluteusfvlaximusmuscles)
Location: Topsurface of theantihelixinferior crus, near LM 16.
Function: Relieves pain inbuttocksmuscles, lowback pain, sciatica, hippain.
Neck (AnteriorNeckmuscles,Throatmuscles, Scalenemuscles)
Location: Scaphoidfossa sideof theantihelixtail, superior toLM 14.
Function: Relieves neck tension, sore throats, torticollis, hyperthyroidism.
[AH 5, PG 5]
[AH8,AH 9, PP 1, PP 3]
16.(
16.E
Clavicle.C (Collarbone)
Location: I nferiorscaphoidfossagroove peripheral totheNeck point.
Function: Relieves clavicle fracture, shoulder pain, arthriticshoulder, rheumatism, upper back pain.
Clavicle.E (Collarbone, Scapula, ShoulderBlade)
[SF 1]
[AH 9, PP 3]
Location: Antihelixregion near thescaphoidfossawhichlies peripheral totheNeck and Chestpoints, at thejunction
of theantihelixbodyand antihelix tail at LM 15.
17.0
18.0
Breast
Location: Scaphoidfossa sideof theantihelixbody, superior toLM 15.
Function: Relieves premenstrual breast tenderness, breast cancer.
Chest (Thorax, Ribs, Sternum,Breast, Pectoral muscles)
Location: Antihelix body, superior toLM 15andnear theBreast point.
Function: Relieves chest pain, chest heaviness, intercostal pain, anginapectoris, cough, asthma, hiccups.
[AH 10]
[AH 10,PP 3]
19.0
20.0
Abdomen (Abdominalmuscles, OutsideAbdomen)
Location: Superior sideof theantihelixbody.
Function: Relieves abdominal pain, lowback pain, hernias.
Pelvic Girdle (Pelvis, PelvicCavity)
Location: Tipof thetriangular fossa, superior toLM 16andbelowtheShen Menpoint.
Function: Relieves groin pain, lowback pain, hernias, digestive disorders.
[AH 11,AH 12,PP 5]
[TF 2, PG 8]
177
20.0
Pelvic Girdle
19.0
Abdomen
12.C
Lumbar Spine
18.0
Chest and Ribs
17.0
Breast
11.C
Thoracic Spine --.::::::l:
16.E _
Clavicle.E
15.0
Neck
10.C
Cervical Spine
Clavicle.C
12.F4
Lumbar Spine
11.F4
Thoracic Spine
10.F4
Cervical Spine
Posterior ear
11.F2
Thoracic
Spine
10.F1
Cervical
Spine
178
Figure 7.7 Hiddenviewofthemusculoskeletal spinerepresented ontheantihelix. (FromLifeARr, Super
Anatomy, 'LippincottWilliams& Wilkins,withpermission.)
14.
Buttocks
13.
Sacral
Spine
12.
Lumbar
Spine
11.
Thoracic
Spine
19.0
Abdomen
18.0
Chest and Ribs
17.0
Breast
12.C
Lumbar Spine
11.C
Thoracic Spine
14.0
Buttocks
12.F1
Lumbar Spine
16.C
Clavicle.C
18.
Chest
17.
Breast
16.
Clavicle ~
15./H
Neck
19.
Abdomen
20.0
Pelvic Girdle
16.E
Clavicle.E
_-+-__ 10.C
Cervical Spine
15.0
Neck
13.F1
Sacral Spine
10B
Cervical Spine
12.F3
Lumbar Spine
11.F3
Thoracic Spine
11.F1
Thoracic Spine
Figure 7.8 Surface viewofthemusculoskeletal spinerepresented ontheantihelix. (FromLifeARtJ9,Super
7.2.2 Leg and foot represented onthe superior crus and triangular fossa
No.
21.C
21.F1
21.F2
21.F3
22.0
23.C1
23.C2
23.F1
23.F2
23.F3
24.E
25.C
Hip.C
Location: Lower region of theantihelixsuperior crus, peripheral to theShenMenpoint.
Function: Relieves hip pain. lowback pain.
Hip.F1 (Coxofemoraljoint)
Location: Peripheral tipof thetriangular fossa, inferior andcentral to theShenMenpoint.
Hip.F2
Location: Floor of thelower inferior concha. inthe region of the intertragicnotch.
Hip.F3
Location: Peripheral antitragusandtheinferior antihelixtail andscaphoidfossa.
Thigh (Upper Leg, Quadricepsmuscles, Femur)
Location: I nferior triangular fossa. immediatelyabove theButtockspoint.
Function: Relieves upper leg pain. pulled hamstringmuscles.
Knee 1(Kneejoint.Kneearticulation)
Location: Middleregion of theantihelixsuperior crus, alongsidethetriangular fossa.
Function: Relieves kneepain. strainedknee, broken knee.
Knee 2 (GenusofKnee)
Location: Peripheral region of theantihelixsuperior crus. alongsidethescaphoidfossa.
Knee.F 1(Patella)
Location: Middleof thedepthof the triangular fossa, central to theShen Menpoint.
Knee.F2
Location: Floor of theinferior concha. intheregionof theThalamuspoint.
Knee.F3
Location: Middlerangeof theantitragusridge. inferior to LM 13.
Calf.E (LowerLeg. Gastrocnemiusmuscle.TibiaandFibula bones)
location: Infcrior, medial region of thetriangular fossa.
Function: Relieves lower legpain.
Ankle.C
Locution: Superior aspect of theantihelixsuperior crus.
Function: Relieves anklepain, swollen ankles.
[Auricularzone]
[AH13]
[TF 1, PT 1]
[IC lI C 2]
[AT3,AH1]
[TF 3, PT 1]
[AH15]
[AH14]
[TF 4. PT 2]
[I C2,I C4]
[AT2,CW2]
[TF 5. PT 3]
[AH17,PP12]
No.
25.Fl
25.F2
25.F3
26.C
Auricular microsystem point (Alternativename)
Ankle.F1
Location: Central region of thetriangular fossa.
Ankle.F2
Location: Floorof theperipheral inferior concha, belowthelower antihelixtail.
Ankle.F3
Location: Central rangeof theantitragusridge.
HeeL.C
Location: Highest region of theantihelixsuperior crus, covered bythesuperior helixbrim.
Function: Relieves heel pain, foot pain.
[Auricular zone]
[TF 6, PT 3]
[IC5]
[AT 1]
[AH 17, PP 12]
--------------------------------- ------
26.E HeeL.E (Tarsus) [TF 5, PT 3]
Location: Mostcentral region Ofthetriangular fossa, covered bythesuperior helixbrim. I tisimmediatelyadjacent to
themedial end of theinferior crus and totheSympatheticAutonomicpoint.
27.Fl
27.F2
27.F3
28.C
Foot.F 1(Metatarsals)
Location: Triangularfossa, covered bythesuperior helixbrim.
Function: Relieves foot pain, peripheral neuralgiainthefeet.
Foot.F2
Location: Floor of theperipheral inferior concha, near theconcharidge and theconchawall.
Foot.F3
Location: I ntertragicnotch.
- - - - - - - - ~ - - -- .--. --. -_._--- -------- - - - - - ~ - - - - - - - - _ . _ - - - _ . _ . _ - - - - - - - _ . _ - - - - - - - - - - - - - - -
Toes.C
[TF 5&TF 6, PT 3]
[IC 5]
[IT1,IT2)
[AH 18, PP 12]
Location: Superior crus, covered bythesuperior helixbrim. Thetoes are moreperipheral thanthepointsfor theheel.
Function: Relieves pain intoes, strainedtoe, inflamed toe, frostbite, peripheral neuralgiainthefeet.
28.E Toes.E [TF 6, PT 3]
Location: Triangularfossa, covered bythesuperior helixbrim. Thelargetoeisthehighest pointonthetriangularfossa,
closetothetopof thesuperior crusof theantihelix.
somatotopicrepresentations 181
28.C
Toes
,leo,
23.C1
Knee 1
21.C
Hip
23.C2
Knee 2
25.F2
Ankle
Posterior ear
25.F4
Ankle
23.F4
Knee
21.F4
Hip
21. F1
Hip
24.E
Calf
23.F1
Knee
22.0
Thigh
27.
Foot
26.
Heel
25.
Ankle
24,
Calf
23.
Knee
22.
Thigh
.....--1-_
21
.
Hip
182
Figure 7.9 Hiddenviewofthelegandfoot represented ontheauricle. (FromLiteARr, Super Anatomy,
'LippincottWilliams& Wilkins,withpermission.)
Auricu/otherapyManual
26.C
Heel
28.C
Toes
r - -,
L __ .I
Region hidden by
helix brim
25. F1
Ankle
27.F1
Foot
23.F1
Knee
26.E
Heel
24.E
Calf
22.0
Thigh
27. F2
Foot
25.F2
Ankle
23.F2
Knee
27.
26. Foot
Heel
24.
Lower leg
22.
Upper leg
21.
Hip
27.F3
Foot
25.F3
Ankle
23.C2
Knee 2
21.F1
Hip
28.
Toes
27.
Foot
24.
Calf
23.
Knee
22.
Thigh
21.
Hip
Figure 7.10 Surface viewofthelegandfootrepresented ontheauricle. (FromLifeARfJi!, SuperAnatomy,
'LippincottWilliams& Wilkins, withpermission.i
7.2.3 Armand hand represented on thescaphoid fossa
No. Auricular microsystem point (Alternativename)
[Auricularzone]
. _.- --_._...._ . _ - - ~ - - - - - - - - ---------- -----_._._--------
29.0
30.0
Thumb
Location: Antihelixsuperior crus, alongsidethescaphoidfossa.
Function: Relieves pain of sprainedthumb.
Fingers (Digits, Phalanges)
Location: Uppermostscaphoidfossa, covered bythesuperior helixbrim.
Function: Relieves pain, swelling, peripheral neuralgia, frostbite, and arthritisinfingers.
[AH16&AH 18, PP 9]
[SF 6, PP 10]
------------_._.,,- ----------
31.0
31.F2
Hand (Palm, Carpals, Metacarpals)
Location: Upperscaphoidfossa, central toLM3andDarwinstubercle.
Function: Relieves pain andswellinginhand.
Hand.F2
[SF 5&AH 14, PP 9]
[SC 8]
31.F3
Location:
Hand.F3
Floorof theperipheral superior concha, above theconcharidge andnear theconchawall.
[LO1]
32.0
32.F2
Locution: Central ear lobe, near theMasterCerebral point.
Wrist
Location: Scaphoidfossa, central toLM4of Darwinstubercle.
Function: Relieves pain, strain, andswelling inthewrist, andreducessymptomsof carpal tunnel syndrome.
Wrist.F2
Location: Floorof theperipheral superior concha, belowLM 16.
[SF 5, PP 7]
[SC6]
32.F3 Wrist.F3
Location: Central ear lobe, near theMastersensorial point.
[LO3]
33.0
34.0
34.F2
Forearm (UlnaandRadiusbones,Brachioradialis muscle)
Location: Inthesuperior scaphoidfossa, inferior totheWristpoint.
Function: Relieves pain andspasms inforearm, tenniselbow.
. ~ - - - - - - - ---------_ .. _._----
Elbow
Location: Inthescaphoidfossa, directly peripheral totheantihelix inferior crus.
Function: Relieves pain, strain, soreness, andswelling inelbowjoint, tenniselbow.
Elbow.F2
Location: Onthefloor of thesuperior concha, belowthemiddleof theinferior crus.
[SF 4, PP 7]
[SF 3, PP 5]
[SC 5]
34.F3
184
. ----------- --_._--_._-----------------------------------------
Elbow.F3
Location: Peripheral car lobe.
AuticuiotherepyManual
[LO5]
No.
35.0
36.0
Upper Arm(BicepsandTricepsmuscles, Humerusbone,ChineseShoulder)
Location: Inthescaphoidfossa, superior totheShoulder point.
Function: Relieves pain andspasms in upper arm.
Shoulder (Pectoral Girdle, Deltoidmuscles, ChineseShoulderjoint)
[Auricular zone]
[SF 3, PP 5]
[SF 2, PP3]
Location: Inthescaphoidfossa, peripheral toLM0and LM IS,wheretheantihelixregion representingtheneck meets
theantihelixregion representingtheupper baek.
Function: Relieves pain, tenderness, swellingand arthritisintheshoulder.
36.F2
36.F3
37.0
Shoulder.F2
Location: Floor of thesuperior conchanear theinternal helixandtheconchawall.
Shoulder.F3
Location: I nferior regions of thescaphoidfossa and thehelixtail.
Master Shoulder point (Scapula, Trapeziusmuscle, ChineseClavicle)
Location: Intheinferior scaphoidfossa, inferior toShoulderpoint, central toLM5.
Function: Relieves pain, tenderness, strainandswelling inshoulder.
[SC 4]
[SF 1,HX 15]
[SF 1,PP 1]
Overview of upper limb representation: Thescaphoidfossa can bedivided intoequal thirds. The
handandfingers arerepresentedontheupper third, theforearm, elbow, and upper armare
representedonthemiddlethird, andtheshoulder isrepresentedon thelower thirdof thescaphoid
fossa. Unlikethedifferences betweentheChineseand Europeanauricular systems representing
thelower limbs, bothsystems of auriculotherapyconcur withregardtothelocation of theupper
limbs.
Physical support of the scaphoid fossa: Because thescaphoidfossa isagroove on themost
peripheral part of theexternal ear, it tendstoflapback andforthwhen theear isscannedfor an
activereflex point. I tisnecessary toprovidefirmback pressurewhileprobingtheskin todetect a
point for auricular diagnosis or auriculotherapytreatment.Thetherapistsownthumbprovides
back pressurewhilestretchingtheear withtheindexfinger. Todetect apointontheposterior
surface of theear, bendtheear over slightly, revealing theback of theear. Treat theidentical
posterior region detectedontheanterior surfaceof theauricleinorder torelieve themuscle
spasms thatmayaccompanythesensory aspects of paininalimb.
32.F2
Wrist
31.F3
Hand
34.F2
Elbow
30.
Fingers
31.
Hand
34.
Elbow
32. __---11"""
Wrist
33.
Forearm
32.F3
Wrist
29.0 Thumb
30.
Fingers
29.
Thumb
Wrist
36.F4
Shoulder
36.F3
32.F4 Shoulder
Wrist
31.F4
Hand
34.F4
Elbow
37.0
Master
Shoulder
....
32.0
Wrist
31.0
Hand
35.0
Arm
34.0
Elbow ---c.,,
33.0
Forearm
36.
Shoulder
Posterior ear
34.
Elbow
Figure 7.11 Hiddenviewofthearmandhandrepresented on theauricle. (FromLifeARr, SuperAnatomy,
'LippincottWilliams& Wilkins, withpermission.t
33.0
Forearm
34.0
Elbow
36.F3
Shoulder
34.F3
Elbow
32.F3
Wrist
r - -, Region hidden by
L.__ .J helix brim
31. F3
Hand
31.F2
Hand
32.F2
Wrist
34.F2
Elbow
36. Shoulder
31. Hand
36.F2
Shoulder
_01,-\--35. Arm
.ltoi&>r--34. Elbow
.--I!';''------33. Forearm
_---1110-+-32. Wrist
~ I -
/
35.
Arm
33.
Forearm
34.
Elbow
29.
Figure 7.12 Surface viewofthearmand handrepresented ontheauricle. (FromLifeARTW, Super Anatomy.
'LippincottWilliams&Wilkins, withpermission.]
7.2.4 Head, skull and face represented onthe antitragus and lobe
[AT3, PL 4]
[AT2, PG 1]
[AT 1,PL 2]
38.0
39.0
40.0
Occiput (Occipital Skull,Back ofHead, AtlasofHead)
Location: Ontheperipheral superior antitragus, near theantitragus-antihelixgroove.
Function: Relievesoccipital headaches, tensionheadaches, facial spasms, stiff neck, epileptic convulsions, brainseizures,
shock, dizziness, seasickness, car sickness, air sickness, vertigo, impairedvision, insomnia, coughsandasthma. InTCM,the
Occiputpoint isutilizedfor all nervousdisorders, calmsthemind,clears heat, dispelswindandnourishes liver qi.
Temple (Temporoparietal Skull, Tai Yang, Sun point)
Location: Onthemiddleof theantitragus, inferior toLM 13, theapex of theantitragus.
Function: Relieves migraineheadaches, temporal headaches, tinnitus, anddisordersrelatedtoblood circulation tothe
head. InTCM,thispointaffects thebody acupoint TaiYangand dispels wind.
Forehead (FrontalSkull)
Location: Lower antitragus, near LM 12andtheintertragicnotch.
Function: Relieves frontal headaches, sinusitis, dizziness, impairedvision, insomnia, distractibility, neurasthenia,
anxiety, worry, depression, lethargy, disturbingdreamsandhypertension.
411
42.C
43.E
44.0
Frontal Sinus
Location: Central lobe, inferior totheantitraguspointfor theforehead.
Function: Relieves frontal headaches, sinusitis, rhinitis.
Vertex (Chinese Top ofHead, ApexofHead)
Location: Peripheral superior lobe, belowtheOcciputpoint.
Function: Relieves pain at thetopof thehead.
TMJ (Temporomandibularjoint)
Location: Peripheral lobe, inferior tothescaphoidfossa, central toLM 6.
Function: Relieves jawtension, toothaches, TMJ, bruxism.
Lower Jaw (fvlandible, fvlasseter muscle, LowerTeeth)
[LO1]
[L06]
[LO8, PL 4/PL6]
[LO7, PL6]
Location: Peripheral lobe, inferior totheTMJ point.
Function: Relieves lower jawtension, toothaches, TMJ, bruxism, anxiety, pain fromdental procedures. Usedfor
acupunctureanalgesia for toothextraction.
45.0 Upper Jaw (fvlaxilla, UpperTeeth)
[LO8, PL 4]
Location: Peripheral lobe, inferior totheTMJ pointand central totheLower Jawpoint.
Function: Relieves upperjawtension, toothaches, TMJ,bruxism, anxiety, painfromdental procedures. TheJawpoints
areused for acupunctureanalgesiafor toothextraction.
~ ~ ~ ~ ~ _ . _ ~ ~ ~ ~ ~ ~ ~ ~ . _ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ . _ - ~ - - _ .
46.C1
46.C2
Toothache 1
Location: Peripheral lobe.
Function: Relieves toothaches, toothdecay.
Toothache 2
Location: Conchawall behindantitragus.
Function: Relieves toothaches.
[L08]
[CW3]
188 Auriculotherapyfvlanual
No.
46.C3
47.C1
47.C2
Toothache 3
Location: I nferiorconcha, belowantitragus.
Function: Relieves toothaches.
DentalAnalgesia1(ToothExtractionAnesthesia1,UpperTeeth)
Location: Central lobe, inferior tointertragicnotchandsuperior totheMasterCerebral point.
Function: Used for pain relief duringdental procedures, gumdisease, toothdecay.
Dental Analgesia 2(ToothExtractionAnesthesia2, LowerTeeth)
[Auricular zone]
[IC 5]
[LO2]
[LO1]
Location: Central lobe, inferior totheDental Analgesia I pointand near theMasterCerebral point.
Function: Used for pain relief duringdental procedures, gumdisease, toothdecay, and periodontal inflammations.
48.C1
48.C2
49.C
49.E
50.E
Palate 1 (UpperPalate)
Location: Upper center of lobe, inferior toLM 12onantitragus.
Function: Relieves sores, ulcers, andinfectionsinthegumsof lower mouth.
Palate 2(LowerPalate)
Location: Centerof thelobe, inferior toLM 13onapex of antitragus.
Function: Relieves sores, ulcers, andinfectionsinthegumsand liningof upper mouth.
Tongue.C
Location: Centerof thelobe, betweenPalate1and Palate2.
Function: Relieves pain andbleedingof tongue.
Tongue.E
Location: Peripheral lobe, inferior toear reflex pointsfor Jaw.
Function: Relieves pain andbleedingof tongue.
Lips
Location: Peripheral lobe, betweenLM 6andLM7.
Function: Relieves chappedlips, cold sores onlips.
[L04]
[L04]
[L04]
[LO5, PL 5, PL 6]
[LO3, PL 5]
------------
5l.E
52.C
Chin
Location: Peripheral lobe, near LM 6.
Function: Relieves skin sores andscrapes onchin.
Face (Cheek)
Function: Relieves facial spasms, tics, paresthesia, trigeminal neuralgia, acne, facial paralysis.
[L08]
[LO3, PL 5]
Overview of head and face representation on the ear: Thefacemuscles arerepresentedonthe
lobe, separatefromtheantitraguspointsfor theskull. Theangled antitraguscan bedivided into
equal thirds, withtheocciput representedontheupper, outerthirdof theantitragus, thetemples
representedonthemiddlethirdof theantitragus, andtheforeheadrepresentedonthelower,
medial thirdof theantitragus. Aswiththerepresentationof theupper limbs, boththeChineseand
Europeansystems of auriculotherapyconcur withregardtothelocationof thehead.
46.C3
Toothache 3
46.C2
Toothache 2
48.C1
Palate 1
49.C
Tongue.C
52.C
Face
50.E
Lips
45.0
Upper Jaw
46.C1
Toothache 1
49.E
Tongue.E
44.0
Lower Jaw
52.
Face
51.
Chin
Ji 50.

,.{/i 51.
i Chin
42.
Vertex
40.
Forehead
39.
Temple
44.0
Lower Jaw
40.
39
1
. ( \ Forehead
Temp e I( (\ 45.
-\" ... .. Upper Jaw
\fEiIN---
Figure7.13 Hiddenviewofthehead and face represented on theauricle. (FromLifeARTJ9,Super Anatomy, 'LippincottWilliams&
Wilkins,withpermission.)
Physical supportof theantitragus: Because theantitragusisaridge ontheperipheral aspect of
theexternal ear, it tendstoflapback andforth when scanningtheear for anear reflex point. It is
necessary to providefirmback pressurewhen detectingaheadpoint for auricular diagnosis or
auriculotherapytreatment.Thepractitionersownthumbprovides back pressurewhilestretching
theear with theindexfinger. Whendetectingapointon theposterior surface of theear, bendthe
ear over slightly, revealing theback of theear. Treat theidentical posterior region detectedonthe
anterior surfaceof theauricleinorder to relieve themuscle spasms thatmayaccompany the
sensory aspects of headaches.
48.
Palate
49.
Tongue
46.C3
Toothache 3
38.0
Posterior ear
Occiput
46.C2
Toothache 2
39.0
Temple
40.0
Forehead
42.C
Vertex
44.0
41.E
Lower Jaw
Frontal Sinus
45.0
47.C1
Upper Jaw
Dental Analgesia 1
46.C1
Toothache 1
47.C2
Dental Analgesia 2
49.E
Tongue.E
43.F4
48.C1
TMJ
Palate 1 48.C2 52.C
38.F4 49.C
Palate 2
Face
44.F4
Occiput
Tongue.C
Lower
jaw
45.F4 39.F4
Upper Temple
jaw
49.F4
40.F4
Tongue
Forehead
41.
Frontal
sinus
Figure 7.14 Surface viewofthehead and face represented on theauricle. (FromLifeARJE!,Super Anatomy, 'LippincottWilliams&
Wilkins.withpermission.)
7.2.5 Sensory organs represented onthe lobe, tragus and subtragus
-----=--------
No.
53.C
53.F1
- - - _ . ~ - - - - - - _ . _ - - - - - ------_.._--------
Skin Disorder.C (Urticaria)
Location: Superior scaphoidfossa, central toLM3and located near theHandpoint.
Function: Relieves dermatitis, urticaria, eczema, hives, poison oak.
Skin Disorder.F1
Location: All alonghelixtail.
[Auricular zone]
[SF 5]
[HX12-HX 15]
53.F2
53.F3
Skin Disorder.F2
Location: Superior concha.
Skin Disorder.F3
Location: Central lobe belowtheintertragicnotch.
[SC 5]
- - - _ . _ - - - - ~ . -
[LO2]
54.0 Eye (Retina, MasterSensorial point)
Location: Centerof lobe, at thesame location asMasterSensorial point.
Function: Relieves poor eyesight, blurredvision, eyeirritation, glaucoma, styeandconjunctivitis.
[LO4]
.- -------------_ .. -_._----------------------
55.C1 EyeDisorder 1(Mu1)
Location: Central sideof intertragicnotch.
Function: Relieves blurredvision, eye irritation, glaucoma, retinitis, myopia, astigmatism.
[IT 1]
-------- - - - ~ - - - - - - - - - --------------------
55.C2
55.C3
Eye Disorder 2(Mu2)
Location: Peripheral sideof intertragicnotch.
Eye Disorder 3 (NewEyepoint)
Location I nferior concha, belowhelixroot.
[AT 1]
[IC6]
56.C Inner Nose (Internal Nose, Nasal Cavity) [ST 2]
Location: Middleof subtragus, underneathinferior tragus protrusion, LM 10.
Function: Relieves runningnose, chronicsneezing, commoncolds, flu, sinusitis, rhinitis, nasal bleeding, profusenasal
discharge, nasal obstruction, and allergies. It eliminatespathogenicwind-cold andwind-heatinthelungs byremoving
obstructionsinthenose.
57.C External Nose.C (OuterNose)
Location: Middleof tragus.
Function: Relieves pain frombrokennose, sunburnednose, rosacea.
[TG 3]
- - _ . _ - - - - - - ~ ----_.------- ----
57.E
58.C
5B.E
59.C
192
External Nose.E
Location: Central sideof inferior lobe.
Inner Ear.C (Internal Ear)
Location: Peripheral lobe, inferior to theantihelix tail.
Function: Relieves deafness, hearingimpairment, tinnitus, dizziness, vertigo, Menieresdisease.
. ~ - _ . - - - - -
Inner Ear.E (Internal Ear, Cochlea)
Location: Middleof subtragus, near ChineseI nnerNose.
. - - - - - - - - ~ - - - - - - - - - - _ . _ - - - -
External Ear (OuterEar, Auricle, Pinna)
Location: Superior tragus.
Function: Relieves pain andinfectionsof external ear, deafness, tinnitus, ear infections.
- - - ~ ~ - - ~ . _ - - - - - - - - - - - - - - - - - - - - - - - - - ~
[LO1]
[LO5]
[ST 3]
[TG5]
Inferior crus
12. F1
LumbarSpine
12.F4
Low Back Spasms
Posterior groove
behindantihelixtail
Concha
floor
Posterior groove
Antihelixtail
10.F4
NeckTension
Paravertebral muscles
10.F1
Cervical Spine
11.F4
Mid Back Spasms
Antihelixbody
Posterior groove
behindantihelixbody
Ligamentsandstructural muscles
Muscle
tension
Figure 7.15 Depthviewofthemusculoskeletal spinerepresented on theauricle. Theshapeofdifferentspinal
vertebrae oftheinvertedsomatotopicbodycorresponds tochanges intheshapeofthecontoursoftheantihelix.
Thesechangesinantihelixcontourscan beused todistinguishdifferent levels of thevertebral
columnrepresentedontheauricle. Theyarealso used todistinguishauricular regionswherethe
hip, shoulder andheadextendfromthespine.
53.C
Skin Disorder.C
53.F1
Skin Disorder. F1
59 . - - - - - - 1 ~
External
Ear
54.
Eye
58.C
Inner Ear.C
54.0
Eye
58.
I nner Ear
55.C3
Eye Disorder 3
58.E
I nner Ear
56.C
Inner Nose
55.C1
Eye Disorder 1
55.C2
Eye Disorder 2
5l.E
External Nose
56.
I nner Nose
194
Figure 7.16 Hiddenviewofthesensory organs represented on theauricle. (FromLileARTJI!, SuperAnatomy,
'LippincottWilliams& Wilkins, withpermission.)
AurieulotherapyManual
57.E
External Nose
53.F 2
Skin Disorder.F 2
55.C3
Eye Disorder 3
59.e
External Ear
57.e
External Nose
58.E
Inner Ear
56.e
Inner Nose
55.c1
Eye Disorder 1
55.C2
Eye Disorder 2
53.F3
Skin Disorder.F 3
53.
Skin
Disorder
~ 5 4 .
Eye (retina)
54.0
Eye
54.
Eye
53.e
Skin
Disorder.e
53.Fl
Skin
Disorder.Fl
53.
Skin
dermatomes
Figure 7.17 Surfaceviewofthesensory organs represented ontheauricle. (FromLifeARTJf!, SuperAnatomy,
'LippincottWilliams&Wilkins,withpermission.)
7.2.6 Auricular landmarksnearmusculoskeletal points
LM 1 Helixinsertion: Thelower Sacral Vertebraearelocatedon theantihelixinferior crus belowthis landmarkon thehelix
root.
LM2 Apexof ear: TheThumbpointislocatedon theantihelixsuperior crusjust belowthis landmarkon thesuperior helix.
- -_.._-----_... _ . _ - - ~ ~
Superior Darwinstubercle: TheHandpoint inthescaphoidfossa isfoundcentrallywithinthis landmark.
- - - - _ . _ - ~ . _ - - - _ . _ - - - - - - - -
I nferior Darwinstubercle: TheWrist pointinthescaphoidfossa isfoundcentrallywithinthis landmark.
LM3
LM4
LM 5 Helixcurve: TheMasterShoulder pointin thescaphoidfossa islocatedcentrallywithinthis landmark.
LM 6 Lobular-HelixJunction: TheLower Jaw and TMJ are located centrallywithinLM 6.
LM 7 Bottomof lobe: TheLipsarelocated superior toLM 7.
LM 8 Lobular insertion: TheEuropeanExternal Noseislocated superior to LM 8.
LM 9 I ntertragicnotch: TheMu1EyeDiseasepointislocatedjust central to this landmark, whereas theMu2EyeDisease
point islocatedjust peripheral to it.
LM 10
LM 11
LM 12
LM 13
I nferiortragusprotrusion: TheChineseExternal Noseislocated halfway between LM 10andLM 11.
Superiortragusprotrusion: TheChineseExternal Earislocatedjust superior to this landmark.
Antitragusprotrusion: TheForeheadon theantitragusislocated near this landmark.
Apexof antitragus: TheTempleson theantitragusarefoundinferior to this landmark. TheEye1point, at thecenter of
thelobe, iseven further belowLM 13.
-------------
LM 14 Baseof antihelix: TheUpper Cervical Vertebraearelocatedjust superior to this landmark, theUpper Neckmuscles
just peripheral toit. TheOcciputon theantitragusisfoundinferior andcentral toLM 14.
.. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~
LM 15
LM 16
Antihelixcurve: Thedivision of theupper ThoracicVertebraefromthelower Cervical Vertebraeislocated at this
landmark. TheShoulder point islocatedjust peripherallyin thescaphoidfossa.
- - - - - - - - - - - - ~ ~ - - - - - - _ . _ - - - _ . _ - -
Antihelixnotch: Theupper LumbarVertebraeare locatedabove this landmark. TheElbowpoint islocated more
laterally inthescaphoidfossa.
LM 17 Midpointof inferior crus: Thedivision of theupper Sacral Vertebraefromthelower LumbarVertebraeislocated at
thislandmark.
----------------------------------- -----_._-----
A B
Sacral Spine
Lumbar Spine
Cervical Spine
Occiput
Temples
Forehead
c o
Master Shoulder
European Foot and Leg
Wrist
Elbow
Shoulder
Fingers and Hand
Chinese Foot and Leg
Thoracic Spine
Figure 7.18 Auricularregions correspondingto theheadandneck(A),lowerspine(B),thoracicspine(C)andupperandlowerlimbs(D).
197
198
7.3 Auricular representation of internal visceral organs
Thearrangementof thelocationof internal organson theauricleisbased uponthesame
anatomical organizationastheorgansthatarefound intheinternal body, onlytheyare upside
down. Theauricular pointsrepresent physiological disturbancesintheseorgans, nottheactual
anatomical organsthemselves.
Digestivesystem: Thegastrointestinal systemor alimentarycanal convertsfood thathasbeen
eatenintosmaller fragments, allowingbasic nutrientstobeabsorbed intothebody tomake energy
andtoformthebasic buildingblocks for muscles, bonesand internal organtissue.
Mouth: Thissoft tissue liningof theoral cavityor buccal cavity includesthegums, palate, tongue,
andsalivary glands, wherefood isinitially tastedaswell asbrokendown.
Esophagus: Thegullet isalongtubethatdeliversfood fromthemouthtothestomach,joiningthe
stomachat thecardiac orifice, asmoothmusclesphincterthatcloses off gastricjuices frominducing
refluxback intotheesophagus.
Stomach: Thisholloworganisatemporarystoragetankfor food. Throughmechanical churning
andgastric acidchemicals, food received fromthemouthisfurther brokendown.
Small intestines: Thisvery longtubewindsback onitself manytimes, allowing for thegradual
absorptionof food nutrientsintothebody. I tbegins at theduodenumconnectedto thestomach
and ends at theileumconnectedtothelarge intestines.
Large intestines: Thisfinal tubeprogresses fromtheascendingcolontothetransversecolon tothe
descendingcolon, endingintherectum. Thecolon withdrawswater fromindigestiblefood.
Circulatorysystem: Thishydraulic systembeginswith thecardiac muscle inthethorax,
which sendsoxygen-rich bloodthroughthearteries to deliver it to all partsof thebody, and
receives oxygen-deficient bloodfromtheveins. Thelymphaticvessels collect excess fluid,
metabolicwastes, and immunesystem breakdown products.
Heart: Thisprimarycardiac muscle pumpsbloodtoall partsof thebody.
Respiratorysystem: Thetubular organsof thissystemallowexchangeof air andcarbondioxide.
Lungs: Thisorganfor exchangeof air gases includesbronchial tubesand alveoli sacs.
Throat: Thisopeningto therespiratory system includes themouth, pharynx, andlarynx.
Tonsils: Theselymphaticorgansintheoral cavity surroundingthethroatserve togather and
eliminatemicroorganismsthatenterthethroat.
Diaphragm: Thissmoothmuscle membranebelowthethoraxallows inhalationtooccur.
Accessory abdominal organs: Organsintheabdomenthatfunctionwithothersystems.
Liver: Thisaccessory gastrointestinal organlies next tothestomach. Theliver converts blood
glucose intoglycogen, incorporatesaminoacids intoproteins, releases enzymes tometabolize
toxicsubstances intheblood, and producesbile. Thebileisreleased intothesmall intestines,
whereit facilitates digestionof fats.
Gall bladder: Thismuscular sac storesbilecreatedbytheliver.
Pancreas: Thisaccessory endocrine-exocrinegland producesdigestive enzymes, thehormone
insulin tofacilitateenergyinsidecells, and thehormoneglucagon to raise bloodsugar levels.
Spleen: Thisaccessory lymphaticorgannext tothestomachfilters thebloodand removes
defective bloodcells andbacteria. I tisasitefor producingadditional immunecells.
Appendix: Thispouchattachedtothelarge intestinescontainslymphatictissue.
Urogenital organs: Abdominal andpelvic organsof theurinaryandreproductivesystems.
Kidney: Thisprimaryurinaryorganfilters toxicsubstances fromthebloodand releases it into the
urine. I tmayretainor releasebodyfluids and mineral salts.
Bladder: Theurinarybladder receives urinefromtheureter andkidneyandholds it for release.
Urethra: Thefinal tubewhich connectsthebladder and gonadstotheoutsideworld.
AuriculothersoyManual
Prostate: Theaccessory reproductiveorganinmales which contributesmilkysubstances tothe
semen.
Uterus: Thisreproductiveorganinfemales potentiallyholdsthefertilized eggor discharges its
vascular liningduringthemenstrual period.
External genitals: Thepenisinthemale andtheclitorisinthefemalearousedduringsexual
performance.
60.
Mouth
106. ...
Salivary
Glands
64.
Duodenum
67.
Rectum
61.
Esophagus
62.
Cardiac
Orifice
---+----\-63.
Stomach
65.
Small
I ntestines
66.
Large
I ntestines
68.
Circulatory
System
liA+-i-\-\--- 69.
Heart
72.
Trachea
76.
Diaphragm
75.
Tonsil
-A-_-r- 70.
Lung
71.
--""--Bronchi
73.
Throat ---.lfl'--
(pharynx)
74.
Larynx
79.
Liver \
81.
Spleen
83.
86.
Pancreas
Bladder
84.
88.
Kidney
Prostate
85.
Ureter
87.
86.
Urethra
Bladder
90.
87. External
Urethra Genitals
77.

