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First edition 1996
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Third edition 2003
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Foreword
I have known Dr Terry Oleson for a number of years and I am very pleased to have
been asked to write some lines of introduction for the third edition of the
Auriculotherapy Manual: Chinese and Western Systems ofEar Acupuncture. I have very
high regard for the advanced level of information contained in this book. Dr Oleson
states extremely well that there are two very differen t approaches to understand about
auriculotherapy. One approach is Oriental, the ot her one is Occidental. The Oriental
approach calls upon the basic concepts of classical acupuncture. Most prominent are
the concepts of yin and yang. In this East ern approach towards auriculotherapy, the
notion of ’energy’ is omnipresent. The metaphysical view of the world and of man is the
primary focus, even more prominent than the doctrines of physiology and anatomy.
The Western approach towards auriculotherapy, t hat which Paul Nogier first proposed,
rests upon the scientific method of observations, and the repetition of such
observations. It is also grounded upon the basic foundations of anatomy and
physiology. In the Western approach, there is no notion of energy and no metaphysical
philosophy t hat underlies this technique. In fact, without going into details, the
external ear has particular diagnostic and t reat ment properties because of its
innervation and because of the presence of neuro- vascular complexes. These
complexes are small, actual entities consisting of micro- hormones dispersed under the
skin of the external ear.
There are actually twojuxtaposed somatotopic systems which explain auriculotherapy
as it is practiced today in Europe. The first system is based on nervous fibers distributed
throughout the auricle and is purely a reflex. It is with this system t hat one uses
auriculotherapy to alleviate pain. The second system rests upon the existence of the
neuro- vascular complexes discovered by the t eam of Pr Senelar: Odile Auziech,
Claudie Terral. On the external ear, there exist cutaneous points of reduced electrical
resistance t hat correspond to histological microformations made up of a nerve, a
lymphatic vessel, a small artery, and a veinule. It is these microformations that are
called neuro-vascular-complexes. Stimulation of these complexes by infra red light
modifies the temperature and the thermal regulation of internal body organs, thus
modifying their function.
Schematically, the external ear is like a computer keyboard which acts on the whole
organism through the intermediary of the central nervous system and the auricular
micro- hormonal system. This auricular system has two types of comput er keys, one set
connected to the spinothalamic system that modulates pain perception and anot her set
which initiates the release of active hormonal substances which modify specific internal
organs. When looking at the ear, one will obtain a different effect if a needle is used, or
a laser light, or a magnetic field. As with everything in medicine, great skill is required
to master this technique. The computer keyboard on the ear allows clinicians to
effectively t reat pain, functional disorders, addictive problems, and minor psychiatric
disorders.
It is well known that Paul Nogier, my father, discovered the somatotopic properties of
the external ear. There are just a few fortunate people who not only dream, but who are
able to carry out their dreams and bring them into reality. Paul Nogier was at the same
time a man of innovativethoughts and a man of productive action. He was a gifted
clinician of exceptional abilities who attentively listened to his patients, respected what
they had to say, and thoroughly investigated their maladies. Tirelessly, he examined
patients from Monday morning to Saturday evening, trying to understand and to cure
their illnesses. One cannot understand the work of Paul Nogier without knowing his
character. He was a man who spent much of his time proposing sometimes
contradictory new ideas, the majority of which fell by the wayside. Nevertheless, his
most original ideas remain: the somatotopic representations on the ear, the vascular
autonomic signal, and the treatment effect of specific frequencies. It isfor these
discoveries that many students followed him so devotedly. At the same time,
confronted with so much apparent inconstancy, much of the teaching by this great
master was not understood or fell out of favor.
Foreword ix
This third edition of the Auriculotherapy Manual strives to bring closer t oget her
Western neurophysiological concepts and Oriental energetic concepts as they relate to
auriculotherapy. Dr Oleson lives in a state in the USA which also assimilates Western
and Eastern cultures. Perhaps only in California could one be able to do the work t hat
he has done. In the third edition of this book, the origins of auriculotherapy are traced
to historical sources in the West as well as China. The use of acupuncture points on the
external ear has had a long tradition in Oriental medicine, which expanded in a
different direction with the introduction of the somatotopic ear charts developed by
Paul Nogier. At the same time, interest in auricular medicine brought great er attention
to the practice of classical acupuncture in Europe.
This book explores a broad range of theoretical perspectives that have been developed
to understand the underlying bases of auriculotherapy. The somatotopic features of
multiple micro- acupuncture systems, the relationship of ear acupuncture to ot her
concepts in Oriental medicine, and holographic models are all described in a
comprehensive manner. Neurophysiological investigations of auricular acupuncture,
and the role of hormonal substances such as endorphins, are substantiated with
numerous scientific studies. Artistic illustrations revealing the anatomical regions of
the external ear facilitate great er comprehension of the correspondences between the
ear and the body. The auricular zone system developed by Dr Oleson provides
clinically useful reference guidelines for conducting auricular diagnosis and
auriculotherapy treatments. The predominant portion of this book presents several
hundred ear acupuncture points organiz ed by major anatomical systems. Auricular
representation of the musculoskeletal system, visceral organs, endocrine glands, and
the nervous system are differentiated by their anatomical location and clinical
function.
The t reat ment plans present ed at the end of this book integrate ear acupuncture points
discovered in the West as well as in China. In European applications of auricular
medicine, great er emphasis is placed upon palpation of the vascular autonomic signal
to determine the reactivity of an ear point and its appropriateness for treatment. This
book is a very import ant contribution to the field of health care in the West and the
East. DrOleson’s work is significant. Even if I ardently defend the Western
conceptualiz ations of auricular acupuncture based upon the ear’s unique physiology, I
wish t hat his hook meets the success which it well deserves,
x
Lyon, July 2003
Foreword
Raphael Nogicr MD
Preface
When one has been on ajourney for almost three decades, it is not uncommon to
wonder how the journey first began. For me, the exploration of the fascinating field of
aurieulotherapy started with an afternoon lecture I heard while completing my
graduate studies at the University of California at Irvine (UCI). The presentation itself
had nothing to do eit her with acupuncture or the external ear, but it stimulated my
mind to be drawn to a path that continues to excite me still. The UCI Depart ment of
Psychobiology sponsored aweekly guest lecturer series that brought in visitingfaculty
from all over the Unit ed States, but t hat day’s present er was from our neighboring
California campus at UCLA. Dr John Liebeskind mesmeriz ed me with his pioneering
research on a concept that, in 1972, was completely new to the field of neuroscience.
His laboratory had demonstrated t hat electrical stimulation of the periaqueductal gray
of the brainstem could inhibit behavioral reflexes to painful stimuli. While the sensory
pathways that carry pain messages to the brain had been thoroughly investigated, the
laboratory of Dr Liebeskind provided the first scientific indication t hat the brain has
the capability to turn off pain as well as respond to pain. It was several years later t hat
subsequent studies would discover endorphins, the morphine- like substances that
serve as the body’s naturally occurring analgesic. What had made the Liebeskind
research so impressive was t hat the analgesia produced by electrical stimulation could
be blocked by the chemical antagonist to morphine known as naloxone. I wrote to
Dr Liebeskind after the lecture, met with him at UCLA, and soon submitted an
application for afederally funded postdoctoral scholarship working in his laboratory. As
my doctoral dissertation examined the firing patterns of neurons in the somatosensory
and auditory pathways during Pavlovian conditioning, my postdoctoral grant sought to
examine neural firing pat t erns in the brain pathways related to the inhibition of pain
sensations.
In Jungian psychology there is the concept of synchronicity, a meaningful coincidence
of separate events t hat do not seem causally connected (Jung 1964). Jung himself
not ed that the classical Chinese texts did not ask, What causes an event?, but instead,
What likes to occur with what?Too often, individuals fail to notice such synchronistic
events, dismissing them as random coincidences. I can often observe such events only
in retrospect. I began my work in Dr Liebeskind’s lab after receiving my PhD in
Psychobiology in 1973. It so happened t hat the neuroscience laboratories at the UCLA
Depart ment of Psychology were in the basement of an l l- story building. After a walk
down a long underground hallway one arrived at the UCLA Acupuncture Research
Clinic. What first drew me to t hat end of the building was a strange smell which seemed
like marijuana, but in fact was the Chinese herb moxa. While I conducted animal
research experiments during the day, I began spending more of my free time hours
interacting with the doctors investigating the effects of acupuncture. In 1974, UCLA
was one of only a few, major US universities to explore the multiple dimensions of
alternativemedicine. The UCLA pain clinic successfully t reat ed hundreds of chronic
pain patients with acupuncture, biofeedback, hypnosis, guided imagery and nutritional
counseling. The directors of the clinic, Dr David Bresler and Dr Richard Kroening,
invited me to their offices one afternoon and asked me to be their research director. It
was like an invisible force pushed me from behind as I leaped at the opportunity. I did
not have any acupuncture skills, but as a psychologist I had extensive trainingin
conducting research. And thus began the amazing journey.
The first research project t hat we undert ook was to examine auricular diagnosis, rat her
than conduct a clinical outcome study. At that time, the medical profession devalued
acupuncture as simply a placebo, but a diagnostic study could not be contaminated by a
patient’s desire to please their practitioner. It took several years to design the research
and collect the data, but there was an energizing atmosphere affecting everyone
participating in the clinic that made it a great pleasure to work there. I was surprised
myself when the results were finally analyzed and there was such a strong statistical
finding. By just examining the external ear, and blind to a patient’s diagnosis, a
physician could identify the parts of the body where a patient had report ed
musculoskeletal pain. While I was initially only a scientific observer of such
Preface xi
phenomena, I subsequently took numerous classes and seminars in auriculotherapy
and body acupuncture. There were not many US acupunct ure schools at that time, but
there were plenty of teachers. While mostly unknown in the white, black and Hispanic
parts of Los Angeles, t here were a large number of practitioners of Orient al medicine
in the Asian districts. They were very willing to share their knowledge of their ancient
and almost mystical arts. It was only aft er I present ed the results of the auricular
diagnosis research to the International Society for the Study of Pain t hat I learned of
the whole field of auricular medicine t hat is practiced in Europe. American doctors
prefer the electrical detection and t reat ment of acupunct ure points more than Asian
doctors, and several electronic equipment manufacturers sponsored seminars that
incorporated the work of European as well as Chinese acupuncturists. I had read about
the pioneering auriculotherapy work of DrPaul Nogier, but I began studying with
physicians who had actually studied with him in France. Dr Tsun-Nin Lee sponsored a
presentation by Nogier in San Francisco, and it was t hen t hat I first had the opportunity
to meet this great man. Dr Nogier only spoke in French, so DrJoseph Helms had to
translate the material into English. It is not always easy to listen to lectures as they are
translated, but DrNogier held the audience enthralled. He had read of my research on
auricular diagnosis and made a special invitation to meet with me, which I was very
glad to accept. I had t hree more opportunities to meet with him personally at
international congresses in Europe, and it always seemed like an honor. I always
wished that I had more time to upgrade my high school French so that I could converse
with him more fluently, but it is very intriguingthat a meeting of minds can occur
beyond one’s linguistic abilities. I feel very fortunate to have received individual
guidance on understanding the underlying mechanisms t hat can account for the
impressive benefits of auriculotherapy.
Dr Richard Kroening had once told me that in medical school, when learning a new
medical procedure, the mot t o is see one, do one, teach one. While not progressing
quite t hat fast, I have now had the occasion to teach courses in auriculotherapy at
colleges and universities across the Unit ed States. The adage that one learns from
one’s students continues to apply even aft er 20 years of teaching. Students come to me
and inform me of patients they have t reat ed with auriculotherapy for unusual
conditions that I have only studied in books. While they tell me that they learned how
to do such treatments from earlier editions of my Auriculotherapy Manual, the clinical
contents of this manual did not begin with me. The works of many acupunct ure masters
in Asia, Europe, and America inspired me to compile t heir teachings in a meaningful
way. I also had the good fortune to connect with DrJim Shores who co- sponsored the
International Consensus Conference on Acupuncture, Auriculotherapy, and Auricular
Medicine in 1999. It was my continued efforts to underst and this unusual clinical
procedure that has led to this most recent edition. That stimulation of the external ear
can affect conditions in ot her parts of the body does not seem intuitively obvious. Even
after treatinghundreds of patients with this approach, it continues to amaz e me that it
can work. The purpose of this book is to explain both the theoretical basis and the
clinical practice of auriculotherapy so t hat ot hers may know of its value.
I would like to acknowledge Tim McCracken, Jan James, and Sinuhe Albert o Avalos
for their invaluable assistance in producing this book. I want to also t hank Danny Watts
for his willingness to serve as the model for the human figures used in this book.
xii
Los Angeles 2003
Preface
Terry Oleson
Auricular microsystem points
Master points and landmarks
Musculoskeletal points
Ankle.C Toes.C
Chest
Arm
Elbow
Abdomen
Skin Disorder.E
Skin Disorder.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
Eye Disorder 1
Eye Disorder 2
Sacral Spine
l.umbar Spine
Thoracic Spine
External Ear.C- - +- - ...(
Muscle Relaxation
LM7
.Apex of Ear
/ Hepatitis.C
I __= t : ~ __ / Prostate.C
"Sciatic Nerve
Bladder
Kidney.C
/ Lesser Occipital Nerve
(Wind Stream.C)
Adrenal Gland .E
Small Intestines
/ Spinal Cord
Heart.E
Pancreas
Spleen.E
Stomach
- Liv er
Thyroid Gland.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 _____
Large intestines
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/
Pituitary GlancY
TSH/ /
Frontal Cort ex’/
LimbicSyst em/
(Prostaglandin)
.C - Chinese ear reflex point
"E- European ear reflex point
e 2003 Elsevier 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
S 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 Introduction to auriculotherapy
1.2 Health care practitioners using auriculotherapy
1.3 Historical overview of auriculotherapy
1.4 Ear acupuncture developments in China
1.5 Auriculotherapy and auricular medicine in the West
1.6 Comparison of ear acupuncture to body acupuncture
1.1 Introduction to auriculotherapy
Auriculotherapyis a healthcare modalityin which t he external surface of the ear, or auricle, is
stimulatedto alleviate pathological conditionsin ot her part s of the body. While originally based
upon the ancient Chinese practice of acupuncture,t he somatotopiccorrespondenceof specific
parts of the body to specific parts of t he ear was first developed in modern France. It is this
integratedsystem of Chinese and Western practices of auriculotherapyt hat is described in this
text.
1.2 Healthcare practitioners using auriculotherapy
Acupuncturists: The practice of classical acupunctureand TraditionalChinese Medicine (TCM)
includes the insertion of needles into ear acupointsas well as body acupunct urepoints. These two
approachesof stimulatingacupuncturepointson the body or the ear can be used in the same
t reat ment session or in different sessions. Some acupuncturistsstimulateear reflex pointsas the
sole met hod of their acupuncturepractice, often finding t hat it is more rapid in relieving pain and
more effective in treatingsubstance abuse t hanbody acupuncture.
Biofeedback therapists: Whereas biofeedback is very useful in teachingpatients
self-control techniques to achieve general relaxation and stress management , auriculotherapy
augments biofeedback proceduresbyproducingmore direct and immediate relief of myofascial
pain and visceral discomfort.
Chiropractic doctors: Auriculotherapyhas been used to facilitate spinal manipulations,deep
tissue work, and mot or point massage. Stimulationof auricular pointsreduces resistance to the
release of muscle spasms and the correction of posturalpositionsby chiropracticadjustments.
When auriculotherapyis applied after a manipulativet reat ment ,it tends to stabilize postural
realignmentsachieved by a chiropracticprocedure.
Dentists: Auriculotherapyhas been used to achieve dental analgesia for the relief of acute pain
from eit her dental drilling or teeth cleaning procedures. For chronicproblems, such as headaches
and t emporomandibularjoint (TMJ) dysfunction, auriculotherapycan be combinedwith trigger
point injections, dental splints, and occlusal work, thus facilitatingmore successful alleviation of
chronichead and neck pain.
Medical doctors: Physicians specializing in anesthesiology, surgery, internalmedicine, and family
practice have employed auriculotherapyfor the management of chronicpain, the t reat ment of
acute muscle sprains, and the reductionof unwantedside effects from narcoticmedications.
Whet her practiced bythemselves, or by medical assistants working under them, auriculotherapy
has been used to alleviate a variety of somatic complaintsseen in st andardmedical practice.
Nat uropat hic doctors: Naturopathicpractitionersoft en include auriculotherapyalong with
homeopathic, nutritionaland preventive modalities. Auricular diagnosis has been used to
Overviewandhistory 1
2
det erminespecific allergies and appropriat eherbal recommendations.Auricular stimulationcan
relieve distress originatingfrom dysfunctional internal organs.
Nurses: The st andardmedical care provided by nurses can be greatly assisted by t he application
of auriculotherapyfor the systematic relief of pain and pathologyt hat is not adequatelyalleviated
byconventional medicationsor procedures.
Ost eopat hicdoctors: Auriculotherapyhas been used to facilitate the correction of misaligned
vertebrae, to reduce severe muscle spasms, and to augment pain management procedures.
Physical therapists: Auriculotherapyis a powerful adjunct to t ranscut aneouselectrical nerve
stimulation(TENS), traction, ultrasound,and t herapeut icexercises for the t reat ment of acute
whiplash injuries, severe muscle spasms, or chronicback pain.
Psychotherapists: Psychiatrists and psychologists have employed auriculotherapyfor the
reductionof anxiety, depression, insomnia, alcoholism, and substance abuse.
Reflexologists: Tactile manipulationof reflex pointson the ear can be combinedwith pressure
applied to t ender regions of the feet and hands in order to relieve specific body aches and internal
organ disorders.
1.3 Historical overview of auriculotherapy
Ancient China: All recorded systems of classical acupunct ureare at t ribut edto the Chinese
medical text, the YellowEmperor’s classic ofinternal medicine (Veith 1972), compiled between 206
BCE and 220 CEo In this text, all sixyang meridianswere said to be directly connect ed to the
auricle. Only the yang meridian channels travel to or from the head, whereas the sixyin meridians
were said to connect to the ear indirectlyt hrought heir correspondingyang meridians. These
ancient Chinese ear acupunct urepoints, however, were not arranged in an anatomicallyorganized
pattern.They were depicted on the ear as a scattered array of non-meridianpoints, with no
apparent logical order. Reactive ear acupointst hat were t ender to palpat ionwere referred to as
yang alarm points.
Ancient Egypt, Greece and Rome: The Egyptologist Alexandre Varille has document edt hat
women in ancient Egypt who did not want any more children sometimes had t heir external ear
prickedwith a needle or cauterized with heat. Gold earrings worn by Medit erraneansailors were
not just used as decorations, but were said to improve vision. Hippocrates, the ’fat her’of Greek
medicine, report ed that doctors made small openings in the veins behind the ear to facilitate
ejaculation and reduce impotencyproblems. Cuttingof the veins sit uat ed behind the ear was also
used to t reat sciatic pains. The Greek physician Galen int roducedHippocraticmedicine to the
Roman empire in the second centuryCE, and comment edon the healingvalue of blood lettingat
the out er ear.
Ancient Persia: Aft er the fall of Rome, the medical records of Egyptian, Greek, and Roman
medicine were best preserved in ancient Persia. Included in these Persian records were specific
references to medical t reat ment sfor sciatic pain producedbycauterizationof the external ear.
European MiddleAges: The Dutch East India Companyactively engaged in t radewith China
from the 1600sto 1800s.As well as silk, porcelain, tea, and spices, Dut chmerchantsbrought
Chinese acupunct urepractices back to Europe. Doct orsworking with the companyhad become
impressed by the effectiveness of needles and moxa for relieving conditionssuch as sciatic pain and
arthritisof the hip. This pain relief could be obtainedby needles insert ed into body acupoints, by
the cauterizationof the external ear, or by cuttingthe veins behind the ears.
Modern Europe: In 1957, Dr Paul Nogier, a physician residing in Lyons, France, first present ed his
observations of the somatotopiccorrespondencesof t he auricle. Considered the ’Fat herof
Auriculotherapy’,Dr Nogier originated the concept of an inverted fetus map on the external ear.
He developed the propositionafter noticingscars on the ears of pat ient swho had been successfully
t reat ed for sciatic pain by a lay healer. Nogier’s research was first publishedby a German
acupuncturesociety, was t hen circulated to acupuncturistsin Japan, and was ultimatelytranslated
into Chinese, for distributionto acupuncturistst hroughoutChina. The Medical Studies Groupof
Lyons (GLEM) was creat ed to further explore the clinical benefits of auricular medicine.
AuriculotherapyManual
Modern China: Aft er learningabout t he Nogier ear charts in 1958, a massive study was initiated
bythe NanjingArmy Ear Acupuncture Research Team. This Chinese medical groupverified the
clinical effectiveness of the Nogier approachto auricular acupuncture.They assessed the
conditionsof over 2000clinical patients, recordingwhich ear pointscorrespondedto specific
diseases. As part of Mao Tse Tung’sefforts to de-Westernize Chinese medicine, ’barefoot doctors’
were taught the easily learned techniquesof ear acupunctureto bringhealthcare to the Chinese
masses. In the 1970s, the Hong Kong physician HL Wen conducted t he first clinical studies on t he
use of ear acupuncturefor opiate detoxification (Wen & Cheung1973;Wen 1977; Wen et al. 1978,
1979).
Modern Unit ed States: Beginningin 1973, clinical work by Dr Michael Smith at Lincoln Hospital
in New York led to the applicationof auricular acupuncturefor withdrawingaddicts from opiate
drugs, crack cocaine, alcohol, and nicotine (Patterson1974;Sacks 1975; Smith 1979). The first
doubleblind evaluation of auricular diagnosis was conducted in 1980, at the University of
Californiaat Los Angeles (Oleson et al. 1980a). The localization of musculoskeletal pain was
established byone investigator, t hen a second doctor examined the auricle for specific areas of
heightened tenderness and increased electrical conductance. Ear pointsidentified as reactive were
significantly correlatedwith specific areas of the body where some pain or dysfunction had been
diagnosed. Trainingprogramson the protocol of using five ear acupunct urepointsfor substance
abuse t reat ment led to the formation oft he National Acupunct ure DetoxificationAssociation
(NADA) (Smith 1990). Anot her organization, the American College of Addictionologyand
Compulsive Disorders(ACACD), has trainedchiropracticand medical doctors in the t reat ment of
addictionwith auricular stimulation(Holder et al. 2001). In 1999, the Int ernat ionalConsensus
Conference on Acupuncture, Auriculotherapy, and Auricular Medicine (ICCAAAM) brought
together auricular medicine practitionersfrom Asia, Europe, and America to establish a
consensus on the current understandingof auricular acupunctureas it is practiced throughoutthe
world. The AuriculotherapyCertificationInstitute(ACI) was established in 1999to certify
practitionerswho have achieved a high level of mastery in this field.
Figure 1.1 Ancient Chinese charts indicatinglocation ofacupuncturemeridian channels in three different presentations.
Overviewandhistory
3
4
World Health Organization (WHO): Internationalmeetings of the WHOsought to standardize
the terminologyused for auricular acupuncturenomenclature. Consensus conferences were held
in China, Korea, and the Philippines,from 1985to 1989. At the 1990WHOmeeting in Lyons,
France, doctorsfrom Asia, Europe, and America agreed to finalize t he standardizationof names
for auricular anatomy(Akerele 1991;WHO1990a). A consensus was arrived at for the
identificationof ear points accordingto Chinese and Europeanear acupuncturecharts.
1.4 Ear acupuncture developments in China
Classical acupuncturewas first developed in Chinaover 2000years ago. Its historical roots have
been intriguinglydocumentedin Unschuld’sMedicine in China (1943), Chen’s historyofChinese
medical science (Hsu & Peacher 1977),Eckman’sIn thefootsteps ofthe YellowEmperor (1996), and
Huan & Rose’s Whocan ride the dragon? (1999). As with primitivemedical practice in ot her parts
of the world, Chinese shamans sought to ward off evil demons that they perceived as the source of
diseases; they enlisted ancestral spirits for assistance in healing. The philosophiesof Taoism
(Oaoism), Confucianism, and Buddhismeach influenced subsequent medical developments in
China. Mystical spiritual beliefs were combinedwith physical observations of clinically effective
treatments. Metaphorical references to light and dark, sun and moon, fire and eart h, metal and
wood, all contributedto the Chinese understandingof disease. The microcosm of mankindwas
related to t he macrocosm of the universe, with systematic correspondencesbetween the visible and
the invisible worlds.
Humanpain and pathologywere attributedto disturbancesin the flowof qi (pronouncedchee)
along distinct energy channels called meridians. The circulationof this vapor-like, invisible energy
through’holes’in the skin was said to be facilitated byt he insertionof needles into specific
acupuncturepoints. The Huang-di-nei-jingtext attributedto the Yellow Emperor had referred to
360such holes as suitable for needling(Veith 1972). The emperor HuangDi purportedlycame to
power in 2698BCE, and the Nei lingwas present ed as a dialogue between the emperor and his
health minister. However, current scholars suggest that the Nei lingwas actually written much
later, in the second centuryBCE. The first recordingof medical informationbycarvings on flat
stones, turtleshells, and bambooslips did not occur until 400 BCE, and paper was not invented in
China until 150CEo Acupunctureneedles were first made from bones and stones, and later from
bronze metal. In 1027CE, a full-sized figure of a man was cast in bronze to guide medical
practitioners. Over the surface of this bronze statuewas located a series of holes t hat corresponded
to the locations of acupuncturepoints. Orient almedicinewas a complete t reat ment system based
upon the empirical findings that examined the clinical efficacy of needling acupuncturepoints.
Or Gong Sun Chen of the NanjingMedical University, has report ed t hat the Nei ling included
numerousreferences to t he theories and experiences of using a uniqueear channel (Chen & Lu
1999). The ear was not considered an isolated organ, but was intimatelyconnected with all organs
of the body, the five viscera (liver, heart, spleen, lungs, kidneys), and t he sixbowels (stomach, small
intestine, large intestine, gall bladder, bladder, and sanjiao or triple warmer). Examinationsof the
ear were used as a means for predictingthe onset of ailments and the recovery from disease. Ear
acupuncturecould treat a variety of diseases, such as headaches, eye disease, asthma, facial nerve
paralysis, and stomach aches.
According to Huang(1974), the Nei ling furt her stated t hat ’bloodand air (subsequentlytranslated
as blood and qi) circulate through12meridians and their 365 accessory pointsto infiltratethe five
sense organs, seven orifices, and brain marrow.’Huangfurt her not ed t hat ’t hemeridian of the
lesser yang of the hand were said to extend upwardstoward the back of the ear. The meridian of
the great yang of the foot extended to the upper corner of the ear. The circulation of the sixyang
meridianspassed directly throughthe ear, while the sixyin meridiansjoined with t heir
correspondingyang meridians.’Inspectionof ancient and modern Chinese acupuncturecharts
demonstratesthat only the Stomach, Small Intestines, Bladder, Gall Bladder and San Jiao
meridian channels circulate in front of or aroundthe external ear, with the Large Intestines
channel runningnearby.
The phrase ’meridianchannel’is actually redundant,but bot hwords will sometimes be used in the
present text to highlight the Oriental medicine applicationof these terms. Some meridiansare
referred to as fu channels t hat carry yang energy to strengthenthe protectionof the body from
AuticulotherepyManual
external pat hogenicfactors and from stress. The zang meridian channels, which carry yin energy,
originateor t erminat ein the internalorgans of the chest and abdomen, but they do not project to
the head or ear. By connectingto their correspondingfu meridianwhen they came t oget her at the
hand or foot, the zang channels were able to int eract with acupunct urepointson t he ear. The
microcosm of the ear was said to have energetic correspondencewith the macrocosm of the whole
body, and the microcosm of the whole body was said to have cosmic correspondencewith the
macrocosm of the universe. The Chinese perceived healt h disorders as a function of the
relationshipsof these energetic systems, rat her t han a causal effect of specific germs producing
specific diseases.
Various ear treatmentsfor curingdiseases were traced by Huang(1974) to the 281CE Chinese text,
Prescriptionsfor emergencies. Anot her ancient text, Thousandgoldremedies written in 581 CE, stated
that jaundiceand a variety of epidemics were reportedlycured byapplyingacupunctureand
moxibustion to the upper ridge in the cent er of the ear. Thestudyofeightspecialmeridians, published
in 1572,containedreportsthat a network connectingall the yang meridiansalso passed throughthe
head to reach the ear. The ear was thus said to be the converging place of the main meridians. Itwas
recorded in Mystical gate: pulsemeasurementthat air (qi) from the kidney is connectedwith the ear. In
1602, Criteria in diagnosis and treatmentsuggested t hatwhen air in the lungs is insufficient, the ear
turnsdeaf. This work st at ed that:
Lungcontrolsair (qi), whichspreadsall over thebodyto converge in theear. Theear is connectedto
everypart ofthebodybecause oftheceaseless circulationofair (qi) and bloodthroughthese
meridiansand vessels. Theouterand inner branchvessels servethefunction ofconnectingwiththe
outerlimbstoformtheharmoniousrelationship betweentheear, thefour limbs, and a hundred
bones. Theear joins withthebodytoformtheunified,inseparable whole, a theorywhichforms the
basisfor diagnosisand treatment.
Also print edin 1602, Thecompendiumofacupunctureand moxibustionrecorded t hat cataracts
could be cured by applyingmoxibustion to the ear apex point. This book also described using one’s
two hands to pull down the ear lobes to cure headaches. As late as 1888, duringthe Qingdynasty,
the physician ZhangZhen described in Li ZhenAnmoYao Shu howt he post erior auricle could be
divided intofive regions, each region relat ed to one of t he five zang organs. The cent ral post erior
auricle was said to correspondto the lung, the lateral area to the liver, the middle area to the
spleen, the upper area to t he heart, and the lower area to the kidney. Massaging the ear lobe was
used to t reat the common cold, needling the helix could expel wind and relieve backaches, while
stimulationof the antihelixand antitraguswas used to t reat headaches due to wind-heat and
pathogenicfire.
Duringthe medieval period in Europe, Western physicians cut open major veins on seriously sick
patientsin order to release ’evil spirits’t hat were said to cause disease. Chinese doctors conducted
a much less brutal form of blood lettingby prickingthe skin at acupointsto release just a few
dropletsof blood. Oneof the primaryloci used for blood lettingwas to prick the t op of the external
ear. Throughoutt heir medicine, Chinese doctors sought to balance t he flowof qi and blood. By
drainingsurpluses of spirit, or bysupplementingdepletionsof subtle energies, Orient almedicine
provided healthcare to t he Chinese masses t hroughoutthe several t housandyears of the Han, Sui,
Tang, Song, Mongol, Ming, and Manchu dynasties. However, widespread use of acupunct urein
Chinadiminishedin the 1800s, when Chinabecame dominat edby imperialist powers from
Europe. In 1822, the minister of health for the Chinese Emperor commandedall hospitalsto stop
practicingacupuncture,but its use nonetheless continued. While the applicationof Western
medical proceduresbecame increasingly prominentin the large cities of China, healthcare
practices in rural Chinachanged much more slowly.
Therewas a subsequent erosion of faith in traditionalOrient almedicine following the defeat of
Chinese militaryin the OpiumWars of the 1840s. British merchant swant ed to purchase Chinese
tea and silk, but they were concerned about the huge t rade imbalance creat ed when the Chinese
did not want to buy European productsin return. Their solutionwas opium. Alt hough the emperor
forbade its importation,smugglers were hired to sneak opiuminto China. When Chinese officials
burneda warehouse of t he British East India Companystocked with smuggled opium, the British
parliament claimed an ’at t ackon British territory’as justificationfor the declaration of war. The
Chinese should probablyhave import edEuropeanweapons, for they were soundly defeat ed in t he
Overviewandhistory 5
6
opiumwars with Great Britain. They were forced to pay substantial sums of currency for the lost
British opiumand to surrenderthe territoryof HongKong. Opiumhouses t hen proliferat edand
the Chinese lost a sense of confidence in uniquelyOriental medical discoveries. Because the
Occidental t raders had more powerful weapons t han t he Chinese, it came to be believed that
Western doctors had more powerful medicine. The Chinese were impressed by Western science
and byEuropean biological discoveries. Antiseptic practices t hat had been int roducedfrom
Europegreatly reduced post-surgical infections. The germ theoryof Western medicine came to
have great er relevance for health t han the energetic theoryof qi. Jesuit missionaries in China
utilized t he disseminationof Western medications as a manifestationof the superiorityof their
Christianfaith. The Chinese government at t empt edto suppress the teachingof Orient al medicinc
as unscientific, issuing prohibitoryedicts in 1914and again in 1929,yet the practice of acupunct ure
continued.
By the 1940s, however, Europe became embroiled in World War II, and Marxism became a more
influential Western import to Chinat han Christianity. Aft er the Communist revolution in 1949,
Mao Tse Tungcalled for a revitalization of ancient Chinese met hodsfor health and healing.
Acupunct urehad declined in the large cities of China, and the main hospitalswere primarilybased
on conventional Western medicine. However, doctors in the rural countrysides of Chinahad
maintainedthe ancient ways of healing. It was from t hese rural rout es t hat Mao derived his
military power, and it ultimatelyled to a renewed interest in classical Oriental practices of
acupuncture,moxibustion, and herbs. However, in additionto its condemnat ionof bourgeois
Western medicine, Communistatheists also rejected the metaphysical, energetic principles
of acupuncture. Maoist dogma encouraged the development of the more scientific Dialectic of
Nature and what is nowknown as TraditionalChinese Medicine (TCM). Nonetheless, the actual
practice of acupuncturestill used the energetic concepts of yin and yang, the five element s of
fire, earth, wood, water, and metal, and t he eight principlesfor differentiatingmedical
syndromes.
It was fortuitoust hat the discoveries of the ear reflex charts by Paul Nogier arrived in China in
1958,at this time of renewed interest in classical acupunct uretechniques. The so-called barefoot
doctors, high school graduat es given 6 mont hsof medical training,were also taught the techniques
of ear acupuncture,and were able to bringhealthcare to the large populat ionsin urban and rural
China. With little plastic models of the inverted fetus mapped ont ot he ear, it was easy to learn to
needle just the part of the ear t hat correspond to where the pat ient report ed pain. Alt hough ear
acupuncturewas used across Chinaprior to learningof Nogier’s treatise on the subject, it was not
practiced in the same manner. In1956,for example, hospitals in ShandongProvince report ed t hat
they had t reat ed acute tonsillitisbystimulatingt hree pointson the ear helix chosen according to
folk experience. Gong Sun Chen (1995) has confirmed t hat it was only after the Chinese learned of
Nogier’s inverted fetus pictureof auricular pointst hat great changes in the practice of ear
acupunctureoccurred. The Nanjingdivision of the medical unit of Chinese military enlisted
acupuncturistsfrom all over the countryto examine and to t reat thousandsof pat ient swith this
somatotopicauricular acupunct ureprotocol. Their report on the success of ear acupunct urefor
several t housanddifferent types of patientsprovided scientific replicationof Nogier’swork and led
to broad inclusion of this approach in traditionalChinese medicine.
Anot her historianof Chinese medicine, Huang(1974), also st at ed t hat 1958saw ’a massive
movement to study and apply ear acupunct ureacross the nation. As a result, general conclusions
were drawn from several hundredclinical cases, and t he scope of ear acupunct urewas greatly
enlarged.’She continues: ’however, certain individualsbegan to promot ethe revisionist line in
medicine and health. They spread erroneous ideas, such as Chinese medicine is unscientific and
insertionof the needle can only kill pain but not cure disease. Since t he Cultural Revolution
dispelled these erroneousideas, ear acupunct urehas been again broadlyapplied all over the
country.’Huangobserved that:
The met hodofear acupunctureis based on thefundament alprincipleofthe unityofopposites. The
humanbeing is regarded as a unified, continuallymovingentity. Disease is the result ofstruggle
between contradictions. By applying Chairman Mao’s brilliant philosophicalideas. we can combine
the revolutionaryspirit ofdaring to t hinkand daring to do with the scientific met hodof’
experimentationin the exploration and application ofear acupuncture.
AuriculotherapyManual
To modern readers, it might seem unusual t hat Communist political rhet oricis int egrat edwithin a
medical text, but it must be remembered t hat t he Cold War in t he 1970s great ly isolat ed China
from West ern influences. Huangalso included more met aphysical influences in Chinese t hought ,
citing t he t ext Mystical gate: treatise on meridiansand vessels: ’t heear is connect ed to every part of
t he body because of t he ceaseless circulat ion of energy and blood t hrought hese meridiansand
vessels. The ear joins with t he body to form t he unified, inseparablewhole.’
Medical research in Chinain t he years since t he int roduct ionof Nogier’s somat ot opic
auriculot herapydiscoveries has focused on t he relat ionshipof ear acupunct ureto classical
meridian channels, t he use of ear seeds as well as needles for t he t reat ment of different diseases,
and t he use of auricular diagnosis as a guide for recommendingChinese herbal remedies. Medical
condit ionswere grouped int o t hree cat egories:
1. t hose which can be cured by auricular acupunct urealone
2. t hose whose sympt oms can be at least partiallyalleviat ed by auriculot herapy
3. t hose where improvement is seen only in individual cases.
Auricular point s in Chinaare select ed according to several factors: t he correspondingbody regions
where t here is pain or pat hology; t he ident ificat ionof pat hologically react ive ear point st ender to
t ouch; t he basic principlesof t radit ionalChinese medicine; physiological underst andingderived
from modern West ern medicine; and t he result s of experiment s and clinical observat ions.
Havingused ear acupunct urefor post operat ivesympt oms, Wen & Cheung(1973) observed t hat
opiat e addict ed pat ient sno longer felt a craving for t heir previously preferred drug. The Shen Men
and Lung ear point s used for acupunct ureanalgesia also affect ed drugdetoxification. Wen
subsequent lyst udied a larger sample of opiumand heroin addict s who were given auricular
elect roacupunct ure.Bilat eral, elect rical st imulat ionbet ween t he Lung point sin t he concha led to
complet e cessat ion of druguse in 39 of 40 addicts. Given t hat it was West ern merchant swho
support edwidespread opiumabuse in China, it is int riguingt hat a Chinese auriculot herapy
t reat ment for drugaddict ion is now one of t he most widely disseminat ed applicat ionsof
acupunct urein t he West.
There are dist inct discrepancies bet ween Orient al and West ern ear chart s. Dist ort ionsmay have
appeared in t he t ransmission of ear maps from France to Germanyto Japan to China. Inaccuracies
could have been due to mist ranslat ionbet ween European and Asian languages. Moreover,
drawings of the convolut edst ruct ureof t he auricle have been t he source of many discrepancies
regardingt he anat omical areas of t he ear being described. The Chinese, however, maint aint hat
t he ear acupunct urepoint sused in t heir t reat ment plans have been verified across t housandsof
pat ient s. Chinese conferences complet ely devot ed to research invest igat ions of ear acupunct ure
were held in 1992, 1995 and 1998, and t he Chinese government aut horizeda commit t eeto
st andardizet he name and locat ion of auricular points. This commit t ee designat ed t he localization
of 91 auricular points, st andardizedalongguidelines est ablished by t he World Healt h
Organizat ionin 1990 (Zhou 1995, 1999).
1.5 Auriculotherapy and auricular medicine in t he West
Alt hough acupunct urewas mostly unknownin t he Unit edSt at es unt il President Nixon visited
Chinain 1972, acupunct urehad been int roducedto Europe several hundredyears earlier. A 16th›
cent uryphysician workingfor t he Dut chEast IndiaCompany, Dr Willem Te Rhyne, was one of t he
first West ern pract it ionersto describe t he impressive curat ive powers of acupunct ure. Medical
int erest in acupunct urewaxed and waned in Europe over t he following cent uries. Itwould elicit
great excit ement , t hen be dismissed and given up as unreliablefolk medicine, yet subsequent lybe
rediscovered as a new met hodof healing. Int he 19thcent ury, t he French Acadernie des Sciences
appoint eda commission to st udy acupunct ure. Gust af Landgaren of Sweden conduct ed
acupunct ureexperiment s on animals and on humanvolunt eers at t he Universit y ofUppsala in
1829. Sporadic report sof t he use of acupunct ureneedles were included in European medical
writings for t he next several cent uries.
It was in t he early 1900s t hat int erest in acupunct urewas once again revived in Europe. From 1907
to 1927, Georges Soulie de Morant served as t he French consul to China. St at ioned in Nanjingand
Shanghai, he became very impressed by t he effectiveness of acupunct urein t reat inga cholera
Overviewandhistory 7
Figure 1.2 Participants at the 1990 World Health Organization meetingon auricular acupuncturenomenclature, Lyons, France (A). The
enlargement below (8) shows Dr Paul Nogier at thefar lejt oft hefront row, his son Dr Raphael Nogier secondfrom the right. Dr Frank
Bahr at t hefar right ojt hesecond row, and Dr Terry Oleson fourth[rom the left ofthe second row.
B
8 AuriculotherapyManual
epidemic and many ot her diseases. Sou lie de Morant t ranslat ed t he Nei Jinginto French and
publishedL’Acupuncturechinoise. He t aught Chinese medical proceduresto physicians
t hroughoutFrance, Germany, and Italy and is considered t he ’Fat her of Acupunct ure in Europe’.
Of intriguinghistorical not e, t he FrenchJournal des connaissances medico-chirurgicales report ed
back in 18S0 t hat 13 different cases of sciatic pain had been t reat ed by caut erizat ionwith a hot iron
applied to t he ear. Only one of t he pat ient sfailed to dramatically improve. It was not until a
cent urylat er, however, t hat the Lyons physician Paul Nogier rediscovered this remarkableear
t reat ment .
In 19S0, Nogier (1972) was ’int riguedby a st range scar which cert ain pat ient s had in t he ext ernal
ear.’ He found t hat t he scar was due to a t reat ment for sciatica involving caut erizat ionof t he
antihelixby Mme Barrin, a lay pract it ionerliving in Marseille, France. The pat ient swere
unanimousin st at ingt hat they had been successfully relieved of sciatic pain within hours, even
minutes, of this ear caut erizat ion. Mme Barrin had learned of this auricular procedurefrom her
father, who had learned it from a Chinese mandarin. Nogier st at ed: ’I t hen proceeded to carry out
some caut erizat ionsmyself, which proved effective, t hen t ried some ot her, less barbarous
processes.’ A simple dry jab with a needle ’also led to t he relief of sciatica if given to t he same
antihelixarea, an area of t he ear which was painful to pressure.’ Nogier was experienced in t he use
of acupunct ureneedles, as he had previously st udied t he works of Soulie de Morant . Anot her
ment or for Nogier was t he Swiss homeopat hicphysician, Pierre Schmidt, who gave massages,
spinal manipulat ions,and acupunct ureas part of his nat uropat hicpract ice. Some critics have
cont ended t hat Nogier developed his ear maps based on t ranslat ionof Chinese writings, but as
st at ed previously, t he Chinese themselves acknowledge t hat it was only aft er they learned of
Nogier’s findings did they develop t heir own modern ear charts.
A quot at ionat t ribut edto t he physiologist Claude Bernard furt her inspired Nogier:
It has often been said, that in order todiscover things, one must be ignorant. It is hetterto know
nothingthan tohave certainfixed ideas in one’s mind, whichare based on theorieswhichone
constantlytriestoconfirm.Adiscovery is usuallyan unexpectedconnection, which is not includedin
some theory. Adiscovery is rarely logical and oftengoes against theconceptionsthen infashion.
Nogier discussed his antihelixcaut erizat ionexperiences with anot her physician, Rene Amat hieu,
who t old him ’t heproblemof sciatica is a problemof t he sacrolumbar hinge’. Nogier conject ured
t hat t he upper antihelixarea used to t reat sciatica could correspondto t he lumbosacral joint , and
A
Lower limb
B
Upper limb
Abdominal organs
Neck
Thoracic organs -+--\ -"’c:->"’t 1!
Head areas ~ - - ~ r - - -
Figure 1.3 Initial ear charts developed by Nogier showsomat ot opiccorrespondences to part icular auricular
regions (A) and the invertedfet us pattern related to the external ear (B). (Reproducedfrom Nogier 1972. with
permission. )
Overviewandhistory 9
Body
Spinal cord
Visceral organs
Brain
10
Figure 1.4 Nogierdiagram ofinvertedmusculoskeletalbody, internalorgansand the
nervoussystemrepresented on theauricle. (ReproducedfromNogier1972, with
permission.)
the whole antihelixcould represent the remainingspinal vertebrae, but upside down. The head
would have its correspondencelower on the auricle. The ear could thus roughly resemble an
upside down embryo in utero. Nogier subsequentlyobt ainedpain relief for ot her problems. Using
electrical microcurrentsimperceptibleto the patient, Nogier concluded t hat the pain relief was not
due to a nervous reaction to the pain from needle insertion, but was in fact caused by the
stimulationof t hat area of the ear.
’Todiscover something,’Nogier observed, ’is to accomplish one stage of the journey. Topush on to
the bot t omof this discovery is to accomplish anot her.’In 1955, Nogier ment ionedhis discoveries
to Dr Jacques Niboyet, the undisputedmast er of acupunct urein France. Niboyet was struck by this
novel ear reflex zone, which had not been described by the Chinese. Niboyet encouraged Nogier to
present his findings to the Congress of the Medit erraneanSociety of Acupunct urein February
1956.One of the at t endees of this meeting, Dr Gerard Bachmann of Munich, published Nogier’s
findings in an acupunct urejournal in 1957,which had worldwide circulation, includingthe Far
East. From these translationsinto German, Nogier’s ear reflex system was soon known by
acupuncturistsin Japan, and was subsequentlypublished in China, where it became incorporat ed
into their ear acupuncturecharts. Nogier acknowledged in his own writings t hat the origins of
auriculotherapymight have begun in Chinaor in Persia. The primarychange t hat he brought to
auricular acupuncturein 1957was t hat these ear acupointswere not just a scat t ered array of
different pointsfor different conditions, but t hat t herewas a somatotopicinverted fetus pat t ernof
auricular pointsthat correspondedto the pat t ernof the actual physical body.
Nogier (1972) limited his classic Treatise ofauriculotherapy to the spinal column and the limbs
because the musculoskeletal body is projected ont othe external ear in a clear and simple manner.
Thetherapeuticapplicationsarefreefromambiguityand oughttoallowthebeginnerto achieve
convincingresults. It ispossibletopalpatefor tenderareas oftheear and readily noticehowthey
correspond topainful areas ofthebody. Thefirst stages oflearningthemap oftheear consist of
gettingtoknowthemorphologyoftheexternalear, itsreflexcartography, and howto treat simple
pains oftraumaticorigin. Each doctorneeds tobeconvincedoftheefficacyofthisear reflex method
bypersonal results that he or she isright. Theyare indeedfortunatepeoplewhocan convince
themselvessimplybynotingtheimprovementofa symptomtheythemselveshave experienced.
AuriculotherapyManual
Aft er he t raced the image of t he spine and t he limbs, Nogier examined t horacicorgans, abdominal
organs, and cent ral nervous system project ionsont ot he ear. He needed a few years, however, to
underst andt hat the ear had a triple innervation, and t hat each innervat ionsupport edthe image of
an embryological derivative: endoderm, mesoderm, and ect oderm.
These embryological correspondences to t he ear were described by Nogier (1968) in anot her text,
Thehandbooktoauriculotherapy, with illust rat edanat omical drawings by his friend and colleague,
Dr Rene Bourdiol. By 1975, Nogier had creat ed a t eaching st ruct urefor trainingin auricular
medicine, establishing t he organization GroupLyonaise Etudes Medicales (GLEM), t ranslat ed int o
English as the Medical St udies Groupof Lyons. The journalAuriculo-medicinewas also launched
in 1975, providinga professional vehicle for disseminatingclinical st udies on auricular medicine.
That same ycar, Nogier, Bourdiol and t he German physician FrankBahr combined t heir efforts to
publish an informativewall chart on ear localizations, Loci auriculo-medicinae. Dr Bahr went on to
organize t he German AcademyofAuricular Medicine(Bahr 1977), which has at t ract ed over 10000
German physicians to t he practice of auricular medicine. In1981, however, Bourdiol disassociated
himself from Nogier, partlybecause he was not comfort ablewith some of Nogier’s more esoteric,
energet ic explanationsof healing. Consequent ly, Bourdiol (1982) wrot e his own book, Elementsof
auriculotherapy. This work remains one of the most anatomicallyprecise texts of t he relationshipof
the auricle to t he nervous system and includes det ailed pict ures of t he external ear and its
represent at ionof t he musculoskeletal system and visceral organs. The innovative collaborat ions
bet ween Nogier and Bourdiol had last ed from 1965 until 1981, but t heir collegial association
unfort unat elywas at an end.
Nogier t urnedhis efforts in a different direct ionwith t he 1981 publicat ionof
Del’auriculotherapieal’auricolomedecine, t ranslat ed int o English as Fromauriculotherapyto
auriculomedicinein 1983. In this work, Nogier present ed his t heoryof t hree somat ot opicphases on
the ear and he discussed his concepts of electric, magnetic, and ret icular energies. The most
prominentfeat ure of this auriculomedicinetext, t hough, feat ured expanded descript ionof
Nogier’s 1966discovery of a new pulse, the refiexe auriculo cardiaque (RAC). This pulse react ion
was lat er labeled the vascular aut onomicsignal (VAS), as it was relat ed to a more general reactivity
of the vascular system. Inhonor of its discoverer, this pulse react ion has also been called the refiexe
arteriel de Nogier by Bourdiol and the Nogierreflexby Bahr. For t he purposes of this text, the Nogier
vascular aut onomicsignal will be abbreviat ed as N-VAS, so as not to confuse it with a well known
pain assessment measure, t he visual analogue scale or VAS. The N-VAS art erial waveform change
becomes distinct in the pulse a few beat s aft er st imulat ionof the skin over t he ear. Similar
aut onomicreactions to touchingsensitive ear point shave also been report edfor changes in the
elect rodermal galvanic skin response and in pupillaryconstriction. Monit oringthis N-VAS radial
pulse react ion became t he fundament al basis of auriculomedicine. Nogier suggest ed t hat each
peripheral stimulation’perceived at t he pulse is at first received by t he brain, t hen t ransmit t edby
the art erial t ree.’ It seemed t hat the ear produceda sympat het icnervous system reflex, initiatinga
systolic cardiac wave t hat reflected off t he art erial wall, followed by a ret urning,ret rogradewave.
This reflex established a st at ionaryvascular wave, which could be perceived at t he radial artery.
Palpationof the N-VAS was used to det erminechanges in pulse amplit udeor pulse waveform t hat
were not relat ed to fluctuationsin pulse rat e. The N-VAS has been at t ribut edto a general
vascular-cut aneous reflex t hat can be activated by tactile, electrical, or laser st imulat ionof many
body areas.
Considerableconfusion was generat ed when subsequent books on t he Nogier phases on the car
seemed to cont radict earlier writings. Pointsreflexes auriculaires (Nogier et al. 1987) mapped some
anat omical st ruct uresont odifferent regions of t he ext ernal ear t han t hose described in previous
publicationsby Nogier. The most det ailed present at ionof t he t hree phases was described by
Nogier et al. (1989) in Complementsdespointsreflexes auriculaires. This text cont inuedto show t hat
in the second phase, the musculoskeletal system shifted from t he antihelixto t he cent ral concha,
whereas in t he t hirdphase, musculoskeletal point swere locat ed on t he tragus, antitragus, and ear
lobe. However, Nogier reversed some of the descript ionfrom his previous writings. Incont rast to
the present at ionof t he phases in the 1981 bookDel’auriculotherapieal’auriculomedecine, in 1989
he switched the lat eral orient at ionof t he second phase spine and t he vertical orient at ionof the
third phase spine. Alt hough Nogier had developed t he t hree-phase model as a means of
reconciling the differences bet ween his findings and t hat of the Chinese, it was a drast ic depart ure
Overviewandhistory 11
from the original, inverted fetus picturefor the ear. The suggestion of different somatotopic
pat t ernson the same auricular regions bot heredmany of Nogier’s followers.
Widespread dissension within the European auriculomedicinemovement occurred by the 1990s
(Nogier 1999). First, the t hree phase theorywas not well accepted by many auriculomedicine
practitionersin France and Germany. Second, Nogier discussed the import anceof ’ret icular
energy,’ without specifically defining what it was. He explored the chakra energy cent ers of
ayurvedic medicine, which seemed to some to be unscientific. The energetic theoryof Paul Nogier
had also been adopt edby a non-medical school t hat used Nogier’s name to develop more esoteric
philosophiesof auricular reflexotherapy, consequentlyt hreat eningt he professional credibilityof
auricular medicine. Many acupuncturistsin England, Italy, and Russia followed the Chinese charts
describing the localization of ear reflex points, rat her t han the ear charts developed by Nogier. A
very personal account of the development and progress of auriculomedicinein Europewas
present ed in the book The man in the ear, written by Paul Nogier with his son Raphael Nogier
(1985). Also a physician, Raphael Nogier has become one of Europe’smost prominentfigures in
the continuedtrainingof doctors in the practice of auricular medicine.
Publicationsat the UCLA Pain Management Cent er sought to integrate the Chinese ear charts
with Nogier’s systems for mappingthe somatotopicimage on the ear (Oleson & Kroening 1983a,
1983b). The World Healt hOrganizationheld its 1990meeting on auricular acupunct ure
nomenclaturein Lyons, France, partly to honor Nogier’s pioneeringdiscoveries. Aft er several
previous WHOsessions t hat had been held in Asia, this Europeangat heringsought to bring
t oget her different factions of the acupunct urecommunity. At a 1994internationalcongress on
auricular medicine in Lyons, Nogier was described as the ’Fat herof Auriculotherapy.’Paul Nogier
died in 1996, leaving an amazing scientific inheritance. He had cont ribut edthe uniquediscovery of
somatotopiccorrespondences to the external ear, developed a newform of pulse diagnosis, and
expanded medical appreciationof the complex, subtle energies of the body.
12
Figure 1.5 Aut hor’sdepiction ofalternative perspectives ofinverted fetus image (A) and
inverted somatotopicpattern (B) on the auricle.
AurkulotherepyManual
1.6 Comparison of ear acupuncture t o body acupuncture
Historical differences: Bot h ear acupunct ureand body acupunct urehad t heir historical origins in
ancient China. However, body acupunct urehas remained essentially unchanged in its perspective
of specific meridian channels, whereas Chinese ear acupunct urewas greatly modified by the
inverted fetus discoveries of Paul Nogier in Europe. Furt her research has yielded even newer
developments in auricular medicine.
Acupuncturemeridians: Body acupunct ureis based upon a system of 12 meridians, six yang or fu
meridians and sixyin or zang meridians, which run along the surface of the body as lines of energy
forces. Ear acupunctureis said to directly connect to t he yang meridians, but it is not dependent
upon these yang meridiansto function. The ear is a self-contained microsystem t hat can affect t he
whole body. In traditionalChinese medicine, the head is more associated with yang energy t han
are lower parts of the body. The Large Intestines, Small Intestines, and San Jiao meridiansrun
from the arm to the head, and the Stomach, Bladder, and Gall Bladder meridiansrun from the
head down the body. Yin meridians, however, do not connect directly to the head, thus they have
no physical means to link to the ear.
Pathological correspondence: The main principlein auriculotherapyis a correspondence
between the cartographyof the external ear and pathological conditionsin homologousparts of
the body. Acupunct urepointson the auricle only appear when t here is some physical or functional
disorder in the part of the body represent ed by t hat region of the ear. There is no evidence of an
auricular point if the correspondingpart of the body is healthy. Acupunct urepointson the body
can almost always be detected, whet her t here is an imbalance in the relat ed meridian channel or
not. While body acupunct urecan be very effective in relieving a variety of health problems, the
organ names of different meridian channels may not be necessarily relat ed to any known pathology
in t hat organ.
Somat ot opicinversion: In body acupuncture,the meridian channels run t hroughoutthe body,
with no apparent anatomical logic regardingthe relationshipof t hat channel to the body organ
represent ed by t hat meridian. Acupoints on the Large Intestinesmeridiansand the Kidney
meridians occur in locations far removed from those specific organs. In ear acupuncture, however,
t here is an orderly, anatomical arrangement of points, based upon t he inverted fetus perspective of
the body. The head areas are represent ed toward the bot t omof the ear, the feet toward the top,
and the body in between. As with the somatotopicmap in the brain, t he auricular homunculus
devotes a proportionallylarger area to t he head and hand t han to t he ot her parts of the body. The
size of a somatotopicarea is relat ed to its functional importance, rat her t han its actual physical
size.
Distinct acupunct urepoints: The acupunct urepointsare anatomicallydefined areas on the skin.
The original Chinese pictographsfor acupointsindicated t hat t herewere holes in t he skin though
which qi energy could flow. They are set at a fixed, specific locus in body acupunct ure,and can
almost always be det ect ed electrically. In ear acupuncture,however, an acupunct urepoint can be
det ect ed only when t here is some pathologyin the correspondingpart of the body, which t hat ear
acupoint represents. A dull, deep, aching feeling called ’de qi’ often accompanies the stimulation
of body acupunct urepoints, but this sensation is not usually observed by stimulatingear
acupunct urepoints. A sharp, piercingfeeling more oft en accompanies auricular stimulation.The
exact location of the ear point may shift from day to day, as it reflects different stages of the
progression or healingof a disorder. A prominentdifference bet ween the systems is t hat body
acupunct urepointslie in the t endon and muscular region deep below the skin surface, whereas ear
acupoints reside in the shallow depth of the skin itself.
Increased t enderness: Paul Nogier observed t hat t here are some cases of pat ient swith an
exceptional sensitivity in which mere palpationof certain parts of the ear provoked a pronounced
pain sensation in the correspondingbody region. This observation can be repeat ed several times
without the phenomenondiminishing, allowing the distinct identificationof the connectionwhich
exists between such ear pointsand the periphery. The tenderness at an ear acupoint increases as
the degree of pathologyof the correspondingorgan worsens, and the t enderness on the ear
decreases as the health conditionimproves. There is not always a small, distinct acupoint, but
sometimes a broad area of the ear where t here is tenderness.
Overviewandhistory 13
14
Decreased skin resistance: In bot h body and ear acupunct ure,the acupunct urepoint sare
localized regions of lowered skin resistance, small areas of t he skin where t here is a decrease in
oppositionto the flow of electricity. Somet imes elect rodermal activity is inversely st at ed as higher
skin conductance, indicatingt hat t here is easy passage of electric current . The technologyof
recordingthis electrical activity from the skin has been used in the fields of psychology and
biofeedback, and was originallydescribed as the galvanic skin response (GSR). Electrical
resistance and electrical conduct ance measure the exact same elect rodermal phenomena, but they
show it as opposit e changes, one increasing from baseline activity while t he ot her decreases. When
pathologyof a body organ is represent ed at its correspondingauricular point, the elect rodermal
conductivityof t hat ear point rises even higher t han normal. The conduct ancein t he flow of
electricity increases as the pathologyin t he body increases. As t he bodyorgan becomes healthier,
the elect rodermal conduct anceof t hat ear point ret urnsto normal levels. Elect rodermal point
det ect ion is one of the most reliable met hodsfor diagnosingt he location of an auricular point.
Ipsilateral representation: In bot h body and ear acupunct ure, unilateral, pathological areas of t he
body are more greatly represent ed by acupunct urepoint son the same side of the body as the body
organ t han by pointson t he opposit eside of the body.
Remote control sites: Ear pointsare found at a considerable dist ance from the area of the body
where the symptom is located, such as pain problems in the ankles, t he hands, or the lower back.
Even t hough body acupunct urealso includes remot e distal acupoints, many body acupoint sare
stimulated directly over t he same body area as where t he symptom is locat ed. Auriculot herapycan
remotely st imulat ea part of the body t hat is too painful to t reat directly. While t he body acupoint s
occur directlywithin a meridian channel, auricular acupoint sserve as remot e cont rol centers. The
ear pointscan remotely affect the flowof energy in meridian channels. In this way, ear pointscan
be compared to the wayan electronic remot e cont rol unit is used to operat e a garage door or to
switch channels on a television set. Alt hough very small in physical size because of t heir microchip
circuitry, remot e control devices can produce pronouncedchanges in much larger systems. While
the auricle is also a physically small st ruct ure, its cont rol of t he gross anat omyof the body can be
quite impressive.
Diagnostic efficacy: Ear acupunct ureprovides a more scientifically verified means of identifying
areas of pain or pathology in the body t han do such t radit ionalChinese medicine approaches as
pulse diagnosis and t onguediagnosis. In auricular diagnosis, one can identifyspecific problemsof
the body by det ect ingareas of the car t hat are darker, discolored or flaky. Pathological ear points
are notablymore t ender or have higher skin conduct ancet han ot her areas of t he auricle. The
subtle changes in auricular diagnosis may identify conditionsof which the patient is only marginally
aware. A new practitioner’sconfidence in auriculotherapyis strengthenedby the recognitionof
reactive ear points for health conditionst hat were not previously report edby a patient.
Therapeutic proof: The second most convincing procedureto verify t he existence of the
correspondencebetween t he location of auricular point sand a part icular part of t he body is when
specific regions of pain are immediatelyrelieved by st imulat ionof the area of the ext ernal ear
designated by established wall charts. There are some pat ient swho present with very unusual
disorders in a specific region of t heir anatomy. These exceptional pat ient shave been found to
demonst rat ereactive pointsat precisely t he predict ed area on t he auricle. Once t reat ment is
applied to t hat ear point, t he pat ient ’scondit ionis immediately alleviated. At t he same time, many
pat ient shave diffuse types of pathologyt hat do not provide such convincing demonst rat ionsof
selective reactivity. The lat t er pat ient shave many body regions in pain, cont ribut ingto broad
regions of the auricle which are sensitive to pressure or are electrically active.
Pulse diagnosis: Both traditionalOrient al medicine and auricular medicine utilize a form of
diagnosis t hat involves palpat ionat the radial pulse on t he wrist. Classical acupunct ureprocedures
for examining the pulse require the placement of t hree middle fingers over t he wrist, assessing for
subtle qualities in the dept h, fullness, and subjective qualities of the pulse. These tactile sensations
help to det ermineconditionsof heat, deficiency, st agnat ion or disorders associated with specific
zang-fu organs. The N-VAS involves placement of only t he t humbover t he wrist. The pract it ioner
discriminates changes in t he react ion of t he pulse to a stimulus placed on the ear, whereas Orient al
doct ors monit or the ongoing, steady-state qualities of t he resting pulse.
AuriculotherapyManual
Types of procedures: Body acupunct ureand ear acupunct ureare oft en used with each ot her in
the same session, or each procedurecan be effectively applied separately. Body acupunct ure
pointsand ear acupunct urepointscan bot h be st imulat edwith t he use of acupressure massage,
acupunct ureneedles and elect roacupunct ure.Many pat ient sare afraid of the insertion of needles
into t heir skin, thus they have a strongaversion to any form of needle acupunct ure. As an
alternative, ear pointscan be activated by t ranscut aneouselectrical stimulation, laser stimulation,
or small metal or seed pellets t aped ont o the auricle. It is recommended t hat because auricular
acupunct urecan work more quickly t han body acupunct ure,t he ear point sshould be t reat ed first.
Clinical efficacy: Stimulationof ear reflex pointsand body acupoint sseem to be equally effective
t reat ment s. Each requires only 20 minutesof t reat ment ,yet each can yield clinical benefits which
last for days and weeks. Both body and ear acupunct ureare utilized for t reat inga broadvariety of
clinical disorders, includingheadaches, back pain, nausea, hypertension, ast hma and dental
disorders. Auriculotherapytends to relieve pain more rapidlyt han body acupunct ure. Ear
acupunct ureneedling is more often the t reat ment of choice for detoxification from substance
abuse t han is body acupuncture. Ear acupunct urehas been found to quickly relieve post operat ive
pain, inflammationfrom joint sprains, pain from bone fractures and the discomfort from gall
stones. It readily can reduce inflammations, nausea, itchingand fever.
Application to many disorders: Since every organ of t he body is represent ed upon the external
ear, auriculot herapyis considered a pot ent ialsource for alleviating any disease. Ear acupunct ureis
certainly not limited to hearingdisorders or even to problems affecting the head. At the same time,
it can be very effective for t reat inginner ear dizziness and for alleviating headaches. Conditions
t reat ed by bot h ear and body acupunct ureinclude appendicitis, tonsillitis, ut erinebleeding,
dermatitis, allergic rhinitis, gastric ulcers, hepatitis, hypertension, impotency, hypothyroidism,
sunburn,heat stroke, frozen shoulder, tennis elbow, torticollisand low back pain.
Healing. not just pain relief: Both body acupunct ureand ear acupunct uredo more t hanjust
reduce the experience of pain. While pain relief is the more immediat e effect, bot h procedures
also facilitate the internal healing processes of the body. Acupunct ure and auriculot herapyt reat
the deeper, underlyingcondition, not just the symptomaticrepresent at ionof t he problem. They
affect deeper physiological changes by facilitating the nat ural self-regulating homeost at ic
mechanisms of the body. Stimulatinga given acupoint can eit her diminish overactive bodily
functions or activate physiological processes t hat were deficient.
Ease in mastery of skills: Because auricular reflex pointsare organized in the same pat t ernas t he
gross anat omyof the body, it is possible to learn the basics of ear acupunct urein just a few days. In
contrast, body acupunct urerequires several years of intensive didactic trainingand clinical
practice. The pointson t he ear are labeled with the organ or the condit iont hat they are used to
treat. While t here are over 200 ear acupoints, t he few ear pointsneeded for t reat ment are readily
identified by the principleof somat ot opiccorrespondence and by t heir selective reactivity.
Ease in treatment application: Ear acupunct ureis often more economical and convenient to use
t han body acupunct ure,since no disrobingis required of a patient. The ear is easily available for
diagnosis and t reat mentwhile someone is sittingin a chair or lying down in t heir st reet clothes.
Insertion of needles into t he ear is more simple to apply t han is t he use of needles at body
acupoints. The skin over t he auricle is very soft and t here is little danger of damaging a critical
blood vessel when punct uringthe ear skin with a needle, a problemt hat has occurred with
insertion of needles into body acupunct urepoints.
Side effects: The primaryside effect of auriculot herapyis t he piercingsensation t hat occurs at
the time needles are inserted into the ear surface or when intense electrical stimulationis applied
to an ear acupoint. For sensitive patients, the auricle should be t reat ed more gently, and ear pellets
or ear seeds may be used instead of needles. Ifthe stimulationintensityis uncomfortable, it should
be reduced. The ear itself can somet imes become t ender and inflamed aft er t he t reat ment . This
post -t reat mentt enderness usually subsides within a short time. As with body acupunct ure,some
pat ient sbecome very drowsy aft er an auricular acupunct uret reat ment . They should be offered t he
opport unit yto rest for a while. This sedat ion effect has been at t ribut edto the systemic release of
endorphins.
Overviewandhistory 15
16
Equipment required: Well-trained acupuncturistscan det ect body acupunct urepointsjust by
t heir palpat ionof the surface of the body or by the rot at ionof an insert ed needle. A muscle spasm
reflex often seems to ’grab’the acupunct ureneedle and hold it in place when t he tip of the needle
is on the appropriat epoint. Auricular diagnosis, however, is best achieved with an electrical point
finder. Furt hermore,a t ranscut aneouselectrical stimulationdevice using microcurrent intensities
can often achieve profoundclinical effects without the unwant edpain which accompanies needle
insertion. Since body acupointstypically lie in the muscle region deep below the skin surface,
electrical point finders are often not needed and are not particularlypractical for body
acupuncture.The auricular skin surface, however, is only a few millimeters deep, and readily
available for detection and t ranscut aneoust reat ment . Reactive ear reflex pointscan slightly shift in
location from one day to t he next, thus the use of an electrical point finder is imperative for precise
det erminat ionof point localization t hat part icularday. Electrical stimulationof ear acupoints,
eit her by electroacupunct urethroughinsert ed needles or by t ranscut aneousmetal probes,
produces more effective pain relief t han does needle stimulationof t he ear.
AuriculotherapyManual
T heoret i cal perspect i ves of
auriculot herapy
2.1 M i cro-acupunct ure systems
2.2 T radit ional O ri en t al medicine and qi energy
2.3 Ayurvedic medicine, yoga and prana energy
2.4 H olographi c model of microsyst ems
2.5 N europhysi ology of pain and pain i n hi bi t i on
2.6 Endorphin release by auricular acupunct ure
2.7 Embryological perspective of auri culot herapy
2.8 N ogi er phases of auricular medicine
2.8.1 Auricular t erri t ori es associated w i t h the three em bryologi cal phases
2.8.2 Functional characteristics associated w i t h di f f eren t N ogier phases
2.8.3 Relationship of N ogier phases to t radi t i on al Chinese m edi ci ne
2.9 I n t egrat i n g alt ernat i ve perspectives of auri culot herapy
T heori es concerni ng any aspect of m edi ci ne are generally useful for provi di ng a fram ework and a
st ru ct u re which brings syst emat ic order to di agnost i c u n derst an di n g and t reat m en t appli cat i ons.
W ith a procedu re as seemingly illogical as auri culot herapy, a com prehen si ve t heory becom es
necessary to justify why auri cular acu pu n ct u re should even be con si dered as a valid t herapy. It does
not seem com m on sense t hat it is possible to t reat problem s in the st om ach or on the foot by
st i m ulat i ng poi nt s on the ext ernal ear. W hile it is observably evi dent t hat the ear is an organ for
hearing, it is not at all obvious t hat the ear could relat e to any ot her healt h condi t i ons. Even when
shown repeat ed clinical examples of pat i en t s who have ben efi t t ed from auri cular acupun ct ure, most
persons still rem ai n skept ical, and auri culot herapy may seem m ore like magic than medicine. T he
t heori es which are presen t ed in this sect i on are varied, but they are n ot mut ually exclusive. It may be
a com bi n at i on of all of t hese t heori es which ult i mat ely account s for the clinical observat i ons which
have been m ade. T here is no presen t evi dence which proves t hat on e of t hese t heori es is m ore
correct than an ot her, but t here is m ore em pi ri cal su pport for the n eu roen docri n e perspect i ves.
T here may develop a new t heoret i cal model which bet t er account s for the current ly available dat a,
but the viewpoint s descri bed below are a good begi nni ng to u n derst an di n g this field.
2.1 M icro-acupunct ure systems
T he first t heory to be con si dered is the con cept t hat au ri cu lar acu pu n ct u re is on e of several
mi crosyst ems t hrou ghou t the hu m an body, a self-con t ai n ed system wi t hi n the whole system. In
O ri en t al t hi nki ng, t here is a syst emat i c correspon den ce of each part to the whole. T he m i crocosm
of each person is i n t errelat ed to the m acrocosm of the world t hat su rrou n ds t hem . Even in the
W est, m edi eval Eu ropean phi losophers descri bed the relat i on shi p bet ween organ s of the
m i crocosm of man to the plan et ary con st ellat i on s in t he m acrocosm of the heavens. M odern
m edi ci ne accept s t hat the m i croorgani sm of each cell wi t hi n the body is i n t errelat ed to the
m acroorgan i sm of the whole body. Ju st as each cell has a prot ect i ve m em bran e, flowing fluids, and
a regulat i n g cen t er, so too does the whole body have skin, blood, and the brai n. For the whole of
the organi sm to be in balan ce, each sm aller system wi t hi n t hat organ i sm must be in balance.
M i cro- versus m acro- acu pu n ct u re systems: Dr Ralph Alan D ale (1976, 1985, 1999) of M iami,
Flori da, was one of the first i nvest i gat ors to suggest t hat not only the ear, but every part of the gross
an at om y can funct i on as a com plet e system for di agnosi s and t herapy. D ale has spen t several
T heoretical perspectives 17
18
decades accu m u lat i n g clinical evi den ce from Chi n a, Japan , Eu rope an d A m eri ca abou t t hese
m ult i ple m i crosyst em s. T he t erm m i cro- acu pu n ct u re was i n t rodu ced by D al e at t he 1974 T hi rd
W orld Sym posi um on Acu pu n ct u re and Chi n ese M edi ci n e. M i cro- acu pu n ct u re is t he expressi on of
the en t i re body’s vital qi en ergy in each m aj or an at om i cal regi on . H e labeled t hem
m i cro- acu pu n ct u re systems to di st i ngui sh t hem f rom t he t radi t i on al m acro- acu pu n ct u re systems
t hat con n ect the acu poi n t s di st ri bu t ed t hrou ghou t t he m eri di an s of t he body. Every
m i cro- acu pu n ct u re system con t ai n s a di st ri bu t i on of acu poi n t s t hat repli cat e t he an at om y of t he
whole organ i sm . M i cro- acu pu n ct u re syst em s have been i den t i fi ed by D al e on t he ear, foot, han d,
scalp, face, nose, iris, t eet h, t on gu e, wrist, abdom en , back and on every long bon e of the body. Each
regi on is a f u n ct i on al m i crocosm of the t radi t i on al en erget i cs of the whole body. Every part of the
body exhi bi t s an en erget i c m i crocosm t hrou gh m i cro- acu poi n t s and m i cro- chan n els t hat rei t erat e
the t opology of the body. Fi gu re 2.1 depi ct s the m i crosyst em s t hat have been i den t i f i ed on the
scalp, the ear, the han d, t he m et acarpal an d the foot. D al e has i den t i f i ed specific pri n ci ples
regardi n g t hese m i cro- acu pu n ct u re syst em s t hat are presen t ed below.
Remote reflex response: Every microsyst em mani fest s neurologi cal reflexes t hat are con n ect ed with
part s of the body rem ot e from the anat om i cal locat i on of t hat microsyst em. T hese reflexes are bot h
diagnost ic and t herapeut i c. T hey may be act i vat ed by massage, n eedle acu pu n ct u re, moxibust ion,
heat, elect ri cal st i m ulat i on, laser st i m ulat i on, m agnet s or any m et hod used in m acro-acupun ct ure.
W hen pressure is appli ed to a reactive microsystem poi nt , a pron ou n ced facial gri m ace or a behavi oral
wit hdrawal reflex is evoked. D i st i nct verbali z at i ons of di scom fort i ndi cat e t hat the react i ve ear poi n t is
t en der to t ouch. T he locat i ons of these di st ant t en der spot s are not due to ran dom chan ce, but are in
fact relat ed to a neurologi cal reflex pat t ern t hat is cent rally m edi at ed.
Som at ot opi c rei t erat i on : T he m i crosyst em reflex m ap of the body repeat s the an at om i cal
arran gem en t of the whole body. T he t erm ’som a’ ref ers to t he word body, an d ’t opography’ ref ers
to the m appi n g of the t errai n of an area. M i crosyst em s are si m i lar to t he som at ot opi c respon ses in
the brai n, where a pi ct u re of a hom u n cu lu s, a ’li t t le m an , ’ can be i den t i f i ed by brai n m appi n g
st udi es. Fi gu re 2.2 shows t he som at ot opi c hom u n cu lu s i m age t hat is rel at ed to di f f eren t regi on s of
the brai n . It is n ot the act u al bon e or m uscle which is represen t ed on t he brai n . Rat her, it is the
m ovem en t activity of t hat area of the body which is m on i t ored by the brai n . Such is also the case
with m i crosyst em poi nt s, which i n di cat e the pat hologi cal fu n ct i on i n g of an organ , n ot the
an at om i cal st ru ct u re of t hat organ .
Som at ot opi c inversion: In som e m i crosyst em s, the reflex t opology di rect ly correspon ds to the
upri ght posi t i on of the body, whereas in ot her m i crosyst em m aps, the body is con f i gu red in an
inverse order. In the au ri cu lot herapy m i crosyst em , the reflex pat t ern resem bles the i n vert ed fet us
in the womb. W ith the han ds poi n t ed down wards and t he toes st ret ched ou t , t he han d and foot
reflexology systems are also i n vert ed. T he scalp m i crosyst em is also represen t ed u psi de down,
whereas the m edi al m i crosyst em s of the abdom en , back, face, nose an d lips are all ori en t ed in an
u pri ght pat t ern . T he t on gu e and t eet h m i crosyst em s are presen t ed hori z on t ally.
Ipsilateral represen t at i on : M icrosyst ems t en d to have bi lat eral effects, but they are usually m ore
reactive when the m i cro-acupoi nt and the area of body pat hology are i psi lat eral to each ot her, on
the same side of the body. Only the scalp microsystem, which correspon ds to the underlyi ng
som at osensory cerebral cortex, exhibits react ive acupoi n t s on the side of the scalp t hat is con t ralat eral
to the side of body pat hology. For the auri cular microsyst em, a con di t i on on the right side of the body
would be represen t ed on the right ear, whereas a problem on the left side of the body would be
reflect ed on the left ear. Actually, each region of the body bilat erally project s to bot h the right and left
ear. Auri cular represen t at i on is simply st ron ger on the i psi lat eral ear t han the con t ralat eral ear.
Bi -di rect i onal con n ect i on s: Pat hology in a specific organ or part of t he body is i n di cat ed by
di st i nct chan ges in the skin at the correspon di n g m i crosyst em poi n t , whi le st i m u lat i n g t hat poi n t
can produ ce chan ges in t he correspon di n g part of the body.
O rgan o-cut an eous reflexes: In this type of reflex, pat hology in an organ of the body produ ces an
alt erat i on in the cu t an eou s region where t hat correspon di n g organ is represen t ed. Locali z ed skin
changes may include i ncreased t en dern ess on palpi t at i on, alt ered blood flow, elevat ed t em perat u re,
changes in elect roderm al activity, changes in skin color or alt erat i on s in skin t ext ure. T hese skin
react i ons are diagnostically useful for all the microsystems, but because of the risks involved with
t reat m en t , the tongue, iris and pulse microsyst ems are u sed almost exclusively for diagnosis.
Auriculotherapy M anual
Scalp m i crosyst em
Ear m i crosyst em
3
Jeg
/ /
~ _ Body
Arm
’1 "l "’I ’I ". - - - H ead
3 4
1
Foot reflexology m i crosyst em
Z han g m et acarpal m i crosyst em
Arm
N eck " / /
H ead/
H and reflexology m i crosyst em
L eg- _
A bdom en - - - ›
Chest -
Chest -
Abdomen
Leg
Arm
- - Chest
- - - - N eck
- - - - - - H ead
1 1
Reflexology z on e di vi si ons
Figure 2.1 M icrosystems that have heen i dent i fi ed on the scalp, ear, hand, m et acarpal hone an d foot, an d the five z on es of the body used
in reflexology. (From Life ART S", Super An at om y, ' Li ppi n cot t W illiams & W ilkins, with perm i ssi on. )
T heoretical perspectives 19
A Sagi t t al view Body
Leg
Arm
Reticular
formation
Cerebral cortex
B Fron t al view
Cerebral cortex
Reticular
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6
Leg
Body
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H ead
Leg
, -
I /
I ,
I ,
I I
I I
- - - . . . . , I
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’, I ,
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Arm
)


Figure 2.2 Som at ot opi c organiz at ion of the cerebral cortex, t halam u s an d reticular f orm at i on of the brain viewed
sagittally (A) an d frontally (B). (From Li j e ART "’, Super An at om y, ' Li ppi n cot t W i lli ams & W ilkins, with
permission. )
20 Auriculotherapy M anual
Cut an eo-organ i c reflexes: St i m ulat i ng the skin at a m i crosyst em acu poi n t produ ces i n t ern al
hom eost at i c changes t hat lead to the reli ef of pai n and the heali n g of the correspon di n g organ.
T his cu t an eou s st i m ulat i on t riggers nervous system m essages to the spi n al cord and brai n,
act ivat ing bi oen erget i c changes, bi ochem i cal releases, and alt erat i on s of the elect ri cal firing in
n eu ron al reflexes.
I n t eract i on s bet ween systems: All of t he m i cro- acu pu n ct u re system i n t eract with the
m acro- acu pu n ct u re systems. T reat m en t by on e system will produ ce chan ges in the body’s
funct i onal pat t ern s as di agn osed by the ot her systems. T reat m en t of t he overall m acrosyst em
affects the funct i oni ng of the mi crosyst ems and t reat m en t of any of t he mi crosyst ems affects the
funct i oni ng of the m acrosyst em and of t he ot her microsyst ems. For i n st an ce, st i m ulat i n g an ear
poi n t can redu ce the i nt ensi t y of di scom fort of a t en der t ri gger poi n t on an acu pu n ct u re channel,
whereas an elect rically react i ve ear poi n t will becom e less conduct i ve if the pat i en t begins to heal
following a body acu pu n ct u re t reat m en t .
M u alarm points and shu t ran sport points: T he first m i cro- acu pu n ct u re systems ori gi n at ed in
anci ent Chi na, but they were not consciously developed as such. T he fron t m u and the back shu
channels are 12-point di agnost i c and t herapeu t i c systems ( D ale 1985). Each of the 12 acupoi nt s on
these mi dli ne m eri di ans reson at es with on e of 12 pri nci pal organs, i ncludi ng the lung, heart , liver,
spleen, st om ach, i nt est i nes, bladder and kidney (Fi gure 2.3). T he f ron t mu poi n t s and back shu
points are m ore or less cu t an eou s project i ons from the visceral organ s t hat are foun d deep ben eat h
the skin. T hese anci ent systems may be seen as organ-energy correspon den ces, whose acupoi nt loci
on the body surface are rei t erat i ve of the underlyi ng anat om y. T he mu and shu poi n t s for the heart
are respectively on the an t eri or chest and on the post eri or spine at the level of the act ual heart ,
whereas the mu and shu poi nt s for the liver are respect ively on the an t eri or body and the post eri or
body above the actual liver. T he mu poi n t s alarm the body abou t i n t ern al di sorders and are
sensitive to pain when t here is acute or chron i c visceral distress. W hi le the shu poi n t s t hat run along
the post eri or spine can also be utilized for di agnost i c discoveries, t hese acupoi nt s on the back are
m ore oft en used for t reat m en t of the underlyi ng organ di sorder. St i m ulat i ng the back shu poi nt s is
said to convey the vital qi energy to the correspon di n g i n t ern al organ.
M i crosyst em s along t he body: In 1913, Kuraki shi H i rat a, a Japan ese psychologist , post u lat ed
seven m i cro- acu pu n ct u re zones: the head, face, neck, abdom en , back, arms, and legs. Each of the
seven z on es m an i fest ed 12 hori z on t al sub-z ones of organ -en ergy funct i on: t rachea- bron chi , lungs,
heart , liver, gall bladder, spleen - pan creas, st om ach, kidneys, large i nt est i nes, small i nt est i nes,
uri n ary bladder and geni t als. T he H i rat a Z on es were ut i li z ed bot h for diagnosis and for t reat m en t .
Begi nni ng in 1973, a Chi n ese researcher, Yi ng-Q i ng Z han g (1980, 1992) from Shan dong
University, publi shed several book s and articles, proposi n g a t heory he called ECI W O ( Em bryo
Con t ai n i n g the I n f orm at i on of the W hole O rgan i sm ). Z han g deli n eat ed m i cro- acu pu n ct u re
systems for every long bon e of the body, which he presen t ed at the W orld Federat i on of
Acu pu n ct u re Soci et i es an d Associ at i ons m eet i n g in 1990. Z han g part i cularly em phasi z ed a set of
mi crosyst em poi n t s locat ed out si de the secon d m et acarpal bon e of t he han d. Like H i rat a, Z han g
i dent i fi ed 12 divisions t hat correspon d to 12 body regions: head, neck, arm, lungs and heart , liver,
st om ach, i nt est i nes, kidney, u pper abdom en , lower abdom en , leg and foot. Bi oholographi c
systems arran ged in a som at ot opi c pat t ern were descri bed for all the pri m ary bon es of the body,
including the head, spine, u pper arm, lower arm, han d, u pper leg, lower leg, and foot. Each of
t hese sk elet al regi ons was said to con t ai n the 12 di fferen t body regi ons and t hei r underlyi ng
i n t ern al organs.
Foot and hand reflexology: T wo of the oldest mi crosyst ems are t hose of the foot and the han d,
bot h known in an ci en t Chi n a and an ci en t India. In 1917, W illiam H Fi t z gerald M D, of H art f ord,
Con n ect i cut , i n depen den t ly redi scovered the mi crosyst em of the foot as well as the han d ( D ale
1976). Fi t z gerald called t hese systems Z on e T herapy. T he t opology of Fi t z gerald’s mi crosyst em
poi n t s was deri ved from the project i on s of five di st i nct z on es t hat ext en ded bi lat erally up the
en t i re lengt h of the body, each zone ori gi n at i n g from on e of the five digits of each han d and each
foot. Several ot her Am eri can s, i ncludi ng W hi t e, Bowers, Riley and St opfel, developed this
procedu re as reflexology, by which n am e it is widely known today. In han d and foot reflexology, the
fingers and toes correspon d to the head, whereas the base of the han d and the heel of the foot
represen t the lower part of the body. T he t hu m b and large toe i n i t i at e z on e I t hat ru n s along the
mi dli ne of the body, whereas the index finger and secon d toe represen t z on e 2, the m i ddle finger
T heoretical perspectives 21
A
B
Front mu poi n t s
Lungs
Pericardium
H eart
~ L i v e r
Gall Bladder
Stomach
Spleen
1 - - - - - - - Kidney
Large Intestines
- - - - - - Sm al l i n t est i n es
i - - - San jiao
- - - - - - Bladder
Back shu poi n t s
Lungs
Pericardium
H eart
Liver
Gall Bladder
Stomach
- - - - - - - Spleen
Kidney
Large Intestines
- - - - Small Intestines
San [iao
Bladder
22
Figure 2.3 M u points (A) found on the anterior torso that represent the internal organs beneath them and the
corresponding shu points (B) found on the posterior torso of the body.
Auricu/otherapy M anual
and t hi rd t oe are foun d in z on e 3, the ring finger an d f ou rt h toe are locat ed in z on e 4, and t he li t t le
finger and li t t le t oe dem ark z on e 5 (see Fi gu re 2.1). T hi s last z on e con n ect s all peri pheral regi ons
of the body, i ncludi ng t he leg, arm, and ear. T he m i dli n e of t he back is in z on e 1, whereas the hips
and shou lders occu r alon g z on e 5. On t he head, t he n ose is in z on e 1, t he eyes in z on es 2 an d 3, an d
the ears are in z on e 5. T he foot reflexology micro syst em is shown in Fi gu re 2.4, an d t he han d
reflexology mi crosyst em in Fi gure 2.5.
Koryo hand therapy: T he Korean acu pu n ct u ri st T ae W oo Yoo has descri bed a di f f eren t set of
correspon den ce poi n t s for the han d (Yoo 1993) (see Fi gu re 2.6). In this Korean m i crosyst em , the
m i dli ne of t he body is represen t ed alon g t he m i ddle fi nger and m i ddle m et acarpal, t he arms are
represen t ed on the secon d and f ou rt h fingers, an d t he legs are represen t ed on t he t hu m b and little
finger. T he post eri or head, neck an d back are f ou n d on the dorsu m of t he han d an d the an t eri or
face, t hroat , chest and abdom en are represen t ed on t he pal m ar side. Beyon d correspon den ces to
the act ual body, Koryo han d t herapy also presen t s poi n t s for st i m u lat i n g each of t he m eri di an
acu pu n ct u re poi n t s t hat ru n over t he act ual body. T he m acro- acu pu n ct u re poi n t s of each chan n el
are represen t ed on the correspon di n g m i cro- acu pu n ct u re regi ons f ou n d on the han d.
Acu pu n ct u ri st s i n sert thin short n eedles j u st ben eat h t he skin surface of t hese han d poi nt s, usually
using a speci al m et al device t hat holds t he small n eedles. T hat this Korean som at ot opi c pat t ern on
t he han d is so di f f eren t from the Am eri can han d reflexology pat t ern seem s paradoxi cal,
part i cularly since pract i t i on ers of bot h systems claim very high rat es of clinical success. Since t here
are also di fferen ces in t he Chi n ese and Eu ropean locat i on s for au ri cu lar poi nt s, a broader view is
t hat the som at ot opi c pat hways may have m ult i ple m i crosyst em represen t at i on s.
Face and nose microsystems: Chi n ese pract i t i on ers have i den t i fi ed m i crosyst em s on the face an d
the nose t hat are ori en t ed in an u pri ght posi t i on (see Fi gu re 2.7). T he hom u n cu lu s for the face
system places the head an d neck in the f orehead, t he lungs bet ween t he eyebrows, t he heart
bet ween t he eyeballs, the liver an d spleen on t he bri dge of the nose, an d t he u rogen i t al system in
the phi lt ru m bet ween the lips an d nose. T he digestive organ s are locat ed alon g t he m edi al cheek s,
t he u pper limbs across t he u pper cheek s, and t he lower limbs are represen t ed on t he lower jaw. In
the nose system, the m i dli ne poi n t s are at approxi m at ely t he sam e locat i on as in t he face system,
the di gest i ve system is at t he wings of the nose, an d the u pper and lower ext rem i t i es are in the
crease alon gsi de the nose.
Scalp microsystem: Scalp acu pu n ct u re was also k n own in an ci en t Chi n a and several m odern
systems have su bsequ en t ly evolved. Scalp m i cro- acu pu n ct u re has been shown to be part i cularly
effect i ve in t reat i n g st rok es and cerebrovascu lar con di t i on s. W hi le t here are two scalp
mi crosyst ems i n di cat ed by D ale (1976), t he pri n ci pal system divides t he t em poral sect i on of the
scalp i n t o t hree part s (see Fi gu re 2.8). A di agon al line is ext en ded lat erally from the top of t he
head to the area of the t em ples above t he ear. T he lowest port i on of t hi s t em poral line relat es to
the head, t he m i ddle area relat es to t he body, arms, an d han ds, an d t he u pperm ost regi on
represen t s t he legs an d feet. T his i n vert ed body pat t ern represen t ed on t he scalp act i vat es reflexes
in the i psi lat eral cerebral cort ex to the con t ralat eral side of the body.
T ongue and pulse microsystems: T ongue exam i n at i on an d palpat i n g t he radi al art ery of the wrist
are two an ci en t Chi n ese di agn ost i c systems. W hi le n ot init ially i n t en ded as such, t he t on gu e and
pulse can also be viewed as mi crosyst ems. For pulse di agnosi s, t he acu pu n ct u re pract i t i on er places
t hree m i ddle fingers on t he wrist of the pat i en t . T he t hree placem en t s are called the cun or distal
posi t i on, the gu an or m i ddle posi t i on, an d t he chi or proxi m al posi t i on . T he distal posi t i on ( n earest
the han d) relat es to t he heart and lungs, t he m i ddle posi t i on relat es to t he di gest i ve organ s, and t he
proxi m al posi t i on ( t oward the elbow) relat es to the k i dneys (see Fi gu re 2.9). T he pract i t i on er
palpat es t he pulse to feel for such subt le quali t i es as superfi ci al versus deep, rapi d versus slow, full
versus em pt y and st ron g versus weak. In t he t on gu e m i crosyst em , t he heart is f ou n d at t he very tip
of t he t on gu e, the lung in t he front , the spleen at t he cen t er, an d t he k i dn ey at t he back of t he
t on gue. T he liver is locat ed on the sides of the t on gue. T ongue qu ali t i es i n clude observat i on s as to
w het her its coat i n g is t hi ck versus thin, t he color of the coat i n g is whi t e or yellow, an d w het her the
color of the t on gu e body is pale, red or pu rple.
Dental microsystem: A com plet e represen t at i on of all regi on s of t he body on the t eet h has been
report ed by Voll (1977), who associ at ed specific t eet h with specific organ s. T he t eet h t hem selves
can be i dent i fi ed by on e of several n om en clat u re m et hods. O n e syst em involves first dividing the
t eet h i n t o f ou r equ al qu adran t s: right u pper jaw, left u pper jaw, right lower jaw and left lower jaw.
T heoretical perspectives 23
A
Foot out st ep
M id Back
Upper Back
H ead ~ = - - - - - -
Shoulder
Upper Arm Elbow and
Forearm
Knee
Ovaries and T estes
Lower Leg
Foot
H ip and
Upper Leg
Dorsum of right f oot Dorsum of l ef t f oot
Right Leg
B
Right Arm
Right Shoulder
Right Side
of N eck
Left Leg
Left Arm
Left Shoulder
Left Side
of N eck
c
Right plan t ar f oot
Sinuses
Eyes
Ears
Right Lung
Liver
Adrenal Gland
Right Kidney
Gall Bladder
Large Intestines
Appendix
Sciatic N erve
Brain
D
Left plan t ar f oot
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 T he f oot reflexology system depicted on the out si de (A), dorsu m (B), plan t ar surface (C) an d instep (D) of the foot.
24 Auriculotherapy M anual
Ear
Shoulder
Arm
H ip
H and
C Right hand dorsum
H ead
Lungs
Kidney
Spleen
Lumbar
Spine
Lower
Back
Pi t u i t ary Gland
Adrenal Gland
T horaci c
Spine
Pancreas
Large I n t est i n es
Bladder
O vary and T estis
Cervical
Spine
U t eru s and Prostate
H ead and
Skull
Small
I n t est i n es
Appen di x
Pancreas
O v ary
and T estis
Gall
Bladder
Bladder
Uterus
Liver
A Left palm
H eart
Large
I nt est i nes
B Ri ght palm
Lung
T hyroid
Kidney
Small I n t est i n es
Figure 2.5 T he han d reflexology system depi ct ed on the pal m ar surface of the left han d (A), the right han d (B), an d on the dorsal surface
of the right han d (C).
T heoretical perspectives 25
Cervical Spine
Left H and
Left W ri st -
Left Elbow
Left Shoulder
Left Foot
Left Ankle
Left H ip
A Dorsal hand
Forehead
B Palmar hand
Right H and -
Right Foot
Right Lung
Liver ~ ~ ~ _
Gall Bladder
Right Kidney
I nt est i nes
Genitals
O cci pu t
Right H and
Right W ri st
Right Elbow
Right Foot
Right Ankle
Right Knee
Right Shoulder
Right H ip
<, T horacic Spine
Lumbar Spine
Sacral Spine
T hroat
Left H and
Chest
H eart
Left Lung
Left Foot
- - ~ S p l e e n
Pancreas
St om ach
Left Kidney
Bladder
26
Figure 2.6 T he Korean han d m i cro-acupunct ure system depi ct ed on the dorsal (A) and palm ar (B) sides of the
hand.
Auriculotherapy M anual
A Front al v i ew
H ead- - - - -
N eck - - -
Lungs
H eart - >:
Liver . - - - - - - -

Large I n t est i n es »>

Spleen
Bladder
Gen i t als
B Side v i ew
Lungs
H eart - - - - - -
Liver - - - - - -
Spleen


G en i t al s/
Large I n t est i n es
Kidney
Gall Bladder
Small I n t est i n es
Shoulder

.i->
- H and
Kidney
---- H ip
Leg
Knee
Foot
Gall Bladder
Small I n t est i n es
- Shoulder
- Arm
»>- H and
- H ip
--- Leg
- Knee
_ _- - - - Foot
Figure 2 . 7 T hef ace microsystems vi ewedfrom t hef ron t (AJ and the side (B).
T heoretical perspectives 27
A Frontal view
B Side view
T horacic
organs
St om ach
and Liver
I nt est i nes
T horacic Organs
M otor area
St om ach and Liver
Small and Large I nt est i nes
I - - - H ead
Som at osen sory area
- - - L eg
28
Figure 2.8 T he scalp m i cro- acu pu n ct u re poi n t s related to the underlyi ng cerebral cortex viewed f rom the fron t (A)
an d the side (B).
Auriculotherapy M anual
A T ongue microsystem
Lower Jiao
M iddle [lao
Upper Jiao
Kidney
Spleen
_ - - - Stomach
- - - - Liver and Gall Bladder
- - - - L u n g
- - - - H eart
B Pulse microsystem
Surface pulse Deep pulse
Bladder
~ e e , p pulse " S ~ .. rface pulse
Kidney
Liver
~ - - - - - - - - Small Intestines
- - - - H eart
’- - _ - - - - - - Gall Bladder
Pericardium
~ ~
Spleen _______
Stomach
San [lao
L u n g- - - - - ›
Large Intestines _ - - - - - - - - :i
Figure 2.9 I n t ern al organs represent ed on the t on gue m i crosyst em (A) are cont rast ed with the acu pu n ct u re chan n els represent ed at the
radial pulse (B).
T heoretical perspectives 29
T able 2.1 Dental microsystem correspondences between teeth and body regions
T ooth position Right upper and lower jaw quadrants Left upper and lower jaw quadrants
I. Cen t er incisor Right kidney, bladder, geni t als, lum bosacral
vert ebrae, right knee and ankle, sinus, ear
Left kidney, bladder, geni t als, lum bosacral
vert ebrae, left knee and ankle, sinus, ear
2. Lat eral incisor Right kidney, bladder, geni t als, lum bosacral Left kidney, bladder, geni t als, lum bosacral
vert ebrae, right knee and ankle, sinus vert ebrae, left knee and ankle, sinus
3. Can i n e Liver, gall bladder, lower t horaci c vert ebrae, Liver, spleen , lower t horaci c vert ebrae,
right hip, right eye left hip, left eye
Left lung, large i nt est i nes, u pper t horaci c
vert ebrae, left foot
Left lung, large i nt est i nes, u pper t horaci c
vert ebrae, left foot
- - - - - - - - - - - - -
Spleen, st om ach, left jaw, left shoulder,
left elbow, left han d
Pancreas, st om ach, right jaw, right shoulder,
right elbow, right hand
Right lung, large i nt est i nes, u pper t horaci c
vert ebrae, right foot
4. First bicuspid
6. First m olar
5. Second bicuspid Right lung, large i nt est i nes, u pper t horaci c
vert ebrae, right foot
- - - - -
7. Second m olar Pancreas, st om ach, right jaw, right shoulder,
right elbow, right han d
- - - - - - - -
Spleen, st om ach, left jaw, left shoulder,
left elbow, left hand
8. W isdom t oot h H eart , small i nt est i nes, i n n er ear, brai n st em ,
limbic brai n, cerebru m , right shoulder,
elbow, han d
H eart , small i nt est i nes, i n n er ear,
brai nst ern, limbic brain, cerebru m ,
left shou lder, elbow, hand
. _ - - - - - - - - - - - - - - - - - - - - _ . _ - - - - - - - - _ . _ - -
T he individual t eet h are t hen n u m bered from 1 to 8, begi nni ng with the mi dli ne, f ron t incisors at I,
then progressi ng lat erally to the bicuspids, and con t i n ui n g m ore post eri orly to the m olars at 7 or 8.
I ndividuals who have had t hei r wisdom t eet h rem oved on a side of t hei r jaw will only have seven
t eet h in t hat qu adran t . U rogen i t al organ s and the lower limbs are represen t ed on the m ore cen t ral
t eet h, whereas t horaci c organ s and the u pper limbs are represen t ed on the m ore peri pheral m olars
(see T able 2.1).
2 . 2 T radi t i onal O ri en t al medicine and qi energy
W hile the Yellow Em peror’s classic of i nt ernal m edi ci n e (Veith 1972) an d subsequen t Chi n ese medical
texts i ncluded a variety of acupun ct ure t reat m en t s appli ed to the ext ernal ear, it was n ot until the late
1950s t hat an auri cular m i cro-acupun ct ure system was first described. Some t radi t i onali st s con t en d
that ear acupun ct ure is not a part of classical Chi nese medicine. N onet heless, both anci ent and
m odern acupun ct ure pract i t i oners recorded the needli ng of ear acupoi nt s for the reli ef of many
healt h disorders. T hey also em phasi z ed the i m port an ce of select ing ear points based on the
fundam ent al principles of t radi t i onal O ri en t al medicine. T he aspect of body acu pu n ct u re t hat is
most relevant to the appli cat i on of auri culot herapy is the use of distal acu pu n ct u re poi nt s. N eedli ng
acupoi nt s on the feet or han ds has long been used for t reat i n g condi t i ons in di st ant part s of the body.
T here are ot hers who seek to make auri culot herapy complet ely divorced from classical acupun ct ure,
suggesting t hat it is an ent i rely i n depen den t system of t ri gger poi n t reflexes. T he clinical appli cat i on
of cert ai n poi nt s for ear acupun ct ure t reat m en t s, however, does not m ak e any sense wi t hout an
underst andi ng of O ri en t al medicine. T he populari t y of the five ear poi nt s used in the N AD A
t reat m en t prot ocol for addi ct i ons is only com prehensi ble from the perspect i ve of this anci ent Asian
t radi t i on t hat is very di fferent from convent i onal W est ern thinking.
I nfluent i al English lan guage texts on t radi t i on al Chi n ese m edi ci ne i nclude T he web t hat has no
weaver by T ed Kapt chuk (1983), M odem t echni ques of acupunct ure: a pract i cal sci ent i fi c guide to
elect ro-acupunct ure by Juli an Kenyon (1983), Chi nese acu pu n ct u re an d m oxi bu st i on from Forei gn
Languages Press (1987), T he f ou n dat i on s of Chinese m edi ci n e by Gi ovan n i M aci oci a (1989),
Between heaven an d earth by Bei nfeld & Korngold (1991 ) , A cu pu n ct u re energetics by Joseph H elm s
(1995), Basics of acupun ct ure by Stux & Pom eran z (1998), and U nderst andi ng acu pu n ct u re by Birch
& Felt (1999). All of t hese books descri be an en erget i c system for heali n g t hat is root ed in a
uniquely O ri en t al vi ewpoi nt of the hu m an body. W hi le all energy is con cept u ali z ed as a form of qi,
t here are di fferen t m an i fest at i on s of this basic energy subst ance, i ncludi ng the en ergy of yin and
30 Auriculotherapy Manual
yang, an en ergy di f f eren t i at ed by five phases, and an en ergy di st i n gu i shed by ei ght pri n ci ples for
cat egori z i n g pat hologi cal condi t i ons. Everyday observat i on s of n at u re, such as the effect s of wind,
fire, dam pn ess and cold, are used as m et aphors for u n derst an di n g how this qi en ergy affects the
i n t ern al con di t i on s t hat lead to di sease.
Qi: T his basic energy refers to a vital life force, a pri m al power, an d a su bt le essen ce t hat sust ai n s
all exi st ence. T he Chi n ese pi ct ograph for qi refers to t he n ut ri en t -fi lled st eam t hat appears while
cook i ng rice. Qi is the di st i lled essence of the finest m at t er. Si m i lar i m ages for qi i n clude the
u n du lat i n g vapors t hat rise from boi li ng tea, the swirling mists of fog t hat crawl over lowlands, t he
flowing m ovem en t of a gen t le st ream , or billowing clou d f orm at i on s appeari n g ov er a hill. T hese
m et aphori cal pi ct ures were all at t em pt s to descri be t he ci rculat i on of this invisible energy.
D i f f eren t m an i f est at i on s of the images of qi are shown in Fi gu re 2.10. H owever, qi was not just
Figure 2 . 1 0 T he Chi nese pi ct ograph for qi energy is related to the rising st eam of cook i n g rice (A). O t her m et aphors f or qi i n clu de misty
clou ds (B), rushing waterfalls (C) an d flowing rivers (D). ((B) fun M a, (C), ( D ) ' L i t a Singer, with perm i ssi on . )
T heoretical perspectives
31
con si dered a m et aphor. Acupun ct uri st s view qi as a real phen om en on , as real as ot her invisible
forces, like gravity or m agnet i sm . Qi is bot h m at t er and the energy forces t hat move m at t er.
Com parable to W est ern effort s to explai n light as u n derst ood in qu an t u m physics, qi is both like a
part i cle and like a wave. Oi perm eat es everyt hing, occurs everywhere, and is the m edi u m by which
all events are linked to each ot her in an i nt erweavi ng pat t ern . T here is qi in the sun, in m oun t ai n s,
in rocks, in flowers, in t rees, in swords, in bowls, in bi rds, in horses, and in all an at om i cal organs. Oi
i nvi gorat es the consci ousness and willpower of a hu m an being.
As things chan ge in the m acrocosm of the heavens, the mi crocosm of t he eart h reson at es with
correspon di n g vibrat ions, all relat ed to the m ovem en t and i n t ercon n ect edn ess of qi. Cert ai n types
of qi an i m at e living organi sms, with the great est focus placed on defensi ve qi and on nut ri t i ve qi.
D efensive qi (wei qi), also called prot ect i ve qi, is said to be the ext eri or defen se of t he hu m an body
and is act i vat ed when the skin surface and muscles are i nvaded by exogenous pat hogen s. N ut ri t i ve
qi (ying qi), also called nouri shi ng qi, has the funct i on of nouri shi ng t he i n t ern al organ s and is
closely relat ed to blood. Pren at al qi is t ran sm i t t ed by paren t s to t hei r chi ldren at con cept i on and
affects t hat child’s i n heri t ed const i t ut i on. Oi is obt ai n ed from the di gest i on of food and is ext ract ed
from the air t hat we breat he. Rebelli ous qi occurs when energy flows in the wrong di rect i on or in
conflicting, opposi ng pat t ern s. In body acu pu n ct u re, healt h is the harm on i ou s m ovem en t of qi
t hrou ghou t the body, whereas illness is due to di sharm on y in the flow of qi. T here can be
deficiency, excess, or st agn at i on of the flow of qi within the m eri di an chan n els or bet ween di fferen t
organs. T he ear has con n ect i on s to t hese channels, bu t it is not a part of an yon e of the classic
m eri di ans.
M eridian channels: ( li n g Lu o) T he ori gi nal Engli sh t ran slat i on s of the zigzag lines drawn on
Chi nese acu pu n ct u re chart s were descri bed as m eri di ans, alludi ng to t he lines of lat i t u de which
circle the eart h on geographi c maps. In acu pu n ct u re, m eri di an s were t hou ght to be invisible lines
of energy which allow ci rculat i on bet ween specific sets of acu pu n ct u re poi nt s. L at er t ran slat i on s
descri bed t hese acu pu n ct u re lines as channels, an alogous to the wat er canals t hat con n ect ed
di fferent cities in anci ent Chi na. As with channels of wat er, the flow of qi in acu pu n ct u re chan n els
could be excessive, as when t here is a flood; deficient, as when t here is a drought ; or st agn an t , as
when wat er becom es foul from the lack of m ovem en t . N eedles i n sert ed into specific acu pu n ct u re
poi nt s were t hou ght to redu ce the flow of excessive qi, as in dams which regu lat e the flow of wat er,
to i ncrease the flow of defi ci ent qi, as in the release of flood gat es of wat er, or to clear areas of qi
st agnat i on, as in rem ovi ng the debri s t hat can som et i m es block wat er channels. W at er has of t en
been used to symbolize invisible energi es, and is still t hou ght of in the W est as a con ven i en t way to
convey the propert i es of elect ri ci t y and the flow of elect ri cal i m pulses along n eu ron s. Acupoi n t s
were t hou ght to be holes (xue) in the lining of the body t hrou gh which qi could flow, like wat er
t hrough a seri es of holes in a spri n k ler system.
T ao: T he phi losophy of T aoism guides on e of the oldest religions of Chi n a. Its basic t en et is t hat
the whole cosmos is com posed of two opposi n g and com plem en t ary quali t i es, yin an d yang. T he
T aoist symbol shown in Fi gu re 2.11 reveals a circle t hat is divided i n t o a white t eardrop and a black
t eardrop. A white dot within the black side represen t s t he yang within yin, and the black dot within
T ao 3it
Yin Yang
32
Figure 2.11 T he T aoist sym bol for the duality of com plem en t ary opposi t es has a yin dark side an d a yan g light
side. Each hal f con t ai n s an elem en t of the opposi t e side.
Auriculotherapy M anual
Figure 2 . 1 2 A depiction of yang as the sunny side and yin as the shadysi de of a hill. (Based on photograph of
m oun t ai n s by Lita Singer, with permission)
the white side reflects t he yin within yang. T he Chi n ese charact er for yang ref erred to the sunny
side of a hill t hat is warm ed by bri ght rays of sunlight , whereas the pi ct ograph charact er for yin
ref erred to the dark er, colder, shady side of a hill. Fi gu re 2.12 depi ct s such a scene. Light and dark,
day and night, hot and cold, male and fem ale, are all exam ples of this basic duali sm of the n at u ral
world. Yin and yang are always relat i ve rat her t han absolut e quali t i es. T he fron t of the body is said
to be yin and the back of the body yang, yet the u pper body is m ore yang com pared to the lower
body. T he ou t er skin of the body and the muscles are m ore yang, t he i n t ern al organ s are m ore yin.
T heoretical perspectives 33
34
Box 2.1 T aoist qualities of yang and yin
Yang qu al i t i es Yin qu al i t i es
Sunny side Shady side
Day N i ght
Sun M oon
Sky Earth
Fire W at er
H ot Cold
H ard Soft
O rder Chaos
Rigid Flexible
Active Passive
Strong W eak
Energetic Restful
M ovem en t Stillness
Aggressive N u rt u ri n g
Rational I n t u i t i v e
I n t ellect Em ot i ons
H ead H eart
M asculine Feminine
Father M ot her
D i sorders rel at ed to overact i vi t y are m ore yang, di seases of weak n ess are m ore yin. ( T he duali st i c
aspect s of yin and yang are su m m ari z ed in Box 2.1.)
T he psychologi st Carl Ju n g (1964) and t he hi st ori an Joseph Cam pbell (1988) have n ot ed com m on
archet ypal i m ages in the an ci en t cu lt u res of Chi n a, I n di a, Egypt, Persi a, Eu rope and am on gst
N ative Am eri can s. In all t hese soci et i es, the sky, t he sun, and fire are ref erred to as ’m ascu li n e’
quali t i es, whereas the eart h, the m oon , an d wat er are associ at ed with ’f em i n i n e’ quali t i es. T aoist
phi losophers descri bed this opposi t i on of duali t i es in every aspect of n at u re. T here is a t en den cy in
W est ern cu lt u re to place great er value on the ’m ascu li n e’ qu ali t i es of bei n g st ron g, act i ve, rat i on al,
and orderly, and to devalu e the ’f em i n i n e’ quali t i es of bei n g passive, weak , or em ot i on al. It is
u n derst an dable t hat most peopl e t en d to pref er bei n g st ron g, bu t it is still i m port an t for t hem to
ack n owledge t i m es when t hey feel weak. T aoism recogn i z ed the i m port an ce of balan ce and
em phasi z ed the value of ’f em i n i n e’ qu ali t i es of n u rt u ran ce and i n t u i t i on as well as t he ’m ascu li n e’
t rai t s of st ren gt h and i nt elli gence.
Yang qi : T his en ergy is like the warm , bri ght light of t he sun. It is said to be st ron g, forceful,
vi gorous, exciting, con t rols active m ovem en t , and is associ at ed with aggressi ve ’m ascu li n e’
quali t i es. Yang m eri di an chan n els are t hou ght to have di rect con n ect i on s to ear acu pu n ct u re
poi nt s. Yang qi flows down the m eri di an s on the back side of the body, pervadi n g skin and m uscles
and affect i n g defensi ve qi. Pat hologi cal con di t i on s in t he body can be cau sed by the excess or
st agn at i on of yang qi, produ ci n g sym pt om s of rest lessness, hyperact i vi t y, t rem ors, st ress, anxi et y
and i n som n i a. T o overwork is to overi n du lge in yang qi, which usually leads to bu rn ou t of yin qi. In
addi t i on to the appli cat i on of acu pu n ct u re n eedles, m oxi bust i on and herbal rem edi es, yang qi can
be act i vat ed by vi gorous physical exerci se, at hlet i c sport s and the pract i ce of m art i al art s such as
k u n g fu or k arat e.
Y i n qi: T his en ergy is like the soft, gen t le light of the m oon t hat com es ou t du ri n g t he dark n ess of
night. It is said to be seren e, qui et , rest ful, n u rt u ri n g, an d is associ at ed with passive, f em i n i n e
quali t i es. Yin is n eeded to balan ce yang. T he yin m eri di an s i ndi rect ly con n ect to t he auri cle
t hrou gh t hei r correspon di n g yang m eri di an . Yin qi flows up acu pu n ct u re m eri di an s on the f ron t
side of body and affect s i n t ern al organ s an d n ut ri t i ve qi. Sym pt om s of sleepi n ess, let hargy,
Auriculotherapy M anual
depressi on and a desi re to be i m m obi le may be due to an excessive focus on cravi ng yin qi.
I nsuffi ci ent yin qi is t hou ght to be at the root of most illness, thus acu pu n ct u re and herbs are used
to rest ore this energy. T he flow of yin qi can be en han ced by m edi t at i on , by repeat i n g the soot hi n g
sou n d of a m an t ra, by vi suali z at i on of a harm on i ou s symbol, or by t he pract i ce of such physical
exercises as qi gong, tai chi or yoga. T he Chi n ese goddess Kuan Yin is the m an i f est at i on of the
Bu ddha in female form, usually port rayed as a caring, n u rt u ri n g, ageless wom an who is dressed in
long flowing robes.
Yang alarm reactions: A reactive ear reflex point is said to show a yang react i on on the ear to signal a
stress react i on in the correspondi ng area of the body. In m odern times, an appropri at e analogy would
be a fire alarm signal in a building, indicat ing the specific hallway where a fire is burning. An alarm in a
car can indicat e when a door is ajar. Such alarms alert on e to the specific location of a problem.
Elevat i on of yang energy manifest s in the ext ernal ear as a small area where t here is localized
activation of the sympat het ic nervous system. Such sympat het i c arousal leads to a localized increase
in elect roderm al skin conduct ance that is det ect able by an electrical poi n t finder. Sympat het i c
activation also induces localized regions of vasoconst rict ion in the skin of the auricle. T he rest rict ed
blood supply causes an accumulat i on of subderm al, toxic biochemicals, thus account i ng for the
percept i on of t enderness and the surface skin react i ons often seen at ear reflex points.
Ashi points: In addi t i on to the 12 pri m ary m eri di an chan n els t hat ru n along the len gt h of the
body, the Chi n ese also descri bed ext ra-m eri di an acupoi n t s locat ed ou t si de t hese channels. O n e
cat egory of such acupoi n t s was the ashi poi nt s. Ashi m ean s ’O u ch!’ or ’T here it is!’, and t here is a
st ron g reflex react i on when a t en der regi on of the skin is palpat ed and a pat i en t says ’O u ch, t hat
hurt s!’. T he exclam at i on poi n t highlight s the great em ot i on al exci t em en t vocali z ed at the time an
ashi poi n t is t ouched. Som et i m es n eedli n g of a very t en der acu poi n t within one of the classic
m eri di an chan n els produ ces this same verbal ou t bu rst . W hile the n at u ral i ncli nat i on is to avoid
t ouchi n g areas of the body t hat hurt, an ci en t acupun ct uri st s and m odern m assage t herapi st s have
observed t hat t here is heali n g value in act ually pu t t i n g i n creased pressu re on t hese sensit ive
regions. T he ashi poi n t s have been suggest ed as the ori gi n of the t ri gger poi n t s which have been
descri bed by Jan et T ravell in her work on myofascial pai n (T ravell & Si m on s 1983). In auri cular
acu pu n ct u re, a t en der spot on the ext ern al ear is on e of the definit ive charact eri st i cs t hat i ndi cat e
such a poi n t should be st i m ulat ed, not avoi ded.
Five Ori ent al elements: Also ref erred to as the five phases, this Chi n ese en erget i c system
organi z es the universe i n t o five cat egori es: wood, fire, eart h, m et al and wat er. T he word ’elem en t ’
is similar to the four elem en t s of n at u re descri bed in m edi eval Eu ropean texts, the elem en t s of fire,
eart h, air, an d wat er. T he word ’phase’ is com parable to the phases of the m oon , observed as
sequ en t i al shifts in the pat t ern of sunli ght t hat is reflect ed from the m oon . I t is also relat ed to the
phases of the sun as it rises at dawn, crosses overhead from m orn i n g to af t ern oon , sets at dusk, and
t hen hides duri n g the dark n ess of night. T he phases of the seasons in Chi n ese writings were said to
rot at e from spring to su m m er to lat e su m m er to fall to wi nt er. T hese long-ago physicians found
observat i on s of n at u ral elem en t s, such as the heat from fire or the dam pn ess of wat er, were useful
analogi es as they at t em pt ed to descri be t he m yst eri ous invisible forces which affect healt h and
disease. M any complex m et aboli c act i ons in the hu m an body are still not u n derst ood by m odern
W est ern medi ci ne, even with the lat est advances in blood chem i cal assays and m agn et i c reson an ce
imaging equ i pm en t .
T he m et aphori cal descri pt i ons of five elem en t t heory reflects the poet ry and rhythm of the Chinese
language in t hei r at t em pt s to u n derst an d each individual who is seek i ng relief from some ailment. At
the same time, t here are cert ai n aspects of the five phases t hat seem like an arbi t rary at t em pt to
assign all things to groups of five. T he W est ern approach of dividing the four seasons as the spring
equinox, su m m er solstice, fall equinox, and winter solstice seem more aligned with n at u re than the
Chinese n ot i on of adding a fifth season labeled late sum m er. M oreover, the appli cat i on of five
elem en t t heory to the energet i c aspects of anat om i cal organ s oft en cont radi ct s m odern
un derst an di n g of the biological function of those organs. I t is difficult for W est ern minds to accept
how the elem en t metal logically relat es to the lung organ and the feelings of sadness, whereas the
elem en t wood is said to be associated with the liver organ and the em ot i on of anger. At some point,
one must accept t hat t hese five phases are simply organiz ing pri nci ples to facilit at e clinical int uit ion
in the un derst an di n g of complex diseases. In some respects, it might have been bet t er to have left the
names of the meri di an channels as Chi nese words rat her than to t ran slat e them into the Eu ropean
T heoretical perspectives 35
names of anat omical organs whose physiological functions were already known. T he conflicts bet ween
the O ri ent al energet i c associations of an organ and the known physiological effects of t hat organ can
lead to confusion rat her t han comprehensi on. I f one thinks of these zang-fu organs as force fields
rat her than organic st ruct ures, their associated function may becom e more underst andable.
Zang-fu organs: Each of the five elem en t s is relat ed to two types of i n t ern al organs: the zang
organs are m ore yin, the fu organs are m ore yang. T he acu pu n ct u re chan n els are the passages by
which the zang-fu organ s con n ect with each ot her. T he zang m eri di an s t en d to run along the i n n er
side of the arms and legs and up the fron t of the body. T he fu m eri di an s run along the ou t er side of
the limbs and down the back of the body. T he zang organ s st ore vital subst ances, such as qi, blood,
essence, and body fluids, whereas the fu organ s are con st an t ly filled an d t hen em pt i ed. T he
Chi nese charact er for zang alluded to a depot st orage facility, whereas the pi ct ograph for fu
depi ct ed an ci en t Chi nese grain collect i on cen t ers t hat were called palaces. Alt hou gh Con fuci an
pri nci ples forbade official dissect ions of the hu m an body, an at om i cal i nvest i gat i ons probably still
occu rred in anci ent Chi n a, as did exam i n at i on of ani mals. Physical observat i on s of gross i n t ern al
anat om y reveal t hat the fu organ s were hollow t ube-li k e st ru ct u res t hat ei t her carri ed food
(st omach, small and large i nt est i nes) or carri ed fluid (uri n ary bladder and gall bladder) . In
con t rast , the zang organs seem ed essent i ally solid st ruct ures, part i cularly the liver, spleen and
kidneys. W hile the heart and lungs have respect i ve passages for blood and air, on e would not
descri be t hese two organ s as hollow, but as having i n t ercon n ect i n g cham bers.
T he specific charact eri st i cs of each z ang-fu chan n el are presen t ed in T able 2.2, which i ndi cat es the
i n t ern al organ for which each chan n el is n am ed, the i n t ern at i on al abbrevi at i on for t hat chan n el
T able 2.2 Differentiation of zang-fu meridian channels
Z ang
fu
Organ
channels
W H O
code
O t her
codes
Channel
locat i on
Elem ent Primary
acupoi nt s
- - - - - -
Lung LU H an d tai yin M et al Z an g LU I , L U 7 ,
L U 9
LI 4, LI 11
ST 3 6 , ST 4 4
Fu
Fu
M et al
Eart h
H an d yang ming
- - - - - - - - - - - ~
Foot yang ming
LI
ST
Large I n t est i n es
St om ach
Fi re
Eart h Spleen SP Foot tai yin
H an d shao yin
Z an g
- - - - - -
Z an g
SP 6, SP 9
H T 7
H an d tai yang Fi re Fu SI 3 , SI I 8
Foot tai yang W at er Fu BL 2 3 , BL 4 0 ,
BL 6 0
KI 3, KI 7
PC6
SJ 5
Fire
Fi re
W at er Z an g
Z an g
- - - - - -
Fu
Foot shao yin
H an dj u e yin
- - - - -
H an d shao yang
P
T H , T E,
T W
PC
SJ
Peri cardi u m
San Ji ao
(T riple W arm er)
- - - - - - - - - - - - - - -
Gall Bl adder GB Foot shao yang W ood Fu G B2 0 , G B3 4 ,
G B4 0
W ood Liver
Con cept i on
Vessel
LR
CV
Liv
Ren mai
Foot j u e yin
- - - - - - -
Fron t - M u yin
Z an g
Govern i n g
Vessel
GV D u m ai Back -Shu yang GV 4, G V 14,
G V 2 0
En ergy is said to ci rculat e t hrou gh these zang-fu chan n els in the order presen t ed, from Lung to Large I n t est i n es to St om ach
to Spleen to H eart to Small I n t est i n es to Bladder to Kidney to Peri cardi u m to San Ji ao to Gall Bladder to Liver and back to
Lung. T ai refers to great er yin or yang. shao refers to lesser yin or yang, ming descri bes bri ght ness, and jue yin i n di cat es
absolut e m an i f est at i on of yin.
36 Auriculotherapy M anual
accordi ng to t he W orld H eal t h O rgan i z at i on , alt ern at i ve abbrevi at i on s which have been u sed in
vari ous clinical texts, t he locat i on of each chan n el, and desi gn at i on of t he pri m ary el em en t
associ at ed with t hat chan n el. T he acu poi n t s which are m ost f requ en t ly u sed in acu pu n ct u re
t reat m en t s are also presen t ed. T he sequ en t i al order of t he chan n els presen t ed in T able 2.2
i ndi cat es t he ci rculat i on pat t ern in which en ergy is said to flow. T he chan n els are di f f eren t i at ed
i n t o t hree yin m eri di an s an d t hree yang m eri di an s on t he han d and t hree yin m eri di an s and t hree
yang m eri di an s on the foot. In T able 2.3, t he z ang-fu chan n els are regrou ped accordi n g to t hose
m eri di an s which are m ore yang an d t he correspon di n g chan n els whi ch are m ore yin. T his t able also
descri bes t he relat i on shi p of t he an at om i cal locat i on of each m eri di an t hat is shown on
acu pu n ct u re chart s as com pared to the z on e regi ons of t he body t hat are u sed in f oot an d han d
reflexology. T he zang chan n els t en d to ru n along t he i nsi de of t he arm s or legs, whereas t he
correspon di n g fu chan n el typically ru n s alon g t he ext ern al side of t he arms or legs.
As seen in Fi gu res 2.13 an d 2.14, when t he arms are rai sed u pwards t oward t he sun, yang en ergy
descen ds down t he post eri or side of the body alon g fu chan n els, whereas yin en ergy ascends t he
an t eri or side of the body alon g zang chan n els. Only t he fu St om ach chan n el descen ds alon g the
an t eri or side of the body. Since the fu chan n els have acu pu n ct u re poi n t s locat ed on t he surface of
the head, t hese yang m eri di an s are said to be m ore di rect ly con n ect ed to t he ear. T he Large
I n t est i n es chan n el crosses from t he n eck to the con t ralat eral face, t he St om ach chan n el bran ches
across t he m edi al cheek s an d in fron t of t he ear, the Sm all I n t est i n es chan n el proj ect s across the
lat eral cheek , t he Bl adder m eri di an goes over t he m i dli n e of t he head, an d bot h t he San Ji ao and
t he Gall Bl adder chan n els circle arou n d the ear at t he si de of the head. A cu pu n ct u re poi n t s on the
zang chan n els only reach as high as t he chest , so they have no physical m ean s to con n ect to t he ear.
A n ot her set of acu pu n ct u re chan n els, t he fron t al Con cept i on Vessel m eri di an ( Ren mai) and t he
dorsal Govern i n g Vessel m eri di an ( D u m ai ) bot h ascen d t he m i dli n e of t he body to reach the head,
as shown in Fi gu re 2.15. Represen t at i on of the Con cept i on Vessel an d Govern i n g Vessel chan n els
u pon the t ragu s regi on of t he ext ern al ear is shown in Fi gu re 6.8 of Chapt er 6.
T he Chi n ese chart s do n ot show how the ext ern al ear con n ect s to t he six z an g chan n els. D ale
(1999) has hypot hesi z ed t hat all m i cro- acu pu n ct u re syst ems fu n ct i on t hrou gh m i cro-m eri di an s,
j u st as t he m acro- en erget i c system funct i ons t hrou gh m acro- acu pu n ct u re m eri di an s. I t is f u rt her
post u lat ed t hat the en t i re m acro- m i cro chan n el com plex forms an ext ensi ve en erget i c net work ,
T able 2.3 Anatomical location of yang and yin meridian channels
Yang Location Reflex Corresponding Direction of Reflex
channels zones yin channels energy flow zones
Large External hand to 1-2 Lung Inner chest to
Intestines arm to shoulder inner arm and
and face hand
" - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - - -
San Jiao External hand to 3-4 Pericardium Inner chest to 3
external arm and inner arm and
head hand
Small External hand to 5 H eart Inner chest to 5
Intestines arm to shoulder inner arm and
and face hand
- _ . _ - - - _ ...- . _ . -
Stomach Face to anterior 2-3 Spleen Foot to inner leg 1-2
body to anterior leg to anterior body
-_.,’-_ .. ,--_.__ .._ . _ - - - - - - - - ’- ’- - - - , . _ - -
Gall Bladder External head to 5 Liver Foot to inner leg 1-2
external body and leg to anterior body
Bladder Posterior head to 1-2 Kidney Foot to inner leg 1-2
back to posterior leg to anterior body
Governing M idline of buttocks Conception M idline abdomen
Vessel to midline back Vessel to midline chest
(Du mai) to midline head (Renmai ) to midline face
- - - - - - - - - - -
T heoretical perspectives 37
5T 45
LR 14
KI 21
LR 13
KI 11
Figure 2 . 1 3 T he descent of yan g qi from the head to the feet viewed on the posterior (A) an d anterior (B) side of the body. T he ascent or
yin qi from the feet to the chest only occurs on the anterior side. Yang acupun ct ure chan n els along the body i n clude m eri di an acu poi n t sf or
the Bladder (BL), Call Bladder ( CB) an d St om ach (ST ). Yin acupun ct ure channels i n clude m eri di an acupoi n t s for the Kidney (KI),
Spleen (SP) an d Li ver (LR).
38 Auriculotherapyfv1anual
PC9
PC 6
PC 1
A H and yin meridians
B H and yang meri di ans
SJ 15
SI 15
SI 19
SJ 1
SI 8
Figure 2 . 1 4 Yin qi flows from the chest distally toward the han d yin m eri di an s (A), while yang qi flows f rom the han d yan g m eri di ans
medi allv toward the head (B). T he yin channels of the i n n er arm i n clude the H eart (H T ), Pericardium (PC) an d L u n g ( L V ) meridians,
whereas the yang chan n els of the exterior arm i nclude the Large I nt est i nes (L1), San Jiao (SJ) an d Sm al l I nt est i nes (51) meridians.
T heoretical perspectives 39
A Con cept i on V essel chan n el
B Governi ng V essel chan n el
GV7
, . - - - - G V 1
: - - ~ ~ G V 1 4
- - - - - - - - G v 2 1
CV2 - ~ - - -
CV7 ~ - - - - - - =
CV14
CV21
CV24 ~ ~ ~ ~ - ~ ~ -
Figure 2.15 T he Concept i on Vessel m eri di an (Ren chan n el) is f ou n d on the m i dli n e of the anterior torso (A), whereas the Governi ng
Vessel meri di an (Du channel) is f ou n d along the m i dli n e of the post eri or spine of the body (B).
perhaps si mi lar to the way veins, art eri es and capi llari es charact eri z e the vascular n et work . Since
bot h m acro- acu pu n ct u re chan n els and m i cro- acu pu n ct u re m eri di an s carry invisible forces of
energy, t he exact m echan i sm s rem ai n myst eri ous.
M etal: T he m et aphor of m et al is relat ed to the Bron z e Age t echn i qu e of heat i n g t he m i n erals of
the eart h to a white hot i nt ensi t y with fire, t hen cooli ng the object with wat er and shapi n g it with
wood. W hile m et al is m alleable when it is warm, it becom es hard an d rigid when it cools and
con t ract s i n t o a fixed shape. T he yin n ouri shi n g aspect s of m et al are represen t ed by the ability to
cook rice in a m et al pot, whereas t he yang aggressive aspect s of m et al are dem on st rat ed by the
creat i on of the sword an d prot ect i ve suits of arm or. T he acu pu n ct u re m eri di an s relat ed to metal
are the L u n g chan n el t hat descen ds from t he chest dist ally down t he i n n er arm and ends on the
palm side of the t hu m b, whereas the Large I nt est i nes chan n el is f ou n d on the opposi n g side of t he
han d, begi n n i n g at the ext ern al, dorsu m side of the secon d finger an d t raveli ng up t he ext ern al side
of the arm t oward the body.
Earth: T he yellow eart h is the stable foundat i on u pon which crops are grown and cities are creat ed.
T he late su m m er qualities of eart h allow one to be solid and grounded. T he acu pu n ct u re meri di ans
relat ed to eart h are the Spleen channel t hat begins on the large toe and travels up the i n n er leg and the
St om ach channel that travels down the ext ernal body and ext ernal leg to end on the second toe.
Fire: T he red flames of a fire bring warm t h and com fort to a cold day, allowing one to move abou t
and funct ion with great er ease and speed. T he su m m er quali t i es of fire accom pany a time when t here
is great activity and a gat heri n g of crops. T he acu pu n ct u re m eri di ans relat ed to fire i nclude the H eart
channel t hat descends from the chest distally down the i n n er arm and en ds on the little finger,
whereas the Sm all Intestines chan n el begins on the little finger and travels up the ext ernal arm t oward
the body. T wo ot her channels also relat ed to fire are t he Pericardium chan n el t hat t ravels distally
down the i n n er arm and t he San Jiao chan n el t hat t ravels up the ou t er arm from t he han d.
40 Auriculotherapy M anual
Yang meridians on right side of body
connect to microsystem points on right ear
Yang meri di ans
Large Intestines (L1)
Small Intestines (SI)
Stomach (ST )
Gall Bladder (GB)
Urinary Bladder (BL)
San [lao (SJ)
Corresponding yin m eri di ans
Lung (LU)
H eart (H T )
Spleen (SP)
Liver (LR)
Kidney (KI)
Pericardium (PC)
Qi energy flow
Right ear relieves pain
on right side of body
Figure 2 . 1 6 T he flow of qi alon g a yan g acu pu n ct u re chan n el up the arm t oward ear reflex poi n t s on the head has
the ability to u n block the f low of energy along the ispsilateral side of body. (From L i f e ART fi, Su per An at om y.
' L i ppi n cot t W i lli am s & W ilkins, with perm i ssi on . }
T heoretical perspectives 41
A Surface v i ew of zang organs B Post eri or v i ew of zang organs
Kidney H eart
Liver
Liver
Spleen
Spleen
Lung
Lung
H eart
Kidney
Figure 2 . 1 7 Localization of the five zang organs represented on the anterior (A) and posterior (B) auricle.
W ater: T he refreshi n g cooln ess of blue wat ers qu en ches on e’s t hi rst and provi des t he body with
on e of its m ost necessary elem en t s. Associ at ed with winter, the qu ali t i es of w at er are st i llness,
qui et n ess, an d a time for reflect i ve m edi t at i on . T he acu pu n ct u re m eri di an s rel at ed to w at er are t he
Kidney chan n el t hat begi n s on the li t t le toe and t ravels up the i n n er leg to t he abdom en , whereas
the Bladder chan n el begi n s on t he f orehead, crosses over the t op of t he head to t he back of the
head, ru n s down the back of the neck, down the spi n e, an d down the back of the leg to the foot.
W ood: T he image of wood is best t hou ght of as the i ni t i al spring growt h of new bran ches on a
t ree, each limb sprou t i n g bri ght green leaves. W ood is associ at ed with new begi n n i n gs, new growt h,
and chan gi n g t em peram en t s. T he acu pu n ct u re m eri di an s rel at ed to wood i n clu de t he L i v er
chan n el t hat begi ns on t he large toe an d t ravels up the i n si de of the leg to t he chest , w hereas the
Gall Bladder chan n el descen ds alon g t he ext ern al side of the head an d body and down the ext ern al
leg to the li t t le toe.
Five zang organs: W hile all the i n t ern al organ s are m ore yin t han yang, a predom i n an t focus in
Chi n ese m edi ci n e is given to the i m port an ce of t he z an g organ s, which are even m ore yin t han the
fu i n t ern al organ s. T he five pri n ci pal z an g organ s are t he lung, heart , liver, spl een an d kidney. T he
en erget i c fun ct i on s of z an g organ s are ut i li z ed in classi cal acu pu n ct u re m ore of t en t han the
physi ologi cal fun ct i on s of t hat organ . As previ ously n ot ed, W est ern lan gu age t ran slat i on s of the
acu pu n ct u re m eri di an s m i ght have been bet t er left as Chi n ese pinyin t erm s. T he di screpan ci es
bet ween the an at om i cal f u n ct i on of t hese organ s and t hei r clinical use in O ri en t al m edi ci n e has
of t en lead to sk ept i ci sm rat her t han u n derst an di n g by W est ern doct ors. T he z an g organ s
represen t ed on the ext ern al ear are shown in Fi gu re 2.17.
Lung (fei): T he t horaci c organ of the lung, in the u pper ji ao, dom i n at es the qi of respi rat i on ,
i nhali ng pu re qi and exhali n g toxic qi. I f lung qi is weak , defensi ve qi will not reach t he skin, thus
the body will be m ore easily i n vaded by pat hogen i c fact ors, part i cu larly cold. Besi des its i nclusi on
in the t reat m en t of respi rat ory di sorders, the Lung poi n t on the auri cle is on e of t he m ost
f requ en t ly u sed ear poi n t s for the det oxi fi cat i on f rom addi ct i ve su bst an ces, such as opi u m , cocai n e
and alcohol. Becau se the skin also con n ect s to respi rat i on and to the release of toxic su bst an ces
t hrou gh sweat i ng, the au ri cu lar Lu n g poi n t is also u sed for the t reat m en t of skin di sorders.
H eart (xin): T his t horaci c organ prom ot es blood ci rcu lat i on and su pport s vi gorou s heart qi.
H eart qi is said to be essen t i al for f orm i n g blood an d also hou ses t he m i n d, em ot i on s an d the spi ri t .
42 Auriculotherapy M anual
In addi t i on to its appli cat i on for coron ary dysfunct ions, the auri cular H eart poi n t is st i m ulat ed to
relieve nervous di sorders, m em ory problem s, sleep i m pai rm en t and di st urbi ng dream s.
Liver (gan): In Chi nese t hought , the liver is said to st ore blood and to i ncrease blood ci rculat i on
for vigorous m ovem ent s by nouri shi ng the sinews, li gam ent s and t en don s t hat at t ach muscles to
bones. T he liver is responsi ble for u n rest rai n ed harm on i ou s activity of all organs and m ai nt ai ns the
free flow of qi. St agn at i on of liver qi is associ at ed with resen t m en t , bi t t ern ess, irrit abilit y, repressed
anger, and m en t al depressi on, while excessive liver qi may cause headaches and i nsomni a. T he
auri cular Liver poi n t is used for myofascial pain and muscle t ensi on du e to repressed rage.
Spleen (pi): Of all the zang organs, the Chi nese con cept uali z at i on of the spleen is probably most
di fferent from W est ern u n derst an di n g of this organ. T his abdom i n al organ report edly governs the
t ran sport at i on of blood and nouri shes t he muscles and the four limbs. I f spleen qi is weak, the
muscles will be weak. Excessive m en t al work or worri ed t hi nki ng is said to weak en spleen qi. In
W estern anat om i cal texts, the spleen is con si dered a part of the lym phat i c drai n age system and has
little effect on muscles or on m en t al worry. Some of the digestive funct i ons t hat t he Chi nese
assigned to the spleen seem m ore appropri at ely delegat ed to the n earby abdom i n al organs of the
st om ach an d the pancreas. N onet heless, the Chi nese Spleen poi n t on the ear is of t en used very
effectively for the t reat m en t of muscle t en si on and gen eral n ouri shm en t .
Kidney (shen): Lower in the abdom en , the kidneys are said to st ore the congeni t al essence of the
physical body t hat people i n heri t from t hei r parent s. T he kidney also affects growt h, developm ent ,
and reproduct i on . T he kidneys dom i n at e wat er m et aboli sm an d regu lat e the di st ri but i on of body
fluid. T he kidney is also said to nouri sh the spinal cord and the brai n, and to be the resi dence of
willpower and vitality. Finally, the kidneys nouri sh heari n g funct i ons of the ear.
Pericardium (xin bao): A sixth zang organ is the peri cardi um , which refers to the prot ect i ve
m em bran es that su rrou n d the heart . T his acu pu n ct u re chan n el has also been labeled the M ast er of
the H eart or as the ci rculat i on -sex channel. T he Peri cardi um m eri di an funct i ons very similar to
the H eart channel and runs along an adjacen t region of the inside of the arm as it t ravels distally
toward the hand. T his zang organ is not oft en utilized in auri culot herapy.
Six fu organs: T he fu organ s are not as prom i nent ly discussed in O ri en t al m edi ci ne as the zang
organs, but the acu pu n ct u re channels associ at ed with each fu organ are very i m port an t in
acu pu n ct u re t reat m en t plans. T wo of t he most commonly used acupoi n t s in all of O ri en t al
medi ci ne are LI 4 (hegu or hoku) on t he Large I n t est i n es m eri di an an d ST 36 (z usanli ) on the
St om ach m eri di an. St i m ulat i on of the Large I n t est i n es chan n el can relieve pains in the index
finger, wrist, elbow, shoulder, neck or jaw t hat occur along the Large I n t est i n es channel. N eedli ng
the St om ach channel can alleviat e condi t i ons in the face, neck, chest, abdom en , leg, knee or foot
t hat are all skelet al st ru ct u res found along the St om ach m eri di an.
San Jiao: T his t erm has been t ran slat ed as T riple W armer, T riple H eat er, T riple Bu rn er and T riple
Energi z er. M em bers of an i n t ern at i on al n om en clat u re com m i t t ee of the W orld H eal t h
O rgan i z at i on ult imat ely deci ded to k eep the Chi nese t erm for this m eri di an , since San Ji ao really
has no correspon den ce in W est ern an at om i cal t hinking. T he classical division of t he body was
di st i ngui shed as t hree regions: the u pper jiao ( t he chest regi on t hat regulat es ci rculat ory and
respi rat ory funct ions), the middle jiao ( t he u pper abdom i n al regi on which affects digestive
funct ions) and the lower jiao (the lower abdom i nal regi on which affects sexual and excret ory
funct i ons). T he u pper bu rn er of San Ji ao is like a vaporou s mist in t he regi on of the heart and
lungs, the middle bu rn er is like foam in the region of t he st om ach an d spleen and the lower bu rn er
is like a den se swamp in the region of t he kidneys, i n t est i n es and bladder. San Ji ao refines the
subtle essence of qi the way a granary refines flour or a brewery distills alcohol. T he physiological
effects of San Jiao are possibly relat ed to the arousal act i ons of the sym pat het i c nervous system
and the release of ci rculat i ng horm on es by the en docri n e system.
Spirit (shen): T his subst an ce serves as the vitality behi n d the an i m at i on of qi, t he flow of blood
and the i nst i nct ual processes relat ed to i ndi vi dual essen ce (jing). Shen is associ at ed with hu m an
consci ousness and the force of hu m an personali t y to think, feel, di scri m i n at e and choose. I t is
associ at ed with a part i cu lar behavi oral style and it affect s the choi ce of a part i cu lar vocat i onal
pat h in life. O n e of the most widely used poi n t s in all of au ri cu lot herapy is the Shen M en poi n t in
the t ri an gu lar fossa. T his Chi n ese ear poi n t has a prof ou n d effect on spirit, will an d gen eral
wellbeing.
T heoretical perspectives 43
2.3 Ayurvedic medicine, yoga and prana energy
W hile the ancest ral source of Chinese medicine is not fully known, many of the concept s used in
acupunct ure are said to come from the Vedic texts of anci ent India. T he principles descri bed in the
Vedas were developed in India by 1500 BeE and have been present ed in recent evaluat ions of
com plem ent ary medicine for the disciplines of yoga (Ross 2001) and ayurvedic medi ci ne (M anyam
2001). In Sanskrit, ayu referred to life, and veda referred to science, thus ayurveda den ot ed the science
of life. T he Vedas included a scientific underst andi ng of body, mind and spirit. Ayurveda was a
complet e system of medicine, with separat e branches for surgery, i nt ernal medicine, toxicology,
pharmacology, neurology and psychology. T he Yoga Sutras of Pant anjali were wri t t en in 200 BCE. T his
text was one of the first docum ent s to describe the healt hcare practices of yoga. Pranayamas are
specific types of breat hi ng, asanas are disciplined post ural movements, dyanas are pract ices of
cont emplat ive medi t at i on, and sam adhi is blissful union with the su prem e existence of all things.
Prana: A f u n dam en t al pri nci ple of this I n di an t radi t i on is t hat the body is com posed of energy,
not just m at eri al subst ance. T his en erget i c view of the hu m an body is very si mi lar to Chi n ese
medicine. Illness was said to be due to t he blockage of energy. T hrou gh di fferen t yoga disciplines,
it was possible to en han ce the ci rculat i on of energy in order to faci li t at e heali ng from a disease.
Ayurvedic pract i t i on ers ref er to the pri m al energy aspran a, which also m ean s breat h. H i n du and
Buddhi st t eachi ngs assert t hat the soul en t ers the body with an i n f an t ’s first breat h and the soul
leaves the body with a person ’s last breat h. T he soul is t hen ready for a new rei n carn at i on , when
the process of life t hrou gh breat h is repeat ed. W hile i n carn at ed on this eart h, a person is
challenged with many lessons for the soul’s evolut i on, i ncludi ng the challen ge of t ak i ng care of the
physical body. Karma is not puni t i ve ret ri bu t i on for past sins, as it is of t en t hou ght of in the W est,
but is i n st ead a guide for edu cat i n g the soul in correct i n g previ ous m i st ak es in living. I t is not
necessary to believe in t he religious phi losophi es of H i n du i sm or Bu ddhi sm in order to find ben efi t
in the breat hi n g and post u ral pract i ces of yoga or the herbs used by ayurvedi c pract i t i on ers. T he
en erget i c perspect i ves of the hu m an body, t hough, are a f u n dam en t al com pon en t in u n derst an di n g
how t hese spi ri t ual t radi t i on s have been appli ed to ayurvedic clinical t reat m en t s.
N adis: Similar to the acu pu n ct u re m eri di ans, Vedic writings descri bed chan n els of energy
ext endi ng over the surface of the body t hrou gh which pran a can flow. In India, the chan n els were
called nadis. Said to be a con du i t bet ween the gross an at om i cal body and the subt le et heri c body,
the n et work of 3 5 0 0 0 0 nadis resem bles m odern descri pt i ons of nerves and n erve plexuses. Of the
di fferent en ergy channels in ayurvedic m edi ci ne, the t hree most i m port an t were the su shu m n a, t he
ida and the pingala. T he m ai n chan n el was the su shu m n a, which rose from the t ai lbon e up the
spine. T he ida and the pi ngala spiral up t he spine on each side of the su shu m n a. T hese t hree
pri m ary chan n els were depi ct ed as two coi led serpen t s spi rali ng up a cen t ral staff, rem ark ably
similar to the Egypt i an, G reek and Rom an caduceus symbol of heali ng. T he su shu m n a has been
said to correspon d to the cen t ral nervous system, the ida represen t s t he sedat i ve parasym pat het i c
nervous system, and the pi n gala affects the fi ght -or-fli ght -relat ed sym pat het i c n ervous system. T he
locat i on of the sushum n a along the spine coi nci des with the m i dli ne f ron t mu and back shu
m eri di an channels of Chi n ese acu pu n ct u re. In bot h the Vedic su shu m n a chan n el and Chi n ese
m u - shu chan n el, vital en ergy ascends the spine t oward the head.
Five Vedic elem en t s: Ju st as t here were five pri nci pal elem en t s or phases in O ri en t al m edi ci ne,
five pri m ary elem en t s are descri bed in ayurvedic m edi ci ne. Ref erred to as five cat egori es of m at t er
( pan cham ahabhu t as) , t hese basic elem en t s i ncluded eart h (prthvi), wat er (ap), fire (tejas), air
(vayu) and uni versal et heri c space (ak asa). T he pri m ordi al sou n d of , O m ’ was said to creat e air
from et heri c space, which gen erat ed fri ct i on as it moved. T his fri ct i on creat ed fire an d heat , which
ult i mat ely cooled and m an i fest ed as wat er, and finally becam e eart h. T he M ateria m edi ca of
ayurveda con t ai n ed a list of several hu n dred bot ani cal herbs t hat em ploy the pri nci ples of t hese five
elem en t s in order to heal vari ous diseases, j u st as the m edi cal appli cat i on of di f f eren t Chi n ese
herbs used the pri nci ples of five phases.
T he five Vedic elem en t s com bi n ed to form di fferen t con st i t ut i on al types of m i n d- body
i nt eract i ons. T hese body types are known as the t hree doshas, which are vatha, pitta an d k apha.
Figure 2.18 Images of chak ra m ot i on are represented as a chariot wheel (A), a wagon wheel (B), the top of a whirlpool (C), a water
wheel (D), the side view of a whirlpool (E), or the swirling pattern of tornados (F). (B from Cellox, Reedsburg, W I, with permission;
D ' U t a Singer, with permission; F from N O AA/ O AR/ N at i on al Severe Storms Laboratory, N orman, OK.)
44 Auriculotherapy M anual
T heoretical perspectives
4S
A
7th
B
c
Figure 2 . 1 9 T he seven chakras f ou n d along the vertical axis of the body viewed from the front (A) an d the side (B). T he caduceus sym bol
(C), still used in m odern medicine, has ancestral roots in the nadis of Vedic scriptures which show the su shu m n a that rises up the spine
surrounded by the snak e-li k e un dulat i on s of the ida an d the pingala nadis.
46 Auriculotherapy M anual
Vatha com bi n es air with et her to con t rol the propagat i on of n erve i m pulses and the m ovem en t of
muscles. Pi t t a utilizes the elem en t of fire, thus affect i ng physi ochem i cal activities of gen eral
m et aboli sm t hat produ ce heat and en ergy t hrou ghou t the body. Kapha com bi n es wat er and eart h
to m ai n t ai n cohesi veness in the body by provi di ng it with a fluid matrix. An excess of k apha,
however, can lead to slow m et aboli sm , chron i c let hargy, obesity or clinical depressi on . T he five
Vedic elem en t s and the t hree doshas faci li t at e an i nt ui t i ve u n derst an di n g of person al con st i t ut i on
and its effects on healt h.
Seven chakras: N at ural sources for faci li t at i ng the flow of pran a were the chak ras ( pron ou n ced
shaw-kraws). T he word chak ra refers to a spi nni ng wheel, like the appearan ce of a rapi dly rot at i ng,
m ult i -spok ed wheel on a carri age as it moves along a road ( M ot oyam a 1981, T ansley 1984). T hey
are an alogous to rot at i n g wat er wheels an d windmills. In m odern times, the rot at i n g gears of a
m ot or en gi n e or the rapi d rot at i on of the propeller on an ai rplan e might be equi valen t analogies.
W hen viewed from the side, as opposed to a front al perspect i ve, the chak ras appeared like a
whirlpool, a whirlwind, or a t orn ado (see Fi gure 2.23). Each chak ra is a vortex of circling, spiraling,
swirling forces of invisible energy. T hese chak ras are f ou n d over specific regi ons of t he body, just as
the spi nni ng pat t ern of hu rri can es occurs over specific regi ons of the eart h as seen from m odern
sat ellit es. T he swirling vort ex of energy ascri bed to the chak ras is con si dered a possi ble explan at i on
for the m an n er in which en ergy ci rculat es at acu pu n ct u re poi nt s. T here are m i n or chak ras at each
joi n t of the body, at the hands, the wrists, the elbows, t he shoulders, the hips, the k nees, the ankles
and the feet. Vedic texts also descri bed secon dary chak ras at the ears. M ost of the focus in
ayurvedic m edi ci ne, t hough, is on the seven pri m ary chak ras t hat ascen d the m i dli ne of the body.
T he axial posi t i on of t hese chak ras runs along the su shu m n a. T he ida and the pi n gala u n du lat e up
the spine in a spiral pat t ern , crossing each ot her at each chak ra. All seven chak ras are shown from
a front al and a sagittal perspect i ve in Fi gu re 2.19. T he first chak ra resi des at the base of the spine,
in the regi on of the male geni t als, and is the initial source for the rise of the kundalini energy t hat is
essent i al for survival. T he secon d chak ra is locat ed wi t hi n the lower abdom en , the t hi rd chak ra
within the u pper abdom en , the fourt h chak ra within t he chest and heart , the fifth chak ra at the
lower t hroat , the sixth chak ra bet ween t he eyebrows, and the seven t h chak ra at the t op of the head.
Seen from the side, the chak ras appear like funnels, with the tip of t hese spi nni ng con es of energy
at the post eri or spine and the broader ci rcular base of the cone t oward the an t eri or body. An ci en t
texts pi ct u red the chak ras as m an y-pet aled lotus blossoms, with t hei r st em t oward the spine and
the blossom pet als t oward the front of the body. T he chak ras were n ot li m i t ed to t hese cone-li ke
confi gurat i ons, but were actually broad fields of spi rali ng en ergy t hat could ext en d well beyond the
physical body.