(penis)
Appendix
Uterus
Figure 7.19 Overviewoftheinternal visceral organs. (FromLifeARfJ9,SuperAnatomy, 'LippincottWilliams&Wilkins, with
permission.)
7.3.1 Digestive system represented intheconcha region around thehelix root
~ ~ ~ ~ ~ ~ ~ -
60.0
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - - - - - ~ - - - - - - - -
Mouth (Fauces, SoftPaiate)
Location: I nferiorconcha, next totheear canal andbelowthehelixroot.
Function: Representingthesoft tissue liningof theinner mouth,gums, and tongue, thisear pointrelieves eating
disorders, mouthulcers, cold sores, glossitis.
[IC6]
- - - ~ - - - - - - - - - - - - - - - - - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -
[IC 7]
[IC 7]
61.0
62.0
Esophagus
Location: I nferiorconcha, peripheral totheMouthpoint.
Function: Representsthelongtubewhich connectsthemouthtothestomach. Relieves indigestion, reflux, difficulty
swallowing, epigastric obstructions, hiccups, sore throats. Thispoint issometimesincludedwith theStomachpoint in
weight control plans.
Cardiac Orifice
Location: I nferiorconcha, belowLM 0and thecentral concharidge.
Function: Representstheopeningbetween theesophagusand thestomach. Relieves indigestion, reflux, heartburn,
hiatal hernias, nausea, vomiting, difficulty swallowing, epigastric obstructions.
63.0 Stomach [CR 1, PC 2]
Location: Medial concharidge, just peripheral toLM O. Control of thesmoothmuscle activity of thestomachisalso
affected bystimulatingtheposterior concharegion behindtheconcharidge.
Function: Representsthegastric chamberwhichchurnsmasticatedfood intochyme. Relieves eatingdisorders,
overeating, poor appetite, diarrhea, indigestion, nausea, vomiting, stomachulcers, gastritis, andstomachcancer. I talso
alleviates toothaches, headaches, andstress. It isthemost commonlyused auricular pointfor appetitecontrol andweight
reduction. However, treatingthiscar pointonlydiminishesthephysiological craving for food when following adiet plan
anddoes not overridethepatientswill if thereisnot conscientiouseffort toreducefood intakeand increase physical
exercise. InTCM,thispoint reducesstomachfireexcess.
63.F2
63.F3
64.0
Stomach.F2
Location: Thisendodermal Phase II point isfound on theperipheral ear lobeof Territory3.
_.__ _ - _ . _ - - - - - - - - - - - - ~ - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -
Stomach.F3
Location: Thisendodermal PhaseIII point isfound on themedial superior helixregionof Territory1.
Duodenum
[LO4& LO5]
[HX4&HX5]
[SC 1, PC 3]
[SC 2, PC 3] 65.0
Location: Superior concha, immediatelyabove theconcharidgeStomachpoint.
Function: Representstheopeningbetween thestomachand thesmall intestines. Relieves duodenal ulcers, duodenal
cancers, diarrheaandissometimesused for eatingdisorders.
Small I ntestines(jejunum, Ileum)
Location: Medial superior concha, below theinternal helixroot.
Function: Representsthelongwindingtubeswhich absorbdigestedfood. Relieves diarrhea, indigestion, abdominal
distension.
65.F2
200
Smalllntestines.F2
Location: Thisendodermal PhaseI Ipoint isfound on themiddleregionsof theear lobe inTerritory3.
- - - - - - - - ~ ~ - - - - - - - - - ~ - - - -
[LO4&LO6]
No.
65.F3
Smalllntestines.F3
Location: Thisendodermal PhaseIII point isfound on thesuperior internal helix inTerritory1.
[Auricularzone]
[IH6-I H 10]
[SC 3&SC4, PC 4] 66.0 Large Intestines (Colon)
Location: Central narrowportionof themost medial superior concha.
Function: Representstheascending, descendingand transversecolonsthatregulatetheamountoffluid released or
ahsorhedfromdigestedmaterial. Relieves diarrhea, constipation, colitis, hemorrhoids, dysentery, enteritis, loose
howels.
66.F2
66.F3
Large Intestines.F2
Location: Thisendodermal PhaseII pointisfound on themedial antitragusaspectsof Territory3.
Large Intestines.F3
Location: Thisendodermal PhaseIII pointisfound on themiddlerangeof thehelixtail of Territory1.
[AT 1&AT 2]
[HX12& HX13]
._------------------------_ .._-------
67.C Rectum.C (Anus, LowerSegmentofRectum)
Location: External surfaceof thehelix root, above theI ntestinespoints.
Function: Representsthefinal portionof thecolon. Thisear pointrelieves diarrhea, constipation, rectal sores,
hemorrhoids, hernias, colitis, fecal incontinence, dysentery.
[HX2]
67.E Rectum.E (Anus, Hemorrhoidpoint)
Location: I nnermostaspect of superior concha, wheretheinternal helixand theinferior crus meet at atip.
[SC 4, PC 4]
Auricular microsystem reflex points and macrosystem yang meridians All yangmeridians
connect directlytotheear andviceversa. Stimulationof theStomach, Small I ntestinesandLarge
I ntestinespointsontheear can alleviate stagnation, deficiency, or over activity of qi energyflowing
throughtherespective meridianchannelsfor Stomach, Small I ntestinesand LargeI ntestines.
201
62.0
Cardiac
Orifice
61.0
Esophagus
e..---65.0
Small
I ntestines
65.F3
Small
I ntestines.F3
63.F2
Stomach.F2
65.F2
Small
I ntestines.F2
66.
----Large
intestines
61.
Esophagus
63.
Stomach
_62.
Cardiac
Orifice
65.
Small
intestines
Figure 7.20 Hiddenviewofthedigestivesystemrepresented on theconcha. (FromLifeARTJf!,SuperAnatomy,
'LippincottWilliams&Wilkins, withpermission.)
63.F3
Stomach.F3
67.E
Rectum.E
67.C
Rectum.C
60.0
Mouth
61.0
Esophagus
62.0
Cardiac Orifice
66.F2
Large I ntestines.F2
65.F2
Smalllntestines.F2
63.F2
Stomach.F2
66.0
Large
I ntestines
65.0
Small
I ntestines
64.0
Duodenum
63.0
Stomach
66.F3
Large
I ntestines.F3
65. __
Small
I ntestines
64.
Duodenum
61.
Esophagus
60.
Mouth
Figure 7.21 Surface viewofthedigestivesystemrepresented on theconcha. (FromLifeARTEJ,SuperAnatomy,
'LippincottWilliams& Wilkins, withpermission.)
7.3.2 Thoracic organs represented ontheinferior concha
No. Auricular microsystempoint (Alternativename)
[Auricular zone]
[CW2-CW9]
[IC4]
6S.E
69.C1
CirculatorySystem(Bloodvessels)
Location: All along theconchawall below theantihelixand theantitragusridge.
Function: Representsperipheral arteriesand veins and thesympatheticnerves thatcontrol vasoconstriction and
vasodilation. Auricular representationof specific internal arteries and veins are found asfollows, all extendingfromthe
conchawall: thecarotidarterytothebrainextendsover thehelix tail to thelobe; thebrachial and radial arteriestothe
armandhandextendover theantihelixbody tothescaphoidfossa; thefemoral arteryto thelegand foot extendsover
thetriangular fossa. Thisset of auricular pointsrelieves coronarydisorders, heart attacks, hypertension, circulatory
problems, cold hands, cold feet.
Heart1
Location: Deepest, most central areaof theinferior concha. (I toften looks likeashiny spot on theconcha.)
Function: Relieves post-heart-attackdysfunctions, chest pain, angina, hypertension, hypotension, palpitations,
tachycardia, arrhythmiaand poor bloodcirculation. InTCM,Heartfunctionstotranquilizethemind andcalm thespirit.
Theauricular Heartpointcan thus beusedtorelieve anxiety, insomnia, neurasthenia, poor memory, perspiration, night
sweats, regulateblood and reduceheart fireexcess.
69.C2
69.C3
69.F1
Heart2(Cardiac point)
Heart3
Location: Middleregion of theposterior concha.
Heart.F1
[TC5]
[PC 2]
[AH4, PC4]
Location: Thismesodermal PhaseI point isfoundon themiddlerangeof theantihelixbody of Territory I. ThePhase
IV control of cardiac muscle isrepresentedon theposterior groove (PO4) immediatelybehindthePhaseI Heartpoint
on theantihelixbody (AH 4).
69.F2 Heart.F2 [IC4]
Location: Thismesodermal Phase II point isfoundon theperipheral inferior conchaof Territory2, inthesame
location astheChineselocation for theHeart.WhileNogier (1983) reportedthat thePhaseII Heartwas intheinferior
concha, hissubsequent text (1989) relocated theHearttotheperipheral superior concha, inzoneSC 7.
69.F3
70,(1
Heart.F3
Location: Thismesodermal PhaseIII point isfoundon theperipheral ear lobe of Territory3.
Lung1(Contralateral Lung)
[LOS]
[IC7]
204
Location: Peripheral region of theinferior concha, below theconcharidge. Nogier located theLungs throughoutthe
inferior concha.
Function: Relieves respiratorydisorders, likeasthma, bronchitis, pneumonia, emphysema, coughs, flu, tuberculosis,
sore throats, edema, chest stuffiness andnight sweats. InTCM,thelungs arc relatedtodetoxification because they
release carbon dioxide witheach exhalation. Theauricular Lungpointcan thusfacilitate detoxification fromany toxic
substance, includingwithdrawal fromnarcoticdrugs, alcohol, and otherforms of substanceabuse. TheLungpoint is
included intreatmentplansfor alcohol abuse, heroinaddiction, opiatewithdrawal, smokingwithdrawal, cocaine and
amphetamineaddiction. Oriental medicinealso associates thelungs with theskin, since webreathethroughour skin as
well asour lungs. TreatingtheLungpointcan thereforealleviate bothskin disordersandhair disorders, including
dermatitis, uticaria, psoriasis, herpeszoster, shingles. TheLungpoint isan essential analgesic point used for auricular
acupunctureanalgesia. Finally, thispoint isused todisperse lungqi and dispel wind.
No.
70.C2
Lung2 (ipsilateral Lung)
[Auricular zone]
[ICZ& IC4]
Location: Lower region of theinferior concha, inferior to theChineseHeartpoint. Nogierstatesthat thewhole
inferior concharepresentstheLungs.
Function: Like theChineseLungI point, this second ear pointfor thelungs relieves problemsrelated to respiratory
disorders, addictiondisorders andskin disorders. Althoughsometexts statethat theChineseLung1pointismoreoften
used for respiratory disorders andtheChineseLung2point ismoreoftenused for addictiondisorders, bothLungpoints
seemto beequally effective for either typeof healthproblem. Themorecritical variable iswhichLungpointismore
electrically reactive.
70.C3
70.F1
Lung3
Location: Superior portionof theposterior periphery.
Lung.F1
Location: Thisendodermal PhaseI point isfoundthroughouttheinferior conchaof Territory2.
[PP 9]
[IC4& IC7]
70.F2 Lung.F2
--------- -------
[LO7& HX15]
70.F3
Location: Thisendodermal PhaseII point isfoundon theperipheral regionsof theear lobeinTerritory3.
Lung.F3 [SF 2&SF 3]
71.C
Location: Thisendodermal PhaseIII point isfoundonthemiddlerangeof thescaphoidfossa inTerritory1.
Bronchi [IC3]
Location: Upper region of theinferior concha, near theEsophaguspoint.
Function: Thisear point isconsidered athirdChineseLungpoint. It isused to relieve bronchitis, bronchial asthma,
pneumonia, andcoughs andhelpsdispel excess phlegm.
72.0 Trachea (Windpipe) [IC3]
Location: Central regionof theinferior concha, near theear canal.
Function: Relieves sorethroats, hoarsevoice, laryngitis, commoncold, coughswith profusesputum. Italso dispels phlegm.
73.C Throat.C (Pharynx, ThroatLining)
Location: Subtragus, underneathsuperior tragusprotrusion, LM 11, aboveear canal.
Function: Relieves sorethroats, hoarsevoice, pharyngitis, tonsillitis, asthma, bronchitis.
[ST 4]
73.E
------------------ ----
Throat. E(Pharynx, ThroatLining, Epiglottis)
Location: Central inferior concha, next to theear canal.
--------------------- ---------
[IC6]
74.C
74.E
74.F2
Larynx.C
Location: Undersideof subtragus, immediatelyabove theear canal.
Function: Relieves laryngitis, sorethroats.
Larynx.E
Location: Thisendoderrnal PhaseI point isfoundon theinferior conchancar theear canal inTerritory2.
--------------------- ------
Larynx.F2
Location: Thisendodermal PhaseII point isfoundon upper, peripheral ear lobeof Territory3.
--------
[ST 4]
[IC3]
[L06]
205
- -- ------------------
.. __._-_._- --------------------
74.F3
75.C1
Larynx.F3
Location: Thisendodermal PhaseIII point isfound on themiddleof theantihelixbody of Territory1.
Tonsil 1
[AH4]
[HX9]
Location: Ontopof superior helix, peripheral toLM 2.
Function: Relieves tonsillitis, sore throats, laryngitis, pharyngitisandacuteinflammations. Thewhole peripheral helix
rimisused inChineseauricular treatmentplans for alleviating inflammatoryconditions.
75.C2
75.C3
75.C4
76.C
76.E
206
Tonsil 2
Location: Middleof helixtail, peripheral toLM 15.
Tonsil 3
Location: Curveof helix tail, whereitjoinsthelobe.
Tonsil 4
Location: Bottomof thelobe, near LM 7.
Diaphragm.C (Hiccupspoint)
Location: Helixroot, above LM O.
Function: Relieves hiccups, diaphragmaticspasms, visceral bleeding, skin disorders.
Diaphragm.E
Location: Peripheral inferior conchaand theconcharidge.
[HX14]
[HX15]
[L03]
[HX2]
[I C8&CR2]
A
Heart.E
Large Intestines Diaphragm.C
Small Intestines Lung 1
Stomach
Mouth Bronchi
Heart.C
Lung 2
B
C D
Kidney.E
Uterus.C
External Genitals.C
Uterus.E
Pancreas
Appendix
Bladder
Gall Bladder
Kidney.C
Liver
External Genitals.E
Spleen.E
Spleen.C
Figure 7.22 Auricularregions correspondingtodigestivesystem(A),thoracicorgans(B), abdominal organs(C) andurogenitalorgans(D)
72.0
Trachea
69.C1
Heart.C1
76.C
Diaphragm
71.C
Bronchi
73.E
Throat.E
74.E
Larynx.E
73.C
Throat.C
74.C
Larynx.C
70.C2
Lung2
68.E
Circulatory
System
72.
Trachea
70.
Lung
71.
Bronchi
74.
Larynx
70B
Lung.F3
70.C1
Lung1
69.F1
Heart.F1
76.E _-=:p;;;;j
Diaphragm.E
Figure 7.23 Hiddenviewofthethoracic organs represented ontheconcha. (FromLifeARr, Super Anatomy,
Posterior ear
70.C1
Lung 1
69.F1
Heart.F1
70.C3
Lung 3
69.F4
Heart.F4
70.C2
Lung2
75.C3
Tonsil 3
70.F4
Lung.F4
69.C3
Heart.C3
76.E
Diaphragm.E
70B
. . . . . . . . J ~ - - -
Lung.F3
75.C2
Tonsil 2
70.F2
Lung.F2
75.C1
Tonsil 1
69.F3
Heart.F3
75.C4
Tonsil 4
69.
Heart
73.C
Throat.C
74.C
Larynx.C
73.E
Throat.E
74.E
Larynx.E
72.0
Trachea
69.C1
Heart.Cl
76.C
Diaphragm.C
71.C
Bronchi
69.C2
- - - l - ~ r
Heart.C2
Figure 7.24 Surfaceviewofthethoracic organs represented on theconcha. (FromLifeARr, Super Anatomy,
'LippincottWilliams&Wilkins,withpermission.)
7.3.3 Abdominal organs represented on thesuperior concha and helix
No.
77.0
78.C1
78.C2
78.C3
79.0
Appendix (PrimaryAppendixpoint)
Location: Superior helix, between theSmall I ntestinesand theLargeI ntestinesear points.
Function: Relieves acuteand chronicappendicitis.
Appendix Disease 1
Location: Superior scaphoidfossa, near ear pointsfor Fingers.
.~ - - - - ~ ~ ~ ~ ~ ~ - - - - _ . _ . _ - - ~ - - - - _ . _ .._._-_._._---_..
Appendix Disease 2
Location: Middlescaphoidfossa, near car pointsfor Shoulder.
Appendix Disease 3
Location: I nferiorscaphoidfossa, near MasterShoulder point.
Liver
[Auricular zone]
[SC 2]
[SF 6]
[SF 3]
[SF 1]
[CR 2]
Location: Peripheral concharidge andconchawall, peripheral totheStomachpoint.
Function: Relieves hepatitis, cirrhosisof liver, jaundice, alcoholism, gall bladder problems, regulates blooddisorders,
hypertensionand anemia. InTCM,theliver affects tendons, sinews, and ligaments, andtheLiver ear point isused to
heal joint sprains, muscles strains, muscle spasms, myastheniaparalysis and soft tissue injuries. TheLiver point also
improves bloodcirculation, enrichesblood, improves eyesight, relieves fainting, digestive disorders, convulsions and
paralysis due toastroke. Theauricular Liver point isused for hypochondriacpain, dizziness, premenstrual syndrome
and hypertension. AccordingtoOriental thought,theliver nourishesyin and restrainsyang bypurgingliver fire.
79.C2
79.F2
79.F3
Liver.C2
Location: A second ChineseLiver point isfoundon themiddlerangeof theposterior periphery.
Liver.F2
Location: Thisendodermal Phase II point isfoundon theperipheral lobe of Territory3.
Liver.F3
Location: Thisendodermal Phase III point isfound on thesuperior scaphoidfossa of Territory1.
[PP 6]
[LO7]
[SF 4&SF 5]
[HX10]
80.C1 LiverYang 1
Location: Superior helix, at LM3, superior to Darwinstubercle.
Function: Relieves liver disorders, hepatitis, and alleviates inflammatoryconditions. InTCM,theLiver Yangpoints
calmtheliver and suppressyang excess and hyperactivity.
80.C2 Liver Yang 2
Location: Helixtail, at LM4, inferior toDarwinstubercle.
[HX12]
[IC8]
81.C1
210
Spleen.C 1 (Foundonleftearonly)
Location: Peripheral inferior concha, inferior totheLiver pointon theconcharidge.
Function: Relieves lymphaticdisorders, blooddisorders, and anemia, abdominal distensionand menstruation. In
TCM,thespleen nourishesmuscles, thus theSpleen point isused torelieve muscle tension, musclespasms, muscular
atrophy, muscular dystrophy. InChinesethought,thespleen governs thetransportationandtransformationof food and
fluid, thus it affects digestive disorders, indigestion, gastritis, stomach ulcers and diarrhea. TheChinesestimulatethis
point tostrengthenbothspleen qi and stomachqi and to regulatethemiddlejiao.
No.
81.C2
81.F1
Spleen.C2
Location: Posteriorconcha, peripheral totheposterior ear point for theLung.
Spleen.F1 (Foundonleftearonly)
[Auricular zone]
[PC 3]
[SC6,CW9]
Location: Superior conchaandconchawall belowtheinferior crus. Because thespleen isof mesodermal origin, early
Nogier chartsindicatedthat thespleen was inoneof twopositions ontheear, thisonefor PhaseI andthenext regionfor
PhaseII.
Function: Westernmedicinefocuses on theroleof thespleen inthelymphatic andimmunesystems, thusEuropean
doctors usetheSpleen pointfor itsphysiological functionratherthanitsenergeticeffects asused inOriental medicine.
81.F2 Spleen.F2 [SC 8]
Location: Peripheral superior concha, superior totheLiver point ontheconcharidge. Even thoughthespleen isof
mesodermal origin, theearlier localizationof thespleenorgan byNogierwasplaced at thisPhaseII position. The
development of thephase model helpedNogier toaccount for thediscrepancies intheidentificationof different
correspondingregions of theexternal ear thatweresaid torepresent thespleen.
- -----------------------------------------------
81.F3
82.0
Spleen.F3
Location: Thismesodermal PhaseIII pointfor thespleenisfoundontheperipheral lobeof Territory3.
Gall Bladder (Foundonrightearonly)
[L08]
[SC 8, PC 3]
Location: Peripheral superior concha, betweenthePancreasandDuodenumpoints. TheChineselocalization of the
Gall Bladder andtheNogier PhaseI representationofthisorgan arethesame.
Function: Relieves gall stones, gall bladder inflammations, deafness, tinnitus, migraines.
82.F2
82.F3
Gall Bladder.F2
Location: Thisendodermal PhaseII pointisfoundon themedial lobeof Territory3.
Gall Bladder.F3
[L02]
--------------------
[AH13&AH14]
Location: Thisendodermal PhaseIII point isfoundonthebaseoftheantihelix superior crus of Territory1.
83.0 Pancreas [SC 7&CW7, PC 4]
Location: Peripheral superior concha andtheadjacent conchawall. TheChineselocalization of thePancreasisthe
sameastheNogier PhaseI representationof thisorgan.
Function: Relieves diabetesmellitus, hypoglycemia, pancreatitis, dyspepsia.
83.F2
83.F3
Pancreas.F2
Location: Thisendodermal PhaseII point isfoundon themedial lobeof Territory3.
Pancreas.F3
[LO1]
[TF 4]
Location: Thisendodermal PhaseIII pointisfoundonthetriangular fossa region near theantihelix inferior crusof
Territory1.
----------------------------------- .. _ ~ - - -
82.F2
Gall Bladder
83.F2
Pancreas
79.F2
Liver
79.
Liver
Right ear
82.F3
Gall Bladder
79.F3
83.F3
Liver
Pancreas
83.0
Pancreas
82.0 77.0
Gall Bladder Appendix
79.0
Liver
82.
Gall Bladder
83.
Pancreas
77.
Appendix
~
) " ... .... "."..
u
l
\
I
Figure 7.25 Hiddenviewoftheabdominal organs represented ontheauricle. (FromLifeARTJ9,Super Anatomy,
CD LippincottWilliams&Wilkins,withpermission.)
77.
Appendix
83.0
Pancreas
71.F3
Liver.F3
Left ear
81.F2
Spleen.F2
Posterior ear
78.C2
Appendix
Disease 2
79.0
Liver
----78.Cl Appendix Disease 1
79.C2
Liver 2
79.F2
Liver.F2
81.C2
Spleen 2
81.
Spleen
83.F2
Pancreas.F2
79.
Liver
82.
Gall Bladder
81.Cl
Spleen 1
78.C3
Appendix
Disease 3
81.Fl
Spleen.Fl
83.F3
Pancreas
Figure 7.26 Surface viewoftheabdominal organs represented on theauricle. (FromLifeARfE!,Super Anatomy,
7.3.4 Urogenital organs represented on thesuperior concha and internal helix
No.
84.C1
Kidney 1
[Auricular zone]
[SC6&CW8]
Location: Superior concha, belowLM16andsuperior totheStomachpoint. I tisoftendifficult toview thispoint
becauseit ishiddenbytheoverhangingledgeof theinferior crus.
Function: Relieves kidneydisorders, kidneystones, urinationproblems, nephritis, diarrheaandpyelitis. InTCM,the
kidneyrelates tothebones, auditoryfunctionandhair conditions, so it isusedfor bonefractures, toothproblems, low
back pain, ear disorders, deafness, tinnitus,bleedinggums, hair loss andstress. TheChineseKidneypointtonifieskidney
qi deficiency, regulates fluid passage, andenrichesessence.
84.C2
84.F1
84.F2
84.F3
85.C
85.E
Kidney 2
Location: Superior regionof theposterior lobe.
Kidney.F1
Location: Thismesodermal PhaseI pointisfoundon themedial internal helix of Territory1.
Kidney.F2
Location: Thismesodermal PhaseII point isfoundon theinferior concharegionof Territory2.
Kidney.F3
Location: Thismesodermal PhaseIII pointisfoundontheantihelixtail regionof Territory3.
Ureter.C
Location: Superior concha, betweentheKidneyandBladder points.
Function: Relieves bladder dysfunctions, urinarytract infections, kidneystones.
Ureter.E
Location: I nternal helix regionwhich overlies theantihelixsuperior crus.
[PL 4]
[I H4&I H5]
[IC7&IC8]
[LO1&SF 1]
[SC 6]
[IH4]
86.0 Bladder (Urinary Bladder)
Location: Superior concha, belowLM 17, superior to Small I ntestinespoints.
Function: Relieves bladder dysfunctions, cystitis, frequent urination, enuresis, drippingor retentionof urine,
bedwetting, pyelitis, sciatica, migraines. InTCM,thebladder clears away dampheat andregulates thelower jiao.
[SC 5]
--------------------------------- - - - - - ~ - - - - - - ~ - -
86.F2
86.F3
87.C
87.E
214
Bladder.F2
Location: Thisendodermal PhaseII pointisfoundon thelowest loberegion of Territory3.
Bladder.F3
Location: Thisendodermal PhaseIII pointisfoundon theupper scaphoidfossa regionof Territory1.
Urethra.C
Location: Helixroot, inferior toLM 1.
Function: Relieves painful urination, urethral infections, urethritis, urinaryincontinence, bladder problems.
Urethra.E
Location: Mostmedial tipof thesuperior concha.
----------------
[LO3]
[SF 6]
[HX3]
[SC 4]
----_._--------------------------------------
88.C Prostate.C [SC4]
Location: I nnermosttipof superior concha, at same siteastheEuropeanUrethrapoint.
Function: Relieves prostatitis, prostatecancer, hernias, impotencyproblems, painful urination, prematureejaculation,
nocturnal emission, urinarytract infection.
88.E
89.C
89.Fl
Prostate.E or Vagina.E
Location: Undersideof internal helix.
Uterus.C
Location: Central regionof triangular fossa.
Function: Relieves premenstrual problems, inflammationsof uterallining, irregular menstruation, dysmenorrhea,
uterinebleeding, sexual dysfunctions, infertility, pregnancyproblems, miscarriages, andcan induceearly childbirth
deliveries. InTCM,thispointreplenishes kidney qi and nourishesessence.
Uterus.F1 (Fallopian Tubes)
Location: Thismesodermal PhaseI pointisfound on theundersideof theinternal helix root of Territory1.
[1HZ]
[TF S]
[IH3]
89.FZ Uterus.F2 [IC1&ICZ]
Location: Thismesodermal PhaseII pointisfound on thelower inferior conchaof Territory2. ThePhaseII pointsfor
theProstateand Vaginaareat thesame locationasthePhaseII Uteruspoints.
89.F3 Uterus.F3
Location: Thismesodermal PhaseIII pointisfound on themedial lobe of Territory3. ThePhaseIII pointsfor the
Prostateand Vaginaareat thesame locationasthePhaseIII Uteruspoints.
[LOZ]
[HX4] 90.C External Genitals.C
Location: Helixregionwhichleaves theface, at LM 1.
Function: Relieves scrotal rashes, groinpain, impotency, lowback pain, impotency, andprematureejaculation, and
facilitates sexual desire. InTCM,thispointclears away heat and dampness.
90.E External Genitals.E (PenisorClitoris, Boschpoint)
Location: Helixroot areawhichisadjacent tothesuperior tragus.
[HX1]
215
89.
Uterus
88.E
Prostate or
Vagina.E
84.F1
Kidney.F1
85.E
86.0
Bladder
85.
Ureter
87.
.-.-----Urethra
84.
Kidney
86.F3
Bladder.F3
89.C
Uterus.C
86.F2_------P
Bladder.F2
84.F3
Kidney.F3
84.F2
Kidney.F2
84.C1
Kidney 1
85.C
Ureter.C
Figure 7.27 Hiddenviewof urogenital organs represented on theauricle. (From LifeARTJ9.Super Anatomy.
'LippincottWilliams& Wilkins.withpermission.)
84.F1
Kidney.F1
85.E
Ureter.E
90.C
External
Genitals.C
89.F1__........"..,.
Uterus.F1
88.E
Prostate or
Vagina.E
90.E
External
Genitals.E
89.F2
Uterus.F2
88.
Vagina
89.
Uterus
86. ,
Bladder
85./