Each of the seven pri m ary chak ras is locat ed next to the an at om i cal posi t i on of an en docri n e gland,
and the force field of each chak ra produ ces funct i onal chan ges t hat are si m i lar to the effects of the
horm on e released by t hat en docri n e gland. T he first chak ra is foun d in the scrot al regi on of the
male geni t al organ , the testis, whereas the secon d chak ra occurs in t he pelvic regi on of the female
geni t al organ , the ovary. T est ost eron e produ ces a feeling of physical power, aggressive rage, and
sexual exci t em ent . T he est rogen released by the ovary i n duces fem i n i n e sexual recept i veness while
the horm on e progest eron e facilit at es m at ern al bondi ng. T he t hi rd chak ra lies in the region of the
abdom i n al adren al gland. T he adren al in and cort isol released by the adren als mobi li z es the en ergy
to deal with stress and st rai n. T he pri m ary en docri n e glan d foun d n ear the heart chak ra is the
thymus glan d at the cen t er of the chest and is part of t he i m m u n e system. T he fifth chak ra is
locat ed at the base of the t hroat , n ear the t hyroi d and parat hyroi d glands. T hyroxi n released by the
thyroid gland en han ces gen eral m et aboli sm when elevat ed, but a sen se of fat i gue and let hargy
when di m i ni shed. T he sixth and sevent h chak ras t hat are cen t ered in t he head are foun d in the
locat i on of the pi n eal glan d and the pi t u i t ary gland. T he pi n eal releases the horm on e m elat on i n
t hat regulat es sleep- wak e pat t ern s, whereas the pi t u i t ary releases specific horm on es t hat con t rol
ot her en docri n e glands.
T he first chak ra is said to t ak e the base physical en ergy from the eart h and t ran sm u t e its raw
subst ance to a m ore refi n ed essence for the body to assi mi lat e. T he hi gher chak ras t ran sf orm the
energy of the lower chak ras into even finer forms, si m i lar to the Chi n ese descri pt i on s of di st i llat i on
by the t hree bu rn ers of San Jiao. T he first and secon d chak ras are very si mi lar to the urogeni t al
funct i ons of the lower jiao, the t hi rd chak ra to the digest ive funct i ons of the m i ddle jiao, and the
fourt h and fifth chak ras to the ci rculat ory aspect s of the u pper jiao. W hen represen t i n g the front of
T heoretical perspectives 47
the chak ras as lotus blossoms, the lower chak ras are shown with j u st a few pet als an d hi gher
chak ras are depi ct ed with progressively m ore pet als. Specifically, the flowers for t he first chak ra
have four pet als, the secon d chak ra has six pet als, the t hi rd chak ra has ten pet als, the f ou rt h chak ra
has 12 pet als, the fifth chak ra has 16 pet als, the sixth chak ra has 96 pet als, and the seven t h chak ra
has 960 pet als. T he sixth chak ra is of t en pi ct u red as two large pet als over the f orehead regi on,
looki ng alm ost like the left and the ri ght cerebral hem i spheres, while the sevent h crown chak ra is
ref erred to as the t hou san d pet aled lotus. T hese m an y- pet aled lotus flowers m et aphori cally
suggest t hat the spi nni ng wheels of the chak ras rot at e f ast er as on e ascends the spi ne.
Chakra colors: In met aphysi cal texts by Beasley (1978) and by Bru yere (1989), the chak ras are
represen t ed by the colors of the rainbow. Red is associ at ed with the first chak ra, from which the
pri m ordi al energy of the k undali ni begins its ascent up the spine. Ju st as red is the lowest frequency
in the visible spect rum , the kundali ni chak ra has the lowest vi brat i on rat e. Progressively hi gher
frequen ci es of color t hat are due to di fferen t wavelengt hs of light rays t hat are associ at ed with
progressively hi gher chak ras spi nni ng at progressively hi gher frequ en ci es of revolut i on. T he
chak ra colors progress from red at the base chak ra to the slightly hi gher reson an ce rat es of oran ge
at the secon d chak ra. T he still fast er color of yellow is associ at ed with the t hi rd chak ra, green with
the fourt h chak ra, blue with the fifth chak ra, pu rple or indigo with the sixth chak ra, and ult i m at ely
white and vi olet with the seven t h chak ra. T he hi gher frequen ci es of the hi gher chak ras are said to
represen t hi gher planes of spi ri t ual exist ence. T his ran ge of hues is act ually an i deali z ed versi on of
the way the chak ra colors would appear in a perfect ly healt hy person , but a rai n bow pat t ern is
rarely the color spect ru m seen on an act ual person , part i cularly som eon e with an illness. O t her
descri pt i ons of the chak ras allude to a di fferen t set of colors at each locat i on, such as green at the
second chak ra and yellow at the fourt h chak ra. T he au ri cu lar m edi ci n e perspect i ves t hat
developed in Eu rope also em phasi z ed seven basic frequen ci es t hat affect the seven di fferen t types
of tissue in the body. T he lowest frequen ci es in au ri cu lar m edi ci n e charact eri z ed pri m i t i ve
i nst i nct ual processes, whereas the hi gher frequenci es are associ at ed with hi gher n eurologi cal
funct ioning.
M any W est ern i nvest i gat ors con si dered the chak ras to be m ore symbolic t han real. H owever,
W est ern as well as East ern physicians have report ed t hat they can feel as well as see t hese chak ra
forces. T he Cali forni a physician Brugh Joy (1979) descri bed his observat i on s of t he subt le energy
fields. Alt hou gh he had n ot read any ayurvedic writings, Joy could sen se vi brat i on al chan ges over a
pat i en t ’s body which precisely correspon ded to the locat i ons of the seven Vedic chak ras.
Elect rophysi ologi cal research at U CL A by Dr Valerie H u n t found t hat t hese chak ra energy
T able 2.4 Relationship of seven chakras to different functions
Chakra name Location Gland Element An i m al Lotus Color Funct i on
t rai t s petals
I. Base chak ra Groi n T estis Fire Serpen t , 4 Red Survival inst inct s, rage,
(M uladhara) dragon vitality, physical power
2. Pelvic chak ra Pelvis Ovary W at er Fish 6 O ran ge D eep em ot i on s, sexual
(Svahishthana) funct i oni ng
- - - - - - - -
3. Solar plexus U pper Adrenal Air Bird 10 Yellow I n t ellect u al mind,
(M anipura) abdom en person al will
- - - - - - - - - - - - - - -
4. H eart chak ra Chest T hymus Eart h M am m al 12 G reen Em pat hy, love,
(Anahata) com passi on
- - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ . _ ..__ . __ ._. __ . ~ .._.------
5. T hroat chak ra T hroat T hyroi d Et her H u m an 16 Blue Verbal expressi on,
(Viahuddua) speech, creat i vi t y
.’-’.- - - , , - ~ - - - - - . - ~ - _ . _ . _ -
6. T hi rd eye Forehead Pineal Soul 96 Pu rple I n t u i t i on , psychic
(Ajna) vision
- - - - - - - - - - - - -
7. Crown chak ra Vertex of Pi t ui t ary Spirit 960 W hi t e and W orldly wisdom, spi ri t ual
(Sahasrara ) head violet awareness
- - , - - _ .._ - - " ' - " ~ . _ ' ... - .
48 Auriculotberepy Manual
pat t ern s could be scientifically m easured. W orking with the au ra reader and spi ri t ual t eacher
Rosalyn Bruyere (1989), H u n t recorded specific elect rophysi ologi cal changes in very high
frequency waves of the elect rom yogram ( EM G) . Surface EM G elect rodes were placed over
specific chak ra locat i ons on the bodi es of hu m an volunt eers. As the au ra reader report ed distinct
changes in t he color and pat t ern of the auri c energy field at di fferen t chak ras, the physiological
equ i pm en t i n di cat ed specific changes in elect rophysi ologi cal frequency and voltage am pli t ude.
T he di fferen t energy pat t ern s report ed by the au ra reader for each chak ra posi t i on were found to
correspon d to specific EM G pat t ern s recorded by the elect rophysi ologi cal equ i pm en t . N o ot her
laborat ory has at t em pt ed to repli cat e H u n t ’s research, thus a scientific explanat i on for t hese
experi ences rem ai ns to be det erm i n ed.
Chakra acupuncture: T he G erm an physician Gabri el Stux (1998) has descri bed a procedu re
called chak ra acu pu n ct u re as an expansi on of the pract i ce of t radi t i on al Chi n ese acupun ct ure. T he
chak ra energy cen t ers of ayurvedic m edi ci ne are act i vat ed in a m an n er si mi lar to st i m ulat i on of the
Chi nese zang-fu channels. T radi t i onal Chi n ese acu pu n ct u re seeks to harm on i z e the flow of qi by
dissolving the blockages in the channels and organs, and t here is a si m i lar aim in ayurvedic
medicine. Con di t i on s of excess or deficiency can be balan ced by harm on i z i n g the yin and yang
forces of each of the seven chak ra cent ers. Chak ra acu pu n ct u re ext ends the t radi t i on al appli cat i on
of acu pu n ct u re to the Vedic chak ra system for bot h diagnosis and t reat m en t . In chak ra
acupunct ure, chakra points are needled in the area of the seven pri mary energy cent ers. Energy flow
st i mulat ed by this needli ng is referred to as ’openi ng of the chakras. ’ T he most frequent ly used
chakra acupoi nt s are GV 20 to activate the seventh chakra, GV 15 to st i mulat e the sixth chakra, and
CV 17 and GV 11 to balance the fourth chakra.
Besides needli ng the chak ra poi nt s on the body, Stux asks the pat i en t to con cen t rat e deli berat ely
on the body area t hat is being n eedled or electrically st i m ulat ed. A f t er a short time, the pat i en t
usually feels a slight tingling sensat i on or a discreet , warm flowing sen sat i on in this chak ra area.
T he pract i t i on er focuses his or her at t en t i on on this regi on too. W hen the flow t hrou gh one energy
cen t er is clearly percept i ble to the pat i ent , t reat m en t proceeds to the next energy cen t er. T he
pat i en t is asked to breat he into the chak ra area, to hold his or her consci ous awareness t here, and
to imagine openi ng the chak ra until he or she feels a sen sat i on of wideness, charge and flow in t hat
region. By at t ent i vely open i n g each energy cen t er, the i n t ern al flow of life force is prom ot ed. T he
individual brings awareness or m en t al focus on a chak ra region, t hen the person i dent i fi es the
locat ion, borders, size, t em perat u re, color and em ot i on s of t hat body area. T he next step is to
release the blocked or st agn an t energy, thus t ran sform i n g the densi t y of the block age t hrough
breat hi n g consciously into t hat region.
Chakras and auricular acupuncture: T he D u t ch physician Ant hony Van Gelder (1999) has
suggest ed t hat the chak ras are also represen t ed on the ext ernal ear. T he locat i on of auri cular areas
associ at ed with each of the seven pri m ary chak ras coi nci des with cert ai n ear acupoi nt s known as
m ast er poi nt s. T he first t hree chak ras respect ively correspon d to the auri cular m ast er poi nt s
ref erred to as the Sym pat het i c Au t on om i c poi nt , the ear poi n t Shen M en, and Poi n t Z ero. T he
represen t at i on of the ot her chak ra cen t ers is not so generally accept ed, but in Van Gelder’s work
they are localiz ed at the root of the helix of the ear. An alt ernat i ve correspon den ce system for the
chak ras correlat es the u pper chak ras to the Eu ropean auri cular poi n t s known as W onderful poi nt ,
T halam u s poi nt , En docri n e poi nt , and M ast er Cerebral point. D i f f eren t possible represen t at i on s
of the chak ras upon the ext ernal ear are i ndi cat ed in Fi gure 2.20.
2 . 4 H olographic m odel of microsyst ems
In T he holographi c universe, M ichael T albot (1991) descri bes how t he t echnology of t he hologram
can serve as a model for many unexplai ned phen om en a, i ncludi ng t he som at ot opi c microsyst em
found on the ext ernal ear. A hologram is creat ed when a laser light is split into separat e beams.
Angled m i rrors are used to boun ce the laser beam off the object bei n g phot ographed. A second
laser beam is bou n ced off the reflect ed light of the first laser beam. T he collision of these reflect ed
laser beam s gen erat es an i n t erferen ce pat t ern on the holographi c film. T his i n t erf eren ce pat t ern is
the area where the two laser beam s i n t eract on the film. W hen the film is developed, it looks like a
m eani ngless swirl of light and dark images, com posed of crisscrossing lines, con cen t ri c circles and
geom et ri c shapes si mi lar to snowflakes. H owever, when the developed film is i llum i nat ed by
an ot her laser beam , a t hree-di m en si on al image of the original object appears. O n e could actually
T heoretical perspectives 49
A. Auricular Chakras descri bed by Van Gelder
1st Chakra
5th Chakra
3rd Chakra
4th Chakra
2nd Chak ra
B. Auricular Chakras descri bed by Oleson
3rd Chakra
6th Chakra
7th Chakra
2nd Chak ra
4th Chakra
so
Figure 2 . 2 0 (A) Five of the seven chak ras hav e been depi ct ed by Van Gelder as locat ed in the u pperext ern al ear.
(B) A l l seven chak ras are shown on the auricle f rom a di fferent perspect i ve developed by Oleson.
Auriculotherapy M anual
walk arou n d this t hree di m ensi onal image and view the hologram from di fferen t sides. For the
pu rpose of this discussion, the m ore i nt ri gui ng aspect of hologram s is t hat each part of the
holographi c film cont ai ns an image of t he whole object t hat was phot ographed. In st an dard
phot ography of a man, for i nst ance, one sect i on of the phot ographi c negat i ve would just cont ai n
the image of the head and an ot her sect i on would just i nclude the image of the foot. In holographi c
phot ography, all sections of the film con t ai n all the images of the head, the foot, an d the en t i re
body in bet ween. A di agram of holographi c equ i pm en t is shown in Fi gu re 2.21 and a holographi c
image of man is shown in Fi gure 2.22.
T he respect ed St an ford University neurobi ologi st Karl Pri bram used the model of the hologram to
explain research experi m en t s dem on st rat i n g t hat m em ory can be st ored in many part s of the brain.
Pri bram suggest ed t hat individual n eu ron s in di fferen t part s of the brai n have an image of what the
whole brai n can rem em ber. Accordi ng to this model, m em ori es are en coded not in n euron s, or
even small groupi ngs of n euron s, but in pat t ern s of nerve i mpulses t hat crisscross t he en t i re brain.
T his brai n map is similar to the way t hat i n t erf eren ce pat t ern s of laser light crisscross the en t i re
area of a pi ece of holographi c film. T he holographi c t heory also explai ns how the hu m an brain can
store so many m em ori es in so little space. I t has been est i m at ed t hat the hu m an brai n has the
capacity to m em ori z e som et hi n g in the order of 10 billion bits of i n f orm at i on duri n g the average
hu m an lifet ime. H ologram s also possess an ast oun di n g capacit y for i n form at i on st orage. Simply by
changing the angle at which the two lasers strike a piece of phot ographi c film, it is possi ble to
record many di fferen t images on the same surface. I t has been dem on st rat ed t hat on e cubic
cen t i m et er of holographi c film can hold as many as 10 billion bits of i nform at i on. O n e of the most
amaz i ng aspect s abou t the hu m an t hi nk i ng process is t hat every piece of i n form at i on seems
inst ant ly cross-correlat ed with every ot her piece of i n form at i on , an ot her feat ure i nt ri nsi c to the
hologram. Ju st as a hologram has a t ran slat i n g device t hat is able to con vert an apparen t ly
meani ngless blu r of freq uenci es into a coheren t image, Pri bram post u lat es t hat the brai n also
employs holographi c pri nci ples to m at hem at i cally convert the neurophysi ologi cal i n form at i on it
receives from the senses to the i n n er world of percept i on s and t hought s.
T he British physicist David Bohm hypot hesi z ed t hat the energy forces which regulat e subat om i c
part i cles could also be account ed for by the holographi c model. In 1982, a research t eam led by
physicist Alain Aspect, at the University of Paris, di scovered t hat one of two twin phot on s traveling
in opposi t e di rect i ons was able to correlat e the angle of its polari z at i on with t hat of its twin. T he two
phot on s seem ed to be non-locally connect ed. T he pai red part i cles were able to i nst ant aneously
i nt eract with each ot her, regardless of the di st ance separat i n g them. I t did not seem to m at t er
whet her the phot on s were a mi lli met er away or 13 m et ers apart . Somehow, each part i cle always
seem ed to know what the ot her was doing. Bohm suggest ed t hat the reason subat om i c part i cles can
remain in cont act with on e an ot her is not because they are sendi ng som e sort of myst erious signal
back and forth. Rat her, he argued that such part i cles are not individual ent i t i es to begin with, but
are actually extensions of the same, subat om i c subst ance. T he elect rons in one atom are con n ect ed
to the subat om i c part icles t hat comprise every ot her atom. Alt hough hu m an n at u re may seek to
cat egori z e an d subdivide the various phen om en a of the universe, all such di fferent i at i ons are
ult imat ely artificial. All of n at u re may be like a seamless web of energy forces.
T albot (1991) concluded from the work of t hese two n ot ed scient ist s t hat the cosmos, the world, the
hu m an brai n , and each subat om i c part i cle are all part of a holographi c con t i n uum : ’O u r brai ns
m at hem at i cally const ruct objective reali t y by i n t erpret i n g frequen ci es t hat are ult i m at ely
project i on s from an ot her di mensi on, a deeper order of exist ence t hat is beyond bot h space and
t i m e. ’ Ju st as each part of the holographi c negat i ve holds an image of the whole pi ct ure, T albot
f u rt her suggest ed t hat t he auri cular microsyst em could hold an image of the whole body. All
microsyst ems might funct i on like the echo resonance, waveform i n t erf eren ce pat t ern s in a
hologram, energy signals bei n g t ran sm i t t ed from the skin to the correspon di n g body organs.
Similar to phot ographi c hologram plat es, each part of t he auri cle might i n t egrat e en erget i c signals
from all the part s of the hu m an body. Ralph Alan D ale (1991, 1999) in Am eri ca, Y i ng-O i ng Z han g
(1980, 1992) in China, and Vilhelm Schjelderup (1982) in Eu rope have all used this holograhi c
paradi gm to account for t he som at ot opi c pat t ern of acupoi nt s found in every m i cro-acupun ct ure
system they have exami ned.
T he holographi c model of microsyst ems is speculat ive, bu t it is con gru en t with the t radi t i on al
Chi n ese perspect i ve t hat every organ in the body is relat ed to specific acupoi nt s on the surface of
T heoretical perspectives 51
A Conventional phot ography
Object
Sunlight
Photographic film
Camera
Lens
B H olographic photography
Beam splitter Reference mirror
Lens
/\
,/
~
!"
/ "
/ "" !
I" \
- / " \
, , \
...................... ( ;A
Reference beam
Object
Lens
Laser beam
Object mirror
Laser source - coherent light
Holographic plate - interference pattern
Figure 2.21 Convent i onal (A) and holographic (B) phot ographic equi pm ent .
S2 Auriculotherapy M anual
A
D
B
E
Figure 2.22 In standard photographic procedures, the original object (A) is converted to a negative image on film (B). W hen it is developed. a
small portion of that negative only contains one part of the picture (C). In holographic photography, the original object (D) is converted to a
distorted image ofinteiference patterns (E). A portion of the holographic negative contains an image of the whole picture (F).
T heoretical perspectives
53
54
the body. In his book T he W eb that has no weaver, Kapt chu k (1983) st at es ’t he cosmos itself is an
i nt egral whole, a web of i n t errelat ed things and event s. W ithin this web of relat i on shi ps and
change, any ent i t y can be defi ned only by its funct i on, and significance only as part of the whole
pat t ern . ’ A n ot her St an f ord sci ent i st has also exam i n ed this perspect i ve. T he physicist W illiam
T iller (1997, 1999) con t en ds t hat t here are non-spat i al, n on - t em poral en ergy waves funct i oni ng in
various ban ds of a vacuum. H is research showed t hat it was possible to focus hu m an i n t en t i on to
alt er the physical propert i es of subst ances in a simple elect ron i c device. Research part i ci pan t s in a
focused m edi t at i ve st at e were able to i nduce an i ncrease or decrease in the pH level of wat er by the
simple act of t hei r i n t en t i on . T here was a small but con si st en t alt erat i on in the pH level of wat er
elect rom agnet i cally i solat ed inside a con t ai n er within a Faraday cage. T he pH level chan ged in a
- 1 . 0 negat i ve di rect i on when the m edi t at ors focused on loweri ng the pH and chan ged in a +1.0
positive di rect i on when t he m edi t at ors focused on raising pH . Accordi n g to T iller, t he result s of
t hese experi m en t s suggest t hat t here is a t ran sfer of un con ven t i on al i n f orm at i on in previously
unk nown frequency dom ai ns. T his un con ven t i on al en ergy could serve as the f ou n dat i on for
auri cular m edi ci n e and ot her holographi c microsyst ems. T he research i nvest i gat i ons by T i ller
highlight the role of the heali n g i n t en t i on of the pract i t i on er when work i n g with a pat i en t using any
healt hcare modality.
M any in the W est are not com fort able with the con cept of a n ebulous, invisible en ergy matrix,
whet her percei ved from the ori en t at i on of Chi n ese m edi ci n e or from the speculat i on s of qu an t u m
physicists. T hat such en erget i c vi ewpoi nt s would be the pri m ary f ou n dat i on for au ri cu lot herapy is
not reassuri ng to such individuals. A great split in the Eu ropean au ri cu lar m edi ci n e com m uni t y
occurred when Paul N ogi er expou n ded the n ot i on of ’ret i cu lar en ergy’ as an explan at i on for the
clinical phen om en a he observed. N ogi er proposed t hat ’ret i cu lar en ergy’ was a vital force t hat
flowed in all living tissue an d t hat it propagat ed the exchange of cellular i n form at i on . Any
st i m ulat i on of the sm allest part of the body by this ret i cu lar energy was said to be i m m edi at ely
t ran sm i t t ed to all ot her regions. W hen a survey was t ak en of professi onals at the 1999
I n t ern at i on al Consensus Con f eren ce on Acu pu n ct u re, Auri culot herapy, and Au ri cu lar M edi ci ne,
most of the respon den t s i n di cat ed t hat they con si dered the holographi c m odel m ore as a useful
analogy t han an actual entity. N on et heless, the n ot i on t hat on e part represen t s the whole appli es to
the basic pri nci ples of microsyst ems as well as to the phen om en a of hologram s.
2.5 Neurophysiology of pain and pain inhibition
Classical Chi n ese m edi ci ne did not really i nclude the role of the nervous system as curren t ly
conceived in W est ern m edi cal science. Even recen t Chi n ese ear acu pu n ct u re chart s con t ai n j u st a
few auri cular locali z at i ons for the brai n. In con t rast , the au ri cu lot herapy texts by N ogi er (1972)
and Bourdi ol (1982) predom i n an t ly focus on a neurologi cal explan at i on for this au ri cu lar reflex
system. T here have been many advances in the field of n eurosci en ce in the last several decades
which have subst ant i ally alt ered basic u n derst an di n g of pain pat hways. I t is now known t hat t here
are m echani sm s by which the nervous system percei ves pain and n earby n eu ral ci rcui t s by which
the brai n can suppress the pain experi ence. N europhysi ologi cal research has also exam i n ed the
role of bot h ear acu pu n ct u re and body acu pu n ct u re in alt eri ng t hese sam e neurobi ologi cal
processes of pain percept i on and pain m odulat i on . Som e i nvest i gat ors believe t hat all of the
energet i c quali t i es descri bed in Chi n ese m edi ci ne can ult i m at ely be accou n t ed for by observable
elect rophysi ologi cal and bi ochemi cal phen om en a in t he brai n and n ervous system. Research
st udi es dem on st rat i n g the di fferen t regi ons of the brai n t hat affect t he basic m echan i sm s of
acu pu n ct u re are reviewed in Birch & Felt (1999), Cho et al. (2001), Stux & H am m erschlag (200 I)
and W ei n t raub (2001).
N eurons: T he f u n dam en t al units of the nervous system are the individual n eu ron s, long slen der
t hreads of nerve tissue which are one of the few types of cells t hat can carry elect ri cal signals. Body
acu pu n ct u re poi nt s occu r at regions u n dern eat h the skin where t here is a nerve plexus or where a
nerve i n n ervat es a muscle. O n e f eat u re of m yeli nat ed n eu ron s is t hat the speed of n eu ral i m pulses
is i n creased by the presen ce of segm en t s of high elect ri cal resi st ance myelin separat ed by gaps of
lower elect ri cal resi st ance n odes of Ranvier. T his aspect of n eu ron s correspon ds to the
elect roderm al feat ure of acu pu n ct u re poi nt s, a seri es of low-ski n-resi st ance gap j u n ct i on s
separat ed by regi ons of hi gh-sk i n-resi st ance n on - acu pu n ct u re poi nt s.
Auriculotherapy M anual
N ociceptors: Alt hough it is the cause of much u n wan t ed suffering, pai n is n on et heless a
biological necessity. Pain sensat i ons t ri gger prot ect i ve wi t hdrawal reflexes essent i al for survival.
T he i ni t i at i on of pain signals begins with the act i vat i on of mi croscopi c n eu ron endi ngs in the skin,
the muscles, the joints, the blood vessels or the viscera. Since t hese sensory recept ors are excited by
noxious stimuli, capable of damagi ng cellular tissue, they have been called noci cept ors. Elect ri c
shock, i n t en se heat , i n t en se cold or pi nchi ng of the skin all lead to an i ncrease in t he n eu ron al
firing rate of nocicept ors. T he n at ural st i muli for noci cept i on, however, seem to be an array of
bi ochemi cals released into the skin following injury to a cell. Su bderm al acidic chemi cals t hat
activate peri pheral noci cept ors include prost aglandi ns, hi st ami ne, bradyk i ni n and subst ance P. In
cont rast , t hose sensory n eu ron s specifically responsi ve to soft t ouch are called m echan orecept ors
and t hose skin recept ors affect ed by changes in heat or cold are called t herm orecept ors. I n sert i on
of acu pu n ct u re needles seems to act i vat e noci cept ors in deep muscles for body acu pu n ct u re and
the noci cept ors in the skin for ear acupun ct ure.
Peripheral nerve pathways: Afferen t sensory n eu ron fibers travel in bun dles of nerves t hat
project from the peri pheral skin surface or deep-lying muscles t oward the cen t ral nervous system
at the m i dli ne of the body. Each n eu ron is capable of rapidly carryi ng elect ri cal n eural impulses
over long anat om i cal dist ances, such as from the foot to the spine, or from the fingers to the neck.
T he n eu ron s from m echan orecept ors, t herm orecept ors and n oci cept ors all travel along t oget her,
like the individual copper wires in an ext ensi on cord. H owever, the type of n eu ron carrying each
type of message is di fferent . T he cat egori es of n eu ron s are di st i ngui shed by the size and the
presen ce of myelin coating. T he t hi n n est neurons, which have no myelin coat i ng, are called T ype C
fibers and t en d to carry i n form at i on abou t nocicept ive pain. T he next larger grou p of n eu ron s are
called T ype B fibers, which are larger and have some myelin coating. T hey typically carry
i nform at i on about skin t em perat u re or i n t ern al organ activity.
N euron s t hat have the t hi ck est di am et er are called T ype A fibers. T he T ype A n eu ron s are
m yeli nat ed and large in size, making t hem much fast er con duct ors t han the T ype B an d T ype C
fibers. T hey are f u rt her subdi vi ded into T ype A bet a fibers, which carry i n form at i on abou t light
touch stimuli act i vat ed by m echan orecept ors, and T ype A delt a fibers, which are n ot as large nor as
fast as the A bet a fibers and carry i n form at i on abou t nocicept ive pain. T he A delt a fibers are still
fast er t han the T ype C fibers, which also are act i vat ed by noci cept ors. W hen one is hurt , t here is
initially the percept i on of first pain from i nform at i on carri ed by A delt a fibers and t hen the
percept i on of second pai n carri ed by C fibers. First pain is i m m edi at e, sharp, and brief, like a pin
prick, whereas second pai n is m ore t hrobbi ng, aching, and enduri ng, as when one is bu rn ed or hits
on e’s han d with a ham m er. Chron i c pai n sensat i ons seem m ore relat ed to C fiber activity t han A
delt a fiber activity, as C fiber firing can su m m at e over time rat her t han habi t uat e. T he fastest
n eu ron s are T ype A alpha fibers. T hese m ot or n eu ron s carry elect ri cal impulses from the spinal
cord to the peri pheral muscles, thus com plet i ng a sen sory- m ot or reflex arc. T ype A gam m a m ot or
n eu ron s are regulat ed by propri ocept i ve feedback from sensory organ s in muscle fibres t hat serve
to regulat e muscle tone. D syfunct i onal n eu ral firing in this propri ocept i ve feedback seems to be
the source of the m ai n t ai n ed muscle con t ract i on s which lead to chron i c myofascial pain.
Spinal cord pathways: T he spinal cord is divided into cen t ral gray m at t er su rrou n ded by white
m at t er, so desi gn at ed because the n eu ron s in white m at t er are m ore thickly coat ed with white fatty
myelin. W hen cut into cross sections, the gray m at t er looks like a but t erfly, with a left and a right
dorsal horn ( post eri or horn ) and a left and a right ven t ral horn ( an t eri or horn). Sensory n eu ron s
carrying nocicept ive signals synapse in t he first and fifth layers of the i psi lat eral dorsal horn,
whereas messages concerni ng light t ouch synapse in the fourt h layer of the dorsal horn. T hese
di fferent messages about t ouch versus pain are t hen sen t up to the brai n in two separat e sect i ons of
the spinal white m at t er. I n form at i on abou t t ouch is carri ed in the dorsal colum ns of the spinal
cord, while i n form at i on abou t nocicept ive pain is carri ed in the an t erolat eral (ven t rolat eral) t ract
of the spinal cord. I mpulses along spinal n eu ron s t ravel up the respect i ve regi ons of white m at t er
to carry i n form at i on abou t touch or abou t pain to hi gher brai n cent ers.
H igher brain processing centers: T he overall organ i z at i on of the brai n is divided into the lower
brain, the i n t erm edi at e brai n, and the hi gher brai n. Spinal pathways con n ect to the brai n stem at
the m edulla, ascend to t he pons and t hen the m i dbrai n. T he ret i cular form at i on ext ends
t hrou ghou t the core of t he lower brai n, receiving t act i le and noci cept i ve messages from the spinal
cord and act ivat ing hi gher brai n cen t ers to produ ce gen eral arousal. T he serot on ergi c raphe nuclei
T heoretical perspectives 55
56
t hat faci li t at e sleep and sedat i on are also f ou n d in the m edu lla, pon s an d m i dbrai n . T he
i n t erm edi at e brai n consi st s of the t halam u s, the hypot halam u s, the li m bi c system, an d the st ri at u m
or basal gangli a. T he t halam u s som at ot opi cally proj ect s sen sory m essages to the cort ex and
m odu lat es sen sory i n f orm at i on t hat ascen ds to consci ousness. T he hypot halam u s an d t he limbic
system affect sym pat het i c arou sal and t he em ot i on al qu ali t i es of pai n . T he hi gher brai n cen t er
consi st s of the four lobes of the n eocort ex, the som at osen sory pari et al lobe, the visual occi pi t al
lobe, the au di t ory t em poral lobe, and t he m ov em en t con t rol cen t ers in the f ron t al lobe and
pref ron t al lobe.
Gate control theory: M elz ack & W all (1965) proposed t hat i n hi bi t ory i n t ern eu ron s in the dorsal
horn of t he spi nal cord are di fferen t i ally af f ect ed by i n pu t from A fiber and C fiber n eu ron s. T he
fast -con duct i n g A bet a fibers, which carry i n f orm at i on abou t light t ou ch, excite i n hi bi t ory
i n t ern eu ron s to su ppress the experi en ce of pai n . Slow-con duct i n g C fibers, which carry
i n f orm at i on abou t pai n , i nhi bi t t hese sam e i n hi bi t ory i n t ern eu ron s. T he con sequ en ce of i n hi bi t i n g
a n eu ron which is i t self i n hi bi t ory result s in a f u rt her i n crease in n eu ral di scharges t hat ascen d
t oward the brai n in the spi n al whi t e m at t er. T he dorsal horn gat i n g cells allow only bri ef n eu ral
exci t at i on following i n pu t from t act i le A bet a fibers, whereas they allow prol on ged n eu ral
exci t at i on following act i vat i on of noci cept i ve C fibers. T he occu rren ce of bri ef versu s prolon ged
burst s of n eu ron al firing accou n t s for di f f eren ces in t he percept i on of t ou ch versus pai n .
Su praspi n al gat i n g systems in the brai n were t heori z ed to sen d descen di n g i n pu t down to the spi n al
i n hi bi t ory n eu ron s, which t hu s allowed t he brai n to su ppress t he i n com i n g pain m essage.
Stimulation-produced analgesia: Em pi ri cal su pport for the exi st en ce of descen di n g pain
i nhi bi t ory pat hways occu rred in the 1970s with research i n vest i gat i on s at U CL A by Li ebesk i n d an d
M ayer ( Li ebesk i n d et al. 1974; M ayer et al. 1971; M ayer & Li ebesk i n d 1974). Elect ri cal
st i m u lat i on of the m i dbrai n peri aqu edu ct al grey (PAG) was f ou n d to su ppress behavi oral
respon ses to noxi ous heat or noxi ous elect ri c shock. O n e of the m ost su rpri si n g fi ndi ngs was t hat
this st i m u lat i on - produ ced an algesi a cou ld be an t agon i z ed by t he opi at e an t agon i st , n aloxon e
( M ayer et al. 1977). Alt hou gh the peri aqu edu ct al grey was the m ost pot en t regi on to produ ce
analgesi a in rats and cats, brai n st i m u lat i on research in m on k eys ( O l eson & L i ebesk i n d 1978;
O leson et al. 1980a) dem on st rat ed t hat t he t halam u s was the m ost pot en t pri m at e site to yield
st i m u lat i on - produ ced analgesi a. Exam i n at i on of deep brai n st i m u lat i on in hu m an pat i en t s has
produ ced si m i lar findings ( H osobu chi et al. 1979). H u m an research has also con f i rm ed t hat
n oci cept i ve pai n m essages act i vat e posi t ron em i ssi on t om ography ( PET ) scan activity in the
peri aqu edu ct al grey, t halam u s, hypot halam u s, som at osen sory cort ex and pref ron t al cort ex of m an
( H sei h et al. 1995). T hese are the same brai n st em and t halam i c areas t hat are able to su ppress pai n
messages. W hi le di rect con n ect i on s bet ween au ri cu lar acu pu n ct u re poi n t s and t hese
an t i n oci cept i ve brai n pat hways has not yet been i n vest i gat ed, n europhysi ologi cal i n vest i gat i on s of
body acu pu n ct u re poi n t s suggest t hat t he regi ons of t he brai n relat ed to pai n i n hi bi t i on are also
affect ed by the st i m u lat i on of acu poi n t s ( Kho & Robert son 1997).
Descending pain inhibitory systems: T he m i dbrai n peri aqu edu ct al grey (PAG) was on e of the
first brai n regi on s where st i m u lat i on - produ ced an algesi a was dem on st rat ed. It was su bsequ en t ly
foun d also to be act i vat ed by m i croi n ject i on s of m orphi n e and to con t ai n opi at e recept ors t hat
respon d to the bet a- en dorphi n s. N eu ron s in the dorsal raphe nuclei an d raphe m agn u s can be
exci t ed by PAG st i m u lat i on . T hese serot on ergi c raphe cells descen d t he spi nal cord in the dorsal
lat eral funi culus and synapse on gat i n g cells in layer II of t he dorsal horn . Basbau m & Fi elds
(1984) showed t hat lesi ons in the descen di n g, dorsolat eral funi culus t ract in t he spi n al cord
block ed behavi oral an algesi a from deep brai n st i m u lat i on . T he raphe n eu ron s release serot on i n to
excite the spi nal gat i n g cells, which release en k ephali n to i n hi bi t af f eren t n oci cept i ve n eu ron s. A
di f f eren t descen di n g pat hway carri es i m pulses from t he ret i cu lar f orm at i on , releasi n g the
n eu rot ran sm i t t er n orepi n ephri n e to act i vat e the i n hi bi t ory gat i n g cells in layer III of t he dorsal
horn . Curi ously, t here is also a descen di n g pain faci li t at i on system in the cen t ral n ervou s system.
W ei et al. (1999) have shown t hat dest ru ct i on of descen di n g, serot on ergi c pat hways from the raphe
m agn u s an d descen di n g n oradren ergi c pat hways from the locus ceru leu s bot h lead to an i n crease
in the Fos prot ei n activity of noci cept i ve spi n al n eu ron s. Conversely, dest ru ct i on of descen di n g
ret i cu lar gi gan t ocellu lar pat hways leads to a decrease in the Fos prot ei n activity of n oci cept i ve
spi nal n eu ron s. T he pai n i n hi bi t i on system was select i vely dam aged by the raphe an d locus
ceru leu s lesions, whereas the pai n faci li t at i on system was di scon n ect ed by t he ret i cu lar lesion.
Auriculotherapy M anual
Neural pathways of acupuncture analgesia: T here are two m aj or CN S pat hways t hat lead to
acu pu n ct u re analgesi a, an af f eren t sensory pat hway an d an ef f eren t m ot or pat hway. St i m u lat i on of
acu pu n ct u re poi n t s act i vat es the af f eren t pat hway t hat t ravels from peri pheral n erves i n t o the
spinal cord, and from the spinal cord up to the brai n. A specific ci rcui t of brai n nuclei con n ect s t he
af f eren t pat hway to the ef f eren t pat hway, which t hen sen ds descen di n g n eu ron s down the spinal
cord to i n hi bi t the percept i on of pain an d to su ppress n oci cept i ve behavi oral reflexes (T akeshige
et al. 1992). T he two brai n ci rcui t s have been revealed by a seri es of experi m en t s con du ct ed by
T akeshigi (2001) of Japan and H an (2001) in Chi n a an d the U n i t ed St at es.
Af f eren t acupun ct ure pat hway: T his af f eren t pat hway begi ns with st i m u lat i on of an acu pu n ct u re
poi n t in t he skin t hat sen ds n eu ral i m pulses to t he spi n al cord. T hese signals t hen ascen d t hrou gh
the con t ralat eral ven t rolat eral t ract of t he spi nal cord to the ret i cu lar gi gan t ocellu lar nucleus and
the raphe m agn us in the m edulla. T he signal next goes to t he dorsal peri aqu edu ct al gray (PAG).
Low-frequency (2 H z) elect ri cal st i m u lat i on of the m uscles t hat u n derli e the acu poi n t s LI 4 (hegu
or hok u ) and ST 36 (z usanli ) produ ce behavi oral analgesi a. T he i n t en si t y of elect ri cal st i m ulat i on
at an acu poi n t must be suffi ci ent to cau se muscle con t ract i on , which t hu s leads to an i n crease in t he
lat ency for the an i m al to move its tail away from a hot light. St i m u lat i on of ot her m uscle regi ons
does not produ ce this i n crease in tail-flick latency. Brai n pot en t i als can be evok ed specifically in
the peri aqu edu ct al cen t ral gray by st i m u lat i on of the m uscles u n derlyi n g the LI 4 an d ST 36
acupoi nt s, bu t not by st i m ulat i on of ot her muscles. T hese evok ed pot en t i als in t he PAG were
block ed by con t ralat eral lesi ons of the an t erolat eral t ract , by adm i n i st rat i on of the an t i seru m to
m et - en k ephali n , by the opi at e an t agon i st naloxone, bu t not by the adm i n i st rat i on of an t agon i st s to
dynorphi n. M oreover, lesi ons of the PAG aboli shed acu pu n ct u re analgesi a, i n di cat i n g t hat the
an at om i cal i nt egri t y of the PAG is necessary for produ ci n g pain reli ef from acu pu n ct u re
st i m ulat i on . T his af f eren t pat hway project s from the PAG to the post eri or hypot halam u s, the
lat eral hypot halam u s, an d the cen t rom edi an nucleus of the t halam u s. T hese n eu ron s proj ect
t hrou gh t he hypot halam i c preopt i c area to t he pi t u i t ary gland, from which bet a- en dorphi n s are
secret ed i n t o the blood.
Efferent acu pu n ct u re pat hway: T he descen di n g pain i nhi bi t ory syst em begi n s in a di f f eren t area of
the m i dbrai n peri aqu edu ct al gray, which project s to dopam i n ergi c n eu ron s in the post eri or
hypot halam i c area and t hen to the v en t rom edi an n ucleus of the hypot halam u s. T he pat h splits i n t o
a serot on ergi c system an d a n oradren ergi c system t hat descen ds down the spi n al cord. Brai n
pot en t i als in the lat eral PAG t hat are evok ed by st i m u lat i on of n on - acu poi n t s are aboli shed by
an t agon i st s to the opi at e n eu rot ran sm i t t er dyn orphi n ; in con t rast , they are not aboli shed by
adm i n i st rat i on of an t agon i st s to ei t her m et - en k ephali n or leu - en k ephali n . D yn orphi n is thus
beli eved to be the n eu rot ran sm i t t er of t he spi nal af f eren t pat hway for n on - acu pu n ct u re- produ ced
analgesi a. T he af f eren t pat hway for the ef f eren t acu pu n ct u re system ori gi n at es at n on - acu poi n t s
and ends in the an t eri or part of the hypot halam i c arcu at e nucleus. N eu ron s from t he ven t ral
peri aqu edu ct al gray synapse in the raphe m agnus, whi ch t hen t ravels down the spi n al cord to
release the n eu rot ran sm i t t er serot on i n on to spi nal gat i n g cells. An alt ern at i ve ef f eren t pat hway
t ravels from the ret i cu lar paragi gan t ocellu lari s n ucleus down to spi n al gat i n g cells. Spi n al
i n t ern eu ron s produ ce ei t her presyn apt i c i n hi bi t i on or post syn apt i c i n hi bi t i on on t he n eu ron t hat
t ran sm i t s pain m essages to the brai n , t hu s blocki ng t he pain m essage.
Opiates in acupun ct ure analgesia: T he af f eren t acu pu n ct u re pat hway produ ces a type of analgesi a
t hat is n aloxon e-reversi ble, di sappears af t er hypophysect om y, persi st s long af t er st i m u lat i on of t he
acu poi n t is t erm i n at ed an d exhibits i ndi vi dual vari at i on in effect i veness. In this first pat hway,
elect ri cal brai n pot en t i als are evok ed by st i m u lat i on of acu poi n t s in t he sam e areas t hat produ ce
analgesi a. In con t rast , st i m u lat i on of brai n areas associ at ed with t he ef f eren t acu pu n ct u re pat hway
produ ces an algesi a t hat is not naloxone-reversi ble, is n ot affect ed by hypophysect om y, and is
produ ced only du ri n g the peri od of elect ri cal st i m ulat i on . Since hypophysect om y only di srupt s t he
activity of t he first pat hway, t he secon d pat hway can fu n ct i on wi t hou t the presen ce of en dorphi n .
M i croi n ject i on of ei t her bet a- en dorphi n or m orphi n e i n t o the hypot halam u s produ ces analgesi a in
a dose- depen den t m an n er, whereas m i croi n ject i on s of n aloxon e to t he hypot halam i c arcu at e
nucleus an t agon i z es acu pu n ct u re analgesi a in a dose- depen den t m an n er.
N eurot ransm i t t ers in acu pu n ct u re analgesia: Acu pu n ct u re’s pai n reli evi ng effect s can be aboli shed
by con cu rren t lesi ons of t he raphe n ucleus and t he ret i cu lar paragi gan t ocellu lar nucleus. T hese are
the known ori gi ns of the serot on gergi c an d t he n oradren ergi c descen di n g pai n - i n hi bi t ory systems.
T heoretical perspectives 57
58
Synaptic t ransmi ssi on from the arcuat e hypot halam us to the ven t rom edi an hypot halam us is
facilit at ed by dopam i n e agonists and is blocked by dopam i n e ant agoni st s. N eu ron s in the
ven t rom edi an hypot halam us which respon d to acupoi n t st i m ulat i on also respon d to
microinject ions of dopam i n e into t hat part of the brai n. Conversely, n eu ron s in the arcu at e
hypot halam us which do not respon d to acupoi n t st i m ulat i on also do n ot respon d to
i ont ophoret i cally adm i n i st ered dopam i ne.
Adrenal activity and acupuncture analgesia: Acu pu n ct u re analgesi a an d st i m ulat i on -produced
analgesia are both aboli shed aft er removal of the adren al glands. Elect roacu pu n ct u re produces
significant i ncreases of bet a- en dorphi n and adren ocort i cot ropi c horm on e ( ACT H ) released by the
pi t ui t ary gland into the peri pheral blood st ream . T here is a cont i nual i ncrease of bot h pept i des for
more than 80 m i nut es af t er t erm i n at i on of acu pu n ct u re st i m ulat i on, alt hough this i ncrease
gradually diminishes t hereaf t er. Elect roacu pu n ct u re appli ed to a don or rat was able to induce
behavi oral analgesia in a crossed-ci rculat ed reci pi ent rat. An i ncrease of en dorphi n s in the
cerebrospi nal fluid aft er elect ro acupun ct ure suggests t hat t here may be a correlat i on bet ween
cerebral and peri pheral bet a- en dorphi n levels. Bet a- en dorphi n and A CT H are co-released from
the pi t ui t ary gland aft er an animal is st ressed. En dorphi n s are most ren own ed for t hei r pain
relieving qualit ies, whereas ACT H and cort i sol are m ore associ at ed with neurobi ologi cal
responses to stress. T hey can reach levels high en ough to activate long peri ods of st i m ulat i on of the
acupun ct ure analgesia pathways.
Electroacupuncture stimulation frequencies: T he opi at e pept i des en k ephali n and dynorphi n, two
subfract i ons of the larger polypept i de m olecule bet a- en dorphi n , are act i vat ed by di fferen t
frequenci es of elect roacupun ct ure. Analgesi a produ ced by low frequency (2 H z)
elect ro acupun ct ure was found by H an (2001) to be selectively at t en u at ed by en k ephali n
ant i bodi es, but not by dynorphi n ant i bodi es. In com pari son, analgesi a obt ai n ed by high frequency
(100 H z) elect roacu pu n ct u re was redu ced by ant i bodi es to dynorphi n, but not by an t i bodi es to
enk ephali n. H an concluded t hat 2-H z elect roacu pu n ct u re activates en k ephali n synapses, whereas
100-H z elect roacu pu n ct u re activates dynorphi n synapses. Both forms of elect roacu pu n ct u re
produ ced m ore pron ou n ced analgesia t han n eedle i n sert i on alone.
Brain i m agi n g and acu pu n ct u re st i m u lat i on : T he most di rect evi dence of the neurologi cal effect
of acupun ct ure st i m ulat i on on the hu m an brain has come from Dr Z H Cho ( Cho & W ong 1998;
W ong & Cho 1999; Cho et al. 2001) at the Universit y of Cali forni a at Irvine. Recordi ng funct i onal
magnet i c resonance imaging ( f M RI ) of the hu m an cerebral cortex, t hese i nvest i gat ors showed t hat
needles i n sert ed into a distal acu pu n ct u re poi n t on the leg used for visual di sorders could act ivat e
i ncreased fM RI activity in the occipital lobe visual cortex, whereas needli ng a di fferen t
acupun ct ure poi n t on the leg t hat is st i m ulat ed to relieve audi t ory problem s selectively act i vat ed
the t em poral lobe audi t ory cortex. I f only tactile nerves were relevan t to st i m ulat i on of
acupun ct ure points in the skin, an i ncrease in fM RI activity should have only been observed in the
pari et al lobe som at osensory cortex. Specificity of fM RI brai n activity to auri cular st i m ulat i on has
been dem on st rat ed by Alimi et al. (2002). St i m ulat i on of the han d area of the auri cle selectively
alt ered fM RI activity in the han d region of the som at osen sory cortex, whereas st i m ulat i on of a
di fferent area of the ext ernal ear did not produ ce this response. Si m i lar correspon den t changes
were obt ai n ed in brai n fM RI activity from st i m ulat i on of the elbow, knee, and foot regi ons of the
auricle. St i m ulat i on of specific areas of t he auricle led to selective changes in the f M RI responses
in the brai n (Alimi 2000).
T halam i c ci rcu i t s for acu pu n ct u re: T sun-nin Lee (1977, 1994) has developed a t halam i c n eu ron
t heory to accoun t for reflex connect i ons bet ween acu pu n ct u re poi nt s and the brai n. Accordi ng to
this t heory, pat hologi cal changes in peri pheral tissue lead to m alfunct i oni ng firing pat t ern s in the
correspon di n g brain pathways. T he n at u ral organ i z at i on of the con n ect i on s bet ween peri pheral
nerves and the CN S is cont rolled by sites in the sensory t halam us t hat are arran ged like a
homunculus. T he CN S i nst i t ut es correct i ve m easures i n t en ded to norm ali z e the pat hologi cal
n eural circuits, but st ron g envi ronm ent al st ressors or i n t en se em ot i on s may cause the CN S
circuitry to misfire. I f the neurophysiological program s in the n eural circuit s are i m pai red, the
peri pheral disease becom es chronic. Pain and disease are thus at t ri bu t ed to learn ed m aladapt i ve
dysfunct ional program m i n g of these n eu ral circuits. St i m ulat i on of acu pu n ct u re poi n t s on the body
or the ear can serve to i n duce a funct i onal reorgan i z at i on of t hese pat hologi cal brai n pathways.
T he spat i al arran gem en t of t hese n eu ron al chains within the t halam i c hom un culus is said to
AuriculotherapyManual
accoun t for the arran gem en t of acu pu n ct u re m eri di an s in the peri phery. T he invisible m eri di an s
which pu rport edly run over the surface of the body may actually be du e to n erve pat hways
proj ect ed on t o n eu ron al chai ns in the t halam us. T he au ri cu lar acu pu n ct u re system is m ore
not i ceably arran ged in a som at ot opi c pat t ern on the skin surface of t he ext ern al ear ( Chen 1993).
N ogi er (1983) also proposed t hat for a chron i c illness to m ai n t ai n itself, the di sorder must be
accom pan i ed by alt ered neurologi cal reflexes t hat t ran sm i t pat hologi cal messages to hi gher
nervous cen t ers. U n t i l this dysfunct i onal n eural ci rcui t is correct ed, som at i c reflexes con t rolled by
the brai n will rem ai n dysfunct i onal. St i m ulat i on of correspon di n g som at ot opi c poi n t s on the ear
sends messages to the brai n which faci li t at e the correct i on of this pat hologi cal brai n activity.
Somatotopic brain map: Research by Penfield & Rasm u ssen (1950) dem on st rat ed t hat when t he
brai n of a hu m an n eu rosu rgery pat i en t was elect ri cally excited, st i m ulat i on of specific cort i cal
areas evok ed verbal report s of sen sat i on s felt in specific part s of the pat i en t ’s body. St i m ulat i on of
the most su peri or and m edi al region of the som at osen sory cort ex eli ci t ed sen sat i on s from the feet;
st i m ulat i on of the m ore i n feri or and peri pheral regi on of the cort ex produ ced the percept i on of
tingling in the head. T he rest of the body was represen t ed in an an at om i cally logical pat t ern . I f the
right cort ex was st i m ulat ed, the pat i en t report ed a sen sat i on on the left side of the body, whereas if
the left cort ex was st i m ulat ed, the pat i en t felt a sen sat i on on the ri ght side. Parallel research by
M oun t cast le & H en n em an (1952) and W oolsey (1958) showed t hat a si m i lar pat t ern existed for
animals. W hen elect ri cal st i m ulat i on was appli ed to t he foot of an ani m al, n eu ron s in one regi on of
the con t ralat eral som at osen sory cort ex began firing, whereas when the leg was st i m ulat ed, a
di fferen t bu t n earby regi on of the brai n was act i vat ed. A syst emat i c represen t at i on of the body has
been foun d for n eu ron s in the cerebral cort ex, in the subcort i cal t halam us, and in the ret i cu lar
form at i on of the brai n st em (see Fi gure 2.1). T his brai n map has the sam e overall pat t ern as the
map on the ear, represen t i n g the body in an i n vert ed ori en t at i on .
Cerebral lat erali t y: T he hi gher brai n cen t ers are split into a left cerebral cort ex an d a right
cerebral cort ex, each side with a front al lobe, a pari et al lobe, a t em poral lobe and an occipit al lobe.
A broad ban d of n eu ron s called the corpu s callosum bri dges the chasm bet ween t hese two sides of
the brai n. T he left side of the hi gher brai n receives signals from and sen ds m essages out to con t rol
the right side of the body, whereas the ri ght side of the hi gher brai n recei ves signals from and sends
messages out to the left side of the body. Besi des con t rolli n g the ability to wri t e with the right han d,
the left n eocort ex dom i n at es ou r ability to u n derst an d language, to verbally art i cu lat e words, to
solve m at hem at i cal problem s, to analyze det ai ls and to report on ou r st at es of consci ousness. Even
left han ded individuals t en d to exhibit dom i nance for language on the left side of the brain.T he right
side of the cerebral cortex regulat es a di fferent set of psychological functions. Besides cont rolling the
left hand, the right side of brai n is superi or to the left side of the brain in recognizing facial features, in
perceiving inflections and int onat ions, and in un derst an di n g the rhythms t hat distinguish different
songs. O u r recognit ion of negative em ot i onal feelings is m ore highly processed by the relat ionship›
ori en t ed right brain than by the more logically-oriented left brain. Box 2.2 present s the different
qualities of the left and right cerebral hem i spheres in a T aoist dualistic perspect ive: the left side of the
brain is more yang-like, whereas the right side of the brain is more yin-like.
Both m at hem at i cs and lan guage involve a sequ en t i al li n ear seri es of let t ers or n u m bers t hat must
be com bi ned in a logical m an n er in order to be rat ionally un derst ood. T he equ at i on (5 + 4) x 3 = 27
has a di fferen t result if t he n u m bers are rearran ged to (3 + 5) x 4 =32. T he phrase ’t he rays of
sunli ght rise over the m ou n t ai n s in the east ’ can not be logically com prehen ded by the left cerebral
cort ex when the words are recom bi n ed to read ’t he east in the rays rise of m ou n t ai n s over the
sunli ght . ’ H owever, the ri ght cerebral cort ex is readily able to recogni z e a pi ct u re of sunli ght rising
over some m ou n t ai n s, whet her on e first focuses on the m ou n t ai n s and t hen looks up at the sun, or
one first focuses on the sun and t hen lowers on e’s gaze to the m ou n t ai n s. W hat is i m port an t to
right brai n percept i on is the overall relat i on shi p of the part s to the whole. T he m ore consci ous left
side of the brai n t en ds to focus on rat i onally solving problem s, whereas the m ore em ot i on ally
sensitive ri ght side of the brai n allows for em pat het i c u n derst an di n g of unconsci ously m ot i vat ed
feelings. Alt hou gh i n f orm at i on processed by the left hem i sphere is necessary to rem em ber
som eon e’s n am e, the right brai n is essent i al to recall his or her face. D om i n an ce for language is
found in 95% of the popu lat i on , with only a few left han ders exhi bi t i ng lan guage dom i n an ce in the
right cerebral cortex. I t should be n ot ed t hat bot h the left side and the right side of the brai n are
actively u sed by everyone, the two hem i spheres con st an t ly cross-referen ci n g each ot her. H owever,
t here can be cert ai n learn i n g di sorders where the com m u n i cat i on bet ween the left cerebral cort ex
T heoretical perspectives 59
Box 2.2 T aoist dualities in the left and right cerebral hemispheres
Yang left brain act i vi t y
Logical
Rational
T hi nk i ng
N ame recogni t i on
M at hem at i cal calculat i ons
Analyzes details
W ord recogni t i on
Verbal m ean i n g
Sequential
Linear
Literal
Abst ract conce pts
Judgm ent al
Cri t i cal
D om i n at i n g
Language
Yin right brain act i vi t y
I n t u i t i v e
Em ot i on al
Feeling
Facial recogni t i on
M usi cal rhyt hm s
Global impressions
Spatial relat i onshi ps
I n t on at i on s and i n f lect i on s
Si m ult aneous
Ci rcular
Sym boli c
M et aphori cal images
Accept i n g
Compassi onat e
Support i ve
A rt
60
an d t he ri ght cerebral cort ex creat es con f u si on rat her t han order. A n ex am pl e w ou l d be dyslexia,
t he reversal of n u m bers, let t ers, or words. T hi s con di t i on is 10 t i m es m ore likely to be f ou n d in
som eon e w ho is left han ded t han in som eon e who is ri ght han ded. In au ri cu l ar m edi ci n e, probl em s
of left hem i sphere an d ri ght hem i sphere i n t eract i on s are ref erred to as lat erali t y di sorders.
Con t ral at eral cort i cal cri ss-crossi n g: I t som et i m es con f u ses begi n n i n g pract i t i on ers of
au ri cu l ot herapy t hat di f f eren t body regi on s are represen t ed con t ral at eral l y in t he brai n , bu t are
represen t ed i psi lat erally on t he ear. T he ex pl an at i on is t hat n erves ori gi n at i n g f rom ear reflex
poi n t s are cen t rally proj ect ed to t he con t ral at eral si de of t he brai n , whi ch su bsequ en t l y sen ds
descen di n g proj ect i on s back to t he i psi lat eral correspon di n g organ . Si gn als f rom t he left ear cross
to t he ri ght si de of t he brai n . T hey t hen cross back f rom t he ri ght si de of t he brai n to t he left si de of
t he body. Con versely, a poi n t on t he ri ght ear proj ect s to t he left brai n , whi ch t hen processes t he
i n f orm at i on an d act i vat es hom eost at i c regu lat i n g m echan i sm s t hat l ead to correct i v e n eu ral
i m pu lses bei n g sen t to t he ri ght si de of t he physi cal body. T hi s con t ral at eral cri ss- crossi n g pat t ern
is represen t ed in Fi gu re 2.23.
Brain com pu t er model: A com m on ly ci t ed analogy for u n derst an di n g the brai n is t he exam ple of
m odern com pu t ers. I f the brai n is com pared to a com pu t er, t hen the ear can be vi ewed as a com pu t er
t erm i nal, having peri pheral access to the body’s cen t ral m i croprocessor unit. T hi s i m age is
represen t ed in Fi gu re 2.24. N eedle or elect ri cal st i m u lat i on of ear acu poi n t s would be like typing a
m essage on a com pu t er k eyboard, whereas the com pu t er screen wou ld be like the appearan ce of
di fferen t di agnost i c signs on the auricle. Losi n g or dam agi n g the ear wou ld n ot necessari ly be
dest ruct i ve to the brai n com pu t er, any m ore t han losing a k eyboard wou ld necessari ly affect a physical
com pu t er. H avi n g a peri pheral t erm i n al on the ext ern al ear allows m ore ready access to t he cen t ral
brai n com pu t er, thus faci li t at i ng cerebral reorgan i z at i on of pat hologi cal reflex pat t ern s.
Som at i c con t rol of m u scle t en si on : T here are two m ai n di vi si ons of t he peri pheral n erv ou s
syst em , t he som at i c n erv ou s syst em an d t he au t on om i c n erv ou s syst em . M yofasci al pai n is t ypi cally
produ ced by t he act i vat i on of som at i c n erv es exci t i ng t he con t ract i on of m u scle fi bers to f orm
m uscle spasm s. T hese fi xat ed m uscle con t ract i on s will n ot release, n o m at t er w hat con sci ou s
ef f ort s are exert ed. T hi s m yofasci al t en si on is t he m ost com m on type of chron i c pai n , i n clu di n g
back pai n , headaches, n eck an d shou l der pai n , an d j oi n t aches. A m u scle will n ot i n i t i at e a
m ov em en t or m ai n t ai n any act i on by itself. T he m u scle m u st first be st i m u l at ed by a m ot or n eu ron
to con t ract . I f on e has ri gi di t y an d st i ffn ess in a li m b, n eu ral reflexes are requ i red to m ai n t ai n t hat
post u ral pat t ern . T he qu est i on becom es w hat f act or w ou l d cau se t he brai n to tell spi n al m ot or
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Right brain
Activation of
elbow area
represented on
right side of
cerebral cortex
i ll
Contralateral crossing
of left ear
to right brain
Stimulation of
elbow point
on left ear
Contralateral crossing
of right brain to left side of body
Electrical impulses
along neurons
L ef t body
T reatment
of pain in
left elbow
Figure 2.23 Contralateral cortical connections that cross from the left external ear to the right brain and from the right brain back to the
left side ofthe body. (From Life ART "’, Super Anatomy, ' Lippincott W illiams & W ilkins, with permission.)
T heoretical perspectives 61
Brain computer microprocessor
somatotopically monitors body
= Pain or
pathology
Pain relieved
in body by
neural output
from brain
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 brain computer
Active ear reflex points
respond to brain input,
acting like computer monitor to
indicate areas of body pathology
B Auri culot herapy
A Auricular diagnosis
Figure 2 . 2 4 Brain computer model indicating peripheral connections from the body to the microchip circuitry of the brain, represented
like a computer monitor (A). Stimulation of the auricle is like sending messages on a computer keyboard (B) to the brain, which
subsequently regulates the body.
62 Aur;culotherapyManual
n euron s to sust ai n muscle con t ract i on in a pat hologi cal st at e. T he t halam i c n eu ron t heory of Lee
and the writings of N ogi er suggest t hat such chroni c pai n is due to a learn ed pat hologi cal reflex
circuit est abli shed in the brai n. I t is t hat m aladapt i ve brai n circuit which unconsciously m ai nt ai ns
chroni c pain. T he pat t ern of n eural firing in t hese pat hologi cal brai n circuit s descends the spinal
cord and act ivat es m ot or n eu ron s to con t ract the muscles in a m an n er t hat is desi gned to be
prot ect i ve agai nst pain, bu t actually t en ds to exacerbat e pain. Auri culot herapy can prom ot e
hom eost at i c balanci ng of t hat pat hologi cal brai n - som at i c nerve circuit.
Sym pat het i c con t rol of blood flow: Blood ci rculat i on and con t rol of ot her visceral organs is
regulat ed by the au t on om i c nervous system. Sym pat het i c arousal leads to peri pheral
vasoconst ri ct i on and a redu ct i on of blood flow to the area. T he locali z ed skin surface changes
som et i m es seen with auri cular diagnosis, such as white flaky skin, can be at t ri bu t ed to
mi crovasoconst ri ct i on (I onescu-T irgovist e et al. 1991). Auri culot herapy st i m ulat i on produces
peri pheral vasodi lat i on, which pat i en t s oft en feel as a sen sat i on of heat in the part of the body
which correspon ds to the poi nt s being t reat ed. T his t reat m en t can t heref ore be used for Rayn au d’s
disease, art hri t i s, and muscle cram ps due to rest ri ct ed blood ci rculat i on.
Sym pat het i c con t rol of sw eat glands: A n ot her system con t rolled by the au t on om i c nervous
system is the sympat het i c con t rol of sweat glands. Sweat is released m ore when it is hot out si de, or
in respon se to anxiety or stress. An elect roderm al di scharge from sweat glands can be recorded
from skin surface elect rodes. Selective changes in the elect ri cal activity on the auri cular skin
surface can be recorded by an elect ri cal poi n t finder. Such devices i n di cat e locali z ed i ncreases in
skin con duct an ce t hat are produ ced by the sym pat het i c nervous system which i nnervat es the sweat
glands (H si eh 1998; Young & M cCart hy 1998). Paradoxically, hist ological i nvest i gat i ons of the skin
overlying the auricle do not reveal the presen ce of sweat glands, i ndi cat i ng t hat som e ot her process
must accoun t for spatial di fferences in skin resi st ance at react ive ear reflex poi nt s. St i m ulat i on of
react ive auri cular poi nt s leads to a redu ct i on in skin con du ct an ce recorded in the palm, thus
indicat ing redu ced sym pat het i c arousal. Represen t at i on of the yang aspect s of the sym pat het i c
nervous system and the yin aspects of the parasym pat het i c nervous system are shown in Fi gure 2.25
and Box 2.3.
Research on acupoi n t elect roderm al act i vi t y: In 1980, O leson and colleagues con du ct ed the first
double blind assessm ent to scientifically vali dat e the som at ot opi c pat t ern of auri cular reflex poi nt s
(O leson et aI 1980b). Forty pat i en t s with specific m usculoskelet al pain problem s were first
evaluat ed by a doct or or n u rse to det erm i n e the exact body locat i on of t hei r physical pain. A
second medi cal doct or who had extensive t rai ni ng in auri cular acu pu n ct u re procedu res t hen
exam i ned each pat i en t ’s ear. T his second doct or had no pri or knowledge of the subject ’s previously
est abli shed medical diagnosis and was not allowed to i n t eract verbally with the pat i en t . T here was
a positive correspon den ce bet ween auri cular poi nt s i dent i fi ed as react i ve and the part s of the body
where t here was musculoskelet al pain. Reactivity was defi ned as au ri cu lar poi nt s t hat were t en der
to palpat i on and exhi bi t ed at least 50 m i croam ps ( pA) of elect ri cal conductivity. N on-react i ve ear
poi nt s correspon ded to part s of the body from which t here was no report ed pain. T he statistically
significant overall correct det ect i on rate was 75.2% . W hen the pain was locat ed on only one side of
the body, elect ri cal conduct ivit y was significantly great er at the som at ot opi c ear poi n t on the
ipsilat eral ear t han at the correspon di n g area of the con t ralat eral ear. A n ot her double blind
evaluat i on of auri cular diagnosis did not occur until a decade lat er. Ear reflex poi nt s relat ed to
heart di sorders were exam i n ed by Saku et al. (1993) in Japan . React i ve elect roperm eable poi nt s on
the ear were defi ned as auri cular skin areas t hat had con du ct an ce of elect ri cal cu rren t great er t han
50 mi croamps, indicat ing relatively low skin resi st ance. T here was a significantly hi gher frequency
of reactive ear poi nt s at the Chi nese H eart poi nt s in t he i nferi or con cha (84% ) and on the tragus
(59% ) for pat i en t s with myocardial i nfarct i ons and angi na pain t han for a con t rol grou p of healt hy
subjects (11% ). T here was no di fference bet ween the coron ary heart di sease grou p and the con t rol
group regardi ng the elect ri cal reactivity of auri cular poi n t s t hat did n ot represen t the heart . T he
frequency of elect roperm eable auri cular poi nt s for the kidney ( 5 % ) , st om ach (6 % ), liver (10% ),
elbow (11 % ) and eye (3% ) was the sam e for coron ary pat i en t s as for individuals wi t hout coronary
problems, highlight ing the specificity of this phen om en on .
O bservat i ons t hat acu pu n ct u re poi nt s exhi bi t ed lower levels of skin resi st ance t han surroun di n g
skin surface areas were first report ed in the 1950s by N ak at an i in Japan and by N iboyet in France
(O leson & Kroeni ng 1983c). In the 1970s, M at su m ot o showed t hat 80% of acu pu n ct u re points
T heoretical perspectives 63
T aoist balance of au t on om i c nervous syst em
Yang react i ons
Sympathetic activation
Rapid heart beats
Pupillary dilation
Elevated GSR
Rise in skin conductance
Yin react i ons
Parasympathetic sedation
Slow heart beats
Pupillary constriction
Decreased GSR
Lowered skin conductance
Figure 2 . 2 5 Physiological activity in the au t on om i c nervous system is com pared to the com plem en t ary qualit ies of yan g an d yin. Ytmg›
like sym pat het i c arousal increases heart rate, pupillary dilation, an d skin conduct ance, whereas parasym pat het i c sedat i on has the
opposi t e effects. (From Li f e A RT ", Super An at om y, ' Li ppi n cot t W illiams & W i lki ns. )
64 Auriculotherapy M anual
Box 2.3 T aoist dualities of t he sym pat het i c and parasym pat het i c nerves
Yin parasym pat het i c nervous syst em
Selective sedat i on
Conservat ion of energy
Slow deep breat hi n g
Slow heart rate
Lowered blood pressure
Peripheral vasodi lat i on
W arm hands
Dry hands
Reduced skin conduct ance
Pupi llary con st ri ct i on
Increased sali vat i on
I m proved di gest i on
Con st i pat i on
Facilit at es muscle relaxat i on
could be det ect ed as low resi st an ce poi n t s. T he elect ri cal resi st an ce of acu pu n ct u re poi n t s was
f ou n d to ran ge f rom 100 to 900 ki lohms, whereas t he elect ri cal resi st an ce of n on - acu pu n ct u re
poi n t s ran ged from 1100 to 11 700 k i lohm s. Rei chm an i s et al. (1975, 1976) f u rt her showed t hat
m eri di an acu pu n ct u re poi n t s exhi bi t even lower elect ri cal resi st an ce w hen t here is pat hology in t he
organ they represen t . For i n st an ce, el ect roderm al resi st an ce on the lu n g m eri di an is lower when
on e has a respi rat ory di sorder, whereas skin resi st an ce on t he liver m eri di an is lower when on e has
a liver di sorder. T hose acu pu n ct u re poi n t s t hat w ere i psi lat eral to the site of body di scom f ort
exhi bi t ed a lower elect ri cal resi st an ce t han the correspon di n g m eri di an poi n t on t he con t ralat eral
side of the body. T his w ork corroborat ed earl i er findings ( Bergsm an & H art 1973; H yvari n en &
Karlsson 1977).
Su bsequ en t research on t he di f f eren t i al elect roderm al activity of acu poi n t s has con t i n u ed to verify
t hese earl i er st udi es. Xi an glon g et al. (1992) of Chi n a exam i n ed 68 healt hy adu lt s for
com pu t eri z ed plot t i n g of low skin resi st an ce poi nt s. A si lver el ect rode was con t i n u ou sly m oved
over a whole area of body surface, while a ref eren ce el ect rode was f ast en ed to t he han d. St art i n g
from the di st al en ds of t he f ou r limbs, i n vest i gat ors m ov ed the el ect rode alon g the known
m eri di an s. T he resi st an ce of low skin i m pedan ce poi n t s ( LSI P) was approxi m at ely 50 ki lohm s,
whereas t he i m pedan ce at n on - L SI P was typically 500 k i lohm s. A t ot al of 83.3% of LSIPs were
locat ed wi t hi n 3 mm of a chan n el. In only a few cases cou ld i n di vi dual LSI Ps be f ou n d in
n on - chan n el areas. T he t opography of low skin resi st an ce poi n t s ( L SRP) in rat s was exam i n ed by
Chi ou et al. (1998). Specific L SRP loci w ere f ou n d to be di st ri bu t ed sym m et ri cally an d bi lat erally
over t he shaved skin of t he an i m al’s ven t ral, dorsal, an d lat eral surface. T he arran gem en t of t hese
poi n t s correspon ded to t he acu pu n ct u re m eri di an s f ou n d in hu m an s. T he L SRPs w ere
hypot hesi z ed to represen t z on es of au t on om i c con cen t rat i on , t he hi gher elect ri cal conduct i vi t y
due to hi gher n eu ral and vascu lar el em en t s ben eat h t he poi nt s. T he L SRPs gradu ally di sappeared
within 30 m i n u t es af t er t he an i m al’s deat h.
Skin and m uscle tissue sam ples were obt ai n ed by Chan et al. (1998) f rom f ou r an est het i z ed dogs.
A cu pu n ct u re poi nt s, def i n ed by regi on s of low skin resi st an ce, w ere com pared to con t rol poi nt s,
which exhi bi t ed hi gher elect roderm al resi st an ce. T he poi n t s w ere m ark ed for l at er hi st ologi cal
exam i n at i on . Con cen t rat i on of su bst an ce P was si gni fi cant ly hi gher at skin acu pu n ct u re poi n t s
(3.33 nglg) t han at con t rol skin poi n t s (2.63 ng/g) t hat did n ot exhi bi t low skin resi st an ce.
Con cen t rat i on of su bst an ce P was also significant ly hi gher in skin t i ssue sam ples (3.33 ng/g) t han in
the deeper, m uscle t i ssue sam ples (1.8 ng/g}, Su bst an ce P is known to be a spi n al n eu rot ran sm i t t er
f ou n d in n oci cept i ve af f eren t C-fi bers ( Kashi ba & V eda 1991). I t plays a role in pai n t ran sm i ssi on ,
st i m u lat es con t ract i li t y of au t on om i c sm oot h muscle, i n du ces su bcu t an eou s li berat i on of
hi st am i n e, cau ses peri pheral vasodi lat i on , and leads to hypersensi t i vi t y of sen sory n eu ron s. T his
T heoretical perspectives 65
6 6
n eu rot ran sm i t t er seems to act i vat e a som at o- au t on orn i c reflex t hat could accoun t for the clinical
observat i ons of specific acu pu n ct u re poi n t s t hat are bot h elect rically active and t en der to
palpat i on .
Experi m ent ally i n duced chan ges in auri cular reflex poi n t s in rats were exam i n ed by Kawak ai t a et
al. (1991). T he subm ucosal tissue of the st om ach of an est het i z ed rats was exposed, t hen acet i c acid
or saline was i nject ed into the st om ach tissue. Skin i m pedan ce of the au ri cu lar skin was m easu red
by con st an t voltage, squ are wave pulses. A silver m et al ball, the search elect rode, was moved over
the surface of the rat ’s ear and a n eedle was i n sert ed i n t o su bcu t an eou s tissue to serve as the
referen ce elect rode. I nject i on of acetic acid lead to the gradual developm en t of lowered skin
resi st ance poi n t s on cen t ral regions of the rat s’ ears, au ri cu lar areas which correspon d to the
gast roi n t est i n al regi on of hu m an ears. In n orm al rats and in experi m en t al rats bef ore the surgical
operat i on , low i m pedan ce poi n t s were rarely det ect ed on the au ri cu lar skin. Af t er experi m ent ally
i n duced peri t oni t i s, t here was a significant i ncrease in low i m pedan ce poi n t s ( 0 - 1 0 0 kilohms) and
m oderat e i m pedan ce poi n t s (100-500 ki lohms), but a decrease in high i m pedan ce poi n t s ( great er
than 500 kilohms). H i st ologi cal i nvest i gat i on could n ot prove the exi st ence of sweat glands in the
rat auri cular skin. T he au t hors suggest ed t hat the low i m pedan ce poi n t s are in fact relat ed to
sym pat het i c con t rol of blood vessels.
Brain act i vi t y relat ed to auri cular st i m ulat i on : T he areas of the brai n which have been classically
relat ed to weight con t rol i nclude two regi ons of the hypot halam us. T he ven t rom edi al
hypot halam us ( V M H ) has been ref erred to as a sat i et y cen t er. W hen the V M H is lesi oned, ani m als
fail to rest ri ct t hei r food i n t ak e. In con t rast , the lat eral hypot halam u s ( L H ) is ref erred to as a
feeding cen t er, since st i m ulat i on of the LH i nduces ani m als to st art eat i n g food. Asam ot o &
T akeshige (1992) st udi ed selective act i vat i on of the hypot halam i c sat i et y cen t er by au ri cu lar
acu pu n ct u re in rats. Elect ri cal st i m ulat i on of i n n er regi ons of the rat ear, which correspon d to
auri cular represen t at i on of the gast roi n t est i n al tract, produ ced evok ed pot en t i als in the V M H
satiety cen t er, but not in the lat eral hypot halam i c feedi ng cen t er. St i m u lat i on of m ore peri pheral
regions of the ear did not act ivat e hypot halam i c evok ed pot en t i als, i ndi cat i ng the selectivity of
auri cular acu poi n t st i m ulat i on. Only the som at ot opi c au ri cu lar areas n ear the regi on represen t i n g
the st om ach caused t hese specific brai n responses. T he same au ri cu lar acu pu n ct u re sites t hat led
to hypot halam i c activity associ at ed with sat i et y led to behavi oral chan ges in food i n t ak e. Au ri cu lar
acu pu n ct u re had no effect on weight in a di fferen t set of rats who had recei ved bi lat eral lesions of
VM H . T hese result s provi de a com pelli ng con n ect i on bet ween au ri cu lar acu pu n ct u re and a part of
the brai n associ at ed with neurophysi ologi cal regu lat i on of feedi ng behavi or.
In su pport of this evok ed pot en t i al research, Shiraishi et al. (1995) recorded single unit n eu ron al
di scharge rat es in the ven t rom edi al ( V M H ) and lat eral hypot halam us ( L H ) of rats. N eu ron s were
recorded in the hypot halam us following elect ri cal st i m ulat i on of low resi st ance regi ons of the
i nferi or con cha St om ach poi nt . Auri cular st i m ulat i on t en ded to faci li t at e n eu ron al di scharges in
the V M H and inhibit n eu ral responses in the LH . O u t of 162 n eu ron s recorded in the V M H ,
44.4% exhi bi t ed i n creased n eu ron al di scharge rat es in respon se to au ri cu lar st i m ulat i ons, 3.7% of
V M H n eu ron s exhi bi t ed i nhi bi t i on, and 51.9% showed no change. O f 2 2 4 n eu ron s recorded in the
LH feedi ng cen t er of 21 rats, 22.8% were i nhi bi t ed by au ri cu lar st i m ulat i on , 7.1 % were excited,
and 70.1 % were unaffect ed. W hen the analysis was li m i t ed to 12 rat s classified as behavi orally
respon di n g to auri cular acu pu n ct u re st i m ulat i on, 49.5% of LH units were i nhi bi t ed, 15.5% were
excited, and 35% were not affect ed by au ri cu lar st i m ulat i on . A di fferen t set of rats was given
lesions of the ven t rom edi al hypot halam us, which led to significant wei ght gain. In t hese
hypot halam i c obese rats, 53.2% of 111 LH n eu ron s were i n hi bi t ed by auri cular st i m ulat i on , 1.8%
showed i n creased activity, and 45% were un chan ged. T hese neurophysi ologi cal findings suggest
t hat au ri cu lar acu pu n ct u re can selectively alt er hypot halam i c brai n activity and is m ore likely to
produ ce sensat i ons of V M H satiety t han redu ct i on of LH appet i t e.
Fedoseeva et al. (1990) appli ed elect rost i m u lat i on to the au ri cu lar lobe of rabbi t s, an area
correspon di n g to the jaw and t eet h in hu m an s. T hey m easu red behavi oral reflexes and
cort i cal som at osen sory evok ed pot en t i als in respon se to t oot h pu l p st i m u lat i on . Au ri cu lar
elect ro acu pu n ct u re produ ced a si gni fi cant decrease in bot h behavi oral reflexes an d in
cort i cal evok ed pot en t i als to t oot h pu l p st i m u lat i on . T he su ppressi on of behavi oral and
n europhysi ologi cal effect s by au ri cu lar el ect roacu pu n ct u re at 15 H z was aboli shed by
i n t raven ou s i n ject i on of the opi at e an t agon i st n aloxon e, suggest i ng en dorphi n ergi c m echan i sm s.
AuriculotherapyManual
N aloxon e did n ot di m i n i sh the an algesi c effect of 100 H z st i m u lat i on f requ en ci es. Conversely,
i n ject i on of saralasi n , an an t agon i st for an gi ot en si n II, block ed the an algesi c ef f ect of 100 H z
au ri cu lar acu pu n ct u re, bu t n ot 15 H z st i m u lat i on . T he am pl i t u de of cort i cal pot en t i als evok ed by
elect ri cal st i m u lat i on of t he hind limb was not at t en u at ed by st i m u lat i on of t he au ri cu lar area for
the t ri gem i n al nerve.
2.6 Endorphin release by auricular acupuncture
T he n at u ral pain relieving bi ochem i cals known as en dorphi n s are en dogen ou s m orphi n e
subst ances which are foun d in the pi t u i t ary gland and part s of the cen t ral nervous system (CN S).
En k ephali n is a subfract i on of en dorphi n , a n eu rot ran sm i t t er occu rri n g in the brai n at the same
sites where opi at e recept ors have been found. Bot h body acu pu n ct u re and ear acu pu n ct u re have
been foun d to raise blood seru m and cerebrospi n al fluid (CSF) levels of en dorphi n s and
en k ephali n s. As st at ed in the previ ous sect i on, n aloxon e is the opi at e an t agon i st which blocks
m orphi n e, blocks en dorphi n s, and also blocks the an algesi a produ ced by the st i m ulat i on of
auri cular reflex poi n t s an d body acu pu n ct u re poi nt s. T he discovery by W en & Cheu n g (1973) t hat
auri cular acu pu n ct u re faci li t at es wi t hdrawal from n arcot i c drugs has led to a plet hora of st udi es
dem on st rat i n g the clinical use of this t echn i qu e for su bst an ce abuse (Sm i t h 1988, D ale 1993).
Auri cular elect roacu pu n ct u re has also been shown to rai se blood seru m and cerebrospi n al fluid
(CSF) levels of en dorphi n s and en k ephali n s (Sjolund & Eri k sson 1976; Sjolund et a1. 1977;
W en et a1. 1978, 1979; Clem en t - Jon es et a1. 1979) and bet a- en dorphi n levels in mice wi t hdrawn
from m orphi n e ( H o et a1. 1978; N g et aI. 1975, 1981). Pom eran z (2001 ) has revi ewed the extensive
research on the en dorphi n ergi c basis of acu pu n ct u re analgesi a and has su bst an t i at ed 17 argu m en t s
to justify the conclusi on t hat en dorphi n s have a scientifically veri fi able role in the pai n relieving
effects of acu pu n ct u re.
M ayer et a1. (1977) were t he first i nvest i gat ors to provi de scientific evi den ce t hat t here is a
neurophysi ologi cal and n eu rochem i cal basis for acu pu n ct u re in hu m an subject s. St i m ulat i on of the
body acu pu n ct u re poi n t LI 4 produ ced a significant i n crease in den t al pai n t hreshold. Acu pu n ct u re
t reat m en t rai sed den t al pai n t hreshold by 27.1 % , whereas an u n t reat ed con t rol grou p showed only
a 6.9% i n crease in den t al pai n t hreshold. A t ot al of 20 ou t of 35 acu pu n ct u re subject s showed
i n creased pai n t hresholds great er t han 20% , while only 5 ou t of 40 con t rol subject s exhi bi t ed a 20%
elevat i on of pain t hreshold. St at ist ically significant reversal of this elevat ed pain t hreshold was
achi eved by i n t raven ous adm i n i st rat i on of 0.8 mg of naloxone, redu ci n g the subject ’s pai n
t hreshold to the same level as t hat of a con t rol grou p given saline. A dou ble blind study by Ern st &
Lee (1987) similarly f ou n d t hat t here was a 27% i n crease in pai n t hreshold af t er 30 m i n u t es of
elect roacu pu n ct u re at LI 4. T he analgesi c effect i n du ced by acu pu n ct u re in t hat st udy was also
block ed by the i n t raven ou s i nject i on of 0.8 mg of naloxone.
Con t radi ct ory findings with regard to t he naloxone reversi bi li t y of acu pu n ct u re analgesi a have
been suggest ed by Chapm an et a1. (1983). D i fferences in experi m en t al desi gn could accou n t for
some of the di screpanci es, but a m ore probable explan at i on for the con t rast i n g findings may be
due to the low sam ple size em ployed in Chapm an et a1.’s research. T hei r study exam i n ed only 7
subject s in the experi m en t al grou p given n aloxon e and 7 in the con t rol grou p given sali ne. W hile
all 14 subject s did exhibit significant analgesi a with acu pu n ct u re st i m u lat i on at LI 4, they failed to
obt ai n a st at ist ically significant reversal in pai n t hreshold by 1.2 mg of i n t raven ou s naloxone. T he
m ean decrease in the elect ri cal cu rren t levels n eeded to evoke pai n was 4.8 /-LA af t er naloxone
adm i n i st rat i on , but only 0.4 /-LA for the con t rol grou p adm i n i st ered sali ne. W hile t he m ean chan ge
in pain t hreshold di fferen ce bet ween grou ps was small, it might have reached st at i st i cal
significance with a larger sam ple size.
T he af orem en t i on ed st udi es all obt ai n ed acu pu n ct u re an algesi a with body acu poi n t LI 4. Si m m ons
& O leson (1993) exam i n ed naloxone reversibilit y of au ri cu lar acu pu n ct u re an algesi a to den t al pain
i n duced in hu m an subject s. Ut iliz ing a Stirn Flex 400 t ran scu t an eou s elect ri cal st i m ulat i on unit, 40
subject s were random ly assi gned to be t reat ed at ei t her 8 au ri cu lar poi n t s specific for den t al pain or
at 8 placebo poi nt s, ear regi ons which have n ot been relat ed to den t al pain. All subject s were
assessed for t oot h pai n t hreshold by a den t al pulp t est er at baseli ne, af t er auri culot herapy, and
t hen again af t er double bli n d i nject i on of 0.8 mg of n aloxon e or placebo saline. Fou r t reat m en t
groups consi st ed of t ru e au ri cu lar elect ri cal st i m u lat i on ( AES) followed by an i nject i on of
naloxone, t ru e AES followed by an i nject i on of saline, placebo st i m u lat i on of the auri cle followed
T heoretical perspectives 67
68
by an inject ion of naloxone, or placebo st i m ulat i on of the auri cle followed by an i nject i on of saline.
D en t al pain t hresholds were significantly i ncreased by AES con du ct ed at appropri at e auri cular
points for den t al pain, bu t were not alt ered by sham st i m ulat i on at i n appropri at e auri cular points.
N aloxone produ ced a slight reduct i on in den t al pain t hreshold in the subject s given t ru e AES,
whereas t he t ru e AES subjects t hen given saline showed a f u rt her i ncrease in pain t hreshold. T he
minimal changes in den t al pain t hreshold shown by the sham auri culot herapy grou p were not
significantly affect ed by saline or by naloxone. Research by Oliveri et al. (1986) and Krause et al.
(1987) has also dem on st rat ed statistically significant elevat i on of pai n t hreshold by t ran scu t an eou s
auri cular st i m ulat i on, while Kitade & H yodo (1979) and Lin (1984) found i n creased pain reli ef by
needles i n sert ed into the auricle. T hese earli er invest igat ions of auri cular analgesi a did not test for
the effects of naloxone.
D i rect evi dence of the en dorphi n ergi c basis of auri culot herapy was first provi ded by Sjolund &
Eri ksson (1976) and by Abbat e et al. (1980). Assaying plasm a bet a- en dorphi n con cen t rat i on s in
subjects un dergoi n g surgery, they observed a significant i ncrease in bet a- en dorphi n s aft er
acupun ct ure st i m ulat i on was com bi ned with ni t rous oxide i nhalat i on, whereas con t rol subjects
given ni t rous oxide wi t hout acu pu n ct u re showed no such elevat i on of en dorphi n s. Pert et al. (1981)
showed t hat 7- H z elect rical st i m ulat i on t hrough n eedles i n sert ed into the con cha of the rat
produ ced an elevat i on of hot plat e t hreshold, an analgesic effect t hat was reversed by naloxone.
T he behavi oral analgesia to auri cular elect roacu pu n ct u re was accom pan i ed by a 60% i ncrease in
radi orecept or activity in cerebrospi n al fluid levels of en dorphi n s. T his auri cular-i nduced elevat i on
in en dorphi n level was significantly great er t han was found in a con t rol grou p of rats. Con com i t an t
with t hese CSF changes, auri cular elect roacu pu n ct u re deplet ed bet a- en dorphi n radi orecept or
activity in the ven t rom edi al hypot halam us and the m edi al t halam us, bu t not the peri aqu edu ct al
gray. Support i ve findings in hu m an back pain pat i en t s was obt ai n ed by Clem en t - Jon es et al.
(1980). Low frequency elect ri cal st i m ulat i on of the con cha led to reli ef of pain within 20 m i nut es of
the on set of auri cular elect roacu pu n ct u re and an accompanyi ng elevat i on of radi oassays for CSF
bet a- en dorphi n activity in all 10 subjects. Abbat e et al. (1980) exam i ned en dorphi n levels in 6
pat i en t s undergoi ng t horaci c surgery with 50% n i t rous oxide and 50 H z auri cular
elect roacupun ct ure. T hey were com pared to 6 cont rol pat i en t s who u n derwen t surgery with 70%
ni t rous oxide but no acupun ct ure. T he auri cular acu pu n ct u re pat i en t s n eeded less n i t rous oxide
than the cont rols and acupun ct ure led to a significant i ncrease in bet a- en dorphi n
immunoreact ivit y.
Ext endi ng the pi on eeri n g work of W en & Cheun g (1973) on the benefi t s of auri cular acu pu n ct u re
for opi at e addicts, Kroeni ng & O leson (1985) exam i ned auri cular elect ro acu pu n ct u re in chroni c
pain pat i ent s. Fou rt een subjects were first switched from t hei r ori gi nal analgesic m edi cat i on to an
equi valent dose of oral m et hadon e, typically 80 mg per day. An elect roderm al poi n t finder was
used to det erm i n e areas of low skin resi st ance for the Lung poi n t an d the Shen M en poi nt . N eedles
were bi lat erally i n sert ed into t hese two ear poi nt s and elect rical st i m ulat i on was i n i t i at ed bet ween
two pairs of needles. Af t er 45 m i nut es of elect roacupun ct ure, the pat i en t s were given peri odi c
inject ions of small doses of naloxone (0’(l4 mg every 15mi nut es). All 14 pat i en t s were wit hdrawn
from m et hadon e within 2 to 7 days, for a m ean of 4.5 days. Only a few pat i en t s report ed minimal
side effects, such as mild n ausea or slight agit at ion. It was proposed t hat occupat i on of opi at e
recept or sites by n arcot i c drugs leads to the i nhi bi t i on of the activity of n at u ral en dorphi n s,
whereas auri cular acupun ct ure facilit at es wit hdrawal from t hese drugs by act ivat ing the release of
previously suppressed en dorphi n s.
O t her bi ochemi cal changes also accompany auri cular acupun ct ure. D ebreci ni (1991) exam i ned
changes in plasma A CT H and growth horm on e ( G H ) levels af t er 20-H z elect ri cal st i m ulat i on
t hrough needles i n sert ed into the Adren al poi n t on the t ragus of the ears of 20 healt hy females.
W hile G H secret i ons i ncreased aft er elect roacu pu n t u re, ACT H levels rem ai n ed t he same. T his
research su pport ed earli er work by W en et al. (1978) t hat auri cular acu pu n ct u re led to a decrease
in the ACT H and cortisol levels associ at ed with stress. Jau n g- Gen g et al. (1995) evaluat ed lactic
acid levels from pressure appli ed to ear vaccaria seeds posi t i oned over the Liver, Lung, San Jiao,
Endocri ne, and T halam u s (subcort ex) poi nt s. Using a wi t hi n-subject s design, pressu re appli ed to
ear points produ ced significantly lower levels of lactic acid obt ai n ed aft er physical exercise on a
t readm i ll test t han when ear seeds were placed over the same auri cular poi nt s but not pressed.
St i m ulat i on of auri cular pressure poi nt s redu ced the toxic bui ld-up of lactic acid to a great er
Auriculotherapy M anual
Box 2.4 T aoist dualities of horm ones and n eurot ran sm i t t ers
Yin sedat ing or nurturing neurochemicals
Endorphin
M elat on i n
Parat horm one
Estrogen and progest erone
GABA
Acet ylcholi n e
Serot oni n
Yang arousing neurochemicals
f - - - - - ’- - - - - - - =- - - - - - - - - - - - - - - :=- - - - - - ="- - - - - - - - - - - I
Adrenalin
Cort i sol
T hyroxi n
T estosterone
G lu t am at e
N orepi n ephri n e
D opam i ne
degree t han the cont rol condi t i on. T he redu ced lactic acid accum ulat i on was at t ri bu t ed to
i mproved peri pheral blood circulat ion.
As i ndi cat ed in Box 2.4 and Fi gure 2.25, the dualist ic pri nci ples of T aoism can be used to
dist inguish the arousi ng and sedat i ng quali t i es of di fferen t horm on es and di fferen t
n eurot ran sm i t t ers. T he pi t ui t ary and t arget glands t hat release adren ali n , cortisol, thyroxin and
t est ost eron e all induce gen eral arousal and energy act ivat ion. In con t rast , the horm on es
en dorphi n , growth horm on e, parat horm on e, est rogen and progest eron e all prom ot e a relaxat i on
response. T he n eu rot ran sm i t t er glu t am at e produces exci t at ory post synapt i c pot en t i als (EPSPs)
t hrou ghou t the brain, while the n eu rot ran sm i t t er gam m a-am i n obut yri c acid ( GABA) produces
inhibit ory post synapt i c pot en t i als (I PSPs) t hrou ghou t t he brai n. N orepi n ephri n e is released by
post gangli oni c fibers in t he adrenergi c sym pat het i c nervous system to act i vat e gen eral arousal,
while acet ylcholine is released by post gangli oni c fibers in the choli nergi c parasym pat het i c nervous
system to facilit at e physiological relaxat i on. In the brai n, dopam i n e t en ds to i ncrease m ot or
excit at ion and int ensely pleasurable feelings, while serot on i n faci li t at es calm, relaxing feelings t hat
facilit at e sleep.
2.7 Embryological perspective of auriculotherapy
As part of his exam i nat i on of the neurophysi ologi cal basis of auri culot herapy, Paul N ogi er (1983)
proposed t hat nervous system i nnervat i ons of the ext ernal ear correspon d to the t hree pri m ary
types of tissue found in t he developi ng embryo. N ogi er t heori z ed t hat the di st ri but i on of the t hree
crani al nerves which supply di fferent auri cular regi ons is relat ed to t hree embryological functions,
the ect oderm , m esoderm , and en doderm . Leib (1999) has ref erred to N ogi er’s embryological
perspect i ve as t hree funct i onal layers, each layer represen t i n g a di fferen t hom eost at i c system in
the organi sm. M ost healt h di sorders are relat ed to di st urbances in all t hree funct i onal layers.
Relationship of auri cular regions to nerve pat hways: T here are actually four pri nci pal nerves,
which i n n ervat e the hu m an ear. Fi gure 2.26 shows the di st ri but i on of di f f eren t nerves to di fferent
auri cular regions. Since the en t i re auri cle is covered with a thin skin layer con t ai n i n g extensively
branchi ng nerves, all anat om i cal areas of the ext ernal ear are in part relat ed to ect oderm al tissue.
Som at i c t ri gemi nal nerve: T he fifth crani al nerve is part of the som at i c nervous system pathway
t hat processes sensat i ons from the face and cont rols some facial m ovem ent s. T he m an di bu lar
division of the t ri gemi nal nerve is di st ri but ed across t he ant ihelix and t he su rrou n di n g auri cular
areas of the ant i t ragus, scaphoi d fossa, t ri an gular fossa and helix. T his auri cular regi on represen t s
som at osensory nervous tissue associ at ed with m esoderm al organs.
Som at i c f aci al nerve: T he sevent h crani al nerve is an exclusively m ot or division ’of the somat i c
nervous system, cont rolli ng most facial m ovem ent s. I t predom i n at ely suppli es the post eri or
regions of the auricle t hat represen t m ot or nerve con t rol of m esoderm al tissue.
A u t on om i c vagus nerve: T he t en t h crani al nerve is a bran ch of the parasym pat het i c division of the
aut on om i c nervous system. I t processes sensat i ons from visceral organ s in the head, the thorax,
and the abdom en and it cont rols the sm oot h muscle activity of the i n t ern al viscera. Vagus nerve
fibers spread t hrou ghou t the concha of the ear and represen t n eu ron s associ at ed with en doderm al
tissue.
T heoretical perspectives 69
A.
Vagus nerve
Cervical plexus
N erve Connect i ons to the Auricle
B.
Auri culo-t emporali s
t rigeminal nerve
D.
M inor occipit alis nerve
of cervical plexus
C.
Auricularis nerve com plex of
vagus nerve, facial nerve,
and glossopharyngeal nerve
Figure 2.26 Cranial and cervical nerves are distributed separately to different regions of the external ear (A). T he auriculo-temporalis division
of the trigeminal nerve projects to the antihelix, antitragus and superior helix (B), the vagus nerve projects to the central concha (C), and the
minor occipital nerve of the cervical plexus projects to the ear lobe (D). T hefacial and glossopharyngeal nerves also project to the concha, tragus
and medial ear lobe. (Reproduced from Nogier 1972. with pennission.)
70 Auriculo therapy M anual
Cerebral cervical plexus nerves: T his set of cervical nerves affects n eu ron al supply to the head,
neck and shoulder. T he lesser occipital nerve and the great er au ri cu lar nerve of the cervical plexus
supply the ear lobe, tragus, and helix tail regions of the auricle. T hese auri cular regi ons correspon d
to ect oderm al tissue.
Auricular representation of embryological t i ssue: All vert ebrat e organi sm s begin as the union of
a single egg and a single sperm , but this one cell soon divides to becom e a m ult i cellular organi sm as
shown in Fi gure 2.27. T his developing ball of cells ult i m at ely folds in on itself and di fferen t i at es
into the t hree di fferent layers of embryological tissue. I t is from t hese t hree basic types of tissue
t hat all ot her organs are formed. T he organ s deri ved from t hese embryological layers are proj ect ed
on to di fferen t regions of the auricle. T able 2.5 out li n es t hese embryologi cal divisions and the
correspon di n g auri cular regions.
Endodermal tissue: T he en doderm becom es the gast roi nt est i nal digestive tract, the respi rat ory
system and abdom i nal organ s such as the liver, pan creas, u ret hra and bladder. T his port i on of the
embryo also gen erat es part s of the en docri n e system, i ncludi ng the t hyroi d gland, parat hyroi d
gland, and thymus gland. D eep embryological tissue is represen t ed in the concha, t he cent ral valley
of the ear. St i mulat i ng this area of the ear affects m et aboli c activities and nut ri t i ve di sorders of t he
i n t ern al organ s t hat ori gi nat e from the en doderm layer of the embryo. D i st urban ces in i n t ern al
organs creat e an obst acle to the success of medi cal t reat m en t s, so t hese m et aboli c di sorders must
be correct ed bef ore com plet e heali ng can occur.
Egg and sperm union D i vi di n g em bryo M u lt i cellu lar em bryo
Embryo pri m ary germ layers
M esoderm
Endoderm - ¥ n ~ " ' "
Ectodermal
tissue
End od e rm a l - - - f ’===\ , - - , - - \ - :- - \ ’
tissue
M esodermal
tissue
Figure 2.27 T he di vi si on of embryologi cal cells leads to a ball of tissue t hat folds in on i t self to becom e the three derm al layers of the
endoderm , m esoderm an d ect oderm. T hese em bryologi cal tissue layers are represent ed on three di fferent regions of the auricle. (From L i f e
AR1 ’’’, Super An at om y, ' Li ppi n cot t W i lli ams & W ilkins, with perm i ssi on . )
T heoretical perspectives 71
T able 2.5 Auricular representation of embryological tissue layers
Endodermal tissue
Innerlayer
M esodermal tissue
Middle layer
Ectodermal tissue
Outer layer
Viscera Sk elet al bon es Skin
St om ach St ri at e muscles H ai r
T endons
Fascia an d sinews Sweat glan ds
- - - - - - - - - - - - - - - - - - - - - -
Peri pheral n erves Large i n t est i n es
Small i n t est i n es
Lungs
T onsils
Li gam en t s
H eart s an d cardi ac m uscle
Spinal cord
Brai n st em
Liver Blood cells and blood vessels T halam u s and hypot halam u s
Pancreas
Bladder
Lym phat i c vessels
- - - - -
Spleen
Li m bi c syst em and st ri at u m
Cerebral cort ex
~ - - - - - - - - - - - - - - - - - - - - -
T hyroi d gland Kidneys Pi n eal glan d
Parat hyroi d gland
T hym us gland
G on ads (ovari es and t est es)
Adren al cort ex
Pi t ui t ary glan d
Adren al m edu lla
Ear lobe, helix tail and tragus
O u t er ridge
Cervi cal plexus regi on
~ - - - - - -
Ear antihelix and antitragus
- - - - -
M i ddle ridge
T ri gemi nal nerve regi on
Ear concha
Cen t ral valley
Vagus nerve region
- - - - -
M esoderm al tissue: T he m esoderm becom es sk elet al muscles, cardi ac muscles, sm oot h muscles,
connect i ve tissue, joi nt s, bon es, blood cells from bon e m arrow, the ci rcu lat ory system, the
lym phat i c system, the adren al cort ex and urogen i t al organ s. M usculosk elet al equ i li brat i on is
regu lat ed by negat i ve f eedback con t rol of som at osen sory reflexes. M i ddle em bryologi cal t i ssue is
represen t ed on the ant ihelix, scaphoi d fossa, t ri an gu lar fossa and port i on s of the helix.
M obi li z at i on of body defen se m echan i sm s is only possi ble if the regi on of the m i ddle layer is
working normally.
Ect oderm al tissue: T he surface layer ori gi n at es from t he ect oderm of t he em bryo. T he ect oderm
becom es t he ou t er skin, corn ea, eye lens, nose epi t heli u m , t eet h, peri pheral nerves, spinal cord,
brai n and t he en docri n e glands of the pi t ui t ary, pi n eal an d adren al m edulla. T his em bryologi cal
tissue is represen t ed on t he ear lobe and helix tail. T he surface em bryologi cal layer affect s the
capaci t y for adapt at i on an d con t act to t he en vi ron m en t . It reveals psychologi cal resi st an ce
react i on s not only from t he consci ous mind, bu t also from the unconsci ous, deep psyche. T his layer
i n t egrat es i n born i nst i nct i ve i n f orm at i on with i ndi vi dual learn ed experi en ces.
2.8 N ogier phases of auricular medicine
In su bsequ en t revisions of the som at ot opi c represen t at i on on the ext ern al ear, Paul N ogi er
( N ogi er 1983) has descri bed di fferen t au ri cu lar maps t han the i n vert ed fetus pat t ern he originally
di scovered. T hese alt ern at i ve au ri cu lar m i crosyst em s vari ed con si derably from eali er descri pt i on s
of the correspon den ce bet ween specific organ s of the body and the part i cu lar regi on s of the ear
where they were represen t ed. Each an at om i cal area of the ext ern al ear could thus represen t m ore
t han one m i crosyst em pat t ern . N ogi er ref erred to t hese di f f eren t represen t at i on s as phases. T he
use of this t erm is an alogou s to the phases of the m oon , just as the sam e surface of t he m oon
reflects di f f eren t degrees of reflect ed light. A rou n d, whi t e ball of light is revealed at the full m oon ,
a semi ci rcle of light at the half m oon , an d a dark rou n d image at t he new m oon . T he di f f eren t
au ri cu lar phases also allu de to phase shifts in the frequen cy of light as it passes t hrou gh a crystal
prism to creat e di f f eren t colored beams. T he same whi t e beam of light can be sen t at di f f eren t
angles t hrou gh a prism to reveal blue light, green light or red light on the sam e reflect ed surface
72 Aur;culotherapy Manual
Phase I pattern
I m ages of N ogi er phases
Phase 1/ and1/1 patterns Phase IVpattern
D i f f eren t phases of ref ract ed li ght I nversi on of i m age by opt i cal lens
Blue light
Green light
Red light
Original image
~ .
Inverted image
Figure 2 . 2 8 Som at ot opi c i m ages of the di fferent phases on the ear are charact eri z ed by an upsi de down m an in
Phase I, an upright m an in Phase II, a hori z on t al m an in Phase III, an d an i nvert ed m an on the post eri or auricle in
Phase I V T he di fferent phases can be sym boli z ed by shifts in the frequency of white light as it passes through a
crystal pri sm to create di fferent colors of refracted light. T hef i rst phase is com parable to the i nversi on of an image
by a con ven t i on al opt i cal lens.
(Fig. 2.28). D i fferen t auri cular regions revealed by specific colored light filters were m apped using
the N ogi er vascular aut on om i c signal (N -VAS). Chan ges in the N -VAS pulse respon se to
st i m ulat i on of a given regi on of the ear were found to selectively vary with colors of light.
N ogi er proposed t hat di fferences bet ween Chi nese an d Eu ropean chart s may have ori gi nat ed from
this unrecogni z ed existence of many reflex systems su peri m posed on the same areas of the auricle.
T he occurren ce of more t han one ear poi n t t hat correspon ds to a given body organ may seem to
con t radi ct the gen eral proposi t i on t hat t here is a som at ot opi c pat t ern on the ear. Preceden ce for
this phen om en on is found by the presen ce of m ult i ple som at ot opi c m aps t hat have already been
plot t ed in the brai n of di fferen t ani m al species. As depi ct ed in Fi gu re 2.29, t here are at least two
som at osensory systems on the cerebral cort ex of rats, cats an d monkeys: a pri m ary and a secondary
som at osensory cortex. T here is also a t hi rd region of t he associ at i on cort ex t hat i n t ercon n ect s
somat ic, m ot or and mult isensory i nput . M ult i ple project i on systems are also f ou n d for the visual
and audi t ory cortex. T hese di fferent cerebral cort ex represen t at i on s may not be responsi ble for the
phases t hat N ogier has descri bed for the ext ernal ear, but they do i n di cat e t hat t he brai n i t self has
similar mult i ple microsyst em arran gem en t s.
2.8.1 Auricular t erri t ori es associ at ed with t he t hree embryological phases
A basic reason t hat N ogi er em phasi z ed the occu rren ce of the phases is t hat he beli eved t hat each
type of pri m ary embryological tissue has a cert ai n reson an ce frequency. T he phase shifts in
Theoretical perspectives 73
M otor cortex Som at osensory cortex area 1
74
Som at osensory cort ex area 2
Figure 2.29 T here are multiple projections of the bodyto the somatosensory cortex in
animals, possibly relating to the different somatotopic phases described by Nogier.
di fferent anat omi cal regions of the ear are relat ed to di fferent i al act ivat ion of the frequency
resonance of the correspondi ng tissue of the body. T o bet t er i ndi cat e how the ear microsystems
reflect t hese reson an t phase shifts, the auricle is first divided into t hree t erri t ori es (see Figure 2.30).
T he locat i on of the t hree t erri t ori es is based u pon t hei r di fferen t i al i n n ervat i on by t hree nerves.
T he t ri gem i nal nerve suppli es T erri t ory 1, the vagus n erve suppli es T erri t ory 2, and the cervical
plexus nerves supply T erri t ory 3. In Phase I, T errit ory 1 represen t s m esoderm al and som at i c
m uscular act ions, T erri t ory 2 represen t s en doderm al and au t on om i c visceral effects, and T erri t ory
3 represen t s ect oderm al and nervous system activity. T he embryologi cal tissue represen t ed by each
t erri t ory shifts as one proceeds from Phase I to Phase II to Phase III, as shown in Fi gure 2.31. T he
n u m ber of each phase correspon ds to the regi on t hat represen t s m esoderm al tissue. T here is
actually a fourt h t erri t ory and a fourt h phase, which has not yet been descri bed. T he facial nerve
suppli es the post eri or regi ons of the auri cle, T erri t ory 4, and it is said to represen t m ot or n eu ron
con t rol of m esoderm al som at i c tissue. T he shifts of phase are su m m ari z ed in T able 2.6.
2.8.2 Functional charact eri st i cs associ at ed with di fferent N ogier phases
T he t hree pri m ary colors of light are red, green and blue. T hese sam e t hree colors were used to
det erm i n e di scordan t reson an ce respon ses relat ed to the t hree phases di scovered by N ogi er. Red
# 2 5 Kodak -W rat t an filters eli ci t ed N ogi er vascular au t on om i c signals (N -VAS) i dent i fi ed with the
first phase, green # 5 8 Kodak -W rat t an filters eli ci t ed N -VAS respon ses i dent i fi ed with the secon d
phase, and blue # 4 4 A Kodak -W rat t an filters eli ci t ed N -VAS respon ses i dent i fi ed with the t hi rd
phase. N ogi er found t hat t here are several reflex systems su peri m posed u pon the auri cle, but ear
poi n t s could react to varying dept hs of pressure. I f an ear poi n t produ ced an N -VAS respon se with
firm pressure, great er than 120 g/rnm-, it was said to belon g to the deep layer. Ear poi n t s react i n g
to only 5 g/mm? were at t ri bu t ed to the superficial layer, whereas ear poi n t s react i n g to an
i n t erm edi at e pressure of 60 g/mm- belon ged to the m i ddle layer. T he deep layer i n di cat es the
som at ot opi c regi on of the ear t hat is the most prom i n en t reason for a sym pt om . T he locat i on of the
ear poi n t can reveal if the problem is due to the sam e body area where the pat i en t report s pain, if it
is due to ref erred pain, or if it is due to an em ot i on al problem , such as depressi on . N ogi er found
t hat ear poi n t s found at the deep layers were most relat ed to Phase I, poi n t s di scovered at the
superficial layer were most relat ed to Phase II, and ear poi n t s di scovered at the m i ddle layer were
most relat ed to Phase III.
Phase I: T he i nvert ed fetus pat t ern is used to t reat the m ajori t y of m edi cal con di t i on s and is most
in con cu rren ce with the Chi n ese ear reflex poi nt s. Phase I represen t s t he t i ssues and organ s of the
actual physical body. T his phase is the pri m ary source for correct i n g som at i c tissue di sorgani z at i on
t hat is the pri nci pal m an i fest at i on of most m edi cal condi t i ons. From a Chi n ese medi cal
perspect i ve, Phase I ear poi n t s i ndi cat e acut e, yang excess react i ons.
Auriculotherapy M anual
T erritory 1
f:J--’--r---E3LT erri t ory 2
T erritory 3
Figure 2 . 3 0 N ogier described three different territories of the auricle which are related to three different phases that
correspond to different somatotopic representations.
Phase I
Embryologi cal phase shifts on auricle
Phase /I Phase 11/
M esodermal
Ectodermal
Endodermal

Ectodermal

Figure 2.31 Somatotopic correspondences shift with the three N ogier phases between auricular T erritory 1, T erritory 2, and T erritory 3.
T able 2.6 Shifts of Nogier phase on the external ear
T erritory 1 T erritory 2 T erri t ory 3 D om i n an t Depth of
Antihelix area Concha Lobeand tragus color ear poi n t
Phase I M esoderm al En doderm al Ect oderm al Red D eep layer
- - - - - - - - _ ...- - - - - - - - - - -
Phase II Ect oderm al M esoderm al En doderm al G reen Superficial layer
Phase III En doderm al Ect oderm al M esoderm al Blue M iddle layer
T heoretical perspectives 75
76
Phase II: T he upright m an pat t ern is used to t reat m ore difficult chron i c con di t i on s t hat have not
respon ded successfully to t reat m en t of the Phase I microsyst em poi nt s. Phase II represen t s
psychosomat ic react i ons and neurophysiological connect i ons to bodily organs. T his phase is useful
for correct i ng cent ral nervous system dysfunct ions and m en t al confusi on t hat con t ri bu t e to the
psychosomat ic aspects of pain and pat hology of chroni c illnesses. Phase II poi nt s are said to be
relat ed to yin degenerat i ve condit ions.
Phase III: T he hori z ont al m an pat t ern is used the least frequent ly, bu t it can be very effective for
relieving unusual condi t i ons or idiosyncrat ic react i ons. Phase III affects basic cellular energy, and
can correct the energy di sorgani z at i on t hat affects cell tissue. I t produ ces subt le chan ges in the
elect rom agnet i c energy fields which su rrou n d individual cells and whole physical organs. Phase III
poi nt s are said to i ndi cat e prolonged, yang excess, i nflam m at ory condi t i ons.
Phase IV: T he second upsi de down m an pat t ern is represen t ed on the post eri or side of the
ext ernal ear and is essent ially the same microsyst em represen t ed by Phase I. T he Phase IV poi nt s
are used to t reat muscle spasm aspects of a condi t i on, whereas Phase I poi nt s i ndi cat e sensory
aspects of pain. Both Phase I and Phase IV relat e to acut e pain or ongoi ng pat hologi cal react i ons,
whereas t he ot her two phases appear with chroni c pain. Phase IV is m ost relat ed to m esoderm al
muscular tissue represen t ed on T errit ory 4, the post eri or side of the auri cle.
2.8.3 Relationship of N ogi er phases t o t radi t i on al Chinese m edi ci ne
N ogier proposed his t hree phases part ly as an at t em pt to account for some of the di screpanci es
bet ween the Eu ropean and the Chi nese ear acu pu n ct u re charts. Pract i t i on ers of auri cular
medi ci ne suggest that the som at ot opi c poi nt s descri bed by N ogi er represen t the act ual physical
organs, whereas the Chi n ese ear poi nt s may relat e to neurologi cal or en erget i c con n ect i on s to
these organs. T he di fferen t anat om i cal localiz at ions on the ear for t he Kidney, Spleen and H eart
points are an example of this view. N ogi er placed t hese t hree m esoderm -deri ved organ s on the
m esoderm al region of the i n t ern al helix and the antihelix, whereas the Chi nese ear chart s show
these same t hree organs on the en doderm al region of the su peri or and i nferi or concha. T he
concept t hat the m esoderm al organs shi ft ed from the ant i heli x to t he concha was a way of
account i ng for this di vergent represen t at i on . Some of the uses of the Kidney poi n t an d the H eart
point in Chi nese acu pu n ct u re are oft en more relat ed to t hei r z ang-fu en erget i c effect t han t hei r
biological function. T aoism descri bes the flow of qi energy from vari ous st at es of yang energy and
yin energy, which can be com pared to t he binary code used in com pu t ers and to the active and
resting st at es of a n eu ron . T he Chi nese symbolized yang as a solid line and yin as a brok en line:
various com bi nat i ons of t hree such lines form what is known as a t ri gram. H elm s (1995) has cited
the work of the French acupunct uri st M auri ce M ussat in presen t i n g eight such t ri gram s rot at i ng
arou n d the yi n-yang symbol. T he yang t ri gram s are di amet ri cally opposi t e to t hei r correspon di n g
yin t ri gram. Each t ri gram code reflects a specific i n t eract i on of t hree basic com pon en t s of the
universe: matter, m ov em en t and energy. From a t ri part i t e phase perspect i ve, N ogi er’s Phase I
represen t s solid matter, Phase II represen t s the con t rol of m ov em en t by the nervous system, and
Phase III represen t s the echo reverberat i on of the energy of the spirit. D i st u rban ce of the dynamic
symmetry of com posi t i on of these t hree funct i onal i n t eract i on s can result in an i m balance of
energy. Dr Ri chard Feely of Chicago has suggest ed t hat t hese t hree energy st at es in Chi nese
phi losophy can be com pared to N ogi er’s t hree microsyst em phases. Sequen t i al shifts in
i nt eract i ons from the initial yang react i ons m an i fest ed in Phase I, to the chroni c degen erat i ve
st at es of Phase 11, to the reson an ce reverberat i on s of Phase III are depi ct ed in the t ri gram pat t ern s
in Figure 2.32.
2.9 I nt egrat i ng alt ern at i ve perspectives of auri culot herapy
T here has been great i n t erest by some i nvest i gat ors of alt ernat i ve an d com plem en t ary medi ci ne in
con t i n ued neurophysiological research t hat aims to provi de a more scientific basis for acu pu n ct u re
and auri culot herapy. T he discovery of en dorphi n s in t he 1970s provi ded a bi ochem i cal m echani sm
which could account for the amazing observat i on t hat injecting the blood or cerebrospi n al fluid
from one laborat ory ani m al to an ot her could also t ran sf er the analgesic benefi t s of acu pu n ct u re to
the second animal. T he same n eu roan at om i cal pathways t hat have now been shown to underli e the
descendi ng pain i nhi bi t ory systems produci ng opi at e analgesi a also affect acu pu n ct u re analgesia,
t hereby provi di ng a physical foun dat i on for acupun ct ure. T he f M RI st udi es of the hu m an brai n
Auriculotherapy M anual
Ci rcu l ar shi f t s in Chi nese t ri gram s
M axi m um yang
Yang symbol =
Yin symbol = _ _
Greater yang
T ai yan g
- -
M iddle yang
Yang ming
- -
- -
- -
Lesser yang
Shao yang
- -
- -
- -
M axi m um yi n
Lesser yin
[ue yi n
- -
M iddle yi n
Shao yi n
- -
- -
- -
- -
Greater yin
T ai yin
Bi n ary progressi on of t ri gram s
- -
0 000 - - M axi m u m yin
001 Greater yin
- -
2 010
-
M iddle yin
3 011
-
Lesser yin
- -
4 100
- -
Lesser yang
- -
5 101 M i ddle yang
6 110 Greater yang
7 111 M axi m um yang
Cou n t er- cl ock w i se shi f t s in au ri cu l ar phases
Upright man
~
Breath of life
Phase I
Phase II
Horizontal man
Phase III
Phase IV
~
Inverted man
......I - - - - - - i I I E- - - - - - 1 Phase III
Qi
~ Q i
Phase I
Inverted
fetus
Figure 2.32 T he ci rcular progression of yin an d yang
relat i onshi ps of Chi nese trigrams are com pared to the
di fferent N ogier phases in auriculotherapy. T he
num eri c, binary progression of t ri gram s is li st edf rom
m ax i m u m yin to m ax i m u m yang.
dem on st rat e neural changes t hat depen d u pon st i m ulat i on of a part i cu lar acupoi n t on the body or
on the ear. At the same time, many pract i t i on ers of the field of t radi t i on al O ri en t al m edi ci ne
mai nt ai n a deep beli ef in t he energet i c pri nci ples t hat were developed in anci ent times. W het her
viewed as a self-cont ai ned m i cro-acupun ct ure system, a con dui t to m acro- acu pu n ct u re m eri di ans,
ashi poi nt s, trigger poi nt s, chak ra cent ers, or even the qu an t u m physical explanat i ons of
holograms, t here is reason to suggest t hat an unconvent i onal energy profoun dly affects the heali ng
effect of auri cular acu pu n ct u re as well as body acupun ct ure. W est ern scient ist s seem to pref er the
neurophysi ologi cal perspect i ve, while t hose t rai n ed in O ri en t al m edi ci ne m ore readily accept an
en erget i c viewpoint.
T heoretical perspectives 77
78
T he di fferences bet ween the i n form at i on processi ng styles of the left an d right hem i spheres of the
cerebral cort ex allow for this yi n-yang duality. T he W est ern mind pref ers the rat i on al order of the
left side of the neocort ex, with its consci ous ability to analyze det ai ls an d come to logical
conclusions, whereas the O ri en t al mind seem s to accept the holistic perspect i ve of the right side of
the neocort ex, which allows for the i nt eract i ve relat i on shi p of all things. W hat is n eeded to
com prehen d au ri cu lot herapy is a corpus callosum which can i n t egrat e bot h perspect i ves as
com plem en t ary vi ewpoi nt s of a very com plex system. T his duali t y of W est ern and Chi n ese
perspect i ves has also alt ered the ear acu pu n ct u re chart s t hat have developed in Asia and Eu rope.
Af t er N ogi er first di scovered the i n vert ed fetus map on the ear in the 1950s, su bsequ en t
i nvest i gat i ons of the i n vert ed auri cular cart ography t ook di vergent pat hs in Eu rope and China.
W hile t here is great overlap in the correspon di n g poi n t s shown in the Chi n ese and Eu ropean
auri cular maps, t here are also specific di fferences. T here is a t en den cy by many i ndi vi duals to feel
the n eed to choose one system over the ot her. In my discussions on t he subject , I have prom ot ed
the accept an ce and i n t egrat i on of bot h systems as clinically valid and t herapeu t i cally useful.
I t seems paradoxi cal t hat two opposi t e observat i on s could bot h be correct , but such is the n at u re in
many part s of life, i ncludi ng ou r cu rren t view of su bat om i c part icles. I t is probably t he arrogan ce of
left brain t hi nk i ng to suggest t hat t here is only one t ru t h. At the 1999 m eet i n g of the I n t ern at i on al
Consensus Con f eren ce on Acu pu n ct u re, Auri culot herapy, and Au ri cu lar M edi ci n e ( I CCAAAM ) ,
I cited the work of a great English au t hor who has com m en t ed on this paradox. T he first line of
Rudyard Kipling’s classic T he ballad of east an d west is well known, bu t the rest of the verse has
even great er relevance to the u n derst an di n g of the di fferen t t heoret i cal views of auri culot herapy.
Oh, East is East, an d W est is W est, an d n ever the twain shall meet,
T ill Earth an d Sky st an d present ly at G od’s great Ju dgm en t Seat;
Bu t there is n ei t her East n or W est, n or Border, n or Breed, n or Birth,
W hen two strong m en st an d face to face, t ho’ they com e f rom the en ds of the earth.
Auriculotherapy M anual
II
Anatomy of t he auricle
As with ot her areas of human anatomy, t here are specific terms for identifying opposing directions
of the ear and for indicating alternative perspectives. Because ot her texts on the topic of auricular
acupuncture have used a variety of different terms to describe the same regions of the ear, this
section will define the anatomical terms used in this manual. Taking the time to learn the
convoluted structure of t he auricle facilitates a deeper underst andingof the corresponding
connections between specific regions of the ear to specific organs of t he body.
CONTENTS
3.1 The spiral 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 The spiral of life
The ear consists of a series of concentric circles t hat spiral from the cent er of the auricle to a series
of curving ridges and deep valleys t hat spread outwards like an undulatingwave. This
configuration is very similar to the rings of water waves t hat radiate out from a splash on a pond.
Such an image is depicted in Figure 3.1. Sound waves are similar to waves on water, consisting of
oscillating increases t hen decreases in t he compression of air molecules. Theexternal ear is shaped
like a funnel to direct these subtle motions of air into the ear canal. Focused sound waves then
vibrate against the eardrum like a baton pounding against a bass drum. Aft er being amplified by
Figure 3.1 Concentric rings ofwater wavessymbolizetheoscillation ofsound wavestowhich
theextemalear conformsin rings ofridges and crevices. (Reproduced withpermissionfrom
Reikifire, Calgary, Canada.)
Anatomyof theauricle 79
B
D
Figure 3.2 Spiral imagesin nature that reiterate theshape oftheauricle include thedouble helixofDNAstrands (A), theswirl ofcloud
[ormations in a hurricane (B), thespiraling cochlea oftheinner ear (C) and thecircular shape ofthecurvingembryo (D). (Fig. 3.2C
reproducedfrom Sadler 2000Langman ’.I’MedicalEmbryology8 edn, withpermission from Lippincott Williams& Wilkins.)
t he serial activation of t he ossicle bones of t he middle ear, t he sound signal generat es a traveling
wave t hat produces deflections in t he bending of membranes within t he snail- shaped inner ear.
The basic shape of bot h t he inner ear and the external ear reiterates t he spiral pat t ern t hat is a
common archetypal symbol. Different examples oft his spiral image are shown in Figure 3.2, from t he
double helix shape of the DNAmolecule, to the swirl of cloud formations, to the curving embryo. The
Latinword for the shape of a spiral is helix.Just as t here are two spiraling helices which form the
structure of DNA, there are two helices for the auricle, an out er helix and an opposing antihelix. The
ot her common pat t ernwhich is represent ed on the ear is t hat of a sea shell, and t he t erm for the deep
central region of the auricle is the concha, which is Latin for shell. From the different sea shells
indicated in Figure 3.3, one can recognize a basic spiral shape common to all of them. In Thespiral of
life, Michio Kushi (1978) has suggested t hat this spiraling pat t ern relates to the cosmic order of the
universe as seen from Oriental medicine, whereas followers of ayurvedic medicine emphasize the
symbol of t he coiled serpent. The undulatingimage of t he two cobras represent s the rise of kundalini
forces of the ida and pingala spiraling around the sushumna to energize the seven primary chakras.
80 AuriculotherapyManual
Figure 3.3 Sea shells that repeat thespiral pattern oftheexternal ear. Thehelix-shaped, spiral tipsand the concha-shaped, central
crevices are I’ery distinctivein thetwolarge conch shells,
Figure 3.4 Cellular buds ofthedevelopingembryo transform intotheexternal ear duringfetal development. Sixnodules on theembryo
migrate10 sixdifferentpositions that become theauricle.
Anatomyof theauricle 81
3.2 Neuro-embryological innervations of t he external ear
Thebiological life of the human embryo begins as the union of cells t hat divide and multiply into a
complex ball of embryonic tissue. The auricle of the ear results from the coalescence of six buds
which appear on the 40th day of embryonic development. Shown in Figure 3.4 is a represent at ion
of the cellular buds t hat transform into the external ear during the fourth mont h of fetal
development. These fetal buds are the expression of mesenchymal proliferation of the first two
branchial arches t hat subsequently develop into the cranial nerves t hat ultimately innervate the
auricle. Thesuperior regions of the auricle are innervated by the auricular- t emporal branch of the
mandibular trigeminal nerve. The concha is innervated by the auricular branch of the vagus nerve.
A third region is supplied by the lesser occipital nerve and the great auricular nerve, both branches
of the cervical plexus. Theseventh cranial nerve which regulates facial muscles sends neuronal
connections to the posterior side of the auricle.
Bossy (1979) has summarized the studies which delineate the t hree territories of the auricle. The
superior somesthetic region is innervated by the trigeminal and sympathetic nerves, a central
visceral region is innervated by the parasympathetic vagus nerve, and a lobular region is innervated
by the superficial cervical plexus. The lobular area has no pronounced autonomic nerve
manifestation. The differential dispersement of cranial nerves provides an embryological basis for
the functional divisions between specific auricular regions and corresponding part s of the gross
anatomy. Thesomatosensory trigeminal nerve innervates cut aneous and muscular regions of the
actual face and also supplies the region of the auricle t hat corresponds with musculoskeletal
functions. The autonomic vagus nerve innervates thoracic and abdominal visceral organs and also
Anterior view
Superior
Midline
Superior
Rightear
t
I
t
Leftear
Rightear Leftear
Peripheral Central Central Peripheral
....-- -------.
....-- -------..
Lateral Lateral
....-- -------..
~
Inferior Medial Medial Inferior
------.. ....--
Superior Superior
Leftear
Posterior view
t
Rightear
Medial Medial
-------.. ....--
Peripheral Centra l Central Peripheral
....--
-------.. Leftear Rightear
....--
-------..
Lateral Lateral
+
Inferior
Inferior
Figure 3.5 Anatomicalperspectives ofthehead and theexternal ear in anterior and posterior surface views. Thesuperior, inferior, central
and peripheral directionsoftheauricle are indicated relative toeach other.
82 AuriculotherapyManual
supplies t he central region of the auricle associated with internal organs. The concha of the ear is
the only region of the body where the vagus nerve comes to the surface of the skin. The cervical
plexus nerves regulate blood supply to the brain and are associated with diencephalic and
telencephalic brain centers represented on the inferior ear lobe.
While it seems logical t hat the auricle is part of the auditory pathway, examination of ot her animal
species shows that the external ear is not only used for the function of hearing. Bossy (2000) has
observed t hat the ears of animals are used to protect against the elements and against predators.
The desert hare, desert fox and desert mouse all have very large auricles compared to their non›
desert relatives, the purpose of which is to facilitate heat loss through the skin over the ears.
African elephants t hat live in the hot plains have larger ears than Indian elephants for a similar
purpose of heat exchange. The series of electroconductive points t hat have been identified on the
shaved skin of rodents suggest that the occurrence of body acupoints and ear points may relate to
the lateral line system offish. This same system bywhich fish sense t he subtle movements of water
may provide the evolutionary foundation for acupuncture points on the body and t he ear.
3.3 Anatomical views of the external ear
Torefer to any object in three dimensional space, there must be certain points of reference. As a
complex convoluted structure, the auricle must be viewed from different angles and from different
depths. Specific terms will be used to indicate these different perspectives of the ear which are
indicated in Figure 3.5.
Surface view: The front side of the external ear is easily available to view. The auricle is
diagonally angled from the side of the skull such t hat it extends from bot h the
ant erior aspects and the lateral sides of the head.
Hiddenview: Vertical or underlying surfaces of t he external ear are not easy to view, thus the
auricle must be pulled back by retractors in order to reveal the hidden regions.
Posterior view: The back side of the external ear faces the mastoid bone behind the ear.
External surface:
Internal surface:
Superior side:
Inferior side:
Central side:
Peripheral side:
The higher regions of the external ear form the external surface view.
The vertical or underlying surface regions of the ear form the hidden view.
The top of the ear is directed toward the upper or dorsal position.
The bottomof the ear is directed toward the lower or ventral position.
The medial, proximal side of the ear is directed inward toward the midline of
the head.
The lateral, distal side of the ear is directed outward from the midline of the head.
3.4 Depth view of the external ear
Because two-dimensional paper can not adequately represent the three- dimensional depth of the
auricle, certain symbols have been developed to represent changes in depth. Ifone were to think of
the rising and falling swells of a wave or the ridges of a hill, the top of the peak is the highest
position, indicated by an open circle, the descending slope is indicated by a square, and the lowest
depths are shown as a filled circle. In Figure 3.6, the deeper, central concha contains areas
represented by filled circles, the surroundingwall of t he concha is represent ed by squares, and the
peaks of t he antihelix and antitragus are shown with open circles.
Raised ear point: Regions of the ear which are elevated ridges or are flat surface protrusions.
Represented byopen circle symbols. 0
Deeper ear point: Regions which are lower in the ear, like a groove or depression. Represented
bysolid circle symbols .
Hiddenear point: Regions of the ear which are hidden from view because they are
perpendicular to the deeper, auricular, surface regions or they are on the
internal, underside of the auricle. Some texts use a broken circle symbol to
represent these hidden points. Represented bysolid square symbols .
Posterior ear point: Regions of the back side of the ear t hat face toward the mastoid bone.
Represented byopen square symbols. 0
Anatomyof theauricle
83
Surface view of left ear
Inferior
Raised
...... ...... ... . .. ... U.. ,.,.;.•.11;!//U//
Deep point - e .///
i .... t m
ii/
Superior
1
- - - +›
Peripheral
External surface

surface
Hidden view of left ear
Inferior
Superior
› Peripheral
84
Figure 3.6 Adepthviewoftheear withthesymbols used to represent raised regions (0), deep regions (e), and
hiddenregions (_) oftheauricle.
3.5 Anatomical regions of t he external ear
Classic anat omical texts have present ed specific anat omical t erms for cert ain regions of the
ext ernal ear. This appendage is also known as t he pinna or auricle. Lat in t erms were used to
describe designat ed regions of t he ear as well as specific t erms t hat were developed at t he meet ings
of t he World Healt h Organizat ion on acupunct ure nomenclat ure. Some regions of t he ext ernal ear
are described in auricular acupunct ure texts, but are not discussed in convent ional anat omy books.
The official t erms for t he external ear t hat were described in t he Nomina anatomica (Int ernat ional
Congress of Anat omist s 1977) included 112 different t erms for t he int ernal ear (Auris int erna), 97
t erms for middle ear (Auris media), but only 30 t erms for t he ext ernal ear (Auris ext erna). The
nine primary auricular st ruct ures t hat were ident ified in Woerdeman’s (1955) classic anat omy text
included t he helix, antihelix, tragus, ant it ragus, fossa triangularis, scapha, lobule, concha and
Darwin’s t ubercle. There are two addit ional subdivisions for t he limbs of t he antihelix, t he superior
crus and t he inferior crus, and two subdivisions of t he concha, a superior cymba concha and an
inferior cavum concha. Delineat ion of t he ant it rago- helicine fissure, which separat es t he
ant it ragus from t he antihelix, brings t he t ot al to 14 auricular t erms for t he lat eral view of t he
auricle and 12addit ional t erms for t he mast oid view of t he ear. Subsequent anat omy books, such as
Hild’s (1974) Atlas ofhuman anatomy or Clement e’s (1997)Anatomy: a regional atlas ofthehuman
body, basically concur with t hese earlier designat ions for t he ext ernal ear. Anat omist s int erest ed in
auricular acupunct ure have t hus considered supplement al t erminology to delineat e t he st ruct ures
of t he auricle t hat are used in t he clinical pract ice of auriculot herapy.
The out er ridge of the auricle is referred to as t he helix, which is t he Lat in t erm for a spiral pat t ern.
A middle ridge within this out er rim is called t he antihelix. The helix is subdivided int o a cent ral
helix root, an arching superior helix, and t he out ermost helix tail. The cauda, or tail, refers to a
long. trailing hind port ion, like t he tail of a comet . Thesubsect ions of t he antihelix include an
antihelix tail at t he bot t omof the middle ridge, an antihelix body in t he cent er, and two limbs t hat
extend from t he antihelix body, the superior crus and t he inferior crus. A fossa in Lat in refers to a
Auricu{otherapyManual
fissure, or groove. Between the two limbs of the antihelix lies a sloping valley known as the
triangular fossa, whereas t he scaphoid fossa is a long, slender groove t hat separates the higher
ridges of the antihelix from the helix tail.
Adjacent to the face and overlying the auditory canal is a flat section of the ear known as the
tragus. Oppositeto the tragus is anot her flap, labeled the antitragus. The latter is a curving
continuation of the antihelix, forming a circular ridge t hat surrounds t he central valley of the ear.
A prominent crease separates the antihelix from the antitragus. Below the antitragus is the soft,
fleshy ear lobe, and between the antitragus and the tragus is a V- shaped curve known as the
intertragic notch. The deepest region of the ear is called the concha, indicating its shell-shaped
structure. Theconcha is further divided into an inferior concha below and a superior concha
above. While most anatomical texts (Clemente 1997; Woerdeman 1955) respectively refer to these
Superior helix
Antihelix
superior crus
Antihelix
inferior crus
Antihelix
body
Helix t ail
Helix root
Tragus
Antihelix
t ail
Intertragic
notch
Inferior
concha
Internal helix
Figure 3.7 Termsused for specific anatomical regionson theexternal ear: helix, antihelix, tragus, antitragus,
triangular fossa, scaphoid fossa, superior concha and inferior concha.
Anatomyof theauricle
85
86
two areas as the cymba conchae and the cavum conchae, the 1990nomenclat ure commit t ee of the
World Healt h Organization (WHO1990a) concluded t hat superior concha and inferior concha
were more useful designations. These two major divisions on the concha are separat ed by a slight
mound. This prolongation of the helix ont o the concha floor is identified in this text as the concha
ridge. A vertical elevation t hat surrounds the whole concha floor has been designated as t he
concha wall. This hidden wall area of t he auricle is not identified in most anatomical texts. Two
ot her hidden areas of the external ear include t he subtragus underneat h the tragus and the internal
helix beneat h the helix root and superior helix.
On the back side of the ear is a whole surface referred to as t he post erior side of t he auricle. It lies
across from the mastoid bone of the skull. This region is subdivided int o a post erior groove behind
the antihelix ridge, a post erior lobe behind the ear lobe, a post erior concha behind t he central
concha, a posterior triangle behind the triangular fossa, and the post erior periphery behind the
scaphoid fossa and helix tail. Taking the time to visually recognize and touch these different
contours of the ear assists practitioners of auriculotherapy in underst andingthe somat ot opic
correspondences between the external ear and specific anatomical structures. Diagrams of specific
anatomical regions of t he auricle are shown in Figure 3.7.
Earcanal (auditory meatus): The funnel- shaped orifice t hat leads from the external ear to the
middle ear and inner ear is an elliptical oval t hat separat es t he inferior concha from the
subtragus.
Helix: This outermost, circular ridge on the external ear provides a folded, cartilaginous rim
around t he auricle. It looks like a question mark (?).
Helixroot: The initial segment of the helix ascends from the cent er of the ear up toward t he
face.
Superior helix: The highest section of the helix is shaped like a broad arch.
Helixtail: Thefinal region of the helix descends vertically downward along t he most
peripheral aspect of t he ear.
Antihelix: This Y- shaped ridge is ’ant i’or opposite to the helix ridge and forms an inner,
concentric hill t hat surrounds the central concha of t he auricle.
Superior crus of t he antihelix: Theupper arm and vertical extension of the antihelix.
Inferior crus of t he antihelix: The lower arm and horizontal extension of the antihelix. This
flat-edged ridge overhangs the superior concha below it.
Antihelix body: A broad sloping ridge at the cent ral third of t he antihelix.
Antihelixtail: A narrow ridge at t he inferior t hird of the antihelix.
Tragus: The tragus of the auricle is a vertical, trapezoid shaped area joining t he car to the face,
projecting over the ear canal.
Antitragus: This angled ridge is ’ant i’ (opposite to) t he tragus t hat rises above t he lowest port ion
of t he inferior concha. It has a distinct groove that separat es the antitragus from t he antihelix
tail above it and a less distinct crevice where the antitragus meets t he intertragic notch below it.
Intertragic notch: This U- shaped curve superior to t he medial ear lobe separat es the tragus from
the antitragus.
lobe: This soft, fleshy tissue is found at the most inferior part of t he external ear.
Scaphoid fossa: A crescent - shaped, shallow valley separating the helix and the antihelix. ’Fossa’
refers to a fissure, groove, or crevice, whereas ’scaphoid’ refers to t he scaffolding used to form
the out er structure of a boat or building while it is under construction.
Triangular fossa (navicular fossa): This triangular groove separat es the superior crus and the
inferior crus of the antihelix. It is shaped like an arch on t he window of a Got hiccathedral.
Concha: A shell- shaped valley at the very cent er of t he ear, concha refers to t he conch sea
shell.
Superior concha: Known as the cymba concha in classical anatomical texts, t he upper
hemiconcha is found immediately below the inferior crus of t he antihelix.
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Concha
Concha wall
Posterior concha
Cutaway viewofposterior ear
Antihelix
Posterior groove
Posterior
triangle
Posterior
groove
Posterior
lobe
ICLl- U- - - -Posterior
concha
Posterior
periphery ~ ----"..
Figure 3.8 Termsused toidentifyspecific areas oftheposterior regionsoftheexternal ear.
Inferior concha: Formally known as the cavum concha in classical anatomical texts, the lower
hemiconcha is found immediately peripheral to t he ear canal.
Concha ridge: This raised ridge divides t he superior concha from t he inferior concha. It is t he
anat omical prolongat ion of the helix root ont o t he concha floor.
Concha wall: Thehidden, vertical region of the ear rises up from the concha floor to the
surrounding antihelix and antitragus. Theconcha wall adjacent to t he antihelix is a curving,
vertical surface which rises from t he floor of the concha up to the antihelix ridge. The concha
wall adjacent to t he antitragus is a vertical region underneat h the antitragus ridge t hat leans
over the lower inferior concha floor.
Subtragus: This underside of the tragus overlies t he ear canal.
Int ernal helix: This hidden, underside port ion oft he brim of t he helix spirals from the cent er of
the helix to the t op of t he ear and around to the helix tail.
3.6 Anatomical regions of t he posterior ear (Figure 3.8)
Posterior lobe: This soft fleshy region behind t he lobe occurs at the bot t omof t he post erior
ear.
Posterior groove: A long vertical depression along the whole back of the posterior ear which lies
immediately behind the Y- shaped antihelix ridge on the front side of the
auricle.
Posterior triangle: Thesmall superior region on t he post erior ear which lies bet ween the two
arms of t he Y- shaped post erior groove.
Posterior concha: Thecentral region of the posterior ear found immediately behind the concha.
Posterior periphery: Theout er, curved region of the post erior ear behind t he helix and the
scaphoid fossa. It lies peripheral to t he post erior groove.
3.7 Curving contours of t he antihelix and antitragus
The cont ours of the ear have different shapes at different levels of the antihelix and t he antitragus
as the concha wall rises up to meet them. These differences in cont our are useful in distinguishing
Anatomyoftheauricle 87
Depth view of auricle
Contours of t he antihelix and antitragus
Antihelixinferior crus

Superior concha
Antihelixbody
Concha wall
Superior concha
Antihelixtail
Inferior concha
Triangular fossa

Scaphoid fossa
Antitragus
ConchaW ' l ~ ) \ \
Inferior concha ~
88
Figure 3.9 A depth view shows changes in the curving contours ofthe antihelix descending from the inferior crus to
the antihelix body, antihelix tail and antitragus.
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different anatomical features on the ear which relate to different correspondences to body regions.
These depth views are presented in Figure 3.9.
Dept h view of the inferior crus of antihelix: At this level of the antihelix, the concha wall exhibits
a sharp overhang before it curves back underneat h and t hen descends down into the superior
concha. The inferior crus itself is somewhat flat, before gradually descending into the triangular
fossa. Thetop surface of this section of the antihelix corresponds to the lumbosacral vertebrae,
whereas the concha wall below it represents the sympathetic nerves affecting blood supply to the
lower spine.
Depth view of the ant ihelix body: At this level of the antihelix, the concha wall exhibits a gradual
slope before it descends down into the superior concha. The antihelix body is like a broad, gentle
mound before it curves down peripherally into the scaphoid fossa. Theconcha side of this
section of the antihelix corresponds to the thoracic spine, whereas t he concha wall below this
region represents the sympathetic nerves affecting blood supply to t he upper back.
Depth view of t he ant ihelix tail: At this level of the antihelix, the concha wall exhibits a steep
slope before it descends down into the inferior concha. The antihelix tail is like a long narrow
ridge before it curves down peripherally into the scaphoid fossa. Theconcha side of this inferior
section of the antihelix corresponds to the cervical spine, whereas t he concha wall below this
region represents the sympathetic nerves affecting blood supply to the neck.
Depth view of t he antitragus: At this level of the antitragus, the concha wall forms an angled
vertical wall, which curves downward from the antitragus to the inferior concha. The antitragus
corresponds to the skull, whereas the concha wall represents the thalamus of the brain.
3.8 Somatotopic correspondences to auricular regions
In auriculotherapy, an active reflex point is only detected when there is pathology, pain or dysfunction
in the corresponding part of the body. Ifthere is no bodily problem, there is no ear reflex point. An
active reflex point is identified as an area of the ear which exhibits increased sensitivity to applied
pressure and increased electrodermal skin conductivity. Theanatomical organ health disorders
commonly associated with each part of the auricle are presented below (see Figures 3.10 and 3.11).
Helix: Anti-inflammatorypoints and t reat ment of allergies and neuralgias.
Helix root: External genitals, sexual disorders, urogenital dysfunctions, diaphragm.
Superior helix: Allergies, arthritis, and anti-inflammatoryprocesses.
Helix tail: Representing the dorsal horn, sensory neurons of t he spinal cord and the pre›
ganglionic sympathetic nervous system, this region is used for peripheral neuropat hies and
neuralgia.
Antihelix: Main t runkand torso of the body t hat is part of the musculoskeletal system.
Superior crus: Lower extremities of leg and foot.
Inferior crus: Lumbosacral spine, buttocks, sciatica, low back pain.
Antihelix body: Thoracic spine, chest, abdomen, upper back pain.
Antihelix tail: Cervical spine, t hroat muscles, neck pain.
Lobe: Cerebral cortex, lobes of the brain, sensation oft he face, eye,jaw, and dental analgesia.
The ear lobe represents conditioned reflexes, psychological resistances and emotional blocks.
Tragus: Corpus callosum, appetite control, adrenal gland.
Antitragus: Skull, head, and t reat ment of frontal, t emporal and occipital headaches.
Intertragic notch: Pituitarygland, control of endocrine glands, hormonal disorders.
Scaphoid fossa: Upper extremities, such as the shoulder, arm, elbow, wrist, hand and fingers.
Triangular fossa: Lower extremities, such as the hip, knee, ankle, foot, uterus and pelvic
organs.
Concha: Visceral organ disorders.
Superior concha: Abdominal organs, such as the spleen, pancreas, kidney and bladder.
Anatomyof theauricle 89
A
B
- - - - - - Helix- - - - - -
- - - - - - Ant ihelix- - - - - -
- - - -Superior concha - - - -
- - - - - Concha ridge - - - - -
.- - - - - - Inferior concha - - - - -
Intertragic notch - - - -
- - - - - -Lobe - - - - - -
Darwin’s 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 Photographs oftheanterior surface ofthe external ear showingthecircular ridges and crevices ofdifferent anatomical areas.
90 Auriculotherapy Manual
A B c
Figure 3.11 Photographs oftheposterior surface oftheexternal ear highlighttheauricular regions behind thehelixand the concha ofthe
left ear (A), therightear (B), and theposterior surface pulled back (C).
Inferior concha: Thoracic organs, such as the heart and lungs, and also substance abuse.
Concha ridge: Stomach and liver.
Concha wall: Thalamus, brain, sympathetic nerves, vascular circulation, general control of
pain.
Subtragus: Laterality problems, auditory nerve, internal nose, throat.
Int ernal helix: Internal genital organs, kidneys, allergies.
Posterior ear: Motor involvement with body problems, such as muscle spasms and motor
paralysis.
Posterior lobe: Mot orcortex, extrapyramidal system, limbic system.
Posterior groove: Mot or control of muscle spasms of paravertebral muscles.
Posterior triangle: Mot orcontrol of leg movement, leg muscle spasms, and leg mot or weakness.
Posterior concha: Mot orcontrol of internal organs.
Posterior periphery: Mot or neurons of spinal cord, mot or control of arm and hand movements.
3.9 Determination of auricular landmarks
One procedure for identifying the same region of the auricle from one person to the next is to
examine t he ear for distinguishing landmarks. While the size and shape of the ear may greatly vary
between different individuals, the auricular landmarks are fairly consistent across most patients.
They are depicted in Figure 3.12, represented by a solid triangle. These landmarks are
distinguished by the beginning or the end of the different subsections of the external ear. The
name and numbering of t he 18 landmarks begins with LM0 because it is at the same location as a
primary master point on the auricle, Point Zero. This first landmark, also called ear center, is
distinguished as a pronounced notch where the helix root rises up from the concha ridge. It is
found at the very center of the ear and is a primary reference point to compare to the location of
ot her regions of the auricle. The second landmark, LM 1, is located on the helix root where the
helix crosses the inferior crus of the antihelix and where the auricle separates from the face.
Anatomyof theauricle 91
92
LM7
Figure 3.12 Thelocation ofauricular landmarks on theexternal ear are represented in a
surface viewand a hidden view.
Continuingup the helix to the top of the ear is LM 2. Thenext two landmarks, LM 3 and LM 4, are
two notches t hat define the uppermost and lowermost boundaries of Darwin’s tubercle. This bulge
on the out er helix is quite distinctive in some persons, but it is barely visible in others. Following
the peripheral helix tail downwards towards the ear lobe, LM 5 occurs where the helix takes a
curving t urn and LM 6 is found where the cartilaginous helix meets t he soft fleshy lobe. The
bottomof t he ear, which follows a straight line from LM 2, at the ear apex, through LM 0, has been
designated LM 7. Thejunction of the ear lobe to the lower jaw is labeled LM 8. Theintertragic
notch has already been distinguished as a separate region of the ear and is identified as LM 9.
Higheron the auricle, t here are two prominent protrusions or tubercles on the tragus, which have
been labeled LM 10and LM 11. There are two comparable protrusions on the antitragus, referred
to as LM 12 and LM 13. Thelandmark LM 13is distinguished as the apex of the antitragus. Above
the antitragus- antihelixgroove there is a protrudingknob on the base of the antihelix tail which
has been labeled LM 14. Following the central side of the antihelix tail up to the antihelix body,
there is a sharp angle which divides the tail and body of the antihelix, which is labeled LM 15.
Continuingupward, along the curving central side of t he antihelix body, a distinct notch is found,
AuriculotherapyManual
LM 16, which indicates t he beginning of t he flat, ledged- shaped inferior crus of t he antihelix. The
final landmark, LM 17, occurs at a not ch which divides t he peripheral and central halves of the
antihelix inferior crus. This notch represent s t he sciatic nerve and is t he auricular point used to
t reat sciatica and low back pain.
LM 0 - Earcenter: A distinct notch is found at t he most central position of the ear, where the
horizontal concha ridge meet s the vertically rising helix root. It can be det ect ed easily with a
fingernail or a metal probe. LM 0 is t he most common landmark to reference ot her anatomical
regions of the auricle. Reactive ear points on the peripheral helix rim are oft en found at 30
angles from a line connecting LM 0 to the auricular point which corresponds to t he area of body
pathology. This region of the helix root represents t he aut onomic solar plexus and the umbilical
cord, bringing any body dysfunctions towards a balanced state.
LM 1 - Helix insertion: The region of t he ear where t he helix root separat es from t he face and
crosses over the inferior crus of the antihelix. Thehelix root, which extends from LM 0 to LM 1,
represent s the genital organs. The external genitalia are found on t he external surface of the
helix root and internal genital organs are found along t he hidden surface of the int ernal helix
root.
LM 2 - Apex of helix: Themost superior point of t he ear is called t he apex and lies along a line
t hat is vertically above LM O. This point represents functional cont rol of allergies and is the point
pricked for blood- lettingto dispel toxic energy.
LM 3 - Superior Darwin’s tubercle: The notch immediately superior to t he auricular tubercle,
separating Darwin’s tubercle from the superior helix above it. This region has points for the
t reat ment of anti- inflammatoryreactions and tonsillitis.
LM 4 - Inferior Darwin’s tubercle: Thenot ch immediately inferior to t he auricular tubercle,
dividing Darwin’s tubercle from the helix tail below it. On t he more peripheral surface of this
prot rudinglandmark, t here is a crevice in the cartilage which separat es t he superior helix from
the helix tail. The helix tail extends from LM 4 down to LM 5, represent ing t he spinal cord.
LM 5 - Helixcurve: The helix tail curves centrally and inferiorly t oward t he lobe. This area
represent s the cervical spinal cord.
LM 6 - Lobular-helix notch: A subtle notch where cartilaginous tissue of t he inferior helix tail
meets t he soft, fleshy tissue of the lobe. This area represent s t he brainst em medulla oblongata.
LM 7 - Base of lobe: The most inferior point of the lobe lies vertically below a
straight line passing through LM 2, LM 0 and LM 7. It represent s inflammatory problems.
LM 8 - Lobular insertion: Themost inferior point of t he lobe t hat at t aches to the jaw. The
position of this landmark varies considerably. In some people, LM 8 is inferior to LM 7, whereas
in ot her individuals, LM 8 is superior to LM 7. This region represent s the limbic system and
cerebral cortex. It affects nervousness, worry, anxiety and neurast henia.