\
90.
External
Genitals
87.
Urethra
86.F2
Bladder.F2
88.
Prostate
86.
Bladder
86.F3
Bladder.F3
85.C
Ureter.C
84.C1
Kidney 1
84.F2
Kidney.F2
84.F3
Kidney.F3
Posterior ear
Figure 7.28 Surface viewof urogenital organs represented on theauricle. (FromLifeARTID,Super Anatomy,
218
7.4 Auricular representation of endocrine glands
Theendocrineglands are referred toastheinternal secretionsystem, sincehormones
manufacturedand released bytheseglandsaresecreteddirectlyintothecirculatorysystem. The
hormonesarecarriedbythebloodtoall otherpartsof thebodywheretheyexert someselective
effects onspecific target cells. Chemical substancesreleased bythehypothalamusat thebase of the
brainaresent tocells inthepituitaryglandbeneaththehypothalamus. Thepituitarygland
subsequently releases tropichormonesthathave selective actionon target glandsinthebody. The
target glandsare directedtorelease theirown hormones, dependingon thelevel of tropic
hormonereceived fromthepituitary. Sensors inthehypothalamusmonitorthebloodlevels of
each target hormonecirculatinginthebloodanddeterminewhether thehypothalamusdirectsthe
pituitarytorelease moreor less tropichormonestoactivateor suppress theactivity of thetarget
glands.
Hypothalamic-pituitary axis (HPA): Thistermrefers tothecentral roleof thehypothalamusthat
controlstheanterior pituitarytorelease hormonesthatcontrol thetarget endocrineglands.
Anterior pituitary: Theanteriorpart of thepituitaryglandcontainsonlychemical secretorycells,
which can release adrenocorticotropins(ACTH),thyrotropins(TSH),gonadotropins(FSH,LH),
endorphins, or growthhormone.
Posterior pituitary: Theposterior part of thepituitaryglandcontainsspecial neuronswhich
descendfromthehypothalamusandsecreteantidiuretichormoneor oxytocin intotheblood. The
antidiuretichormone(ADH)directsthekidneys toreabsorbmorewater fromurineand return
thatwater tothegeneral bloodstreamtoincreaseoverall fluid level. Oxytocininducesuterine
contractionsduringchildbirth.
Pineal gland: Thisglandlies above themidbrainandbelowthecerebral cortex, releasing
melatoninat night tofacilitatesleep andinducetheregulationof day-nightcircadian rhythms.
Deficiencies inmelatoninare sometimesrelatedtodepression.
Thyroid gland: Thisglandlies at thebaseof thethroatand releases thyroxin hormonein
responsetothereleaseof pituitarythyrotropinhormone. Thyroxinaccelerates therateof cellular
metabolismthroughoutthebody, affectingvirtually every cell of thebodybystimulatingenzymes
concernedwithglucose oxidation. I rondeficiency reduces theability of thethyroidglandto
producethyroxin, thusleadingtogoiter. Hyperthyroidactivity can leadtoGraves disease, an
autoimmunesystemdisorder thatcauses elevated metabolicrateandnervousness, whereas
hypothyroidismproducessymptomsof lethargyanddepression.
Parathyroid gland: Thisglandlies at thebase of thethroatnext tothethyroidgland, andreleases
parathormoneintothebloodwhenit sensedecreasingcalciumlevels intheblood. Byfacilitation
of theavailability of calcium, parathormoneaffects nervous systemexcitability.
Mammary gland: Thisglandinthebreastsaffects milk productioninnursingwomen.
Thymus gland: Thisglandliesbehindthesternuminthechest and affects thedifferentiationof
basal whitebloodcells madeinthebonemarrowintoactive immunecells. Specific differentiated
immunecells can becomeT-helpercells, T-suppressorcells or T-killer cells. Thymusglandactivity
isrelatedtoAI DS/HI Y,cancer andautoimmuneproblems.
Pancreas gland: Thisglandlies next tothestomachandreleases thehormoneinsulintofacilitate
thetransportof glucose fromthebloodstreamintoindividual cells, whereglucose canthen
becomeavailable asenergy. Thepancreas also releases thehormoneglucagon topromotehigher
bloodglucose levels.
Adrenal gland: Thisglandlies at thetopof theabdomen, on top (ad-) of eachkidney(-renal). It
isdivided intotheinneradrenal medulla, which releases thehormoneadrenalininresponseto
activation bysympatheticnerves, and theadrenal cortex, which releases cortisol andotherstress
relatedhormonesinresponsetopituitaryadrenocorticotropinhormone(ACTH).
Gonads: Thesesexglandslieat thebase of thebody. Theovaries inwomenlieinthepelvic cavity
andsequentially releaseestrogenand progesteroneinresponsetopituitarygonadotropin
hormonesFSHand LH.Thetestesinmenrelease thehormonetestosteroneto increasesexdrive,
energylevel and aggressiveness.
100.
Posterior
Pituitary
99.
Anterior
Pituitary
o
Connectionto
circulatorysystem
136.
Hypothalamus
106.
SalivaryGland
95.
Mammary
Gland
91.
Testis
91.
Ovary
91.
Ovary
fff:!lr..... 92.
Adrenal
Gland
83.
Pancreas
e:o
96. rv 94
Thyroid rf\.A
Gland Gland
97.
Parathyroid
Gland
Figure 7.29 OvelViewoftheendocrineglands. (FromLifeARr, SuperAnatomy, 'LippincottWilliams& Wilkins,withpermission.)
7.4.1 Peripheral endocrineglandsrepresentedalongtheconchawall
No.
91.C
Auricular microsystempoint (Alternativename)
Ovaries.C orTestes.C (SexGlands, Gonads, Internal Genitals)
[Auricular zone]
[CW1]
Location: Conchawall near theintertragicnotch. Locatedtowardthebottomof theauricle, this Chinesepoint is
inconsistent with otherpointsreflectingan invertedfetus orientation, but isconsistent with theNogier locationfor the
pituitarygonadal hormonesFSHandLH. Thesetwo pituitaryhormoneswould beappropriatelyfoundon theinferior
part of theexternal ear that representsthehead, wheretheactual pituitaryglandislocated.
Function: Relieves sexual dysfunctions, testitis, ovaritis, impotency, frigidity.
91.F1 Ovaries.F1 orTestes.F1 [IH1]
Location: Thismesodermal PhaseI endocrineglandisfoundundertheinternal helix root of Territory1. The
correspondenceof thesex glandsto this auricular areamakeslogical sensefor theinvertedfetus model as this helix root
region of theear generally representsurogenital organsfoundlower in thebody, thushigher intheear.
- - - - ~ ..- .. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ __~ ~ -
91.F2 Ovaries.F2orTestes.F2
Location: Thismesodermal PhaseII endocrinegland isfoundon thelower inferior conchaof Territory2.
[I C2]
.. _.._ ~ ~ ..... ----------------_ .. - - - - - - - - - - - - - - - - - - - _ ~
91.F3
92.C
Ovaries.F30rTestes.F3
Location: Thismesodermal PhaseIII endocrineglandisfoundon thelower medial lobeof Territory3.
... ------- ... _---
Adrenal Gland.C (Suprarenal Gland)
[L02]
[TG3]
Location: Theprominentknobof theinferior tragusprotrusionat LM 10. As this lower tragal andintertragicnotch
region of theauriclegenerally representstropichormonesreleased bythepituitarygland, theChineseAdrenal gland
may actually correspondto thepituitaryhormoneACTHthat regulates theadrenal cortex. Nogier reportedthatseveral
pointson theauricle represent therelease of theadrenal hormonecortisol; oneof thoselocationsoccurs at thesame
region of thetragusas theChineselocationfor theadrenal glands.
Function: Affects adrenocortical hormonesthatassist oneindealingwith stress. Relieves stress-relateddisorders,
fevers, inflammatorydisorders, infections, hypersensitivity, rheumatism, allergies, coughs, asthma, skin disorders,
hypertension, hypotensiveshock, profusemenstruationandbloodcirculation problems. I tisusedfor disturbanceof
adrenocortical function, such asAddisonsdisease andCushingssyndrome. Thispointisused inear acupuncture
treatmentplansalmost asfrequently as manymaster points.
92.E Adrenal Gland.E [CW?]
Location: Conchawall, belowLM 16, near locationfor ChineseKidneypoint. Theactual adrenal glandsin thebodysit
on top (ad-) of each kidney(-renal). Althoughsomeauricular medicinepractitionerscontinuedto maintainthat the
upper conchawall correspondedto theadrenal cortex, Nogierchanged thepositionof therepresentationof thisglandas
hedeveloped thethreephasemodel.
93.Fl
93.F2
Cortisol 1
Location: Thismesodermal PhaseI adrenal hormoneisfoundon theantihelixbody of Territory1.
Function: A corticosteroid adrenal hormonethatisutilizedtodeal with stress.
Cortisol 2
[SF 2&AH 9]
[SC 6]
Location: Thismesodermal PhaseII adrenal hormoneisfoundon thesuperior conchaof Territory2, near ear points
for theEuropeanAdrenal GlandandtheChineseKidney.
93.F3 Cortisol 3 [TG 2]
220
Location: Thismesodermal PhaseIII adrenal hormoneisfoundon thelower tragusof Territory3, near theChinese
Adrenal GlandandtheMasterTranquilizerpoint.
No. Auricular microsystem point (Alternativename) [Auricularzone]
[CW6] 94.E Thymus Gland.E
Location: Thisendodermal endocrinegland isfound on theperipheral conchawall near thePancreaspoint.
Function: Thethymusgland affects thedevelopment of l-cells of theimmunesystem. Thisear pointisused for the
commoncold, flu, allergies, cancer, HIY, AI DS,and autoimmunedisorders.
95.C
95.E
96.C
Mammary Gland.C
Location: Eachsideof theantihelixbody, just superior totheantihelixtail.
Function: Thispointisused totreat problemswithmilk secretion, breast development, or breast cancer.
Mammary Gland.E
Location: Conchawall above concharidge, central toChineseMammaryGlandpoints.
Thyroid Gland.C
Location: Antihelixtail, alongside thescaphoidfossa.
Function: Thyroxinreleased bythethyroid gland affects overall metabolicrateand general arousal. Relieves
hyperthyroidism, hypothyroidism, goiter, sore throats.
[AH10]
[CW6]
[AH8]
-----------------------------------------------
96.E Thyroid Gland.E [CW5]
Location: Thisendodermal PhaseI endocrinegland isfound ontheconchawall of Territory2, above thejunctionof the
concha ridgeand theinferior concha.
96.F2 Thyroid Gland.F2 [AH8]
Location: Thisendodermal PhaseII endocrinegland isfound ontheantihelixtail of Territory3, identical totheregion
where theChineseThyroidGlandisfound.
96.F3 Thyroid Gland.F3
[CW1/IT2]
97.E
Location: Thisendodermal PhaseIII endocrinegland isfound at theintertragicnotch, also associated withthe
pituitaryhormoneTSH,whichregulates thereleaseof thyroxin bythethyroidgland.
Parathyroid Gland.E
Location: Conchawall, inferior toEuropeanThyroidGlandpoint.
Function: Theparathyroidgland affects calciummetabolism. Thispointrelieves muscle cramps, muscle spasms.
[CW4]
221
7.4.2 Cranialendocrineglands representedattheintertragicnotch
No. Auricular microsystempoint (Alternativename)
[Auricular zone]
[TC 1]
[IC 1]
98.E
99.0
Pineal Gland(Epiphysis, Point E)
Location: Themost inferior aspect of thetragus, at LM 9.
Function: Pineal gland releases melatoninhormonetoaffect circadian rhythmandday-nightcycles. Relieves jet lag,
irregular sleep patterns, insomnia, depression.
AnteriorPituitary(Adenohypophysis, Internal Secretion. MasterEndocrine)
Location: Most inferior partof inferior concha, belowintertragicnotch.
Function: Anteriorpituitaryisthemaster endocrinegland, releasingpituitaryhormonestocontrol thereleaseof
hormonesfromall otherendocrineglands. Thisear point relieves hypersensitivity, allergies, rheumatism, skindiseases,
reproductivedisorders, diseases of bloodvessels, digestive disorders.
100.E Posterior Pituitary(Neurohypophysis)
Location: I nferiorconchanear inferior sideof ear canal.
[IC 3]
[cw1]
[IT2]
[IT2]
lOU
102.E
103.E
Function: Posterior pituitarycontainsneuronsfromthehypothalamus, whichreleases hormonesintothegeneral
bloodstream. Theposterior pituitaryreleases antidiuretichormoneaffectingthirst, internal water regulationandsalt
metabolism.
Gonadotropins(FollicleStimulatingHormone, FSH; Luteinizing Hormone,LH)
Location: Conchawall near intertragicnotch.
Function: Gonadal pituitaryhormonesFSH andLH regulatereleaseof sexhormonesbytheovaries or testes. This
point relieves sexual dysfunctions, lowsexdrive, infertility, irregular menstruation,premenstrual syndrome, testitis,
ovaritis, fatigue, depression, eyetroubles.
Thyrotropin(ThyroidStimulatingHormone,TSH)
Location: Wallof intertragicnotch, midwaybetweentragusand antitragus.
Function: Thyroidal pituitaryhormoneTSH regulates thereleaseof thyroxin hormonebythethyroid gland. Reduces
metabolicrate, hyperthyroidism, hypothyroidism, hyperactivity and Graves disease.
Parathyrotropin(ParathyroidStimulatingHormone, PSH)
Location: Mostcentral part of wall of intertragicnotch, belowLM9.
Function: ParathyroidpituitaryhormonePSH regulates parathormonerelease bytheparathyroidgland. Thispoint
facilitates calciummetabolism, reduces muscletetanus.
104.Fl ACTH1 [LO7]
Location: ThisPhaseI pituitaryhormoneisfound ontheperipheral ear lobeof Territory3.
Function: ThepituitaryhormoneACTHregulates thereleaseof cortisol andothercorticosteroidhormonesbythe
adrenal cortex toalleviate stress andstress-relateddisorders.
--------------------------------- .. _ . ~ ~ - - -
104.F2
104.F3
222
ACTH2
Location: ThisPhaseII pituitaryhormoneisfound ontheupper scaphoidfossa of Territory1.
ACTH3 (Adrenocorticotrophin,Surrenalian point, AdrenalControl point)
Location: ThisPhaseIII pituitarygland hormoneisfound near theintertragicnotch and inferior totheChinese
Adrenal point.
[SF 6]
[ST 1]
10S.E Prolactin (LTH) [IC 1]
Location: I nferior regionof inferior concha, peripheral toinferior ear canal.
Function: Thispituitaryhormoneregulates theactivity of themammaryglands, initiatinglactationand milksecretion.
106.C Salivary Gland.C (ParotidGland)
Location: Conchawall just behindtheapex of antitragus, LM 14.
Function: Salivary glands areregulatedbyactivation of theparasympatheticnervous systeminresponsetofood.
Relieves mumps, salivary gland inflammations, skindiseases.
[CW2]
------- ----
106.E Salivary Gland.E (ParotidGland)
Location: Peripheral region of lobe, next totheLower Jawpoint.
Function: Relieves mouthdryness, mumps, salivary gland inflammations. Thesalivary glands areactually exocrine
glands rather thanendocrineglands.
[LOB]
100.E
Posterior
Pituitary
Gland
106.E
SalivaryGland.E
98.E
Pineal
Gland
99.0
Anterior
Pituitary
Gland
137.
Hypothalamus
10S.E
Prolactin
104.E
ACTH - 1 . ~ . _ .
lOU
Parathyrotropin
102.E
Thyrotropin
lOU
Gonadotropin
100.
Posterior
Pituitary
Gland
99.
Anterior
Pituitary
Gland
138.
Thalamus
106.
SalivaryGlands
Figure 7.30 Cranial endocrine glands represented on the auricle. (From LifeARTJi!, Super Anatomy,
223
91.
Ovaries
104.F3
ACTH 3
103.E
Parathyrotropin
102.E
Thyrotropin
96.F3
ThyroidGland.F3
lOU
Gonadotropins(FSH, LH)
91.C
Gland or Testes.C
94.
I
Thymus
Gland
96.F2
ThyroidGland.F2
106.C
SalivaryGland.C
104.Fl
ACTH 1
106.E
SalivaryGland.E
104.F2
ACTH 2
92.E
Adrenal
Gland.E
94.E
Thymus==:::::;:;:;;
Gland
95.C
Mammary
Gland.C
95.E
Mammary
Gland.E
93.Fl
Cortisol1
95.
Mammary
Gland
106.
Salivary
Gland
96.
I
Thyroid
Gland
DB
Figure 7.31 Hidden viewoftheendocrineglands represented on theauricle. (FromLifeARY@,SuperAnatomy, 'LippincottWilliams
& Wilkins,withpermission.]
95.E
Mammary
Gland.E
104.F2
ACTH2
92.E
Adrenal
Gland.E
93.Fl
Cortisol 1
95.C
Mammary
Gland.C
96.Fl
Thyroid Gland.Fl
96.C
Thyroid Gland.C
97. E
Parathyroid Gland
96.F2
Thyroid Gland.F2
104.Fl
ACTHl
106.E
Salivary Gland.E
91.
Testes
91.F2
Ovaries or Testes.F2
106.C
Salivary Gland.C
92.F3
Adrenal Gland.F3
91.
Ovaries
93.F2
Cortisol 2
91.F3
Ovaries or Testes.F3
105.E
Prolactin
91.Fl
Ovaries or
Testes.Fl
93.F3
Cortisol 3 ---
104.F3
ACTH3
99.0
Anterior Pituitary
98.E
Pineal Gland
102.E
Thyrotropin
92.C
Adrenal Gland.C
100.E
Posterior Pituitary
lOUGonadotropins (FSH, LH)
91.C Ovaries or testes.C
Figure 7.32 Surface viewoftheendocrineglands represented on theauricle. (FromLifeARTID,Super Anatomy,
226
7.5 Auricular representation of the nervous system
Thenervous systemisprimarilyrepresentedonthehelixand lobe, butisfoundthroughoutall
partsof theexternal ear because thenervous systemconnectstoevery part of thebody.
Central nervous system (CNS): Thecoreof thenervous systemconsistsof thebrainand spinal
cord, which maketheprincipal decisions regardingtheregulationof all otherpartsof thebody.
Peripheral nervous system: Theperipheral nerves consist of sensory neuronswhich send
messages tothespinal cordfromtheskin, muscles andvisceral organs, or motorneuronswhich
travel fromthespinal cordout tothemuscles andorgansof thebody.
Somatic nervous system: Thisdivision of theperipheral nervous systemconsistsof sensory
neuronswhich receive afferent messages fromtheskin and themuscles and motorneuronswhich
control theactivity of skeletal muscles. Thesomaticnerves arevoluntarily controlledbythemore
conscious aspects of thepyramidal systemof themotorcortexdescendingtoalphamotorneurons
thatsend out impulses tocontract striatemuscles. Subtleshiftsinthemannerof movement and in
muscle toneareregulatedbygammamotorneuronsthataremodulatedbytheless conscious
subcortical extrapyramidal system. Sensorysomaticneuronsenterthedorsal root of thespinal
cord and ascend thedorsal columnsof thespinal whitemattertosynapse inthebrainstem, the
thalamus, and ultimatelyarrive at thesomatosensorycortexonthepostcentral gyrus of theparietal
lobe. Thesomaticnerves maintainthepathological reflexes which producethechronicmuscle
tensionthatleads tomyofascial pain.
Autonomic nervous system: Thisdivision of theperipheral nervous systemconsistsof those
nerves which connect thespinal cord to thevisceral organsof thebody. Thissystemisregulated
unconsciously bythesubcortical hypothalamusinthebrain. All autonomicnerves leaving theeNS
havepreganglionic nerveswhich travel fromthespinal cordtoaperipheral ganglionandwhich
synapse ontopostganglionicnerves thattravel fromthatganglion toavisceral organ. Every
internal organsendssensory neuronstothespinal cordor brain, which thensendthevisceral
message tothehypothalamus. Eachvisceral organalso receives descendingmotormessages from
thehypothalamus.
Sympathetic nervous system: Thissubdivision of theautonomicnervous systemconsistsof those
autonomicnerves whichleave thespinal cord intheregionof thethoracicand lumbar vertebrae
andtravel toachain of gangliaalongsidethespinal vertebrae. Fromthissympatheticchain,
postganglionicnerves branchout tointernal organs. Sympatheticnerves causeexcitationand
arousal of bodily energyintimesof stress, strongemotionor physical exercise. Thissystemleads to
anincreaseinheart rate, bloodpressure, vasoconstriction, sweating, andpupillarydilation, and is
accompaniedbytherelease of thehormoneadrenalinfromtheadrenal medullagland.
Sympatheticpostganglionicnerves are adrenergic, utilizingtheneurotransmitternorepinephrine.
Parasympathetic nervous system: Thissubdivision of theautonomicnervous systemconsistsof
thoseautonomicnerves which leave thecentral nervous systemfromeitherthecraniumor from
thesacral vertebrae. Thesepreganglionicnerves travel out intothebody andsynapseon
postganglionicnerves near avisceral organ. Parasympatheticnerves leadtosedationand
conservation of bodily energy. Theycausedecreases inheart rateandbloodpressure, while
producingincreases invasodilation, pupillaryconstriction, salivation and digestionof food.
Parasympatheticsynapses arecholinergic, employingtheneurotransmitteracetylcholine.
Sympathetic preganglionic nerves: Theseautonomicnerves travel fromthethoracic-lumbar
spinetothesympatheticchain of gangliaoutsidethespinal vertebrae.
Sympathetic postganglionic nerves: Theseautonomicnerves travel fromthesympathetic
chain of gangliaoutsidethespinal vertebraetotheactual visceral organ.
Splanchnic nerves: Theseperipheral, sympatheticnerves connect tolower visceral organs.
Vagus nerve: Thisprimaryparasympatheticnerve connectstomost visceral organs.
Sciatic nerve: Thissomaticnerve travels fromthelumbar spinal corddown totheleg.
Trigeminal nerve: Thissomaticnerve affects sensationsof theface and facial movements.
Facial nerve: Thissomaticnerve controlsmajor facial movements.
Oculomotor nerve: Thissomaticnerve controlseyemovements.
Optic nerve: Thiscranial nerve respondstovisual sensationsfromtheeye.
Olfactory nerve: Thiscranial nerve respondstosmell sensationsfromthenose.
Auditory nerve: Thiscranial nerve respondstohearingsensationsfromtheear andaffects the
sense of physical balanceandequilibrium.
Central nervous system regions of the brain
Cortical brain regions: Thehighest level of thebraindeterminestheintellectual processes of
thinking, learningandmemory. Thecerebral cortexinitiatesvoluntarymovementsandis
consciously aware of sensationsandfeelings.
Prefrontal cortex: Thismost evolved region of thehumancortex initiatesconscious decisions.
Frontal cortex: Thisanteriorcortical regioncontainstheprecentral gyrus motorcortexwhich
initiatesspecific voluntarymovements. I tactivates upper motorneuronsinthepyramidal system
thatsend direct neural impulsestolower motorneuronsinthespinal cord.
Parietal cortex: Thisposterior regioncontainsthesomatosensorycortexonthepostcentral
gyrus. Thisregion consciously perceives thesensationsof touchandthegeneral awareness of
spatial relationships.
Temporal cortex: Thisposterior and lateral cortical regioncontainsthehearingcentersof the
brain. Theleft temporal lobeprocesses theverbal meaningof languageandtherational logicof
mathematics, whereas theright temporal lobeprocesses theintonationand rhythmof sounds
andmusic.
Occipital cortex: Thismost posterior cortical regionprocesses conscious visual perceptions.
Theleft occipital lobecan consciously readwords, whereas theright occipital lobe isbetterat
recognizingfaces andemotional expressions.
Corpus callosum: Thisbroadbandof myelinatedaxon fibers connectstheleft cerebral
hemispherecortical lobes withtheirrespective lobeontheright cerebral hemisphere.
Cerebellum: Thisposterior region beneaththeoccipital lobeand above theponsispart of the
extrapyramidal systemcontrol of semivoluntary movementsand postural adjustments.
Subcortical brain regions: Theseregionsof thebrainserve asanintermediarybetweenthe
cerebral cortexabove andthespinal cordbelow, operatingoutsideof conscious awareness.
Thalamus: Thisspherical nucleus relays sensory messages fromlower brainstemregionsupto
aspecific locus onthecerebral cortex. Thethalamusalso containsneuronswhich participatein
thesupraspinal gatingof pain andingeneral arousal or sedation.
Anterior hypothalamus: Thisnucleus liesbelowthethalamus, whereit connectstothelimbic
system, thepituitarygland andtheparasympatheticnervoussystem. Thisnucleusproduces
general sedation.
Posterior hypothalamus: Thisnucleusconnectstothelimbic systemandthepituitarygland. I t
activates thesympatheticnervoussystem, producingbrainarousal andbehavioral aggression.
Limbic system: Thiscollection of subcortical nuclei affects emotionsandmemory.
Cingulate cortex: Thispaleocortexlimbic regionlies immediatelybeneaththehigher
neocortex.
Hippocampus: Thissemicircular limbic structureliesbeneaththeneocortex, but outsidethe
thalamus. I taffects attentionspan, longtermmemorystorageandemotional experiences.
Amygdala nucleus: Thisspherical limbic nucleus liesunder thelateral temporal lobeand
modulatesincreases or decreases inaggressiveness, irritabilityand mania.
Septal nucleus: Thismedial limbicstructureisinvolved inpleasuresensationsand reward.
Nucleus accumbens: Thismidlinenucleusoccurs next totheseptal nucleusand istheprimary
dopaminergiccontrol center for therewardpathways of thebrain. I tplays asignificant rolein
thebrainsresponsetoall substances thatareaddictiveinnature. Neuronsinthisnucleus are
excited byalcohol, opium, cocaine, andmethamphetamine.Stimulationof thisnucleusproduces
strongpleasurecravings.
228
Striatum: Thesebasal ganglianuclei liealongthelimbic system, andoutsidethethalamus. The
specific striatal nuclei includethecaudate, putamenandglobus pallidus, all of which arepart of
theextrapyramidal systemcontrol of semivoluntary movements.
Brainstem: Thistermrefers tothemedullaoblongataof thebrainstem. I taffects basic,
unconsciouscontrol of bodymetabolism, respirationand heart rate.
Pons: Thisbrainstemregionliesbelowthecerebellumandaffects REMsleep anddreams.
Midbrain tectum: Thissuperior part of themidbraincontainscolliculi for sensory reflexes.
Midbrain tegmentum: Thisinferior part of themidbrainaffects basic metabolismandpain.
Reticular formation: Thisregion within themidbraintegmentumactivates general arousal.
Red nucleus and substantia nigra: Thisregion within themidbraintegmentumaffects the
extrapyramidal systemandthestriatum, regulatingsemivoluntary movements.
AuriculotherepyManual
7.5.1 Nogier phaserepresentationof thenervous system
Neurological points for Phase I Thecentral nervous systemisrepresentedon theear lobe of
Territory3inPhaseI of Nogierssystem. TheThalamusand Hypothalamusarefoundon the
external surfaceof theantitragus, whereas theywerepreviously locatedon theconchawall and
inferior concha. TheCerebral Cortexisstill representedon theear lobe.
Neurological points for Phase II Theectodermal central nervous systemshifts tothehelix, the
antihelix, scaphoidfossaand thetriangular fossaregionsof Territory1inPhaseII. TheThalamusin
PhaseII correspondstotheauricular locationfor theChinesemaster pointShen Men. TheCerebral
CortexinPhaseII isfoundalongtheantihelixsuperior crus, scaphoidfossa, and triangular fossa.
Neurological points for Phase III Thecentral nervoussystemshiftstotheconchaof Territory2in
PhaseIII. Thecortical areas arelocatedinthesuperior concha, whilesubcortical limbic andstriatal
areas arefound intheinferior concha. Thelocationof thePhaseIII Thalamusoccurs withitsoriginal
designationontheconchawall, whiletheHypothalamusthatisfound intheinferior conchacoincides
withthelocationof theChineseLungpointsused inthetreatmentof narcoticdetoxification anddrug
abuse.
Table 7.1 Auricular zone representation of nervous system points for each Nogier phase
No. Neurological representationsonear PhaseI PhaseII PhaseIII
Territory3 Territory1 Territory2
54 Eye L04 AH11 I C3
58 Ear LO1 TG5 SC6
98 Pineal Gland(epiphysis) TG 1 HXl SC5
99 PituitaryGland(hypophysis) I T2, IC1 AH17,AH18 CWI
109 Sympatheticnerves CW2 HX12,HX13 CRl,CR2
110 ParasympatheticSacral nerves CW3 HX15 CR2
113 Vagusnerve CWI HX12 CRI
124 Spinal Cord HX 14,HX15 AH9,SF2 I C5
127 Brainstem(MedullaOblongata) L07,L08 HX2 SC1
131 Reticular Formation L08 AH 12,SF3 I C8
~ - - -
133 RedNucleus L06 CWlO I C6
134 SubstantiaNigra L06 IH 1, I H2 I C7
135 Striatum(Basal Ganglia) L04,AT1 HX9,HXlO I C3,I C4
137 Hypothalamus L06 AH3,AH4 I C4
138 Thalamus(Subcortex, Brain) AT2,AT3 AHll CW2,CW3
140 Hippocampus L02 CW9 I C6
- - - - - - ~ . _ - - - - -
141 Amygdala L02,I TI CW8 I C7
142 Septal NucleusandNucleus Accumbens L02 HX7 IC1
143 CingulateGyrus IT 1 CW7 I C6
145 Cerebellum AT3,AHI HX5,HX6 SC8
147 Occipital Cerebral Cortex L07 AHI 2,SF4 SC7
148 Temporal Cerebral Cortex L05 AH 14,SF5 SC6
149 Parietal Cerebral Cortex L05 AH 18,SF6 SC6
~ - - - - ~ - - ---- ~ - - ~ - - - - - - - - - - - -
150 Frontal Cerebral Cortex L03 AH 13,TF2 SC5
151 Prefrontal Cerebral Cortex L01 AH 15,TF3 SC4
Brain
Spinal cord
Peripheral nerves
Spinal cord
whitematter
Autonomicnervoussystem
Sympathetic
postganglionic nerves
Somaticnervoussystem
Spinal cord
graymatter
Dorsal root sensory neurons
Ventral root motor neurons
Spinal cord
Spinal
vertebra
Cranial nervesoriginating
frombrainstem
Opticnerve
Oculomotor
nerve
Auditory
nerve
Vagus nerve
Figure 7.33 Overviewoftheperipheral nervous systemandthespinal cord. (FromLifeARTFJ,Super Anatomy, 'LippincottWilliams&
Wilkins,withpermission.)
230 Auriculotherapy fvlanual
/
Thalamus-+-------;1"------
Striatum
Coronal crossviewofanteriorbrain
Occipital
cortex
Cerebellum
Parietal cortex
Brainstem-------""\
medulla
oblongata
Sagittal sideviewofbrain
Frontalcortex
Prefrontal
cortex
Midsagittal sideviewofbrain
Coronal crossviewofposteriorbrain
Frontal
cortex
Septal nucleus/
Nucleusaccumbens
Brainstem
medulla
oblongata
Cingulatecortex
Corpuscallosum
Thalamus
Striatum
Midbrain
tectum
-+I --f...--"""----,,-f-- Midbrain
tegmentum
Cerebellum
Reticular formation
Horizontal viewacross brain
Hippocampus
Red nucleus
Substantianigra
Horizontal viewofbottomofbrain
Thalamus
Brainstem__
medulla -
oblongata
Striatum
Frontal cortex
Olfactorybulb
Cerebellum
d?_..-ff---.+--Temporalcortex
Pons
Occipital
cortex
Figure 7.34 Overviewof the central nervous system. (FromLifeARJ, Super Anatomy, 'Lippincott Williams & Wilkins, with
permission.)
7.5.2 Peripheral nervous system represented onthe ear
No.
107.0
108.E
Sciatic nerve (Sciatica, Ischium, Ischialgia)
Location: A notchat themidpointof thetopsurface of theantihelix inferior crus, at LM 17.
Function: Relieves sciatic neuralgia, lower limbparalysis, post-poliosyndrome.
Sympathetic Preganglionic nerves
Location: Alongthelength of thehelixtail asitjoins thegutterof thescaphoidfossa.
Function: Relieves reflex sympatheticdystrophy, vasospasms, neuralgias.
[Auricular zone]
[AH6]
[HX12-HX 14]
[CWS-CW9] 109.E Sympathetic Postganglionic nerves (Paravertebral Sympatheticchain)
Location: Alongthelength of theconchawall above theconcharidgeandsuperior concha.
Function: Relieves back pain, reflex sympatheticdystrophy, neuralgias, vasospasms, poor blood circulation.
. _ - - - - - - - - - - - - - - ~ .. - ~ .. _----_.._------_._-----_._--------------------------
110.E 1
110n
Parasympathetic Cranial nerves
Location: I ntertragicnotch region of theinferior concha.
Function: Relieves autonomicnervous disordersaffectingtheupper bodyand thehead.
Parasympathetic Sacral nerves (Pelvic Splanchnicnerve)
Location: I nferior concha, superior totheear canal.
Function: Relieves abdominal visceral control, pelvic pain, sexual desire.
[IC1]
[IC6]
[SC 4]
[HX1]
[IC1, IC3, IC6]
111.E
112.E
113.E
Hypogastric plexus (Lumbosacral Splanchnicnerves)
Location: Central region of thesuperior concha.
Function: Thisplexus distributeslumbar sympatheticnerves totherectum, bladder, ureter andgenital organs. Relieves
pelvic dysfunctions, rectal, ureter andbladder control.
Solar plexus (Celiacplexus, ThoracicSplanchnicnerves, AbdominalBrain)
Location: Helixroot, above Point ZeroandLMO.
Function: Relieves abdominal dysfunctions, gastrointestinal spasms and pathologyintheviscera of upper abdominal
organs, suchasthestomach, liver, spleen, pancreas and adrenal glands.
-------------------------
Vagus nerve (TenthCranial nerve, Xn.,Cranial Parasympathetic nerves)
Location: I nferiorconcha, next totheear canal, andspreadsthroughouttheconcha.
Function: Vagusnerve affects parasympatheticnervous systemcontrol of most thoracicand abdominal organs. This
point relieves diarrhea, heart palpitations, anxiety.
114.E
11S.E
Auditory nerve (EighthCranial nerve, VIII n.,Cochleovestibular nerve)
Location: Undersideof thesubtragus.
Function: Affects hearingandvestibular disorders, deafness, tinnitus, equilibriumimbalance.
Facial nerve (SeventhCranial nerve, VII n.,NucleusofSolitaryTract)
Location: Peripheral region of theposterior ear lobe.
Function: Relieves facial musclespasms, tics, facial paralysis.
[ST 3]
[PL 6]
No.
116.E
117.E
118.E
119.E
120.E
121.E
Trigeminal nerve (FifthCranial nerve, Vn.)
Location: Peripheral edge of theear lobe.
Function: Relieves trigeminal neuralgia, dental analgesia.
Oculomotor nerve (ThirdCranial nerve, III n.)
Location: Peripheral edgeof theear lobe.
Function: Affects control of eyemovements, relieves eyetwitches.
Optic nerve (SecondCranial nerve, II n.)
Location: Central sideof theear lobe, inferior totheintertragicnotch, LM 9.
Function: Relieves visual disorders, eyesight dysfunctions.
Olfactory nerve (First Cranial nerve, In.)
Location: Central sideof theear lobe, inferior totheintertragicnotch, LM9.
Function: Relieves problemswithsmell sensations.
- - - - - - - - - - - - - - - - - - - - - - - - - - - ~ . _ - ~ - _ .
Inferior Cervical ganglia (Stellateganglion, Cervical-Thoracicganglia)
Location: Junctionof theinferior concharidgeandconchawall.
Function: Affects thoracicsympatheticcontrol, migraines, whiplash.
MiddleCervical ganglia (Wonderfulpoint,fv1arvelous point)
Location: Junctionof theinferior conchaandconchawall.
[Auricular zone]
[LO5,PL 5]
[PL 3]
[LO1]
[L02]
[CW5]
[CR 2/CW4]
Function: Balances excessive sympatheticarousal, reduces hypertension, affects bloodvascular regulation, relieves
muscletension.
122.E Superior Cervical ganglia
Location: Junctionof inferior conchaandconchawall, belowLM 14.
Function: Affects cranial sympatheticcontrol.
[CW4]
[IH10/SF 5]
123.C Lesser Occipital nerve (fv1inor Occipital nerve, WindStream)
Location: Junctionof theinternal helixwiththesuperior scaphoidfossa.
Function: Alleviates migraineheadaches, occipital headaches, blood vessel spasms, posttraumaticbrainsyndrome,
arteriosclerosis, neuralgias, numbness, spondylopathy, neurastheniaand anxiety. I tisused inChineseear acupuncture
likeamaster pointtotranquilizethemindandclear zang-fumeridianchannels.
-_._---_._--_.. - - - - - - - - - - - - - ~
122.E
Superior
Cervical ganglia
123.C
Lesser
Occipital
nerve
108.E
Sympathetic
Preganglionic
nerves
109.E
Sympathetic
Postganglionic
nerves
120.E
Inferior
Cervical ganglia
121.E
Middle
Cervical ganglia
115.F4
Facial nerve
117.F4
Oculomotor
nerve
___ -116.F4
Trigeminal nerve
110.E2
Parasympathetic
Sacral nerves
114.E
Auditorynerve
113.E
Vagusnerve
110.E1
Parasympathetic
Cranialnerves
119.E
Olfactorynerve
118.E
Opticnerve
234
Figure 7.35 Hiddenviewof theperipheral nervous systemrepresented on theauricle. (FromLifeARl
fID
, Super
Aur;culotherapyManual
Backofear
r ,
120.E
I nferior
Cervical ganglia
121.E
Middle
Cervical ganglia
122.E
Superior
Cervical ganglia
123.C
Lesser
Occipital
nerve
117.F4
Oculomotor nerve
108.E
Sympathetic
Preganglionic
nerves
.-oof---l09.E
Sympathetic
Postganglionic
nerves
115.F4
Facial nerve
116.E
Trigeminal nerve
Peripheral nerves
Cranial nerves
118. Optic nerve
119. Olfactory nerve
117. Oculomotor nerve
116. Trigeminal nerve
114. Auditory nerve
113.E
Vagusnerve
110.El
Parasympathetic
Cranial nerves
119.E
Olfactory nerve
115. Facial nerve
114.E
Auditory nerve
118.E
Optic nerve
110.E2
Parasympathetic
Sacral nerves
112.E
Solar plexus
107.0
Sciatic nerve
111.E
Hypogastric plexus
113.
Vagusnerve
.. .I
Figure 7.36 Surface viewoftheperipheral nervous systemrepresented on theauricle. (FromLifeARTW, Super Anatomy, 'Lippincott
Williams&Wilkins,withpermission.)
7.5.3 Spinal cordandbrainstemrepresentedonthehelixtail andlobe
No.
124.E
Auricularmicrosystem point (Alternativename)
LumbosacralSpinalCord
[Auricular zone]
[HX12, PP 8]
[HX13, PP 6]
[HX14, PP 4]
[CW4]
125.E
126.E
127.C
Location: Superior helixtail, belowDarwinstubercle, LM4.
Function: Theanteriorsideof helixtail representsthesensory dorsal horncells of thelumbosacral spinal cord, whereas
posterior sideof helixtail representsmotorventral horncells of thelumbosacral spinal cord. Thispointrelieves
peripheral neuralgias intheregion of thelower limbs. I tisalso used effectively totreat patientswho have neuralgicside
effects fromAIDSor cancer medication, or for diabeticpatientswithpoor circulation tothefeet.
ThoracicSpinalCord
Location: Helixtail, peripheral totheconcharidgeand LM O.
Function: Anteriorsideaffects sensory neuronsof thoracicspinal cord, whereas theposterior sideaffects motor
neuronsof thoracicspinal cord. Relieves shingles, sunburns, poison oak or poison ivyonbodyor arms.
Cervical SpinalCord
Location: I nferior helixtail, above LM5.
Function: Relieves sunburnedneck, neuralgias, shingles, poison oak on neck. Theanteriorsideof thehelix tail affects
sensory cervical neurons, whiletheposterior sideaffects motorcervical neurons.
Brainstem(MedullaOblongata)
Location: Central sideof conchawall, just belowthebase of antihelix, LM 14.
Function: Affects bodytemperature, respiration, cardiac regulation, shock, meningitis, braintrauma, hypersensitivity
topain. Thispointtonifies thebrain, invigorates thespirit, arrestsepilepticconvulsions, reduces overexcitement, abates
fever andtranquilizesendopathicwind.
127.E MedullaOblongata(Brainstem)
Location: I nferior helixtail, betweenLM5and LM6.
Function: Affects bodytemperature, respiration, cardiac regulation.
[HX15, PP 2]
[LO7, PL6] 128.E Pons
Function: Affects sleep andarousal, paradoxical REMsleep, emotionallyreparativedreams, and relieves insomnia,
disturbingdreams, dizziness andpsychosomatic reactions.
129.E MidbrainTectum
Location: Peripheral ear lobe.
Function: Themidbraintectumincludes thesuperior colliculus andinferior colliculus, whichrespectively affect
subcortical reflexes for visual stimuli and auditorystimuli.
[L06]
[LO5,PL 5] 130.E MidbrainTegmentum(Mesolimbicventral tegmentalarea)
Function: Midbraintegmentumcontainsred nucleus andsubstantianigranuclei which affect extrapyramidal control of
semivoluntary muscles and motorintegrationof voluntary movements. Thispointrelieves Parkinsoniantremors,
torticollis, writerscramp.
131.E ReticularFormation [LO8,5T 3]
Location: Peripheral ear lobeat thebaseof thescaphoidfossa and inferior totheantitragus, and also isrepresentedon
thesubtragus.
Function: Thereticular activating system(RAS) of thebrainstemactivates arousal, attention,alertness, vigilance,
integrationof nociceptive input, and affects brain laterality.
132.E TrigeminalNucleus
Function: Relieves symptoms of trigeminal neuralgia, dental pain, facial tremors.
[LO7,PL 5]
7.5.4 Subcortical brain nuclei represented onthe concha wall and lobe
[Auricular zone]
- - - - - ~ - - - - ~
~ - - - - - ------------ ---------------------
133.E
134.E
Red Nucleus
Location: Superior region of ear lobe, belowtheperipheral antitragus.
Function: Regulatessemivoluntary actsandrelieves extrapyramidal muscle tremorsand spasms.
------- - - - -
Substantia Nigra
Location: Superior region of lobe, belowtheperipheral antitragus.
Function: Regulates semivoluntary actsandrelieves extrapyramidal muscle tremorsandspasms.
~ ~ ------ - - - - - - - - - - - - ~ - - - - - - - - - - - -
[LO6, PL6]
[LO6, PL6]
[LO4, PL4]
135.E Striatum (Basal Ganglia, Extrapyramidal motorsystem)
Location: Superior region of ear lobe, belowthemedial antitragus.
Function: Affects muscle tone, elaborationof automaticandsemiautomaticmovements, andinhibitionof involuntary
movements. Relieves Parkinsoniandisease, tremors, spasms.
~ - - - - - ~ - - - - - - - - -
[CW3]
136.E
137.E
138.C
Anterior Hypothalamus
Location: I nferiorconcharegion near theintertragicnotch.
Function: Affects parasympatheticsedation, diuresis.
Posterior Hypothalamus
Location: Peripheral inferior concha, belowtheantitragus, near theThalamuspoint.
Function: Facilitatessympatheticarousal andrelieves hypertensionandcardiac acceleration. Affects secretionof
adrenal in, vigilance, wakeful consciousness anddecreases digestion.
Brain (Thalamicnuclei, Diencephalon, Central Rim)
Location: Upperedgeof theconchawall, behindtheocciput onantitragusexternal surface.
Function: Alleviates deficiency of blood supplytothebrain, cerebral concussion, restlessness, cerebellar ataxia,
epilepsy, attentiondeficit disorder, hyperactivity, addictions, clinical depression, asthma, sleep disturbanceandpoor
intellectual functioning. I talso affects hypothalamiccontrol of pituitarygland, endocrineglands, relieving glandular
disturbances, irregular menstruation,sexual impotence, diabetesmellitus andpituitarytumors.
[IC2]
[IC 5]
138.E Thalamic Nuclei (Brain, Diencephalon)
Location: Conchawall behindthewholeantitragusridge, above theThalamuspoint.
Function: Affects all thalamicrelay sensory connectionstotheposterior cerebral cortex.
[CW1-CW3]
[LO1, PL 1] 139.E Limbic System (Rhinencephalon, Reactional Brain, Visceral Brain)
Location: Bottomof thejunctionof theear lobeandthejaw, at LM8.
Function: Affects memory, amnesia, retentionof lived-throughemotional experiences, sexual arousal, aggressive
impulses, compulsive behaviors.
140.E Hippocampus (MemoryBrain, Fornix, AmmonsHorn)
Location: Superior ear lobeimmediatelyinferior tothelengthof theantitragus.
Function: Thislimbicnucleus affects memory, amnesia, retentionof lived-throughemotional experiences.
[LO4, PL 6]
237
[Auricular zone]
[LO2]
141.E Amygdala Nucleus (EmotionalBrain, Aggressivitypoint)
Location: Notchonthesuperior lobeas itjoins theperipheral intertragicnotch.
Function: Thislimbic nucleus affects anger, irritability, excessive aggressiveness, mania, sexual compulsions, sexual
dramas.
..._ - - ~ - - - _ .. _--------_.- - - - - - - - - - ~ ~ ~ ~ .. ---------
142.E Septal Nucleus/Nucleus Accumbens (Sexual Brain, Pleasure Center)
Location: Central ear lobe, just inferior tointertragicnotch.
Function: Thislimbicnucleusaffects pleasure, reinforcement, instinctiveresponses and seems tobetheprimary
contributingbrainregion tosubstanceabuseandaddiction.
[L02]
------------- --------_ ...__.._ - ~ -
143.E Cingulate Gyrus (Paleocortex)
Location: Central intertragicnotch.
Function: Thislimbicnucleusaffects memoryandemotions.
[IT 1]
~ ~ ~ ~ - - ~ ~ ~ - - ~ ~ ~ ~ ~ - ~ ~ - - - - - - - - - - -
138.E
ThalamicNuclei
141.E
Amygdala Nucleus
133.E
Red Nucleus
139.E1
LimbicSystem1
134.E
SubstantiaNigra
137.E
Posterior
Hypothalamus
136.E
Anterior
Hypothalamus
132.E
Trigeminal Nucleus
131.E 1
Reticular Formation
127.E
MedullaOblongata
138.C
Brain
128.E
Pons
127.C _----V
Brainstem
125.E
Thoracic
Spinal Cord
124.E
Lumbosacral
Spinal Cord
126.E
Cervical
Spinal Cord
129.E
MidbrainTectum
Figure 7.37 Hiddenviewofthesubcortical central nervoussystemrepresented on theauricle. (FromLijeARTQfJ,
SuperAnatomy,'LippincottWilliams& Wilkins, withpermission.)
124.
Lumbosacral
spinal cord
138.
Brain
125.E
Thoracic
Spinal Cord
124.E
Lumbosacral
Spinal Cord
133.E
Red Nucleus
131.E
Reticular
Formation
132.F4
Trigeminal Nucleus
neurons
127.F4
Medulla Oblongata
131.F4
Reticular Formation
125.F4
Thoracic motor neurons
126.F4
P ; I j ~ __127.E
Medulla Oblongata
128.E Pons
132.E
Trigeminal Nucleus
134.E
Substantia Nigra 124.F4
Lumbosacral motor neurons
135.
Striatum
Cervical motor
141.
Amygdala
,----...:1.-140.
Hippocampus
127.C
Brainstem
137.E
Posterior
Hypothalamus
138.C
Brain
131.E2
Reticular
Formation
136.E
Anterior
Hypothalamus
138.E
Thalamic Nuclei
143.E
Cingulate Gyrus
142.E
Septal Nucleus
141.E
Amygdala
135.E
Striatum
142.
Septal Nucleus/
Nucleus Accumbens
Posterior
hypothalamus
Figure 7.38 Surface viewof thesubcortical central nervous systemrepresented on theauricle. (FromLifeARfF!, Super Anatomy,
7.5.5 Cerebral cortex represented ontheear lobe
No.
144.E
Olfactory Bulb
Location: Central ear lobeasit meets theface, midwaybetweenLM8andLM 9.
[Auricularzone]
[LO2]
Function: Affects sense of smell.
[AH1,PL 4]
[TG1-TG 5]
14s.E
146.E
Cerebellum
Location: I nferior antihelixtail andtheposterior lobe.
Function: Affects motorcoordinationandpostural tonus. Relieves intentional tremors, spasms, semiautomatic
movements, coordinationof axial movements, postural tonus, perfectionof intentional, cortical movements, vertigo,
vestibular equilibriumandclinical depression.
Corpus Callosum
Location: Wholelength of vertically ascendingtragus.
Function: Affects brainlateralityof left and right cerebral hemispheres. Theinteractionsbetweenthetwosidesof the
brain are representedonthetragus inan invertedpattern.Thecallosal radiationstothefrontal cortex are projectedonto
theinferior tragus, near LM9; thetemporal-occipital cortexradiationsareprojectedontothemiddleof thetragus,
betweenLM 10and LM 11;theparietal cortex radiationsareprojectedontothesuperior tragus. Thetragusalso
representstheanterior ConceptionVessel (Ren mai channel) andposterior GoverningVessel (Dumai channel) inan
invertedposition, theheaddowntoward TG1andthebase of thebodyuptoward TG5.
Cerebral laterality Theleft ear inaright-handedpersonrepresentsthelogical, linguistic, left cerebral cortex andtheright
ear representstherhythmic, artisticrightcerebral hemisphere. Theserepresentationsarereversed insomeleft handed
individualsandinpatientswithoscillation problems. Thusanoscillator would havetheleft cerebral cortex projectedonto
therightear andtherightcerebral cortex representedontheleft ear. Theleft hemispherecontrols theright sideof the
body, ismoreconscious, drawslogical conclusions, analyzes specificdetails, understandstheverbal contentof languageand
canrationally solvemathematicsproblems. Therighthemispherecontrolstheleft sideof thebody, tendstooperate
unconsciously, perceives theworldwithglobal impressions, andholdsemotional memoriesmorestrongly.
147.E
148.E
149.E
Occipital Cortex (Occipital Lobe, Visual Cortex)
Location: Peripheral antitragusandtheear lobebelowit.
Function: Affects visual neurological disorders, blindness, visual distortions.
Temporal Cortex (AcousticLine, Temporal Lobe, Auditory Cortex)
Function: Affects auditorydisorders, musical tonediscriminations, auditoryimpairment, deafness.
Parietal Cortex (Postcentral Gyrus, ParietalLobe, Somatosensory Cortex)
Location: Middleof ear lobe.
Function: Affects tactile paresthesia, musculoskeletal pain andsomestheticstrokes.
[AT 3, La8]
[L06, L08]
[LO5,La6]
----------------_._-_ .. _._-----------
iso.t
isu
Frontal Cortex (Precentral Gyrus, FrontalLobe, Pyramidal Motor System)
Location: Central ear lobe.
Function: I nitiatesmotoraction. Relieves motorparalysis, alters muscle tonus.
Prefrontal Cortex (MasterCerebral point)
Location: Central ear lobeasitjoins face.
Function: I nitiatesdecision making. Relieves poor concentration, obsessions, worry.
[LO3, PL 3]
[La1,PL 1]
-------------------_._---------
146.E
Corpus
Callosum
144.E
OlfactoryBulb
151.E
PrefrontalCortex
150.E
Frontal Cortex
151.
Prefrontal
Cortex
150. -"0---,.
Frontal
Cortex
145.
Cerebellum
147.
Occipital
Cortex