LM 9 - Int ert ragicnotch: Thecurving notch which divides the tragus from the antitragus. It
represent s pituitary gland control of hormones released by ot her endocrine glands.
LM 10 - Inferiort ragus protrusion: The prot rudingknob on t he lower tragus, opposite the top of
t he antitragus. It represent s adrenal glands and is used in t he t reat ment of various stress related
disorders.
LM 11 - Superior t ragus protrusion: Theprot rudingknob on t he upper tragus, opposit e to the
helix root. It affects thirst and wat er regulation.
LM 12 - Ant it ragusprotrusion: Theprot rudingknob at t he base of t he ’Invert ed ~ of t he curving
ridge of t he antitragus, superior to the lobe. It represent s the forehead of the skull and is used for
the t reat ment of headaches.
LM 13 - Apex of antitragus: Theprot rudingknob at t he top of the curving ridge of the antitragus,
opposite to LM 12. It represent s the temples of the skull and is used for t he t reat ment of
migraine headaches and for asthma.
LM 14 - Base of antihelix: A round knob at the base of t he antihelix tail, rising above the
antitragal- antihelixgroove. This groove divides t he peripheral antitragus from t he antihelix tail.
Theknob at LM 14 represent s the upper cervical vert ebrae near t he skull. The antihelix tail,
Anatomyof theauricle
93
94
which extends from LM 14up to LM 15, represents all seven cervical vert ebrae and is used in the
t reat ment of neck pain.
LM 15 - Ant ihelixcurve: A slight notch t hat divides t he central antihelix body from the antihelix
tail. This landmark is located above t he concha ridge, horizontally across from LM 0, and divides
the lower cervical vert ebrae from the upper thoracic vertebrae. The antihelix body, which
extends from LM 15up to LM 16, represent s all 12 thoracic vert ebrae and is used for t reat ment
of upper back pain.
LM 16 - Ant ihelixnotch: A distinct notch which divides t he flat curving ledge of t he antihelix
inferior crus from the antihelix body. This notch divides the somat ot opic represent at ion of the
lower thoracic vert ebrae from the upper lumbar vert ebrae. The peripheral inferior crus of the
antihelix is used for t he t reat ment of low back pain.
LM 17 - Midpoint of inferior crus: This notch on the t op surface of t he inferior crus of the
antihelix divides the inferior crus int o two halves. This notch separat es the lower lumbar
vertebrae from the upper sacral vertebrae. This landmark was the ear point used for the
t reat ment of sciatica, first identified by Dr Nogier, t hat led to the discovery of t he inverted fetus
somatotopic map on t he ear.
3.10 Anatomical relationships of auricular landmarks
Auricular quadrants: Twointerconnectingstraight lines can be drawn which form a cross dividing
the ear into four equal quadrants, with LM 0 at its cent er (Figure 3.13A). A vertical line can
connect landmarks LM 2, LM 0, LM 13 and LM 7. A horizontal line can connect the landmarks
LM 11, LM 0, and LM 15. The actual horizontal level of the ear depends upon t he vertical
orient at ion of the person’s head, which can be held eit her slightly forward or bent slightly back.
For the purposes of these ear diagrams, the horizontal level is set relative to its perpendicular
relationship to the vertical line which runs from LM 2 to LM 7.
Auricular grid coordinates: Subdivisions of approximately one centimeter square allow for the
linear division of the whole surface of the external ear into nine columns, labeled 1-9, and 14rows,
labeled A- Nin Figure 3.13A. The width and length of an average ear are shown in Figure 3.13B as
going from 0-45 cm across when progressing from medial to peripheral auricular regions and going
from 0- 70cm down when progressing from superior to inferior areas of the external ear.
3.11 Standard dimensions of auricular landmarks
Tosubstantiate the relative proport ions of the st andardized ear chart used in this work, the
landmark locations on t he external ears of 134volunteers were measured to est imat e t he relative
distances between landmarks. Volunteers were recruited by st udent s at two acupunct ure schools in
Sout hern California. Eight een landmark points were marked with a felt pen and multiple
measurement s were made of the distances between two sets of landmarks (see Figures 3.14, 3.15).
The means, st andard deviations and ranges of the measurement s were t hen comput ed. Analyses of
variance and correlation coefficients bet ween the distances between specific landmarks were also
performed. In addition, measurement s of the width and length of t he head, hand and foot were
also recorded. The height of t he head was measured from the chin to t he top of the forehead,
whereas t he width of the head was designated as the distance bet ween the ears. The length of the
hand was comput ed between the wrist and t he middle finger, while t he width of t he hand was
measured between the t humb and the little finger. The length of the foot was assessed between t he
heel and the longest toe, and the width of the foot was measured bet ween the big t oe and the little
toe. All of these measurement s were used to det ermine t he consistency of using t he auricular zone
system described in this paper with actual persons.
The sample of 134volunteers cont ained equal numbers of male and female subjects, with a mean
average age of 39.7 years (SD = 14). The ethnic frequency of these participants consisted of 96
Caucasians (71.6%),26 Asians (19.4%),7 Hispanics (5.2%), and 5 blacks (3.7%). According to t he
U.S. Census Bureau for 1999, the relative represent at ion of these et hnic groups in California
would be 49.9% Caucasian, 11.4% Asian, 31.6% Hispanic, and 6.7% black (Nelson & O’Reilly
2000). Theoverrepresent at ion of whites and Asians in this sample probably reflected the social
network of students attendingacupunct ure colleges in the Los Angeles area, from whom
volunteers for this study were recruited. It was not int ended t hat t he external ears measured in this
Auricu{otherapyManual
Auricular quadrants and
auricular grid coordinates
Average measurements of the ear
( in millimet ers)
V
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10
15
20
25
30
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40
45
50
55
60
65
70
05 10 15 20
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25 30 35 40 45
Figure 3.13 Theexternal ear divided into quadrants and x- ygrid coordinates (A). Horizontal sections are numbered 1 to 9 going from
center to periphery, while vertical sections are labeled A to Nfrom superior to inferior edges ofthe ear. The averaged value ofactual
measurement (in millimeters) ofthe external ears ofdifferent individuals is also shown (B).
study were representative of the general population, only t hat there be a large cross sampling of
the auricles of different individuals.
Ears from two such participants are shown in Figure 3.16, whereas t he accumulated mean data
from the multiple observations of different auricles are presented in Box 3.1. This indicates the
relative mean distances between each landmark and the central landmark LM 0, and between each
landmark and the subsequent landmark. The set of measurements provides an overall indication
of the shape and size of different ears. Acupuncture practitioners and students asked to identify
the 18 landmarks on these 134 participants were readily able to distinguish each landmark on each
subject, indicating t hat these auricular demarcations are reliably observed on most individuals.
The relatively lowstandard deviations for these measurements suggests t hat the landmarks
examined on many different ears is a reliable procedure for recognizing the specific areas of the
auricle. A series of analyses of variance (ANOYA) computations compared auricular
measurements between male and female participants. Correlation coefficients were also obtained
across all subjects for all measurements.
In his Treatise ofauriculotherapy, Nogier (1972) report ed t hat the vertical axis of the auricle varied
from 60 to 65 mm and t hat the horizontal axis varied between 30 and 35 mm. Slightly larger
measurements were found in the present study. The mean height of the auricle, measured between
the top of the ear apex at LM 2 and the bot t omof the ear lobe at LM 7, was 68.4 mm. The mean
width of the auricle, measured between the helix root as it leaves the face at LM 1 and the most
Anatomyof theauricle
9S
LM2
LM 7
LM 1
LM 2
LM 7
A B
96
Figure 3.14 Specific lines ofmeasurement between auricular landmarks indicate the basis for data collected ji-O/11
participants in the ear measurement study. Connectionsbetween LM0 and peripheral landmarks (A); connections
between LM0 and central landmarks, and between successive pairs oflandmarks (B).
Figure 3.15 A millimeter ruler was used to measure the distance between auricular landmarks.
AuriculotherapyManual
A B
Figure 3.16 Photographs ofexternal ears from two people showthe consistent location ofauricular landmarks despite variations in the
actual pattern ofdifferent ears.
peripheral part of Darwin’s tubercle at LM 4, was 33.8 mm. In the assessment of the length and width
of the head, hand, and foot, males were found to have significantly larger measurements t han females
(p < 0.05). This result was not surprising, since men are typically larger than women. Men also have
significantly larger external ears than women, and all ear measurement segments were larger in
males than in females, with statistically significant differences found for the distances of LM 1 to
LM 4 and LM 2 to LM 7. Therelationship of the size of different regions was also examined. Only
correlation coefficients great er t han 0.40were considered meaningful. Thelength of the foot was
significantly correlated with the length oft he hand (r = 0.44) and the width of the hand (r = 0.42).
The width of the foot was also correlated with the height of the head (r = 0.42). Curiously, the length
of these body areas was not as highlycorrelated with the width of their respective body region. For
example, t here was only a small correlation (r =0.39) between the length of the foot and the width of
the foot, even less between the length and width of the hand (r = 0.34), and was lowest between the
height and width of the head (r = 0.22). Ofall the auricular measurements, the only distances to
correlate significantly with the foot, hand, or head were t he correlations between the width of the
head and t he distance between LM 0 and LM 12(r =0.41) and the correlation of the width of the
head with the distance between LM 0 and LM 17 (r = 0.42).
The auricular measurements that correlated best with each ot her were of the distances between the
center of the auricle, LM 0, to the more peripheral regions of the ear, LM I to LM 7. Significant
correlat ions t hat ranged from r =0.44 to r =0.89 were found for t he measurement s of LM 0 to
LM 1, LM 0 to LM 2, LM 0 to LM 3, LM 0 to LM 4, LM 0 to LM 5, LM 0 to LM 6, LM 0 to LM 7,
LM0 to LM 8, and LM 0 to LM 12. The great est number of significant correlat ions bet ween t he
distances of two auricular landmarks were found for t he distances of LM 0 to LM 2, LM 0 to LM
7, and LM 0 to LM 12. The more central landmarks on t he ear probably had fewer significant
correlations to ot her auricular areas because they were smaller in length and thus did not vary as
Anatomyof theauricle 97
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- LM 5 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
Earwidt h 33.8 6.3
Head height 193.3 22.7
Head widt h 163.9 28.4
Hand length 171.8 27.9
Hand widt h 101.9 16.7
Foot length 235.8 30.8
Foot widt h 93.5 14.5
much from one person to the next. Ofthe distances between sequential auricular landmarks, only
the distance of LM 2 to LM 4 was significantly correlat ed with more t han four ot her
measurements. Thepurpose in obtaining these auricular measurement s was primarily to
demonstrate t hat these specific landmarks on the external ear can be reliably observed on many
individuals and are as consistently found as the relationship between the fingers and base of the
hand or between the toes and heel of the foot. While the external ears do vary considerably from
one person to the next, t here is a general consistency in the distinctive pat t ern of the auricle and
the relative size of different anatomical sections.
AuticulothetepyManual
Auricular zones
4.1 Overview of the auricular zone system
4.2 International standardization of auricular nomenclature
4.3 Anatomical identification of auricular zones
4.4 Somatotopic correspondences to auricular zones
4.5 Representation of Nogier phases in auricular zones
4.5.1 Auricular zones for different phases of mesodermal myofascial tissue
4.5.2 Auricular zones for different phases of internal organ tissue
4.5.3 Auricular zones for different phases of ectodermal neuroendocrine tissue
4.5.4 Nogier phases related to auricular master points
4.6 Microsystem points represented in auricular zones
4.6.1 Helixzones
4.6.2 Antihelixzones
4.6.3 Internal helixzones
4.6.4 Lobezones
4.6.5 Scaphoid fossa zones
4.6.6 Triangularfossa zones
4.6.7 Traguszones
4.6.8 Antitragus zones
4.6.9 Subtragus zones
4.6.10 Intertragic notch zones
4.6.11 Inferiorconcha zones
4.6.12 Concha ridge zones
4.6.13 Superior concha zones
4.6.14 Conchawall zones
4.1 Overview of t he auricular zone system
In order to provide a systematic met hod for locating t he precise posit ion of a point on t he ear, a
zone system was developed which uses t he proport ional subdivision of major anat omical regions of
t he auricle. A set of two let t ers and a number represent each ear zone, in concurrence with
guidelines est ablished by t he World Healt h Organizat ion acupunct ure nomenclat ure commit t ee
(Akerele 1991; WHO1990b). This zone system is modified from t he auricular zone system first
developed in 1983 at t he UCLAPain Management Cent er (Oleson & Kroening 1983b). The
original zone system developed at UCLAis shown in Figure 4.1, wherein a single let t er was used to
designat e each area of t he auricular anat omy and a number designat ed each subdivision of t hat
area. A different zone system t hat was suggest ed by Paul Nogier (1983) is present ed in Figure 4.2.
TheNogier zone system divided the whole auricle int o a rect angular grid pat t ern of rows and
columns. The capital let t ers A to 0 ident ified t he horizont al axis, whereas t he lower case let t ers a to
z indicat ed t he vertical axis. While such a grid pat t ern is simple to use on flat, two dimensional
paper, it is not easily adapt able to the t hree- dimensional dept hs of t he auricle. Thecurving
cont ours of t he ear do not conform well to t he configurat ion of basic squares and t here is no means
for indicating hidden or post erior regions of t he auricle. Moreover, as t he ear measurement s
present ed in Chapt er3 indicat ed, t here are marked variat ions in t he size of different areas of t he
auricle, even t hough t he relative proport ions remain t he same. The dist ance from landmark 0 to t he
ear apex at LM 2 ranged from 20 mm to 50 mm, and t he measured lengt hs of t he subjects’ ear lobes
Auricular zones 99
H Helix 0
I Inner rim of 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 zone system developed in the 1980s at UCLAsubdivided each anat omical region ofthe external ear
referenced with a single letter and a number.
varied between 15 mm and 45 mm. A gridwork of rows and columns of fixed length can not easily
accommodate such discrepancies in size. The auricular zone system developed at UCLA
designated each section of the ear based upon the proportional size of the auricular region of each
individual, not the absolute size of the whole ear. The revised UCLAnomenclature system (Oleson
1995) shown in Figure 4.3 provides a consistent logical order for the numberingof each anatomical
subdivision of the external ear. The lowest numbers correspond to t he most inferior and most
central zone of that anatomical part of the ear. The numbers ascend from 1 to 2 to 3, etc.,
progressing from inferior to superior zones of that anatomical area and from central to peripheral
zones. In international communications about the location of ear acupoints, the region of the ear
referred to can be listed by its anatomical zone designation, rat her t han its organ correspondence.
4.2 International standardization of auricular nomenclature
Thefirst concerted effort to create a st andard terminology for human anatomywas developed by a
group of Germanscientists in 1895 (International Congress of Anatomists 1977). TheBasle nomina
100 AuriculotherapyManual
ONMLKJ I HGFEDCBA ABCDEFGHIJKLMNO
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Figure 4.2 Theauricular zonesystemfirst proposed byDr Paul Nogier: a rectangular grid referenced withcapital letters for thehorizontal
axis and lower case letters for thevertical axis. (Reproducedfrom Nogier1983, withpermission.)
anatomica (RNA)was first adopt ed in Germany, Italy, USA, and later in Great Britain. In 1950, an
international congress of anatomists met in Oxford, England, to discuss revisions in the earlier
anatomical nomenclature system. A newNominaanatomica was accepted by the Sixth
International Congress of Anatomists meeting at Paris in 1955. Most phrases were adopt ed from
the original RNA,with all anatomical terms derived from Latin, employing words t hat were simple,
informative and descriptive. Changes to Nominaanatomica were made by subsequent
nomenclature committees in an at t empt to simplify unnecessarily complex or unfamiliar terms.
While it was the strong opinion of the international nomenclature commit t ee t hat only official
Latin terms should be employed in scientific publications, it was also recognized t hat many
scientific data- retrieval systems accept vernacular anatomical terms. English words in particular are
commonly used in comput er searches since English is currently the most widely used scientific
language at international meetings and on the internet.
TheWorld Health Organization (WHO)sought to form an international consensus on the
terminology used for acupuncture points by holding a series of international meetings of
distinguished acupuncturists. Dr Olayiwola Akerele (1991) present ed the findings by the WHO
working group t hat had been convened to specify the criteria for the standardization of
acupuncture nomenclature. Thefirst WHOworking group meeting on this topic was held in
Manila, Philippines, in 1982, with general acceptance of a st andard nomenclature for 361 classical
acupuncture points. Acupuncture programs in Australia, China, HongKong, Japan, Korea, New
Zealand, Philippines and Vietnam adopt ed this meridian acupuncture system. Theconclusions of
the WHOregional working group were published in 1984 as the Standard 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
Hidden viewofauricular zones
Auricular zonecodes
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
102
Figure 4.3 Revisions ofthe auricular nomenclature system originally developed byOleson were based upon the
recommendations ofthe 1990 WHOnomenclature committee. Different zones are referenced with two letters and a
numbet: Theprogression ofnumbersgoes from bottomto top andfrom center to periphery.
AuricuiotherepyManual
Alphanumeric codes to designate different acupuncture pointswere labeled with two letter
abbreviations (Helms 1990). Thus LUwas used for the Lung meridian and LI for t he Large
Intestines meridian. Some authors use only one letter to represent a meridian, such as P for the
Pericardium meridian instead of PC, or H for Heart meridian instead of HT.The least agreed upon
English designation was t he termTriple Energizer and its abbreviation TE. The Hancharacter for
this meridian is often translated as Triple Warmer or Triple Heater, but some members of the
nomenclature committee felt that this meridian should have been left with its Chinese name, San
Jiao. Consequently, this meridian channel is nowabbreviated SJ. Representatives from each
countrywho were at this meeting were encouraged to communicate to journals, textbook
publishers and universities in their country to use only the official WHOtwo letter designations for
zang-fu meridians and for acupuncture points.
The second WHOworking group was held in HongKong, in 1985 (WHO1985). Representatives
reported general acceptance of the Standard Acupuncture Nomenclature from nine Asian
countries. Revisions were suggested for standardization of extra meridian points and for new
points. Twodocumentswere presented at this WHOmeeting to guide standardization of ear
acupuncture nomenclature, the text Ear acupuncture by Helen Huang(1974) and a journal article
written by myself and Dr Richard Kroening (Oleson & Kroening 1983a). However, all decisions
about auricular acupuncture nomenclature were deferred to a later meeting. The third WHO
Working Groupmet in Seoul, Korea (WHO1987). Having already arrived at a consensus regarding
classical meridian points, the final area of discord was with the nomenclature for auricular points.
As the meetingwas organized by the WHORegional Office for the Western Pacific, most of the
representatives were from Asia. Only Dr Raphael Nogier of France represented a European
perspective. Standard nomenclature was adopted for 43 auricular points, each point designated by
one or two letters and by a number. In addition to the standard nomenclature accepted for 43
auricular points identified as Category 1 points, anot her 36 ear points were identified as Category2
points that needed further study for verification. All ear points were preceded by the letters MAto
designate Microsystem Auricular. For example, MA- H1indicated t he location for t he Ear Cent er
point on the helix and MA-TF 1 indicated the location for the Shen Men point in t he triangular
fossa. The only ot her approved designation for a microsystem was the designation MSfor
Microsystem Scalp. No agreement was made on the two main schools of auricular points, the one
initiated by Paul Nogier of France and the ot her one utilized by Chinese practitioners for ear
acupuncture.
The final WHOGeneral Working Groupon Auricular Acupuncture Nomenclature met in Lyons,
France (WHO1990a). Themeeting was led by Raphael Nogier and Jean Bossy of France, by
c.T. Tsiang of Australia, and by Olayiwola Akerele representing the World HealthOrganization.
International participants at this meeting included representatives from Australia, Austria, China
(PR), Columbia, Egypt, Finland, France, Germany, Italy, Japan, Korea (DPR), New Zealand,
Norway, Spain, Switzerland, Venezuela and the USA. Hiroshi Nakajima, Director- Generalof the
World Health Organization, proclaimed to the gathering that ’auricular acupuncture is probably
the most developed and best documented, scientifically, of all the microsystems of acupuncture and
is the most practical and widely used.’ He further acknowledged that ’unlike classical acupuncture,
which is almost entirely derived from ancient China, auricular acupuncture is, to a large extent, a
more recent development that has received considerable contributions from the West.’
In his personal address to the audience, Paul Nogier observed that:
thestudies byDrNiboyethaveproved that theear points, liketheacupuncture points, can bedetected
electrically. Wealso knowfrom thestudies byProfessor Durinian ofthe USSRthat theauricle, by
virtue ofitsshort nervelinks withthebrain, permitsrapid therapeutic action that cannot otherwise be
explained. Thetimehas come toidentifyeach major reflex sitein theauricle, and I knowthat some of
you are busyon this. Thisidentificationseems tome tobe essential so that therecan be a common
language in all countriesfor therecognition oftheear points.
Three qualities were emphasized:
(1) ear points that have international and common names in use;
(2) ear points that have proven clinical efficacy;
(3) ear points whose localization in the auricular area are generally accepted.
Auricularzones 103
The group agreed t hat each anatomical area of the ear should be designated by two letters, not one,
to conform to the body acupuncture nomenclature. The abbreviation for helix became HXrat her
than H and the designation for lobe became LO rat her than L. Terminologywas also added for
points on the back of the ear, each area to begin with the initial letter P, as in PP for posterior
periphery, and PL for posterior lobe. The Chinese have also developed a revised auricular zone
system based upon the recommendations of the 1990WHOauricular nomenclature committee
(Zhou1995,1999; see Figure 4.4).
The primary difficulty at this WHOnomenclature conference was the discrepancy between the
Chinese and European locations for an ear point. For example, the Knee point is localized on the
superior crus of the antihelix in the Chinese system and in the triangular fossa in the European
system. No concurrent agreement on this issue was determined. The group did adopt a
standardized nomenclature for 39 auricular points, but decided t hat anot her 36 ear points did not
as yet meet the three working criteria. The Category 1 and Category2 ear points described by the
1987Working Groupfrom the Western Pacific Division of the WHOare respectively similar to the
’agreed upon’and ’not agreed upon’auricular points listed by the 1990 WHOmeeting. The two
lists of ear points are respectively presented in Tables 4.1 and 4.2. Duringthe course of discussions,
many divergent points of view emerged concerning bot h the localization and terminology of
auricular points. After a free exchange of ideas and opinions, the WHOworking group agreed t hat
a priority of future activity should be the development of a st andard reference chart of the ear. This
chart should provide a correct anatomical illustration of the ear, an appropriat e anatomical
mapping of topographical areas, consultation with experts in anatomy and auricular acupuncture,
illustrations of correct zones in relation to auricular acupuncture, and the actual delineation and
localization of ear points. A subsequent committee directed by Akerele (WHO1990b) developed
specific anatomical drawings of the ear and specific terminology for the auricle.



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

Figure 4.4 Thezone system developed in China after the 1990 WHOauricular nomenclature meetinghas been described by
Dr Li- QunZhou (reproduced with permission).
104 AuriculotherapyManual
Table 4.1 WHO 1990 standard nomenclature for auricular points, accepted points
English name Pinyin name
Ear Center Erzhong
Urethra Niaodao
External Genitals Waishengzhiqi
Anus Ganmen
- - - - - - -
Ear Apex Erjian
Heel Gen
Ankle Huai
Knee Xi
PelvicGirdle Tun Kuan
- - - - - - -
Sciatic nerve Zuogu shenjing
Autonomic point Jiaogan
Cervical Vertebrae Jingzhui
Thoracic Vertebrae Xiongzhui
Neck Jing
Thorax Xiong
Fingers Zhi
Wrist Wan
Elbow Zhou
Shoulder Girdle Jian
- - - ~ - - - - _ . _ - _ . - - - - - - - -
EarShen Men Ershenmen
External Nose Waibi
Apex of Tragus Pingjian
Pharynxand Larynx 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- IT
MA- ICI Lung Fei
Qiguan
- - - -
Neifenmi
San Jiao
Kou
Trachea
Hypothalamic-PituitaryAxis
TripleEnergizer
Mouth
- - - - - - - - - - - - - - - - - - - - - -
MA- IC6 Esophagus Shidao
MA- IC7 Cardia Bennen
Superior concha MA- SCI
MA- SC2
MA- SC3
Duodenum
Small Intestines
Appendix
MA- SC4 Large Intestines Dachang
MA- SC5 Liver Gan
MA- SC6
- - - - - -
MA- SC7
MA- SC8
Pancreas-Gall bladder
Ureter
Yidan
Lobe MA- LOI Eye Mu
Auricularzones 105
Table 4.2 WHO 1990 standard nomenclature for auricular points. not yet considered
Pinyin name
Neishengzhiqi
Shangergen
- _ . _ . _ - - - - - - - - ~ . . - - - - - - - _....... ,._- _._- - - - -
Xiaergen
Ermigen
- - - - - - - - - - - -
Zuzhi
English name
MA- HX Internal Genitals
MA- HX Upper ear root
Alphanumeric
- - - - - - - - - - - - - - -
MA- HX Lower ear root
._- - - -
MA- HX Root of ear vagus
MA- AH Toe Antihelix
Anatomical
Helix
MA- AH
MA- AH
Lumbosacral Spine
- - - - - ’- - - - - -
Abdomen
Yaodizhui
- - ~
Fu
Pelvis
Scaphoid fossa
Triangular fossa
Tragus
Antitragus
WindStream or Occipital Nerve
Middletriangular fossa
- - - - - -
Superior triangular fossa
Adrenal Gland
Nie MA-AT
MA-AT Apex of Antitragus Duipingjian
- - - - - - - - =- - . - = - - - - - - ~
MA-AT Central Rimor Brain Yuanzhong
- - - - - - - - - - - - - - - - - - - - - - - - - - - - _ . ~ . -
MA-AT Occiput Zhen
---------- - - - - - - - - - - - - - - - - - - - - - = - - - - - - - - - - - - - - - - - - - - ~ - - - - -
Temple
MA-AT Forehead E
Intertragic notch
- - - - - - - - ~ ~ . _ - _ . _ - _ .._- - -
Inferior concha
MA- IT
MA- IC Heart Xin
MA- IC Spleen Pi
Superior concha
MA- IC
MA-SC
MA-SC
Stomach
Kidney
Angle of 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
Internal ear
Cheek
Tonsil
Nei’er
Mianjia
- - - - - - - - - - - - - - - - - - -
Biant aoui
Posterior lobe
MA-LO
MA- PL
Anterior Ear Lobe Chuiqian
Posterior peripheral MA- PP
Posterior intermediate
Posterior central
MA-PI
MA-PC
Groove of posterior surface
Heart of posterior surface
MA-PC
MA-PC
Spleen of posterior surface
Liver of posterior surface
Erbeipi
- - - -
Erbeigan
MA-PC
MA-PC
Lungof posterior surface
Kidneyof posterior surface
Erbeifei
Erbeishen
106 Auriculotherapy Manual
4.3 Anatomical identification of auricular zones
Each auricular zone is based upon the proportional subdivision of the principal anatomical regions,
such as the helix and the antitragus. In concurrence with the system established by the 1990 WHO
auricular nomenclature meeting, each zone is identified by a two let t er abbreviation for each
anatomical region and a number indicating that particular subsection of that anatomical area.
Auricular zones on the anterolateral and the posterior sides of the ear are shown in Figure 4.5. The
lowest numbers for each auricular area begin at the most inferior and most central zone of t hat
anatomical region. The numbers then ascend to higher digits as one progresses to superior and
more lateral sections of t hat anatomical region. The auricular landmarks are useful in
distinguishing where some zones end and the next one begins. A dept h view of the zones is shown
in Figure 4.6.
Thefirst zone of the helix, HX I, begins at landmark LM 0, then proceeds to higher numbers, HX2
and HX 3, as one rises to landmark LM 1 higher on the helix root. These numbers continue from
HX4 to HX 7 as one rises even higher to the apex of the auricle, LM 7. The helix numbers progress
higher as one descends from the superior helix to the bot t omof the helix tail, ending in HX15. The
first zone of the antihelix, AH 1, begins on the central side of the bot t omof the antihelix tail, LM
14, then rises to the antihelix body at LM 15, curves around to the inferior crus at LM 16, where the
antihelix numbers continue from AH 5 to AH 7. The antihelix numbers continue again on the
peripheral side of the antihelix tail, at AH 8, progressing to higher numbers as one ascends higher
toward the superior crus, ultimately to AH 18. The deeper valleys of the scaphoid fossa and the
triangular fossa are divided into six equal parts. The zones for the scaphoid fossa rise from SF 1
near the ear lobe to SF 6 toward the top of the ear, while the zones for the triangular fossa increase
from TF 1 at the lower tip of the triangular fossa to TF 6 toward the t op of the ear. A series of five
vertical zones divides the tragus, rising from TG1near the intertragic notch to TG5, where the
tragus meets the helix root. The landmark LM 10separates TG2 from TG3, while t he landmark
LM 11 divides TG 3 from TG 4. The antitragus is divided into t hree zones, beginning with AT I at
the intertragic notch, rising in number and in location at AT 2, and peripherally at AT 3. There are
two zones for the intertragic notch. The zone IT 1 is found higher toward the surface of the auricle,
whereas t he zone IT 2 occurs on the wall of the intertragic notch, and is vertical to IT 1.
The zones for the inferior concha begin at IC 1and IC 2 at the intertragic notch. Thezone numbers
then rise on a second concha row t hat begins with IC 3 and continues peripherally on the concha
floor to IC 5 near the concha wall. Subsequent inferior concha sections are found on a third row
which begins at IC 6 below the helix root and progresses peripherally below the concha ridge to IC
8. The zones for the superior concha begin with SC 1 immediately above the central concha ridge
and ascend to higher concha regions at SC 4. These values for the superior concha zones then circle
back peripherally to SC 8, found above the more peripheral concha ridge. Theconcha ridge itself is
divided into two zones, the central zone CR 1 and the peripheral zone CR 2. Thedifferent
auricular zones of the posterior auricle each begin with the let t er P. They rise from lower to higher
numbers as anatomical subdivisions progress from a central to peripheral direction and from an
inferior to superior direction. There are different zones for the posterior lobe (PL), the posterior
concha (PC), and the posterior periphery (PP), behind the helix rim and the scaphoid fossa. The
most prominent zones are for the posterior groove (PG), which is the deep crevice directly behind
the antihelix ridge.
The intention in providing such a detailed and complex auricular zone system is to be able to label
specific auricular reflex points with the actual area of the external ear on which an auricular point is
found during clinical detection. Both Chinese and European ear charts label the auricular
acupoints with the somatotopic body organ t hat they represent. The standardization of zone
terminology for verbally designating different anatomical regions of the ear can provide a universal
system to facilitate international communication t hat is based on ear anatomy, not ear
correspondences. While photographs and illustrations of the auricle are very useful in depicting
various regions of the external ear, verbal descriptions of these pictures are often inadequat e in
precisely determiningthe auricular area indicated. Box 4.1 shows the auricular locations of the
principal reflex points used in ear acupuncture by this zone coding system, rat her t han by pictures.
Further indicated in Box 4.1 are the differences between the location of auricular points as
described by Chinese auricular acupuncturists, denot ed by the suffix ’C,’and the auricular zones
delineated by European practitioners of auricular medicine, indicated by the suffix ’E.’
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 zones seen from anterior and posterior views ofthe ear, and their relationship to the
somatotopic map on the ear.
AuriculotherapyManual
Auricular zones
at antihelix tail
o L06
Auricular zones
at antitragus
Auricular zones
at tragus
Auricular zones
at helixroot
Auricular zonesat inferior crus
AH 5 TF 1
Figure 4.6 A depth viewofthe auricular zones showing the ascent from the concha to the concha wall to the
antihelix, and also the location ofhidden zones.
4.4 Somatotopic correspondences t o auricular zones
Thesomatotopic representation of the cervical spine is said to be in zones AH 1 and AH 2 in
European charts, but on the more peripheral zone AH 8 in many Chinese ear charts. The Chinese
further report t hat the Lumbar Spine is found on the antihelix body in zones AH 11 and AH 12,
while the Europeans maintain t hat the Lumbar Spine is located on the inferior crus in zones AH 5
and AH 6. A primary difference between the European and Chinese auricular charts is the location
of points for the leg. The knee is said to be found on t he superior crus zone AH 15 in Chinese ear
charts, but the knee is represented in the triangular fossa zone TF4 in European ear charts.
Internal organs are also found in different auricular regions in these two systems. For example, the
uterus is found in the triangular fossa zone TF6 in the Chinese system, but the uterus is found
underneat h the helix root in the European system, in zone IH 3.
Some ear points are more easily identified once one knows this auricular zone system. Depicting
the location of the Sympathetic (Autonomic) point or t he Thalamus (Subcortex) point is often
confusing because these two auricular points are hidden from a conventional view of the ear. The
Sympathetic Autonomicpoint is found in zone IH 4, which is underneat h the helix and near the
triangular fossa, whereas the Thalamus point is found in zone CW 2, which is behind the antitragus
and near the inferior concha. These zone identifications distinctly reveal the specific localization of
these two ear points more clearly than many pictures of these points. It is also possible to show the
Auricular zones 109
110
Box4.1 Primary auricular points represented in different 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
Thyroid Gland.C Limbicsystem IC6 Mouth, Throat
AH9- 10 Thoracic Spine.C LO7 Teeth, Lower jaw IC7 Esophagus
AH11-12 Lumbar Spine.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 Apex of Ear SC 3 Large Intestines
TF 3- 4 Knee.E, Leg.E HX12 Lumbar Spinal 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 IH4 Sympathetic Autonomic point CW3 Brain.C
A13 Occiput IH5- 6 Kidney.E, Ureter.E CW4 Brainstem.C
TG 3 Adrenal Gland.C IH7 Allergy point CW5 Thyroid Gland.E
TG 2 Tranquilizer point IH11 Wind Stream CW6 Thymus Gland.E
TG 1 Pineal Gland.E ST 2 Master Oscillation CW7 Adrenal Gland.E
S13 Larynx.C, Throat.C
differential location of ot her points found on the concha wall. The Chinese Brain point is found in
zone CW3 and the Brainstem in CW4. TheEuropean locations for the Thyroid Gland are
localized in zone CW4/CW5, the Thymus Gland in CW 6, and the Adrenal Gland in zone CW 7.
Understandinghow the contours and landmarks on the ear can assist the identification and
comparison of such ear points is an attainable goal.
4.5 Representation of Nogier phases in auricular zones
In subsequent revisions of the somatotopic representation of the body on the external ear, Paul
Nogier has postulated two additional auricular microsystems t hat are distinct from the original
inverted fetus pattern. Each anatomical region of the external ear can represent more than one
microsystem point. As not ed in Chapt er 2, the three different Nogier phases represent
embryological tissue in t hree different territories on the auricle. Territory1 consists of the antihelix.
the antitragus, and areas adjacent to the antihelix, such as the scaphoid fossa, triangular fossa and
helix. Territory2 consists of the concha, including the superior concha, the inferior concha, the
concha ridge and the concha wall. Territory3 consists of the lobe, the tragus, the intertragic notch
and the most inferior region of the helix tail. Thephase number for representation of mesodermal
tissue concurs with the number for each territory. Phase I mesodermal tissue is represent ed in
Territory 1, Phase II mesodermal tissue is represented in Territory2, and Phase III mesodermal tissue
is represented in Territory3. The endodermal tissue for different phases shifts from Territory 2 in
Phase I, to Territory 3 in Phase II, to TerritoryI in Phase III. The ectodermal tissue for different
phases shifts from Territory3 in Phase I, to Territory1 in Phase II, to Territory3 in Phase III.
Functionally, Phase I points are more associated with representation of acute somatic reactions and
AuriculotherapyManual
Phase II point s are more reflective of chronic, degenerat ive conditions. Phase III point s seem to
reflect subacut e syndromes t hat are not as serious as pathological st at es represent ed in Phase II,
but are the most salient point s in pat ient s with underlying obstacles to t reat ment success.
4.5.1 Auricular zones for different phases of mesodermal myofascial tissue
Vertebral column: For bot h the Chinese system and t he Nogier Phase I system, the vert ebral
column is found in Territory 1, along the medial side of t he antihelix. The Chinese st at e in t heir
texts t hat t he whole vert ebral column is limited to the body and tail of t he antihelix. Nogier has
indicated t hat the Phase I Cervical Vertebrae are found on the antihelix tail, t he Thoracic
Vertebrae are found on t he antihelix body, and the Lumbosacral Vert ebrae extend ont o the
inferior crus of the antihelix. TheChinese charts do show the But t ocks and Sciatic point s on the
inferior crus, but do not include the lower vert ebrae t here. In Nogier’s Phase II, the Lumbosacral
Vertebrae are found on t he helix root, whereas the Thoracic and Cervical Vert ebrae extend
peripherally ont o the concha ridge, in Territory2. In Phase III, The Cervical, Thoracic, and
Lumbosacral Vertebrae occur along the surface of the tragus in Territory3.
Upper and lower limbs: The Chinese placed the Hip, Knee, and Foot on t he superior crus of the
antihelix of Territory1. Nogier placed t he Phase I lower limb points in t he nearby triangular fossa
Table 4.3 Mesodermal tissue for different phases found in auricular zones
No. Anatomical region Chinese Phase I Phase II Phase III Phase IV
10 Cervical Spine AHI AH 1-2 CR2 TGI- 2 PG 1-2
11 ThoracicSpine AH2- 3 AH3- 4 CRI TG2- 3 PG3- 4
12 Lumbosacral Spine AH4 AH5- 6 HXI TG4- 5 PG5- 6
18 Chest and Ribs AHIO AHIO SCI TG3 PG3
19 Abdomen AHII AH11 IH 1 TG4 PG4
- ~ - - - - - - - - ~ -
21 Hipand Buttocks AH13 TF I IC1-2 AH I,AT3 PT I
~ - - - - _ . - - " - - - ' ~ - - - ' ~ - - - - - - - - - ~ - ~ ~ - - " - - - " ' - ' . _ . _ .._._-
23 Knee and Thigh AH 15 TF4 IC2/4 AT2 PT2
- - - - - - - _.._- - - - - - - - - _._- - - - - - - - - _._- - - _._- ".
25 Ankle and Calf AHI7 TF5 IC5 AT1 PT3
- - ' - - - ' - ' - ' - ' - ' - ~
26 Foot, Heel, Toes AHI7 TF5- 6 IC8 IT1 PT3
30 Handand Fingers SF6 SF6 SC8 L01 PP9- 10
- - - - - - _.._- - - - - - - -
32 Wristand Forearm SF5 SF5 SC7 L03 PP7- 8
34 Elbowand Arm SF4 SF4 SC5- 6 L05 PP5-6
36 Shoulder SF2 SF2 SC4 L07, SF 1 PP3- 4
-" - - - _........__._. __.
38 Head and Scalp AT1-3 IH7- 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 AH 11 SC2 TG4
- - - - - - - - _ ..- - - - - - - - - - - - - - - -
81 Spleen IC8 CW9 SC8 L08 PC3
84 Kidneyand Ureter SC6 IH5,6 IC7-8 AHl,8 PP 10
88 Prostate SC4 IH3- 4 IC I L02
.- - - - - - - - -
89 Uterus TF5/6 IH3- 4 IC2 L02
-_.._,.,- - - - -
91 OvarieslTestes CWI IH 1-2 IC4- 5 L04
92 Adrenal Gland TG2/3 HX2- 7 IC3,6 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
Thoracic Spine
13.C
Sacral Spine
19.C & 19.Fl
Abdomen
7i:.’....L_\ - - ..- t - - - - Ji12.CLumbar Spine
53.Fl Skin
10.F3
Cervical
Spine
53.F3 Skin
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 spine and head points.
112 AuriculotherapyManual
Chinese ear points, Phase Iarm, and Phase /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
Phase IVpoints
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
Phase Ileg and Phase" 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 limb and lower limb points.
Auricular zones 113
of Territory 1. In both the Chinese system and Phase I of Nogier’s system, the Shoulder, Elbow, and
Hand are found in identical areas of the scaphoid fossa. In Nogier’s Phase II, the upper limbs shift
to the inferior concha and the lower limbs are found in the superior concha. Both limbs are thus
located in Territory2. In Phase III, the ear points for the upper and lower limbs shift to the lobe and
antihelix of Territory 3.
Faceand skull: The auricular points for head areas like the Skull, Jaw, Eye, and Ear are found on
the antitragus of Territory1. In Phase II, the points for the head are found with ot her
musculoskeletal points on the concha wall of Territory2. In Phase III, the head is found at the most
inferior level of the tragus in Territory 3.
4.5.2 Auricular zones for different phases of int ernal organ t issue
Endodermal internal organs: Almost all ear reflex points for the endodermal internal organs arc
found in the concha of Territory2 for both the Chinese system and for Phase I of Nogier’s system.
The Phase I internal organ points include ear reflex points for the digestive system, such as the
Stomach and Intestines, respiratory points such as the Lungs and Bronchi, abdominal organs such
as the Bladder, Gall Bladder, Pancreas, and Liver, and the endocrine glands such as the Thymus,
the Thyroid, and the Parathyroid. All of these endodermal points shift to the lobe and the tragus of
Territory 3 in Phase II, and to the helix and antihelix areas of Territory1 in Phase III.
Mesodermal internal organs: While most cells which develop from t he mesodermal layer of the
embryo become part of the musculoskeletal system, some mesodermal tissue differentiates into
visceral organs. These mesodermal internal organs include the Heart , the Spleen, the Kidneys, the
Ureter, the Adrenal Glands, and Genital organs, such as the Vagina, the Uterus, the Prostate, the
Ovaries and the Testes. In the Nogier phases, this set of internal organs is found in the same
territories that the musculoskeletal tissue is found. In Phase I these points are found in Territory I,
in Phase II they are found in Territory 2, and in Phase III they are found in Territory3.
Table4.4 Endodermal tissue for different phases found in auricular zones
64 Duodenum
65 Small Intestines
No. Anatomical region PhaseII Phase III Phase IV
LO 1 HX1 PC2
..-.._ - ~ - - - - - _ . -
L03 HX2- 5 PC2
L05 TF4 PC3
- - - _._._.... _.._"- - - - - - - - - -
L04 IH3- 9 PC3
ATl- 3 HX10-14 PC4
- - _._- - - - _._- - - - -
ITI HXI5 PC4
_ .. --_.-,,_.--_._-.---.-_._-_._--
CWI- 3 CW9- 10 PG2- 5
L08 SF 2-3 PC2
L07 SF 1 PC2
L08 AH4 PC2
IC3
IC4,5
CW4- 8
STI
SC3,4
IH3
IC4
IC6
ST4
SC3
._- - - - - - - - - - - -
HX3
- ~ _ . _ ~ ~ - - ~ ~ - - - - _ . _ - - - - - - - - - - - - - -
Chinese PhaseI
IC7 IC6
.. _ - ~ - - - - _ ..__.
CRI IC7,CR1
- - - - - -
SC 1 SC 1
SC2 SC 1-2
Bronchi
Larynx
Lungs
Circulatory System
Large Intestines
Rectum
74
67
66
68
70
71
61 Esophagus
63 Stomach
L07 SF4,5 PC3
L02 AH 13, 14 PC3
LO 1 TF3,4,5 PC3
LO I,L03 SF6 PC3
AHI8
- - - - - - - - - ---_.._- - -- - - -
L01 TF6 PC3
L05 HX6- 8 PG4
AH1,8 AH2 PG3
HX15 AHI PG I
IC2
- - - - - - - -
IC 1
SC4
IC8
SC7
SC5- 6
CR 2, SC 8
SC8
HX4
AH8
CR2
SC8
SC7
- - - - - - - - - - -
SC5
Liver
Bladder
Urethra
Thymus Gland
Gall Bladder
Thyroid Gland
Parathyroid Gland 97
94
87
96
79
82
83 Pancreas
- - -
86
114 Aur;culotherapy Manual
79.F2
Liver
64.F2
Duodenum
94.F2 ThymusGland
>+-"'-';="'r/-- 96.(
ThyroidGland
96.F2
ThyroidGland
70.F2
Lung
71.F2
Bronchi
NogierPhase /Iear points
Chinese ear pointsand
NogierPhase Iear points
83.( & .F1 Pancreas
82.( & .F1 Gall Bladder
63.( and .F1 Stomach
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 & .F1 Liver
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.F3 Larynx .....
Figure 4.9 Phases for the endodennal internal organs.
Auricular zones 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 the mesodermal internal organs.
116 AuriculotherapyManual
4.5.3 Auricular zones for different phases of ectodermal neuroendocrine tissue
Chinese neuroendocrine points: The Chinese have identified only a few neuroendocrine system
points on the concha wall of Territory2, whereas the European auricular charts have indicated
many areas of the auricle which represent the brain and spinal cord. There is concurrence between
the Oriental and Western systems for those few ear points the Chinese have recognized. The
master point t hat Nogier and his colleagues first identified as the Thalamus point was labeled the
Subcortex point by the Chinese. While the Chinese ear charts do describe the location of the
PituitaryGland in a similar location as the European ear charts, the Chinese do not go into as
much detail regarding the peripheral endocrine glands t hat are regulated by the pituitarygland.
Table 4.5 Ectodermal tissue for different phases found in auricular zones
No. Anatomical region Chinese Phase I Phase II Phase III Phase IV
54 Eye L04 L04 AHll IC3 PL4
59 External Ear TG5 L01 TG5 SC6
95
98
99
109
110
113 Vagus Nerve
AH10
IC 1
IH4
L01
TG1
IT 2, IC I
CW2
CW3
CW1
HX7- 9
HX1
AH 15-18
HX13-14
HX15
HX12
IC 1
SC5
CW1
CRl- 2
CR2
CR1
PG3
PC1
PG3- 6
PG7
PG1
124 Spinal Cord AH8,SF1 AH8,9
SF 1, 2
IC5 PP2,4,6
Brainstem Medulla Oblongata
Reticular Formation
CW4 L07
L08
HXl- 3
AH 10, 12
SF 3-4
SC 1
IC8
PP2
PL6
133
134
Red Nucleus
Substantia Nigra
L06
L06
CWlO
IH1
IC6
IC7
PL4
PL4
135 Striatum (Basal Ganglia) L04,AT1 HX9- 11 IC3,4 PL4
PL2
PG 1
PL2
PL2
IC4
CWl- 3
IC6
IC7
AH3
AHll
CW9
CW8
L06
AT2-3
L02
LO 2, IT 1
CW2
Hypothalamus
Thalamus (Subcortex, Brain)
Hippocampus
Amygdala
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
137
138
140
141
143
145
Cingulate Gyrus
Cerebellum
IT 1
AT3,AH1
CW7
HX4- 6
IC6
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 LO 1 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
Substantia Nigra
133.Fl
Red Nucleus
135.F1
Striatum
127.C
Brainstem
110.Fl
Parasympathetic Nerves
109.Fl
Sympathetic Nerves
113.Fl
Vagus Nerve
143.F1
u- - _-
CingulateGyrus
140.Fl
Hippocampus
95.Fl
MammaryGland
141.F1 Amygdala
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 neuroendocrine and Chineseear points.
AuriculotherapyManual
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
Substantia Nigra
Figure 4.12 Phase Il neuroendocrineear points.
Auricularzones
95.F2
MammaryGland
135.F2
Striatum
54.F2
Eye
110.F2
Parasympathetic Nerves
109.F2
Sympathetic Nerves
113.F2
Vagus Nerve
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 . - ­
Hypot halamus
138.F3
Thalamus
151.F3
Prefrontal
Cortex
~
150B
Frontal Cortex
~ __ 149.F3
Parietal Cortex
148.F3
Temporal Cortex
147.F3
Occipit al Cort ex
135.F3
St riat um
99.F3
Pit uit ary Gland
Figure 4.13 Phase III neuroendocrine ear points.
120 Aur;culotherapyf\1anual
Phase I neuroendocrine points: The nervous system and the endocrine system are first represent ed
on the lobe of Territory3 in Phase I of Nogier’s system. In all t hree phases, t he Nogier system allows
for different auricular localizations for pituitary control of endocrine hormones, as cont rast ed with
the actual placement of the peripheral endocrine gland itself. TheThalamus and Hypot halamusare
found on the external surface of the antitragus, whereas they were previously described on the
concha wall and inferior concha. The Cerebral Cortexis still represent ed on the ear lobe
Phase IIneuroendocrine points: The ect odermal neuroendocrine systems shift to t he helix, the
antihelix, and the triangular fossa regions of Territory 1 in Phase II. The Pituitarypoint for genital
control in Phase II is locat ed in the t riangular fossa region, near the Chinese Ut erus point. The
Frontal Cort exin Phase II corresponds to the auricular location for t he Chinese mast er point Shen
Men. The Cerebral Cort exin Phase II is found along t he superior helix, leading to the Spinal Cord
located on t he helix tail.
Phase IIIneuroendocrine points: The neuroendocrine systems shift to the concha in Territory2 in
Phase III. Thecortical areas are located in the superior concha and t he subcortical areas in the
inferior concha. Thelocation of the Phase III Ant erior Hypot halamusand Post erior Hypot halamus
in the inferior concha coincides with the location of t he Chinese Lung point s used in t he t reat ment
of narcotic detoxification and drug abuse.
4.5.4 Nogier phases related to auricular master points
There are cert ain points on the auricle used in bot h Chinese ear acupunct ure and European
auricular medicine t hat do not relate to one specific anat omical organ but affect a broad range of
physiological functions. These ear points are referred to as mast er points, the two principal
examples being the Chinese ear point Shen Men and t he Nogier auricular locus identified as Point
Zero. These two functional points do correspond to specific anat omical organs when viewed from
the perspective of the Nogier phases.
Frank (1999) has not ed t hat Shen Men is identified at t he auricular locations consistent with the
Phase I Spleen projection, the Phase II Thalamus projection, and Phase III Liver projection. The
spleen deals with inflammatory cellular element s and is thus reasonably seen in many inflammatory
conditions. Thethalamus is a significant central nervous system st ruct ure involved in the
modulat ion of pain signals from t he spinal cord to the cerebral cortex. It is reasonable, therefore, to
find this zone reactive with chronic, degenerative, painful conditions. Theliver is associated with
hepatobiliary physiology and t herefore this zone would reasonably be active in subacut e or chronic
pain or dysfunctional problems.
Point Zero lies in the helix root area innervated by the vagus nerve t hat supplies the endodermal
organ structures represent ed in Phase I at the superior and inferior concha. Vagus nerve activity is
commonly seen with physiologic stress and painful experiences. Phase II location at t he region where
Point Zerois found is consistent with location of the Cerebellum. Specific cerebellar functions
include coordination of somatic mot or activity, regulation of muscle tone, and the balancing
mechanisms of equilibrium. With such significant impact on the body’s coordination functions, it is
not surprising t hat this point is reactive in many chronic degenerative Phase II conditions. ThePhase
III point for the Corpus Callosum is located at the anatomical position of Point Zero. This neural
bridge between the left and right cerebral cortex is a critical relay for proper neurophysiologic
function. Phase III disturbances at this point may manifest as at t ent iondeficit disorder, stuttering,
dyslexia, confusion with directions and visual and auditory processing disturbances.
4.6 Microsystem points represented in auricular zones
Each anatomical part of t he human body and each health condition are represent ed in the auricular
microsystem codes by an ear reflex point designated by a number and a let t er extension. The
numbers continue from 0.0 to over 200.0, each number designating a different part of human
anatomy. Thelet t er extensions following the decimal point shown in Box 4.2 indicate whet her t hat
ear reflex point belongs to the Chinese ear acupuncture microsystem, ’.C’, the European
auriculotherapy microsystem, ’.E’, or whet her it is a universally accepted location. In some cases,
there is more t han one Chinese or European ear reflex point for a given body area. In those
instances, t here can be several extensions, such as .Cl, .C2, and .C3. Box 4.2 also shows how the
Nogier Phases I- IIIare indicated by .Fl- .F3and .F4 for the fourth phase on the post erior side of
the ear.
Auricular zones
121
4.6.1 Helix zones
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 Darwin’s point, Liver Yang 2, Helix 1.
HX12 Lumbosacral Spinal Cord,Alertness.
HX13 Thoracic Spinal Cord, Helix 2.
HX14 Cervical Spinal Cord, Tonsil 2, Helix 3.
HX15 Medulla Oblongata, Tonsil 3, Helix 4, 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
Darwin’s Point
180.C1
Helix 1
\ .....- <- - - _ 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
Medulla Oblongata
75.C3
Tonsil 3
122
Figure 4.14 Helixzonesand corresponding auricular points.
AuriculotherapyManual
4.6.2
AH 1
AH2
AH3
AH4
AHS
AH6
AH7
AH8
AH9
AH10
AH 11
AH12
AH13
AH14
AH1S
Ant ihelix zones
Upper Cervical Vertebrae, Cerebellum.
Lower Cervical Vertebrae, Torticollis.
Upper Thoracic 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.
Lower Anterior Neck muscles, Clavicle.E, Thoracic Spine.C, Scapula.E, Thyroid Gland.C.
Chest and Ribs, Thorax, Pectoral Muscles, Breast, Mammary Gland.C, Lumbar Spine.C.
Abdomen, Lumbago (lumbodynia) point, Heat point.
Abdomen. AH 16 Thumb.E.
Hip.C. AH 17 Heel.C,Ankle.C.
Knee joint.C2. AH 18 Toes.C.
Knee.C1.
Antihelix a uricular zones
168.C
Heat point
14.0
Buttocks
13.E
Sacral Spine
107.0
Sciatic Nerve
12.E
LumbarSpine
HE
ThoracicSpine
69.E
HeartE
95.C
Mammary Gland.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 Antihelixzones and corresponding auricular points.
Auricularzones 123
4.6.3
IH1
IH2
IH3
IH4
IHS
IH6
IH7
IH11
IH12
Internal helix zones
Ovaries or Testes.E.
Vagina or Prostate.E.
Uterus.E.
Sympathetic Autonomic point, Ureter.E.
Kidney.E, Hemorrhoids.C 1.
Kidney.E.
Allergy point.
Wind Stream, Lesser Occipital Nerve.
Lumbar Sympathetic Preganglionic Nerves.
174.C
Hemorrhoids
8S.E
Ureter.E
2.0
Sympathetic
Aut onomic
point
89.E
Uterus.E
88.E
Vagina or Prostate.E
124
Figure 4.16 Internalhelixzones and corresponding auricular points.
AuriculotherapyManual
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, Irritabilitypoint,
DentalAnalgesia 1 (Tooth extraction 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, Helix 5.
LO6 Upper jaw, Maxilla,Vertex, Hippocampus, Temporal Cortex,Auditory Line, Parietal Cortex.
LO7 Lower jaw, 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 Helix 6
Tonsil 4
42.C
Vert ex
43.E
TMJ
190.E
Antidepressant
51.E

46.0
Teeth
44.0
Lower Jaw
45.0
Upper Jaw
180.C5
Helix 5
49.E
Tongue.E
58.C
Internal Ear.C
149.E
Parietal Cortex
Figure 4.17 Lobezones and corresponding auricular points.
Auricular zones 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
(Urticaria point)
~ - - 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 Scaphoid fossa zones and corresponding auricular points.
AuriculotherapyManual
4.6.6 Triangular fossa zones
TF1 Hip.E, Pelvic Girdle.
TF2 Shen Men (Spirit Gate, Divine Gate).
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
Hypert ension 1
89.C
Uterus.C
155.C1
Hepat it is 1
153.C
Ant ihist amine
1.C
Shen Men
20.0
Pelvic girdle
Figure 4.19 Triangular fossa zonesand corresponding auricular points.
Auricular zones 127
4.6.7 Tragus zones
TG1 Pineal Gland, Epiphysis, Point E, Eye Disorder 1 (Mu 1).
TG2 Tranquilizer point, Hypertension 2 (High Blood Pressure point), Valium Analog, Relaxation point.
Mania point, Nicotine point. Corpus Callosum.
TG3 External Nose.C,Appetite Control (Hunger point),Adrenal Gland.C (Suprarenal Gland),
Stress Control point, Corpus Callosum.
TG4 Vitality point. Viscera, Thirst point, 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 (Ping Chuan),Apex of Antitragus.
AT3 Occiput. Atlas, Occipital Cortex.
146.E
Corpus
Callosum
92.C
Adrenal Gland
192.E
Nicotine Point
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
Vitality Point
162.C
Thirst Point
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 Tragus and antitragus zones and corresponding auricular points.
128 AuriculotherapyManual
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 (Mu 1). Cingulate Gyrus, Hypotension point.
IT2 Endocrine point. Internal Secretion. Thyrotropins, Thyroid Stimulating hormone (TSH),
Parathyrotropin.
5.0
Endocrine point
(Internal Secretion)
114.E
Audit ory Nerve.E
56.C
Internal Nose.C
55.C1
Eye Disorder 1
143.E
Cingulate Gyrus
102.E
Thyrotropins (TSH)
157.C
Hypotension
Figure 4.21 Subtragusand intertragic notchzones and corresponding auricular 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, Larynx and Pharynx.E, Vagus Nerve, Bronchi.
IC4 Lung, Heart.C, Bronchi, Tuberculosis point.
IC5 Lung 1, 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), Muscle Relaxation 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 concha zones and corresponding auricular points.
130 AuriculotherapyManual
4.6.12 Concha ridge zones
eR 1 Stomach.
eR 2 Liver, Cirrhosis, Hepatitis.
4.6.13 Superior concha zones
se 1 Duodenum,Appendix.
se 2 Small Intestines, Appendix, Omega 1,Alcoholic point.
se 3 Large Intestines, Colon, Hypogastric Nerve.
se 4 Prostate Gland.C, Urethra.E, Hemorrhoids.C2.
se 5 Urethra.E, Bladder.
se 6 Kidney.C, Ureter.c.
se 7 Pancreas, Ascites point.
se 8 Gall Bladder (right ear), Spleen.E (left ear).
67.E
Rectum.E
77.0
Appendix
65.0
Small Intestines
r- ,,_......
163.C
Alcoholic point
64.0
Duodenum
Figure 4.23 Superior concha and concha ridge zones and auricular 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
ew 1 Gonadotropins (FSH. LH), Ovaries or Testes.c.
ew 2 Thalamus point, Subcortex (Dermis), Thalamic Nuclei. Excitement point, Salivary Gland.
ew 3 Brain (Diencephalon), Central Rim, Dizziness, Vertigo. Toothache 2.
ew4 Parathyroid Gland, Brainstem, Superior and Middle Cervical Sympathetic Ganglia.
ew 5 Thyroid Gland.E, Wonderful point, Inferior Cervical Sympathetic Ganglia.
ew 6 Mammary Gland.E, Thoracic Sympathetic Ganglia.
ew 7 Thymus Gland, Thoracic Sympathetic Ganglia.
ew 8 Adrenal Gland, Lumbar Sympathetic Ganglia.
ew9 Lumbar Sympathetic Ganglia.
ew 10 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- - - _Circulat ory
System
96.E
Thyroid Gland
97.E
Parathyroid Gland
127.C
Brainstem
176.C
Central Rim
130.C
Brain
132
Figure 4.24 Concha wall zones and corresponding auricular 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
Large Intestines
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
Lower Jaw
10.F4
Cervical Spine
34.F4
Elbow
69.F4 - - \ - - - - - - lc- - - n
Heart
11.F4
Thoracic Spine
49.F4
Tongue
Figure 4.25 Posterior auricular zones for the somat ot opic body.
Auricular zones 133
LM2
LM 1
134
LM 7
LM Al LM Al LM Al
LM 0 HX 1/ CR 1 LM 6 HX15/ LO 7 LM 12 AT 1 / AT 2
LM 1 HX4 / HX5 LM 7 LO 1 / LO 3 LM 13 AT 2 / AT 3
LM 2 HX7 / HX8 LM 8 LO 1 / 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 TG 2 / TG 3 LM 16 AH 4/ AH 5
LM 5 HX15 LM 11 TG 4 / TG 5 LM 17 AH 6 / AH 7
Figure 4.26 Relationship ofauricular landmarks to auricular zones.
AuriculotherapyManual
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 aut onomic 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 t oxic scars and dental foci
5.8 Scientific investigations of auricular diagnosis
5.1 Visual observation of skin surface changes
Just as classical acupuncturists have observed distinct changes in the color and shape of the tongue
and in the subtle qualities of the radial pulse, practitioners of ear acupuncture have emphasized the
diagnostic value of visually examining the external ear (Kvirchishvili 1974, Romoli & Vet toni 1982).
Thoughnot as routinely observed as ot her diagnostic indicators of reactive ear points, prominent
physical attributes of the auricular skin surface have been associated with specific clinical conditions.
Thisvisual inspection of the auricle should be conducted before the ear surface is cleaned or
manipulated for ot her auricular procedures.
Dark colored spots: Shiny red, purple or brown spots at distinct regions on the ear surface usually
indicate acut e inflammations. Bright red t ends to indicate an acute reaction t hat is painful,
whereas dark red is seen with patients who have a long history of disease. Darkgrey or dark brown
can indicate tissue dedifferentiation or t umors could be found in the corresponding organ. These
colored spots are not to be confused with ordinary freckles t hat do not necessarily indicate a
diagnostic condition. If pressure is applied to these colored regions of t he auricle, t hat spot is oft en
painful to touch. Absence of these spots does not indicate t he absence of any medical problem, but
the occurrence of colored regions on t he ear does suggest t he high probability of some type of
pathology in the corresponding part of t he body. These colored spots only gradually go away when
the health of the related body area improves.
White skin: Whiteflakes, crusty scales, peeling skin, shedding and dandruff- like areas of
desquamat ion always indicate a chronic condition. Whitenesssurrounded by redness in the heart
region indicates rheumat ic heart disease. A close inspection of t he ear of many pat ient s indicates
t hat t here is a dryness on localized regions of the skin. Ift he auricle is cleaned, the white flaky
regions will reappear within several days unless the corresponding condition is t reat ed. Ifa
t reat ment is effective for healing a given condition, flaky regions do not reappear.
Physical protrusions: Specific areas of t he auricular skin surface can exhibit spot-like protrusions,
slight depressions, rough thickened skin or blister-like papules prot rudingabove t he surface. The
papules are small, circumscribed solid elevations of skin t hat could be colored red, white or a white
papule surrounded by redness. Sometimes t here is a dark grey papule.
Ear lobe creases: Diagonal folds in the skin over the ear lobe have been correlat ed with certain
types of health disorders. Lichstein et al. (1974) and Meht a& Hornby(1974) bot h published
Diagnosis procedures 135
Groove of
t innit us - - """";111
Groove of
hypertension - - -......,
Tumor-specific
area I by Huang
- - -Tumor specific
area IIby Huang
~ .........,.’- - - - Groove of coronary
heart disease
Figure 5.1 Photograph ofan ear lobe crease related to
coronary problems.
Figure 5.2 Representation offunct ional regions on the ear identified by
Dr Li Chun Huangthat have been associated with tumors and cardiovascular
disorders.
136
studies in the New EnglandJournal ofMedicine t hat demonst rat ed significant correspondences
between ear lobe creases and coronary problems. These double blind clinical studies showed t hat
the presence of a crease running diagonally from the intertragic notch to t he bot t omof the lobe
was more predictive of t he occurrence of a coronary problem t han eit her blood pressure level or
serum cholesterol level. Huang(1996, 1999) has report ed t hat ot her ear lobe creases are
associated with the incidence of cancer.
5.2 Tactile palpation of auricular tenderness
The most readily available technique for determining the reactivity of auricular reflex points is to
apply localized pressure to specific areas of the auricle. Patients are oft en very surprised t hat
palpation of one area of t he external ear is so much more painful t han identical pressure applied to
a nearby auricular region. Even more amazing is how t he specific area of the ear had been
previously recognized on ear reflex charts as indicative of pathological problems t hat the pat ient is
experienci ng.
General reactivity: Check broad regions of the external ear by using long stroking movements
with your fingers and by applying generalized pinching pressure to given regions of t he auricle.
Det ermineareas of increased ear sensitivity of the pat ient to applied palpation with the t humbon
the front of the ear and t he index finger on the post erior side of the auricle. Ask if t he pat ient
notices whet her one region is more t ender than anot her. Monit orfacial grimaces in response to
your tactile pressure. Gentlypinch the two sides of t he auricle at different areas. It is import ant to
develop tactile awareness of the different contours of t he cartilaginous antihelix and the curving
ridges around the helix. Oneshould pull down on the fleshy ear lobe and feel t hroughout the
depths of the concha. Not e areas of skin surface that may be rough, bumpy, scaly, waxy, dry, oily,
cold or warm. Especially sensitive patients experience t enderness from even light touching of
broad areas of the auricle, and it is import ant to proceed slowly and gently with t hat individual. For
less sensitive patients, more selective palpation can be applied with a fingernail.
Auriculotherapyfv1anual
Specific tenderness: Localized t ender areas on the external ear are investigated with a long metal
probe with a round, blunt smooth tip approximately 1.5 mm in diameter. Such probes are available
from acupuncture, medical or dental equipment suppliers. Some art supply stores offer similarly
effective tools for use bygraphic artists, spring- loaded metal devices with a small, spherical tip.
Firmly stretch out the auricle with one hand, while holding the probe with the ot her hand. Slowly
glide the probe over the ear surface, stopping on small regions t hat the patient states are sensitive
to lightly applied pressure. Palpate auricular areas t hat you suspect of being reactive by their
correspondence to the parts of the body where the pat ient has report ed pain or pathology. If
several points on the ear are found to be tender, selectively examine each point to det ermine which
is the most painful of the group. The degree of tenderness usually relates to the severity of the
condition. The more sensitive the point, the more serious the disorder. Tenderness appears within
12 hours aft er a health problem occurs, becomes more sensitive if the condition worsens, and
disappears within 7 days aft er the problem is corrected. There is a learned clinical skill in knowing
the level of pressure needed to discriminate the most accurate point t hat exhibits the highest
intensity of tenderness. Avoid overly stressing the pat ient with unnecessarily severe discomfort
while conducting a tactile examination oft he auricle.
Behavioral monitoring: Thepractitioner should ask t he pat ient to rat e the degree of sensitivity
t hat is felt at each point on the auricle when pressure is applied. Like t he ashi points in body
acupuncture, one could simply have the pat ient say eit her ’Ouch’or There’when a region is
especially tender. Alternatively, one can use a range of numerical or verbal responses to indicate
the degree oft enderness. A value ofT or ’Slight’could indicate low level tenderness, ’2’ or
’Moderat e’could indicate middle level tenderness, ’3’ or ’Strong’could indicate high level
tenderness, and ’4’ or ’Very Strong’could indicate extremely high level tenderness. Spontaneous,
facial grimace reactions or behavioral flinches in response to applied pressure should also be
noted. A noticeable wince by the patient when you palpat e a specific point on the ear may not be
comfortable for the patient, but it is one of the best predictors t hat you are on an active reflex point
t hat is appropriat e for treatment. Nogier referred to the contraction of face muscles in response to
auricular palpation as the ’sign of the grimace,’ the most reliable indication t hat a ’real’ ear reflex
point has been located. The Chinese have developed a similar grading system where the degree of
facial grimaces and verbal expressions is rat ed as follows: (- ) for no pain, ( +) for flinching or
saying ’Ouch,’(++) for frowning, ( +++) for wincing, and ( ++++) for dodging away or saying
’t he pain is unbearable.’
5.3 Electrical detection of ear reflex points
Ofall the methods for conducting auricular diagnosis, examination of the auricle with an electrical
point finder is the most reliable and least aversive. Even small changes in electrodermal skin
resistance can be det ermined by electrical detection procedures. For many practitioners, the main
considerations are eit her the cost of a quality point finder or the extra time taken to first determine
the most reactive points. While both of these objections have their validity, the increase in accuracy
of discovering the most appropriat e ear point for diagnosis and t reat ment of t hat client is worth the
expense and effort. Familiarity allows even inexpensive but less sophisticated equipment to be used
in an effective manner.
Clean skin: Toexamine the ear with an electrical point finder, first clean the ear with alcohol to
remove sources of electrodermal skin resistance. High electrical resistance impairs t he electrical
point finder’s ability to discriminate active ear reflex points from normal regions of the auricle.
Sources of such unwanted skin resistance could include earwax, flaky skin, dust from the air,
make-up from the face, or hairspray ingredients.
Point finder: Use an electrical point finder designed for the ear by bot h its size and its electrical
amperage. Some probes designed for the body are inappropriat e for t he ear because they are too
big or use t oo high an electrical detecting voltage. Ear points are smaller, closer to the surface and
have lower electrodermal skin resistance than do body acupoints. The point finder should be a
spring-loaded, constant pressure rod with a small ball at the end. Even more selective are
concentric bipolar probes with a small rod in the middle and an out er barrel. Bipolar detecting
probes use differential amplification of the voltage difference between the two adjacent
electrodes. This procedure allows for maximum discrimination of the difference in electrodermal
Diagnosis procedures 137
A B
c D
Figure 5.3 Pressure palpation devices that are used on the auricle are shown on Point Zero (A) and the SympatheticAut onomicpoint
(R). A triangular stylus can be used to discern the indentation at landmark zero (C), and a spring-loaded stylus can maint ain constant
pressure while detecting reactive ear point s (D).
138 AuriculotherapyManual
skin resistance between adjacent skin areas. The auricular probe is applied to the ear by the
therapist, while anot her lead is held in t he patient’s hand.
Electrodermal measurement: Thepractitioner monitors decreased skin resistance, or inversely
stated, increased skin conductance, as t he probe is glided over the skin with one hand while the
ot her hand stretches out the auricle. Elect rodermal activity has also been designated as the
galvanic skin response (GSR), a measure of the degree of electrical current t hat flows through the
skin from the detecting probe to the hand held neutral probe. Electricity must always flow between
two points, thus for some point finders t hat do not utilize a hand held probe, it is imperative t hat
the practitioner touch the skin of the pat ient at the ear. Usually a light or a sound from the point
finder indicates a change in skin conductance. Dependingon the equipment ’s design, a change in
the electrodermal measurements leads to a change in auditory or visual signals to indicate the
occurrence of reactive auricular points.
Threshold settings: Some equipment requires an individual threshold to be set for each patient
before assessing ot her ear points. Toset the threshold, place the probe on the Shen Men point or
Point Zero, increase the detection sensitivity until the sound, lights or visual met er on the equipment
indicate that there is high electrical conductance. Next, slightly reduce the sensitivity until the Shen
Men point or Point Zero is only barely detected. It should be possible to find these two master points
in all persons examined, and they are usually reactive because they indicate the effects of everyday
stress in a person’s life. Shen Men and Point Zero may not be the most electrically active points on a
patient’s ear, but they are the two points most consistently identified in most people.
Probe procedures: Slowly glide the ear probe across all regions of t he auricle to det ermine
localized areas of increased skin conductance (decreased skin resistance). Moving the probe too
quickly can easily miss a reactive ear point. Applying t oo much pressure with the probe can create
false ear points merely because of the increased electrical contact with the skin. Holdthe auricular
probe perpendicular to the stretched surface of the ear, and gently glide the probe over the ear,
A B
Figure 5.4 Different electrical point finder devices have been developed in China (A) and in Europe (B). Astheprohe glides over the
surface of/ heear, changes in electrodermal skin conduct ance are shown bya variation in the rate ofa flickering light or in the frequency of
soundfeedback:
Diagnosis procedures 139
140
using firm but not overly strong pressure. Do not lift and poke with t he probe. Theot her hand
supports the back of the patient’s ear. It is important to follow the contours of the auricle while
applying the probe, checking both hidden and posterior surfaces as well as the front external
surface of the auricle. Theback of the ear is often less electrically sensitive than the front of the
auricle, but the posterior side of the ear is usually more t ender to applied pressure t han is the front.
Tomore readily find an ear point on the posterior surface, first det ect the point on the front of the
auricle, t hen put a finger on that spot and bend the ear over. It is now easier to search the back of
the ear for the identical region on the ant erior and the posterior surface.
5.4 Nogier vascular autonomic signal (N-VAS)
The auricular cardiac reflex was first described by Paul Nogier (1972), and was only later renamed the
Nogier vascular autonomic signal (N-VAS).The practitioner touches certain parts of the external ear
while monitoringthe radial pulse for either a decrease or an increase in pulse amplitude. The pulse
may seem to diminish and collapse, or it may seem to become sharper and more vibrant. The
modification of the pulse can occur anywhere from the second pulse beat up to the t ent hpulse beat
following auricular stimulation. Thischange in the N-VAScan last for 2 to 4 pulse beats. The stimulus
could be tactile pressure to the skin, but it could also be provided by holding a magnet over the ear
surface, by pulsed laser stimulation, by placing a colored plastic filter over the auricle, or by using a
slide that contains a specific chemical substance. Theart of this technique is in learning to feel the
subjective subtleties of the radial pulse. Classical pulse diagnosis as practiced in Oriental medicine
uses the three middle fingers lightlyplaced on the radial artery at the wrist (see Figure 5.5A). The
Nogier pulse technique requires placement of only the thumbover the radial artery (see Figure 5.5B,
5.5C). Rat her than feeling for steady state qualities of the pulse, N-VASis a change in pulse
amplitude and pulse volume that occurs in response to stimulation of the auricle. Mastery of this
technique requires many practice sessions with someone already skilled in the procedure.
Ackerman (1999) has proposed that N-VASexists as a specific autonomic biophysical response
system constitutingone of the principal coordinating and integratingsystems of t he body. At the
same time, N-VASis a pathway by which the central nervous system receives information and
modulates sympathetic outflow for precise modulation of the blood vascular system. N-VASis
thought to occur in every artery of the body and is expressed through changes in smoot h muscle
tone and blood influx. This vascular system is controlled by endothelium- derived factors, mainly by
the vasodilator nitric oxide (NO). NO acts directly on vascular smooth muscle cells to regulate
vascular tone. The release of NO is modulat ed bywall shear stress, frequency of pulsatile flow, and
amplitude of pulsatile flow.
Fromthe standpoint of information theory, the autonomic controlled blood vascular supply could
be represented as an analog system, contrary to the neurons t hat operat e as a digital system
consisting of on- or- offneural impulses. As an analog system, the vascular system is regulated by
the strength of flow, wavelength variations in its strength and the direction of flow. The adaptive
capability of the vascular system results from mechanical stimuli such as wall shear stress and
transmural pressure that is modulated by vascular muscle tone.
5.5 Auricular diagnosis guidelines
Ear as finaL guide: The auricular charts depicting different organs of the body are somatotopic
maps t hat indicate the general area in which a particular ear reflex point could be found. However,
it is the measured reactivity of specific sites on the auricle which serves as the best det erminant of
the exact location of an appropriate ear point. By monitoringthe heightened t enderness to applied
pressure and the increased electrical conductance at a specific locus, one is able to select the most
relevant ear points t hat represent body pathology. The ear charts indicate a territory of the auricle
where the correct point may be found, but t here are several possible spots within t hat region to
choose from. Only the most reactive ear points definitely represent the actual location of the
somatotopic site. Ifthere is no reactive ear point in a region of the auricle, t here is no body
pathology indicated for treatment. Ift here is no pathology in the corresponding body area, there
will be no tenderness or electrical activity at the related microsystem point on the ear. When
choosing between different ear points to treat, whet her it is in the Chinese system or the European
system, whet her it is in the Nogier first phase or second phase, this fundamental principle, that t he
ear itself is the final guide, should always be followed.
Aur;culotherapyManual
A
B
Diagnosis procedures
c
Figure 5.5 In Oriental pulse diagnosis (A), three
fingers are placed on each wrist to detect differences in
theposition, depth and qualities ofthe steady pulse.
Practitioners ofauricular medicine in Europe hold the
wrist at only one position (B) andfeel for changes in
the amplit ude and waveform ofthe radial pulse in
response to stimulation ofthe ear by light passing
through a filter (C).
141
142
Alternative points within an area: The actual auricular point consists of a small site within a
general area of the auricle indicated by t he somat ot opic auricular map. The ear reflex point
representing a part icular part of the body can be found in one of several possible locations within
this area. In some individuals, the ear point will be found in one auricular location, whereas in
ot her persons, it will be found in a nearby but different auricular location. The location of a point
may change from one day to the next, thus it is essential t hat one checks for t he ear point t hat
exhibits t he highest degree of reactivity at the time someone is examined.
Ipsilateral ear reactivity: In 80- 90%of individuals, reactive ear reflex point s are found on the
same ear as the side of body where t here is pain or pathology. In t he remaining 10- 20% of cases,
the represent at ion is cont ralat eral, and t he most active ear point is found on the opposit e side of
the body. Since most clinical problems have a bilateral represent at ion, it is common to t reat bot h
the right and the left ears on a patient. Iftreatingjust one ear of a pat ient , it is usually best to
stimulate t he ear which is ipsilateral to t he side of t he body with t he great est degree of discomfort.
Those few persons who exhibit cont ralat eral auricular represent at ion of a body problem are
referred to as lateralizers or oscillators, and need special consideration.
5.6 Assessment of oscillation and laterality disorders
Persons who have difficulties with neural communication between the left and the right sides of the
brain are referred to as having problems with laterality or oscillation in the European school of
auriculotherapy. This crossed-laterality condition is sometimes identified as ’switched’ or ’cross-wired’
in certain American chiropractic schools. It is as if the two cerebral hemispheres are competing for
control of the body rat her than working in a complementary fashion. Laterality problems are typically
found in the 10- 20%of the population which exhibits higher electrically conductivity at ear reflex
points on the contralateral ear than on the ipsilateral ear. Usually these patients show high electrical
conductance at the Master Oscillation point, but not everyone who has an active Mast er Oscillation
point is an oscillator. Oscillation can also be due to severe stress or dental foci. TheMast er Oscillation
point in patientswith laterality disorders needs to be corrected with acupressure, needling or
electrication stimulation before that patient can receive satisfactory medical treatment.
It is believed that many functional disorders are due to dysfunctions in the interhemispheric
connections through the corpus callosum, the anterior commisure and the reticular formation of the
brain. Thereis inappropriate interference of one side of the brain by the ot her side of the brain.
Global relationships t hat should be processed by the right cerebral hemisphere are analyzed by the
left cerebral cortex. Verbal information t hat should be processed by the left cerebral hemisphere is
processed by the right cerebral cortex. Such individuals frequently exhibit dyslexia, learning
disabilities, problems with orientation in space and are susceptible to immune system disorders.
People with laterality problems report t hat they often had problems in elementary school with poor
concentration, stuttering, spelling mistakes, attention deficit, and feeling ’different’from others. As
adolescents, they experienced frequent anxiety, hyperactivity, gastrointestinal dysfunctions and they
often misgauged distances or tripped over things. Oneway a person may recognize t hat they are an
oscillator is that they have overly sensitive or rat her unusual reactions to prescription medications.
Dysfunctions of laterality and oscillation are found more often in left- handedor in ambidextrous
persons. Theproportion of dyslexia and ot her learning disorders is significantly higher in left›
handers t han in right -handers. Laterality problems are rarely noticeable before the age of two, but
cerebral organization begins to be definitely lateralized by the age of seven, the ’age of reason.’ It is
from this age t hat disorders of laterality may first appear.
5.6.1 Physical t est s for t he presence of laterality disorders
Handwriting: Have a person write something. Which hand did they use, the right hand or the left
hand? Many individuals were t rained to write with t heir right hand when they were children, even
though they were naturally left handed. For t hat reason, some of the following tests may be a more
aut hent ic appraisal of t heir actual laterality preference.
Hand clap: Have a person clap t heir hands as if they were giving polite applause at a social
function, with one hand on t op of the ot her hand. Which hand is on t op?
Hand clasp: Have a person clasp their hands, with the fingers interlocked. Whicht humbis on top?
Armfold: Have a person fold t heir arms, with one arm on top of t he ot her. Which arm is on t op?
The hand t hat touches t he crease at the opposit e elbow is considered the arm t hat is on top.
AuriculotherapyManual
Foot kick: Have a person pret end to kick a football. Which foot do they kick with, t he right or the
left foot?
Eye gaze: Have a person open bot h eyes and t hen line up t he raised t humbof t heir out st ret ched
hand toward a small point on the opposite wall. Alternatively, have t he person make a circular hole
by pinching t heir middle finger to t heir thumb, then look at the spot t hrough the hole. In eit her
case, next have t hemclose first one eye, open again, t hen close t he ot her eye. Closing one eye
produces a great er shift in alignment with the object on t he opposit e wall t han closing the ot her
eye. Ifthe object shifts more on closing t he right eye, t hen the right eye is dominant; if the point
shifts more on closing the left eye, t hen t he left eye is dominant. Alternatively have someone notice
which eye they would leave open and which they would close if they were to imagine shooting a
target with a rifle. The eye used for aiming the rifle would be t he dominant eye.
5.6.2 Scoring laterality tests
Each of the above behavioral assessments is scored as either right or left. Ifa person scores 4 or more on
the left side, that individual is likely to have a laterality dysfunction. Theymight also have problems with
spatial orientation, dyslexia, learning difficulties, allergies, immune system disorders and unusual
medical reactions. Laterality does not necessarily produce a medical problem, as many individuals learn
to compensate for this imbalance over the course of their life time. At the same time, they may have
certain vulnerabilities that conventional medicine does not allowfor. The dosage and incidence of side
effects of Western medications are based on the average response by a large group of people, but do not
take into account the idiosyncratic reactions of unusual individuals. Persons with laterality dysfunctions
must be very careful about the treatmentsthat theyare given because of their high level of sensitivity.
5.7 Obstructions from toxic scars and dental foci
In addition to idiosyncratic problems attributable to laterality disorders, ot her factors may also
interfere with subsequent pathologies t hat have a longstanding nat ure. The failure to completely
heal from one condition may act as a source of disequilibrium t hat blocks t he alleviation of newer
health problems. Twosuch sources of obstruction are (1) toxic scars from old wounds or previous
surgeries, and (2) damaged tissue from invasive dent al procedures. Toxic scars could occur on the
skin surface or in deeper structures, creating a region of cellular disorganization t hat emits
abnormal electrical charges. This pathological tissue generat es a disharmonious resonance causing
chronic stress and interference with general homeostatic balance. Abnormal sensations, such as
itching, numbness, pain or soreness, oft en occur in the region of toxic scars. Besides checking the
region of t he external ear t hat corresponds to a body area t hat was previously injured, also examine
the skin disorder region of the external ear. Dent al procedures, such as removing decayed t eet h or
drilling a root canal, are beneficial for dent al care, but they may also leave a dent al focus that
interferes with general healt h maintenance. Dent al foci may follow dent al surgery, be related to
bacterial foci under a filling, or result from an abscess or gum disease. Theremay also be
pathogenic responses to mercury fillings. Patients themselves are oft en unaware of having such a
disorder, since the consequence of these previous scars may not necessarily be experienced at a
conscious level. These pathological regions may be electrically det ect ed at the auricular area that
corresponds to the site of t he toxic scar or dental focus. Theymay also be discovered by monitoring
the N-VASresponse to stimulation of t he affected region of the body. Only when this toxic scar
region is successfully t reat ed can ot her healt hcare procedures be effective.
Sometimes one’s own personal experience is the most impressive source of confirmation for accepting
a newconcept in healthcare. WhenI was an adolescent, I dislocated my right shoulder during a
skateboard accident. I also had mywisdom teeth removed by an oral surgeon. As I became an adult,
the chronic stress of everyday living was most strongly manifest as discomforting shoulder aches, but I
never experienced jaw pain. Frequent massages, chiropractic adjustments, acupuncture sessions and
auriculotherapy treatmentsall produced temporary relief of the shoulder pain, but there was no stable
resolution. Myears were recently examined bya Germanphysician who practices auricular medicine.
Dr Beate Strittmatterrevealed a toxic scar at the location of the wisdom tooth at the left lower jaw.
Theinsertion of a needle at a point on the left ear lobe which corresponded to the left mandible was
added to stimulation of the Shoulder point on the right auricle. This t reat ment of the dental
obstruction as well as the corresponding Shoulder point on the auricle led to an immediate correction
of a shoulder condition that had been a problem for years.
Diagnosis procedures 143
144
5.8 Scientific investigations of auricular diagnosis
Auricular diagnosis is mostly used for det ect ion of active points on t he ear which need to be
treated, rat her t han as a primary means of diagnosing a patient. Nonetheless, findings from
auricular diagnosis can reveal a clinical problem missed by ot her medical examination procedures,
or verify a problem only suspected from ot her diagnostic tests. Physical auricular reactions may
appear before the body symptoms appear or reveal a permanent reactive mark of pathology in the
corresponding body organ. The auricular points change with the various stages of an illness or
injury, including the initial occurrence, cont inued development, and ultimate resolution. Reactive
auricular points reflect t he ongoing information about a disease, not only t he healt h condition
occurring in the present. It can indicate the state of an illness or injury in the past or in the near
future. Positive auricular points may have a different appearance in different stages of a diseases
and indicate when a pathology is completely healed.
At the 1995InternationalSymposium on Auricular Medicine in Beijing, China, several scientific
studies indicated that auricular diagnosis has been used to detect malignant tumors, coronary heart
disease and pulmonary tuberculosis. Onestudy found t hat 36 of 79 cases of colon cancer showed dark
red capillaries in the superior concha, 54 of 78 cases of lung cancer revealed brown pinpoint
depressions scattered in patches in the inferior concha, and 16of 31 cases of uterine cancer showed
spotted depressions in the internal genitals area of the concha wall. No such changes in the color or
the morphology of corresponding ear points were found in normal control subjects. Anot her
investigation showed that 116patients out of 1263hospitalized patients had reactive Liver points on
the ear. Further examination of these 116patients revealed 80 cases of hepatitis. Still anot her study
found that of 84 cases diagnosed with ultrasound to have gall bladder disease, 81% showed a dark red
region in the gall bladder area of the auricle. In 93% of cases of chronic gastritis, the stomach and
duodenum auricular regions appeared white, shiny and bulgy when there was no acute infection. In
contrast, these two points appeared deep red when there was an acute gastric disorder. The results of
using pressure or electronic detection were essentially the same as visual observation.
Dr Michel Marignan (1999), of Marseilles, France, report ed on his investigations with digital
thermographyof the ear at the International Consensus Conference on Acupuncture,
Auriculotheraphy, and Auricular Medicine (ICCAAAM).Skin t emperat ure radiations from the
auricular surface were measured with an infrared camera. Thephot ographyequipment was cooled
with liquid nitrogen and a comput er was especially adapt ed for this procedure. The t emperat ure
variations of radiation across the human ear changed in response to stimulation of various areas of
the ear pavilion. Marignan suggested t hat reactive auricular points are due to microscopic t hermal
regulation. The evidence of correspondence between anatomical localization and t he auricular
thermal reaction provided a scientific basis for auriculotherapy. At t he same ICCAAAM
conference, Edward Dvorkin (1999) of Israel examined ’active’ auricular points from skin samples
obtained in humans undergoing surgery. Some skin samples correspond to ear points t hat were
detected before surgery by monitoringt he Nogier vascular aut onomic signal and by electrical
detection. Small pieces of skin were taken from healthy tissue at the surgical edges of auricular
regions corresponding to the Thalamus point, the Allergy point, t he Ant idepressant point and the
Aggressivity point. A neut ral part of the auricular skin of each pat ient was also t aken for
comparison examination. Electron microscopy examination of ult rat hin sections of all the studied
zones revealed the following findings:
thick nerve bundles with myelinated as well as non- myelinated nerve fibres;
solitary thin bundles of non- myelinated nerve fibres;
mast cells related to blood vessels and nerves;
numerous veins without innervation;
solitary arteries without innervation.
However, no specific ultrastructure or morphological subst rat um was found in Dvorkin’s study for
’active’ ear reflex points compared to neut ral ear points. The distinctive characteristics of active
auricular points must thus be based on physiological rat her t han anatomical st ruct ural differences.
The research by Marignan suggests that peripheral sympathetic nerve control of blood vessels
supplying t he auricle can bet t er account for active auricular points.
AuriculotherapyManual
II
Auriculotherapy t reat ment procedures
6.1 Auricular acupressure
6.2 Ear acupuncture 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 in auriculotherapy
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 wit h auriculotherapy
6.14 Hindrances to treatment success
6.15 Overall guidelines for auriculotherapy treatments
6.1 Auricular acupressure
I. General massage: Stroke broad regions of the external ear by rubbing the t humb against the
front of the auricle, while the tip or length of the index finger is held against the posterior side of
the ear for support. First stroke down the tragus with the thumb, then spread the strokes across the
ear lobe to induce a general calming effect. Next, stroke from the beginning of the helix root at
landmark zero and rise up and around the curving helix, ending at t he base of the helix tail.
Proceed by stroking across the antihelix tail, beginning at the base, t hen work up the antihelix. In
each case massage across the inner ridge of the antihelix outward toward the scaphoid fossa and
helix rim. End with gentle strokes t hroughout the superior concha, concha ridge, and inferior
concha. Ifpatients are taught to do this procedure on themselves, t heir index finger is used on front
of the ear and their t humbis placed on the back of the ear.
2. Specific massage: Apply a metal stylus with a small ball at the end (see Figure 6.1) to the auricle.
Palpate the most reactive ear point determined during auricular diagnosis. You could also use the
eraser end of a pencil or a fingertip. Hold the auricle t aut with the opposite hand. Micromassage of
an ear point may first lead to an increase in pain at that point, but the tenderness can gradually
diminish and disappear as the massage is continued. Thedirection of massage can vary. Adopt the
one that is least tender and most tolerable for the patient. For neck, back and shoulder tension, apply
firm but gentle pressure on the antihelix tail, antihelix body, inferior crus and scaphoid fossa. For
headaches, specific pressure is applied to the antitragus and antihelix tail. Visceral dysfunctions are
treated with the stylus probe pressed against specific regions of the concha.
3. Auriculopressure techniques: Massage each t ender ear point for 1 to 2 minutes, repeating the
process once or twice daily. Apply massage with a circling motion, first noticing which direction
produces the least discomfort. A more longitudinal massage along t he out er helix or antihelix
reduces muscle tension and sympathomimetic excess excitation. Descending longitudinal strokes
tend to tonify muscles and excite sympathetic activity, while ascending longitudinal strokes tend to
relax muscles and enhance parasympathetic tone. A radial centrifugal massage away from
landmark zero across the concha enhances parasympathetic sedation and visceral relaxation.
Treatmentprocedures 145
146
Figure 6.1 Ear acupressure massage can be activated witha metal stylusapplied tospecificparts oftheauricle
whiletheopposinghand provides back pressure.
Massaging the tragus downward and outward, from superior to inferior, can augment cellular
reactions and interhemispheric communication, whereas massaging t he tragus upward and inward,
from inferior to superior, tends to slow down metabolism and calm interhemispheric
communication between the two sides of t he brain.
6.2 Ear acupuncture needling techniques
1. CLean ear: After conducting any visual inspection necessary for auricular diagnosis, clean the
ear with alcohol. This sterilizes the skin and removes wax, oils, sweat, grease, make- up and
hairspray. Besides its antiseptic value, removing oily substances from the skin surface of the ear
improves t he ability to det ect auricular points with electrical point finders.
2. Prepare needLes: Unpack at least 5 sterilized 0.5 inch (15 mm) needles, to be inserted ipsilaterally
or bilaterally. Shorter needles are preferred, since longer needles tend to fall out too easily. Thicker
needle diameter sizes of30 gauge (0.30 mm), 32 gauge (0.25 mm) or 34 gauge (0.22 mm) are preferred
for the ear, since thinner needles tend to bend on insertion. Stainless steel needles are appropriate for
most clinical purposes, although better results are sometimes obtained by using gold needles on one
ear and silver needles on the opposite ear. Knowledge of the Nogier vascular autonomic signal is
necessary to determine whether gold or silver needles are more appropriate for which ear.
3. Determine treatment pLan: Examine the specific t reat ment plans listed in the last section of
this text to select the auricular points which are most appropriat e for the condition being treated.
A typical t reat ment includes the corresponding anatomic points, selective mast er points and
supportive points listed for that condition. You should not t reat all of the ear points listed, only
those which are the most t ender and show the highest electrical conductance.
4. SeLect ear points: Det ect 2 to 6 points on each ear with an electrical point finder, selecting only
the most reactive points. The point finder should be spring- loaded and will leave a brief
AuriculotherapyNanual
Figure 6.2 Needle insertion techniques demonstrated on a rubber modelear.
indentation at the ear point if stronger pressure is applied when a reactive ear point is detected.
Use that indentationfor identification of the region of the auricle where the needle should be
inserted. The order in which auricular points are needled depends more on the practical
convenience of their location t han on the priority of their importance for treating t hat specific
condition. Needles are first inserted into ear points which are located in more central or hidden
regions of the auricle because needles in more peripheral areas of the ear would get in the way.
5. Needle insertion: First stretch out t he auricle with one hand while using the ot her hand to
hold the needle over the appropriate ear point (see Figure 6.2). Avoid doing one- handedear
acupuncture, only using the hand holding the needle. Insert the needle with a quick jab and a twist
to a depth of 1 to 2 mm. Theneedle should just barely penet rat e the skin, but it is acceptable if it
touches the cartilage. The needle should be inserted deep enough to hold firmly, but not so deep
that it pierces through to t he ot her side (see Figure 6.3). Be careful not to let the needle pierce the
hand that is stabilizing the patient’s ear.
It is usually more comfortable for the patient if the needle is inserted on the patient’s inhalation
breath. The patient may gasp or choke when a needle is inserted into a particularly sensitive
region. Even though the needle may produce intense discomfort on first insertion, this adverse
effect is short lived and t he pain quickly subsides. The intensityof pain at an auricular point is
usually a sign that the point is appropriate for treatment. Guide tubes t hat are often used to insert
needles into body acupuncture points are not needed because of the shallow depth of ear points. It
is bet t er to locate the needle by sight precisely over an ear point previously identified by skin
surface indentation from a point finder. Insert all the needles you plan to use at one time and leave
them in place. You may periodically twirl the needles to maintain a firm connection and to further
stimulate t hat auricular point. Bleeding may occur when a needle is withdrawn from the ear, but
gentle pressure applied to the point usually stops the bleeding within a few seconds.
6. Treatment duration: Leave all the inserted needles in place for 10-30 minutes, then remove and
place the used needles in an approved container. Some needles fall out before the session is over,
which tends to indicate that the particular needle insertion point had received sufficient stimulation.
Treatmentprocedures 147
148
Figure6.3 Half-inch needles inserted into the auricular acupoints Shen Men, Point Zero, and Thalamus point.
7. Number of sessions: Treat 1- 3 t imes a week for 2- 10 weeks, t hen gradually space out t he
t reat ment sessions. A given condit ion may require as few as 2 or as many as 12 sessions, depending
on t he chronicit y and severity of t he problem and on t he pat ient ’s energy level. If aft er 3 sessions
t here is no improvement in t he condit ion, eit her use a different set of ear point s or try anot her
form of t herapy.
6.3 Auricular electroacupuncture stimulation (AES)
1. Ear needling t echniques: For elect roacupunct ure, first use needling t echniques described in
t he previous sect ion to det ect t he appropriat e ear point s and to insert t he needles.
2. Tape needles: In order to hold t he insert ed needles securely in place, t ape t he needles across
t he ear wit h medical adhesive t ape. At t achingt he st imulat ing elect rodes will t end to pull out t he
needles, unless they are first fast ened with prot ect ive t ape.
3. At t ach elect rodes: Use microgat or clips to connect t he insert ed needles to t he elect rode leads
of an electrical st imulat or (see Figure 6.4). Because t hese moveable clips may pull out t he insert ed
needles when at t ached, make sure t hat t he needles are first securely t aped in place. It is also wise to
fasten t he elect rode wires to a secure anchor so t hat t he wires will not drag on t he needles and pull
t hem out .
4. Electrode pairs: It is always necessary to st imulat e bet ween two needles, as electricity flows
from a positive to a negat ive pole. It does not usually mat t er which pole of t he st imulat or is
at t ached to which ear point , but if t he pat ient report s any increase in pain, try switching t he
elect rode leads to t he opposit e polarity.
5. Frequency paramet ers: Preset t he elect rical frequency rat e to eit her a slow 2 Hz or 10 Hz
frequency, or to a paramet er known as dense- disperse, where 2 Hz frequencies are alt ernat ed
wit h 100 Hz frequencies (see Figure 6.5). Lower frequencies, 10 Hz or less, affect enkephalins,
endorphins, and visceral and somat ic disorders, whereas higher frequencies, 100 Hz or higher,
affect dynorphins and neurological dysfunct ions.
AuriculotherapyManual
A
B
Figure 6.4 Alligatorclipelectrodes attachedtoneedlesinserted intotheShenMenand Lungpointsoftheauricle (A). Electroacupuncture
stimulationequipmentisshownwithelectrode wires leadingtoneedlesin a rubberear model (B). Needlesin thisfigure are not shown taped to
theear toallowgood visualization oftheattachment ofelectrodes to theacupuncture needles, hut theywould typically he taped securely in
place.
Treatmentprocedures 149
Hz
5 Hz frequency
20 llA current intensity
1.0 s stimulus duration
10 Hz frequency
40 llA current intensity
2.0 s stimulus duration
1.0 s
Figure 6.5 Thestimulation parameters used in activating auricular acupoints can vary byfrequency in cycles per second, byintensityin
current amplitude, and by duration in the numberofseconds a point is stimulated.
6. Current intensity: Gradually raise the electrical current intensity to a percept ible level and
t hen reduce it to a subpain threshold. The electrical stimulation intensity should not be painful.
7. Treat mentsessions: As with auricular acupunct ure without electrical stimulation, leave the
needles in place and maintain the stimulation current for 10- 30minutes. Treat the pat ient once to
t hree times a week, for 2 to 10weeks. While more cumbersome to apply t han needle insertion alone,
electroacupuncture is typically more powerful and more successful in relieving pain and alleviating
the problems of addiction.
6.4 Transcutaneous auricular stimulation (TAS)
I. Overview: In this t reat ment met hod, the t herapist det ect s and stimulates each ear point with
the same electrical probe. The auricular point is det ect ed and t hen immediately t reat ed with
microcurrent stimulation before moving on to the next ear point. It is a form of t ranscut aneous
electrical nerve stimulation (TENS)or neurost imulat ion and can be medically billed as such.
Before beginning auriculotherapy, it is best to have t he pat ient repeat t hose movements, or
maintain those postures, which most aggravate his or her condition. It is also useful for the
pract it ioner to put physical pressure on t hose body areas which are painful. Onecan thus establish
a behavioral baseline from which t here can be seen a change as a result of t he t reat ment . The same
movements, postures, or applied pressures are repeat ed following t he t reat ment . This practice
t ends to eliminate doubt s about the procedure which oft en occur when only subjective impressions
are elicited. A facial grimace by the pat ient during movements, or in response to pressure, is much
more convincing t han verbal assessments t hat ’it hurt s.’
2. Clean ear: Clean t he external ear with alcohol to eliminate skin oil and surface flakiness.
Having a clean auricular surface is very import ant for det ermining t he accuracy of reactive ear
points t hat will be t reat ed with t ranscut aneous auricular stimulation.
3. Determinet reat ment plan: As with ot her auricular procedures, consult the specific t reat ment
plans listed in last section of this text to select t he auricular points which seem most appropriat e for
the condition being t reat ed. First t reat local anat omic points corresponding to specific body
symptoms. Ift here is more t han one local point, only t reat the most t ender and most electrically
conductive local points. Next t reat mast er points and supportive points.
150 AuriculotherapyManual
A
B
Figure 6.6 Transcutaneous stimulation ofthe skin surface ofan auricular acupoint and the hand held reference probe (A). Stim Flex
equipment that provides a probe for both auricular detection and auricular stimulation (B), one ofseveral possible electrical stimulation
devices.
Treatmentprocedures 151
152
4. Threshold setting: Some inst rument s require t he pract it ioner to first set a t hreshold level by
raising the sensitivity of t he unit to allow electrical det ect ion of the Shen Men point or Point Zero.
Most reactive corresponding points are typically more electrically conductive t han Shen Men or
Point Zero, but t hese two mast er points are more consistently active in a majority of clients.
Sometimes, by first stimulating one of t hese two mast er points, ot her auricular point s become
more identifiable for detection. This process is called ’lighting up t he ear.’
5. Auricular probe: Apply the auricular detecting and stimulating probe to the external ear,
stretching the skin tightly to reveal different surfaces of t he ear. Thepract it ioner’s ot her hand
support s the back of the ear so t hat bot h it and the probe are steady. Gent lyglide t he auricular
probe over the ear, holding the probe perpendicular to t he ear surface. Do not pick up the probe
and jab at different areas of the ear. Thepat ient usually holds a common lead in one of t heir hands
in order to complete a full electrical circuit. Electric current flows from t he stimulating equipment
to the elect rode leads to t he ear probe held to the pat ient ’s auricle. Current t hen passes t hrough
the pat ient ’s body to the pat ient ’s hand to the metal common lead. Finally, the current goes
t hrough t he ret urn elect rode wires and back to the electronic equipment . Ift here is some problem
with stimulation, be sure t hat all part s of the circuit are complete. Therecould be a break in
elect rode wires or the pat ient may fail to cont inue holding t he common lead.
6. Detection mode: Diagnosis of reactive ear points is achieved with low level direct current
(DC). The microcurrent levels used for detection are usually only 2 microamps in st rengt h. The
detecting cycle is usually indicat ed by a change in a cont inuous t one or by a light t hat flashes when
a reactive point is det ect ed.
7. Stimulation mode: Reactive ear point s discovered during auricular diagnosis are t reat ed with
alternating current (AC). Themicrocurrent levels used for t reat ment are typically 10- 80 microamps
in strength. Thet reat ment cycle is usually indicated by a pulsating t one or a flickering light. It is
usually necessary to press a but t on on t he auricular probe while it is held in place at a reactive ear
point. Det ect and stimulate one ear point before proceeding to the next ear point.
8. Stimulation frequency: Preset the frequency rat e of stimulation, measured in cycles per
second or Hert z(Hz), by the specific zone of the ear to be st imulat ed or by the type of body tissue
to be t reat ed. Although Asian electronic equipment is oft en supplied with only one frequency,
usually 2 Hz or 10Hz, American and European electronic equipment comes with a range of
frequency rates to choose from. The specific frequencies developed by Nogier are as follows:
2.5 Hz for the subtragus, 5 Hz for the concha, 10Hzfor the antihelix, antitragus and superior helix,
20 Hz for t he tragus and intertragic notch, 40 Hz for t he helix tail, 80 Hz for the peripheral ear
lobe, and 160 Hz for the medial ear lobe. The type of organ tissue being t reat ed is also a factor,
with 5 Hz used for visceral disorders, 10 Hz for musculoskeletal disorders, 40 Hz for neuralgias,
80 Hz for subcortical dysfunctions and 160 Hz for cerebral dysfunctions.
9. Stimulation intensity: Set the intensity of stimulation by the pat ient ’s pain t olerance, usually
ranging from 10- 80 microamps. Lower t he current intensity if the pat ient complains of pain from
the auricular stimulation. Ifeven the lowest intensity is experienced as painful, t hen only auricular
acupressure should be used at t hat ear point. A major problem with electrical stimulators t hat arc
designed for treating the body as well as t he ear is t hat the skin surface on t he body has a much
higher resistance t han does the ear. Consequently, electrical current levels t hat are sufficient to
activate body acupoints are too intense for stimulating auricular points. Pract it ioners should be
clear not to confuse stimulation frequency with stimulation intensity. Frequency refers to the
number of pulses of current in a period of time, whereas intensity refers to the amplit ude or
strength of the electric current . Only intensity is relat ed to perceived pain, whereas frequency is
related to the pat t ern of electric pulses.
10. Stimulation duration: Treat each ear point for 8- 30seconds, sometimes treatingfor as long as
2 minutes in chronic conditions, addictions or very severe symptoms. Anat omicpoints are usually
t reat ed for over 20 seconds, whereas mast er points may only require 10 seconds of stimulation.
11. Number of ear points: Treat 5 to 15 points per ear, using as few auricular point s as possible.
Usually t reat the external ear ipsilateral to the corresponding body area where t here is pathology.
12. Bilateral stimulation: Aft er t reat ing all the point s on the ipsilateral ear, st imulat e points on
the opposit e ear if the problem is bilateral, i.e. in most healt h problems. Even when the problem is
localized on one side of the body, it is oft en useful to t reat the mast er points on bot h ears.
AuriculotherapyManual
13. Tenderness ratings: The precise ear points det ect ed and the level of stimulation intensity
used depends partly on the degree of tenderness experienced by the patient. Ratings of tenderness
could be a verbal descriptor or could be numbers on a scale of 1 to 10 or ’0, 1,2,3’levels of
increasing discomfort. Ask the patient to monitor the area of bodily discomfort while you stimulate
the ear. Continuetreating an ear point longer if the symptom starts to diminish, or ift he patient
notices sensations of warmth in the area of the body where the symptom is located. Ifno symptom
changes are noticed within 30 seconds, stimulate anot her point.
14. Number of sessions: Twoto ten auriculotherapy sessions are usually required to completely
relieve a condition, but significant improvement can be noticed within the first two sessions. By
monitoringperceived pain level in a body region, and bydeterminingthe range of movement of
musculoskeletal areas, one can more easily determine the progress of the auriculotherapy treatments.
These behavioral assessments should be conducted before and after an auriculotherapy session. For
internal organs and neuroendocrine disorders, there is often no specific symptom to notice, so one
must wait to observe a change in the patient’s condition. Even for musculoskeletal problems, there
may not be a marked relief of pain for several hours, so the patient should continue to monitor their
symptoms for the next 24hours after a session.
15. Laser stimulation: The exact procedures described above can be applied to laser stimulation
as well as to electrical stimulation. Both laser stimulation and transcutaneous electrical stimulation
are non-invasive procedures and they seem to yield similar results. However, at the present time,
the US Food and DrugAdministration (FDA) has not approved the use of laser stimulation for
auriculotherapy in the Unit ed States. Surface electrical stimulation of the external ear is FDA
approved as a form of transcutaneous electrical nerve stimulation.
16. Medical billing: Tobill for auriculotherapy as TENS,assign the CPTCode 64550 for peripheral
nerve neurostimulation or CPTCode 97032 for electrical stimulation with constant therapist
attendance. CPTCode 97781for acupuncture with electrical stimulation can also be used.
17. St imulat ion equipment: Various American, European and Asian manufacturers produce
electronic equipment designed for auricular stimulation, ranging in price from $80 to $8000 (US).
Among the units available in the United States are the Acuscope, Acumatic, Alpha-Stim, Stim
Flex 400, Hibiki 7, Neuroprobe and Pointer Plus. Addresses and t elephone numbers for these
manufacturers are found at the back of this book.
6.5 Auricular medicine
European doctors who monit or the Nogier vascular autonomic signal (N-VAS)to det ermine which
ear points to stimulate refer to this clinical procedure as aurieular medicine rat her t han
auriculotherapy. The somatotopic cartography of the auricle is verified by a positive or a negative
change in radial pulse amplitude following tactile pressure at specific points on the auricle. N-VAS
can also be activated by the positive or negative poles of a magnet. Different sides of a two-prong
polarized probe are used to elicit the change in pulse qualities which indicate the reactivity of
specific areas of the ear. Needles are then inserted into the identified ear points, or sometimes they
are t reat ed with laser stimulation. As the focus of this book is the description of auriculotherapy
procedures, rat her t han auricular medicine, further explanation of this more advanced technique
is omitted here.
6.6 Seven frequency zones
Nogier identified seven specific regions of the body t hat resonat ed with seven basic frequencies.
Thespecific frequency associated with each body region was det ermined by holding different
colored transparency slides over the auricle and notingwhet her t hat color could balance
disturbances of N-VASresponse. Alternatively, Nogier would stimulate the ear or the body with
different frequencies of a flashing white strobe light. Thebody regions were differentiated with
letters A t hrough G (see Figure 6.7). Each let t er also indicated certain types of health conditions
t hat were related to the type of tissue of t hat organ region. Thecolor and number of a Kodak›
Wrattenfilter that relates to each frequency zone of t he body is present ed in the second and third
columns of Table 6.1. Individual colors have different frequencies of oscillating phot ons of light,
progressing from the lowest frequency of red to progressively higher frequencies in a rainbow or
prism. Nogier determined t hat the effects of progressively short er wavelengths of different colored
Treatmentprocedures 153
Internalorgans
zone B
5 Hz
Musculoskeletal body
zoneC
10 Hz
Frequency rates for body regions
Cerebral cortex
zone G
160 Hz
Subcortical brain
zone F
80 Hz
Intercellular core
zoneA
2.5 Hz
Frequency rates for auricle regions
Corpus callosum
zone D
20 Hz
Antihelix
zone C
10 Hz
Concha
zone B
5 Hz
Subtragus
zoneA
2.5 Hz
Tragus
zone D
20 Hz
Helix tail
,.""’__- - -zone E
40 Hz
Peripheral lobe
~ I - f ' : r - - - - - - - - zone F
80 Hz
Centrallobe
zone G
160 Hz
Figure6.7 Seven frequency zones ofthe body are designated bythe letters A for 2.5Hz, Bfor 5 Hz, Cfor 10 Hz, Dfor 20 Hz, £for40 Hz,
F’[or 80 Hz, and G for 160 Hz. These same frequencies are related to different regions ofthe auricle and different types ofsomatic tissue.
154 AuriculotherapyManual
Table 6.1 Color, electrical and laser stimulation frequencies
Zone Color Wratten Electrical Exact Laser Correspondingauricular areas
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, Intertragic notch
- - , - _ . ~ - " . _ .._._" ... ~ _ .. -
E Green #44 40.0 36.50 4672 Helix tail
F Blue #98 80.0 73.00 9334 Peripheral ear lobe
G Purple #30 160.0 146.00 18688* Medial ear lobe
"Inclinical practice, theharmonic resonance frequency of 146 HZ isusedfor laser stimulation because such a rapid
frequency rate of 18kHz tendstooverheat thelaser equipment.
light filters on body tissue could also be found with progressively higher frequencies of flashing
light, faster frequencies of electrical pulses, or higher frequencies of laser stimulation.
The electrical frequencies for each zone of the body are present ed in column 4 of Table 6.1 and
the exact body resonance rates are present ed in column 5. Each rat e is twice the rat e of the
frequency below it. Concha and visceral disorders are stimulated at 5 Hz, antihelix and
musculoskeletal disorders are stimulated at 10 Hz, and t he highest frequencies of 160 Hz relate
to cerebral and learning disorders. The corresponding frequencies for laser stimulation are
present ed in column 6, with the last column reserved for the areas of auricular anatomy relat ed
to each frequency zone. Some pract it ioners of auricular medicine have suggested t hat these
seven resonant frequencies are relat ed to the energies of t he seven primary chakras of ayurvedic
medicine. In some energetic systems, each chakra is associated with the different colors of the
spectrum, from red to orange to yellow to green to blue to violet to white light.
Anatomical zones and energy expressions of different frequencies
Zone A- Cellular vitality: This zone runs up the midline of the physical body like the acupuncture
channels of the ConceptionVessel and Governing Vessel in Oriental medicine and like the
sushumna nadi of ayurvedic medicine. The auricular area for this 2.5-Hzzone is the subtragus. It
affects primitive reticular energy and the primordial forces t hat affect cellular organization. This
frequency often occurs at the site of scars and tissue disturbance and relates to the embryonic
organization of cellular tissue. It is used to t reat cellular hyperactivity, cellular proliferation,
inflammatory processes, neoplastic cancers, tumors or tissue dedifferentiation.
Zone B- Nutritional metabolism: This zone affects internal organs. The frequency of 5Hz is the
optimal rat e for stimulating points in t he concha of the auricle. Affecting vagal nerve projections to
visceral organs, the 5 Hzfrequency is used to t reat nutritional disorders, assimilation disorders,
tissue malnutrition, neurovegetative dysfunctions, organic allergies, constitutional dysfunctions
and parasympathetic imbalance. When treatingendodermal visceral organ points related to the
Nogier second and third phase, the 5 Hz frequency moves with the territory related to that phase.
Zone C- Kinetic movements: This zone affects proprioception, kinetic movements and the
musculoskeletal body. The resonant frequency for the zone is 10 Hz, which is the frequency used to
t reat auricular points on the antihelix and the surrounding areas of the auricle, such as the
scaphoid fossa and triangular fossa. This zone affects myofascial pain, sympathetic nervous system
arousal, somatization disorders, cutaneous allergies, mot or spasms, muscle pathology and any
disorder aggravated by kinetic movement. Whentreating mesodermal musculoskeletal points
related to the Nogier second and third phase, the 10Hzfrequency moves with the territory related
to that phase.
Zone D- Global coordination: This 20-Hzzone represents the corpus callosum and the anterior
commissure which coordinate associations between t he two sides of t he brain. It is represented on
Treatmentprocedures
155
Acupuncture microsystems on zone 0 of tragus
Right ear
Conception
Vessel
Governing
Vessel
Leftear
Right ear
Internal Musculoskeletal
organs body
Genitals Coccyx
Bladder Sacral Spine
Intestines Lumbar Spine
Stomach ThoracicSpine
Heart ThoracicSpine
Lungs Cervical Spine
Throat Cervical Spine
Mouth Head
Figure 6.8 TheConception Vessel channel isfound on thetragus oftherightauricle, whereas theGoverning Vessel meridian isfound Oil
thetragus oftheleft ear. Similarly, theinternal organs represented bythefront mu points are found on thetragus oftheright ear, whilerear
shu pointsare shown all thetragus oft heleft ear.
156 AuriculotherapyManual
the external tragus of the auricle that lies immediately above the subtragal zone A. It corresponds to
crossed-laterality dysfunctions, problems of cerebral symmetry versus divergence, incoordination of
the two sides of the body, symmetrically bilateral dysfunctions or midline pain problems. This
frequency affects symmetrically bilateral pain problems and strictly median pain problems. In a right›
handed person, the right tragus corresponds to the anterior side of the body ConceptionVessel and
the left tragus corresponds to the posterior body Governing Vessel (see Figure 6.8). For a left- handed
person or an oscillator, the opposite is the case. The left tragus corresponds to the ant erior side of
the body and the right tragus corresponds to the posterior side of the body. In each case, the body is
represented upside down, with the upper body toward the inferior tragus and the lower body
toward the superior tragus.
Zone E- Neurological interactions: This zone represents the spinal cord and peripheral nerves
and corresponds to the helix tail of the auricle. The40 Hz frequency is used for spinal disorders,
skin disorders, dermatitis, skin scars, neuropathies, neuralgias and herpes zoster.
Zone F - Emotional reactions: This 80-Hzzone represents the brainstem, thalamus, limbic
system, and striatum and is represented on the peripheral lobe of the auricle. It corresponds to
problems related to unconscious postures, conditioned reflexes, tics, muscular spasms,
stammering, headaches, facial pain, overly sensitive sensations, clinical depression and emotional
disturbances. When treating ectodermal neuroendocrine points relat ed to the Nogier second and
third phase, the 80 Hz frequency moves with the territory related to t hat phase.
Zone G - Int ellect ual organization: This zone represents psychological functions affected by the
frontal cortex t hat are represent ed on the medial lobe of the auricle. The 160 Hz stimulation
frequency is used for pyramidal system dysfunctions, memory disorders, intellectual dysfunctions,
psychosomatic reactions, obsessive nervousness, chronic worry, malfunctioning conditioned
reflexes and deep- seated psychopathology. Whentreating ect odermal cerebral cortex points
related to the Nogier second and third phase, the 160 Hz frequency moves with the territory
related to t hat phase.
The placement of colored filters or the selection of electrical or laser stimulation frequencies is
based on the type of disorder and the region of the ear t hat correspond to each zone (see Box 6.1).
Box 6.1 Stimulation frequencies for specific auricular points
Auricular point
Master Oscillation point
Point Zero
Shen Men
Sympathetic Aut onomic point
Allergy point
Endocrine point
Tranquilizer point
Thalamus point
Master Sensorial point
Master Cerebral point
Muscle Relaxation point
Wind Stream
San Jiao (triple warmer)
Appetite Control point
Vit alit y point
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
Lung and Respiratory Organs
Abdominal Organs
UrogentialOrgans
Heart Muscle Act ivit y
Musculoskeletal Spine
Musculoskeletal Limbs
Musculoskeletal Head
Sensory Organs
Endocrine Glands
Peripheral Nerves
Spinal Cord
Brainstem
Thalamus and Hypot halamus
Limbic System 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
The rise in resonance frequencies going from zone A to zone G reflects the increasing evolutionary
complexity of organic tissue organization. As one ascends from basic cellular metabolism to
visceral organs to musculoskeletal tissue to peripheral nerves to subcortical brain structures to the
hierarchical structure of the cerebral cortex, the frequencies t hat relate to each successive zone
become progressively faster. This rise in frequencies when going from primitive tissue to more
recently evolved neurological tissue corresponds to the increasingly faster rot at ion of chakra
vortices described in Chapt er 2.3.
6.7 Semipermanent auricular procedures
Ear pellets: Small stainless steel balls or small seeds soaked in an herbal solution can be placed on a
specific ear point and held there byan adhesive strip. Ear acupoint pellets are also called ear seeds, ion
spheres, semen vaccaria grains, otoacupoint beads or magrain pellets. Thesmall adhesive strips used
to hold the seeds are best placed with forceps or tweezers in difficult-to-reach areas of the ear. In
Chinese ear acupuncture, the ripe seeds from the vaccaria plant have become a popular replacement
for ear needles, and are now used as the sole methodof auricular stimulation. The seeds can be as
effective as needles and have less chance of leading to infections. Even after needle insertion
treatments, ear pellets are left in place at reactive ear points in order to sustain the benefits of
auricular acupuncture. Theyshould not be left on the auricle for longer than a week. Spontaneous
sweating on the ear surface and dailybathingmay make it difficult for ear pellets to stay attached.
Whilepatients are often encouraged to periodically press on the pellets during the week, this added
procedure runs the risk of knocking the pellet out of place.
Ear magnets: These magnets appear similar to the acupoint pellets, but consist of small magnets
held ont o the auricular surface with an adhesive strip.
Press needles and ear tacks: These are small, semipermanent needles or indwelling thin tacks
that are inserted into the ear to be left in place for several days. These types of needle provide
stronger stimulation t han ear pellets.
Staple puncture: A surgical staple gun is used to apply staple needles into the skin at specific ear
points. This procedure has been most commonly used for the t reat ment of weight loss by a staple
inserted into the Stomach and Esophagus points.
Aqua puncture: Novocaine, saline, vitamins or an herb solution can be subcutaneously injected
into a specific region of the ear. Thesubdermal pressure as well as t he ingredients of the injected
solution provides prolonged stimulation of an ear point.
6.8 Selection of auricular acupoints for t reat ment
The selection of ear points for t reat ment is based on the following criteria:
I. Byreference to the corresponding area on the body which exhibits pain or pathology.
2. Selective reactivity, as indicated by abnormal color or shape, t enderness or increased
electrodermal response at the ear.
3. Reactivity based on changes in the N-VASpulse.
4. Differentiations of zang- fu syndromes related to TCMtheory and the flow of qi in acupuncture
channels.
5. Modern physiological understandingof the neurobiological mechanisms underlying a medical
disorder.
6. The function of an ear point as based upon clinical writings and scientific studies.
7. Presentingclinical symptoms, requiring a general medical diagnosis of the pat ient to
differentiate superficial complaints from underlying pathology.
8. Personal clinical experience.
Some auricular loci are found to elicit t herapeut ic effects for a certain disease t hat seem to have
nothingto do with either conventional Western medicine or traditional Chinese medicine.
6.9 Tonification and sedation in auriculotherapy
Positive gold tonification: The Chinese refer to tonification as the activation or augmentation of
areas with weak energy. Use brief (6-10 seconds duration) positive electrical polarity for activating
weak functions. Master points and functional points are often tonified with this brief stimulation.
AuriculotherapyManual
A B
c o
Figure 6.9 Earpellets applied totheauricular skin surface tapedontotheauricularlow back region (A), and theauricular neck region (C).
Asmall gold hall can heapplied tothetragus withforceps (B), whereas semipermanent needlesare shown insertedintotheear lobe (D).
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160
In auricular acupuncture needling, tonify by inserting gold needles into the ear ipsilateral to the
problem, turningthe needle in a clockwise rotation. Gold activates the sympathetic nervous
system, so tonification procedures are used to t reat parasympathetic disorders, hyporeactions and
energetic vacuums. It is usual to t reat the dominant side of the body. Any complaint which is
aggravated by rest will often indicate the need for a gold needle.
Negative silver sedation: The Chinese refer to sedation as the dispersion of excessive energy to
diminish its overactivity. Use negative electrical polarity, of 12- 30 seconds durat ion, to diminish
overactive organs or excessive reactions due to stress or tension. Onetypically sedat es local
points representing a specific area of t he body by t reat ing t hemwith more prolonged
stimulation, from 10seconds to several minutes. In auricular acupuncture, one may sedat e by
inserting silver needles into the reactive ear point, turning the needle in a counterclockwise
rotation. Silver activates the parasympathetic nervous system. Most reactive points on the ear
require sedative procedures, since they represent muscle tension, sympathetic arousal, stressful
reactions, and excessive energy use. For some individuals, it may also be necessary to t reat the
ear cont ralat eral to the area of the body where t here is a problem, t he non- dominantside. A
pain which is aggravated by movement or exercise suggests the need for a silver needle. Onecan
stimulate a point with a strong stimulus over a short period of time or a weak stimulus over a
prolonged period of time.
6.10 Relationship of yin organs to ear acupoints
The principal organs used to balance the acupuncture channels in Oriental medicine can also be
activated by stimulation of the corresponding auricular points. Recent revisions of t he Chinese ear
acupuncture charts have emphasized the representation of the Lung, Heart, Liver, Spleen and
Kidney points on the posterior surface of the auricle as well as in the concha of the anterolateral
surface (see Figure 2.17).
I. Lung point: Affects respiratory disorders, drug detoxification and skin diseases.
2. Heart point: Produces mental calming, relieves nervousness, and improves memory.
3. Liver point: Affects blood, muscles, tendons, inflammations, sprains, and eye diseases.
4. Spleen point: Affects digestion, reduces muscle tensions, and facilitates physical
relaxation.
5. Kidney point: Affects urinary disorders, bone fractures, back pain, and hearing disorders.
6.11 Geometric ear points
Nogier and his colleagues discovered t hat aft er t reat ing corresponding ear point s indicated by
somatotopic maps, it was also possible to discern a series of reactive auricular points t hat
occurred along an imaginary straight line. These lines were referred to as geomet ric because
they occurred at 30 angles to each ot her (see Figure 6.10). The pract it ioner would first
configure an imaginary line t hat ext ended from Point Zero to t he corresponding auricular
point. The line was t hen cont inued out ward to t he peripheral helix t hat int ersect ed with t hat
line. Stimulation of any reactive ear points found along this line were found to augment the
t reat ment effects seen with auriculotherapy. In addit ion to t reat ing the helix point itself,
30 angles extending from this helix location were used to creat e additional imaginary lines
which were also stimulated. These configurations are depict ed in Figure 6.10. The application
of these 30 angles has been suggested by Bahr (1977) to account for the Chinese ear
acupunct ure points used for Appendix disorders found in t he Scaphoid Fossa and Tonsil points
found on t he helix. There is also a 30 angle bet ween t he Chinese Hypert ension point in the
triangular fossa, a second Hypert ension point on t he tragus, and t he European Marvelous
point, which is also used to t reat high blood pressure. The complexity of this geomet ric
procedure, however, limits its usefulness to those clinical cases which do not respond to more
straightforward applications of auriculotherapy. Dr Bahr has also described a linear
relationship of import ant functional ear points he described as t he Omega points. Figure 6.11
shows the vertical alignment of the Mast er Omega point, Omega 1, and Omega 2 along the
medial aspects of the auricle.
Auriculotherapy Manual
A Geometric ear points
C Chinese Appendix ear points
Helix extension
of Elbow point
Elbow point
B
D
Chinese helix ear points
Ear apex
Helix 6
Chinese Tonsil ear points
Tonsil 1
Appendix 2
Tonsil 4
Figure 6.10 Geometricear points occur at .10 angles from a line that extendsfrom Point Zero to the helix (A). Chinese ear acupuncture
points alsofound at 30 angles are located on the helix (8), for AppendixDisorder acupoints in the scaphoid fossa (C) and Tonsilpoints
on the helix (D).
Treatmentprocedures 161
Omega points
Master
Omega
Figure 6.11 Omega point sform a vertical line along the medial aspects ofthe external eat; including Master
Omega, Omega 1, and Omega 2 points.
6.12 Inverse and contrary relationships of the ear and body
When treating the muscles at t ached to t he spinal vert ebrae and t he peripheral limbs, it has been
found in both auriculotherapy and manipulative t herapies that it is possible to t reat opposing
regions of the musculoskeletal body. This technique can be used to stimulate reactive points on 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
AuriculotherapyManual
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
Thoracic spine 12
Thoracic spine 11
Thoracic spine 10
Thoracic spine 9
Thoracic spine 8
Right side of body
Right hand
Right wrist
Right elbow
Right shoulder
Right hip
Right knee
Right ankle
Right foot
Contrary side of
opposing body
Left foot
Left ankle
Left knee
Left hip
Left shoulder
Left elbow
Left wrist
Left hand
cervical spine to relieve a condition in t he lumbosacral spine or to t reat the foot to provide pain
relief in the shoulder. These specific relationships are present ed in Box 6.2. For example, one
would look for a reactive point on the part of the auricle which represents the sixth cervical
vertebra to affect the fifth lumbar vertebra and one would t reat the first lumbar vertebra to affect
the third thoracic vertebra. Onecould t reat the region of the auricle representing the right wrist in
order to alleviate a dysfunction in the left ankle or t reat the ear point representing the left hip to
relieve tension in the right shoulder.
6.13 Precautions associated wit h auriculotherapy
Do not t reat any pain needed to diagnose an underlying problem.
Do not relieve any pain that warns a patient against engaging in inappropriate physical activity
t hat could aggravate the condition.
Be cautious when treating pregnant women. This precaution is mostly required for malpractice
reasons, rat her than any known clinical evidence regarding possible harmful effects of
auriculotherapy upon a fetus or pregnant woman. Nonetheless, Chinese studies have suggested
that strong stimulation of the Uterus and Ovary points on the external ear can possibly induce
an abortion.
Do not use on patients with a cardiac pacemaker, even though the electrical microcurrents used in
auriculotherapy are delivered at extremely small intensity levels.
Do not use aggressive stimulation with children or elderly patients who may be particularly
sensitive to strong auriculotherapy treatments.
Avoid treating patients when they are excessively weak, anemic, tired, fasting, hypoglycemic or
have just eaten a heavy meal. The t reat ment will not be as effective.
Allow nervous, anxious, weak or hypertensive patients some time for a rest after the treatment.
It is helpful to offer patients warm tea while they recover.
Inform the patient not to use alcohol or drugs before the auriculotherapy treatment.
Some patients may become sleepy or dizzy after a t reat ment and they may need to lie down for a
while. This sedation effect has been attributed to the release of endorphins.
The most common adverse side effect from auriculotherapy is t hat the ear becomes red and
t ender after the treatment. Inform the patient that this tenderness is only temporary.
Treat patient with antibiotics if the ear becomes infected.
6.14 Hindrances t o t reat ment success
Ifa patient’s disorder persists after auriculotherapy t reat ment of the corresponding ear points,
there may be a therapeutic blockage due to a toxic scar or dental focus. Inquire about the patient’s
medical history and previous accidents or surgeries. Sometimes a hindrance to t reat ment is due to
an allergy, which is an excess of energy. At ot her times, there is an obstacle to the transmission of
the cellular information because of a region of energy deficiency. The loss of energy may be
attributable to the after-effects of an accident or surgery which caused a toxic scar and a short›
circuit in t he patient’s energy. A different type of toxic scar is a dental focus related to continued
inflammation from a prior dental procedure. Mercury amalgam in t oot h fillings or chronic
infection of the gingiva can also produce a dental focus.
Accept t hat some medical problems present ed by a pat ient can not be effectively t reat ed by
auriculot herapy because t here is (1) a st ruct ural imbalance t hat needs to be correct ed by some
physical t herapy procedure, or (2) a psychological dysfunction t hat needs to be addressed by
some type of psychotherapeutic intervention. Nogier oft en combined auriculot herapy with
ost epat hic manipulat ions in order to provide st ruct ural integration to the neuromuscular
changes t hat could be achieved with auriculotherapy. When t he obstacle is due to an
unresolved emot ional st at e, stimulation of Point Zero can bring balance to t he psychosomatic
resistance.
While psychosomatic disorders are often dismissed by physicians and patients alike, there is ample
evidence to suggest that psychological factors have a profound impact on many physical
conditions. Until emotional issues related to anxiety, depression, loneliness and shame are
satisfactorily resolved, a patient’s unconscious motivations may defeat the most skilled clinician.
Even when patients strongly vocalize t hat they want to be relieved of their physical suffering, they
may not be consciously aware of their own thoughts, attitudes and behaviors t hat have the opposite
Treatmentprocedures 163
164
effect. Gent lebut firm confrontation regarding the possibility t hat such psychological barriers exist
is often necessary before proceeding further with any medical t reat ment . Many practitioners are
not comfortable addressing such issues with resistant patients, but such confrontations are often
very necessary for the eventual improvement of t hat person’s health problems.
6.15 Overall guidelines for auriculotherapy treatments
1 Treat as few ear points as possible.
2 Only t reat ear points t hat are t ender to palpation or are electrically conductive.
3 Treat a maximum of t hree problems at a time, treating the primary problem first.
4 Treat ipsilateral ear reflex points for unilateral problems and t reat both ears for bilateral
conditions.
5 Ifthe patient exhibits a laterality or oscillation disorder, the Mast er Oscillation point should be
t reat ed first, then corresponding points on bot h auricles should be stimulated.
6 Treat the front of the external ear for relieving the sensations of pain, t hen t reat the back of the
ear for relieving muscle spasms which produce muscle tension and limit range of motion.
7 After treating the anatomic points t hat correspond to the area of the bodily symptom, next
treat t he master points, and lastly t reat supportive functional points.
The most commonly used master points are Point Zero, Shen Men, Sympathetic Autonomic
point, Thalamus point and Mast er Cerebral point.
Anatomic points t hat are often used as supportive points to alleviate ot her disorders include
ear points for the Occiput, the Chinese Adrenal Gland, the Chinese Kidney, the Chinese
Heart, the Lung, t he Liver and the Stomach.
The most commonly used Chinese functional points are Muscle Relaxation point, Appet it e
Control point, Brain (Central Rim), Wind Stream (Lesser Occipital nerve), and San Jiao
(Triple Warmer).
Themost frequently used European functional points are Vitality point, Antidepressant
point, Aggressivity point and Psychosomatic point.
8 Treat Nogier Phase II and Phase 1II points if successful results are not obtainedwith Phase I
points or with Chinese ear points. Phase II points are indicated for chronic deficiency conditions,
whereas Phase III ear points are indicated for chronic excess conditions.
9 Evaluate the patient for the presence of physical hindrances or psychological obstacles that
could interfere with the treatment. One might also notice if treating reactive points on the ear
related to geometric, inverse, or contrary relationships improves the clinical effectiveness of
the auriculotherapy treatment.
i 0 Auriculotherapyworks very well with other treatment modalities. It is quite common to combine
ear acupuncture and body acupuncture in the same treatment session.
Chinese herbs, moxibustion, homeopathic medicines and acupressure massage can be
effectively integrated with auriculotherapy as well as body acupuncture.
Postural adjustments with osteopathic or chiropractic manipulations serve to facilitate the
reduction of muscle spasms attained with auricular stimulation.
Biofeedback, hypnosis, meditation and yoga all serve to augment the general relaxation
effect seen with auricuiotherapy.
Patientswith psychosomatic disturbances would probably benefit from psychotherapeutic
interventions if they could accept the perspective t hat unconscious emotional conflicts could
be a contributingfactor to their physical health problem.
Any procedure used as standard medical practice for the condition being t reat ed can be
further enhanced by the use of auricuiotherapy.
AuriculotherapyManual
Somatotopic representations
on t heear
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 Leg and foot represented on the superior crus and triangular fossa
7.2.3 Arm and 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 in the 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 t ail 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 20 books on auricular acupuncture have been consulted to det ermine the anatomical location and
somatotopic function of specific regions of t he ear. Textswhich focus on t he identification of Chinese
ear acupuncture points include: Huang(1974), Wexu (1975), Nahemkis & Smith (1975), Lu (1975),
Van Gelder (1985), Grobglas & Levy (1986), Chen& Cui (1991), Zhaohaoet a1. (1991), Konig &
Wancura (1993), Shan et al. (1996) and Huang(1996). Journal articles and conference presentations by
Zhou(1995, 1999) have addressed the most recent Chinesepublications for the standardization of
auricular points. A Europeanperspective on the corresponding representations of the gross anatomy
on the external ear begins with the pioneeringwork of Paul Nogier (1972,1983,1987,1989). The latter
texts present the three phases of the auricular microsystem as delineated by Nogier. Ot herbooks which
have described the somatotopic localization of auricular points in the European schools of
auriculotherapy and auricular medicine include the following: Bahr (1977), Bourdiol (1982), Kropej
(1984), Van Gelder (1992), Bucek (1994), Pesikov & Rybalko (1994), Strittmatter(1998,2001) and
Rubach (2001). Informationfrom all of these texts was combined to det ermine the location and
function of the auricular points described by the Chinese and the European schools of auriculotherapy.
In general, t here is more congruence t han disparity bet ween t he Chinese and European
somat ot opic maps for t he auricle. Even when t here are not iceable differences bet ween t he two
systems, t he corresponding point s are oft en locat ed on adjacent regions of t he ext ernal ear. The
lower extremities are locat ed on t he antihelix superior crus in t he Chinese ear charts, but t he legs
are localized to t he t riangular fossa in t he European cart ography. These two auricular areas lie
Somatotopicrepresentations 165
Overview of auricular microsystem somatotopic maps
Master points Represented throughout auricle
- - - - - - ~ - - - -
Sensory Organs
Auricular representation of the musculoskeletal system and sensory systems
- - - - -
Spinal Vertebrae and Ant erior Body Represented on antihelix _
Leg and Foot Represented on triangular fossa and superior crus
Arm and Hand Represented on scaphoid fossa
Head and Skull Represented on antitragus
Face, Jaw, Teeth and Tongue Represented on lobe
..--..._- - - - - - - - -
Represented on lobe, tragus, and subtragus
Represented on inferior concha
. _ - - - - ~ - - - - ~ - - - - - - -
Represented on superior concha and concha ridge
- - - - - - - - - - - - -
Represented on superior concha and internal helix
Represented on concha wall
Urogenital Organs
Endocrine Glands
Abdominal Organs
Auricular representation of internal organs
- - - - - - - ~ - - - - ~ ~ - - - - - - - ~ ~ -
Represented on concha around helix root Digestive Organs
Thoracic Organs
- - - - ~ - - - - - -
Auricular representation of the nervous system
Somatic peripheral nerves Represented on antihelix
- - - - - - - - -
Sympathetic peripheral nerves Represented on concha wall
Spinal Cord and Brainstem Represented on helix tail and lobe
Subcortical Brain Nuclei Represented on antitragus and concha wall
- _._- - - - - - - -
Cerebral Cortex Represented on lobe
~ ~ .... _ - - - ~ - ~ - - - - - - - - - - - - - - - -
Auricular representation of functional conditions
- - - - - - - - - - -
Chinese primary functional points
- - - - - - - - - - - - - - - -
Chinese secondary functional points
European primary functional points
European secondary functional points
next to each other, and in each case t he hip is found toward the inferior tip of the triangular fossa
and the feet are found toward the top of the ear. The Chinese assert t hat the kidney is found in the
superior concha and the spleen in the inferior concha, whereas European texts maintain that the
kidney is located underneat h the helix root and the spleen is found above the concha ridge. In each
case, though, the kidney is found toward the upper regions of the auricle where bot h schools locate
the bladder and the spleen is found on each side of t he Liver point, which is also in the same area of
the concha in bot h schools. A general impression is t hat the European ear points delineate the
musculoskeletal points and neuroendocrine points more precisely, whereas the Chinese charts
seem to indicate the location of the internal organs more accurately. That so much of Oriental
medicine is focused on t he constitutional factors established by the internal organs, and that each
acupuncture channel is named for an internal organ, may provide good reason for this difference.
European approaches to auriculotherapy have placed greater emphasis on the neurophysiological
control of the musculoskeletal system and the relationship of each organ to the embryological
tissue from which it originates. The Nogier system of three different phases relat ed to three
different territories on the auricle may at first seem overly complex and confusing, but the clinical
applicability of these phases becomes easier with continued practice.
166 AuriculotherapyManual
7.1 Master points on t he ear
The master points are so identified because they are typically active in most patients and they are
useful for t he t reat ment of a variety of health disorders. The practitioner should first stimulate the
appropriate corresponding points for a given anatomical organ, and t hen stimulate the master
points also indicated for t hat medical condition.
Each auricular point presented in this text is identified with a number, the point’s principal name,
alternative names, and t he auricular zone (AZ) where it is found. Ifan auricular zone location
includes a slash (I), the ear point occurs at the junction of two zones. The location of each ear
point is described with regard to a specific region of auricular anatomy and the nearest auricular
landmark (LM). The physiological function of the corresponding organ or the health disorders
affected by a particular ear point are presented after t he location of t hat ear point.
Musculoskeletal body represent ed on t he ear Internal organs represent ed on t he ear
Spinal vertebrae
and anterior
Legand Foot
Armand Hand
Urogenital
Organs __+
Digestive
System -----,<L
Thoracic
Organs - - - - 1h
Pituitary
Gland
Abdominal
Organs
Nervous syst em
represent ed on t he ear Territories of t he ear
Spinal Cord
Territory
Territory 2 .....
Cerebral Cortex
e:
Subcortical Nuclei Territory 3- - - I++H+++t - .l
Figure 7.1 Overview ofthe musculoskeletal body, internal organs and the nervous system represented on the external ear. Also indicated
are the three primary territories ofthe auricle.
Somatotopicrepresentations
167
No.
0.0
AuricuLar microsystem point (Alternative name)
Point Zero (Ear Center, Point ofSupport, Umbilical Cord, Solar Plexus)
[Auricular zone]
[HX1/ CR1]
Location: Notch on t he helix root at LM 0, just as the vertically ascending helix rises from the more horizontal concha
ridge.
Function: This mast er point is the geometrical and physiological cent er of the whole auricle. It brings the whole body
towards homeostasis, producing a balance of energy, hormones and brain activity. It support s the actions of ot her
auricular points and ret urns the body to the idealized st at e which was present in the womb. On the auricular somat ot opic
map, Point Zero is located where the umbilical cord would rise from the abdomen of t he inverted fetus pat t ern found on
the ear. As the solar plexus point, Point Zero serves as the ’aut onomic brain’ t hat cont rols visceral organs t hrough
peripheral nerve ganglia.
1.C Shen Men (Spirit Gate, DivineGate) [TF 2]
Location: Superior and central to the tip of the t riangular fossa, bet ween the junct ion of the superior crus and the
inferior crus of the antihelix. It is not at the tip of the t riangular fossa, but slightly inward and slightly upward from where
the triangular fossa descends from the superior crus toward deeper regions of the t riangular fossa.
Function: Thepurpose of Shen Men is to tranquilize the mind and to allow a harmonious connect ion to essential spirit.
This master point alleviates stress, pain, tension, anxiety, depression, insomnia, restlessness, and excessive sensitivity.
The Chinese believe t hat Shen Men affects excitation and inhibition of t he cerebral cortex, which is similar in function to
Nogier’s second phase Thalamus point localized to the same area of the ear. Utilized in almost all t reat ment plans,
including auricular acupuncture analgesia for surgery. Shen Men was one of the first points emphasized for the
detoxification from drugs and the t reat ment of alcoholism and substance abuse. It is also used to reduce coughs, fever,
inflammatory diseases, epilepsy and high blood pressure. Whenit is difficult to find t ender or electrically active car
points, stimulation of eit her Shen Men or Point Zero increases the reactivity of ot her auricular points, making it easier to
detect them.
2.0 Sympathetic Autonomic point [IH4/AH 7]
Location: Junct ion of the more vertically rising int ernal helix and the more horizontal inferior crus, directly below
LM I. It is covered by the brim of the helix root above it, t hus making this ear point difficult to view directly from the
external surface of the car. It can be found on the vertically rising int ernal helix wall, on the flat ledge of the inferior crus
or at the junction where the two meet.
Function: This mast er point balances sympathetic nervous system activation with parasympat het ic sedation. This point
is the primary ear locus for diagnosing visceral pain and for inducing sedat ion effects during acupunct ure. It improves
blood circulation by facilitating vasodilation, corrects irregular or rapid heart beats, reduces angina pain, alleviates
Raynaud’s disease, reduces visceral pain from internal organs, calms smoot h muscle spasms and reduces
neurovegetative disequilibrium. It is also used for the t reat ment of kidney stones, gall stones, gastric ulcers, abdominal
distension, ast hma and dysfunctions of the aut onomic nervous system.
3.0 Allergy point [IH7 or HX7]
Location: Internal and external sides of the apex of the ear, below or at LM 2.
Function: This mast er point leads to a general reduction in inflammatory reactions relat ed to allergies, rheumat oid
arthritis and asthma. It is used for the elimination of toxic substances, the excretion of met abolic wastes and t reat ment of
anaphylactic shock. In Orient al medicine, the top surface of the Allergy point is pricked with a needle to reduce excess qi
or it is pinched to diminish allergic reactions.
4.0 ThaLamus point (Subcortex, Brain, Pain Control point) [CW 2/IC 4]
168
Location: Base of the concha wall which lies behind the antitragus. Todet ect this point , follow a vertical ridge which
descends down the concha wall from the apex of the ant it ragus (LM 13). It is located on the internal surface behind the
antitragus, where the concha wall meet s the floor of the inferior concha.
Function: This master point represents the whole diencephalon, including the thalamus and the hypothalamus. It affects
thalamic relay connections to the cerebral cortex and hypothalamic regulation of autonomic nerves and endocrine glands.
The thalamus is like a preamplifier for signals sent to the cerebral cortex, refining the neural message and eliminating
meaningless background noise. The thalamus is the highest level of the supraspinal gate control system, and so is used for
AurlculotherspyManual
No. Auricular microsystem point (Alternative name) [Auricular zone]
[ITZ]
[ST 3]
[TG Z]
6.0
6.E
7.0
most pain disorders, acute and chronic, and is frequently used for auricular acupuncture analgesia. It also reduces
neurasthenia, anxiety, depression, schizophrenia, over-excitement, sweating, swelling, shock, hypertension, coronary
disorders, cardiac arrhythmias, Raynaud’s disease, gastritis, nausea, vomiting, diarrhea, constipation, liver disorders and gall
bladder dysfunctions. In TCM,the ThalamusSubcortex point tonifies the brain and calms the mind. In the Nogier phase
system, the Phase II Thalamusis located in the region of Shen Men and Phase III Thalamus is located in the region of the
Lung. These three points, Thalamus, Shcn Men and Lung, are all used for drug detoxification.
Endocrine point (Internal Secretion, Pituitary Gland)
Location: Wallof the intertragic notch, below LM 9.
Function: This master point brings endocrine hormones to their appropriat e homeostatic levels, eit her raising or
lowering glandular secretions. It functions by activating the pituitarygland below the brain. The pituitary is the master
gland controlling all ot her endocrine glands. It relieves hypersensitivity, rheumatism, hyperthyroidism, diabetes
mellitus, irregular menstruation, sexual dysfunction and urogenital disorders. It has antiallergic, antirheumatic, and
anti-inflammatoryeffects. In TCM treatments, it reduces dampness and relieves swelling and edema.
Mast er Oscillation point (Laterality point,Switchingpoint)
Location: Underside of the subtragus, internal to the inferior tragus protrusion, LM 10.
Function: This master point balances laterality disorders related to the left and right cerebral hemispheres.
Anatomically it represents the corpus callosum and the ant erior commissure. The point is active in those persons who
are left handed or mixed dominant in handedness. Whereas 80% of individuals show ipsilateral represent at ion of body
organs, 20% of patients exhibit contralateral representation of body organs. These individuals are viewed as oscillators
in the European school of auriculotherapy, and this laterality dysfunction is labeled ’switched’ in some chiropractic
schools. Stimulation of this auricular point in oscillators is often necessary before any ot her auriculotherapy t reat ment
can be effective. Aft er stimulation of the Master Oscillation point, auricular points t hat were initially more electrically
active on the contralateral ear may become more conductive on the ipsilateral ear. This point is used to alleviate
dyslexia, learning disabilities and at t ent iondeficit disorder. People who have unusual or hypersensitive reactions to
prescription medications or aut oimmune problems oft en need to be t reat ed for oscillation.
- - - - - - - - - - - - - - - - - - - - - - -
Tranquilizer point (ValiumAnalogpoint,Hypertensive point)
Location: Inferior tragus as it joins the face, lying halfway between LM 9 and LM 10.
Function: This mast er point produces a general sedation effect, facilitating overall relaxation and relieving generalized
anxiety. It also reduces high blood pressure and chronic stress.
8.E Mast er Sensorial point (Eye point) [L04]
[LO 1] 9.0
Location: Middle of the lobe, vertically inferior to LM 13and vertically superior to LM 7. It is found at the same site as
the Eye point.
Function: This master point controls the sensory cerebral cortex areas of the parietal lobe, the t emporal lobe, and the
occipital lobe. It is used to reduce any unpleasant or excessive sensation, such as tactile paresthesia, ringing in the ears
and blurred vision.
Mast er Cerebral point (fvfaster Omega,Nervousness, Neurasthenia, Worry)
Location: Where the medial ear lobe meets the face. It lies vertically inferior to the intertragic notch.
Function: This mast er point represents the prefrontal lobe of the brain, the part of the cerebral cortex which makes
decisions and initiates conscious action. Stimulation of this auricular point diminishes nervous anxiety, fear, worry,
lassitude, dream- disturbedsleep, poor memory, obsessive-compulsive disorders, psychosomatic disorders, and the
negative pessimistic thinkingwhich often accompanies chronic pain problems.
Somatotopicrepresentations 169
Superior helix
1.(
Shen Men
(Spirit Gate )
0.0
Point Zero
4.0
Thalamus point
(Subcortex)
Antitragus Concha wall
~
Internal ridge
~
behindconcha
wall
T atamus point
In erior concha
3.0
Allergy point
8.E
Master Sensorial point
Helixroot
- - - - 2.0
Sympathetic
Aut onomic point
Tragus
f- - - - - - -6.E
Master Oscillation point
’- - - - - - - - - 5.0
Endocrine point
(Internal Secretion)
9.0
Master Cerebral point
Figure 7,2 Hidden view ofauricular master points. The Tranquilizer point is not shown in Figure 7.2because this point on the external
tragus is only visible from a Surface View, as indicated in Figure 7.3.
170 Auriculotherapyfvlanual
8.E Master Sensorial point
~ ~ /
. , \
! \
c l - ' - ~ >
4.0 Thalamus point
(Subcortex)
3.0
Allergy point
9.0
Master Cerebral point
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 Surface viewofauricular masterpoints.
Somatotopicrepresentations 171
A B
c
D
Figure 7.4 Photographs ofthemasterpoints:PointZero(A),ShenMen(B), SympatheticAutonomicpoint (C),Allergypoint and Thalamus
point (D).
172 AurieulotherapyManual
A
B
c D
Figure 7.5 Photographs ofthe muster points: Endocrinepoint (A), Master Oscillation point (B), Tranquilizer point (C), Master Sensorial
point and Master Cerehral point (D).
Somatotopicrepresentations 173
174
7.2 Auricular representation of t he musculoskeletal syst em
The anatomical location of all auricular points presented in this text are described verbally and are
also indicated by their zone location. Ifdifferent auricular regions represent a single
corresponding part of the body, as seen in Chinese and European ear points, or differences in the
Nogier phase location of a point, the function of t hat ear point is present ed with the first citation of
that point. The nomenclature system described in Chapt er4 will be used with each auricular
microsystem point. Chinese ear points will be represented by the extension .C, European ear
points by .E, and ear points t hat are the same in both systems by .0. The three phases of the Nogier
(French) system will be designated by the extensions .FI, .F2, and .F3. Each anatomical area of the
body and each functional condition is designated by a different Arabic number. Whet herthe
musculoskeletal point is found in Territory I in Phase I, Territory2 in Phase II, or Territory3 in
Phase III, the optimal electrical stimulation for that ear point will be 10Hz.
Musculoskeletal auricular points represent the skin, muscles, tendons, ligaments and skeletal bone
structures of the corresponding body area, as well as blood vessel circulation to that area. These
ear reflex points represent somatic nervous system reflexes controlling limb and postural
movements and autonomic sympathetic reflexes affecting vascular supply to a body region.
Most pain problems are due to myofascial pain related to chronic restimulation of sensory neuron
feedback. A muscle in spasm reactivates interneurons in the spinal cord to restimulate motor
neuron excitation, which leads to more neural impulses going to the muscle, causing the muscle to
stay in spasm. Muscles do not stay in spasm without a neuron causing t hemto contract and
auricular stimulation serves to disrupt the feedback loop between sensory neuron and mot or
neuron.
Clinical problems t reat ed by ear reflex points include relief of muscle tension, muscle strains,
muscle tremors, muscle weakness, tendonitis, sprained ligaments, bone fractures, bone spurs,
peripheral neuralgias, swollen joints, arthritis, shingles, sunburns, skin irritations and skin lesions.
For all ear reflex points, the anterior surface of the ear is used to t reat the sensory neuron aspects
of nociceptive pain sensation, whereas the posterior surface of the ear is used to t reat the motor
neuron aspects of muscular spasm.
The consensus for the Chinese location of the vertebral column is not clear. Some Chinese charts
concur with European maps that the spine is located on the concha side of the antihelix ridge,
whereas ot her Chinese charts put it on the scaphoid fossa side of the antihelix ridge. The Phase I
location of ear points for the cervical, thoracic and lumbar vertebrae, designated .FI, are most
similar to the Chinese identification of t he regions of the auricle which correspond to the spine.