Parietal
Cortex
150.
Frontal
Cortex
147.E
Occipital
Cortex
148.E
Temporal
Cortex
150.F4
Frontal Cortex
151.F4
PrefrontaI Cortex
Figure 7.39 Surface viewofthecortical central nervous systemrepresented on theauricle. (FromLifeARr,
SuperAnatomy, 'LippincottWilliams&Wilkins,withpermission.)
7.6 Auricular representation of functional conditions
7.6.1 Primary Chinese functional points represented onthe ear
-------
No.
152.(
153.(
154.(
Asthma (Ping Chuan)
Location: Apex of theantitragus, at LM 13.
Function: Relieves symptomsof asthma, bronchitis, coughs, difficulty breathing, itching.
------------_..
Antihistamine
Location: Middleof thetriangular fossa, near theEuropeanKnee point.
Function: Relieves symptomsof colds, allergies, asthma, bronchitis, coughs.
. ..... ......- ... _--------------
Constipation
Location: I nferior triangular fossa, superior toLM 17ontheantihelixinferior crus.
Function: Relieves constipation, indigestion.
[Auricularzone]
[AT 2]
[TF 4]
[TF 3]
155.(1
155.(2
156.(1
156.(2
156.C3
157.(
Hepatitis 1
Location: Superior aspects of thetriangular fossa asit curves uptotheantihelixsuperior crus.
Function: Reducesliver dysfunctions, liver inflammations.
Hepatitis 2 (Hepatomeglia, Cirrhosis)
Location: Peripheral inferior concha, at theLiver point.
---_._--_._-_.
Hypertension 1 (Depressing point, Lowering BloodPressure point)
Location: Central, superior triangular fossa, near theEuropeanpointsfor theToes.
Function: Reduceshighbloodpressure, inducesrelaxation.
Hypertension 2 (HighBloodPressure point)
Location: I nferior tragus, at theTranquilizerpoint.
Hypertension 3 (Hypertensive groove)
Location: Superior region of theposterior groove, behindtheupper antihelixbody.
Hypotension (Raising BloodPressure point)
Location: Central intertragicnotch, betweenEyeDisordersMu1and EyeDisordersMu2.
Function: Elevates abnormallylowbloodpressure.
[TF 4]
[IC 5]
[TF 3]
[TG 2]
[PG 4& PG 8]
[IT1]
158.( Lumbago (Lumbodynia, Coxalgia)
Location: Middleof antihelixbody.
Function: Relieves thefunctional or psychosomatic aspects of lowback pain.
[AH 11]
159.( Muscle Relaxation [IC7/IC8]
242
Location: Peripheral inferior concha, near theChineseSpleenpointand theLiver points.
Function: Thispoint isoneof themost clinically effective pointsontheauriclefor reducingmuscle tension, withalmost
thestatusof amaster pointbecause it isused sooftentoreducepain and stress.
No.
160.C
San Jiao (TripleWarmer, TripleHeater, TripleBurner, TripleEnergizer)
[Auricularzone]
[IC 1]
Location: I nferiorconcha, near thePituitaryGlandpoint, theglandwhich regulatesantidiuretichormonethat controls
fluidlevels released inurine.
Function: Affects diseases of theinternal organs and theendocrineglands. Affects thecirculatorysystem, respiratory
system, and thermoregulation. I trelieves indigestion, shortnessof breath, anemia, hepatitis, abdominal distension,
constipationandedema. SanJiao regulateswater circulation andfluiddistributionrelatedtothelower jiao, middlejiao,
andupperjiao.
161.C Appetite Control (Hungerpoint,WeightControl)
Location: Middleof tragus, between LM10and LM 11.
[TG 3]
[TG4]
[SC 2]
162.C
163.C
Function: Diminishesappetite, nervous over-eating, overweight disorders, hyperthyroidismand hypertension. Thisear
point can bevery effectively combinedwithstimulationoftheStomachpointfor reductionof thefood cravings that may
accompanycommitmenttoadiet plan and exercise program. However, it does not replacetheneedfor willpower to
maintaincommitmenttoacomprehensiveweight reductionprogram.
Thirst point
Location: Tragus, just medial and inferior tothesuperior tragus protrusion, LM11.
Function: Diminishesexcessive thirst relatedtodiabetesinsipidus and diabetesmellitus. InTCM,it nourishesyinand
promotestheproductionof bodyfluidstoreducethirst.
----------------------
Alcoholic point (Drunkpoint)
Location: Superior concha, betweentheSmall I ntestinespoint andtheChineseKidney point.
Function: Relieves hangovers, assists treatmentof alcoholism. Just astheAppetiteControl pointcan onlyfacilitatebut
not overrule theeffects of willpower for weight reduction, thisAlcoholicpointcan onlyfacilitatebut not override
conscious volition. Analcoholic patient must commit toalifeof sobrietyandsome typeof support and empowerment
group, such asa12-stepprogram.
164.C
165.C
Nervousness (Neurasthenia, fVIaster Cerebral point)
Location: Central ear lobe, near LM8and theMaster Cerebral point.
Function: Relieves anxiety, worry, neurosis, neurasthenia.
Excitement point
Location: Conchawall belowtheapex of antitragusand above theThalamuspoint.
Function: Thispointinducesexcitationof thecerebral cortex torelieve drowsiness, lethargy, depression,
hypogonadism, sexual impairment, impotency, andobesity.
somatotopicrepresentations
[LO1]
[CW2]
243
158.C
Lumbago
159.C
Muscle
Relaxation
165.C
Excitement
156.(1
Hypertension 1
155.C1
Hepatitis 1
153.C
Antihistamine
163.C
Alcoholic
point
162.C
Thirst point
_161.C
Appetite
Control
160.C
\
San [iao
156.C2
Hypertension 2
157.C
Hypotension
164.C
Nervousness
244
Figure 7.40 HiddenviewofprimaryChinesefunctional conditionsrepresentedontheauricle.
164.C
Nervousness
Figure 7.41 SurfaceviewofprimaryChinesefunctional conditionsrepresentedontheauricle.
7.6.2 Secondary Chinese functional points represented ontheear
Secondaryfunctional pointsare onlydistinguishedfromtheprimaryfunctional pointsbybeing less commonlyused as
theprimary ear reflex points. Even thisdistinctionisnot completely accurate, asmorerecent clinical workbythe
Chinesehasemphasizedtheuseof particular secondary ear reflex pointslikeWindStreamand Central Rim.
No.
166.C
167.C
---------------------
Tuberculosis
Location: I nferiorconcha, at center of theLungpointregion.
Function: Relieves tuberculosis, pneumonia, breathingdifficulties.
Bronchitis
Location: I nferiorconcha, at theBronchi point, inward fromtheLungpointregion.
Function: Relieves bronchitis, pneumonia, breathingdifficulties.
[Auricular zone]
[IC S]
[IC 7]
[AH11] 168.C Heat point
Location: Antihelixbody, at thejunctionof theinferior andsuperior crus.
Function: Producesperipheral vasodilation, reducingvascular inflammationandsensationof beingwarmor feverish. It
isused for acutestrains, lowback pain, Raynaudsdisease andphlebitis.
169.C
170.C
Cirrhosis
Location: Peripheral concha ridge, withintheLiver pointregion.
Function: Relieves cirrhosisdamage totheliver and hepatomeglia.
Pancreatitis
Location: Peripheral superior concha, withinthePancreaspoint region.
Function: Relieves inflammationand deficiencies of thepancreas, diabetes, indigestion.
[CR 2]
[SC 7]
171.C Nephritis
Location:
Function:
I nferior helixtail asit meets thegutterof thescaphoidfossa, near LM5.
Reduceskidneyinflammations.
[HX 1S]
172.C
173.C
174.C1
--------------- -----------------------
Ascites point
Location: Superior concha, between theDuodenumpointand ChineseKidneypoint.
Function: Reducesexcess abdominal fluid, cirrhosis, flatulence.
Mutism (Dumbpoint)
Location: Undersideof subtragus, superior totheI nnerNosepoint.
Function: Used toassist problemswithspeakingclearly or withstuttering.
Hemorrhoids 1
Location: Undersideof theinternal helix, near theEuropeanKidneypoint.
Function: Alleviates hemorrhoids.
[SC 6]
[ST 3]
[IH S]
174.C2 Hemorrhoids 2
Location: Central superior concha, near theChineseProstatepoint.
------- ------------------
[SC 4]
No.
175.C
Wind Stream (Lesser Occipital nerve, MinorOccipital nerve)
[Auricularzone]
[IH10]
Location: Peripheral internal helixasitjoins superior scaphoidfossa. Thisear reflex pointwaspreviously referredtoin
ChinesetextsastheMinorOccipital nerve.
Function: Alleviates allergies, bronchial asthma, allergic rhinitis, coughs, dermatitis, urticaria, andallergic
constitutions. Thispointisutilized inChineseear acupuncturetreatmentstoreducetheeffects of pathogenicwind.
.. ---...._-------_._--
176.C Central Rim(ChineseBrain point) [CW3]
[TG5] 177.C
Location: Portionof conchawall belowthejunctionof theantihelixtail andtheantitragus. Thisear reflex pointwas
previously referredtoinChinesetextsastheBrain pointor Brainstempoint.
Function: Alleviates basic metabolicsymptoms of stress, neurological problems, and addictiondisorders. InTCM,it
replenishes spleen qi and kidneyqui, nourishesthebrain, andtranquilizesthemind.
Apex ofTragus
Location: Tragussuperior protrusion, at LM 11.
Function: Reducesinflammation, fever, swelling, arthriticpain. I thasanalgesic, antipyretic, and anti-inflammatory
properties.
178.C Apex of Antitragus
Location: Antitragussuperior protrusion, at LM 13.
Function: Reduces inflammation, fever, swelling.
[AT 2]
[HX7]
[HX11]
179.C
180.C1
Apex of Ear (TipofEar, EarApex,ApexofAuricle)
Location: Topof thesuperior helix, at LM2.
Function: Antipyreticpoint toreduceinflammation, fever, swelling, andblood pressure. Thispointisoftenused for
blood-lettingbypricking thetopoftheear toreducefever, blood pressure, inflammation, delirium, andacutepain. This
point hasanalgesic, antipyretic, and anti-inflammatoryproperties. InTCM,thispointclears awayheat and toxic
substances, calms liver qi and reduceswind.
--_._-----
Helix 1(Helixpoints)
Location: Peripheral helix, at Darwinstubercle, betweenLM3and LM4.
Function: Antipyreticpoint toreduceinflammation, fever, swelling,blood pressure(samefunctionfor all Helixpoints).
180.C2 Helix2
Location: Helixtail, within theregion of theLumbosacral Spinal Cord.
[HX13]
180.C3 Helix3
._-_.... _--------------------_._----------
[HX14]
180.C4
180.C5
180.C6
Location: Helixtail, withintheregion of theCervical Spinal Cord.
Helix4
Location: Helixtail, where thehelixmeetsthelobeat LM 6, superior totheChineseTonsil 3point.
-------". -----------------------
Helix5
Location: Peripheral ear lobe, midwaybetweenLM 6and LM7.
Helix6
Location: Bottomof theear lobe, at LM 7, inferior totheChineseTonsil 4point.
[HX14]
[LO7]
[LO3]
I mportant ear points: Themost commonlyused Chinesefunctional pointsareMuscle Relaxationpoint, Appetite
Control point, Brain (Central Rim), andWindStream(Lesser Occipital nerve). TheNervousnesspointisidentical to
theMasterCerebral pointand theHypertension2pointoverlaps theTranquilizerpoint.
175.C
Wind Stream
180.C1
Helix 1
168.C
Heat point
180.C2
Helix 2
169.C
Cirrhosis
180.C3 -----''rr
Helix 3
176.C
Central Rim
171.C
Nephritis
180.C4
Helix 4
180.C5
Helix 5
179.C
Apex of Ear
174.C1
Hemorrhoids
170.C
Pancreatitis
167.C
Bronchitis
166.C
Tuberculosis
178.C
Apex of
Antitragus
180.C6
Helix 6
248
Figure 7.42 Hiddenviewofsecondary Chinesefunctional conditionsrepresented on theauricle.
179.C
Apex of Ear ---------=.....::::::::A
174.C1
Hemorrhoids
168.C
Heat point
174.C2
Hemorrhoids
172.C ~
Ascites
177.C
Apex of
Tragus
173.C
Mutism
178.C
Apex of
Antitragus
180.C6
Helix 6
175.C
WindStream
180.C1
Helix 1
170.C
Pancreatitis
180.C2
Helix2
180.C3
Helix 3
167.C
Bronchitis
166.C
Tuberculosis
180.C4
Helix4
180.C5
Helix5
Figure 7.43 Surface viewofsecondary Chinesefunctional conditionsrepresented on theauricle.
7.6.3 Primary European functional points represented ontheear
--------------------
No.
18l.E
Auditory Line
[Auricular zone]
[L06]
182.El
Location: A horizontal lineontheear lobe, inferior totheantitragus, intheauricular region that correspondstothe
auditorycortex of thetemporal lobe. Thereissecond auditorylineontheneck, belowtheear lobe.
Function: Theauditorylinerepresentstheauditorycortex onthetemporal lobe, withstimulationof highfrequency
sounds morepresent on thecentral part of thislineandrepresentationof lowfrequency soundsmorepresent onthe
peripheral part of thisline. I tisused torelieve deafness, tinnitusandotherhearingdisorders.
Aggressivity 1(AggressionControl, Anti-aggressivity, Irritability) [LO2]
Location: Notchat thejunctionof themedial antitragusandmedial ear lobe. I tislocatedat same auricular region as
thelimbicAmygdala Nucleus whichregulates aggressive behaviors.
Function: Reducesirritability, aggression, frustration, rage, maniaand drugwithdrawal.
182.E2
182.E3
Aggressivity 2
Aggressivity 3
[TG 5]
[IC 2]
Location: I nferiorconchanext toconchawall region behindtheantitragus.
[HX4] 183.E 1 Psychosomatic point 1(Psychotherapeuticpoint,PointR, Bourdiol point)
Location: Superior helixroot, asitjoins theface at LM 1.I tislocated near Chineseear reflex pointfor External
Genitalsandexternal totheAutonomicpoint.
Function: Alleviates psychological disorders, andcan help psychotherapypatientsremember long-forgottenmemories
andrepressed emotional experiences. I talso facilities theoccurrenceof vivid intensedreams.
183.E2 Psychosomatic point 2 [LO1]
Location: I nferior lobeasitjoins theface, superior toLM8, inregion for theintellectual Prefrontal Cortexregion of
ear. It isalso near MasterCerebral, Neurasthenia, andNervousness.
- - - - ~ ...._ - - - ~ - - - - - . _ -
184.E Sexual Desire (Boschpoint,Libidopoint) [HX1]
Location: Helixroot asitjoins thesuperior edgeof tragus, at theEuropeanear pointfor theExternal Genitals, Penis
andClitoris.
Function: I ncreaseslibido, enhancessexual arousal.
185.E Sexual Compulsion (jeromepoint,Sexual Suppression)
Location: Helixtail asitjoins theear lobe, near LM5, at theEuropeanMedullaOblongata.
Function: Lowers libido, calms sexuality, alleviates insomnia.
[HX15]
186.E Master Omega (MasterCerebral point,Psychosomaticpoint,Worrypoint,Angst) [LO1]
Location: I nferiorear lobenear theface, superior toLM8. I tisthesame pointastheEuropeanMasterCerebral point
andtheChineseNervousness or Neurastheniapoints. I tisintheregion of theear reflex pointfor thePrefrontal Cortex.
A vertical linecan bedrawn betweenthisMasterOmegapointand thefunctional points Omega1and Omega2.
Function: Affects psychological stress, such asobsessive-compulsive disorders, fear, worry, ruminatingthoughts, angst,
psychosomatic disordersandgeneral analgesia.
250
-. . - - - - - - ~ - - - - - ----
- - - - - - - - _ . _ - - - ~ . ------------- ---------_.
No.
187.E
188.E
Omega 1
Location: Superior concha, central totheSmall I ntestinespoint.
Function: Affects vegetative stress, such asdigestive disordersandvisceral pain.
Omega 2
Location: Superior helix, central totheAllergy pointat LM 2.
Function: Affects somaticstress, reducingrheumatoidarthritis, inflammationsof thelimbs.
[Auricular zone]
[SC 2]
[HX6]
[CR 2/CW4] 189.E Marvelous point (Wonderfulpoint,MiddleCervical plexus)
Location: Peripheral concharidge, inregion of theLiver point.
Function: Balances excessive sympatheticarousal, reduces hypertension. Affects bloodvascular regulation, relieves
muscle tension.
190.E
191.E
192.E
Antidepressant point (Cheerfulness, Joypoint)
Location: Peripheral ear lobe, belowtheperipheral antitragusandbelowtheOcciput point.
Function: Relieves endogenousdepression, reactive depression anddysphoric mood.
Mania point
Location: I nferior tragusedgethat lies above theinferior concha, betweenLM9and LM 10.
Function: Relieves hyperactive manic behavior that oftenaccompanies addictions.
Nicotine point
[L08]
[TG 1]
[TG2]
Location: I nferior tragus edgethatisover theconcha, superior totheManiapoint and inferior totheChineseAdrenal
Glandpoint.
Function: Used toreducenicotinecraving inpersonswithdrawingfromsmoking.
193.E
194.E
195.E1
195.E2
196.E
Vitality point
Location: Superior tragus, central toLM 11.
Function: Affects immunesystemdisorders, AIDS, cancer.
Alertness point
Location: Helixtail, belowtheDarwinstubercle, near LM4.
Function: I nducesarousal, activation, alertness.
Insomnia 1 (Sleeppoint)
Location: Superior scaphoidfossa, near theWristpoint.
Function: Relieves insomnia, nervousness, depression.
Insomnia 2 (Sleeppoint)
Location: I nferior scaphoidfossa, near MasterShoulder point.
Function: Relieves insomnia, sleep difficulties, nervous dreams, inability todream.
- ---------- - - - - ~ - - - - - - - - - - - - - - -
Dizziness (Vertigo)
Location: Conchawall, belowtheOcciputandCervical Spinepoints.
Function: Relieves dizziness, vertigo.
------------------ -------
[TG2]
[HX12]
[SF 4]
[SF 1]
._---------
[CW3]
251
183.E1
Psychosomatic
o point 1
19S.E1
Insomnia 1
19S.E2 _
Insomnia 2
18S.E
Sexual
Compulsion
190.E
Antidepressant
point
181.E1
Auditory line
\
181.E2---\
Auditory line \
188.E
Omega 2
187.E
Omega 1
184.E
Sexual Desire
193.E
Vitality
182.E3
Aggressivity 3
191.E
Mania point
182.E1
Aggressivity 1
186.E
Master Omega
183.E2
Psychosomatic
point 2
252
Figure 7.44 HiddenviewofprimaryEuropeanfunctional conditionsreprr-entedontheauricle.
188.E
Omega 2
183.El 0
Psychosomatic
point 1
187.E
Omega 1
182.E2
Aggressivity 2
184.E ---14
Sexual Desire
193.E
Vitalitypoint
196.E
Dizziness -----I f--_
192.E
Nicotine point
191.E
Mania point
182.El -----I ll!
Aggressivity 1
186.E -----\{J
Master Omega
183.E2
Psychosomatic /
point 2
181.E2 ~ - O
Auditory U", 2 /
195.El
Insomnia 1
194.E
Alertness
189.E
Marvelous
point
195.E2
Insomnia 2
)...........,.., 185.E
Sexual
Compulsion
190.E
Antidepressant
point
181.El
Auditory line 1
Figure 7.45 Surfaceviewofprimary Europeanfunctional conditionsrepresented ontheauricle.
7.6.4 Secondary European functional points represented ontheear
AswiththeChinesesecondaryfunctional points, theEuropeansecondaryfunctional pointsare distinguishedfromthe
Europeanprimaryfunctional pointsonlybecause theyare not ascommonlyused.
No. Auricular microsystem point (Alternativename) [Auricularzone]
' - ~ ~ ~ ~ ~ ~ ~ ~ ~ ' - - - - - - - " - - -------------
197.E
198.E
199.E
200.E
201.E
202.E
Sneezing point
Location: Peripheral ear lobe, near thelocationfor EuropeanTrigeminal Nucleuspoint.
Function: Reducessneezing, allergies.
Weather point
Location: Helixroot, superior totheChineseRectumpoint andabove theEuropeanProstatepoint.
Function: Alleviates anysymptomsdue tochangesinweather.
Laterality point
Location: Sideburnsareaof theface, central toLM 10.
Function: Facilitatesbalanceof left and right cerebral hemispheres, reducesoscillation.
Darwins point (BodilyDefense)
Location: Darwinstubercleontheperipheral helix, betweenLM3and LM 4.
Function: Relieves all types of pain inthelower back and lower limbssince it representsthespinal cord.
Master point for Lower Limbs
Location: Helixroot, above theEuropeanExternal Genitalspoint.
Function: Relieves pain andswelling inlegsandfeet.
Master point for Upper Limbs
Location: Helixtail, intheregion of theEuropeanMedullaOblongata.
Function: Relieves pain andswelling inarms, hands, andfingers.
[LO5j
[HX3]
[Face]
[HX11]
[HX2]
[HX15]
~ - - - - . ~ ~ ~ ~ - - - - - - - - - -
203.E
204.E
Master point for Ectodermal Tissue
Location: I ntertragicnotch, inferior tothePineal Glandand EyeDisorderspoints.
Function: Affects treatmentof ectodermal tissueof skin and nervous system.
Master point for Mesodermal Tissue
Location: I nternal helix, near theEuropeanKidney and Ureterpoints.
Function: Affects treatmentof musculoskeletal disorders.
[IT 1]
[IH4]
-- - - - - ~ - - - ..- - - - ~ - - - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ . - ~ ~ ~ - ~ ~ ~ -
205.E
206.E
254
Master point for Endodermal Tissue
Location: I nternal helix, ncar theEuropeanOvary andTestespoints.
Function: Affects treatmentof internal organand endocrinedisorders.
-- - - -----.. ~ - - _ . - - . _ - - - ~ _ .
Master point for Metabolism
Function: Affects treatmentof anymetabolicdisorder.
[IH1]
[LO7]
No.
207.E 1
207.E2
208.E
209.E
210.E
211.E
212.E
213.E
Auricular microsystempoint (Alternativename)
Prostaglandin1
Location: Undersideof ear lobe, whereactual ear joinslower jaw.
Function: Reduces inflammationsand pain.
Prostaglandin2
Location: Head,superior totheApex of Earand LM2.
Function: Reduces inflammationsand pain.
VitaminC
Location: Head,superior totheApex of EarandLM2.
Function: Relieves stressandsymptomsof colds or flu.
Vitamin E
Location: Superior helix, peripheral totheAllergy point.
Function: Used toamplify effects of takingVitamin E.
VitaminA
Location: Neck, inferior totheear lobe.
Function: Used toamplify effects of takingVitamin A.
. ------_._--._-----------
MercuryToxicity
Location: Superior concha, near theBladder point.
Function: Used torelieve effects of metal toxicity reactions.
Analgesia
Location: Superior concha, near theDuodenumpoint.
Function: Usedtofacilitate pain relief for surgeries.
Hypnotic
Location: Helixtail, horizontallyacross fromLMO.
Function: Usedtotranquilizeandsedate.
[Auricular zone]
[LO 1]
[Head]
[Head]
----------- .. _----
[HX9]
[Neck]
[SC 6]
[SC 7]
[HX13]
------------------------
214.E 1
214.E2
214.E3
Memory1
Location: Central ear lobe, inregionof thePrefrontal Cortexpoint.
Function: Facilitatesimprovement inmemoryandattention.
-----_.- ...._. ----
Memory2
Location: Superior ear lobe, inregionof theHippocampuspoint.
Function: Facilitatesimprovement inmemoryand attention.
Memory3
Location: Posterior ear lobe, inregionof thePrefrontal Cortexpoint.
Function: Facilitatesimprovement inmemoryandattention.
[LO 1]
[L04]
[PL 2]
I mportantear points: Themost frequently utilized Europeanfunctional pointsareAggressivity 1,Psychosomatic
Reactions 1,Antidepressantpoint, andVitalitypoint. MasterOmegapointisidentical to MasterCerebral point.
208.E ----------10
Vitamin C
209.E
Vitamin E
200.E
Darwins point
211.E
Mercury
Toxicity
212.E
Analgesia
213.E
Hypnotic
206.E
Master point for
Metabolism
197.E
Sneezing point
0)-------- 207.E2
Prostaglandin 2
204.E
Master point
for Mesodermal
Tissue
205.E
Master point for
Endodermal Tissue
201.E
Master point for
Lower Limbs
199.E
Laterality point --0
203.E
Master point for
Ectodermal Tissue
207.E1
Prostaglandin 1
256
Figure 7.46 Hiddenviewofsecondary Europeanfunctional conditionsrepresented on theauricle.
207.E2 _----0
Prostaglandin 2
204.E
Master point
for Mesodermal
Tissue
198.E
Weather
20S.E
Master point for
Endodermal Tissue
201.E
Master point for
Lower Limbs
~ 1 9 9 . E
Laterality point
203.E
----"
Master point for
Ectodermal Tissue
214.E2
Memory 2
214.E 1
Memory 1
207.E1
Prostaglandin 1
0--------- 208.E
Vitamin C
209.E
Vitamin E
200.E
Darwins point
211.E
Mercury
Toxicity
212.E
Analgesia
213.E
Hypnotic
....,nf---__ 202.E
Master point for
Upper Limbs
_____ 206.E
Master point for
Metabolism
197.E
Sneezing point
0 210.E
Vitamin A
Figure 7.47 Surface viewofsecondary Europeanfunctional conditionsrepresented ontheauricle.
258
Clinical casestudies of
auriculotherapy
CONTENTS
8.1 Relief of nausea
8.2 Myofascial trigger points
8.3 Back pain
8.4 Peripheral neuropathy and neuralgia
8.5 Weight control
8.6 NADA addiction protocol
8.7 Alternative addiction protocols
8.8 I nternational Consensus Conference on Acupuncture,Auriculotherapy, andAuricular Medicine
(ICCAAAM)
8.9 Auriculotherapy Certification I nstitute
Mypersonal experiencewithauriculotherapybeganat theUCLA PainManagement Clinicin
1975.As alicensed psychologist workinginaninterdisciplinarypainclinic, I wasoften asked tosee
thechronicpainpatientswho hadnot benefitedfromprevioustrialsof opiatemedications,
antidepressants,localized nerveblocks or trigger pointinjections. Clientswere referredtomeby
other doctorsintheUCLA Medical Center for biofeedback trainingor auriculotherapy.
Biofeedback therapyallowed patientstolearntoreducetheirpathological muscle spasms
andtoimprovevascular circulation.Patientswere referredfor auriculotherapyasamoredirect
procedurefor immediatelyalleviatingchronicpain. Whilelicenced acupuncturistsactivate
acupuncturepointswiththeinsertionof needles, myclinical practicewithauriculotherapyhas
employed transcutaneousmicrocurrentstimulationof ear reflex points. Electronicequipment that
wasused at UCLA includedtheStirnFlex, theAcuscope, andtheHMRstimulator.An electrical
detectingprobeisguidedover specific regionsof theauricletoidentifyreactivepointsanda
buttonon thesamebipolarprobeispressed tobrieflystimulatethesameear points. Thereisno
invasionof theskinwithneedles, so thisapproachtendstobeless painful thanother forms of
auricularstimulation.I alsoworkedwithphysicians, nurses, andacupuncturistswho didinsert
needles intotheear.
WhenI wasfirst learningauriculotherapy,itwasvery helpful tohaveawall chartof ear
acupuncturepointsimmediatelyabovethetreatmenttablewherepatientswere seen. Electronic
equipment, acupunctureneedles, or ear pelletswere availableon anearbystand.Whilethe
invertedfetus concept facilitatesaneasy comprehension of which portionsof theauriclerelate
toaparticularpatientsproblem, andtheauricularacupointsused inmost treatmentplansare
quicklylearned, itisuseful tohaveavisual reminderof less frequentlyused ear pointsandtheir
precisepointlocation. It isnot necessary for patientstolieon atreatmenttable, since they
canbetreatedeasilyinanordinarychair. It isbest, however, for thepractitionertoeither
standor sit ateye level above thepatientsear. It isimportantthatthepractitionersarmisnot
excessively strainedwhen holdinganelectronicprobeagainst theauricleor when insertinga
needle. Comfort for thepractitioneraswell asthepatientisimportantwhen seeing many
patients.
Thefirst several years of mypracticeof auriculotherapyrequiredmetosuspend myskepticism
stemmingfromthelack of scientific explanationsfor thisprocedure. I would repeatedlysee
significant improvementsinthehealthstatusof patientswithpreviously intractablepain, but my
internaldisbelief remained. I wasencouragedbyreadingthewords of Nogier (1972), who stated
that
any method should not be rejected out ofhand merelybecauseit remains unexplainedand does not
tie up withourpresentscientificknowledge. A discovery is rarely logicaland oftengoes againstthe
conceptions then infashion. It is often the resultofa basicobservationwhichhas been sufficiently
clearand repeatable for it to be retained.
Nogier furthercommented that
the spinal column, like the limbs, isprojectedclearly and simply in the externalear. The therapeutic
applicationsarefreefrom ambiguityand ought to allowthe beginnerto achieveconvincingresults.
Each doctor needs to be convincedofthe efficacyofthe method bypersonal results, and he is right.
I neededmanyobservationsof theclinical effectiveness of auriculotherapybeforeI wasconvinced.
Thesestatementsof Nogier remindedmeof myreadingsinthebiofeedback literatureof the
pioneeringresearchonstress byHansSelye. Inhisclassic text, The stressoflife (1976), Selye
described theinitialscientific oppositiontohisconcept of anon-specific factor thatcontributesto
disease inadditiontothespecific pathogensfirst discovered byLouis Pasteur.Selye relatedthe
storythatonesenior professor whomheadmiredremindedmethatfor monthsnowhehad
attemptedtoconvince methatI must abandonthisfutilelineofresearch. Fortunately,Selye
persevered inhisresearchanddiscovered thatchronicstress leads toanenlargement of the
adrenalglands, atrophyof thethymus glands andulcers inthegastrointestinal tissue. These
organicchanges arenowwidelyrecognized asreliableindicationsof thebiological response toa
varietyof non-specific stressors. Pasteurhimself hadtoovercome considerableoppositiontothe
germtheorypostulatethatinvisiblemicroorganismscouldbethesourceof anillness. Manyof
Pasteurscolleagues scoffed at thesupposed dangersof theseinvisibleagents, but today,
sterilizationtechniquesinsurgery andinacupunctureoriginatefromPasteursproposals.
Alternativetheoriesandtherapiesoftenrequirepatienceandpersistencebeforethey become
widelyaccepted bythemedical profession asawhole.
Inthissection, I haveincorporatedmyown clinical findingswiththatof other healthcare
practitionerswhotreatauricularacupuncturepointswithneedles or who usetheNogier vascular
autonomicsignal indiagnosis andtreatment.I haveendeavoredtoselect cases thatprovideinsight
intotheunderlyingprocesses affecting auriculotherapyaswell asexamples of typical clinical
results onemight expect fromsuch treatments.Theorder of presentationof specific clinical
cases will first focus onpainconditionsrelatedtointernalorgans, thenuponmyofascial pain
disorders, andlastlywill examineneuropathicpainproblems. Theuseof auriculotherapyfor
addictionsandother healthcaredisorderswill alsobediscussed. Finally, theresultsof clinical
surveys conductedbyskilled practitionersinthisfieldwill bepresentedtoindicatewhich
auriculotherapytreatmentplanshavebeenfound tobethemost effective for particularhealth
conditions.
8.1 Relief of nausea
As Nogier suggested, whatmaybemost persuasivefor abeginningpractitioneristherelief of a
symptom thathehimself hasexperienced. I hadworkedwithDrsRichardKroeningandDavid
Bresler at theUCLA Medical Center for manymonthsconductingresearchon auriculardiagnosis.
I myself, however, hadnever received anyauricularacupuncturetreatment.At oneof thefirst
lecturepresentationsof our auriculardiagnosis research, I hadthefirst handopportunitytoassess
theclinical effectiveness of ear acupuncture.I hadeatensomethingfor breakfastthatbeganto
greatly disagreewithme. Bythetimethelecturewasset tobegin, thediscomfortingstomach
sensationsweregettingworse. I toldthistoDr Kroening, who noticedtheunpleasantgrimaces
uponmyface. Hepromptlypulledasterilizedneedleoutof thepocket of hislabcoat andinserted
itintotheStomachpointonmyleft ear. Tomyunexpected surprise, thenauseainmystomach
disappearedwithinoneminute. Sincetheskeptical scientific sideof mypersonalitywondered
whether thissuddenrelief of painwassimplyaplaceboeffect, I removed theneedle. The
uncomfortablenauseousfeelings immediatelyreturnedandI almost startedtovomit. Somewhat
embarrassedbymylack of faithinhismedical skills, I hadtoask DrKroeningtoreinsertthe
acupunctureneedleinmyear. Hesmiled andcompliedwithmyrequest. Almost immediatelyafter
hereplacedtheacupunctureneedle, theabdominaldiscomfort quicklysubsided. Onlyafter
leavingtheneedleinplacefor 20minuteswasI abletoremoveitwithoutnauseareturning.
Clinical casestudies 259
260
Whatthisexperience clearlytaughtmewas thatauriculotherapycouldbevery fast acting, but
withoutsufficient stimulationof theappropriateear acupuncturepoint, thebenefitscouldrapidly
fade. Thechanges innauseasensationsweredirectlyrelatedtotheinsertion, theremoval, thenthe
reinsertionof theacupunctureneedle. Since thisinitialobservation, I haveused theStomachpoint
for myself andmanyclientsI haveworkedwith. Bothneedleinsertionandtranscutaneous
electrical stimulationcanquickly relievestomachaches, not onlyinresponse todisagreeablefoods,
but also fromthesideeffects of variousmedications. It isalso possible toproduceamoregradual
reductioninnauseousfeelings fromjust thetactilepressureof rubbingonesown finger over the
Stomachpoint. Acupressure isnot asrapidaselectrical stimulation,usuallyrequiringseveral
minutesof maintainedpressureagainsttheear points, butit allows patientstohelpthemselves
withoutanyequipment.
Paincomplaintsrelatedtointernalviscera arerepresentedinadifferent region of theear thanare
musculoskeletal complaints. Thecentral concha zoneisassociatedwithdiffuserepresentationof
thevagus nervecontrol of internalorgans. Thesurroundingridgeof theantihelixandantitragus
areassociatedwithmoreprecisecontrol of musculoskeletal movements. For thatreason, abroad
areaof concha pointsaffectingthestomachcan befound, butthereareonly asmall set of specific
antihelixpointsthatcould affect thethoracicspine. Auriculotherapyisvery effective for therelief
of gastrointestinaldistresswhich isnot successfully alleviatedbyconventional treatments. I have
nowtreatednauseainmanypatientswithAI DS who arebeingadministeredantiviralmedication
or cancer patientswho areundergoingchemotherapy. Inmost of thesecases, stimulationof the
auricularStomachpointdramaticallyalleviatestheirgastrointestinal reactions. Therearenow
over 20controlledclinical trialsdemonstratingthatneedlingof thebodyacupuncturepoint PC 6
on thewrist hasasignificant antiemeticeffect. Therelief of nauseabystimulatingtheauricular
Stomachpointcan bejust asprofound.
PL wasa28-year-oldgaymalewho hadbeen diagnosedwithHI Vdisease6yearsbeforeI sawhim.
Theadvent of triplecombinationtherapyhadyielded agreat improvement inhisT-helper cell
count andadramaticdropinviral load, yet PL continuedtosuffer fromagonizingstomach
discomfort relatedtohisHI Vmedications. Weekly treatmentof theStomachpoint (5Hz, 40/-LA,
30s) andmaster points(10Hz, 40/-LA, 10s) on bothearsallowed PL tofeel substantiallymore
comfortablefor thenext several months. However, auriculotherapystimulationof hisThymus
Glandpointdidnot reverse theprogressive deteriorationof hisimmunesystem. Heonlystopped
comingfor treatmentsintheseveral weeks beforehisdeath,when hewastooweak toget out of
bed. Another AI DS patientreportedasimilarpositiveexperiencewith auriculotherapy.LR wasa
30-year-oldgaymalewho continuedtolose weight fromhislack of appetite. HisHI V medications
gave himsuch severe stomachaches thatheneededtostopthemperiodicallyso thattheside
effects of thesedrugsdidnot compromise hishealth. WhenhedidtakehisHI Vmedications, LR
reportedthattheauriculotherapytreatmentwastheonly medical procedurethatprovidedhimany
sense of comfort. Hehascontinuedtopositively respondtostimulationof theStomachpoint, to
theauricularmaster pointsShen Men andPointZero, andtostimulationof theVitalitypointon
theupper tragusof theear.
AS wasa47-year-oldfemalewho hadbeenpreviouslydiagnosedwith liver cancer. Her healthhad
not improvedafter threedifferent trialsof chemotherapy. She alsowasgreatlydistressed by
nauseafromthechemotherapymedicationsshewastaking. Stimulationof theStomachpointon
theconcha ridgeof theear producedpronouncedalleviationof her chronicstomachaches.
Electrical detectionindicatedabroadspreadof reactivepointsrelatedtotheStomachregion of
theear, notjust asingle point. As indicatedpreviously, determinationof auricularpointsfor
internalorgansdoes not requirethesameprecisionastheidentificationof musculoskeletal ear
points. Whenusingmicrocurrenttranscutaneousstimulation,theconcha region of theear is
stimulatedat 5Hzfor 30seconds, whileneedles areleft inplacefor 30minutes. For bothformsof
stimulation,thetreatmenteffect isaugmentedbytheplacement of ear seeds over theStomach
pointthatareleft inplacefor thenext week.
Oleson & Flocco (1993) conducted acontrolledclinical trial thatdemonstratedthatpremenstrual
symptoms weremoresignificantlyreducedinagroupof women who weregiven acupressureat
appropriateauricularreflex pointsascontrastedwithadifferent set of women who weregiven
shamreflexology sessions over asimilartimeperiod.
8.2 Myofascial trigger points
As ateachinghospital, theUCLA Medical Center exposes beginningdoctorstoavarietyof
educational experiences. Residents intheUCLA Departmentof Anesthesiology wereoffered
traininginthePainManagementCenter asoneof theirelective rotations.Theseresidentswere
routinelyshown demonstrationsof trigger pointinjectionsasanalternativeproceduretothenerve
blocks thatanesthesiologists conventionallyusetotreatchronicpain. Myofascial paincanbe
alleviatedbytrigger pointstimulationwhen intravenousinjectionof alocal anestheticintoa
specific muscle region blocks thereflex arcthatmaintainsmuscle spasms. Ononeoccasion, a
groupof UCLA residentsfirstobserved theprimaryclinicphysician palpatethetrapeziusmuscle
of patientCN, whowassufferingfromshoulder pain. Hypersensitivetrigger pointswereidentified
onthepatientsright trapeziusmuscle, andCN hadsignificant limitationintherangeof motionof
hisright arm. Theattendingphysician suggested thattheresidentsobserve ademonstrationof
auriculotherapypriortotheirpracticewithtrigger pointinjections. I examinedthepatientsright
ear andreactivepointswerefound on theshoulder regionof theauricle. Electrical stimulationof
these reactiveear pointsled toanimmediatereductioninthepatientssubjectivesense of
discomfort. Therangeof motioninhisarmwasnolonger limited. Whentheoriginal physician
againpalpatedCNstrapeziusmuscle, hecould nolonger objectively identifythepreviously
detected trigger points. Thesuccess of theauriculotherapyeliminatedtheneedfor anyother
treatment.Sincethepresenceof thetrigger pointshadbeenevaluatedbyanotherdoctor whowas
not present when theauriculotherapywasconducted, thisobservationwascomparabletoa
double-blindassessment of patientimprovement.
Oneof themost common conditionsrecentlyseen inmanypainclinicsisthediagnosisof
fibromyalgia, literallydefinedasthepresenceof paininmanygroupsof muscle fibers. JM wasa43
year-oldfemale whoreportedpaininmultiplepartsof her body. Sheexhibitedhypersensitive
trigger pointsinher jaw, neck, shoulders, upperback, hips, andlegs. Reactiveauricularpoints
wereevidenced throughouttheear. Theauricularpointscorrespondingtothejaw, cervical spine,
thoracicspine, shoulders, andhipswere electricallystimulatedat 10Hz, onboththeanteriorand
posterior regionsof theexternal ear. BilateralstimulationwasalsoappliedtoPoint Zero, Shen
Men, Thalamus,EndocrineandMuscle Relaxation. After each auriculotherapytreatment,JM
reportedfeeling veryrelaxedandexperienced aprofounddecreaseinher variouspainsymptoms.
Unfortunately,theaches inher spineandinher limbsgraduallyreturnedseveral daysafter the
treatment.Biofeedback relaxationtrainingandindividualpsychotherapy were alsointegral tothe
progressive improvement over 14weeks of treatment.Complex paindisorders, such as
fibromyalgia, requiremorethanthealleviationof nociceptivesensations. Successful treatmentof
fibromyalgia alsorequiresattentiontothemanagementof dailystressors andhelpingthe
individual toresolve deeper psychodynamic emotional conflicts.
Someonewho didnot respondso favorablytointerdisciplinarytreatmentwasEJ, a45-year-old
mother of twoadolescent children. Shecomplainedof chronicpaininmanypartsof her bodyand
reluctantlydiscussed thatshesuffered distressfromproblemsinher marriage.Shehadbeen
referredtomebyafibromyalgia supportgroupthatmeets inahospital inLos Angeles. EJ
reportedtendernessanddiscomfort at trigger pointsfoundinvariouspartsof her body, andfor
each of themultiplesitesof painperceptioninthebody therewerecorrespondingtender pointson
her external ear. Stimulationof theelectricallyreactiveauricularpointsled toreducedlevels of
perceived painandenhancedfeelings of comfort andrelaxation.EJ seemed grateful for the
immediaterelief, but thetreatmenteffects onlylastedseveral days. Shewasconstantlyinconflict
regardingher marriageandafraidof beingleft alone. At thesame timeshewasfrustratedbythe
continuedlack of attentionfromher husband.Thestress of thisindecisionseemed toreinitiateher
fibromyalgia paineachweek. Besides themusculoskeletal andmaster pointsthataretypicallyused
for pain, EJ alsoreceived stimulationof theear acupointsrelatedtopsychosomatic disorders,
nervousness, anddepression. Whenitwassuggested inthecourseof therapythatshe might
consider theoptionof assertingherself withher husband,shebecamedefensive andquiet. Shedid
not returnfor anyother sessions, insistingthatsheonlywantedtofocus on her painproblemand
not these other issues inher life. Several monthslater, shewasstill inthefibromyalgia support
group, still sufferingfromchronicpain.Therearecertainpatientswho arenot readytofully
engage intheactivitiesthatwould reducetheirphysical painwhen itrequiresthatthey alsoaddress
thesources of their emotional discomfort.
262
8.3 Back pain
Oneof themost frequent applicationsof auriculotherapyisfor thetreatmentof backpain. OF, a
43-year-oldmarriedmother of twoadultchildren, hadbeen injuredon theplaygroundatthe
elementaryschool whereshetaught. Variousmedical proceduresbyfour other doctorsat UCLA
led topartialbut inconsistent relief of her back pain.Auriculotherapytreatmentproduceda
markedreleaseof thetightnessinher back, but her paingraduallyreturnedafter eachsession.
Despitethepersistent achinginher back, OFcontinuedtogo toworkregularlyasanelementary
teacher andtodothehousehold chores andcookingfor her husband,andher adultson, andher
daughterwhen shegot home. I twasnot until OFalsolearnedbiofeedback relaxationand
assertiveness skillsthatthepainsubsidedfor longer periods. Sheneeded strongencouragement to
ask her familyfor theassistanceshe needed aroundthehouseandtotaketimefor herself torelax.
Sometimes apainproblemispresent for secondarygain issues thatmust becorrected beforethe
effects of auriculotherapycanbesustained. Auriculotherapycandramaticallyalleviateback pain,
but thepatientslifestylethatputsadditionalstress on thatindividualmust alsobeaddressed.
CJ wasa38-year-oldmaleairlinepilot who attributedhischronicback paintothe2-hourcommute
fromhishomeinSantaBarbaratohisairlinebaseatLos Angeles I nternationalAirport. The
patientsdrawingsof thelocationof hisdiscomfort indicatedthathispainwaslocalizedtohisleft
buttocks. Whiletherewere several reactiveacupointson CJs right andleft external ears, the
ButtocksandLumbagopointson theleft earshowed themost tendernessandelectrical
conductivity. Even thoughhisjobstress remainedunchanged, fiveauriculotherapytreatmentsled
topronouncedrelief of thepaininhisbuttocks. CJ alsocametogreater acceptanceregardinghis
divorce, incidentallydescribinghiswifeasapainintheass. Several weeks after thepaininhis
lower backwasgone, CJ noticedanewpainproblemon theleft sideof hisneck. Sometimes,
successful treatmentof aprimaryproblemallowsasecondaryissuetosurface. CJ alsocommented
onastressful weekend withhisnewgirlfriend, andsuggested she hadbeenareal painintheneck.
WhiletheButtocksandLowBack pointson theearwere nolonger tenderon palpation,theNeck
region of theleft auriclehadbecomeverysensitive. I trequiredonlytwoauriculotherapysessions to
ease thepainandtightnessinCJs neck. Treatmentprimarilyconsisted of electrical stimulationof
theNeck point(10Hz, 60ftA, 20s). Themaster pointsShen Men, PointZero, Thalamuspointand
Muscle Relaxationpointwere alsostimulated.I twasfurthersuggested thatheneededtodiscuss his
angryfeelings withhisnewgirlfriendratherthanunconsciously somatizinghisemotions.
Whilehisoriginal motivationtoseek treatmentwasfor generalizedanxiety, AC hadcalled to
cancel anappointmentbecauseof acuteback pain. A 33-year-oldmalepublicrelationsexecutive,
AC could notget upout of hisbed thedayafter hehadbeen inanaccident. Hehadalready
missed twodaysof work on thedayhecontactedmeabouthiscondition. I wasabletosee himin
hishomewithaportable, electronicdevice. Auricularstimulationwasappliedtoextremely tender
andelectricallyreactivepointson theanteriorantihelixpointsandon theposterior groove points
thatcorrespondtothelumbarspine. Stimulation(10Hz, 20ftA, 30s) of theseauricularacupoints
on theright andleft external earswasaccompaniedbytreatmentof themaster pointsShenMen,
Point Zero, Thalamus,andMaster Cerebral point. Theresponse tothistreatmentwasimmediate
andprofound. At theconclusion of theauricularstimulationprocedures, AC wasabletoget up
fromhisbed withoutanydiscomfort inhisback. Hecouldbendandturninwaysthatwere
impossible just 15minutesearlier.Because thecauseof hisproblemwasso recent, auriculotherapy
treatmentled todramaticimprovement injust asingle session. Auricularpelletswereplacedon
thefront andtheback of theLumbarSpinepoints. Bythenext day, hewasabletoreturntowork.
Theearpelletswereremoved after onedayandhisbackproblemswere gone.
Sciaticaisthemedical conditionwhichfirst brought thepossibilitiesof auriculotherapytothe
attentionof Paul Nogier inthe1950s.As notedbyhimover 50years ago, andasobserved bymany
ear acupuncturistssince, sciaticapaincan begreatlyalleviatedbyauricularacupuncture.BHwasa
23-year-oldmalewithcomplaintsof sciaticaandshootingpainsdown theleft hipandleft leg.
When pressurewasappliedtotheL5-S1 pointon theinferiorcrusof theleft antihelix,BHfound it
excruciatinganditwasalsothemost electricallyresponsive regionof hisleft ear. Reactivepoints
werealsofoundinthetriangularfossa, theauricularregionwhich Nogier correlatedwiththe
locationfor theleg. Electrical stimulationof reactivepointson thefront andback of theauricleled
toan85%reductioninpainlevel thatBHrecordedon avisual analogscale. Earseeds were placed
on theSciaticapointandon theNogier Leg pointtosustainthetreatmenteffects.
MJ, anormallyvery athletic26-year-oldmalepatient,hadbecome incapacitatedbysevere back
pain. Duringthefirst auriculotherapysession for hisbackpainproblems, I also noticedthatMJ
hadanopenscar on theregionof thehelix root thatadjoinstheface. Twomonthsof antibiotic
medicationsprescribedbyhisprimaryphysician hadfailed toheal thisscar. Thescar waslocated
on apartof theexternal earwhereChineseauricularchartsdepict theexternal genitals. For MJ s
back pain,bipolarelectrical stimulationwasappliedtotheLumbosacral pointson theantihelix
inferiorcrusof hisleft auricle. Tofacilitatewoundhealing, monopolar probeswere placedacross
theedges of thescar on theear. Thepatientwastold thatelectrical stimulationcouldpotentially
heal skinlesions aswell asrelieve back pain. At hisappointmentaweek later, MJ cameintothe
treatmentroomvery upbeat.Hewasamazednot onlybyadecreaseinhisback pain,but also