The Phase IV location for the vertebrae and for ot her musculoskeletal tissue is found on the
posterior region of the auricle immediately behind the Phase I location. For the spine, these points
are located on the posterior groove.
AuriculotherapyManual
15.
Neck
17.
Breast
19.
Abdomen
39.
Temporal muscles
10.
Cervical muscles
11.
Thoracicmuscles
36.
Shoulder muscles
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 Overview ofthe muscular and skeletal systems.
Somatotopicrepresentations 175
7.2.1 Vertebral spine and anterior body represented on the antihelix
No.
10.C
Auricular microsystem point (Alternative name)
Cervical Spine.C
Location: Ridge and scaphoid fossa side of the antihelix tail.
Function: Relieves neck strain, neck pain, torticollis, headaches, TMJ.
[Auricular zone]
[AHB]
1OJ 1 Cervical Spine.F1 (CervicalVertebrae, PosteriorNeckmuscles) [AH1, AH2, PG 2]
Location: Conchaside of the antihelix tail, between LM 14and LM IS. The Cl vert ebra lies central to the
antitragus- antihelixgroove and runs along the narrow ridge of the antihelix tail up to C7 above the concha ridge.
Function: Improves range of motion of tight muscles along the neck, increasing flexibility and circulation.
10.F2
10.F3
11.C
Cervical Spine.F2
Location: Peripheral concha ridge below LM IS, where the concha floor lies next to the concha wall.
Cervical Spine.F3
Location: Inferior region of the tragus, between LM 9 and LM 10. Locat ed at the Tranquilizer point.
Thoracic Spine.C
Location: Ridge and scaphoid fossa side of the antihelix body.
Function: Relieves upper back pain, low back pain, shoulder pain, arthritis.
[CR 2]
[TG 2]
[AH9,AH 10]
11.F1 Thoracic Spine.F1 (Upper Back, Dorsal Spine, Thoracic Vertebrae) [AH3,AH 4, PG 3, PG 4]
Location: Conchaside of the antihelix body, between LM 15 and LM 16. TheTl vert ebra lies above the concha ridge,
across from LMD. Theot her thoracic vert ebrae are sequentially found along the sloping antihelix as it curves upward
and medially toward the inferior crus.
11.F2
11.F3
Thoracic Spine.F2
Location: Medial concha ridge, just peripheral to LM O.
Thoracic Spine.F3
Location: Middle region of the tragus, between LM 10 and LM 11.
[CR 1]
[TG 3,TG4]
12.C Lumbar Spine.C (LowerBack, LumbarVertebrae, Sacroiliac) [AH11]
Location: Upper region of the antihelix body.
Function: Representing sacroiliac muscles and ligaments, this point relieves low back pain, sciatica pain, peripheral
neuralgia, back strain and disc degeneration.
12J1 Lumbar Spine.F1 [AH5,AH 6, PG 5, PG 6]
Location: Topsurface of the antihelix inferior crus, between LM 16 and LM 17. The L1 vert ebra occurs at LM 16,
where the inferior crus begins, and proceeds along the flat ledge of the inferior crus to L5 at LM 17.
12.F2
12.F3
176
Lumbar Spine.F2
Location: Rising helix root, above LM D.
Lumbar Spine.F3
Location: Superior region of the tragus, above LM 10.
AuriculotherapyManual
[HX 1]
[TG 5]
No. Auricular microsystem point (Alternative name) [Auricular zone]
13.Fl Sacral Spine.F1 (Coccyx) [AH 7, PG 7)
Location: Topsurface of the antihelix inferior crus, between LM 17and LM 1. TheS1vertebra occurs at the midpoint
of the inferior crus, at LM 17,while S5 is found below the Lung point.
Function: Relieves low back pain, sciatica pain.
14.0
15.0
Buttocks (Gluteus fvlaximus muscles)
Location: Topsurface of the antihelix inferior crus, near LM 16.
Function: Relieves pain in buttocks muscles, lowback pain, sciatica, hip pain.
Neck (Anterior Neckmuscles, Throat muscles, Scalene muscles)
Location: Scaphoid fossa side of the antihelix tail, superior to LM 14.
Function: Relieves neck tension, sore throats, torticollis, hyperthyroidism.
[AH 5, PG 5]
[AH 8,AH 9, PP 1, PP 3]
16.(
16.E
Clavicle.C (Collarbone)
Location: Inferior scaphoid fossa groove peripheral to the Neck point.
Function: Relieves clavicle fracture, shoulder pain, arthritic shoulder, rheumatism, upper back pain.
Clavicle.E (Collarbone, Scapula, Shoulder Blade)
[SF 1]
[AH 9, PP 3]
Location: Antihelix region near the scaphoid fossa which lies peripheral to the Neck and Chest points, at the junction
of the antihelix body and antihelix tail at LM 15.
17.0
18.0
Breast
Location: Scaphoid fossa side of the antihelix body, superior to LM 15.
Function: Relieves premenstrual breast tenderness, breast cancer.
Chest (Thorax, Ribs, Sternum, Breast, Pectoral muscles)
Location: Antihelix body, superior to LM 15 and near the Breast point.
Function: Relieves chest pain, chest heaviness, intercostal pain, angina pectoris, cough, asthma, hiccups.
[AH 10]
[AH 10, PP 3]
19.0
20.0
Abdomen (Abdominalmuscles, OutsideAbdomen)
Location: Superior side of the antihelix body.
Function: Relieves abdominal pain, low back pain, hernias.
Pelvic Girdle (Pelvis, Pelvic Cavity)
Location: Tip of the triangular fossa, superior to LM 16 and below the Shen Men point.
Function: Relieves groin pain, low back pain, hernias, digestive disorders.
Somatotopicrepresentations
[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
Post erior ear
11.F2
Thoracic
Spine
10.F1
Cervical
Spine
178
Figure 7.7 Hidden viewofthe musculoskeletal spine represented on the antihelix. (From LifeARrfi, Super
Anatomy, ' Lippincott Williams & Wilkins, with permission.)
AuriculotherapyManual
14.
But t ocks
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
But t ocks
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 viewofthe musculoskeletal spine represented on the antihelix. (From LifeARt J9, Super
Anatomy, ' Lippincott Williams & Wilkins, with permission.)
Somatotopicrepresentations 179
7.2.2 Leg and foot represented on the 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
AuricuLar microsystem point (Alternative name)
Hip.C
Location: Lower region of the antihelix superior crus, peripheral to t he Shen Men point .
Function: Relieves hip pain. low back pain.
Hip.F1 (Coxofemoraljoint)
Location: Peripheral tip of the t riangular fossa, inferior and cent ral to t he Shen Men point .
Hip.F2
Location: Floor of t he lower inferior concha. in the region of the int ert ragic notch.
Hip.F3
Location: Peripheral ant it ragus and t he inferior ant ihelix tail and scaphoid fossa.
Thigh (Upper Leg, Quadriceps muscles, Femur)
Location: Inferior t riangular fossa. immediat ely above the But t ocks point .
Function: Relieves upper leg pain. pulled hamst ring muscles.
Knee 1 (Kneejoint. Knee articulation)
Location: Middle region of the antihelix superior crus, alongside the t riangular fossa.
Function: Relieves knee pain. st rained knee, broken knee.
Knee 2 (Genus ofKnee)
Location: Peripheral region of the antihelix superior crus. alongside t he scaphoid fossa.
Knee.F 1 (Patella)
Location: Middle of t he dept h of the t riangular fossa, cent ral to the Shen Men point.
Knee.F2
Location: Floor of t he inferior concha. in the region of the Thalamus point .
Knee.F3
Location: Middle range of the ant it ragus ridge. inferior to LM 13.
Calf.E (Lower Leg. Gastrocnemius muscle.Tibia andFibula bones)
locat ion: Infcrior, medial region of t he t riangular fossa.
Function: Relieves lower leg pain.
Ankle.C
Locution: Superior aspect of the antihelix superior crus.
Function: Relieves ankle pain, swollen ankles.
[Auricularzone]
[AH13]
[TF 1, PT 1]
[IC lIC 2]
[AT3,AH1]
[TF 3, PT 1]
[AH15]
[AH14]
[TF 4. PT 2]
[IC2,IC4]
[AT2,CW 2]
[TF 5. PT 3]
[AH17,PP12]
180 AuriculotherapyManual
No.
25.Fl
25.F2
25.F3
26.C
Auricular microsystem point (Alternative name)
Ankle.F1
Location: Central region of the triangular fossa.
Ankle.F2
Location: Floor of the peripheral inferior concha, below the lower antihelix tail.
Ankle.F3
Location: Central range of the antitragus ridge.
HeeL.C
Location: Highest region of the antihelix superior crus, covered by the superior helix brim.
Function: Relieves heel pain, foot pain.
[Auricular zone]
[TF 6, PT 3]
[IC 5]
[AT 1]
[AH 17, PP 12]
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
26.E HeeL.E (Tarsus) [TF 5, PT 3]
Location: Most central region Ofthe triangular fossa, covered by the superior helix brim. It is immediately adjacent to
the medial end of the inferior crus and to the Sympathetic Autonomic point.
27.Fl
27.F2
27.F3
28.C
Foot.F 1 (Metatarsals)
Location: Triangular fossa, covered by the superior helix brim.
Function: Relieves foot pain, peripheral neuralgia in the feet.
Foot.F2
Location: Floor of the peripheral inferior concha, near the concha ridge and the concha wall.
Foot.F3
Location: Intertragic notch.
- - - - - - - - ~ - - - - .--. --. - _._- - - - - - - - - - - - - - - - ~ - - - - - - - - _ . _ - - - _ . _ . _ - - - - - - - _ . _ - - - - - - - - - - - - - - -
Toes.C
[TF 5 &TF 6, PT 3]
[IC 5]
[IT1, IT2)
[AH 18, PP 12]
Location: Superior crus, covered by the superior helix brim. The toes are more peripheral than the points for the heel.
Function: Relieves pain in toes, strained toe, inflamed toe, frostbite, peripheral neuralgia in the feet.
28.E Toes.E [TF 6, PT 3]
Location: Triangular fossa, covered by the superior helix brim. The large toe is the highest point on the triangular fossa,
close to the top of the superior crus of the antihelix.
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 Hidden viewoft helegand foot represented on the auricle. (From Lit’eARrfi, Super Anatomy,
' Lippincott Williams & 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 viewofthe leg and foot represented on the auricle. (From LifeARfJi!, Super Anatomy,
' Lippincott Williams & Wilkins, with permission.i
Somatotopicrepresentations 183
7.2.3 Arm and hand represented on the scaphoid fossa
No. Auricular microsystem point (Alternative name)
[Auricular zone]
. _.- - - _._.... _ . _ - - ~ - - - - - - - - - - - - - - - - - - - - - - - _._._- - - - - - - -
29.0
30.0
Thumb
Location: Antihelix superior crus, alongside the scaphoid fossa.
Function: Relieves pain of sprained thumb.
Fingers (Digits, Phalanges)
Location: Uppermost scaphoid fossa, covered by the superior helix brim.
Function: Relieves pain, swelling, peripheral neuralgia, frostbite, and arthritis in fingers.
[AH16 &AH 18, PP 9]
[SF 6, PP 10]
- - - - - - - - - - - - _._.,,- - - - - - - - - - -
31.0
31.F2
Hand (Palm, Carpals, Metacarpals)
Location: Upper scaphoid fossa, central to LM 3 and Darwin’s tubercle.
Function: Relieves pain and swelling in hand.
Hand.F2
[SF 5 &AH 14, PP 9]
[SC 8]
31.F3
Location:
Hand.F3
Floor of the peripheral superior concha, above the concha ridge and near the concha wall.
[LO1]
32.0
32.F2
Locution: Central ear lobe, near the Master Cerebral point.
Wrist
Location: Scaphoid fossa, central to LM 4 of Darwin’s tubercle.
Function: Relieves pain, strain, and swelling in the wrist, and reduces symptoms of carpal tunnel syndrome.
Wrist.F2
Location: Floor of the peripheral superior concha, below LM 16.
[SF 5, PP 7]
[SC6]
32.F3 Wrist.F3
Location: Central ear lobe, near the Master sensorial point.
[LO3]
33.0
34.0
34.F2
Forearm (Ulna andRadius bones, Brachioradialis muscle)
Location: In the superior scaphoid fossa, inferior to the Wrist point.
Function: Relieves pain and spasms in forearm, tennis elbow.
. ~ - - - - - - - - - - - - - - - ’- _ .. _._- - - -
Elbow
Location: In the scaphoid fossa, directly peripheral to the antihelix inferior crus.
Function: Relieves pain, strain, soreness, and swelling in elbow joint, tennis elbow.
Elbow.F2
Location: On the floor of the superior concha, below the middle of the inferior 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
Auricular microsystem point (Alternative name)
Upper Arm (Biceps andTriceps muscles, Humerusbone, ChineseShoulder)
Location: In the scaphoid fossa, superior to the Shoulder point.
Function: Relieves pain and spasms in upper arm.
Shoulder (Pectoral Girdle, Deltoidmuscles, ChineseShoulderjoint)
[Auricular zone]
[SF 3, PP 5]
[SF 2, PP3]
Location: Inthe scaphoid fossa, peripheral to LM0 and LM IS,where the antihelix region representing the neck meets
the antihelix region representing the upper baek.
Function: Relieves pain, tenderness, swelling and arthritis in the shoulder.
36.F2
36.F3
37.0
Shoulder.F2
Location: Floor of the superior concha near the internal helix and the concha wall.
Shoulder.F3
Location: Inferior regions of the scaphoid fossa and the helix tail.
Master Shoulder point (Scapula, Trapezius muscle, Chinese Clavicle)
Location: In the inferior scaphoid fossa, inferior to Shoulder point, central to LM 5.
Function: Relieves pain, tenderness, strain and swelling in shoulder.
[SC 4]
[SF 1,HX 15]
[SF 1, PP 1]
Overview of upper limb representation: The scaphoid fossa can be divided into equal thirds. The
hand and fingers are represented on the upper third, the forearm, elbow, and upper arm are
represented on the middle third, and the shoulder is represented on the lower third of the scaphoid
fossa. Unlike the differences between t he Chinese and European auricular systems representing
the lower limbs, both systems of auriculotherapy concur with regard to the location of the upper
limbs.
Physical support of the scaphoid fossa: Because the scaphoid fossa is a groove on the most
peripheral part of the external ear, it tends to flap back and forth when the ear is scanned for an
active reflex point. It is necessary to provide firm back pressure while probing the skin to detect a
point for auricular diagnosis or auriculotherapy treatment. The therapist’s own thumbprovides
back pressure while stretching the ear with the index finger. Todetect a point on the posterior
surface of the ear, bend t he ear over slightly, revealing the back of t he ear. Treat the identical
posterior region detected on the anterior surface of the auricle in order to relieve the muscle
spasms t hat may accompany the sensory aspects of pain in a limb.
somatotopicrepresentations 185
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 Hidden view ofthe arm and hand represented on the auricle. (From LifeARrfi, Super Anat omy,
' Lippincott Williams & Wilkins, with permission.t
186 AuriculotherapyManual
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
.lt oi&>r- - 34. Elbow
.--I!';''------33. Forearm
_- - - 1110- +-32. Wrist
~ I -
/
35.
Arm
33.
Forearm
34.
Elbow
29.
Figure 7.12 Surface viewofthe arm and hand represented on the auricle. (From LifeARTW, Super Anatomy.
' Lippincott Williams & Wilkins, withpermission.]
somatotopicrepresentations 187
7.2.4 Head, skull and face represented on the antitragus and lobe
No. Auricular microsystem point (Alternativename) [Auricular zone]
[AT3, PL 4]
[AT2, PG 1]
[AT 1, PL 2]
38.0
39.0
40.0
Occiput (Occipital Skull,Back ofHead, AtlasofHead)
Location: On the peripheral superior antitragus, near the antitragus- antihelixgroove.
Function: Relieves occipital headaches, tension headaches, facial spasms, stiff neck, epileptic convulsions, brain seizures,
shock, dizziness, sea sickness, car sickness, air sickness, vertigo, impaired vision, insomnia, coughs and asthma. InTCM,the
Occiput point is utilized for all nervous disorders, calms the mind, clears heat, dispels wind and nourishes liver qi.
Temple (Temporoparietal Skull, Tai Yang, Sun point)
Location: On the middle of the antitragus, inferior to LM 13, the apex of the antitragus.
Function: Relieves migraine headaches, temporal headaches, tinnitus, and disorders related to blood circulation to the
head. In TCM,this point affects the body acupoint TaiYang and dispels wind.
Forehead (FrontalSkull)
Location: Lower antitragus, near LM 12and the intertragic notch.
Function: Relieves frontal headaches, sinusitis, dizziness, impaired vision, insomnia, distractibility, neurasthenia,
anxiety, worry, depression, lethargy, disturbing dreams and hypertension.
411
42.C
43.E
44.0
Frontal Sinus
Location: Central lobe, inferior to the antitragus point for the forehead.
Function: Relieves frontal headaches, sinusitis, rhinitis.
Vertex (Chinese Top ofHead, ApexofHead)
Location: Peripheral superior lobe, below the Occiput point.
Function: Relieves pain at the top of the head.
TMJ (Temporomandibularjoint)
Location: Peripheral lobe, inferior to the scaphoid fossa, central to LM 6.
Function: Relieves jaw tension, toothaches, TMJ, bruxism.
Lower Jaw (fvlandible, fvlasseter muscle, LowerTeeth)
[LO1]
[L06]
[LO8, PL 4/PL6]
[LO7, PL6]
Location: Peripheral lobe, inferior to the TMJ point.
Function: Relieves lower jaw tension, toothaches, TMJ, bruxism, anxiety, pain from dental procedures. Used for
acupuncture analgesia for tooth extraction.
45.0 Upper Jaw (fvlaxilla, UpperTeeth)
[LO8, PL 4]
Location: Peripheral lobe, inferior to the TMJ point and central to the Lower Jaw point.
Function: Relieves upper jaw tension, toothaches, TMJ, bruxism, anxiety, pain from dental procedures. TheJaw points
are used for acupuncture analgesia for tooth extraction.
~ ~ ~ ~ ~ _ . _ ~ ~ ~ ~ ~ ~ ~ ~ . _ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ . _ - ~ - - _ .
46.C1
46.C2
Toothache 1
Location: Peripheral lobe.
Function: Relieves toothaches, tooth decay.
Toothache 2
Location: Conchawall behind antitragus.
Function: Relieves toothaches.
[L08]
[CW3]
188 Auriculotherapyfvlanual
No.
46.C3
47.C1
47.C2
Auricular microsystem point (Alternative name)
Toothache 3
Location: Inferior concha, below antitragus.
Function: Relieves toothaches.
DentalAnalgesia 1 (ToothExtraction Anesthesia 1,UpperTeeth)
Location: Central lobe, inferior to intertragic notch and superior to the Master Cerebral point.
Function: Used for pain relief during dental procedures, gum disease, tooth decay.
Dental Analgesia 2 (ToothExtraction Anesthesia 2, Lower Teeth)
[Auricular zone]
[IC 5]
[LO 2]
[LO 1]
Location: Central lobe, inferior to the Dental Analgesia I point and near the Master Cerebral point.
Function: Used for pain relief during dental procedures, gum disease, tooth decay, and periodontal inflammations.
48.C1
48.C2
49.C
49.E
50.E
Palate 1 (UpperPalate)
Location: Upper cent er of lobe, inferior to LM 12on antitragus.
Function: Relieves sores, ulcers, and infections in the gums of lower mouth.
Palate 2 (Lower Palate)
Location: Cent er of the lobe, inferior to LM 13on apex of antitragus.
Function: Relieves sores, ulcers, and infections in the gums and lining of upper mouth.
Tongue.C
Location: Cent erof the lobe, between Palate 1and Palate 2.
Function: Relieves pain and bleeding of tongue.
Tongue.E
Location: Peripheral lobe, inferior to ear reflex points for Jaw.
Function: Relieves pain and bleeding of tongue.
Lips
Location: Peripheral lobe, between LM 6 and LM 7.
Function: Relieves chapped lips, cold sores on lips.
[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 and scrapes on chin.
Face (Cheek)
Location: Peripheral lobe.
Function: Relieves facial spasms, tics, paresthesia, trigeminal neuralgia, acne, facial paralysis.
[L08]
[LO3, PL 5]
Overview of head and face representation on t he ear: Theface muscles are represented on the
lobe, separate from the antitragus points for the skull. The angled antitragus can be divided into
equal thirds, with the occiput represented on the upper, out er third of the antitragus, the temples
represented on the middle third of the antitragus, and the forehead represented on the lower,
medial third of the antitragus. As with the representation of the upper limbs, both the Chinese and
European systems of auriculotherapy concur with regard to the location of the head.
Somatotopicrepresentations 189
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
Toot hache 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
\fEi’IN- - -
Figure 7.13 Hidden viewofthe head and face represented on the auricle. (From LifeARTJ9,Super Anatomy, ' Lippincott Williams &
Wilkins,withpermission.)
Physical support of t he antitragus: Because the antitragus is a ridge on the peripheral aspect of
the external ear, it tends to flap back and forth when scanning the ear for an ear reflex point. It is
necessary to provide firm back pressure when detecting a head point for auricular diagnosis or
auriculotherapy treatment. Thepractitioner’s own thumb provides back pressure while stretching
the ear with the index finger. When detecting a point on the posterior surface of the ear, bend the
ear over slightly, revealing the back of the ear. Treat t he identical post erior region det ect ed on the
anterior surface of the auricle in order to relieve the muscle spasms t hat may accompany the
sensory aspects of headaches.
190 AuriculotherapyManual
48.
Palate
49.
Tongue
46.C3
Toothache 3
38.0
Post erior ear
Occiput
46.C2
Toothache 2
39.0
Temple
40.0
Forehead
42.C
Vert ex
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 viewofthe head and face represented on the auricle. (From LifeAR’J’E!, Super Anatomy, ' Lippincott Williams &
Wilkins. withpermission.)
Somatotopicrepresentations 191
7.2.5 Sensory organs represented on the lobe, tragus and subtragus
- - - - - =- - - - - - - -
No.
53.C
53.F1
Auricular microsystem point (Alternative name)
- - - _ . ~ - - - - - - _ . _ - - - - - - - - - - - _.._- - - - - - - -
Skin Disorder.C (Urticaria)
Location: Superior scaphoid fossa, central to LM3 and located near the Handpoint.
Function: Relieves dermatitis, urticaria, eczema, hives, poison oak.
Skin Disorder.F1
Location: All along helix tail.
[Auricular zone]
[SF 5]
[HX12- HX15]
53.F2
53.F3
Skin Disorder.F2
Location: Superior concha.
Skin Disorder.F3
Location: Central lobe below the intertragic notch.
[SC 5]
- - - _ . _ - - - - ~ . -
[LO2]
54.0 Eye (Retina, Master Sensorial point)
Location: Center of lobe, at the same location as Master Sensorial point.
Function: Relieves poor eyesight, blurred vision, eye irritation, glaucoma, stye and conjunctivitis.
[LO4]
.- - - - - - - - - - - - - - _ .. - _._- - - - - - - - - - - - - - - - - - - - - -
55.C1 Eye Disorder 1 (Mu 1)
Location: Central side of intertragic notch.
Function: Relieves blurred vision, eye irritation, glaucoma, retinitis, myopia, astigmatism.
[IT 1]
- - - - - - - -- - - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
55.C2
55.C3
Eye Disorder 2 (Mu 2)
Location: Peripheral side of intertragic notch.
Eye Disorder 3 (NewEye point)
Location Inferior concha, below helix root.
[AT 1]
[IC6]
56.C Inner Nose (Internal Nose, Nasal Cavity) [ST 2]
Location: Middle of subtragus, underneath inferior tragus protrusion, LM 10.
Function: Relieves running nose, chronic sneezing, common colds, flu, sinusitis, rhinitis, nasal bleeding, profuse nasal
discharge, nasal obstruction, and allergies. It eliminates pathogenic wind-cold and wind-heat in the lungs by removing
obstructions in the nose.
57.C External Nose.C (OuterNose)
Location: Middle of tragus.
Function: Relieves pain from broken nose, sunburned nose, rosacea.
[TG 3]
- - _ . _ - - - - - - ~ - - - - _.- - - - - - - - - - -
57.E
58.C
5B.E
59.C
192
External Nose.E
Location: Central side of inferior lobe.
Inner Ear.C (Internal Ear)
Location: Peripheral lobe, inferior to the antihelix tail.
Function: Relieves deafness, hearing impairment, tinnitus, dizziness, vertigo, Meniere’s disease .
. ~ - _ . - - - - -
Inner Ear.E (Internal Ear, Cochlea)
Location: Middle of subtragus, near Chinese Inner Nose.
._ - - - - - - - - ~ - - - - - - - - - - _ . _ - - - -
External Ear (OuterEar, Auricle, Pinna)
Location: Superior tragus.
Function: Relieves pain and infections of external ear, deafness, tinnitus, ear infections.
- - - ~ ~ - - ~ . _ - - - - - - - - - - - - - - - - - - - - - - - - - ~
AuriculotherapyManual
[LO1]
[LO5]
[ST 3]
[TG 5]
Inferior crus
12. F1
Lumbar Spine
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
Ligaments and structural muscles
Muscle
tension
Figure 7.15 Depth viewofthe musculoskeletal spine represented on the auricle. Theshape ofdifferent spinal
vertebrae ofthe inverted somatotopic body corresponds to changes in the shape ofthe contours ofthe antihelix.
These changes in antihelix contours can be used to distinguish different levels of t he vertebral
column represented on t he auricle. They are also used to distinguish auricular regions where the
hip, shoulder and head extend from the spine.
somatotopicrepresentations 193
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.
Inner Ear
55.C3
Eye Disorder 3
58.E
Inner Ear
56.C
Inner Nose
55.C1
Eye Disorder 1
55.C2
Eye Disorder 2
5l.E
External Nose
56.
Inner Nose
194
Figure 7.16 Hidden viewoft hesensory organs represented on the auricle. (From LileARTJI!, Super Anat omy,
' Lippincott Williams& Wilkins, with permission.)
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
dermat omes
Figure 7.17 Surface viewofthe sensory organs represented on the auricle. (From LifeARTJf!, Super Anatomy,
' Lippincott Williams & Wilkins, withpermission.)
Somatotopicrepresentations 195
7.2.6 Auricular landmarks near musculoskeletal points
LM 1 Helix insertion: The lower Sacral Vert ebrae are locat ed on the antihelix inferior crus below this landmark on the helix
root.
LM2 Apex of ear: TheThumbpoint is locat ed on t he antihelix superior crus just below this landmark on t he superior helix.
- -_.._-----_...~ _ . _ - - ~ ~
Superior Darwin’s t ubercle: The Handpoint in t he scaphoid fossa is found centrally within this landmark.
- - - - _ . _ - ~ . _ - - - _ . _ - - - - - - - -
Inferior Darwin’s tubercle: TheWrist point in the scaphoid fossa is found centrally within this landmark.
LM3
LM4
LM 5 Helixcurve: The Mast er Shoulder point in the scaphoid fossa is locat ed centrally within this landmark.
LM 6 Lobular-HelixJunction: The Lower Jaw and TMJ are locat ed centrally within LM 6.
LM 7 Bot t omof lobe: The Lips are locat ed superior to LM 7.
LM 8 Lobular insertion: TheEuropean Ext ernal Nose is locat ed superior to LM 8.
LM 9 Intertragic notch: The Mu 1 Eye Disease point is locat ed just cent ral to this landmark, whereas t he Mu 2 Eye Disease
point is locat ed just peripheral to it.
LM 10
LM 11
LM 12
LM 13
Inferior t ragus protrusion: The Chinese Ext ernal Nose is locat ed halfway bet ween LM 10and LM 11.
Superior t ragus protrusion: TheChinese Ext ernal Ear is locat ed just superior to this landmark.
Ant it ragus protrusion: The Forehead on the ant it ragus is locat ed near this landmark.
Apex of ant it ragus: TheTemples on t he ant it ragus are found inferior to this landmark. The Eye 1 point , at t he cent er of
the lobe, is even furt her below LM 13.
- - - - - - - - - - - - -
LM 14 Base of antihelix: The Upper Cervical Vert ebrae are locat ed just superior to this landmark, t he Upper Neck muscles
just peripheral to it. The Occiput on t he ant it ragus is found inferior and cent ral to LM 14.
.. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~
LM 15
LM 16
Antihelix curve: The division of t he upper Thoracic Vert ebrae from t he lower Cervical Vert ebrae is locat ed at this
landmark. The Shoulder point is locat ed just peripherally in the scaphoid fossa.
- - - - - - - - - - - - ~ ~ - - - - - - _ . _ - - - _ . _ - -
Antihelix notch: The upper Lumbar Vert ebrae are locat ed above this landmark. TheElbowpoint is locat ed more
laterally in t he scaphoid fossa.
LM 17 Midpoint of inferior crus: The division of t he upper Sacral Vert ebrae from t he lower Lumbar Vert ebrae is locat ed at
this landmark.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _._- - - - -
196 AuriculotherapyManual
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 Auricular regions corresponding to thehead and neck (A), lowerspine (B), thoracicspine (C) and upper and lower limbs (D).
Somatotopicrepresentations
197
198
7.3 Auricular representation of internal visceral organs
The arrangement of the location of internal organs on the auricle is based upon the same
anatomical organization as the organs t hat are found in the internal body, only they are upside
down. The auricular points represent physiological disturbances in these organs, not the actual
anatomical organs themselves.
Digestive system: The gastrointestinal system or alimentary canal converts food t hat has been
eat en into smaller fragments, allowing basic nutrients to be absorbed into t he body to make energy
and to form the basic building blocks for muscles, bones and internal organ tissue.
Mouth: This soft tissue lining of the oral cavity or buccal cavity includes the gums, palate, tongue,
and salivary glands, where food is initially tasted as well as broken down.
Esophagus: Thegullet is a long tube that delivers food from the mouth to the stomach, joining the
stomach at the cardiac orifice, a smooth muscle sphincter that closes off gastric juices from inducing
reflux back into the esophagus.
Stomach: This hollow organ is a temporary storage t ank for food. Throughmechanical churning
and gastric acid chemicals, food received from the mout h is further broken down.
Small intestines: This very long tube winds back on itself many times, allowing for t he gradual
absorption of food nutrients into the body. It begins at the duodenumconnected to the stomach
and ends at the ileum connected to the large intestines.
Large intestines: This final tube progresses from the ascending colon to the transverse colon to the
descending colon, ending in the rectum. Thecolon withdraws water from indigestible food.
Circulatory syst em: This hydraulic system begins with t he cardiac muscle in t he thorax,
which sends oxygen-rich blood t hrough the art eries to deliver it to all part s of t he body, and
receives oxygen-deficient blood from t he veins. The lymphatic vessels collect excess fluid,
metabolic wastes, and immune system breakdown product s.
Heart: This primary cardiac muscle pumps blood to all parts of the body.
Respiratory system: Thetubular organs of this system allow exchange of air and carbon dioxide.
Lungs: This organ for exchange of air gases includes bronchial tubes and alveoli sacs.
Throat: This opening to the respirat ory system includes t he mout h, pharynx, and larynx.
Tonsils: These lymphatic organs in the oral cavity surrounding the t hroat serve to gat her and
eliminate microorganisms t hat ent er the throat.
Diaphragm: This smooth muscle membrane below t he thorax allows inhalation to occur.
Accessory abdominal organs: Organs in the abdomen t hat function with ot her systems.
Liver: This accessory gastrointestinal organ lies next to the stomach. The liver converts blood
glucose into glycogen, incorporates amino acids into proteins, releases enzymes to metabolize
toxic substances in the blood, and produces bile. Thebile is released into the small intestines,
where it facilitates digestion of fats.
Gall bladder: This muscular sac stores bile created by the liver.
Pancreas: This accessory endocrine- exocrine gland produces digestive enzymes, t he hormone
insulin to facilitate energy inside cells, and the hormone glucagon to raise blood sugar levels.
Spleen: This accessory lymphatic organ next to the stomach filters t he blood and removes
defective blood cells and bacteria. It is a site for producing additional immune cells.
Appendix: This pouch at t ached to the large intestines contains lymphatic tissue.
Urogenital organs: Abdominal and pelvic organs of t he urinary and reproductive systems.
Kidney: This primary urinary organ filters toxic substances from the blood and releases it into the
urine. It may retain or release body fluids and mineral salts.
Bladder: Theurinary bladder receives urine from the uret er and kidney and holds it for release.
Urethra: Thefinal tube which connects the bladder and gonads to the outside world.
AuriculothersoyManual
Prostate: The accessory reproductive organ in males which contributes milky substances to the
semen.
Uterus: This reproductive organ in females potentially holds the fertilized egg or discharges its
vascular lining during the menstrual period.
External genitals: The penis in the male and the clitoris in the female aroused during sexual
performance.
60.
Mout h
106. ...
Salivary
Glands
64.
Duodenum
67.
Rectum
61.
Esophagus
62.
Cardiac
Orifice
- - - +- - - - \ -63.
Stomach
65.
Small
Intestines
66.
Large
Intestines
68.
Circulat ory
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.
Uret er
87.
86.
Urethra
Bladder
90.
87. External
Urethra Genitals
77.

(penis)
Appendix
Uterus
Figure 7.19 Overview ofthe internal visceral organs. (From LifeAR’fJ9, Super Anat omy, ' Lippincot t Williams&Wilkins, with
permission.)
Somatotopicrepresentations 199
7.3.1 Digestive system represented in the concha region around the helix root
~ ~ ~ ~ ~ ~ ~ ~ -
No. Auricular microsystem point (Alternative name) [Auricular zone]
60.0
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - - - - - ~ - - - - - - - -
Mouth (Fauces, SoftPaiate)
Location: Inferior concha, next to the ear canal and below the helix root.
Function: Representing the soft tissue lining of the inner mouth, gums, and tongue, this ear point relieves eating
disorders, mouth ulcers, cold sores, glossitis.
[IC6]
- - - ~ - - - - - - - - - - - - - - - - - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -
[IC 7]
[IC 7]
61.0
62.0
Esophagus
Location: Inferior concha, peripheral to the Mouth point.
Function: Represents the long tube which connects the mouth to the stomach. Relieves indigestion, reflux, difficulty
swallowing, epigastric obstructions, hiccups, sore throats. This point is sometimes included with the Stomach point in
weight control plans.
Cardiac Orifice
Location: Inferior concha, below LM 0 and the central concha ridge.
Function: Represents the opening between the esophagus and the stomach. Relieves indigestion, reflux, heartburn,
hiatal hernias, nausea, vomiting, difficulty swallowing, epigastric obstructions.
63.0 Stomach [CR 1, PC 2]
Location: Medial concha ridge, just peripheral to LM O. Control of the smooth muscle activity of the stomach is also
affected by stimulating the posterior concha region behind the concha ridge.
Function: Represents the gastric chamber which churns masticated food into chyme. Relieves eating disorders,
overeating, poor appetite, diarrhea, indigestion, nausea, vomiting, stomach ulcers, gastritis, and stomach cancer. It also
alleviates toothaches, headaches, and stress. It is the most commonly used auricular point for appetite control and weight
reduction. However, treating this car point only diminishes the physiological craving for food when following a diet plan
and does not override the patient’swill if there is not conscientious effort to reduce food intake and increase physical
exercise. In TCM, this point reduces stomach fire excess.
63.F2
63.F3
64.0
Stomach.F2
Location: This endodermal Phase II point is found on the peripheral ear lobe of Territory3.
_.__. _ - _ . _ - - - - - - - - - - - - ~ - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -
Stomach.F3
Location: This endodermal Phase III point is found on the medial superior helix region of Territory 1.
Duodenum
[LO4 & LO5]
[HX4&HX5]
[SC 1, PC 3]
[SC 2, PC 3] 65.0
Location: Superior concha, immediately above the concha ridge Stomach point.
Function: Represents the opening between the stomach and the small intestines. Relieves duodenal ulcers, duodenal
cancers, diarrhea and is sometimes used for eating disorders.
Small Intestines (jejunum, Ileum)
Location: Medial superior concha, below the internal helix root.
Function: Represents the long winding tubes which absorb digested food. Relieves diarrhea, indigestion, abdominal
distension.
65.F2
200
Smalllntestines.F2
Location: This endodermal Phase IIpoint is found on the middle regions of the ear lobe in Territory3.
- - - - - - - - ~ ~ - - - - - - - - - ~ - - - -
AuriculotherapyManual
[LO4 & LO6]
No.
65.F3
AuricuLar microsystem point (Alternative name)
Smalllntestines.F3
Location: This endodermal Phase III point is found on the superior internal helix in Territory 1.
[Auricular zone]
[IH6- IH 10]
[SC 3 & SC4, PC 4] 66.0 Large Intestines (Colon)
Location: Central narrow portion of the most medial superior concha.
Function: Represents the ascending, descending and transverse colons t hat regulate the amount offluid released or
ahsorhed from digested material. Relieves diarrhea, constipation, colitis, hemorrhoids, dysentery, enteritis, loose
howels.
66.F2
66.F3
Large Intestines.F2
Location: This endodermal Phase II point is found on the medial antitragus aspects of Territory3.
Large Intestines.F3
Location: This endodermal Phase III point is found on the middle range of the helix tail of Territory 1.
[AT 1 &AT 2]
[HX12 & HX13]
._- - - - - - - - - - - - - - - - - - - - - - - - _ .._- - - - - - -
67.C Rectum.C (Anus, LowerSegmentofRectum)
Location: External surface of the helix root, above the Intestines points.
Function: Represents the final portion of the colon. This ear point relieves diarrhea, constipation, rectal sores,
hemorrhoids, hernias, colitis, fecal incontinence, dysentery.
[HX2]
67.E Rectum.E (Anus, Hemorrhoidpoint)
Location: Innermost aspect of superior concha, where the internal helix and the inferior crus meet at a tip.
[SC 4, PC 4]
Auricular microsystem reflex points and macrosystem yang meridians All yang meridians
connect directly to the ear and vice versa. Stimulation of the Stomach, Small Intestines and Large
Intestines points on the ear can alleviate stagnation, deficiency, or over activity of qi energy flowing
through the respective meridian channels for Stomach, Small Intestines and Large Intestines.
Somatotopicrepresentations
201
62.0
Cardiac
Orifice
61.0
Esophagus
e..- - - 65.0
Small
Intestines
65.F3
Small
Intestines.F3
63.F2
Stomach.F2
65.F2
Small
Intestines.F2
66.
- - - -Large
intestines
61.
Esophagus
63.
Stomach
_62.
Cardiac
Orifice
65.
Small
intestines
Figure 7.20 Hidden viewofthe digestive system represented on the concha. (From LifeARTJf!,Super Anatomy,
' Lippincott Williams & Wilkins, withpermission.)
202 AuriculotherapyManual
63.F3
Stomach.F3
67.E
Rectum.E
67.C
Rectum.C
60.0
Mout h
61.0
Esophagus
62.0
Cardiac Orifice
66.F2
Large Intestines.F2
65.F2
Smalllntestines.F2
63.F2
Stomach.F2
66.0
Large
Intestines
65.0
Small
Intestines
64.0
Duodenum
63.0
Stomach
66.F3
Large
Intestines.F3
65. __
Small
Intestines
64.
Duodenum
61.
Esophagus
60.
Mout h
Figure 7.21 Surface viewofthe digestive system represented on the concha. (From LifeARTEJ,Super Anatomy,
' Lippincot t Williams & Wilkins, with permission.)
Somatotopicrepresentations 203
7.3.2 Thoracic organs represented on the inferior concha
No. Auricular microsystem point (Alternative name)
[Auricular zone]
[CW2- CW9]
[IC4]
6S.E
69.C1
Circulatory System (Blood vessels)
Location: All along the concha wall below the antihelix and the ant it ragus ridge.
Function: Represent s peripheral art eries and veins and the sympathetic nerves t hat control vasoconstriction and
vasodilation. Auricular represent at ion of specific int ernal art eries and veins are found as follows, all extending from the
concha wall: the carotid artery to the brain extends over the helix tail to the lobe; the brachial and radial art eries to the
arm and hand extend over the antihelix body to the scaphoid fossa; the femoral art ery to the leg and foot extends over
the triangular fossa. This set of auricular points relieves coronary disorders, heart attacks, hypertension, circulatory
problems, cold hands, cold feet.
Heart 1
Location: Deepest , most central area of the inferior concha. (It oft en looks like a shiny spot on the concha.)
Function: Relieves post - heart - at t ackdysfunctions, chest pain, angina, hypertension, hypotension, palpitations,
tachycardia, arrhythmia and poor blood circulation. In TCM,Heart functions to tranquilize the mind and calm the spirit.
The auricular Heart point can thus be used to relieve anxiety, insomnia, neurast henia, poor memory, perspirat ion, night
sweats, regulate blood and reduce heart fire excess.
69.C2
69.C3
69.F1
Heart 2 (Cardiac point)
Location: Superior tragus.
Heart 3
Location: Middle region of the post erior concha.
Heart.F1
[TC5]
[PC 2]
[AH4, PC4]
Location: This mesodermal Phase I point is found on the middle range of the antihelix body of Territory I. The Phase
IV control of cardiac muscle is represent ed on the post erior groove (PO 4) immediately behind the Phase I Heart point
on the antihelix body (AH 4).
69.F2 Heart.F2 [IC4]
Location: This mesodermal Phase II point is found on the peripheral inferior concha of Territory2, in the same
location as the Chinese location for the Heart . While Nogier (1983) report ed t hat t he Phase II Heart was in the inferior
concha, his subsequent text (1989) relocat ed the Heart to the peripheral superior concha, in zone SC 7.
69.F3
70,(1
Heart.F3
Location: This mesodermal Phase III point is found on the peripheral ear lobe of Territory3.
Lung1 (Contralateral Lung)
[LOS]
[IC7]
204
Location: Peripheral region of the inferior concha, below the concha ridge. Nogier located the Lungs t hroughout the
inferior concha.
Function: Relieves respiratory disorders, like asthma, bronchitis, pneumonia, emphysema, coughs, flu, tuberculosis,
sore throats, edema, chest stuffiness and night sweats. In TCM,the lungs arc relat ed to detoxification because they
release carbon dioxide with each exhalation. The auricular Lung point can thus facilitate detoxification from any toxic
substance, including withdrawal from narcotic drugs, alcohol, and ot her forms of substance abuse. The Lung point is
included in t reat ment plans for alcohol abuse, heroin addiction, opiat e withdrawal, smoking withdrawal, cocaine and
amphet amine addiction. Orient al medicine also associates the lungs with the skin, since we breat he t hrough our skin as
well as our lungs. Treatingthe Lung point can t herefore alleviate bot h skin disorders and hair disorders, including
dermatitis, utica ria, psoriasis, herpes zoster, shingles. The Lung point is an essential analgesic point used for auricular
acupunct ure analgesia. Finally, this point is used to disperse lung qi and dispel wind.
AuriculotherapyManual
No.
70.C2
Auricular microsyst em point (Alternative name)
Lung 2 (ipsilateral Lung)
[Auricular zone]
[ICZ& IC4]
Location: Lower region of the inferior concha, inferior to t he Chinese Heart point . Nogier st at es t hat t he whole
inferior concha represent s t he Lungs.
Function: Like t he Chinese Lung I point , this second ear point for t he lungs relieves problems relat ed to respirat ory
disorders, addict ion disorders and skin disorders. Alt hough some texts st at e t hat t he Chinese Lung 1 point is more oft en
used for respirat ory disorders and t he Chinese Lung 2 point is more oft en used for addict ion disorders, bot h Lung point s
seem to be equally effective for eit her t ype of healt h problem. The more critical variable is which Lung point is more
electrically reactive.
70.C3
70.F1
Lung 3
Location: Superior port ion of t he post erior periphery.
Lung.F1
Location: This endodermal Phase I point is found t hroughout t he inferior concha of Territ ory2.
[PP 9]
[IC4 & IC7]
70.F2 Lung.F2
- - - - - - - - - - - - - - - -
[LO7 & HX15]
70.F3
Location: This endodermal Phase II point is found on t he peripheral regions of t he ear lobe in Territ ory3.
Lung.F3 [SF 2 & SF 3]
71.C
Location: This endodermal Phase III point is found on t he middle range of t he scaphoid fossa in Territ ory 1.
Bronchi [IC3]
Location: Upper region of t he inferior concha, near t he Esophagus point .
Function: This ear point is considered a t hird Chinese Lung point . It is used to relieve bronchit is, bronchial ast hma,
pneumonia, and coughs and helps dispel excess phlegm.
72.0 Trachea (Windpipe) [IC3]
Location: Cent ral region of t he inferior concha, near t he ear canal.
Function: Relieves sore throats, hoarse voice, laryngitis, common cold, coughs with profuse sput um. It also dispels phlegm.
73.C Throat.C (Pharynx, ThroatLining)
Location: Subt ragus, underneat h superior t ragus prot rusion, LM 11, above ear canal.
Function: Relieves sore t hroat s, hoarse voice, pharyngit is, tonsillitis, ast hma, bronchit is.
[ST 4]
73.E
- - - - - - - - - - - - - - - - - - - - - -
Throat. E(Pharynx, Throat Lining, Epiglottis)
Location: Cent ral inferior concha, next to t he ear canal.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
[IC6]
74.C
74.E
74.F2
Larynx.C
Location: Underside of subt ragus, immediat ely above t he ear canal.
Function: Relieves laryngitis, sore t hroat s.
Larynx.E
Location: This endoderrnal Phase I point is found on t he inferior concha ncar t he ear canal in Territ ory 2.
- - - - -- - - - - - - - - - - - - - - - - - - - - -
Larynx.F2
Location: This endodermal Phase II point is found on upper, peripheral ear lobe of Territ ory3.
- - - - - - - -
Somatotopicrepresentations
[ST 4]
[IC3]
[L06]
205
- - - - - - - - -- - - - - - - - - - - -
No. Auricular microsystem point (Alternative name) [Auricular zone]
.. __._- _._- - - - - - - - - - - - - - - - - - - - -
74.F3
75.C1
Larynx.F3
Location: This endodermal Phase III point is found on the middle of the antihelix body of Territory 1.
Tonsil 1
[AH4]
[HX9]
Location: On top of superior helix, peripheral to LM 2.
Function: Relieves tonsillitis, sore throats, laryngitis, pharyngitis and acut e inflammations. The whole peripheral helix
rim is used in Chinese auricular t reat ment plans for alleviating inflammatory conditions.
75.C2
75.C3
75.C4
76.C
76.E
206
Tonsil 2
Location: Middle of helix tail, peripheral to LM 15.
Tonsil 3
Location: Curve of helix tail, where it joins the lobe.
Tonsil 4
Location: Bottomof the lobe, near LM 7.
Diaphragm.C (Hiccups point)
Location: Helixroot, above LM O.
Function: Relieves hiccups, diaphragmatic spasms, visceral bleeding, skin disorders.
Diaphragm.E
Location: Peripheral inferior concha and the concha ridge.
AuriculotherapyManual
[HX14]
[HX15]
[L03]
[HX2]
[IC8 &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 Auricular regions corresponding todigestive system(A), thoracic organs (B), abdominal organs (C) and urogenitalorgans (D)
Somatotopicrepresentations 207
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
Lung 2
68.E
Circulatory
System
72.
Trachea
70.
Lung
71.
Bronchi
74.
Larynx
70B
Lung.F3
70.C1
Lung 1
69.F1
Heart.F1
76.E _- =:p;;;;j
Diaphragm.E
Figure 7.23 Hidden viewofthe thoracic organs represented on the concha. (From LifeARrfi, Super Anatomy,
' Lippincott Williams & Wilkins, withpermission.)
208 AuriculotherapyManual
Post erior ear
70.C1
Lung 1
69.F1
Heart.F1
70.C3
Lung 3
69.F4
Heart.F4
70.C2
Lung 2
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 Surface viewofthe thoracic organs represented on the concha. (From LifeARrfi, Super Anatomy,
' Lippincott Williams & Wilkins, with permission.)
Somatotopicrepresentations 209
7.3.3 Abdominal organs represented on t he superior concha and helix
No.
77.0
78.C1
78.C2
78.C3
79.0
Auricular microsyst em point (Alternative name)
Appendix (Primary Appendixpoint)
Location: Superior helix, between the Small Intestines and the Large Intestines ear points.
Function: Relieves acute and chronic appendicitis.
Appendix Disease 1
Location: Superior scaphoid fossa, near ear points for Fingers.
. ~ - - - - ~ ~ ~ ~ ~ ~ - - - - _ . _ . _ - - ~ - - - - _ . _ .. _._- _._._- - - _..
Appendix Disease 2
Location: Middle scaphoid fossa, near car points for Shoulder.
Appendix Disease 3
Location: Inferior scaphoid fossa, near Mast er Shoulder point.
Liver
[Auricular zone]
[SC 2]
[SF 6]
[SF 3]
[SF 1]
[CR 2]
Location: Peripheral concha ridge and concha wall, peripheral to the St omach point.
Function: Relieves hepatitis, cirrhosis of liver, jaundice, alcoholism, gall bladder problems, regulates blood disorders,
hypertension and anemia. In TCM, the liver affects tendons, sinews, and ligaments, and the Liver ear point is used to
heal joint sprains, muscles strains, muscle spasms, myasthenia paralysis and soft tissue injuries. The Liver point also
improves blood circulation, enriches blood, improves eyesight, relieves fainting, digestive disorders, convulsions and
paralysis due to a stroke. The auricular Liver point is used for hypochondriac pain, dizziness, premenst rual syndrome
and hypertension. According to Orient al thought, the liver nourishes yin and restrains yang by purging liver fire.
79.C2
79.F2
79.F3
Liver.C2
Location: A second Chinese Liver point is found on the middle range of the post erior periphery.
Liver.F2
Location: This endodermal Phase II point is found on the peripheral lobe of Territory3.
Liver.F3
Location: This endodermal Phase III point is found on the superior scaphoid fossa of Territory 1.
[PP 6]
[LO 7]
[SF 4 & SF 5]
[HX10]
80.C1 LiverYang 1
Location: Superior helix, at LM3, superior to Darwin’s tubercle.
Function: Relieves liver disorders, hepatitis, and alleviates inflammatory conditions. In TCM,the Liver Yang points
calm the liver and suppress yang excess and hyperactivity.
80.C2 Liver Yang 2
Location: Helix tail, at LM 4, inferior to Darwin’s tubercle.
[HX12]
[IC 8]
81.C1
210
Spleen.C 1 (Found onleft ear only)
Location: Peripheral inferior concha, inferior to the Liver point on the concha ridge.
Function: Relieves lymphatic disorders, blood disorders, and anemia, abdominal distension and menstruation. In
TCM, the spleen nourishes muscles, thus the Spleen point is used to relieve muscle tension, muscle spasms, muscular
atrophy, muscular dystrophy. In Chinese thought, the spleen governs the t ransport at ion and t ransformat ion of food and
fluid, thus it affects digestive disorders, indigestion, gastritis, stomach ulcers and diarrhea. The Chinese stimulate this
point to strengthen bot h spleen qi and stomach qi and to regulate the middle jiao.
AuriculotherapyManual
No.
81.C2
81.F1
Auricular microsystem point (Alternative name)
Spleen.C2
Location: Posterior concha, peripheral to the posterior ear point for the Lung.
Spleen.F1 (Found onleft ear only)
[Auricular zone]
[PC 3]
[SC6,CW9]
Location: Superior concha and concha wall below the inferior crus. Because the spleen is of mesodermal origin, early
Nogier charts indicated that the spleen was in one of two positions on the ear, this one for Phase I and the next region for
Phase II.
Function: Western medicine focuses on the role of the spleen in the lymphatic and immune systems, thus European
doctors use the Spleen point for its physiological function rather than its energetic effects as used in Oriental medicine.
81.F2 Spleen.F2 [SC 8]
Location: Peripheral superior concha, superior to the Liver point on the concha ridge. Even though the spleen is of
mesodermal origin, the earlier localization of the spleen organ by Nogier was placed at this Phase II position. The
development of the phase model helped Nogier to account for the discrepancies in the identification of different
corresponding regions of the external ear that were said to represent the spleen.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
81.F3
82.0
Spleen.F3
Location: This mesodermal Phase III point for the spleen is found on the peripheral lobe of Territory 3.
Gall Bladder (Foundonrightear only)
[L08]
[SC 8, PC 3]
Location: Peripheral superior concha, between the Pancreas and Duodenumpoints. The Chinese localization of the
Gall Bladder and the Nogier Phase I representation oft his organ are the same.
Function: Relieves gall stones, gall bladder inflammations, deafness, tinnitus, migraines.
82.F2
82.F3
Gall Bladder.F2
Location: This endodermal Phase II point is found on the medial lobe of Territory 3.
Gall Bladder.F3
[L02]
- - - - -- - - - - - - - - - - - - - -
[AH13 &AH14]
Location: This endodermal Phase III point is found on the base oft he antihelix superior crus of Territory 1.
83.0 Pancreas [SC 7 &CW 7, PC 4]
Location: Peripheral superior concha and the adjacent concha wall. The Chinese localization of the Pancreas is the
same as the Nogier Phase I representation of this organ.
Function: Relieves diabetes mellitus, hypoglycemia, pancreatitis, dyspepsia.
83.F2
83.F3
Pancreas.F2
Location: This endodermal Phase II point is found on the medial lobe of Territory 3.
Pancreas.F3
[LO 1]
[TF 4]
Location: This endodermal Phase III point is found on the triangular fossa region near the antihelix inferior crus of
Territory 1.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .. _ ~ - - -
Somatotopicrepresentations 211
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 Hidden viewofthe abdominal organs represented on the auricle. (From LifeARTJ9,Super Anatomy,
CD Lippincott Williams & Wilkins, with permission.)
212 AuriculotherapyManual
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 viewofthe abdominal organs represented on the auricle. (From LifeARfE!,Super Anatomy,
' Lippincott Williams & Wilkins, withpermission.)
Somatotopicrepresentations 213
7.3.4 Urogenital organs represented on the superior concha and internal helix
No.
84.C1
Auricular microsystem point (Alternative name)
Kidney 1
[Auricular zone]
[SC6&CW8]
Location: Superior concha, below LM 16 and superior to t he St omach point. It is oft en difficult to view this point
because it is hidden by t he overhanging ledge of t he inferior crus.
Function: Relieves kidney disorders, kidney stones, urinat ion problems, nephritis, diarrhea and pyelitis. In TCM,the
kidney relat es to t he bones, audit ory funct ion and hair conditions, so it is used for bone fractures, t oot h problems, low
back pain, ear disorders, deafness, tinnitus, bleeding gums, hair loss and stress. The Chinese Kidney point tonifies kidney
qi deficiency, regulat es fluid passage, and enriches essence.
84.C2
84.F1
84.F2
84.F3
85.C
85.E
Kidney 2
Location: Superior region of t he post erior lobe.
Kidney.F1
Location: This mesodermal Phase I point is found on t he medial int ernal helix of Territory 1.
Kidney.F2
Location: This mesodermal Phase II point is found on t he inferior concha region of Territory2.
Kidney.F3
Location: This mesodermal Phase III point is found on t he antihelix tail region of Territory3.
Ureter.C
Location: Superior concha, bet ween t he Kidney and Bladder points.
Function: Relieves bladder dysfunctions, urinary t ract infections, kidney stones.
Ureter.E
Location: Int ernal helix region which overlies t he antihelix superior crus.
[PL 4]
[IH4&IH5]
[IC7 & IC8]
[LO1 &SF 1]
[SC 6]
[IH4]
86.0 Bladder (Urinary Bladder)
Location: Superior concha, below LM 17, superior to Small Int est ines points.
Function: Relieves bladder dysfunctions, cystitis, frequent urinat ion, enuresis, dripping or ret ent ion of urine,
bedwetting, pyelitis, sciatica, migraines. In TCM,the bladder clears away damp heat and regulat es t he lower jiao.
[SC 5]
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - ~ - - - - - - ~ - -
86.F2
86.F3
87.C
87.E
214
Bladder.F2
Location: This endodermal Phase II point is found on t he lowest lobe region of Territory3.
Bladder.F3
Location: This endodermal Phase III point is found on t he upper scaphoid fossa region of Territory 1.
Urethra.C
Location: Helix root , inferior to LM 1.
Function: Relieves painful urinat ion, uret hral infections, urethritis, urinary incont inence, bladder problems.
Urethra.E
Location: Most medial tip of the superior concha.
- - - - - - - - - - - - - - - -
AuriculotherapyManual
[LO3]
[SF 6]
[HX3]
[SC 4]
No. Auricular microsystem point (Alternative name) [Auricular zone]
- -- - _._- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
88.C Prostate.C [SC4]
Location: Innermost tip of superior concha, at same site as the European Uret hrapoint.
Function: Relieves prostatitis, prost at e cancer, hernias, impotency problems, painful urination, premat ure ejaculation,
nocturnal emission, urinary tract infection.
88.E
89.C
89.Fl
Prostate.E or Vagina.E
Location: Underside of internal helix.
Uterus.C
Location: Central region of triangular fossa.
Function: Relieves premenst rual problems, inflammations of uterallining, irregular menstruation, dysmenorrhea,
uterine bleeding, sexual dysfunctions, infertility, pregnancy problems, miscarriages, and can induce early childbirth
deliveries. In TCM, this point replenishes kidney qi and nourishes essence.
Uterus.F1 (Fallopian Tubes)
Location: This mesodermal Phase I point is found on the underside of the internal helix root of Territory 1.
[1HZ]
[TF S]
[IH3]
89.FZ Uterus.F2 [IC1 & ICZ]
Location: This mesodermal Phase II point is found on the lower inferior concha of Territory2. ThePhase II points for
the Prostate and Vagina are at the same location as the Phase II Ut erus points.
89.F3 Uterus.F3
Location: This mesodermal Phase III point is found on the medial lobe of Territory3. ThePhase III points for the
Prostate and Vagina are at the same location as the Phase III Ut erus points.
[LOZ]
[HX4] 90.C External Genitals.C
Location: Helix region which leaves the face, at LM 1.
Function: Relieves scrotal rashes, groin pain, impotency, low back pain, impotency, and premat ure ejaculation, and
facilitates sexual desire. In TCM, this point clears away heat and dampness.
90.E External Genitals.E (Penis or Clitoris, Bosch point)
Location: Helix root area which is adjacent to the superior tragus.
Somatotopicrepresentations
[HX1]
215
89.
Uterus
88.E
Prostate or
Vagina.E
84.F1
Kidney.F1
85.E
86.0
Bladder
85.
Uret er
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 Hidden view of urogenital organs represented on the auricle. (From LifeART’J9.Super Anatomy.
' Lippincott Williams& Wilkins.withpermission.)
216 AuriculotherapyManual
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 view of urogenital organs represented on the auricle. (From LifeARTID,Super Anatomy,
' Lippincott Williams& Wilkins,withpermission.)
Somatotopicrepresentations 217
218
7.4 Auricular representation of endocrine glands
Theendocrine glands are referred to as t he internal secretion system, since hormones
manufact ured and released by these glands are secret ed directly into t he circulatory system. The
hormones are carried by t he blood to all ot her part s of t he body where they exert some selective
effects on specific target cells. Chemical substances released by the hypothalamus at the base of the
brain are sent to cells in t he pituitarygland beneat h t he hypothalamus. The pituitary gland
subsequently releases tropic hormones t hat have selective action on t arget glands in the body. The
target glands are directed to release t heir own hormones, depending on t he level of tropic
hormone received from t he pituitary. Sensors in t he hypothalamus monit or t he blood levels of
each target hormone circulating in t he blood and det ermine whet her the hypothalamus directs the
pituitary to release more or less tropic hormones to activate or suppress the activity of the target
glands.
Hypothalamic-pituitary axis (HPA): This t erm refers to t he central role of t he hypothalamus t hat
controls t he ant erior pituitary to release hormones t hat control t he t arget endocrine glands.
Anterior pituitary: The ant erior part of t he pituitarygland contains only chemical secretory cells,
which can release adrenocorticotropins (ACTH),thyrotropins (TSH),gonadot ropins (FSH, LH),
endorphins, or growth hormone.
Posterior pituitary: Theposterior part of t he pituitary gland contains special neurons which
descend from the hypothalamus and secrete antidiuretic hormone or oxytocin into t he blood. The
antidiuretic hormone (ADH)directs t he kidneys to reabsorb more wat er from urine and ret urn
t hat wat er to t he general bloodst ream to increase overall fluid level. Oxytocin induces ut erine
contractions during childbirth.
Pineal gland: This gland lies above t he midbrain and below t he cerebral cortex, releasing
melatonin at night to facilitate sleep and induce t he regulation of day- night circadian rhythms.
Deficiencies in melatonin are sometimes relat ed to depression.
Thyroid gland: This gland lies at the base of the t hroat and releases thyroxin hormone in
response to t he release of pituitary thyrotropin hormone. Thyroxin accelerates the rat e of cellular
metabolism t hroughout t he body, affecting virtually every cell of the body by stimulating enzymes
concerned with glucose oxidation. Iron deficiency reduces t he ability of t he thyroid gland to
produce thyroxin, thus leading to goiter. Hyperthyroid activity can lead to Graves’ disease, an
aut oimmune system disorder t hat causes elevated metabolic rat e and nervousness, whereas
hypothyroidism produces symptoms of lethargy and depression.
Parathyroid gland: This gland lies at t he base of the t hroat next to t he thyroid gland, and releases
parat hormone into the blood when it sense decreasing calcium levels in t he blood. By facilitation
of the availability of calcium, parat hormoneaffects nervous system excitability.
Mammary gland: This gland in t he breasts affects milk production in nursing women.
Thymus gland: This gland lies behind t he st ernum in the chest and affects the differentiation of
basal white blood cells made in the bone marrow into active immune cells. Specific differentiated
immune cells can become T-helpercells, T-suppressor cells or T-killer cells. Thymus gland activity
is related to AIDS/ HIY,cancer and aut oimmune problems.
Pancreas gland: This gland lies next to the stomach and releases the hormone insulin to facilitate
the t ransport of glucose from t he bloodst ream into individual cells, where glucose can t hen
become available as energy. Thepancreas also releases t he hormone glucagon to promot e higher
blood glucose levels.
Adrenal gland: This gland lies at the t op of the abdomen, on top (ad- ) of each kidney (-renal). It
is divided into the inner adrenal medulla, which releases t he hormone adrenalin in response to
activation by sympathetic nerves, and t he adrenal cortex, which releases cortisol and ot her stress›
related hormones in response to pituitary adrenocort icot ropin hormone (ACTH).
Gonads: These sex glands lie at the base of t he body. Theovaries in women lie in t he pelvic cavity
and sequentially release est rogen and progest erone in response to pituitarygonadot ropin
hormones FSH and LH. Thetestes in men release the hormone t est ost erone to increase sex drive,
energy level and aggressiveness.
AuriculotherapyManual
100.
Posterior
Pituitary
99.
Anterior
Pituitary
o
Connection to
circulatory system
136.
Hypothalamus
106.
Salivary Gland
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 OvelViewofthe endocrine glands. (From LifeARrfi, Super Anatomy, ' Lippincott Williams & Wilkins, withpermission.)
Somatotopicrepresentations 219
7.4.1 Peripheral endocrine glandsrepresentedalongthe conchawall
No.
91.C
Auricular microsyst em point (Alternative name)
Ovaries.C orTestes.C (SexGlands, Gonads, Internal Genitals)
[Auricular zone]
[CW1]
Location: Conchawall near the int ert ragic notch. Locat ed t oward t he bot t omof the auricle, this Chinese point is
inconsistent with ot her point s reflecting an inverted fetus orient at ion, but is consist ent with t he Nogier locat ion for t he
pituitary gonadal hormones FSH and LH. These two pit uit ary hormones would be appropriat ely found on t he inferior
part of the external ear t hat represent s t he head, where t he actual pit uit ary gland is locat ed.
Function: Relieves sexual dysfunctions, testitis, ovaritis, impotency, frigidity.
91.F1 Ovaries.F1 orTestes.F1 [IH1]
Location: This mesodermal Phase I endocrine gland is found under t he int ernal helix root of Territory 1. The
correspondence of the sex glands to this auricular area makes logical sense for t he invert ed fetus model as this helix root
region of the ear generally represent s urogenit al organs found lower in the body, thus higher in t he ear.
- - - - ~ ..- ..~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ __~ ~ -
91.F2 Ovaries.F2orTestes.F2
Location: This mesodermal Phase II endocrine gland is found on t he lower inferior concha of Territory2.
[IC2]
.. _.. _ ~ ~ ..... - - - - - - - - - - - - - - - - _ ..- - - - - - - - - - - - - - - - - - - - _ ~
91.F3
92.C
Ovaries.F30rTestes.F3
Location: This mesodermal Phase III endocrine gland is found on t he lower medial lobe of Territory3.
... - - - - - - - ... _- - -
Adrenal Gland.C (Suprarenal Gland)
[L02]
[TG3]
Location: The prominent knob of the inferior tragus prot rusion at LM 10. As this lower tragal and int ert ragic notch
region of the auricle generally represent s t ropic hormones released by t he pituitary gland, t he Chinese Adrenal gland
may actually correspond to the pituitary hormone ACTHt hat regulat es the adrenal cortex. Nogier report ed t hat several
points on the auricle represent t he release of the adrenal hormone cortisol; one of t hose locations occurs at t he same
region of t he tragus as t he Chinese loca tion for t he adrenal glands.
Function: Affects adrenocort ical hormones t hat assist one in dealing with stress. Relieves st ress- relat ed disorders,
fevers, inflammatory disorders, infections, hypersensitivity, rheumat ism, allergies, coughs, ast hma, skin disorders,
hypertension, hypotensive shock, profuse menst ruat ion and blood circulat ion problems. It is used for dist urbance of
adrenocort ical function, such as Addison’s disease and Cushing’s syndrome. This point is used in ear acupunct ure
t reat ment plans almost as frequently as many mast er points.
92.E Adrenal Gland.E [CW?]
Location: Conchawall, below LM 16, near location for Chinese Kidney point. The act ual adrenal glands in the body sit
on top (ad- ) of each kidney (- renal). Alt hough some auricular medicine pract it ioners cont inued to maint ain t hat the
upper concha wall corresponded to the adrenal cortex, Nogier changed t he position of t he represent at ion of this gland as
he developed the t hree phase model.
93.Fl
93.F2
Cortisol 1
Location: This mesodermal Phase I adrenal hormone is found on t he antihelix body of Territory 1.
Function: A cort icost eroid adrenal hormone t hat is utilized to deal with stress.
Cortisol 2
[SF 2 &AH 9]
[SC 6]
Location: This mesodermal Phase II adrenal hormone is found on the superior concha of Territ ory2, near ear point s
for the European Adrenal Gland and t he Chinese Kidney.
93.F3 Cortisol 3 [TG 2]
220
Location: This mesodermal Phase III adrenal hormone is found on t he lower t ragus of Territory3, near t he Chinese
Adrenal Gland and t he Mast er Tranquilizer point.
Auriculo therapyManual
No. Auricular microsystem point (Alternative name) [Auricular zone]
[CW6] 94.E Thymus Gland.E
Location: This endodermal endocrine gland is found on the peripheral concha wall near the Pancreas point.
Function: The thymus gland affects the development of ’l-cells of the immune system. This ear point is used for the
common cold, flu, allergies, cancer, HIY, AIDS, and autoimmune disorders.
95.C
95.E
96.C
Mammary Gland.C
Location: Each side of the antihelix body, just superior to the antihelix tail.
Function: This point is used to treat problems with milk secretion, breast development, or breast cancer.
Mammary Gland.E
Location: Conchawall above concha ridge, central to Chinese MammaryGland points.
Thyroid Gland.C
Location: Antihelix tail, alongside the scaphoid fossa.
Function: Thyroxin released by the thyroid gland affects overall metabolic rat e and general arousal. Relieves
hyperthyroidism, hypothyroidism, goiter, sore throats.
[AH10]
[CW6]
[AH8]
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
96.E Thyroid Gland.E [CW5]
Location: This endodermal Phase I endocrine gland is found on the concha wall of Territory2, above the junction of the
concha ridge and the inferior concha.
96.F2 Thyroid Gland.F2 [AH8]
Location: This endodermal Phase II endocrine gland is found on the antihelix tail of Territory3, identical to the region
where the Chinese Thyroid Gland is found.
96.F3 Thyroid Gland.F3
[CW1/IT2]
97.E
Location: This endodermal Phase III endocrine gland is found at the intertragic notch, also associated with the
pituitary hormone TSH, which regulates the release of thyroxin by the thyroid gland.
Parathyroid Gland.E
Location: Conchawall, inferior to European Thyroid Glandpoint.
Function: The parathyroid gland affects calcium metabolism. This point relieves muscle cramps, muscle spasms.
Somatotopicrepresentations
[CW4]
221
7.4.2 Cranialendocrine glands represented at t he intertragic notch
No. Auricular microsyst em point (Alternativename)
[Auricular zone]
[TC 1]
[IC 1]
98.E
99.0
Pineal Gland (Epiphysis, Point E)
Location: The most inferior aspect of the tragus, at LM 9.
Function: Pineal gland releases melatonin hormone to affect circadian rhythm and day- night cycles. Relieves jet lag,
irregular sleep patterns, insomnia, depression.
Ant erior Pit uit ary(Adenohypophysis, Internal Secretion. MasterEndocrine)
Location: Most inferior part of inferior concha, below intertragic notch.
Function: Anterior pituitary is the master endocrine gland, releasing pituitary hormones to control t he release of
hormones from all ot her endocrine glands. This ear point relieves hypersensitivity, allergies, rheumatism, skin diseases,
reproductive disorders, diseases of blood vessels, digestive disorders.
100.E Post erior Pit uit ary (Neurohypophysis)
Location: Inferior concha near inferior side of ear canal.
[IC 3]
[cw 1]
[IT2]
[IT2]
lOU
102.E
103.E
Function: Posterior pituitarycontains neurons from the hypothalamus, which releases hormones into the general
bloodstream. The posterior pituitary releases antidiuretic hormone affecting thirst, internal water regulation and salt
metabolism.
Gonadot ropins(FollicleStimulatingHormone, FSH; Luteinizing Hormone,LH)
Location: Conchawall near intertragic notch.
Function: Gonadal pituitary hormones FSH and LH regulate release of sex hormones by the ovaries or testes. This
point relieves sexual dysfunctions, lowsex drive, infertility, irregular menstruation, premenstrual syndrome, testitis,
ovaritis, fatigue, depression, eye troubles.
Thyrot ropin (ThyroidStimulatingHormone,TSH)
Location: Wallof intertragic notch, midway between tragus and antitragus.
Function: Thyroidal pituitary hormone TSH regulates the release of thyroxin hormone by the thyroid gland. Reduces
metabolic rate, hyperthyroidism, hypothyroidism, hyperactivity and Graves’ disease.
Parat hyrot ropin (ParathyroidStimulatingHormone, PSH)
Location: Most central part of wall of intertragic notch, below LM 9.
Function: Parathyroid pituitary hormone PSH regulates parat hormone release by the parathyroid gland. This point
facilitates calcium metabolism, reduces muscle tetanus.
104.Fl ACTH1 [LO 7]
Location: This Phase I pituitary hormone is found on the peripheral ear lobe of Territory3.
Function: The pituitary hormone ACTHregulates the release of cortisol and ot her corticosteroid hormones by the
adrenal cortex to alleviate stress and stress-related disorders.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - .. _ . ~ ~ - - -
104.F2
104.F3
222
ACTH2
Location: This Phase II pituitary hormone is found on the upper scaphoid fossa of Territory 1.
ACTH3 (Adrenocorticotrophin,Surrenalian point, AdrenalControl point)
Location: This Phase III pituitarygland hormone is found near the intertragic notch and inferior to the Chinese
Adrenal point.
AuriculotherapyManual
[SF 6]
[ST 1]
No. Auricular microsystem point (Alternative name) [Auricular zone]
10S.E Prolactin (LTH) [IC 1]
Location: Inferior region of inferior concha, peripheral to inferior ear canal.
Function: This pituitary hormone regulates the activity of the mammary glands, initiating lactation and milk secretion.
106.C Salivary Gland.C (Parotid Gland)
Location: Conchawall just behind the apex of antitragus, LM 14.
Function: Salivary glands are regulated by activation of the parasympathetic nervous system in response to food.
Relieves mumps, salivary gland inflammations, skin diseases.
[CW2]
- -- - - - - - - - -
106.E Salivary Gland.E (Parotid Gland)
Location: Peripheral region of lobe, next to the Lower Jaw point.
Function: Relieves mouth dryness, mumps, salivary gland inflammations. Thesalivary glands are actually exocrine
glands rat her than endocrine glands.
[LOB]
100.E
Posterior
Pituitary
Gland
106.E
Salivary Gland.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.
Salivary Glands
Figure 7.30 Cranial endocrine glands represented on the auricle. (From LifeARTJi!, Super Anatomy,
' Lippincott Williams& Wilkins,withpermission.)
Somatotopicrepresentations
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
Salivary Gland.C
104.Fl
ACTH 1
106.E
Salivary Gland.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 viewofthe endocrine glands represented on the auricle. (From LifeARY@, Super Anatomy, ' Lippincott Williams
& Wilkins, withpermission.]
224 AuriculotherapyManual
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
Ant erior Pit uit ary
98.E
Pineal Gland
102.E
Thyrot ropin
92.C
Adrenal Gland.C
100.E
Posterior Pit uit ary
lOUGonadotropins (FSH, LH)
91.C Ovaries or testes.C
Figure 7.32 Surface view ofthe endocrine glands represented on the auricle. (From LifeARTID,Super Anatomy,
' Lippincott Williams& Wilkins, withpermission.)
Somatotopicrepresentations 225
226
7.5 Auricular representation of t he nervous system
The nervous system is primarily represent ed on the helix and lobe, but is found t hroughout all
parts of the external ear because the nervous system connects to every part of the body.
Central nervous system (CNS): The core of the nervous system consists of the brain and spinal
cord, which make the principal decisions regarding the regulation of all ot her parts of the body.
Peripheral nervous system: The peripheral nerves consist of sensory neurons which send
messages to the spinal cord from the skin, muscles and visceral organs, or mot or neurons which
travel from the spinal cord out to the muscles and organs of the body.
Somatic nervous system: This division of the peripheral nervous system consists of sensory
neurons which receive afferent messages from the skin and the muscles and mot or neurons which
control the activity of skeletal muscles. Thesomatic nerves are voluntarily controlled by the more
conscious aspects of the pyramidal system of the mot or cortex descending to alpha mot or neurons
that send out impulses to contract striate muscles. Subtle shifts in the manner of movement and in
muscle tone are regulated by gamma mot or neurons t hat are modulat ed by the less conscious
subcortical extrapyramidal system. Sensory somatic neurons ent er the dorsal root of the spinal
cord and ascend the dorsal columns of the spinal white mat t er to synapse in the brainstem, the
thalamus, and ultimately arrive at the somatosensory cortex on the postcentral gyrus of the parietal
lobe. Thesomatic nerves maintain the pathological reflexes which produce the chronic muscle
tension t hat leads to myofascial pain.