becausehispreviouslyundisclosed scrotal painhaddiminished- asurprisefor bothof us. These
resultsareexplainedbymicrosystemtheoryasorganocutaneousreflexes producingthemysterious
scar on MJ sear andtreatmentof thatscar activatedacutaneo-organicreflex thatalleviated
discomfort inthegenital region.
Whileitisimpressive toobservethemanypatientssuccessfully treatedwithauriculotherapy,itis
alsoimportanttodistinguishthesources of treatmentfailures. Twodifferent cases of back pain
illustratethelimitationsof thisprocedure. RT wasa33-year-oldmaleartdealer andEEwasa
41-year-oldmaleexecutive at aHollywood moviestudio. They bothsuffered fromrecurrentback
painthatwasattimes manageable, but at other times preventedthemfromgoing towork. Both
menhadreceived nerveblocks andphysical therapy. Onlyperiodictreatmentwithopiate
medicationsproducedtemporaryalleviationof their discomfort. Bothmenwere contemplating
surgeryfor theremoval of bonespurs alongthespine, uncoveredbyMRI scans. RT andEE both
expressed interestintryingauriculotherapybeforeundergoingpossibly riskysurgical procedures.
They were each given several auriculotherapysessions wherereactivepointsthatrepresent the
back wereelectricallystimulated.RT reportedthattheauricularstimulationproducedabrief
reductionof hisback pain, but anybody movement reactivatedintensediscomfort. WhileEE did
not initiallyreportverysevere pain, healso didnot exhibit muchrelief fromthatpainafter
receiving auricularstimulation.Bothmenultimatelyunderwentsurgical procedurestoremovethe
bonespurs andtheirback conditionswere almost completely relieved.
Fromthesetwoexamples, itcanbeseen thatauriculotherapyisnotparticularlyeffective when
thereisanunderlyingphysical structurecausingpain, intheseinstancesabonespur.
Auriculotherapycan bemorehelpful when theproblemisduetomuscletension andthe
pathological functioningof neuromuscularcontrol of muscle spasms. Failuretoprovide
satisfactorypainrelief toanothermalepatientwasaccountedfor bythepresenceof adifferent
structuralproblem. MBwasa34-year-oldcomputer graphicsartistwho hadbeen tofour different
physicians for chronicneck painbeforebeingreferredtome. After fivesessions where
auriculotherapydidnot alleviatehispainproblem, MB discontinuedtreatment.A year laterhe
contactedmetoinformmethatasubsequent physicianhaddiagnosed aconstrictioninhiscervical
spinethatwascorrected bysurgery. I twasonlyafter thissurgerythathispersistent neck painwas
alleviated. Whileosteopathicsurgerycan sometimes leadtofurthercomplicationsof achronic
paincondition, itisatother times theonly effective solution.
8.4 Peripheral neuropathy and neuralgia
Differentregions of theauricleanddifferent stimulationfrequencies areused for neuropathicpain
thanfor musculoskeletal or internalorganconditions(Oleson 1998). Muscular atrophyand
persistent paininhisleft armwereattributedby57-year-oldJJ tostress andstrainrelatedtowork
activities. Reactive ear pointswereelectricallydetected on theauricleattheCervical Spineregion
alongtheantihelixtail andattheElbow andWristpointson thescaphoidfossa of theleft ear.
Microcurrentstimulationatthesethreepointswasaccompaniedbyanimmediatewarmtingly
sensationthroughoutJ J sleft armandhand.IntheNogier school of auriculotherapy,
musculoskeletal disordersarestimulatedwithafrequencyof 10Hz, usuallyat40j.1A for 20s.
Moreover, becausemuscle tensionor weakness isrelatedtoapathological disturbancewithin
motor neurons, thecervical posterior groove andtheposterior trianglewere alsostimulated.These
posterior ear pointslieimmediatelybehindtheacupointsfoundonthefront surfaceof theauricle.
After only3weekly sessions, JJ reporteda70%reductioninpain, asmeasuredbythevisual analog
Clinicalcase studies 263
264
scale, andwasabletoreturntohispositionasanaccountantfor arestaurantchain. Whilethe
alleviationof painhadbeenfairlyrapid, theimprovement inmuscular atrophywasinitiallyjust
slight. Satisfactoryimprovement inmotor function required8moreweeks of auriculotherapy.
TM wasa28-year-oldmalegraduatestudentwho hadbeenseverely injuredbyfaultywiringina
piece of electronicequipment. A lethal jolt of electricityflowed fromthewall cordof the
equipment uphisleft hand,spreadingtohisheadanddown theleft sideof hisbody. Hisshoe was
completely meltedaroundhisleft foot. WhenI first sawhim, hewalkedwithalimp, dragginghis
partiallyparalyzedleft leg, andhecould not fullyusethefingers of hisleft hand. Auriculotherapy
treatmentof hisleft external ear includedpointscorrespondingtothehand, thearm, thelegand
thebrain.Thesesessions werecontinuedfor over 3months. Thereductioninpainsensationsinhis
handandtheenhancement of hismotor abilitiesandhismemorywasgradual,butsteady. Bythe
last session, auriculotherapyhadassisted TM inbeingabletowritemorelegibly andwithout
feeling paininhisfingers. Hislegmovementswere morefluidandhecould remember moredetails
of theacademictopics hehadstudiedbeforetheaccident. Hewasbynomeanscompletely healed,
astheneurological damagehehadsuffered seemed toresult inpermanentmotor dystrophy.
Nonetheless, auriculotherapyhadled tofar greater improvementsthananyof hismedical doctors
hadexpected.
Oneof themost distinctivedemonstrationsthatI hadever witnessed of thespecificity of
auriculotherapywaswiththetreatmentof a46-year-oldfemale diabeticpatientwithperipheral
neuropathy.HRhadaccumulatedthreevolumes of UCLA medical recordsthatdescribed indetail
her multipletreatmentsfor multipleconditionsresultingfromalifehistoryof diabetesmellitus. In
additiontothesevere paininher feet, HRexperienced severe glaucoma, chronicback painand
feelings of bitternessanddespair. Shehaddeveloped aratherresentful, pessimistic andhostile
attitudetowardthemedical profession for failingtoprovideadequaterelief of her variedsources of
discomfort. Her negative reactionstowardconventional medical treatmentsmadeitseem unlikely
thatshewould respondanymorefavorablytoalternativetherapies, butauriculotherapywas
recommended nonetheless. When HRenteredtheUCLA painclinic, shewalkedwithalimp,
requiringtheassistance of her husband, andtherewasapronouncedscowl upon her face. After the
initialinterview, shelaydownupontheexaminationtableandher external earswere scannedfor
areasof decreased electrical resistance. Therewerereactivepointson her right earinauricular
regions thatcorrespondedtothefeet. Theseauricularpointsfor thefoot wereelectrically
stimulatedfirst (10Hz, 40fLA, 30s), followed bystimulationof themaster pointson theright ear
identifiedasShen Men (10Hz,40fLA, 10s), PointZero(10Hz, 40fLA, 10s), andThalamus(80Hz,
40fLA, 20s). Within2minutesof thecompletion of thisstimulationof acupointson theright
auricle, amarkedchange appearedupon thepatientsface. Her negativefrownswere replacedby
analmost peaceful countenance. HRquietlyexclaimed thatthepaininher right foot was
completely gone- for thefirst timeinover 7years. Interestingly, thepaininher left foot andon the
left sideof her backwasapproximatelythesame. I twasnot until after reactivepointson theleft
external earwerestimulatedthattherewasareductionof paininher left foot andleft back.
Thesignificance of thisdifferential effect observed inHRwasprofound. I ftheauriculotherapy
wereduetoageneral systemic effect, such asfromamorphineinjection, thepainrelief should
havebeen experienced equallyinbothfeet. I fHRhadbeengiven anintravenousinjectionof
morphineitwould not havetakeneffect so quicklybut would havetaken10-20minutesfor her to
noticesignificant analgesia. Numerousscientific studiesinhumansandanimalsindicatethatthere
isasystemic releaseof endorphinsfollowing auricularacupuncture.Localized painrelief inonly
onefoot of HRsuggests thatspecific neurological reflex circuitsmoreappropriatelyaccount for
thisselective actionof auriculotherapyratherthangeneral endorphinrelease. PatientHR
continuedtoimproveover thenext several monthsof weekly treatments.Thepaininboth
her feet graduallyreturnedtosome degree, but witheachsuccessive auriculotherapytreatmentit
diminishedfor longer periodsof time. Her back painandher abilitytowalkwithoutassistancealso
improved, andtherewasapronouncedenhancement of her mood. Bysession 15,therewasonly
minimal recurrentpaininher feet andinteractionswithHRbecamemorepleasant. Shereported
feeling optimisticabouther health, even thoughshe still suffered fromdiabetesandglaucoma.
Auriculotherapyhasbeen used effectively for neuropathicpainbothfromdiabetesandfromHI V
disease. JT wasa37-year-oldmandiagnosedwithAI DS andsufferingfromneuropathicpaininhis
feet andlower legs for over 8months, whereasRB wasa58-year-oldmanwho hadperiodically
suffered fromdiabeticneuropathyaffectinghisfeet. Even thoughthesourceof their neuropathy
wasvery different, theauriculartreatmentof theneuropathicpainwasalmost identical.For both
JT andRB, reactiveear pointswere identifiedon theuppermost regionsof theauricle,which
represent theChineseandEuropeanlocalizationsof theFeet. Ear acupointswere also stimulated
on theuppermost region of thehelixtail,which correspondstotheLumbarSpinal Cord. The
somaticregionof theauricle, representingcontrol of themusculoskeletal tissues of thefeet, is
stimulatedat 10Hz.Thehelixtail region thatrepresentsneurological spinal tissue isstimulatedat
40Hz. Higher frequencies of stimulationareused for neurological tissuethanmuscular tissue
accordingtoamodel first proposed byNogier (1983). SimilartothefindingsfromMRI scans,
resonantwaveforms occur at different frequencies for different types of tissue. Morerecently
evolved tissue, such asthatof thenervoussystem, issaidtorespondmoreoptimallytohigher
resonancefrequencies thanmoreprimitivetissue, such asmuscles andinternalorgans.
Stimulationof theFoot pointsandtheLumbarSpinal Cordpointson theauriclecontributedto
thecomplete eliminationof theperipheral neuralgiapaininthefeet. BothJT andRB reported
maintainedrelief of their peripheral neuralgiaaftersixsessions of auriculotherapy.
Herpeszoster, or shingles, isadifferent typeof neuropathicpainthatisfoundinmanyAIDS
patientsaswell aspatientswithdiabetes. TP wasa32-year-oldmandiagnosedwithAI DS 5years
priortomyfirst examininghim. Hewasinitiallyseen for relief of thestress andanxietyassociated
withhisHI V infection. At agrouptherapysession, TP becameextremely distressed after he
revealedhisHI V+status. Even thoughthegroupwasverysupportive, TP felt enormousshame
andadeep sense of rejection. Thenext dayhecamedown withshingles. Theacuteinflammation
of theT4dermatomeabruptlyappearedon theright sideof hischest, upper abdomenandupper
back. Reactive ear pointswere found on hisantihelixbody, which representsthechest, andon the
thoracicspinal cord regionof thehelixtail. After thefirst session of auriculotherapy,not onlyhad
thepainsensationsinthebody beeneliminated,but therewasarapidreductioninthebumpy
swellingandrednessof theskin. After 2furtherweekly auriculotherapysessions, therewasno
furtherpresenceof theherpes reaction.
An almost identical responsewasexhibitedbyEO, a76-year-oldwomanwho becameaffected by
shingles asareactiontoher antihypertensivemedication. Theherpeszoster affected theLl
dermatomeon her right side, manifestedbyblotchy red hypersensitive skin. Shewasgiven bipolar
auricularstimulation(10Hz,40/-LA, 60s) totheantihelixcrusandantihelixbody regions, which
represent themusculoskeletal tissueof thelower spine, andfaster frequency auricularstimulation
(40Hz, 40/-LA, 60s) tothelumbarspinal cord region foundon theupper helixtail. Monopolar
electrodes were also held oneachsideof thedermatomalzonethatwasinflamed. Lowfrequency
stimulationwasappliedacross theskinof thebody for afurther 10minutes. Therewasagradual
lessening of heightened sensitivity, andafter 2daysher blotchy redskin hadalmost completely
returnedtonormal. Combiningbody stimulationwithauriculotherapyisaveryeffective
procedurefor treatingbothneuropathiesandneuralgia.
Several case studieson theeffect of auriculotherapyfor healinglegwoundswere reportedbyFred
Swingat the 1999I nternationalConsensus ConferenceonAcupuncture, Auriculotherapy, and
Auricular Medicine(lCCAAAM). JC wasa68-year-oldmaleadmittedtoaTexashospital for
sepsis, pneumoniaandmultiplelargeulcersonbothlower legs. Becauseof thesensitivity of the
woundson thepatientslegs, onlyear acupuncturewasallowed. Thedayafter auriculotherapy,
increasedpresence of fluidsandredness inthewoundareaswasobserved bytheattendingnurse,
thefeet werewarmer, andthepatientreportedgreater sensationsinhislower legs.
Auriculotherapyandtraditionalwoundcaretreatmentwere continuedfor thenext 4months.
After 50eartreatments,theright legwascompletely healedandtheleft legwassufficiently
improvedtopermitsuccessful skingrafting. Theear acupointsfor theLeg, Shen Men,
SympatheticAutonomic, Lungs, andpointsfor dermatological disorderswere activatedbyboth
needles aloneandbyelectrical stimulation.Sincewoundhealingrequiressufficient oxygen and
body nutrientsdelivered tothewoundsite, auriculotherapycan improvevasodilationof thesmall
arteriolesthatlead todelivery of oxygen tothelower legs.
Thetotal numberof pointstreatedineachclinical case canvaryfrom5-10ear points, depending
uponhowmanyanatomicandmaster pointsarestimulated.Thewhole auricleisfirst examined
withapointlocator, oftenrevealingmorethan20reactiveear points. Onlythemost electrically
conductiveandmost tenderof thepointsthatspecifically correspondtothepatientscomplaints
arefinallyused. Withtranscutaneouselectrical nervestimulationon theauricle, eachpointis
stimulatedwith20-40/-LAs for only 10-30s. Thepractitionerthenmoves ontothenext point.
Clinical case studies 265
266
Needles insertedintotheselected ear pointsareleft inplacefor approximately20minutes, similar
tobody acupuncture.Treatmentsareoffered twiceaweek for several weeks andthenspaced out to
once aweek for several moreweeks until thereissatisfactoryimprovement insymptoms. Both
practitionersandpatientscontinuetobeamazedthatthesedifferent sites on theearcanhavesuch
aprofoundpainrelievingeffect oncomplaintsfromother partsof thebody.
8.5 Weight control
An intriguingpotential of auricularacupuncturehasbeenitsclinical applicationinweight control.
Clinical studiesdemonstratingthevalueof auricularacupuncturefor thetreatmentof obesity date
back tothe 1970s(Cox 1975;Giller 1975).Sun& Xu (1993) treatedobesity patientswith
otoacupointstimulation,anothertermfor ear acupressure. All patientswere alsogiven body
acupuncturefor the3-monthperiodof thestudy. Theacupuncturegroupconsisted of 110patients
diagnosedas20%or moreaboveideal weight. They werecomparedto51obesity patientsina
control groupgiven anoral medicationfor weight control. An electrical pointfinder wasused to
determinethefollowing auricularpoints: Mouth, Esophagus, Stomach, Abdomen, Hunger, Shen
Men, LungandEndocrine. Pressurepelletsmadefromvaccariaseeds were appliedtothe
appropriatepointsof bothears. Body acupuncturepointsneedledincludedST 25, ST 36,ST 40,
SP 6, andPC6. Theacupuncturegroupexhibitedanaveragereductioninbodyweight of 5kg,
whichwassignificantlygreater thantheaverage2kgreductionof bodyweight measuredinthe
control group. Thepercentageof bodyfat wasreducedby3%intheacupuncturegroupandby
1.54%inthecontrol group, whilethetriglyceridebloodlipidlevels were diminished67unitsinthe
acupuncturegroupand38unitsinthecontrol group.
A randomizedcontrolledtrial byRichards& Marley(1998) alsofoundthatweight loss was
significantlygreater for women inanauricularacupuncturegroupthaninacontrol group. Women
intheauriculargroupwere given surfaceelectrical stimulationtotheear acupointsfor Stomach
andShen Men, whereaswomen inthecontrol groupweregiven transcutaneouselectrical
stimulationtothefirstjointof thethumb.Auricularacupuncturewastheorizedtosuppress
appetitebystimulatingtheauricularbranchof thevagal nerveandbyraisingserotoninlevels, both
of which increasesmooth muscle toneinthegastricwall. Rather thanexaminechanges inweight
measurements, Choy & Eidenschenk (1998) examinedtheeffect of tragusclipsongastric
peristalsisin13volunteers. Thedurationof singleperistalticwaveswasmeasuredbeforeandafter
theapplicationof ear clips tothetragus. Thefrequency of peristalsiswasreducedbyonethirdwith
clipson theear andwasreturnedtonormal levels withclips off. Theearclipswere saidtoproduce
inhibitionof vagal nerveactivity, leadingtoadelayof gastricemptying, whichwouldthenlead toa
sense of fullness andearlysatiety. Theseobesity studieson humansubjects havereceived potential
validationfromneurophysiological researchinanimals.
Clinical observationsbyNiemtzow(1998) showed thatbloodassays in42patientssufferingfrom
obesity showed asignificant decreaseinphysiological measuresof lipidlevels aswell assignificant
reductionsinphysical weight. Thepatientswererequiredtomaintainahigh proteindiet whilethey
werereceivingtheweekly auricularacupuncturetreatments.Needles were insertedintothe
followingear points: AppetiteControl, Shen Men, PointZero, andTranquilizer.Theneedles were
held inbothearsfor aperiodof 15minutes. Over a12-week period, meanweight decreased
significantlyfrom206poundsto187pounds, triglycerides changedsignificantly aswell, andthere
wasamarkedbut statisticallysignificant reductionintotal cholesterol. Patientinterviews
conductedafter thestudywascompleted suggested thatcomparedtoother timeswhen attempting
todiet, auriculotherapyseemed tohelp themfeel morecomfortablewhiletheywere tryingto
disciplinethemselves intheireating.
8.6 NADA addiction protocol
Oneof thefastest growingapplicationsof auriculotherapyinthehealthcarefieldistheuseof ear
acupuncturepointsfor thetreatmentof variousaddictions.TheNationalDetoxificationand
AddictionAssociation (NADA) wasfoundeduponthepioneeringworkof Dr HL Wenof Hong
Kongandtheearlyapplicationof thisprocedurebyDr Michael Smithof NewYork City. Wen
(Wen& Cheung1973,Wen1977)foundthatplacingoneneedleintheLungpointalonewas
sufficient towithdrawaheroinaddictfromhisaddiction,but healsoneedledtheShen Men pointto
producegeneral calming. DrMichael Smith(Smith1979,1990;Smithet al. 1982)developed a
5-pointprotocol for substanceabuserecovery thatincludedtheLung, Shen Men, Sympathetic
Autonomic, KidneyandLiver pointsontheear. NADA wasformed in1985(Brewingtonet al. 1994)
toalloworganizationandtrainingopportunitybeyondthatoffered bySmithatLincolnHospital.
Thefirstopenmeetingof NADA washeldinWashingtonDCandtheNADA boardwasformed.
Thefirst NADA conference occurredinMiami in1990becausemanypeoplewereinterestedin
seeing theDrugCourtthathadbeendeveloped inMiami in1989.Similar drugcourtsthat
incorporatereferral toNADA practitionershavenowbeendeveloped inmanyother states. NADAs
official websiteishttp://www.acudetox.com. Controlledclinical trialshaveshown thatthefiveear
pointsused intheNADA protocol areeffective inthetreatmentof alcoholism(Bullock et al. 1989),
cocaine addiction(Margolinet al. 1993a,1993b),andmorphinewithdrawal(Yang& Kwok 1986).
ToobtaintrainingandcertificationinNADA, thereisa70-hourcourse. Thistrainingincludes30
didactichoursof instructionand40clinical hoursworkingwithclients. Trainingalso includes
attendanceat 12-step meetings. Greatemphasisisplacedon clinical experienceso thatNADA
practitionerscanbecome comfortableworkingwithanaddictpopulation.At Lincoln Recovery
Center, most traineesarechemical dependency counselors. They spendmuchof theirtimegetting
comfortablewithdoingacupunctureasaphysical procedure. Studentslearnabouttheyinnature
of theNADA atmosphere, which isintendedtobesupportiveandnon-confrontational.For
acupuncturists,thetrainingcovers definitionsof addictionandmental healthtreatments.They are
instructedtospeak thesamelanguageasthechemical dependency counselors, thecriminaljustice
system, andmedical professionals inthoseenvironments.
Oneof themost importantlessons thatbothacupuncturistsandcounselors havetolearnistobe
quietandlet theacupunctureneedles do thework. Bothgroupsareused tospendingtimetalking
toevaluatepatientprogress. TheNADA protocol encourages anon-verbal approachtotreatment.
Substanceabusersoftenfeel shame, guilt, anger or other issues thatthey donot knowhowtocope
withverbally. Withoutacupuncture,theonlytherapyavailableistalktherapy, either individually
or inagroupsetting. NADA trainingalso includeslearningaboutvariousdrugs, their
pharmacological effects andvarioustypes of settingintowhich acupuncturehasbeenintegrated.
As agrassrootsmovement, most NADA programswerestartedbecausedoorswere knocked on
andadministratorswere convinced of thevalue. Over 4000practitionersthroughouttheworld
havebeen taughtthisprotocol for thetreatmentof varioustypes of substanceabuse.
8.7 Alternative addiction protocols
Whilethe5-pointNADA protocol hasbecome themost commonly employed treatmentprogramin
theUnitedStates, itisnottheonlyauriculotherapyproceduretobedeveloped. Theearpointsused
for NADA treatmentareprincipallybasedonChineseearcharts, but additionalauricularpointsfor
addictionhavebeenderivedfromEuropeantreatmentplans. Orientalmedicinefocuses uponthe
useof theauricularLungpointfor detoxification, theKidney pointfor yindeficiency, andtheLiver
pointfor nourishment.TheShen Men andSympatheticAutonomicpointsareintendedtoalleviate
psychological distress andimbalanceof spirit. Europeanpractitionersof auricularmedicinefocus
upontreatingearpointsthatactivatetheNogier vascular autonomicsignal (N-VAS). Repeated
experiencewithmanysubstanceabusepatientshasled tothediscovery of earpointsadditionalto
those developed atLincolnHospital. DrsJayHolder (Holder et al. 2001) andKennethBlum
(Blumet al. 2000)wereinstrumentalindevelopingtheAmerican College of Addictionology and
CompulsiveDisorders(ACACD) basedinMiami Beach, Florida.TheACACD protocol includesa
total of sixauricularpoints: PointZero, Shen Men, SympatheticAutonomic, Kidney, Brain, and
LimbicSystem. Twoaddictionaxislineswereemphasizedthatconnect thesedifferenttreatment
points. A primaryaxiscouldbeverticallydrawnbetween theShen Men, Kidney, PointZero, and
Brainpoints, whereasasecondaryaxislinecould beindicatedwhichconnected theSympathetic
AutonomicpointandLimbicpoint.TheACACD approachemphasizes thatonlyreactiveearpoints
aretobestimulated.Therehasbeennocontrolledscientific researchtoverifywhether theNADA
protocol or theACACD treatmentismoreeffective inworkingwithaddicts.
Whilesmokingcessation hasbeen treatedfrequentlywithear pointsLungandShenMen (Regrena
et al. 1980),other ear pointshavealsobeensuccessful (Oleson 1995).
8.8 International ConsensusConference on Acupuncture,
Auriculotherapy, and Auricular Medicine (ICCAAAM)
In1999,notedauthoritiesinthefieldof auricularacupuncturefromChina,EuropeandAmerica
weregatheredinUnitedStatestoarriveat aconsensus on internationalperspectives of
auriculotherapy.Fortyspeakerswithprofessional expertiseinthefield discussed varying
268
Box 8.1 Survey of professional opinions on auriculotherapy
%
f - - ~ ~ ~ ~ ~ - _ . ~ ~ ~ ~ ~ ~ ~ . ~ - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ - - ~ ~ - - -
Conditionsbettertreatedwithauriculotherapythanbodyacupuncture
Smoking cessation 68
Substance abuse 53
Weight control 53
Anxiety 43
Nausea 38
Insomnia 38
Depression 35
Allergies 35
Musculoskeletal pain 28
Attention deficit disorder 25
Neck and shoulder tension 25
Conditionsnot effectively treatedwithauriculotherapy
AIDSand HIVdisease 45
Cancer or tumors 43
Schizophrenia 38
Nerve impairment 35
Strokes 33
Spinal spurs 30
Deteriorated disks 28
viewpoints beforeanaudienceof over 400attendeesat theI CCAAAM meetinginLasVegas,
Nevada. RepresentativesfromChina, J apan,France, Germany, Belgium, Holland, Israel, Canada
andtheUnitedStatesdiscussed bothOrientalandWesternapproachestotheauricular
microsystem andauricularacupuncturetreatments.Participantsat thisconferencewere asked to
complete asurveyof their experiencewithauriculotherapyandtocomment on different
theoretical perspectives of thisprocedure. A summaryof some of theseresultsispresentedin
Box8.1.Otherpartsof thisconsensus questionnairearedescribed inthetext thatfollows. A total
samplesizeof 42professionalscompleted the100items on thequestionnaire.Therewere24males
and18females, withameanageof 50.2years. Theirmeannumberof years of auriculotherapy
practicewaslOA years. Thedataarepresentedaspercentagescores.
Themajorityof respondents, 70%, felt thatauriculotherapycould becombinedwithbody
acupunctureor used alone, whereas20%of thesurvey participantsthought itwasbetter to
combineauriculotherapywithbodyacupunctureinmost circumstances. Most of thepractitioners,
45%, felt thatauricularstimulationproducedfaster painrelief thanbody acupuncture,andan
equal numberof respondentsbelieved thatthelongtermbenefitsof auriculotherapywereequal to
bodyacupuncture.Most healthconditionswerethought tobealleviatedwithinthreetofive
sessions of auriculotherapy,withtreatmentsessions typicallyonevisit per week. Theusual
durationof anauriculotherapysession wassaidtolast 21to30minutes. Themost common fee for
such sessions wasthought tobe$40to$55.Electrical pointlocatorswerethought toprovidethe
most accurateprocedurefor findingreactiveauricularpointsby73%of theprofessionals, whereas
20%statedthatuseof theN-VAS isthemost accuratemeansfor conductingauriculardiagnosis.
Orientalpulsediagnosis wasused by45%of thesurveyed practitionersandwasseen tobea
valuablecomplement toauriculardiagnosis. A majority(53%) of respondentsbelieved thatthe
auricularmicrosystem interactswiththemacro-acupuncturemeridiansof classical Chinese
medicine, and63%believed thatthereisaninvisibleenergy such asqi thatisaffected by
auriculotherapy.At thesame time, 63%of theprofessionals believed thattheeffectiveness of
auricularpointsisduetotheirconnectionstocentral nervoussystem pathwaysand65%thought
that theinvertedfetus patternontheear isconnected tothesomatotopicorganizationof thebrain.
Box8.2 Conditionssuccessfully treatedbycertifiedprofessionals inthe
AuriculotherapyCertificationI nstitute
Health condition
Chronic pain
Back pain, sciatica, hippain
Pain inleg, arm,wrist, elbow, knee, foot
Neck andshoulder pain
Migraines andtension headaches
Dental pain,TMJ, teeth, gums, facial tics
Fibromyalgia, general body aches
Osteoarthritis or rheumatoid arthritis
Neuropathy, peripheral neuralgia, shingles
Cancer pain
Substance abuse
Smoking cessation
Obesity, weight reduction, anorexia
Alcohol abuse
Cocaine, methamphetamine abuse
Heroin,morphineabuse
Psychological disorders
Anxiety or stress
Sleep disorders, insomnia
Depression, mood disorders
Chronicfatiguesyndrome
Attention deficit disorder, dyslexia
Childhood problems, bedwetting
I nternal organ disorders
Asthma, bronchitis, sinusitis, hiccups, coughing
Allergies, common cold, flu,sore throat
Dysmenorrhea, PMS, menopausal problems
Gastrointestinal pain,constipation, diarrhea
Nausea, vomiting, stomach cramps
Kidney, bladder or prostate problems
Coronary disorder, angina, cardiac arrhythmias
Hypertension, blood pressure problems
Infertility,labor, postpartum pain
AIDS, HIVdisease
Sexual dysfunctions, impotency
Liverdisease, gall bladder, appendicitis
Neurological disorders
Sensorineural deafness, tinnitus, vertigo
Dermatological, skindisorders
Visual impairment, eye disorder
Epilepsy, palsy, Parkinsons, motor tremors
Stroke, head injury,muscular dystrophy, polio
Olfactory disorders, drymouth
Clinical casestudies
Number of cases
216
174
155
76
42
36
12
11
10
51
26
10
8
5
62
48
24
17
6
5
54
46
28
28
19
16
13
9
6
6
5
5
45
26
9
6
6
5
269
270
8.9 Auriculotherapy Certification Institute (ACI)
An internationalnon-profitorganizationfor trainingandcertifyingpractitionersof
auriculotherapywasestablishedinLos Angeles, Californiain1999.Thewebsite isat
www.auriculotherapy.org. As partof thecertificationrequirements, applicantsareaskedto
describe20clinical cases inwhichthey haveused auriculotherapyor auricularacupuncture.The
most common conditionswhich 16different practitionersreportedthatthey havesuccessfully
treatedarepresentedinBox8.2. Inmost cases, effective alleviationof thehealthconditionwas
achieved withinfiveauriculotherapysessions. Themost common conditionsthatweretreated
wereback pain, painintheextremities, andneck andshoulder pain. Headaches, smoking
cessation, stress, anxiety, andrespiratorydifficultieswerethenext most frequentlytreated
problems. Therewereanumberof other disordersthatwereseen less frequently, butstill could be
effectively treatedbyauriculotherapy.Applicantsfor certificationalso needtopass awrittenexam
whichcovers academicknowledge of auricularanatomyandthelocationandfunctionof different
earacupointsused intheChineseandEuropeanschools of auriculotherapy.A practicumexam
withanACI certifiedprofessional isgiven todeterminethehands-oncapabilityof theapplicant.
All individualswhofulfil therequirementsof certificationarelisted on theACI website.
I I
Auriculotherapy treatment
protocols
CONTENTS
9.1 Addictivebehaviorsanddrugdetoxification
9.2 Acuteandchronicpaininupper and lower limbs
9.3 Backpainandbodyaches
9.4 Headandneck pain
9.5 Dental pain
9.6 Neurological disorders
9.7 Stress-relateddisorders
9.8 Psychological disorders
9.9 Eyesight disorders
9.10 Hearingdisorders
9.11 Noseandthroatdisorders
9.12 Skin andhairdisorders
9.13 Heartandcirculatorydisorders
9.14 Lungandrespiratorydisorders
9.15 Gastrointestinalanddigestivedisorders
9.16 Kidneyandurinarydisorders
9.17 Abdominal organdisorders
9.18 Gynecological andmenstrual disorders
9.19 Glandulardisordersandsexual dysfunctions
9.20 Illnesses, inflammationsandallergies
Standard treatment plans: Thefollowing treatmentplansindicatethoseearreflex pointsthathave
previouslybeenused for effective treatmentof thathealthcondition.Thisselection of earpointswas
originallyderivedfromtreatmentplansdeveloped inChina,butwasmodifiedbyauriculotherapy
discoveries inEurope. Practitionersof auricularacupunctureshouldnottreattheentireearpoints
listed for agiven disorder. Onlystimulatethosereactiveearpointswhich areappropriatefor that
patientssymptoms andunderlyingconditions. Consider theearpointslisted for eachtreatmentplan
asguidelines, not definiterequirementsthatmust berigidlyfollowed. Moreover, somepatientsmay
haveother earpointsneedingtreatmentthatarenot listedon thesepages. Earpointsfor eachplan
aredesignatedbyoneof thefollowing twocategories: primaryearpointsandsupplementalearpoints.
Primary ear pointsaretheinitialset of pointson theauriclelisted immediatelyunderthenameof the
treatmentof adisorder inaparticularbodyorganor aspecific physiological dysfunction. Primaryear
pointsfor agiven conditionareindicatedon theearchartsbyunderlining.
Supplemental pointsarethoseareasof theearfor alternativetreatmentof agiven conditionor for
facilitationof theactionof theprimaryear points.
Reactive ear reflexpoints: For all of thetreatmentplanslisted, thepractitionershouldlimit the
treatmenttothoseauricularpointsthataremost reactive, asindicatedbyincreasedskin conductance
or heightened tendernesstoappliedpressure. I fapointwhich islisted intheseplansisneither
electrically reactivenor tendertotouch, thenitshouldnot beincludedinthetreatmentplan.
Treatment protocols 271
272
9.1 Addictive behaviors and drug detoxification (Figure9.1)
9.1.1 Alcoholism
Primary: Alcoholic point, Liver, Lung1, Lung2, Brain,Occiput, Forehead, Kidney.C, Point
Zero, ShenMen, Lesser Occipital nerve.
Supplemental: Thirstpoint, SympatheticAutonomicpoint, Endocrinepoint,Tranquilizerpoint,
Master Cerebral, Master Oscillation, LimbicSystem, Aggressivity, Antidepressant point.
9.1.2 Drug addiction, drug detoxification, substance abuse
Primary: Lung1,Lung2, Shen Men, SympatheticAutonomicpoint, Liver, Kidney.C, Brain.
Supplemental: Occiput, Adrenal Gland.C,LimbicSystem.
9.1.3 Nervous drinking
Primary: Alcoholic point,Thirst point, Kidney.C, Brain,Shen Men, SympatheticAutonomicpoint,
PointZero, Endocrinepoint, Thalamuspoint, Master Cerebral,Tranquilizerpoint, Nervousness.
9.1.4 Smoking cessation
Primary: Nicotinepoint, Lung1,Lung2, Mouth, PointZero, ShenMen, SympatheticAutonomic
point, Brain. (ElectricallytreatLungpointsat80Hzfor 2minutes, or needlefor 20minutes.)
Supplemental: Adrenal Gland.C,Aggressivity, Limbic System.
9.1.5 Weight control
Primary: AppetiteControl, Stomach, Mouth, Esophagus, Small I ntestines, Shen Men, PointZero.
Supplemental: Thalamuspoint, Master Sensorial, Master Cerebral, Endocrinepoint,
Antidepressant point,Adrenal Gland.C,Brain, SanJ iao.
Shen Men
Brain
Smoking cessation
Mouth
Adrenal
Gland.C
Nicotine
point
Point Zero
Limbic _
System
Sympathetic
Autonomic
point
Aggressivity----+--=:u
NADA addiction protocol
Sympathetic Autonomic
point
Lung
Liver
Kidney.C
Shen Men
Addiction axis lines Weight control
Shen Men
Kidney.C
Primary
axis
I
Secondary
axis
Sympathetic Autonomic
point
Small Intestines
Point Zero
Mouth
Esophagus
Appetite Control
Adrenal Gland.C
San Jiao
Endocrine point
Master Cerebral
Shen Men
Stomach
Occiput
Antidepressant
point
Thalamus point
Master Sensorial
Figure 9.1 Addictive behaviors and drug detoxification treatment protocols.
274
9.2 Acute andchronic pain inupperandlower limbs (Figures9.2and9.3)
Corresponding body area Thisphrasereferstoear reflex pointsfor thehip, knee, ankle, heel,
toes, shoulder, elbow, wrist, handor fingerswhichcorrespondtothepartof theactual bodywhere
thepatientexperiences some pain, pathology, tensionor weakness. I fthereisonlylimited
treatmentsuccess for relievingtheprobleminaparticularlimb, thepractitionershouldstimulate
PhaseII andPhaseIII pointsandalsoexaminefor obstacles, toxicscars anddental foci.
9.2.1 Bone fracture
Primary: Correspondingbodyarea,Shen Men, Kidney.C, Adrenal Gland.C, ParathyroidGland.
9.2.2 Dislocated joint
Primary: Correspondingbodyarea,Shen Men, Thalamuspoint, Adrenal Gland.C,Liver,
Spleen.C.
9.2.3 Joint inflammation,jointswelling
Primary: Correspondingbody area, Endocrinepoint, Kidney.C, Adrenal Gland.C,Point Zero,
ShenMen.
Supplemental: Allergy point,Apex of Ear,Apex of Tragus, Omega2, Helix1,Helix 2, Helix3,
Helix4, Helix5, Helix6, Occiput, Prostaglandin1,Prostaglandin2.
9.2.4 Muscular atrophy, muscular dystrophy, motorparalysis
Primary: Correspondingbodyarea, Spinal Motor Neurons, FrontalCortex, Cerebellum,
Spleen.C, ParathyroidGland.
9.2.5 Muscle spasms, muscle tension, muscle cramp
Primary: Correspondingbodyarea, Muscle Relaxationpoint,Thalamuspoint, PointZero,
Shen Men.
9.2.6 Muscle sprain, sports injuries
Primary: Correspondingbodyarea, Heatpoint, PointZero, Shen Men, Thalamuspoint,
Adrenal Gland.C,Liver, Spleen.C, Kidney.C.
9.2.7 Peripheral neuralgia
Primary: Correspondingbodyarea, Spinal Sensory Neurons, Thalamuspoint,PointZero,
ShenMen.
Supplemental: Brain,Sympatheticchain,Adrenal Gland.C,Master Sensorial.
9.2.8 Shoulder pain, frozen shoulder, bursitis
Primary: Shoulder, Shoulder PhaseII, Master Shoulder, Clavicle.C, Clavicle.E, Cervical Spine,
ThoracicSpine.
Supplemental: Point Zero, Shen Men, Thalamuspoint, Muscle Relaxationpoint,Adrenal
Gland.C,Kidney.C, Lesser Occipital nerve.
9.2.9 Tennis elbow
Primary: Elbow PhaseI, ElbowPhaseII, Elbow PhaseIII, Forearm,Arm, ThoracicSpine, Point
Zero, Shen Men, Thalamuspoint, Muscle Relaxationpoint,Adrenal Gland.C,Kidney.C, Occiput.
9.2.10 Carpal tunnel syndrome, wrist pain
Primary: WristPhaseI, WristPhaseII, WristPhaseIII, Forearm,Hand,ThoracicSpine, Point
Zero, Shen Men, Thalamuspoint.
Shen Me
Shen Me
PointZer
Muscle
Relaxation
Adrenal
Gland.C
Shoulder pain
Kidney.C
Lesser
Occipital
nerve
Thoracic
Spine
Clavicle.E
Shoulder
r-r--/----I -._ Cervical
Spine
Master
Shoulder
Clavicle.C
Thalamus
point
Hand and fingers
PointZer
Muscle
Relaxation
Adrenal
Gland.C
Elbow and wrist pain
Wrist.F2
Wrist.F1
Elbow.F1
~ - k - . - + - - - r - Thoracic
Spine
Arm
Occiput
Thalamus
point
Elbow.F3
Wrist.F3
Posterior armpoints
Shen Men
Fingers.F1
Hand.F4
Wrist.F4
Elbow.F4
Arm.F4
---f--- Thoracic
Spine.F4
Shoulder.F4
Figure 9.2 Upper limb treatment protocols.
Hippain Knee pain
Shen Men
Kidney.C ...
PointZero
Muscle --t-.......
Relaxation
Lumbar Spine
Knee.E
PointZero
Muscle
Relaxation
Adrenal ---1-_.1>"
Gland.C
Knee.F2
Thalamus
point
Knee.C1
Shen Men
Knee.C2
Kidney.C
Thalamus
point
Knee.F3
Posterior leg points
Foot.C 4
Lumbar
Spine.F4
Ankle.F4
Hip.C4 -+----n
Lumbar
Spinal
Motor
Neurons
Knee.C4
Ankle.F3
Shen men
Ankle.C
--:r-+-I---- Toes .F2
Foot and ankle
Kidney.C
PointZero
Thalamus
point
Muscle
Relaxation
Figure 9.3 Lower limb treatment protocols.
9.3 Back pain andbodyaches (Figure9.4)
9.3.1 Abdominal pain, pelvic pain
Primary: Abdomen, Pelvis, Vagusnerve, SympatheticAutonomicpoint,Shen Men, Point Zero.
9.3.2 Amyotrophic lateralsclerosis
Primary: Correspondingbodyarea, Spinal Motor Neurons, MedullaOblongata,Brain,
Brainstem, Shen Men, Point Zero, SympatheticAutonomicpoint, Endocrinepoint, Occiput,
Kidney.C, SanJiao.
9.3.3 Back pain
Primary: ThoracicSpine, Lumbosacral Spine, Buttocks, Sciaticnerve, Lumbago, LumbarSpine
PhaseII on concharidge, LumbarSpinePhaseIII on tragus, PointZero, Shen Men, Thalamus
point.
Supplemental: Darwinspoint, Muscle Relaxationpoint, Liver, Bladder,Adrenal Gland.C.
9.3.4 Fibromyalgia
Primary: ThoracicSpine, Lumbosacral Spine, Muscle Relaxationpoint,Antidepressant point,
Psychosomatic Reactions 1, PointZero, Shen Men, Thalamuspoint.
Supplemental: Abdomen, Kidney.C, Sympatheticchain, Master Oscillationpoint, Vitalitypoint,
Tranquilizerpoint.
9.3.5 Intercostal neuralgia
Primary: Chest, ThoracicSpine, ThoracicSpinal Cord, PointZero, ShenMen, Thalamuspoint.
Supplemental: Occiput, Liver, Gall Bladder,Lung1, Lung2.
9.3.6 Osteoarthritis, osteoporosis
Primary: Correspondingbodyarea, ParathyroidGland,Parathyrotropin,PointZero, Shen Men.
Supplemental: Endocrinepoint,Adrenal Gland.C,Adrenal Gland.E,ACTH, Omega2,Allergy
point, Apex of Ear.
9.3.7 Rheumatoid arthritis
Primary: Correspondingbodyarea, Omega2,Prostaglandin1, Prostaglandin2,Allergy point,
Adrenal Gland.C,PointZero, Shen Men, Thalamuspoint,Endocrinepoint.
Supplemental: Master Oscillationpoint, Kidney.C, Spleen.C, Occiput, SanJiao, Apex of Ear,
Helix1, Helix2, Helix3, Helix4, Helix5, Helix6.
9.3.8 Sciatica
Primary: Sciaticnerve, Buttocks, Lumbago, LumbarSpine, Hip.C, Hip.E, Thigh, Calf, Point
Zero, Shen Men, Thalamuspoint,Adrenal Gland.C,Kidney.C, Bladder.
Supplemental: Tranquilizerpoint.
9.3.9 Sedation
Primary: Tranquilizerpoint, Point Zero, Shen Men, Thalamuspoint, Forehead, Occiput, Master
Cerebral, Heart.C,Kidney.C.
9.3.10 Surgical anesthesia
Primary: Chest, Abdomen, Stomach, Lung1, Lung2, Point Zero, ShenMen, Thalamuspoint,
Occiput, External Genitals.C.
Point
Zero
Muscle
Relaxation
ShenMen
Sympathetic
chain
Antidepressant
point
Abdomen
\.:""--_-+--I --j-Thoracic
Spine
Fibromyalgia
SacralSpine
LumbarSpine
Darwins
point
Kidney.C
Vitality
point
Master--
Muscle Oscillation
RelaxationThalamus
Ioint
Thalamus
point
Back painandsciatica
Shenmen
Hip.C
Buttocks
Lumbago
Abdomen
Calf
SacralSpine
Sciaticnerve
LumbarSpine
Bladder
Kidney.C
ThoracicSpine
PointZero
Adrenal
Gland.C
Tranquilizer
point
Rheumatoidarthritis Osteoarthritis
Fingers
Wrist
Adrenal
Gland.E
,.""I-----.L Elbow
;.... Parathyroid
Gland
Apex of Ear
Omega2
Knee.E
ShenMen
PointZero
Parathyrotropin_-v.....,
Kidney.C
Master
Spleen.C Oscillation
Adrenal
Gland.C
ACTH
o Prostaglandin2
Allergy point
ShenMen
Adrenal
Gland.C
Apex of Ear
Omega 2
PointZero
SanJiao
Endocrine
point
Thalamus
point
Prostaglandin1
Master
Oscillation
Helix 6
Figure9.4 Back pain and body aches treatment protocols.
9.4 Headand neck pain (Figures9.5and9.6)
9.4.1 Facial nerve spasms
Primary: Trigeminal Nucleus, Facial nerve, Face, Occiput, Temples, Forehead, Liver, PointZero,
Shen Men, Thalamuspoint, Master Sensorial, Cervical Spine, Lesser Occipital nerve, Stomach.
Supplemental: Muscle Relaxation,Adrenal Gland.C,Master Cerebral,Tranquilizerpoint.
9.4.2 Facial paralysis
Primary: Trigeminal Nucleus, Face, Occiput, PointZero, Shen Men, Thalamuspoint, Lesser
Occipital nerve, Liver, ParathyroidGland.
Supplemental: Muscle Relaxation,Adrenal Gland.C,Master Cerebral,Tranquilizerpoint.
9.4.3 Migraine headaches
Primary: Temples, Lesser Occipital nerve, Vagusnerve, Shen Men, Kidney.C, Thalamuspoint,
Cervical Spine.
Supplemental: SympatheticAutonomicpoint, PointZero, Tranquilizerpoint, Master Oscillation,
Master Sensorial, Master Cerebral, Muscle Relaxation.
9.4.4 Sinusitis
Primary: I nnerNose, FrontalSinus, Forehead, Occiput, Point Zero, Shen Men,
Adrenal Gland.C.
Supplemental: ACTH, Adrenal Gland.E,Asthma, Antihistamine,Allergy point.
9.4.5 Tension headaches
Primary: Occiput, Forehead, Cervical Spine, Point Zero, Shen Men, Thalamuspoint, Shoulder,
Master Shoulder, Tranquilizerpoint, Master Cerebral, Muscle Relaxation, Psychosomatic
Reactions.
9.4.6 Temporomandibular joint (TMJ) dysfunction and bruxism
Primary: TMJ , Upper Jaw, Lower Jaw, Cervical Spine, Trigeminal nerve, Occiput.
Supplemental: Master Cerebral, Point Zero, Shen Men, Thalamuspoint, Master Sensorial, San
Jiao, Muscle Relaxation, Psychosomatic Reactions.
9.4.7 Torticollis, neck strain
Primary: Cervical Spine, Neck, Occiput, Clavicle.C, Clavicle.E, PointZero, Shen Men.
Supplemental: Thalamuspoint, Endocrinepoint, Trigeminal Nucleus, MuscleRelaxation.
9.4.8 Whiplash
Primary: Neck, Cervical Spine, Clavicle.C, Clavicle.E, Shoulder, PointZero, Shen Men.
Supplemental: Muscle Relaxation, Thalamuspoint, Master Cerebral.
Tensionheadaches Migraineheadaches
MasterCerebral
Forehead
Muscle
Relaxation
Kidney.C
ShenMen
Lesser
Occipital
nerve
MasterSensorial
Thalamuspoint
Cervical
1,--...1 ,L-..I --r-
Spine
Vag\Jd
nerve
Master
Oscillation
Tranquilizer_ .... ,--..1
point
ShenMen
Sympathetic
Autonomic
point
Cervical
Spine
Master
Shoulder
Occiput
Master
Cerebral
Muscle
Relaxation
Tranquilizer
point
Thalamus
point
Facialparalysisor facial nervespasms Posterior ear pointsfor facial nerve
ShenMen
PointZero
Muscle
Relaxation
Adrenal Gland.C
ParathyroidGland
Tranquilizerpoint
Thalamuspoint
Forehead
MasterCerebral
Lesser Occipital
nerve
Stomach
:L_-+--+-r- Liver
...II. 11---1----,1----1-- CervicaI
Spine
Occiput
Temples
Facialnerve,
lJ:.igeminal
Nucleus
Face
MasterSensorial
Facial._+-__
nerve
Wgeminal
Nucleus
Shoulder
Cervical
Spine
Occiput
Forehead
Figure9.5 Head andface pain treatment protocols.
TMJ dysfunction andbruxism
Torticollis andneck strain
Clavicle.E
Neck
Clavicle.C
CervicalSpine
__ Trigeminal
Nucleus
Thalamus----1r----f--JL--llII---""----
point
Endocrine
point
MasterSensorial
TMJ
Lower Jaw
UpperJaw
Irigeminal
nerve
PointZero
ShenMen
SanJiao
Thalamus
point
Muscle
Relaxation
Psychosomatic
Reactions1
MasterCerebral
Whiplash Posterior ear pointsfor neck andjawpain
Shoulder
Cervical
Spine
\ __ OcciRut
Fadal -+_---1
nerve
Trigeminal
Nucleus
Shoulder
Clavicle.E
CervicalSpine
Neck
Clavicle.C
PointZero
ShenMen
Muscle
Relaxation--+-.....----4fj
Thalamus
Point
MasterCerebral
Figure9.6 TMJ and neck pain treatment protocols.
282
9.5 Dental pain (Figure9.7)
9.5.1 Dental Analgesia
Primary: DentalAnalgesia 1,DentalAnalgesia 2, Upper Jaw, Lower Jaw, Toothache1,
Toothache2, Toothache3, Trigeminal nerve.
Supplemental: TMJ , PointZero, Shen Men, Thalamuspoint,Tranquilizerpoint, Stomach,
Master Sensorial, Occiput, Kidney.C.
9.5.2 Dental surgery
Primary: Upper Jaw, Lower Jaw, Toothache1,Toothache2, Toothache3, Trigeminal nerve, Point
Zero, Shen Men, Palate.
9.5.3 Drymouth
Primary: SalivaryGland.C,SalivaryGland.E,Thirstpoint, Mouth, Posterior pituitary,Point
Zero, Shen Men, SympatheticAutonomicpoint.
9.5.4 Gingivitis, periodontitis, gum disease, bleeding of gums
Primary: Upper Jaw, Lower Jaw, Mouth, Palate,Adrenal Gland.C.
Supplemental: PointZero, Shen Men, Kidney.C, Spleen.C, Diaphragm,Stomach, Large
I ntestines.
9.5.5 Mouth ulcer
Primary: Mouth, Tongue.C, Tongue.E, Face, PointZero, ShenMen.
9.5.6 Toothache
Primary: Toothache1,Toothache2, Toothache3, Upper Jaw, Lower Jaw, Dental Analgesia 1,
DentalAnalgesia 2,Trigeminal nerve, Shen Men.
Supplemental: Occiput, Kidney.C, PointZero, Cervical Spine, Master Sensorial.
9.5.7 Trigeminal neuralgia, facial neuralgia
Primary: Trigeminal nerve, Face, Upper Jaw, Lower Jaw, Mouth, Occiput, Shen Men, SanJiao.
Supplemental: Point Zero, Thalamuspoint, Master Sensorial, Master Cerebral,Temples,
Shoulder, Brainstem, Liver, Lesser Occipital nerve, Master Oscillation, WindStream.
Dental analgesia Drymouth
Salivary
Gland.E
Posterior
Pituitary
Salivary
Gland.C
Thirst
point
ShenMen
Sympathetic
Autonomic point
PointZero
Kidney.C
TMJ
Lower Jaw
Toothache1
.upp-er Jgw
Trigeminal
nerve
PointZero
ShenMen
Stomach
Tranquilizer ......./---l---t--t- Toothache3
point Toothache2
Thalamus--\---l:--I--a>!::HrT/L.--Occiput
point
Dental
Analgesia 1
Dental
Analgesia 2
MasterSensorial
Toothache Trigeminal neuralgiaandfacial neuralgia
ShenMen
PointZero
Dental
Analgesia 1 J
MasterSensorial
Kidney.C
Cervical
Spine
Toothache3
Toothache2

Occiput
Toothache1
Trigeminal
nerve
UpperJaw
ShenMen
Mouth
Master
Oscillation
Temples

Cerebral
Master
Sensorial
Lesser
Occipital
nerve
WindStream
Liver
__-+---r-,
,.4--4-- Shoulder
"-IIi----f-.......f--r-- Brainstem
__ Occiput
lY"F--- Lower Jaw
Jaw
Trigeminal
nerve
Thalamuspoint
Figure9.7 Dentalpain treatmentprotocols.
284
9.6 Neurological disorders (Figure9.8)
9.6.1 Attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD)
Primary: Hippocampus, Amygdala, Thyrotropin,ThyroidGland.C,ThyroidGland.E,Shen Men,
PosteriorShen Men, Master Oscillation.
Supplemental: Master Cerebral,Point Zero, Kidney.C, Brain, Brainstem,Occiput.
9.6.2 Bell's palsy
Primary: Face, Forehead, Facial nerve, Point Zero, Shen Men, Thalamuspoint.
9.6.3 Cerebral palsy
Primary: Brainstem, Point Zero, Shen Men, Thalamuspoint, Master Cerebral.
9.6.4 Concussion
Primary: Brain, Brainstem, Master Cerebral, Forehead, Occiput, Adrenal Gland.C,Lesser
Occipital nerve, PointZero, Shen Men, Thalamuspoint, Heart.C,Kidney.C.
9.6.5 Encephalitis, brain trauma
Primary: Brainstem,Forehead, Occiput, Lesser Occipital nerve, Point Zero, Shen Men,
Kidney.C, Thalamuspoint, Master Cerebral, Heart.C.
9.6.6 Epilepsy, seizures, convulsions
Primary: Amygdala, Temporal Cortex, Forehead, Brain, Brainstem,Occiput, Heart.C,Spleen.C.
Supplemental: PointZero, Shen Men, Thalamuspoint, Master Oscillation, Stomach, Liver,
Lesser Occipital nerve.
9.6.7 Facial tics
Primary: Face, Forehead, Upper Jaw, Cervical Spine, Point Zero, Shen Men, Thalamuspoint,
Master Cerebral,Stomach, Liver.
9.6.8 Laterality dysfunction
Primary: Master Oscillation, Lateralitypoint, CorpusCallosum, PointZero, Shen Men, Reticular
Formation,Yintangpointon forehead.
9.6.9 Meningitis
Primary: Brainstem, Point Zero, Shen Men, Thalamuspoint, Occiput, Forehead, Kidney.C,
Stomach, Heart.C,Lesser Occipital nerve, Thymus Gland,Vitalitypoint.
9.6.10 Multiple sclerosis
Primary: Correspondingbodyarea, Brainstem, MedullaOblongata,Master Oscillation, Point
Zero, Shen Men, Thalamuspoint, Occiput, ThymusGland,Vitalitypoint.
Supplemental: Lesser Occipital nerve.
9.6.11 Parkinsonian tremors
Primary: MidbrainTegmentum, Striatum,Adrenal Gland.C,ACTH, PointZero, Shen Men.
9.6.12 Polio and post-polio syndrome
Primary: Correspondingbodyarea, Spinal Motor Neurons, MedullaOblongata,Master
Cerebral, Point Zero, Posterior Shen Men, Endocrinepoint.
Supplemental: Thalamuspoint, Adrenal Gland.C,Occiput.
9.6.13 Stroke orcerebral vascular accident
Primary: Correspondingbodyarea, Brain, Adrenal Gland.C,Adrenal Gland.E,ACTH, Shen
Men, SympatheticAutonomicpoint, Master Cerebral, Endocrinepoint.
9.6.14 Tremors
Primary: Spinal Motor Neurons, Striatum,Cerebellum, Point Zero, Shen Men.
Attentiondeficit hyperactivitydisorder
ShenMen
Posterior
ShenMen
PointZero
Brainstem
Master
Oscillation
Brain
Thyrotropin
MasterCerebral
Multiplesclerosis
Shenmen
Forehead
Epilepsy, seizures or convulsions
----+---+-+_ Liver
'----1-+-+-1--- Spleen.C
Brainstem
~ i i ~ ~ ~ - Occiput
Brain
Temporal
Cortex
Polioandpost-poliosyndrome
ShenMen
PointZero
Vitalitypoint
Thalamus
point
Lesser Occipital
nerve
.--+--I ------,/- Brainstem
J ->--- Medulla
Oblongata
Occiput
$Rinal
Motor
Neurons
Medulla--.4.-I
Oblongata
Occiput
Posterior
ShenMen
Adrenal
Gland.C
Thalamus
point
Endocrine
point
Master
Cerebral
Figure9.8 Neurological disorders treatmentprotocols.
286
9.7 Stress-related disorders (Figure9.9)
9.7.1 Autonomic excessive activity
Primary: SympatheticAutonomic point,Sympatheticchainonconchawall, Thalamuspoint,
External Genitals.C, External Genitals.E, Kidney.C.
9.7.2 Chronic fatigue syndrome
Primary: Vitalitypoint, Antidepressant point, Brain,ACTH, Adrenal Gland.C,Adrenal
Gland.E,Point Zero, Shen Men, Master Oscillation, Master Cerebral.
9.7.3 Drowsiness
Primary: Excitement point,Alertness, I nsomnia1, I nsomnia2.
9.7.4 Heat stroke
Primary: Thalamuspoint, Occiput, Heart.C,Heatpoint,Adrenal Gland.C,Adrenal Gland.E,
Lesser Occipital nerve.
9.7.5 Hyperhydrosis or excessive sweating
Primary: Fingers, Hand,Forehead, Sympatheticchainonconchawall, SympatheticAutonomic
point, Endocrinepoint, PointZero, Shen Men, Adrenal Gland.C,Adrenal Gland.E,Occiput,
Heart.C.
9.7.6 Hysteria, hysterical disorder
Primary: Correspondingbodyareafor perceived problem, Point Zero, Shen Men, Thalamus
point, Brainstem,Brain,Occiput, Heart.C,Stomach, Kidney.C, Heart.C,Lesser Occipital nerve.
9.7.7 Insomnia
Primary: I nsomnia1,I nsomnia2, Pineal Gland,Heart.C,Master Cerebral, Point Zero, Shen
Men, Thalamuspoint, Forehead, Occiput, Brain, Kidney.C.
9.7.8 Jet lagor circadian rhythmdysfunction
Primary: Pineal Gland,I nsomnia1,I nsomnia2, Point Zero, Shen Men, Endocrinepoint.
9.7.9 Psychosomatic disorders
Primary: Psychosomatic Reactions 1,Psychosomatic Reactions2, Master Cerebral, Point Zero,
Shen Men, SympatheticAutonomicpoint,Thalamuspoint, Occiput.
Supplemental: Heart.C,External Genitals.C, External Genitals.E, Endocrinepoint.
9.7.10 Reflex sympathetic dystrophy
Primary: SympatheticAutonomicpoint,Sympatheticchain, Point Zero, Shen Men, Thalamus
point.
9.7.11 Shock
Primary: Brain, Lesser Occipital nerve, Thalamuspoint, Adrenal Gland.C,Occiput, Heart.C.
Supplemental: Shen Men, PointZero, Liver, Spleen.C, Kidney.C, Gall Bladder.
9.7.12 Stress and strain
Primary: Adrenal Gland.C,Adrenal Gland.E,ACTH, Tranquilizerpoint, Point Zero, Shen Men,
Master Cerebral, Muscle Relaxation, Psychosomatic Reactions 1,Psychosomatic Reactions2.
Supplemental: Endocrinepoint,Anterior Hypothalamus, Occiput, Posterior Hypothalamus.
Chronic fatigue syndrome I nsomnia
Insomnia 2
I nsomnia 1
Forehead
Kidney.C
Brain
Master
Cerebral
Thalamus
point
Pineal
Gland
Shen Men
Point Zero
Master
Cerebral
Point Zero
Vitality
point
Master
Oscillation
Adrenal
Gland.C
ACTH
Shen Men
Psychosomatic disorders Stress and strain
Tranquilizer
point
ACTH
Psychosomatic
Reactions 1
b
Adrenal
Gland.E
Muscle
Relaxation
Posterior
Hypothalamus
Anterior
Hypothalamus
Adrenal
Gland.C
Shen Men
Point Zero
Endocrine
point
Master
Cerebral
Psychosomatic
Reactions 2
Thalamus
point
Point Zero
Shen Men
Psychosomatic
Reactions 1
External b
Genitals.C
Sympathetic
Autonomic
point
External
Genitals.E
Heart.C
Psychosomatic
Reactions 2
Endocrine point
Master Cerebral --_.L.-.,.
Figure 9.9 Stress-related disorders treatment protocols.
288
9.8 Psychological disorders (Figure9.10)
9.8.1 Anxiety
Primary: Nervousness, Master Cerebral,Tranquilizerpoint, Occiput, Heart.C,PointZero, Shen
Men, SympatheticAutonomicpoint.
Supplemental: Stomach, Adrenal Gland.C,Vagusnerve.
9.8.2 Depression
Primary: Antidepressant, Brain, Excitement point, Pineal Gland,Master Cerebral,Shen Men,
SympatheticAutonomicpoint.
Supplemental: PointZero, Endocrinepoint, Master Oscillation, Occiput, External Genitals.C,
External Genitals.E.
9.8.3 Irritability
Primary: Aggressivity, Master Cerebral,PointZero, Shen Men, Thalamuspoint, Heart.C.
9.8.4 Mania
Primary: Maniapoint,Amygdala, Master Cerebral,Tranquilizerpoint, Point Zero, Shen Men.
9.8.5 Memory problems, poor concentration
Primary: FrontalCortex, Hippocampus, Memory 1,Memory 2, Master Cerebral, Heart.C,Point
Zero, Shen Men.
9.8.6 Neurasthenia, nervous exhaustion
Primary: Nervousness, Thalamuspoint, Occiput, Heart.C,Kidney.C, Shen Men, Tranquilizer
point.
Supplemental: PointZero, Master Cerebral, Brainstem, Stomach.
9.8.7 Nightmares, disturbing dreams
Primary: Pons, Psychosomatic Reactions1,Psychosomatic Reactions2, Nervousness, Master
Cerebral,Thalamuspoint,Heart.C,Shen Men, Point Zero, I nsomnia1, I nsomnia2, Reticular
Formation.
9.8.8 Obsessive-compulsiveness
Primary: Master Cerebral, FrontalCortex, Point Zero, Shen Men, Thalamuspoint, Heart.C,
Occiput.
9.8.9 Repressed emotional experiences
Primary: Psychosomatic Reactions 1,Psychosomatic Reactions2, Hippocampus, ShenMen,
Heart.C.
9.8.10 Schizophrenia and psychosis
Primary: Master Cerebral, Brain,Thalamuspoint, Occiput, Heart.C,Kidney.C, Stomach,
Brainstem, Lesser Occipital nerve.
Supplemental: PointZero, Shen Men, Nervousness, Forehead, Liver, Apex of Ear.
Anxiety Depression
Shen Men
Sympathetic
Autonomic
point
Point Zero
Vagus nerve
Adrenal Gland.C
Tranquilizer
p-oint
Master Cerebral
Nervousness
Shen Men
External
Genitals.C
Sympathetic
Autonomic
point
External
Genitals.E
Point Zero
Master
Oscillation
Excitement
p-oint
Pineal Gland
Endocrine point
Master Cerebral
Occiput
Antidepressant
point
Memory problems or poor concentration Schizophrenia and psychosis
Apex of Ear
Lesser
Occipital
nerve
Occiput
Kidney.C
e:.....i:t:--I---+---J- Stomach
Liver
Brain ...-----.f-+--+- Brainstem

Heart.C
Thalamus ----1r-t--I -__1
point
Forehead
Master
Cerebral
Shen Men
Point Zero
Nervousness
Hippocampus
Frontal Cortex
Shen Men
Heart.C __-1-_+...............
Point Zero
Memo!Y..1
Master Cerebral
Figure 9.10 Psychological disorders treatmentprotocols.
290
9.9 Eyesight disorders (Figure9.11)
9.9.1 Astigmatism
Primary: Eye, Eye Disorders2, Opticnerve, Kidney.C, Liver, Occiput, ShenMen.
9.9.2 Blurred vision, poor eyesight
Primary: Eye, Eye Disorders2, Eye Disorders3, Opticnerve, Occipital Cortex.
Supplemental: Shen Men, Master Sensorial, Brain, Occiput, Kidney.C, Liver, Lung2.
9.9.3 Conjunctivitis
Primary: Eye, ShenMen, Liver, SkinDisorders.C, Occiput, Adrenal Gland.C,Adrenal Gland.E.
9.9.4 Eye irritation
Primary: Eye Disorders1,Eye Disorders2,Shen Men, Endocrinepoint.
9.9.5 Glaucoma
Primary: Eye, Eye Disorders1,Eye Disorders2, ShenMen, Occiput, Kidney.C, Liver, Apex of
Ear.
9.9.6 Myopia
Primary: Eye, EyeDisorders2, Eye Disorders3, Opticnerve, Occiput, Forehead, Shen Men,
Kidney.C, Liver, Spleen.C, Apex of Ear.
9.9.7 Stye
Primary: Eye, Shen Men, Liver, Spleen.C, Spleen.E.
Auticuiotherspy Manual
Blurred vision and poor eyesight Conjunctivitis
Skin Disorders.C
Occiput
Adrenal
Gland.C
Shen Men
Kidney.C
Occipital
Cortex
Master
Sensorial
Liver
Shen Men
. ../----1(.........-I-T- Lung2
Brain--t-----jL--_.. ""\
Optic nerve __
Disorders 2
Disorders 3
---j---....
Glaucoma Myopia
Kidney.C
Liver
Occiput
Spleen.C
Forehead
_--::""-",.,,_---- Apex of Ear
Optic nerve

Disorders 3
Disorders 2 ---Y---tc\ ..J
Kidney.C
Apex of Ear
Shen Men
Disorders 2
Disorders 1

Figure 9.11 Eyesightdisorders treatment protocols.
292
9.10 Hearingdisorders (Figure9.12)
9.10.1 Dizziness, vertigo
Primary: Dizzinesspoint, I nnerEar.C, I nnerEar.E,Cerebellum, Occiput, Lesser Occipital
nerve, Point Zero, Master Sensorial.
Supplemental: Shen Men, Thalamuspoint, Forehead, Liver, Kidney.C.
9.10.2 Ear infection, earache
Primary: I nnerEar.C, I nnerEar.E, External Ear.C,Kidney.C, PointZero, Shen Men.
Supplemental: Master Oscillation, Master Cerebral,Adrenal Gland.C,Occiput, SanJiao, Apex
of Ear.
9.10.3 I mpaired hearing
Primary: I nnerEar.C, I nnerEar.E, External Ear.C, Kidney.C, Occiput, Point Zero, Shen Men.
9.10.4 Motionsickness, car sickness, sea sickness
Primary: I nnerEar.C, I nnerEar.E, Stomach, Occiput, Point Zero, Shen Men, Lesser Occipital
nerve, Master Oscillation.
9.10.5 Mutism, stuttering, difficultyspeaking
Primary: Mutism, I nnerEar.C,Tongue.C, Tongue.E, Kidney.C, Master Oscillation, Point Zero,
Shen Men, Thalamuspoint, Heart.C.
Supplemental: External Ear.C,Master Cerebral.
9.10.6 Sensorineural deafness
Primary: I nnerEar.C,External Ear.C, Auditorynerve, Temporal Cortex, Auditoryline, Adrenal
Gland.C,Adrenal Gland.E,Kidney.C, Shen Men, PointZero, Master Sensorial, Occiput, SanJiao.
Treatthefour wallsof theear canal directlywithaprobeor needle, or fill theear canal withsaline
andplaceamonopolar auricularprobeintothesaline. Witheither method, treatarangeof
frequencies, from1Hzto320Hz, stimulatingeach pointat 150f.LA for 30seconds.
Also treatactiveear reflex pointsalongtheauditorylineon thelobeinferiortotheantitragus,and
8pointson theareaof theskull whichsurroundstheear. Patientssufferingfromdeafness needto
makeaminimumcommitment to20sessions of 3D-minutetreatments.
9.10.7 Sudden deafness
Primary: I nnerEar.C, I nnerEar.E, Brain, Brainstem, PointZero, Shen Men, Thalamuspoint.
9.10.8 Tinnitus
Primary: I nnerEar.C, External Ear.C, Auditorynerve, Kidney.C, PointZero, Shen Men, Master
Sensorial, SanJiao.
Supplemental: Cervical Spine, Master Oscillation, Adrenal Gland.C,Adrenal Gland.E,Occiput,
Shoulder, Lesser Occipital nerve.
Sensorineural deafness and tinnitus
Surface view
Sensorineural deafness and tinnitus
Hidden view
Shen Men
Point Zero
External Ear.C
Adrenal Gland.C _+--{
Occiput
Temporal __
Cortex
Master Sensorial
Cervical Master
Spine 0 11 .
SCI ation
San [lao
Inner Ear.C
Lesser
Occipital
nerve
.+-1__ Shoulder
Dizziness and vertigo
Mutismand stuttering
Shen Men
Point Zero
Inner Ear.E
Dizziness __
point
Thalamus point
Forehead
Master Sensorial
Figure 9.12 Hearingdisorders treatment protocols.
Treatment protocols
Lesser Occipital
nerve
Kidney.C
External Ear.C
Liver
Master
Oscillation
Cerebellum
Occiput
Inner Ear.C Tongue.C
Master Cerebral
Shen Men
Kidney.C
Point Zero
.........----f.......4----1-- Heart.C
__
point
Inner Ear.C
293
294
9.11 Nose and throat disorders (Figure9.13)
9.11.1 Allergic rhinitis
Primary: I nnerNose, Apex of Ear, Adrenal Gland.C,Forehead, Endocrinepoint, LungI, Lung2,
Kidney.C, Spleen.C, Allergy point, Diaphragm.C.
9.11.2 Broken nose
Primary: External Nose.C, External Nose.E, Point Zero, Shen Men, Thalamuspoint.
9.11.3 Hoarseness
Primary: Throat.C,Throat.E,Trachea,Point Zero, Shen Men, Endocrinepoint, Heart.C,Lung1,
Lung2.
9.11.4 Laryngitis
Primary: Larynx.C, Larynx.E, Tonsil 1,Tonsil 2, Tonsil 3, Tonsil 4, PointZero, ShenMen,
Endocrinepoint, Palate,Lung1,Lung2.
9.11.5 Nose bleeding
Primary: I nnerNose, Forehead, Lung1,Lung2,Apex of Ear, Shen Men, Adrenal Gland.C.
9.11.6 Pharyngitis
Primary: Throat.C,Throat.E,Point Zero, Shen Men, Endocrinepoint, Lung1,Lung2,Adrenal
Gland.C.
9.11.7 Rhinitis, running nose
Primary: I nnerNose, External Nose, PointZero, Forehead, Kidney.C, Shen Men, Endocrine
point,Adrenal Gland.C,Lung1,Lung2, Spleen.C, Allergy point.
9.11.8 Sneezing
Primary: Sneezingpoint, I nnerNose, Apex of Ear,Asthma, Antihistamine,Allergy point, Point
Zero, Shen Men.
9.11.9 Sore throat
Primary: Throat.C,Throat.E,Mouth, Trachea,Tonsil 1,Tonsil 2,Tonsil 3, Tonsil 4.
Supplemental: Lung1,Lung2, Adrenal Gland.C,Adrenal Gland.E,Point Zero, Shen Men,
Thalamuspoint, Prostaglandin1,Prostaglandin2, Master Oscillation.
9.11.10 Sunburned nose
Primary: External Nose.C, External Nose.E, SkinDisorder.C,SkinDisorder.E, PointZero, Shen
Men, Thalamuspoint,Lung1,Lung2.
9.11.11 Tonsillitis
Primary: Throat.C,Throat.E,Laryngitis.C, Palate,Tonsil 1,Tonsil 2, Tonsil 3, Tonsil 4.
Supplemental: Point Zero, Shen Men, Apex of Ear, ThyroidGland.C,ThyroidGland.E.
Thalamus point
Sore throat
o Prostaglandin 2
Tonsil 1
Adrenal
Gland.E
Shen Men
Point Zero
Mouth
ThroatE
Tonsil 2
Throat.C
Thyroid
Trachea
Gland.E
Thyroid
Adrenal
Gland.C
Gland.C
Tonsil 3
Master
Oscillation
Shen Men
Laryngitis and tonsillitis
Apex of Ear
Tonsil 1
Endocrine
point
Palate
Point Zero
bill:)tnx.E
ThroatE
lir,ynx.C
Throat.C
Lung 1
Lung 2
Apex of Ear
Allergy point
Sneezing
Shen Men
Antihistamine
point
Rhinitisand allergic rhinitis
Apex of Ear
Allergy point
Kidney.C
Shen Men
Diaphragm.C
Point Zero
External
Point Zero
Nose
Inner Nose
Spleen.C
Inner Nose
Lung 1
Adrenal
Gland.C
Lung2
Asthma
Endocrine
Forehead
point
Figure 9.13 Nose and throat disorders treatment protocols.
296
9.12 Skin and hairdisorders (Figure9.14)
9.12.1 Acne
Primary: Face, SkinDisorder.C,SkinDisorder.E,Lung1,Lung2,PointZero, Shen Men.
Supplemental: External Genitals.C, External Genitals.E, Gonadotropins,Endocrinepoint.
9.12.2 Boil, carbuncle
Primary: Correspondingbody area,Lung1,Lung2, Occiput, Endocrinepoint, PointZero, Shen
Men, Adrenal Gland.C,Adrenal Gland.E.
9.12.3 Coldsores (herpes simplex)
Primary: Lips, Mouth, Lung1,Lung2, Occiput, SalivaryGland.C,SalivaryGland.E,Point Zero,
Shen Men.
Supplemental: Adrenal Gland.C,Adrenal Gland.E,ACTH, SkinDisorder.C, SkinDisorder.E.
9.12.4 Dermatitis,hives, urticaria
Primary: Correspondingbodyarea,SkinDisorder.C, SkinDisorder.E, Endocrinepoint, Shen
Men.
Supplemental: Adrenal Gland.C,Kidney.C, Lung1,Lung2, Occiput, Point Zero, Master
Sensorial, ThyroidGland.C,ThyroidGland.E,Apex of Ear.
9.12.5 Eczema, itching, pruritus
Primary: Correspondingbody area,SkinDisorder.C,SkinDisorder.E, Lung1,Lung2.
Supplemental: Occiput, LargeI ntestines, Adrenal Gland.C,Point Zero, ShenMen, Endocrine
point, Psychosomatic Reactions 1,Psychosomatic Reactions2.
9.12.6 Frostbite
Primary: Correspondingbody area,Occiput, Heatpoint,Adrenal Gland.C,Adrenal Gland.E.
Supplemental: Point Zero, Shen Men, Lung1,Lung2, Spleen.C, Spleen.E.
9.12.7 Hairloss, baldness, alopecia
Primary: Occiput, Endocrinepoint, Lung1,Lung2, Kidney.C, PointZero, Shen Men.
9.12.8 Poisonoak, poison ivy
Primary: Correspondingbody area,SkinDisorder.C, SkinDisorder.E, Lung1,Lung2, Point
Zero, Shen Men, Endocrinepoint, Apex of Ear, Allergy point.
9.12.9 Postherpeticneuralgia
Primary: Chest, ThoracicSpine, SkinDisorder.C,SkinDisorder.E, PointZero, Shen Men,
Endocrinepoint, Kidney.C.
9.12.10 Rosacea
Primary: External Nose.C, External Nose.E, Lung1, Lung2, Endocrinepoint,Adrenal Gland.C,
Adrenal Gland.E,Spleen.C, Apex of Ear.
9.12.11 Shingles (herpes zoster)
Primary: Correspondingarea,Chest, ThoracicSpine, SkinDisorder.C,SkinDisorder.E, Endocrine
point,Lung1,Lung2,Occiput, Adrenal Gland.C,Adrenal Gland.E,Kidney.C.
Supplemental: Point Zero, Shen Men, Anterior Pituitary,Apex of Ear,Allergy point.
9.12.12 Sunburn
Primary: Correspondingbodyarea,SkinDisorder.C,SkinDisorder.E,Thalamuspoint,
Kidney.C.
Supplemental: Shen Men, Endocrinepoint, Adrenal Gland.C,Lung1,Lung2.
Dermatitis, hives, urticariaand eczema Sunburn
Shen Men
Psychosomatic
Reactions 1 0
Kidney.C
Large
I ntestines
Point Zero
Adrenal ---I ------\ --I J
Gland.C
Endocrine
point
Psychosomatic ~
Reactions 2
Shen Men
Skin
Disorder.C
Kidney.C
Skin
Disorder.E
Lung 1
Lung2
Adrenal
Gland.C
Thyroid
Gland.E
Thyroid
Gland.C
Occiput
Skin
Disorder.C
Thoracic
Spine
Skin
Disorder.E
Thalamus point
Face
Shen Men
Adrenal
Gland.E
Skin
Disorder.E
Skin
Disorder.C
Lung]
L u n g ~
Occiput
Salivary
Gland.E
Salivary
Gland.C
Cold sores (herpes simplex)
Adrenal
Gland.C
(ACTH)
Point Zero
Mouth _ __>__---.
Skin
Disorder.C
Thoracic
Spine
Skin
Disorder.E
Occiput
Herpes zoster and postherpetic neuralgia
Apex of Ear
Allergy point
Adrenal
Gland.E
Adrenal
Gland.C
Shen Men
Anterior
Pituitary
Endocrine
point
Kidney.C
Point Zero
Lungj
Lungl
Figure 9.14 Skin and hair disorders treatment protocols.
298
9.13 Heart and circulatory disorders (Figure9.15)
9.13.1 Anemia
Primary: Heart.C1,Heart.C2,Heart.E,Liver, Spleen.C, Spleen.E, Endocrinepoint, Stomach,
Small I ntestines, Diaphragm.C,Kidney.C.
9.13.2 Angina pain
Primary: Heart.C1,Heart.C2,Heart.E,Vagusnerve, SympatheticAutonomicpoint, PointZero,
Shen Men, Thalamuspoint, Lung1,Lung2, Stomach.
9.13.3 Bradycardia, pulselessness
Primary: Heart.C1,Heart.C2,Heart.E,SympatheticAutonomicpoint,Thalamuspoint,
Kidney.C, Liver, Adrenal Gland.C.
9.13.4 Cardiac arrest
Primary: Heart.C1,Heart.C2,Heart.E,Adrenal Gland.C,Adrenal Gland.E,Shen Men,
Thalamuspoint, Liver, Spleen.C, Spleen.E.
9.13.5 Cardiac arrhythmias
Primary: Heart.C1,Heart.C2,Heart.E,Chest, SympatheticAutonomicpoint, ShenMen, Vagus
nerve, Adrenal Gland.C,Adrenal Gland.E,Thalamuspoint.
Supplemental: PointZero, Kidney.C, Liver, Stomach, Small I ntestines.
9.13.6 Heartattack, coronary thrombosis
Primary: Heart.C1,Heart.C2,Heart.E,SympatheticAutonomicpoint, Endocrinepoint, Point
Zero, Shen Men, Thalamuspoint, Small I ntestines, Kidney.C, ACTH.
9.13.7 Hypertension (high blood pressure)
Primary: Hypertension1,Hypertension2, Hypertensivegroove, Heart.C1,Heart.C2,Heart.E,
Marvelouspoint, SympatheticAutonomicpoint, PointZero, Shen Men, Sympatheticchain.
Supplemental: Vagusnerve, Thalamuspoint,Adrenal Gland.C,Apex of Ear.
9.13.8 Hypotension (lowblood pressure)
Primary: Hypotension, Heart.C,Heart.E,Vagusnerve, Thalamuspoint,Endocrinepoint,Shen
Men, SympatheticAutonomicpoint, PointZero.
Supplemental: Adrenal Gland.C,Liver, Spleen.C, Spleen.E.
9.13.9 Lymphatic disorders
Primary: Spleen.C, Spleen.E, ThymusGland,PointZero, ShenMen, Vitalitypoint.
9.13.10 Myocarditis
Primary: Heart.C1,Heart.C2,Heart.E,SympatheticAutonomicpoint, Shen Men, Occiput,
Small I ntestines, Spleen.C.
9.13.11 Premature ventricular contraction
Primary: Heart.C1,Heart.C2,Heart.E,SympatheticAutonomicpoint,Thalamuspoint, Small
I ntestines.
9.13.12 Tachycardia, heart palpitations
Primary: Heart.C1,Heart.C2,Heart.E,SympatheticAutonomic point,PointZero, Shen Men,
Thalamuspoint, Small I ntestines, Adrenal Gland.C,Adrenal Gland.E.
9.13.13 Raynaud's disease, vascular circulation problems, cold hands, cold feet
Primary: Heart.C1,Heart.C2,Heart.E,Heatpoint, SympatheticAutonomicpoint, Endocrine
point,Adrenal Gland.C,Adrenal Gland.E,Lesser Occipital nerve.
Supplemental: Shen Men, Thalamuspoint, Sympatheticchain, Occiput, Liver, Spleen.C,
Hypertension Hypotension
Apex of Ear
!::!yp.ertension 1
ShenMen

Autonomic
point
Sympathetic
chain
PointZero
Heart.C2__
Heart.Cl
Adrenal Gland.C__+-_r)I
Hypertension 2----t-(
Vagus nerve
Anginapain
ShenMen
Sympathetic
Autonomic
point
PointZero
HeartE
Vagusnerve
Adrenal Gland.C
Endocrine
point
t:!yp-otension
Thalamuspoint
rr:....,..-...J L Spleen.E
Liver
Spleen.C
Heart.C
Thalamuspoint
Cardiacarrhythymias
ShenMen
Sympathetic
Autonomic
point
PointZero
Heart.C2
Lung1
Vagus nerve__-+-_
Heart.Cl
Lung2
ShenMen
$YlDp-athetic
Autonomic
p-oint
Small Intestines
PointZero
Heart.C2
Heart.E
nerve---"""1f--
Stomach
AdrenalGland.C
Thalamuspoint
Kidney.C
Adrenal
Gland.E
,----.N- ()--t---=t--t Heart.,1.
Chest
Stomach
Liver
Heart.Cl
Thalamuspoint
Figure9.15 Heart and circulatory disorders treatment protocols.
300
9.14 Lung and respiratory disorders (Figure9.16)
9.14.1 Asthma
Primary: Asthma, Antihistamine, Lung1,Lung2, Bronchi, SympatheticAutonomicpoint, Point
Zero, Shen Men, Allergy point,Apex of Ear.
Supplemental: Adrenal Gland.C,Tranquilizerpoint, Master Cerebral, Kidney.C, Occiput,
Spleen.C, Spleen.E, Psychosomatic Reactions1.
9.14.2 Bronchitis
Primary: Bronchi, Trachea,Asthma, Antihistamine,Shen Men, PointZero, Adrenal Gland.C,
Adrenal Gland.E,SympatheticAutonomicpoint, Occiput.
9.14.3 Bronchopneumonia
Primary: Asthma, Antihistamine, Bronchi, PointZero, Shen Men, SympatheticAutonomic
point, Adrenal Gland.C,Adrenal Gland.E,Endocrinepoint, Occiput.
9.14.4 Chest pain, chest heaviness
Primary: Lung1,Lung2, Chest, Heart.C,Asthma, Adrenal Gland.C,SympatheticAutonomic
point, Point Zero, Shen Men.
9.14.5 Cough
Primary: Asthma, Antihistamine,Throat.C,Throat.E,Lung1, Lung2,Adrenal Gland.C,
Adrenal Gland.E.
Supplemental: SympatheticAutonomicpoint,Shen Men, PointZero, Trachea, Occiput,
Spleen.C, Spleen.E.
9.14.6 Emphysema
Primary: Lung1,Lung2, Bronchi, Chest, Asthma, Antihistamine, Point Zero, Shen Men,
SympatheticAutonomicpoint,Adrenal Gland.C,Adrenal Gland.E,Occiput.
9.14.7 Hiccups
Primary: Diaphragm.C,Diaphragm.E,ParasympatheticCranialnerves, SanJiao.
Supplemental: PointZero, Shen Men, Thalamuspoint, Esophagus, Liver, Occiput.
9.14.8 Pleurisy
Primary: Lung1, Lung2, Chest, PointZero, Shen Men, Endocrinepoint,Adrenal Gland.C,
Adrenal Gland.E,SanJiao.
9.14.9 Pneumonia
Primary: Lung1,Lung2, Chest, Adrenal Gland.C,Adrenal Gland.E,Endocrinepoint, Point
Zero, Shen Men, Thalamuspoint,SanJiao.
9.14.10 Shortness of breath, breathing difficulties
Primary: I nnerNose, Lung1,Lung2, Chest, Forehead, Adrenal Gland.C,Adrenal Gland.E,
Shen Men.
9.14.11 Tuberculosis
Primary: Tuberculosis, Lung1,Lung2, Point Zero, Shen Men.
9.14.12 Whooping cough
Primary: Asthma, Antihistamine, Bronchi, Adrenal Gland.C,Adrenal Gland.E,Sympathetic
Autonomic point, Occiput.
Asthma Cough
ShenMen
Sympathetic
Autonomic
point
Antihistamine
ShenMen
Adrenal
Gland.E
Occiput
Asthma
Spleen.E
Trachea
Adrenal
Gland.C
Apex of Ear
Allergy point
-,----jr...-I-..f- LungJ

Kidney.C
PointZero
Throat.E
""'lw,J'--+---Tt- Spleen.C
Throat.C
Tranquilizer --Td
point
Antihistamine
Master
---,
Cerebral
PointZero
Psychosomatic
Reactions 1
b
Sympathetic
Autonomic
point
Adrenal Gland.C --f----{
Emphysema Hiccups
Liver
ShenMen
Thalamuspoint
PointZero
fl::>""d-----I H-r
Esophagus
Parasympathetic ->---T""_
Cranialnerves
Adrenal
Gland.E
Chest
Sympathetic
Autonomic
point
Bronchi __+-_
PointZero
ShenMen
Antihistamine
Adrenal Gland.C
Figure9.16 Lung and respiratory disorders treatmentprotocols.
302
9.15 Gastrointestinal and digestive disorders (Figure9.17)
9.15.1 Abdominal distension
Primary: Stomach, Small Intestines, LargeIntestines, Abdomen, PelvicGirdle, Ascites.
Supplemental: Solar plexus, PointZero, Shen Men, SympatheticAutonomicpoint, SanJiao.
9.15.2 Colitis, enteritis
Primary: Small I ntestines, Large I ntestines, Point Zero, Shen Men, SympatheticAutonomic
point, Stomach.
Supplemental: Rectum.C, Shen Men, Spleen.C, Occiput.
9.15.3 Constipation
Primary: Constipation,LargeI ntestines, Rectum.C, Rectum.E, Omega 1,Abdomen.
Supplemental: Thalamuspoint,SanJiao, Stomach, Spleen.C, SympatheticAutonomicpoint.
9.15.4 Diarrhea
Primary: Small Intestines, LargeIntestines, PointZero, Shen Men, SympatheticAutonomicpoint.
Supplemental: Rectum.C, Rectum.E, Omega 1,Spleen.C, Kidney.C, Occiput.
9.15.5 Dysentery
Primary: Small Intestines, LargeIntestines, Rectum.C, Shen Men, SympatheticAutonomicpoint.
Supplemental: Endocrinepoint, Lung1, Lung2, Occiput, Adrenal Gland.C,Kidney.C, Spleen.C,
Vitalitypoint.
9.15.6 Flatulence, ascites
Primary: Ascites, LargeI ntestines, Small I ntestines, Abdomen, SympatheticAutonomicpoint,
SanJiao.
9.15.7 Fecal incontinence
Primary: Rectum.C, Rectum.E, LargeI ntestines, Shen Men.
9.15.8 Gastritis, gastric spasm
Primary: Stomach, Abdomen, Point Zero, Shen Men, SympatheticAutonomic point, Spleen.C.
Supplemental: LargeI ntestines, Liver, Lung1,Lung2, Lesser Occipital nerve.
9.15.9 Hemorrhoids
Primary: Hemorrhoids.C1, Hemorrhoids.C2, Rectum.C, Rectum.E, LargeI ntestines, Spleen.C,
Thalamuspoint, PointZero, Shen Men, Adrenal Gland.C.
9.15.10 Indigestion
Primary: Stomach, CardiacOrifice, Small I ntestines, SympatheticAutonomicpoint, Pancreas,
Spleen.C, Shen Men, PointZero, Omega 1,LargeI ntestines, Abdomen, SanJiao, Liver, Occiput.
9.15.11 Irritable bowel syndrome
Primary: Small I ntestines, LargeI ntestines, Rectum.C, Rectum.E, Abdomen, Omega 1,
Constipation,Point Zero, Shen Men, Stomach.
Supplemental: SympatheticAutonomicpoint, Pancreas,Occiput, SanJiao.
9.15.12 Nausea, vomiting
Primary: Stomach, Esophagus, Omega 1,Point Zero, Shen Men, SympatheticAutonomic point,
Thalamuspoint, Occiput.
9.15.13 Stomach ulcer, duodenal ulcer
Primary: Stomach, Duodenum,Small I ntestines, Abdomen, Shen Men, SympatheticAutonomic
point, Point Zero.
Supplemental: Psychosomatic Reactions1,Thalamuspoint, Master Cerebral, Aggressivity,
Occiput, Spleen.C, Lung1,Lung2.
Stomach ulcer or duodenal ulcer I rritablebowel syndrome and colitis

Shen Men
Psychosomatic
Reactions 1
o
Sympathetic
Autonomic
point
Small
Intestines
Duodenum
Point Zero
Stomach
Lung1
Lung2
Aggressivity __
Master ---r\ J
Cerebral
Constipation
Sympathetic
Autonomic
point
San Jiao
Sympathetic
Autonomic
point
Abdomen
Rectum.C
Rectum.E
Omegi!J
Small
Intestines
San Jiao
Thalamus point
Hemorrhoids.C2
Constipation
Shen Men
Larg
Intestines
Abdomen
").-+o......-f-;-
a---+--+---jr Pancreas
Point Zero
Stomach
Occiput
Hemorrhoids
Shen Men
Figure 9.17 Gastrointestinal and digestive disorders treatmentprotocols.
304
9.16 Kidney and urinarydisorders (Figure9.18)
9.16.1 Antidiuresis, waterimbaLance
Primary: Bladder, Kidney.C, Kidney.E, SanJiao, Posterior Pituitary,Occiput.
Supplemental: Point Zero, Shen Men, SympatheticAutonomicpoint, Heart.C,Spleen.C,
Spleen.E, Adrenal Gland.C,Adrenal Gland.E.
9.16.2 Bedwetting
Primary: Bladder,Kidney.C, Kidney.E, Urethra.C,Urethra.E,Occiput, Excitement, Shen Men.
Supplemental: PointZero, Thalamuspoint, Brain, Hypogastricnerve, Spleen.C, Liver, SanJiao.
9.16.3 BLadder controL probLems
Primary: Bladder,Kidney.C, Kidney.E, Urethra.C,Urethra.E,Ovariesor Testes.C, Ovariesor
Testes.E, Brain, Thalamuspoint, Shen Men, Point Zero, Spleen.C, Liver.
9.16.4 Diabetes insipidus
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Urethra.E,Thirstpoint, Brain, Posterior
Pituitary,SympatheticAutonomicpoint,Adrenal Gland.C,Adrenal Gland.E,Spleen.E.
Supplemental: PointZero, Shen Men, Endocrinepoint, Spleen.C, Liver.
9.16.5 Frequent urination, urination probLems
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Urethra.E,Excitement point, Thalamus
point.
Supplemental: Endocrinepoint, PointZero, Shen Men, Adrenal Gland.C,Adrenal Gland.E.
9.16.6 Kidney pyelitis
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Urethra.E,Point Zero, Shen Men, Thalamus
point, Adrenal Gland.C,Adrenal Gland.E,Spleen.C, Liver.
9.16.7 Kidney stones
Primary: Kidney.C, Kidney.E, Ureter.C, Ureter.E, Bladder,Point Zero, Shen Men, Sympathetic
Autonomic point, Thalamuspoint.
9.16.8 Nephritis
Primary: Nephritispoint, Kidney.C, Kidney.E, Bladder,Occiput, Endocrinepoint, Sympathetic
Autonomic point,Adrenal Gland.C,Adrenal Gland.E,Spleen.C, Liver.
Supplemental: Shen Men, PointZero, Spleen.E, Thalamuspoint.
9.16.9 Uresiestesis
Primary: Urethra.C,Urethra.E,Bladder, Kidney.C, Kidney.E, Shen Men, SympatheticAutonomic
point,Thalamuspoint,External Genitals.C, External Genitals.E.
9.16.10 Urinary disorders
Primary: Kidney.C, Kidney.E, Bladder, Ureter.C, Ureter.E, Urethra.C,Urethra.E,Sympathetic
Autonomic point, Shen Men, Occiput.
Supplemental: External Genitals.C, External Genitals.E,Adrenal Gland.C,Adrenal Gland.E.
9.16.11 Urinary incontinence, urinary retention
Primary: Kidney.C, Kidney.E, Bladder,Urethra.C,Urethra.E,Ureter.C, Ureter.E, Endocrine
point, External Genitals.C, External Genitals.E, SanJiao.
9.16.12 Urinary infection, cystitis
Primary: Bladder, Urethra.C,Urethra.E,Ureter.C,Ureter.E,Kidney.C, Kidney.E, Shen Men,
Occiput.
Supplemental: Point Zero, SympatheticAutonomicpoint,Adrenal Gland.C,Adrenal Gland.E.
ShenMen
Kidney.E
Ureter.E
Sympathetic
Autonomic
point
External
Genitals.C
Urethra.E
Urethra.C
External
Genitals.E
PointZero
Adrenal
Gland.C
Thalamus
point
Urinarydisorders
Adrenal
Gland.E
Thalamuspoint
Kidneystones
Bladder
ShenMen
Ureter.C
Adrenal
Gland.E
Spleen.C
Occiput
Thalamuspoint
r----t--+---I---- Liver
Nephritis
Endocrine
point
Adrenal
Gland.E
Bladder
Spleen.E
PointZero
. .,---j.--.,.I ---,f.-- Liver
Diabetesinsipidus
Bladder ShenMen
KidneYi Kidney
Sympathetic
Autonomic
point
KidneYI-
Posterior
---
Pituitary
Endocrine
point
Adrenal --4-_,
Gland.C
ShenMen
PointZero
- - - - f - - - ~ ~
Thirstpoint ----I -(
Sympathetic
Autonomic
point
Urethra.E
Urethra.C _ - - - . . ~ _ ~
Figure9.18 Kidneyand urinary disorders treatmentprotocols.
306
9.17 Abdominal organ disorders (Figure9.19)
9.17.1 Appendicitis
Primary: Appendix, Appendix Disorder 1,Appendix Disorder2, Appendix Disorder3, Large
I ntestines, SympatheticAutonomicpoint.
Supplemental: Abdomen, SanJiao, Point Zero, Shen Men, Thalamuspoint.
9.17.2 Cirrhosis
Primary: Hepatitis,Liver, Liver Yang1, Liver Yang2, SympatheticAutonomicpoint,Spleen.C,
ShenMen.
Supplemental: Gall Bladder,Stomach, Ovariesor Testes.C, Ovariesor Testes.E.
9.17.3 Diabetes mellitus
Primary: Pancreas,Pancreatitis,Brain, SanJiao, AppetiteControl, PointZero, ShenMen,
Endocrinepoint, Liver, Spleen.C.
9.17.4 Edema
Primary: Kidney.C, Kidney.E, Bladder,Heart.C,Liver, SympatheticAutonomicpoint,
Endocrinepoint.
9.17.5 Gall stones, gall bladder inflammation
Primary: Gall Bladder,Endocrinepoint,Point Zero, Shen Men, SympatheticAutonomicpoint,
Liver, Lung1,Lung2,SanJiao.
9.17.6 Hepatitis
Primary: Hepatitis1,Liver, Liver Yang1,Liver Yang2, Point Zero, Shen Men, Thalamuspoint,
SympatheticAutonomicpoint,Abdomen, SanJiao, Adrenal Gland.C.
Supplemental: Endocrinepoint, Kidney.C, Gall Bladder,Stomach.
9.17.7 Hernia
Primary: Abdomen, LargeI ntestines, Prostate.C, Prostate.E,Point Zero, Shen Men, Endocrine
point,Thalamuspoint,Spleen.C.
9.17.8 Hypoglycemia
Primary: Pancreas, Stomach, SympatheticAutonomicpoint, Thalamuspoint, Adrenal Gland.C,
Kidney.C, Kidney.E, Liver, PointZero, Shen Men, Heart.C,Spleen.C, Spleen.E.
9.17.9 Jaundice
Primary: Hepatitis,Liver, Liver Yang1, Liver Yang2, SympatheticAutonomicpoint,Spleen.C.
Supplemental: Gall Bladder,Stomach, Ovariesor Testes.C, Ovariesor Testes.E.
9.17.10 Liver dysfunction
Primary: Liver, Liver Yang1,Liver Yang2, SympatheticAutonomicpoint, Endocrinepoint,
Adrenal Gland.C.
Supplemental: PointZero, Shen Men, Spleen.C, Spleen.E, Kidney.C, Kidney.E, Gall Bladder,
Stomach, Ovariesor Testes.C, Ovariesor Testes.E.
9.17.11 Pancreatitis
Primary: Pancreas,Pancreatitis,PointZero, Shen Men, Endocrinepoint,Sympathetic
Autonomic point.
Abdomen
Appendix
Disorder1
Appendix
Disorder 3
Thalamus
point
I ."f--+- Appendix
Disorder2
Appendicitis
San[iao
Endocrine
point
Sympathetic
Autonomic
point

Intestines
Appendix
Kidney.C
PointZero
_.J .----Adrenal
Gland.C
Hepatitisandliver dysfunction
Hepatitis1
ShenMen
Stomach
Liver
Yang1.
Abdomen
Gall -\ ---1---4--4_
Bladder
Thalamus
point
Gallstones andgall bladder inflammation Diabetesmellitusandpancreatitis
GallBladder
Liver
ShenMen
Sympathetic
Autonomic
point
PointZero
Appetite
Control
SanJiao
Endocrine
point
Pancreas
Y\ ----iH--.f----I - Pancreatitis

---1--1--.,1- Liver
Spleen.C
Brain
Figure9.19 Abdominal organ disorders treatment protocols.
308
9.18 Gynecological andmenstrual disorders (Figure9.20)
9.18.1 Breasttenderness
Primary: MammaryGland.C,MammaryGland.E,Chest, Endocrinepoint, Shen Men, Thalamus
point.
Supplemental: PointZero, Adrenal Gland.C,Adrenal Gland.E,Brain, Occiput.
9.18.2 Breast tumor, ovarian cancer
Primary: MammaryGland.C,MammaryGland.E,Chest, Ovary.C, Ovary.E, Shen Men.
Supplemental: PointZero, Endocrinepoint,Thalamuspoint,ThymusGland.E,Vitalitypoint.
9.18.3 Dysmenorrhea, irregular menstruation
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Abdomen, Endocrinepoint, External
Genitals.C, External Genitals.E, Prostaglandin1, Prostaglandin2.
Supplemental: PointZero, Shen Men, SympatheticAutonomicpoint, Thalamuspoint,Adrenal
Gland.C,Brain, Kidney.C.
9.18.4 Endometriosis
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Shen Men, Endocrinepoint, PointZero,
Abdomen, Adrenal Gland.C,Adrenal Gland.E.
9.18.5 Infertility
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Point Zero, Shen Men, External Genitals.C,
External Genitals.E, Endocrinepoint,Adrenal Gland.C,Kidney.C, Abdomen, Brain.
9.18.6 Inflammation of uterine lining, uterine prolapse
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Gonadotropins,PelvicGirdle,Endocrinepoint.
Supplemental: External Genitals.C, External Genitals.E, Lung1,Lung2.
9.18.7 Labor induction
Primary: Uterus.C, Uterus.E, Abdomen, PointZero, Shen Men, SympatheticAutonomic point,
Thalamuspoint, LumbarSpine, Spleen.C, Spleen.E.
9.18.8 Lactation stimulation
Primary: Prolactin,MammaryGland.C,MammaryGland.E,Endocrinepoint,Spleen.C,
Kidney.C.
9.18.9 Mammary gland swelling
Primary: MammaryGland.C,MammaryGland.E,Chest, Endocrinepoint,Adrenal Gland.C.
9.18.10 Menopause
Primary: Ovary.C, Ovary.E, Uterus.C, Uterus.E, Endocrinepoint,Shen Men, Kidney.C, Liver.
9.18.11 Postpartum pain
Primary: Uterus.C, Uterus.E, Abdomen, External Genitals.C, External Genitals.E, Point Zero,
Shen Men, SympatheticAutonomicpoint, Thalamuspoint, LumbarSpine, Spleen.C.
9.18.12 Premenstrual syndrome
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Endocrinepoint, Shen Men.
Supplemental: Point Zero, SympatheticAutonomic point,Thalamuspoint,Adrenal Gland.C,
Brain, Kidney.C, Abdomen.
9.18.13 Vaginismus
Primary: Vagina, Ovary.C, Ovary.E, Point Zero, Shen Men, Endocrinepoint.
Supplemental: Adrenal Gland.C,Lung1,Lung2, Brain, Occiput, Kidney.C, Abdomen.
Shen Men
Thalamus point
Premenstrual syndrome
Uterus.C
Endocrine
point
Point Zero
Thalamus
point
Adrenal
Gland.C
Uterus .E
Endocrine __
point
__ ....
External
Genitals.E
Dysmenorrhea. irregular menstruation
o Prostaglandin 2
Uterus .C Shen Men
Sympathetic
Autonomic
point
External
Genitals.C
Breast tumor. ovarian cancer I nfertility
Mammary
Gland.C
Shen Men
Brain
Endocrine
point
Uterus.C
External
Genitals.C
Mammary
Gland.E
Thalamus
point
Thymus
Gland.E

Vitality
!oint
PointZero
Shen Men
Endocrine
point
Figure 9.20 Gynecological and menstrual disorders treatment protocols.
310
9.19 Glandular disorders andsexual dysfunctions (Figure9.21)
9.19.1 Calcium metabolism
Primary: ParathyroidGland,Parathormone,Endocrinepoint,ShenMen.
9.19.2 Dwarfism
Primary: Anterior Pituitary,Kidney.C, Kidney.E, PointZero, Shen Men, Endocrinepoint.
Supplemental: Ovariesor Testes.C, Ovariesor Testes.E, Brain.
9.19.3 Goiter
Primary: ThyroidGland.C,ThyroidGland.E,Thyrotropin,Point Zero, Shen Men, Endocrine
point.
9.19.4 Hypergonadism, hypogonadism
Primary: Ovariesor Testes.C, Ovaryor Testes.E, PointZero, Shen Men, Endocrinepoint, Brain.
9.19.5 Hyperthyroidism, hypothyroidism
Primary: ThyroidGland.C,ThyroidGland.E,Thyrotropin,Point Zero, Shen Men, Endocrine
point, Brain, Master Oscillation,Apex of Ear.
9.19.6 Impotency, frigidity, lacking sexual desire
Primary: Sexual Desire, External Genitals.C,External Genitals.E, Ovariesor Testes.C, Ovaries
or Testes.E, Uterus.C, Uterus.E, Point Zero, Excitement point.
Supplemental: ShenMen, Brain,SympatheticAutonomicpoint,Endocrinepoint, Master
Oscillation,Master Cerebral,Kidney.C, PelvicGirdle, Forehead.
9.19.7 Premature ejaculation
Primary: Sexual Compulsion, Testes.C, Testes.E, External Genitals.C, External Genitals.E,
Thalamuspoint.
Supplemental: Shen Men, Point Zero, Endocrinepoint.
9.19.8 Prostatitis
Primary: Prostate.C,Prostate.E,Testes.C, Testes.E, PelvicGirdle,ShenMen, Endocrinepoint.
Supplemental: PointZero, Adrenal Gland.C,Bladder,Occiput, SkinDisorder.C,Skin
Disorder.E.
9.19.9 Scrotal rash
Primary: External Genitals.C, External Genitals.E,SkinDisorder.C,SkinDisorder.E, Master
Sensorial.
9.19.10 Sexual compulsion
Primary: Sexual Compulsion, Aggressivity, Excitement point, Ovariesor Testes.C, Ovariesor
Testes.E, Point Zero, Shen Men, Tranquilizerpoint, Master Cerebral,Thalamuspoint.
9.19.11 Testitis
Primary: Testes.C, Testes.E, External Genitals.C, External Genitals.E, PelvicGirdle,Shen Men.
Supplemental: Prostate.C,Prostate.E, Point Zero, Endocrinepoint,Adrenal Gland.C,Hip.C,
Hip.E, Occiput, Liver.
Ovariesor
Testes.C
Endocrine
point
External
Genitals.C
Brain
Ovariesor
Testes.C
Impotency, frigidity, lackingsexual desire Prostatitisandtestitis
Bladder ShenMen
Prostate.C
Uterus.C
External
Genitals.C
Sympathetic
Autonomic
point
Uterus.E
External
Genitals.E
Sexual
Desire
Master
Oscillation
Excitement
point
Endocrine
point
MasterCerebral
Sexual compulsion, prematureejaculation Hyperthyroidism, hypothyroidism
External
Genitals.C
Ovariesor
Testes.C

Genitals.E
Tranquilizer
point
Excitement
point
Endocrine
point
Master
Cerebral
Apex of Ear
ShenMen
PointZero
Thalamuspoint
Ovariesor
Testes.C

Brain
Figure9.21 Glandulardisorders and sexualdysfunctionstreatmentprotocols.
312
9.20 Illnesses, inflammationsandallergies (Figure9.22)
9.20.1 AIDS, HIVdisease
Primary: Thymus Gland,Vitalitypoint,Spleen.C, Spleen.E, Point Zero, Shen Men, Endocrine
point, Thalamuspoint, SympatheticAutonomicpoint, Heart.C,Occiput, ThyroidGland.E.
9.20.2 Allergies
Primary: Apex of Ear, Allergy point, Omega2, I nnerNose, Asthma, Antihistamine,Thymus
Gland,Point Zero, Shen Men, SympatheticAutonomicpoint, Endocrinepoint.
Supplemental: Adrenal Gland.C,ThyroidGland.C,ThyroidGland.E,Kidney.C,
SanJiao, Lung1,Lung2, Brain,Spleen.C, Spleen.E.
9.20.3 Anaphylaxis hypersensitivity
Primary: Asthma, Lung1,Lung2, LargeI ntestines, ThymusGland,Shen Men, Endocrinepoint,
Thalamuspoint,Adrenal Gland.C,Adrenal Gland.E.
9.20.4 Antiinflammatory
Primary: Apex of Ear, Allergy point, Omega2, Occiput, Point Zero, Shen Men, Sympathetic
Autonomicpoint,Thalamuspoint, Adrenal Gland.C,Adrenal Gland.E.
9.20.5 Antipyretic
Primary: Apex of Ear, Omega2, Liver, Large I ntestines, Adrenal Gland.C,Shen Men.
9.20.6 Cancer
Primary: Correspondingbodyarea, ThymusGland,Vitalitypoint, Heart.C,Point Zero, Shen
Men, ThyroidGland.E.
9.20.7 Chicken pox
Primary: Lung1, Lung2, Point Zero, Shen Men, Endocrinepoint, Adrenal Gland.C,Occiput.
9.20.8 Common cold
Primary: I nnerNose, Throat.C,Throat.E,Forehead, Lung1, Lung2,Asthma, Antihistamine,
Prostaglandin1, Prostaglandin2,Apex of Ear.
Supplemental: PointZero, Shen Men, Adrenal Gland.C,Adrenal Gland.E,Occiput, Thalamus
point, ThyroidGland.C,ThyroidGland.E.
9.20.9 Fever
Primary: Vitalitypoint, Occiput, Point Zero, Shen Men, Thalamuspoint,
Endocrinepoint, Adrenal Gland.C,ACTH, Apex of Ear,Omega2, Prostaglandin1,
Prostaglandin2.
9.20.10 Influenza
Primary: Forehead, Lung1,Lung2, PointZero, Shen Men, Adrenal Gland.C,ThymusGland,
Apex of Ear.
Supplemental: Apex of Tragus, Helix1, Helix2, Helix3, Helix4, Helix5, Helix6, Omega2,
Prostaglandin1,Prostaglandin2.
9.20.11 Lowwhiteblood cells
Primary: Liver, Spleen.C, Heart.C,Kidney.C, Adrenal Gland.C,Endocrinepoint, Shen Men.
Supplemental: Diaphragm,Occiput, SympatheticAutonomicpoint, Vitalitypoint.
9.20.12 Malaria
Primary: Thalamuspoint, Endocrinepoint,Adrenal Gland.C,Liver, LargeI ntestines, Spleen.C.
9.20.13 Mumps
Primary: Face, SalivaryGland.C,SalivaryGland.E,Thalamuspoint, Endocrinepoint.
9.20.14 Weather changes
Primary: Weather point, PointZero, Shen Men.
Apex of Ear
Common cold
o Prostaglandin 2
Apex of Ear
I nfluenza
o Prostaglandin 2
Antihistamine
Point Zero
Throat.E
Throat.C
Inner Nose __---H.
Adrenal
Gland.C
Asthma
Forehead
Shen Men
Adrenal
Gland.E
Thyroid
Gland.E
LungJ
Thyroid
Gland.C
Lungl
Occiput
Thalamus point
Point Zero
Adrenal
Gland.C
Apex of

Forehead
Shen Men
Helix 1
Thymus
Gland
Helix 2
LungJ
I r-r--Helix 3
Helix4
Helix6
Allergies
Apex of Ear
AIDS, HI Vdisease, and cancer
Shen Men
Thalamus point
Thyroid
Gland.E
Th)mus
Gland
Spleen.E

Heart.C
Endocrine
point
Spleen.C
Thyroid
Gland.C
Asthma
Brain
Allergy point
Shen Men
Kidney.C
Sympathetic
Autonomic
point
Adrenal
Gland.C
Lung 1
Lung 2
Point Zero
San [lao
Endocrine
point

Antihistamine
Sympathetic
Autonomic
point
Figure 9.22 Illnesses, inflammations and allergies treatment protocols.
Wrist
Arm
Elbow
Master
Shoulder
Fingers
Hand
TMJ
Lower Jaw
Upper Jaw
Inner Ear.C
Face
Chest
__--1-_ Shoulder
.......,._l-_Neck
Nogier Phase I andChinese ear points
Toes.C
Knee.C
Hip.Fl
Ankle.Fl
Knee.Fl
Heel.Fl
Eye
Cervical Spine.Fl__-1-_
Occiput
Temples --+-+..,..".4
Forehead __ :, j
Eye Disorder 1
Eye Disorder 2
Sacral Spine.Fll--l
Lumbar Spine.Fl
Thoracic Spine.Fl __---P_-
External Ear.C
Nogier Phase 11/ andChinese ear points
Foot.F3
Cervical
Spine.F3
External
Genitals.C
Diaphragm.C
External
Genitals.E
Lumbar
Spine.F3
Thoracic
Spine.F3
Nogier Phase" and11/ ear points Nogier Phase IVear points
Hip.F2
Hand.F3
f------l.........I -1-Cervical
Spine.F2
"----j.+-I --J -._ Foot.F2
Ankle.F2
Shoulder.F3
Fingers.F4
Wrist.F4
Elbow.F4_-,-_
Shoulder.F4
Foot.F4
Knee.F4
Lumbar
Spine.F4
Hip.F4
Thoracic
Spine.F4
Cervical
Spine.F4
Head.F4
Figure 9.23 Earpoints and correspondingbodyareas.

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'Terry Oleson1996, 1998

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