Autonomic nervous system: This division of the peripheral nervous system consists of those
nerves which connect the spinal cord to the visceral organs of t he body. This system is regulated
unconsciously by the subcortical hypothalamus in the brain. All aut onomic nerves leaving the eNS
have preganglionic nerves which travel from the spinal cord to a peripheral ganglion and which
synapse ont o postganglionic nerves t hat travel from t hat ganglion to a visceral organ. Every
internal organ sends sensory neurons to the spinal cord or brain, which t hen send the visceral
message to the hypothalamus. Each visceral organ also receives descending mot or messages from
the hypothalamus.
Sympathetic nervous system: This subdivision of the autonomic nervous system consists of those
autonomic nerves which leave the spinal cord in the region of the thoracic and lumbar vertebrae
and travel to a chain of ganglia alongside the spinal vertebrae. From this sympathetic chain,
postganglionic nerves branch out to internal organs. Sympathetic nerves cause excitation and
arousal of bodily energy in times of stress, strong emot ion or physical exercise. This system leads to
an increase in heart rate, blood pressure, vasoconstriction, sweating, and pupillary dilation, and is
accompanied by the release of the hormone adrenalin from the adrenal medulla gland.
Sympathetic postganglionic nerves are adrenergic, utilizing the neurot ransmit t er norepinephrine.
Parasympathetic nervous system: This subdivision of the autonomic nervous system consists of
those autonomic nerves which leave the central nervous system from eit her the cranium or from
the sacral vertebrae. These preganglionic nerves travel out into the body and synapse on
postganglionic nerves near a visceral organ. Parasympathetic nerves lead to sedation and
conservation of bodily energy. They cause decreases in heart rat e and blood pressure, while
producing increases in vasodilation, pupillary constriction, salivation and digestion of food.
Parasympathetic synapses are cholinergic, employing t he neurot ransmit t er acetylcholine.
Sympathetic preganglionic nerves: These autonomic nerves travel from the t horacic- lumbar
spine to the sympathetic chain of ganglia outside t he spinal vertebrae.
Sympathetic postganglionic nerves: These autonomic nerves travel from the sympathetic
chain of ganglia outside the spinal vert ebrae to the actual visceral organ.
Splanchnic nerves: These peripheral, sympathetic nerves connect to lower visceral organs.
Vagus nerve: This primary parasympathetic nerve connects to most visceral organs.
Sciatic nerve: This somatic nerve travels from the lumbar spinal cord down to t he leg.
Trigeminal nerve: This somatic nerve affects sensations of the face and facial movements.
Facial nerve: This somatic nerve controls major facial movements.
Oculomotor nerve: This somatic nerve controls eye movements.
AuriculotherapyManual
Optic nerve: This cranial nerve responds to visual sensations from the eye.
Olfactory nerve: This cranial nerve responds to smell sensations from the nose.
Auditory nerve: This cranial nerve responds to hearing sensations from the ear and affects the
sense of physical balance and equilibrium.
Central nervous system regions of the brain
Cortical brain regions: Thehighest level of the brain determines the intellectual processes of
thinking, learning and memory. The cerebral cortex initiates voluntary movements and is
consciously aware of sensations and feelings.
Prefrontal cortex: This most evolved region of the human cortex initiates conscious decisions.
Frontal cortex: This anterior cortical region contains the precentral gyrus mot or cortex which
initiates specific voluntary movements. It activates upper mot or neurons in the pyramidal system
that send direct neural impulses to lower motor neurons in the spinal cord.
Parietal cortex: This posterior region contains the somatosensory cortex on the postcentral
gyrus. This region consciously perceives the sensations of touch and the general awareness of
spatial relationships.
Temporal cortex: This posterior and lateral cortical region contains the hearing centers of the
brain. The left temporal lobe processes the verbal meaning of language and the rational logic of
mathematics, whereas the right temporal lobe processes the intonationand rhythmof sounds
and music.
Occipital cortex: This most posterior cortical region processes conscious visual perceptions.
The left occipital lobe can consciously read words, whereas the right occipital lobe is bet t er at
recognizing faces and emotional expressions.
Corpus callosum: This broad band of myelinated axon fibers connects the left cerebral
hemisphere cortical lobes with their respective lobe on the right cerebral hemisphere.
Cerebellum: This posterior region beneat h the occipital lobe and above the pons is part of the
extrapyramidal system control of semivoluntary movements and postural adjustments.
Subcortical brain regions: These regions of the brain serve as an intermediary between the
cerebral cortex above and the spinal cord below, operating outside of conscious awareness.
Thalamus: This spherical nucleus relays sensory messages from lower brainstem regions up to
a specific locus on the cerebral cortex. The thalamus also contains neurons which participate in
the supraspinal gating of pain and in general arousal or sedation.
Anterior hypothalamus: This nucleus lies below the thalamus, where it connects to the limbic
system, t he pituitarygland and the parasympathetic nervous system. This nucleus produces
general sedation.
Posterior hypothalamus: This nucleus connects to the limbic system and the pituitarygland. It
activates the sympathetic nervous system, producing brain arousal and behavioral aggression.
Limbic system: This collection of subcortical nuclei affects emotions and memory.
Cingulate cortex: This paleocortex limbic region lies immediately beneat h the higher
neocortex.
Hippocampus: This semicircular limbic structure lies beneat h t he neocortex, but outside the
thalamus. It affects attentionspan, long term memory storage and emotional experiences.
Amygdala nucleus: This spherical limbic nucleus lies under the lateral temporal lobe and
modulates increases or decreases in aggressiveness, irritability and mania.
Septal nucleus: This medial limbic structure is involved in pleasure sensations and reward.
Nucleus accumbens: This midline nucleus occurs next to the septal nucleus and is the primary
dopaminergic control cent er for the reward pathways of the brain. It plays a significant role in
the brain’s response to all substances t hat are addictive in nature. Neurons in this nucleus are
excited by alcohol, opium, cocaine, and methamphetamine. Stimulation of this nucleus produces
strong pleasure cravings.
Somatotopicrepresentations 227
228
Striatum: These basal ganglia nuclei lie along the limbic system, and outside t he thalamus. The
specific striatal nuclei include the caudate, put amen and globus pallidus, all of which are part of
the extrapyramidal system control of semivoluntary movements.
Brainstem: This term refers to the medulla oblongata of the brainstem. It affects basic,
unconscious control of body metabolism, respiration and heart rate.
Pons: This brainstem region lies below the cerebellum and affects REMsleep and dreams.
Midbrain tectum: This superior part of the midbrain contains colliculi for sensory reflexes.
Midbrain tegmentum: This inferior part of the midbrain affects basic metabolism and pain.
Reticular formation: This region within the midbrain tegmentumactivates general arousal.
Red nucleus and substantia nigra: This region within the midbrain tegmentumaffects the
extrapyramidal system and the striatum, regulating semivoluntary movements.
AuriculotherepyManual
7.5.1 Nogier phase representation of t he nervous system
Neurological point s for Phase I Thecent ral nervous system is represent ed on the ear lobe of
Territory3 in Phase I of Nogier’s system. TheThalamus and Hypot halamusare found on the
external surface of the antitragus, whereas they were previously locat ed on t he concha wall and
inferior concha. The Cerebral Cortexis still represent ed on t he ear lobe.
Neurological point s for Phase II Theect odermal cent ral nervous system shifts to t he helix, the
antihelix, scaphoid fossa and the triangular fossa regions of Territory1 in Phase II. TheThalamus in
Phase II corresponds to t he auricular location for the Chinese mast er point Shen Men. The Cerebral
Cortexin Phase II is found along the antihelix superior crus, scaphoid fossa, and triangular fossa.
Neurological points for Phase III Thecentral nervous system shifts to t he concha of Territory2 in
Phase III. Thecortical areas are located in the superior concha, while subcortical limbic and striatal
areas are found in the inferior concha. Thelocation of the Phase III Thalamusoccurs with its original
designation on the concha wall, while the Hypothalamus t hat is found in the inferior concha coincides
with the location of the Chinese Lung points used in the t reat ment of narcotic detoxification and drug
abuse.
Table 7.1 Auricular zone representation of nervous system points for each Nogier phase
No. Neurological representationson ear PhaseI PhaseII Phase III
Territory3 Territory 1 Territory2
54 Eye L04 AH11 IC3
58 Ear LO 1 TG5 SC6
98 Pineal Gland (epiphysis) TG 1 HXl SC5
99 Pituitary Gland (hypophysis) IT2, IC 1 AH17,AH18 CWI
109 Sympathetic nerves CW2 HX12,HX13 CRl,CR2
110 Parasympathetic Sacral nerves CW3 HX15 CR2
113 Vagus nerve CWI HX12 CRI
124 Spinal Cord HX 14,HX15 AH9,SF2 IC5
127 Brainstem (Medulla Oblongata) L07,L08 HX2 SC 1
131 Reticular Formation L08 AH 12,SF3 IC8
~ ~ - - -
133 Red Nucleus L06 CWlO IC6
134 Substantia Nigra L06 IH 1, IH2 IC7
135 Striatum(Basal Ganglia) L04,AT1 HX9,HXlO IC3,IC4
137 Hypothalamus L06 AH3,AH4 IC4
138 Thalamus (Subcortex, Brain) AT2,AT3 AHll CW2,CW3
140 Hippocampus L02 CW9 IC6
- - - - - - ~ . _ - - - - -
141 Amygdala L02,ITI CW8 IC7
142 Septal Nucleus and Nucleus Accumbens L02 HX7 IC 1
143 Cingulate Gyrus IT 1 CW7 IC6
145 Cerebellum AT3,AHI HX5,HX6 SC8
147 Occipital Cerebral Cortex L07 AHI2,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
Somatotopicrepresentations 229
Brain
Spinal cord
Peripheral nerves
Spinal cord
white matter
Autonomicnervous system
Sympathetic
postganglionic nerves
Somaticnervous system
Spinal cord
gray matter
Dorsal root sensory neurons
Ventral root motor neurons
Spinal cord
Spinal
vertebra
Cranial nerves originating
from brainstem
Opticnerve
Oculomotor
nerve
Auditory
nerve
Vagus nerve
Figure 7.33 Overview oftheperipheral nervous system and the spinal cord. (From LifeARTFJ,Super Anatomy, ' Lippincott Williams &
Wilkins, withpermission.)
230 Auriculotherapy fvlanual
/
Thalamus-+-------;1"------
Striatum
Coronal cross viewofanteriorbrain
Occipital
cortex
Cerebellum
Parietal cortex
Brainstem - - - - - - - ""\
medulla
oblongata
Sagittal sideviewofbrain
Frontalcortex
Prefrontal
cortex
Midsagittal side viewofbrain
Coronal cross viewofposteriorbrain
Frontal
cortex
Septal nucleus/
Nucleus accumbens
Brainstem
medulla
oblongata
Cingulatecortex
Corpuscallosum
Thalamus
Striatum
Midbrain
tectum
- +I- - ’f...- - """’’- - - ’- ’’’’’’’’,,- f- - Midbrain
tegmentum
Cerebellum
Reticular formation
Horizontal viewacross brain
Hippocampus
Red nucleus
Substantia nigra
Horizontal viewofbottomofbrain
Thalamus
Brainstem __
medulla -
oblongata
Striatum
Frontal cortex
Olfactory bulb
Cerebellum
d?_..- ff- - - .+- - Temporalcortex
Pons
Occipital
cortex
Figure 7.34 Overview of the central nervous system. (From LifeAR’J’fi, Super Anatomy, ' Lippincott Williams & Wilkins, with
permission. )
Somatotopicrepresentations 231
7.5.2 Peripheral nervous system represented on the ear
No.
107.0
108.E
Auricular microsystem point (Alternative name)
Sciatic nerve (Sciatica, Ischium, Ischialgia)
Location: A notch at the midpoint of the top surface of the antihelix inferior crus, at LM 17.
Function: Relieves sciatic neuralgia, lower limb paralysis, post-polio syndrome.
Sympathetic Preganglionic nerves
Location: Along the length of the helix tail as it joins the gutter of the scaphoid fossa.
Function: Relieves reflex sympathetic dystrophy, vasospasms, neuralgias.
[Auricular zone]
[AH6]
[HX12- HX14]
[CWS- CW9] 109.E Sympathetic Postganglionic nerves (Paravertebral Sympatheticchain)
Location: Along the length of the concha wall above the concha ridge and superior concha.
Function: Relieves back pain, reflex sympathetic dystrophy, neuralgias, vasospasms, poor blood circulation .
. _ - - - - - - - - - - - - - - ~ .._ - ~ .. _----_.. _- - - - - - _._- - - - - _._- - - - - - - - - - - - - - - - - - - - - - - - - -
110.E 1
110n
Parasympathetic Cranial nerves
Location: Intertragic notch region of the inferior concha.
Function: Relieves autonomic nervous disorders affecting the upper body and the head.
Parasympathetic Sacral nerves (Pelvic Splanchnic nerve)
Location: Inferior concha, superior to the ear 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 Splanchnic nerves)
Location: Central region of the superior concha.
Function: This plexus distributes lumbar sympathetic nerves to the rectum, bladder, uret er and genital organs. Relieves
pelvic dysfunctions, rectal, ureter and bladder control.
Solar plexus (Celiac plexus, Thoracic Splanchnic nerves, AbdominalBrain)
Location: Helix root, above Point Zero and LM O.
Function: Relieves abdominal dysfunctions, gastrointestinal spasms and pathology in the viscera of upper abdominal
organs, such as the stomach, liver, spleen, pancreas and adrenal glands.
- - - - - - - - - - - - - - - - - - - - - - - - -
Vagus nerve (TenthCranial nerve, Xn., Cranial Parasympathetic nerves)
Location: Inferior concha, next to the ear canal, and spreads throughout the concha.
Function: Vagus nerve affects parasympathetic nervous system control of most thoracic and abdominal organs. This
point relieves diarrhea, heart palpitations, anxiety.
114.E
11S.E
Auditory nerve (EighthCranial nerve, VIII n., Cochleovestibular nerve)
Location: Underside of the subtragus.
Function: Affects hearing and vestibular disorders, deafness, tinnitus, equilibrium imbalance.
Facial nerve (Seventh Cranial nerve, VII n., Nucleus ofSolitary Tract)
Location: Peripheral region of the posterior ear lobe.
Function: Relieves facial muscle spasms, tics, facial paralysis.
[ST 3]
[PL 6]
232 AuriculotherapyManual
No.
116.E
117.E
118.E
119.E
120.E
121.E
Auricular microsystem point (Alternative name)
Trigeminal nerve (Fifth Cranial nerve, Vn.)
Location: Peripheral edge of the ear lobe.
Function: Relieves trigeminal neuralgia, dental analgesia.
Oculomotor nerve (ThirdCranial nerve, III n.)
Location: Peripheral edge of the ear lobe.
Function: Affects control of eye movements, relieves eye twitches.
Optic nerve (SecondCranial nerve, II n.)
Location: Central side of the ear lobe, inferior to the intertragic notch, LM 9.
Function: Relieves visual disorders, eyesight dysfunctions.
Olfactory nerve (First Cranial nerve, In.)
Location: Central side of the ear lobe, inferior to the intertragic notch, LM 9.
Function: Relieves problems with smell sensations.
- - - - - - - - - - - - - - - - - - - - - - - - - - - ~ . _ - ~ - _ .
Inferior Cervical ganglia (Stellateganglion, Cervical-Thoracic ganglia)
Location: Junction of the inferior concha ridge and concha wall.
Function: Affects thoracic sympathetic control, migraines, whiplash.
Middle Cervical ganglia (Wonderfulpoint, fv1arvelous point)
Location: Junction of the inferior concha and concha wall.
[Auricular zone]
[LO5, PL 5]
[PL 3]
[LO1]
[L02]
[CW5]
[CR 2/CW4]
Function: Balances excessive sympathetic arousal, reduces hypertension, affects blood vascular regulation, relieves
muscle tension.
122.E Superior Cervical ganglia
Location: Junction of inferior concha and concha wall, below LM 14.
Function: Affects cranial sympathetic control.
[CW4]
[IH10/SF 5]
123.C Lesser Occipital nerve (fv1inor Occipital nerve, WindStream)
Location: Junction of the internal helix with the superior scaphoid fossa.
Function: Alleviates migraine headaches, occipital headaches, blood vessel spasms, posttraumaticbrain syndrome,
arteriosclerosis, neuralgias, numbness, spondylopathy, neurasthenia and anxiety. It is used in Chinese ear acupuncture
like a master point to tranquilize the mind and clear zang-fu meridian channels.
- _._- - - _._- - _.._ - - - - - - - - - - - - - ~
Somatotopicrepresentations 233
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
Vagus nerve
110.E1
Parasympathetic
Cranialnerves
119.E
Olfactory nerve
118.E
Opticnerve
234
Figure 7.35 Hidden view of the peripheral nervous system represented on the auricle. (From LifeARl
fID
, Super
Anatomy, ' Lippincott Williams& Wilkins,with permission.)
Aur;culotherapy Manual
Back of ear
r ,
120.E
Inferior
Cervical ganglia
121.E
Middle
Cervical ganglia
122.E
Superior
Cervical ganglia
123.C
Lesser
Occipital
nerve
117.F4
Oculomot or 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. Opt ic nerve
119. Olfact ory nerve
117. Oculomot or nerve
116. Trigeminal nerve
114. Audit ory nerve
113.E
Vagus nerve
110.El
Parasympathetic
Cranial nerves
119.E
Olfact ory nerve
115. Facial nerve
114.E
Audit ory nerve
118.E
Opt ic nerve
110.E2
Parasympathetic
Sacral nerves
112.E
Solar plexus
107.0
Sciatic nerve
111.E
Hypogastric plexus
113.
Vagus nerve
.. .I
Figure 7.36 Surface view ofthe peripheral nervous system represented on the auricle. (From LifeARTW, Super Anatomy, ' Lippincott
Williams & Wilkins, withpermission.)
Somatotopicrepresentations 235
7.5.3 Spinal cordandbrainstemrepresentedonthe helix tail andlobe
No.
124.E
Auricular microsystem point (Alternative name)
LumbosacralSpinalCord
[Auricular zone]
[HX12, PP 8]
[HX13, PP 6]
[HX14, PP 4]
[CW4]
125.E
126.E
127.C
Location: Superior helix tail, below Darwin’s tubercle, LM 4.
Function: The anterior side of helix tail represents the sensory dorsal horn cells of the lumbosacral spinal cord, whereas
posterior side of helix tail represents mot or ventral horn cells of the lumbosacral spinal cord. This point relieves
peripheral neuralgias in the region of the lower limbs. It is also used effectively to treat patientswho have neuralgic side
effects from AIDS or cancer medication, or for diabetic patientswith poor circulation to the feet.
ThoracicSpinalCord
Location: Helix tail, peripheral to the concha ridge and LM O.
Function: Ant erior side affects sensory neurons of thoracic spinal cord, whereas the posterior side affects mot or
neurons of thoracic spinal cord. Relieves shingles, sunburns, poison oak or poison ivy on body or arms.
Cervical SpinalCord
Location: Inferior helix tail, above LM 5.
Function: Relieves sunburned neck, neuralgias, shingles, poison oak on neck. The anterior side of the helix tail affects
sensory cervical neurons, while the posterior side affects mot or cervical neurons.
Brainstem(Medulla Oblongata)
Location: Central side of concha wall, just below the base of antihelix, LM 14.
Function: Affects body temperature, respiration, cardiac regulation, shock, meningitis, brain trauma, hypersensitivity
to pain. This point tonifies the brain, invigorates the spirit, arrests epileptic convulsions, reduces overexcitement, abates
fever and tranquilizes endopathicwind.
127.E MedullaOblongata (Brainstem)
Location: Inferior helix tail, between LM 5 and LM6.
Function: Affects body temperature, respiration, cardiac regulation.
[HX15, PP 2]
[LO 7, PL6] 128.E Pons
Location: Peripheral lobe.
Function: Affects sleep and arousal, paradoxical REMsleep, emotionally reparative dreams, and relieves insomnia,
disturbing dreams, dizziness and psychosomatic reactions.
129.E MidbrainTectum
Location: Peripheral ear lobe.
Function: The midbrain tectum includes the superior colliculus and inferior colliculus, which respectively affect
subcortical reflexes for visual stimuli and auditory stimuli.
[L06]
[LO 5, PL 5] 130.E MidbrainTegmentum(Mesolimbic ventral tegmentalarea)
Location: Peripheral ear lobe.
Function: Midbrain tegmentumcontains red nucleus and substantia nigra nuclei which affect extrapyramidal control of
semivoluntary muscles and motor integration of voluntary movements. This point relieves Parkinsonian tremors,
torticollis, writer’s cramp.
131.E Reticular Formation [LO8, 5T 3]
Location: Peripheral ear lobe at the base of the scaphoid fossa and inferior to the antitragus, and also is represented on
the subtragus.
Function: The reticular activating system (RAS) of the brainstem activates arousal, attention, alertness, vigilance,
integration of nociceptive input, and affects brain laterality.
132.E TrigeminalNucleus
Location: Peripheral ear lobe.
Function: Relieves symptoms of trigeminal neuralgia, dental pain, facial tremors.
[LO 7, PL 5]
236 AuriculotherapyManual
7.5.4 Subcortical brain nuclei represented on the concha wall and lobe
No. Auricular microsystem point (Alternative name)
[Auricular zone]
- - - - - ~ - - - - ~
~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
133.E
134.E
Red Nucleus
Location: Superior region of ear lobe, below the peripheral antitragus.
Function: Regulates semivoluntary acts and relieves extrapyramidal muscle tremors and spasms.
- - - - - -~ - - - - -
Substantia Nigra
Location: Superior region of lobe, below the peripheral antitragus.
Function: Regulates semivoluntary acts and relieves extrapyramidal muscle tremors and spasms.
~ ~ - - - - - -~ - - - - - - - - - - - - ~ - - - - - - - - - - - -
[LO6, PL6]
[LO6, PL6]
[LO4, PL4]
135.E Striatum (Basal Ganglia, Extrapyramidal motorsystem)
Location: Superior region of ear lobe, below the medial antitragus.
Function: Affects muscle tone, elaboration of automatic and semiautomatic movements, and inhibition of involuntary
movements. Relieves Parkinsonian disease, tremors, spasms.
~ - - - - - ~ - - - - - - - - -
[CW3]
136.E
137.E
138.C
Anterior Hypothalamus
Location: Inferior concha region near the intertragic notch.
Function: Affects parasympathetic sedation, diuresis.
Posterior Hypothalamus
Location: Peripheral inferior concha, below the antitragus, near the Thalamus point.
Function: Facilitates sympathetic arousal and relieves hypertension and cardiac acceleration. Affects secretion of
adrenal in, vigilance, wakeful consciousness and decreases digestion.
Brain (Thalamicnuclei, Diencephalon, Central Rim)
Location: Upper edge of the concha wall, behind the occiput on antitragus external surface.
Function: Alleviates deficiency of blood supply to the brain, cerebral concussion, restlessness, cerebellar ataxia,
epilepsy, attention deficit disorder, hyperactivity, addictions, clinical depression, asthma, sleep disturbance and poor
intellectual functioning. It also affects hypothalamic control of pituitary gland, endocrine glands, relieving glandular
disturbances, irregular menstruation, sexual impotence, diabetes mellitus and pituitary tumors.
[IC2]
[IC 5]
138.E Thalamic Nuclei (Brain, Diencephalon)
Location: Concha wall behind the whole antitragus ridge, above the Thalamus point.
Function: Affects all thalamic relay sensory connections to the posterior cerebral cortex.
[CW1- CW3]
[LO1, PL 1] 139.E Limbic System (Rhinencephalon, Reactional Brain, Visceral Brain)
Location: Bottomof the junction of the ear lobe and the jaw, at LM8.
Function: Affects memory, amnesia, retention of lived-through emotional experiences, sexual arousal, aggressive
impulses, compulsive behaviors.
140.E Hippocampus (MemoryBrain, Fornix, Ammon’sHorn)
Location: Superior ear lobe immediately inferior to the length of the antitragus.
Function: This limbic nucleus affects memory, amnesia, retention of lived-through emotional experiences.
Somatotopicrepresentations
[LO4, PL 6]
237
No. Auricular microsystem point (Alternativename)
[Auricular zone]
[LO 2]
141.E Amygdala Nucleus (EmotionalBrain, Aggressivitypoint)
Location: Notch on the superior lobe as it joins the peripheral intertragic notch.
Function: This limbic 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 to intertragic notch.
Function: This limbic nucleus affects pleasure, reinforcement, instinctive responses and seems to be the primary
contributingbrain region to substance abuse and addiction.
[L02]
- - - - - - - - - - - - - - - - - - - - - _ ...__.. _ - ~ -
143.E Cingulate Gyrus (Paleocortex)
Location: Central intertragic notch.
Function: This limbic nucleus affects memory and emotions.
[IT 1]
~ ~ ~ ~ - - ~ ~ ~ - - ~ ~ ~ ~ ~ - ~ ~ - - - - - - - - - - -
138.E
ThalamicNuclei
141.E
Amygdala Nucleus
133.E
Red Nucleus
139.E1
Limbic System 1
134.E
Substantia Nigra
137.E
Posterior
Hypothalamus
136.E
Anterior
Hypothalamus
132.E
Trigeminal Nucleus
131.E 1
Reticular Formation
127.E
Medulla Oblongata
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 Hiddenviewof the subcortical central nervous systemrepresented on the auricle. (From Lij’eARTQfJ,
SuperAnatomy, ' LippincottWilliams& Wilkins, withpermission.)
238 AuriculotherapyManual
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 mot or neurons
126.F4
P ; I j ~ __127.E
Medulla Oblongata
128.E Pons
132.E
Trigeminal Nucleus
134.E
Substantia Nigra 124.F4
Lumbosacral mot or neurons
135.
Striatum
Cervical mot or
141.
Amygdala
,- - - - ...:1.- 140.
Hippocampus
127.C
Brainstem
137.E
Posterior
Hypothalamus
138.C
Brain
131.E2
Reticular
Formation
136.E
Ant erior
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 view of the subcortical central nervous system represented on the auricle. (From LifeAR’fF!, Super Anatomy,
' Lippincott Williams& Wilkins,withpermission.)
Somatotopicrepresentations 239
7.5.5 Cerebral cortex represented on the ear lobe
No.
144.E
Auricular microsystem point (Alternativename)
Olfact ory Bulb
Location: Central ear lobe as it meets the face, midway between LM8 and LM 9.
[Auricular zone]
[LO2]
Function: Affects sense of smell.
[AH1, PL 4]
[TG1-TG 5]
14s.E
146.E
Cerebellum
Location: Inferior antihelix tail and the posterior lobe.
Function: Affects mot or coordination and postural tonus. Relieves intentional tremors, spasms, semiautomatic
movements, coordination of axial movements, postural tonus, perfection of intentional, cortical movements, vertigo,
vestibular equilibrium and clinical depression.
Corpus Callosum
Location: Whole length of vertically ascending tragus.
Function: Affects brain laterality of left and right cerebral hemispheres. The interactions between the two sides of the
brain are represented on the tragus in an inverted pattern. The callosal radiations to the frontal cortex are projected ont o
the inferior tragus, near LM 9; the temporal- occipital cortex radiations are projected ont o the middle of the tragus,
between LM 10and LM 11; the parietal cortex radiations are projected ont o the superior tragus. Thetragus also
represents the anterior Conception Vessel (Ren mai channel) and posterior Governing Vessel (Du mai channel) in an
inverted position, the head down toward TG 1 and the base of the body up toward TG 5.
Cerebral laterality The left ear in a right-handedperson represents the logical, linguistic, left cerebral cortex and the right
ear represents the rhythmic, artistic right cerebral hemisphere. These representations are reversed in some left handed
individuals and in patientswith oscillation problems. Thus an oscillator would have the left cerebral cortex projected onto
the right ear and the right cerebral cortex represented on the left ear. The left hemisphere controls the right side of the
body, is more conscious, draws logical conclusions, analyzes specific details, understands the verbal content of language and
can rationally solve mathematics problems. The right hemisphere controls the left side of the body, tends to operate
unconsciously, perceives the world with global impressions, and holds emotional memories more strongly.
147.E
148.E
149.E
Occipital Cortex (Occipital Lobe, Visual Cortex)
Location: Peripheral antitragus and the ear lobe below it.
Function: Affects visual neurological disorders, blindness, visual distortions.
Temporal Cortex (AcousticLine, Temporal Lobe, Auditory Cortex)
Location: Peripheral ear lobe.
Function: Affects auditory disorders, musical tone discriminations, auditory impairment, deafness.
Parietal Cortex (Postcentral Gyrus, ParietalLobe, Somatosensory Cortex)
Location: Middle of ear lobe.
Function: Affects tactile paresthesia, musculoskeletal pain and somes thetic strokes.
[AT 3, La 8]
[L06, L08]
[LO5, La 6]
- - - - - - - - - - - - - - - - _._- _ .. _._- - - - - - - - - - -
iso.t
is u
Frontal Cortex (Precentral Gyrus, FrontalLobe, Pyramidal Motor System)
Location: Central ear lobe.
Function: Initiates motor action. Relieves motor paralysis, alters muscle tonus.
Prefrontal Cortex (MasterCerebral point)
Location: Central ear lobe as it joins face.
Function: Initiates decision making. Relieves poor concentration, obsessions, worry.
[LO3, PL 3]
[La 1, PL 1]
240 AuriculotherapyManual
- - - - - - - - - - - - - - - - - - - _._- - - - - - - - -
146.E
Corpus
Callosum
144.E
Olfactory Bulb
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 view of the cortical central nervous system represented on the auricle. (From LifeARrfi,
Super Anatomy, ' Lippincott Williams & Wilkins, withpermission.)
Somatotopicrepresentations 241
7.6 Auricular representation of functional conditions
7.6.1 Primary Chinese functional points represented on the ear
- - - - - - -
No.
152.(
153.(
154.(
Auricular microsystem point (Alternativename)
Asthma (Ping Chuan)
Location: Apex of the antitragus, at LM 13.
Function: Relieves symptoms of asthma, bronchitis, coughs, difficulty breathing, itching.
- - - - - -- - - - - - _..
Antihistamine
Location: Middle of the triangular fossa, near the European Knee point.
Function: Relieves symptoms of colds, allergies, asthma, bronchitis, coughs.
. ..... ......- ... _- - - - - - - - - - - - - -
Constipation
Location: Inferior triangular fossa, superior to LM 17 on the antihelix inferior crus.
Function: Relieves constipation, indigestion.
[Auricular zone]
[AT 2]
[TF 4]
[TF 3]
155.(1
155.(2
156.(1
156.(2
156.C3
157.(
Hepatitis 1
Location: Superior aspects of the triangular fossa as it curves up to the antihelix superior crus.
Function: Reduces liver dysfunctions, liver inflammations.
Hepatitis 2 (Hepatomeglia, Cirrhosis)
Location: Peripheral inferior concha, at the Liver point.
- - - _._- - _._- _.
Hypertension 1 (Depressing point, Lowering BloodPressure point)
Location: Central, superior triangular fossa, near the European points for the Toes.
Function: Reduces high blood pressure, induces relaxation.
Hypertension 2 (HighBloodPressure point)
Location: Inferior tragus, at the Tranquilizer point.
Hypertension 3 (Hypertensive groove)
Location: Superior region of the posterior groove, behind the upper antihelix body.
Hypotension (Raising BloodPressure point)
Location: Central intertragic notch, between Eye Disorders Mu 1and Eye Disorders Mu 2.
Function: Elevates abnormally low blood pressure.
[TF 4]
[IC 5]
[TF 3]
[TG 2]
[PG 4 & PG 8]
[IT1]
158.( Lumbago (Lumbodynia, Coxalgia)
Location: Middle of antihelix body.
Function: Relieves the functional or psychosomatic aspects of low back pain.
[AH 11]
159.( Muscle Relaxation [IC 7/IC 8]
242
Location: Peripheral inferior concha, near the Chinese Spleen point and the Liver points.
Function: This point is one of the most clinically effective points on the auricle for reducing muscle tension, with almost
the status of a master point because it is used so often to reduce pain and stress.
AuriculotherapyManual
No.
160.C
Auricular microsystem point (Alternative name)
San Jiao (Triple Warmer, Triple Heater, Triple Burner, Triple Energizer)
[Auricular zone]
[IC 1]
Location: Inferior concha, near the PituitaryGland point, the gland which regulates antidiuretic hormone that controls
fluid levels released in urine.
Function: Affects diseases of the internal organs and the endocrine glands. Affects the circulatory system, respiratory
system, and thermoregulation. It relieves indigestion, shortness of breath, anemia, hepatitis, abdominal distension,
constipation and edema. San Jiao regulates water circulation and fluid distribution related to the lower jiao, middle jiao,
and upper jiao.
161.C Appetite Control (Hungerpoint,WeightControl)
Location: Middle of tragus, between LM10 and LM 11.
[TG 3]
[TG4]
[SC 2]
162.C
163.C
Function: Diminishes appetite, nervous over-eating, overweight disorders, hyperthyroidism and hypertension. This ear
point can be very effectively combined with stimulation oft he Stomach point for reduction of the food cravings that may
accompany commitment to a diet plan and exercise program. However, it does not replace the need for willpower to
maintain commitment to a comprehensive weight reduction program.
Thirst point
Location: Tragus, just medial and inferior to the superior tragus protrusion, LM11.
Function: Diminishes excessive thirst related to diabetes insipidus and diabetes mellitus. In TCM, it nourishes yin and
promotes the production of body fluids to reduce thirst.
- - - - - - - - - - - - - - - - - - - - - -
Alcoholic point (Drunkpoint)
Location: Superior concha, between the Small Intestines point and the Chinese Kidney point.
Function: Relieves hangovers, assists t reat ment of alcoholism. Just as the Appetite Control point can only facilitate but
not overrule the effects of willpower for weight reduction, this Alcoholic point can only facilitate but not override
conscious volition. An alcoholic patient must commit to a life of sobriety and some type of support and empowerment
group, such as a 12-step program.
164.C
165.C
Nervousness (Neurasthenia, fVIaster Cerebral point)
Location: Central ear lobe, near LM8 and the Master Cerebral point.
Function: Relieves anxiety, worry, neurosis, neurasthenia.
Excitement point
Location: Conchawall below the apex of antitragus and above the Thalamus point.
Function: This point induces excitation of the cerebral cortex to relieve drowsiness, lethargy, depression,
hypogonadism, sexual impairment, impotency, and obesity.
somatotopicrepresentations
[LO 1]
[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 conditionsrepresented on theauricle.
AuriculotherapyManual
164.C
Nervousness
Figure 7.41 Surface viewofprimaryChinesefunctional conditionsrepresented on theauricle.
somatotopicrepresentations 245
7.6.2 Secondary Chinese functional points represented on the ear
Secondary functional points are only distinguished from t he primary functional points by being less commonly used as
the primary ear reflex points. Even this distinction is not completely accurate, as more recent clinical work by the
Chinese has emphasized the use of particular secondary ear reflex points like Wind Stream and Cent ral Rim.
No.
166.C
167.C
Auricular microsystem point (Alternative name)
- - - - - - - - - - - - - - - - - - - - -
Tuberculosis
Location: Inferior concha, at center of the Lung point region.
Function: Relieves tuberculosis, pneumonia, breathingdifficulties.
Bronchitis
Location: Inferior concha, at the Bronchi point, inward from the Lung point region.
Function: Relieves bronchitis, pneumonia, breathing difficulties.
[Auricular zone]
[IC S]
[IC 7]
[AH11] 168.C Heat point
Location: Antihelixbody, at the junction of the inferior and superior crus.
Function: Produces peripheral vasodilation, reducing vascular inflammation and sensation of being warm or feverish. It
is used for acute strains, lowback pain, Raynaud’s disease and phlebitis.
169.C
170.C
Cirrhosis
Location: Peripheral concha ridge, within the Liver point region.
Function: Relieves cirrhosis damage to the liver and hepatomeglia.
Pancreatitis
Location: Peripheral superior concha, within the Pancreas point region.
Function: Relieves inflammation and deficiencies of the pancreas, diabetes, indigestion.
[CR 2]
[SC 7]
171.C Nephritis
Location:
Function:
Inferior helix tail as it meets the gutter of the scaphoid fossa, near LM 5.
Reduces kidney inflammations.
[HX 1S]
172.C
173.C
174.C1
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ascites point
Location: Superior concha, between the Duodenumpoint and Chinese Kidney point.
Function: Reduces excess abdominal fluid, cirrhosis, flatulence.
Mutism (Dumbpoint)
Location: Underside of subtragus, superior to the Inner Nose point.
Function: Used to assist problems with speaking clearly or with stuttering.
Hemorrhoids 1
Location: Underside of the internal helix, near the European Kidney point.
Function: Alleviates hemorrhoids.
[SC 6]
[ST 3]
[IH S]
174.C2 Hemorrhoids 2
Location: Central superior concha, near the Chinese Prostate point.
- - - -- - - - - - - - - - - - - - - - - - - - -
[SC 4]
246 AuriculotherapyManual
No.
175.C
Auricular microsystem point (Alternative name)
Wind Stream (Lesser Occipital nerve, MinorOccipital nerve)
[Auricular zone]
[IH10]
Location: Peripheral internal helix as it joins superior scaphoid fossa. This ear reflex point was previously referred to in
Chinese texts as the Minor Occipital nerve.
Function: Alleviates allergies, bronchial asthma, allergic rhinitis, coughs, dermatitis, urticaria, and allergic
constitutions. This point is utilized in Chinese ear acupuncture treatments to reduce the effects of pathogenic wind.
.. - - -...._- - - - - - - _._- -
176.C Central Rim (Chinese Brain point) [CW3]
[TG 5] 177.C
Location: Portion of concha wall below the junction of the antihelix tail and the antitragus. This ear reflex point was
previously referred to in Chinese texts as the Brain point or Brainstem point.
Function: Alleviates basic metabolic symptoms of stress, neurological problems, and addiction disorders. In TCM, it
replenishes spleen qi and kidney qui, nourishes the brain, and tranquilizes the mind.
Apex ofTragus
Location: Tragus superior protrusion, at LM 11.
Function: Reduces inflammation, fever, swelling, arthritic pain. It has analgesic, antipyretic, and anti-inflammatory
properties.
178.C Apex of Antitragus
Location: Antitragus superior protrusion, at LM 13.
Function: Reduces inflammation, fever, swelling.
[AT 2]
[HX7]
[HX11]
179.C
180.C1
Apex of Ear (Tip of Ear, Ear Apex,ApexofAuricle)
Location: Topof the superior helix, at LM 2.
Function: Antipyretic point to reduce inflammation, fever, swelling, and blood pressure. This point is often used for
blood-lettingby pricking the top oft he ear to reduce fever, blood pressure, inflammation, delirium, and acute pain. This
point has analgesic, antipyretic, and anti-inflammatoryproperties. In TCM,this point clears away heat and toxic
substances, calms liver qi and reduces wind.
- - _._- - - - -
Helix 1 (Helixpoints)
Location: Peripheral helix, at Darwin’s tubercle, between LM 3 and LM 4.
Function: Antipyretic point to reduce inflammation, fever, swelling, blood pressure (same function for all Helixpoints).
180.C2 Helix 2
Location: Helix tail, within the region of the Lumbosacral Spinal Cord.
[HX13]
180.C3 Helix 3
._- _.... _- - - - - - - - - - - - - - - - - - - - _._- - - - - - - - - -
[HX14]
180.C4
180.C5
180.C6
Location: Helix tail, within the region of the Cervical Spinal Cord.
Helix 4
Location: Helix tail, where the helix meets the lobe at LM 6, superior to the Chinese Tonsil 3 point.
- - - - - - - ". - - - - - - - - - - - - - - - - - - - - - - -
Helix 5
Location: Peripheral ear lobe, midway between LM 6 and LM 7.
Helix 6
Location: Bottomof the ear lobe, at LM 7, inferior to the Chinese Tonsil 4 point.
[HX14]
[LO 7]
[LO 3]
Important ear points: The most commonly used Chinese functional points are Muscle Relaxation point, Appetite
Control point, Brain (Central Rim), and Wind Stream (Lesser Occipital nerve). The Nervousness point is identical to
the Master Cerebral point and the Hypertension 2 point overlaps the Tranquilizer point.
Somatotopicrepresentations 247
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 Hidden viewofsecondary Chinesefunctional conditions represented on the auricle.
AuriculotherapyManual
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
Wind Stream
180.C1
Helix 1
170.C
Pancreatitis
180.C2
Helix 2
180.C3
Helix 3
167.C
Bronchitis
166.C
Tuberculosis
180.C4
Helix 4
180.C5
Helix 5
Figure 7.43 Surface viewofsecondary Chinese functional conditions represented on the auricle.
Somatotopicrepresentations 249
7.6.3 Primary European functional points represented on the ear
- - - - - - - - - - - - - - - - - - - -
No.
18l.E
Auricular microsystem point (Alternative name)
Auditory Line
[Auricular zone]
[L06]
182.El
Location: A horizontal line on the ear lobe, inferior to the antitragus, in the auricular region that corresponds to the
auditory cortex of the temporal lobe. There is second auditory line on the neck, below the ear lobe.
Function: The auditory line represents the auditory cortex on the temporal lobe, with stimulation of high frequency
sounds more present on the central part of this line and representation of lowfrequency sounds more present on the
peripheral part of this line. It is used to relieve deafness, tinnitus and ot her hearing disorders.
Aggressivity 1 (Aggression Control, Anti-aggressivity, Irritability) [LO2]
Location: Notch at the junction of the medial antitragus and medial ear lobe. It is located at same auricular region as
the limbic Amygdala Nucleus which regulates aggressive behaviors.
Function: Reduces irritability, aggression, frustration, rage, mania and drug withdrawal.
182.E2
182.E3
Aggressivity 2
Location: Superior tragus.
Aggressivity 3
[TG 5]
[IC 2]
Location: Inferior concha next to concha wall region behind the antitragus.
[HX4] 183.E 1 Psychosomatic point 1 (Psychotherapeutic point,Point R, Bourdiol point)
Location: Superior helix root, as it joins the face at LM 1. It is located near Chinese ear reflex point for External
Genitals and external to the Autonomic point.
Function: Alleviates psychological disorders, and can help psychotherapy patients remember long-forgotten memories
and repressed emotional experiences. It also facilities the occurrence of vivid intense dreams.
183.E2 Psychosomatic point 2 [LO1]
Location: Inferior lobe as it joins the face, superior to LM8, in region for the intellectual Prefrontal Cortexregion of
ear. It is also near Master Cerebral, Neurasthenia, and Nervousness.
- - - - ~ .... _ - - - ~ - - - - - . _ -
184.E Sexual Desire (Bosch point,Libidopoint) [HX1]
Location: Helix root as it joins the superior edge of tragus, at the European ear point for the External Genitals, Penis
and Clitoris.
Function: Increases libido, enhances sexual arousal.
185.E Sexual Compulsion (jeromepoint,Sexual Suppression)
Location: Helix tail as it joins the ear lobe, near LM5, at the European Medulla Oblongata.
Function: Lowers libido, calms sexuality, alleviates insomnia.
[HX15]
186.E Master Omega (Master Cerebral point,Psychosomatic point,Worrypoint,Angst) [LO1]
Location: Inferior ear lobe near the face, superior to LM 8. It is the same point as the European Mast er Cerebral point
and the Chinese Nervousness or Neurasthenia points. It is in the region of the ear reflex point for the Prefrontal Cortex.
A vertical line can be drawn between this Master Omega point and the functional points Omega 1 and Omega 2.
Function: Affects psychological stress, such as obsessive-compulsive disorders, fear, worry, ruminatingthoughts, angst,
psychosomatic disorders and general analgesia.
250
- . . - - - - - - ~ - - - - - - - - -
AuriculotherapyManual
- - - - - - - - _ . _ - - - ~ . - - - - - - - - - - - - - - - - - - - - - - _.
No.
187.E
188.E
Auricular microsystem point (Alternative name)
Omega 1
Location: Superior concha, central to the Small Intestines point.
Function: Affects vegetative stress, such as digestive disorders and visceral pain.
Omega 2
Location: Superior helix, central to the Allergy point at LM 2.
Function: Affects somatic stress, reducing rheumatoid arthritis, inflammations of the limbs.
[Auricular zone]
[SC 2]
[HX6]
[CR 2/CW4] 189.E Marvelous point (Wonderfulpoint,MiddleCervical plexus)
Location: Peripheral concha ridge, in region of the Liver point.
Function: Balances excessive sympathetic arousal, reduces hypertension. Affects blood vascular regulation, relieves
muscle tension.
190.E
191.E
192.E
Antidepressant point (Cheerfulness, Joypoint)
Location: Peripheral ear lobe, below the peripheral antitragus and below the Occiput point.
Function: Relieves endogenous depression, reactive depression and dysphoric mood.
Mania point
Location: Inferior tragus edge that lies above the inferior concha, between LM 9 and LM 10.
Function: Relieves hyperactive manic behavior that often accompanies addictions.
Nicotine point
[L08]
[TG 1]
[TG 2]
Location: Inferior tragus edge t hat is over the concha, superior to the Mania point and inferior to the Chinese Adrenal
Gland point.
Function: Used to reduce nicotine craving in persons withdrawing from smoking.
193.E
194.E
195.E1
195.E2
196.E
Vit alit y point
Location: Superior tragus, central to LM 11.
Function: Affects immune system disorders, AIDS, cancer.
Alertness point
Location: Helix tail, below the Darwin’s tubercle, near LM 4.
Function: Induces arousal, activation, alertness.
Insomnia 1 (Sleeppoint)
Location: Superior scaphoid fossa, near the Wrist point.
Function: Relieves insomnia, nervousness, depression.
Insomnia 2 (Sleeppoint)
Location: Inferior scaphoid fossa, near Master Shoulder point.
Function: Relieves insomnia, sleep difficulties, nervous dreams, inability to dream.
- - - - - -- - - - - - - - - ~ - - - - - - - - - - - - - - -
Dizziness (Vertigo)
Location: Conchawall, below the Occiput and Cervical Spine points.
Function: Relieves dizziness, vertigo.
- - - - - - - - - - - - - - - - - - - - -- - - -
Somatotopicrepresentations
[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
Audit ory line
\
181.E2- - - \
Audit ory line \
188.E
Omega 2
187.E
Omega 1
184.E
Sexual Desire
193.E
Vit alit y
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 Hidden viewofprimary European functional conditions reprr-ented on the auricle.
AuriculotherapyManual
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
Vit alit y point
196.E
Dizziness - - - - - If- - _
192.E
Nicotine point
191.E
Mania point
182.El - - - - - Ill!
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
Audit ory line 1
Figure 7.45 Surface viewofprimary European functional conditions represented on the auricle.
Somatotopicrepresentations 253
7.6.4 Secondary European functional points represented on the ear
As with the Chinese secondary functional points, the European secondary functional points are distinguished from the
European primary functional points only because they are not as commonly used.
No. Auricular microsystem point (Alternative name) [Auricularzone]
' - ~ ~ ~ ~ ~ ~ ~ ~ ~ ' - - - - - - - " - - - - - - - - - - - - - - -
197.E
198.E
199.E
200.E
201.E
202.E
Sneezing point
Location: Peripheral ear lobe, near the location for European Trigeminal Nucleus point.
Function: Reduces sneezing, allergies.
Weather point
Location: Helix root, superior to the Chinese Rectum point and above the European Prostate point.
Function: Alleviates any symptoms due to changes in weather.
Laterality point
Location: Sideburns area of the face, central to LM 10.
Function: Facilitates balance of left and right cerebral hemispheres, reduces oscillation.
Darwin’s point (BodilyDefense)
Location: Darwin’s tubercle on the peripheral helix, between LM 3 and LM 4.
Function: Relieves all types of pain in the lower back and lower limbs since it represents the spinal cord.
Master point for Lower Limbs
Location: Helix root, above the European External Genitals point.
Function: Relieves pain and swelling in legs and feet.
Master point for Upper Limbs
Location: Helix tail, in the region of the European Medulla Oblongata.
Function: Relieves pain and swelling in arms, hands, and fingers.
[LO 5j
[HX3]
[Face]
[HX11]
[HX2]
[HX15]
~ - - - - . ~ ~ ~ ~ - - - - - - - - - -
203.E
204.E
Master point for Ectodermal Tissue
Location: Intertragic notch, inferior to the Pineal Gland and Eye Disorders points.
Function: Affects t reat ment of ectodermal tissue of skin and nervous system.
Master point for Mesodermal Tissue
Location: Internal helix, near the European Kidney and Uret er points.
Function: Affects t reat ment of musculoskeletal disorders.
[IT 1]
[IH4]
- - - - - - ~ - - - .. - - - - ~ - - - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ . - ~ ~ ~ - ~ ~ ~ -
205.E
206.E
254
Master point for Endodermal Tissue
Location: Internal helix, ncar the European Ovary and Testes points.
Function: Affects t reat ment of internal organ and endocrine disorders.
-- - - - - - - -.. ~ - - _ . - - . _ - - - ~ _ .
Master point for Metabolism
Location: Peripheral ear lobe.
Function: Affects t reat ment of any metabolic disorder.
Auriculo therapyManual
[IH 1]
[LO 7]
No.
207.E 1
207.E2
208.E
209.E
210.E
211.E
212.E
213.E
Auricular microsystem point (Alternative name)
Prostaglandin 1
Location: Underside of ear lobe, where actual ear joins lower jaw.
Function: Reduces inflammations and pain.
Prostaglandin 2
Location: Head, superior to the Apex of Ear and LM2.
Function: Reduces inflammations and pain.
VitaminC
Location: Head, superior to the Apex of Ear and LM2.
Function: Relieves stress and symptoms of colds or flu.
Vitamin E
Location: Superior helix, peripheral to the Allergy point.
Function: Used to amplify effects of taking Vitamin E.
Vitamin A
Location: Neck, inferior to the ear lobe.
Function: Used to amplify effects of taking Vitamin A.
. - - - - - - _._- - ._- - - - - - - - - - -
MercuryToxicity
Location: Superior concha, near the Bladder point.
Function: Used to relieve effects of metal toxicity reactions.
Analgesia
Location: Superior concha, near the Duodenumpoint.
Function: Used to facilitate pain relief for surgeries.
Hypnotic
Location: Helix tail, horizontally across from LMO.
Function: Used to tranquilize and sedate.
[Auricular zone]
[LO 1]
[Head]
[Head]
- - - - - - - - - - - .. _- - - -
[HX9]
[Neck]
[SC 6]
[SC 7]
[HX13]
- - - - - - - - - - - - - - - - - - - - - - - -
214.E 1
214.E2
214.E3
Memory 1
Location: Central ear lobe, in region of the Prefrontal Cortexpoint.
Function: Facilitates improvement in memory and attention.
- - - - - _.- .... _. - - - -
Memory 2
Location: Superior ear lobe, in region of the Hippocampuspoint.
Function: Facilitates improvement in memory and attention.
Memory 3
Loca tion: Posterior ear lobe, in region of the Prefrontal Cortexpoint.
Function: Facilitates improvement in memory and attention.
[LO 1]
[L04]
[PL 2]
Important ear points: The most frequently utilized European functional points are Aggressivity 1, Psychosomatic
Reactions 1, Antidepressant point, and Vitality point. Master Omegapoint is identical to Master Cerebral point.
somatotopicrepresentations 255
208.E - - - - - - - - - - 10
Vitamin C
209.E
Vitamin E
200.E
Darwin’s 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 Hidden viewofsecondary European functional conditions represented on the auricle.
AuriculotherapyManual
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
Darwin’s 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
Vit amin A
Figure 7.47 Surface viewofsecondary European functional conditions represented on the auricle.
Somatotopicrepresentations 257
258
Clinical case st udies 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 International Consensus Conference on Acupuncture,Auriculotherapy, and Auricular Medicine
(ICCAAAM)
8.9 Auriculotherapy Certification Institute
My personal experience with auriculotherapybegan at the UCLA Pain Management Clinic in
1975. As a licensed psychologist working in an interdisciplinarypainclinic, I was oft en asked to see
the chronic pain patientswho had not benefited from previous trials of opiate medications,
antidepressants, localized nerve blocks or trigger point injections. Clients were referred to me by
ot her doctors in the UCLA Medical Cent er for biofeedback trainingor auriculotherapy.
Biofeedback therapy allowed patientsto learn to reduce their pathological muscle spasms
and to improve vascular circulation. Patientswere referred for auriculotherapyas a more direct
procedure for immediately alleviatingchronic pain. While licenced acupuncturistsactivate
acupuncturepointswith the insertion of needles, my clinical practice with auriculotherapyhas
employed transcutaneousmicrocurrent stimulationof ear reflex points. Electronic equipment t hat
was used at UCLA included the StirnFlex, the Acuscope, and the HMR stimulator. An electrical
detecting probe is guided over specific regions of the auricleto identify reactive points and a
button on the same bipolarprobe is pressed to briefly stimulatethe same ear points. There is no
invasion of the skin with needles, so this approach tends to be less painful t han ot her forms of
auricularstimulation. I also worked with physicians, nurses, and acupuncturistswho did insert
needles into the ear.
When I was first learningauriculotherapy,it was very helpful to have a wall chart of ear
acupuncturepoints immediately above the t reat ment tablewhere patientswere seen. Electronic
equipment, acupunctureneedles, or ear pellets were availableon a nearby stand. While the
inverted fetus concept facilitates an easy comprehension of which portions of the auricle relate
to a particularpatient’sproblem, and t he auricularacupoints used in most t reat ment plans are
quickly learned, it is useful to have a visual reminderof less frequently used ear points and their
precise point location. It is not necessary for patientsto lie on a t reat ment table, since they
can be t reat ed easily in an ordinarychair. It is best, however, for the pract it ionerto eit her
stand or sit at eye level above the pat ient ’sear. It is import antt hat t he practitioner’sarm is not
excessively strainedwhen holding an electronic probe against the auricleor when insertinga
needle. Comfort for the practitioneras well as the pat ient is import antwhen seeing many
patients.
The first several years of my practice of auriculotherapyrequiredme to suspend my skepticism
stemming from the lack of scientific explanationsfor this procedure. I would repeatedly see
significant improvements in the health status of patientswith previously intractablepain, but my
internaldisbelief remained. I was encouraged by readingthe words of Nogier (1972), who stated
t hat
Auriculotherapy Manual
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 further comment ed 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 needed many observations of the clinical effectiveness of auriculotherapybefore I was convinced.
These statements of Nogier reminded me of my readings in the biofeedback literatureof the
pioneeringresearch on stress by Hans Selye. In his classic text, The stressoflife (1976), Selye
described the initialscientific opposition to his concept of a ’non-specific’ factor t hat contributes to
disease in additionto the ’specific’ pathogens first discovered by Louis Pasteur. Selye related the
story that one senior professor whom he admired’remindedme t hat for months now he had
attempted to convince me that I must abandonthis futile line ofresearch.’ Fortunately, Selye
persevered in his research and discovered t hat chronic stress leads to an enlargement of the
adrenalglands, atrophyof the thymus glands and ulcers in the gastrointestinal tissue. These
organic changes are now widely recognized as reliable indicationsof the biological response to a
variety of non-specific stressors. Pasteurhimself had to overcome considerable opposition to the
germ theory postulate t hat invisible microorganisms could be the source of an illness. Many of
Pasteur’scolleagues scoffed at the supposed dangers of these invisible agents, but today,
sterilizationtechniques in surgery and in acupunctureoriginatefrom Pasteur’sproposals.
Alternative theories and therapies often requirepatience and persistence before they become
widely accepted by the medical profession as awhole.
In this section, I have incorporatedmy own clinical findings with t hat of ot her healthcare
practitionerswho t reat auricularacupuncturepointswith needles or who use the Nogier vascular
autonomicsignal in diagnosis and treatment. I have endeavored to select cases t hat provide insight
into the underlyingprocesses affecting auriculotherapyas well as examples of typical clinical
results one might expect from such treatments. The order of present at ionof specific clinical
cases will first focus on painconditions related to internalorgans, t hen upon myofascial pain
disorders, and lastly will examine neuropathicpain problems. The use of auriculotherapyfor
addictions and ot her healthcaredisorders will also be discussed. Finally, the results of clinical
surveys conducted by skilled practitionersin this field will be present ed to indicatewhich
auriculotherapyt reat mentplans have been found to be the most effective for particularhealth
conditions.
8.1 Relief of nausea
As Nogier suggested, what may be most persuasive for a beginningpractitioneris t he relief of a
symptom t hat he himself has experienced. I had worked with Drs Richard Kroening and David
Bresler at the UCLA Medical Cent er for many months conducting research on auriculardiagnosis.
I myself, however, had never received any auricularacupuncturet reat ment .At one of the first
lecture presentationsof our auriculardiagnosis research, I had the first handopportunityto assess
the clinical effectiveness of ear acupuncture. I had eat en something for breakfast t hat began to
greatly disagree with me. By the time the lecture was set to begin, t he discomforting stomach
sensations were gettingworse. I told this to Dr Kroening, who noticed the unpleasant grimaces
upon my face. He promptly pulled a sterilized needle out of the pocket of his lab coat and inserted
it into the Stomach point on my left ear. Tomy unexpected surprise, the nausea in my stomach
disappearedwithin one minute. Since the skeptical scientific side of my personalitywondered
whether this sudden relief of pain was simply a placebo effect, I removed the needle. The
uncomfortable nauseous feelings immediately ret urnedand I almost started to vomit. Somewhat
embarrassed by my lack of faith in his medical skills, I had to ask DrKroening to reinsert the
acupunctureneedle in my ear. He smiled and complied with my request. Almost immediately after
he replaced the acupunctureneedle, t he abdominaldiscomfort quickly subsided. Only after
leaving t he needle in place for 20 minuteswas I able to remove it without nauseareturning.
Clinical casestudies 259
260
What this experience clearly t aught me was t hat auriculot herapycould be very fast acting, but
without sufficient stimulationof the appropriat eear acupunct urepoint , t he benefits could rapidly
fade. The changes in nausea sensations were directly relat ed to the insertion, the removal, t hen t he
reinsertion of the acupunct ureneedle. Since this initialobservation, I have used the St omach point
for myself and many clients I have worked with. Bot h needle insert ion and t ranscut aneous
electrical stimulationcan quickly relieve stomachaches, not only in response to disagreeable foods,
but also from the side effects of various medications. It is also possible to produce a more gradual
reduct ion in nauseous feelings from just the tactile pressure of rubbingone’s own finger over the
St omach point. Acupressure is not as rapidas electrical stimulation, usually requiringseveral
minutes of maint ainedpressure against t he ear points, but it allows pat ient sto help themselves
without any equipment .
Paincomplaints relat ed to internalviscera are represent ed in a different region of t he ear t han are
musculoskeletal complaints. The cent ral concha zone is associated wit h diffuse represent at ionof
the vagus nerve control of internalorgans. The surroundingridge of t he antihelixand antitragus
are associated with more precise control of musculoskeletal movements. For t hat reason, a broad
areaof concha points affecting t he st omach can be found, but t here areonly a small set of specific
antihelixpoints t hat could affect the thoracic spine. Auriculot herapy is very effective for the relief
of gastrointestinaldistress which is not successfully alleviated by convent ional t reat ment s. I have
now t reat ednausea in many pat ient swith AIDS who arebeing administ eredantiviralmedicat ion
or cancer pat ient swho are undergoingchemot herapy. In most of t hese cases, stimulationof t he
auricularSt omach point dramaticallyalleviates t heirgast roint est inal reactions. There are now
over 20 cont rolled clinical trialsdemonst rat ingt hat needling of the body acupunct urepoint PC 6
on the wrist has a significant antiemeticeffect. The relief of nauseaby stimulatingt he auricular
Stomach point can be just as profound.
PL was a 28-year-old gay male who had been diagnosed with HIV disease 6 years before I saw him.
The advent of triple combinat ion t herapy had yielded a great improvement in his T-helper cell
count and a dramat icdrop in viral load, yet PL cont inued to suffer from agonizing st omach
discomfort relat ed to his HIV medications. Weekly t reat ment of t he St omach point (5 Hz, 40 /-LA,
30 s) and mast er points (10 Hz, 40 /-LA, 10 s) on bot h ears allowed PL to feel substantiallymore
comfort able for the next several months. However, auriculot herapyst imulat ionof his Thymus
Glandpoint did not reverse the progressive det eriorat ionof his immune system. He only st opped
coming for t reat ment sin the several weeks before his deat h, when he was t oo weak to get out of
bed. Anot her AIDS pat ient report ed a similar positive experience with auriculotherapy. LR was a
30-year-old gay male who cont inued to lose weight from his lack of appet it e. His HIV medications
gave him such severe st omachaches t hat he needed to st op t hem periodically so t hat t he side
effects of t hese drugs did not compromise his health. When he did t ake his HIV medications, LR
report ed t hat the auriculot herapyt reat mentwas the only medical procedure t hat provided him any
sense of comfort. He has cont inued to positively respond to st imulat ionof the St omach point, to
the auricularmast er points Shen Men and Point Zero, and to st imulat ionof the Vitality point on
the upper tragus of the ear.
AS was a 47-year-old female who had been previously diagnosed with liver cancer. Her healt h had
not improved aft er t hree different trialsof chemot herapy. She also was greatly distressed by
nausea from the chemot herapy medications she was taking. St imulat ionof t he St omach point on
the concha ridge of the ear produced pronounced alleviationof her chronic stomachaches.
Electrical det ect ion indicateda broadspread of reactive point s relat ed to t he St omach region of
the ear, not just a single point. As indicatedpreviously, det erminat ionof auricularpoint s for
internalorgans does not requirethe same precision as t he identificationof musculoskeletal ear
points. When using microcurrent t ranscut aneousstimulation, the concha region of t he ear is
stimulated at 5 Hz for 30 seconds, while needles are left in place for 30 minutes. For bot h forms of
stimulation, the t reat ment effect is augment ed by the placement of ear seeds over t he St omach
point t hat are left in place for the next week.
Oleson & Flocco (1993) conduct ed a controlled clinical trial t hat demonst rat ed t hat premenst rual
symptoms were more significantly reduced in a group of women who were given acupressure at
appropriat eauricularreflex points as cont rast ed with a different set of women who were given
sham reflexology sessions over a similar t ime period.
Auriculotherapy Manual
8.2 Myofascial trigger points
As a teaching hospital, t he UCLA Medical Cent er exposes beginningdoctors to a variety of
educational experiences. Residents in the UCLA Depart mentof Anesthesiology were offered
trainingin the PainManagement Cent er as one of t heir elective rotations. These residents were
routinely shown demonstrationsof trigger point injections as an alternativeprocedure to the nerve
blocks that anesthesiologists conventionally use to t reat chronic pain. Myofascial paincan be
alleviated by trigger point stimulationwhen intravenousinjection of a local anesthetic into a
specific muscle region blocks the reflex arc that maintainsmuscle spasms. On one occasion, a
group of UCLA residents first observed the primaryclinic physician palpat ethe trapeziusmuscle
of patient CN, who was suffering from shoulder pain. Hypersensitive trigger pointswere identified
on the patient’sright trapeziusmuscle, and CN had significant limitationin the range of motion of
his right arm. The attendingphysician suggested that t he residents observe a demonstrationof
auriculotherapypriorto t heir practicewith trigger point injections. I examined the patient’sright
ear and reactive pointswere found on the shoulder region of the auricle. Electrical stimulationof
these reactive ear points led to an immediatereduction in the pat ient ’ssubjective sense of
discomfort. The range of motion in his arm was no longer limited. When the original physician
again palpatedCN’s trapeziusmuscle, he could no longer objectively identify the previously
detected trigger points. The success of the auriculotherapyeliminatedthe need for any ot her
treatment.Since the presence of the trigger points had been evaluatedby anot herdoctor who was
not present when the auriculotherapywas conducted, this observation was comparable to a
double-blind assessment of patient improvement.
One of the most common conditions recently seen in many pain clinics is the diagnosis of
fibromyalgia, literally defined as the presence of pain in many groups of muscle fibers. JM was a 43›
year-old female who report ed pain in multiple partsof her body. She exhibited hypersensitive
trigger points in her jaw, neck, shoulders, upper back, hips, and legs. Reactive auricularpoints
were evidenced throughout the ear. The auricularpoints corresponding to the jaw, cervical spine,
thoracicspine, shoulders, and hips were electrically stimulated at 10 Hz, on bot h t he anteriorand
posterior regions of the external ear. Bilateralstimulationwas also applied to Point Zero, Shen
Men, Thalamus, Endocrine and Muscle Relaxation. Aft er each auriculotherapyt reat ment ,JM
report ed feeling very relaxed and experienced a profound decrease in her various painsymptoms.
Unfortunately, the aches in her spine andin her limbs graduallyret urnedseveral days after the
treatment. Biofeedback relaxationtrainingand individualpsychotherapy were also integral to the
progressive improvement over 14weeks of treatment. Complex pain disorders, such as
fibromyalgia, requiremore t hanthe alleviationof nociceptive sensations. Successful t reat mentof
fibromyalgia also requires attentionto the management of daily stressors and helping the
individual to resolve deeper psychodynamic emotional conflicts.
Someone who did not respond so favorably to interdisciplinaryt reat mentwas EJ, a 45-year-old
mot her of two adolescent children. She complained of chronic pain in many partsof her body and
reluctantly discussed that she suffered distress from problems in her marriage. She had been
referred to me by a fibromyalgia support group that meets in a hospital in Los Angeles. EJ
report ed tenderness and discomfort at trigger points found in variouspartsof her body, and for
each of the multiple sites of pain perception in the body t here were corresponding t ender points on
her external ear. Stimulationof the electrically reactive auricularpoints led to reduced levels of
perceived pain and enhanced feelings of comfort and relaxation. EJ seemed grateful for the
immediaterelief, but the t reat menteffects only lasted several days. She was constantly in conflict
regardingher marriageand afraidof being left alone. At the same time she was frustratedby the
continued lack of attentionfrom her husband. The stress of this indecision seemed to reinitiateher
fibromyalgia pain each week. Besides t he musculoskeletal and master points that are typically used
for pain, EJ also received stimulationof the ear acupoints related to psychosomatic disorders,
nervousness, and depression. When it was suggested in the course of therapy t hat she might
consider the option of asserting herself with her husband, she became defensive and quiet. She did
not ret urnfor any ot her sessions, insisting that she only wanted to focus on her pain problem and
not these ot her issues in her life. Several months later, she was still in the fibromyalgia support
group, still suffering from chronic pain. There are certain patientswho are not ready to fully
engage in the activities t hat would reduce their physical pain when it requires t hat they also address
the sources of their emotional discomfort.
Clinical casestudies 261
262
8.3 Back pain
One of the most frequent applicationsof auriculotherapyis for the t reat ment of back pain. OF, a
43-year-old marriedmot her of two adult children, had been injuredon the playground at the
elementary school where she taught. Various medical procedures by four ot her doctors at UCLA
led to partialbut inconsistent relief of her back pain. Auriculotherapy t reat ment produced a
marked release of the tightness in her back, but her paingraduallyret urnedafter each session.
Despite t he persistent aching in her back, OFcontinued to go to work regularly as an elementary
t eacher and to do the household chores and cooking for her husband, and her adult son, and her
daught erwhen she got home. Itwas not until OFalso learned biofeedback relaxationand
assertiveness skills t hat the pain subsided for longer periods. She needed strong encouragement to
ask her family for the assistance she needed aroundt he house and to take time for herself to relax.
Sometimes a pain problem is present for secondary gain issues t hat must be correct ed before the
effects of auriculotherapycan be sustained. Auriculotherapy can dramaticallyalleviate back pain,
but the patient’slife style t hat puts additionalstress on t hat individualmust also be addressed.
CJ was a 38-year-old male airlinepilot who attributedhis chronic back painto the 2-hour commute
from his home in SantaBarbarato his airlinebase at Los Angeles InternationalAirport. The
patient’sdrawings of the location of his discomfort indicatedthat his painwas localized to his left
buttocks. While there were several reactive acupoints on CJ’s right and left external ears, the
Buttocks and Lumbago points on the left ear showed the most tenderness and electrical
conductivity. Even though his job stress remainedunchanged, five auriculotherapyt reat ment sled
to pronounced relief of the pain in his buttocks. CJ also came to great er acceptance regardinghis
divorce, incidentallydescribing his wife as a ’painin the ass.’ Several weeks after the pain in his
lower back was gone, CJ noticed a new painproblem on the left side of his neck. Sometimes,
successful t reat ment of a primaryproblem allows a secondary issue to surface. CJ also commented
on a stressful weekend with his new girlfriend, and suggested she had been a ’real painin the neck.’
While the Buttocks and Low Back points on the earwere no longer t ender on palpation,the Neck
region of the left auricle had become very sensitive. It requiredonly two auriculotherapysessions to
ease the pain and tightness in CJ’s neck. Treatmentprimarilyconsisted of electrical stimulationof
the Neck point (10 Hz, 60 ftA, 20 s). The master points Shen Men, Point Zero, Thalamuspoint and
Muscle Relaxation point were also stimulated. Itwas furt her suggested t hat he needed to discuss his
angry feelings with his new girlfriend rat hert han unconsciously somatizinghis emotions.
While his original motivation to seek t reat mentwas for generalized anxiety, AC had called to
cancel an appoint mentbecause of acute back pain. A 33-year-old male public relationsexecutive,
AC could not get up out of his bed the day aft er he had been in an accident. He had already
missed two days of work on the day he contacted me about his condition. I was able to see him in
his home with a portable, electronic device. Auricularstimulationwas applied to extremely t ender
and electrically reactive points on the ant eriorantihelixpoints and on the posterior groove points
that correspond to the lumbarspine. Stimulation(10 Hz, 20 ftA, 30 s) of these auricularacupoints
on the right and left external ears was accompanied by t reat ment of the mast er points Shen Men,
Point Zero, Thalamus, and Master Cerebral point. The response to this t reat mentwas immediate
and profound. At the conclusion of the auricularstimulationprocedures, AC was able to get up
from his bed without any discomfort in his back. He could bend and t urnin ways t hat were
impossible just 15minutes earlier. Because the cause of his problem was so recent, auriculotherapy
t reat ment led to dramaticimprovement in just a single session. Auricular pellets were placed on
the front and the back of the LumbarSpine points. By the next day, he was able to ret urnto work.
The ear pellets were removed after one day and his back problems were gone.
Sciatica is the medical condition which first brought the possibilities of auriculotherapyto the
at t ent ionof Paul Nogier in the 1950s. As not ed by him over 50 years ago, and as observed by many
ear acupuncturistssince, sciatica paincan be greatly alleviated by auricularacupuncture. BH was a
23-year-old male with complaints of sciatica and shooting painsdown the left hip and left leg.
When pressure was applied to the L5-S1 point on the inferiorcrus of the left antihelix, BH found it
excruciatingand it was also the most electrically responsive region of his left ear. Reactive points
were also found in the triangularfossa, t he auricularregion which Nogier correlat ed with the
location for the leg. Electrical stimulationof reactive points on the front and back of the auricle led
to an 85% reduction in pain level t hat BH recorded on avisual analogscale. Ear seeds were placed
on the Sciatica point and on the Nogier Leg point to sustain the t reat menteffects.
Auriculotherapy Manual
MJ, a normallyvery athletic26-year-old male patient, had become incapacitatedby severe back
pain. Duringthe first auriculotherapysession for his back painproblems, I also noticed t hat MJ
had an open scar on the region of the helix root t hat adjoinsthe face. Two months of antibiotic
medications prescribed by his primaryphysician had failed to heal this scar. The scar was located
on a part of the external earwhere Chinese auricularcharts depict t he external genitals. For MJ’s
back pain, bipolarelectrical stimulationwas applied to the Lumbosacral points on t he antihelix
inferiorcrus of his left auricle. Tofacilitatewound healing, monopolar probes were placed across
the edges of the scar on t he ear. The pat ientwas told t hat electrical stimulationcould potentially
heal skin lesions as well as relieve back pain. At his appoint ment a week later, MJ came intothe
t reat ment room very upbeat. He was amazed not only by a decrease in his back pain, but also
because his previously undisclosed scrotal pain had diminished - a surprise for bot h of us. These
results are explained by microsystem theory as organocut aneous reflexes producingthe mysterious
scar on MJ’s ear and t reat ment of t hat scar activated a cutaneo-organicreflex t hat alleviated
discomfort in the genital region.
While it is impressive to observe the many patientssuccessfully t reat edwith auriculotherapy,it is
also import antto distinguish the sources of t reat ment failures. Two different cases of back pain
illustratet he limitationsof this procedure. RT was a 33-year-old male art dealer and EE was a
41-year-old male executive at a Hollywood movie studio. They bot h suffered from recurrent back
pain t hat was at times manageable, but at ot her times prevent ed t hem from going to work. Both
men had received nerve blocks and physical therapy. Only periodic t reat mentwith opiat e
medications produced t emporary alleviationof their discomfort. Bot h men were contemplating
surgery for the removal of bone spurs along the spine, uncovered by MRI scans. RT and EE bot h
expressed interest in trying auriculotherapybefore undergoingpossibly risky surgical procedures.
They were each given several auriculotherapysessions where reactive points t hat represent the
back were electrically stimulated. RT report ed t hat t he auricularstimulationproduced a brief
reduction of his back pain, but any body movement reactivated intense discomfort. While EE did
not initially report very severe pain, he also did not exhibit much relief from t hat pain after
receiving auricularstimulation. Both men ultimatelyunderwent surgical procedures to remove t he
bone spurs and their back conditionswere almost completely relieved.
From these two examples, it can be seen that auriculotherapyis not particularlyeffective when
t here is an underlyingphysical structurecausing pain, in these instances a bone spur.
Auriculotherapy can be more helpful when the problem is due to muscle tension and the
pathological functioningof neuromuscularcontrol of muscle spasms. Failureto provide
satisfactory pain relief to anot hermale pat ientwas account ed for by t he presence of a different
structuralproblem. MB was a 34-year-old comput er graphics artist who had been to four different
physicians for chronic neck painbefore being referred to me. Aft er five sessions where
auriculotherapydid not alleviate his painproblem, MB discontinued t reat ment .A year lat erhe
contacted me to inform me t hat a subsequent physician had diagnosed a constriction in his cervical
spine t hat was corrected by surgery. Itwas only aft er this surgery t hat his persistent neck painwas
alleviated. While osteopathic surgery can sometimes lead to furt her complications of a chronic
pain condition, it is at ot her times the only effective solution.
8.4 Peripheral neuropathy and neuralgia
Different regions of the auricle and different stimulationfrequencies are used for neuropathicpain
t hanfor musculoskeletal or internalorgan conditions (Oleson 1998). Muscular atrophy and
persistent painin his left arm were attributedby 57-year-old JJ to stress and strainrelated to work
activities. Reactive ear pointswere electrically detected on the auricle at the Cervical Spine region
along the antihelixtail and at the Elbow and Wrist points on the scaphoid fossa of the left ear.
Microcurrent stimulationat these t hree pointswas accompanied by an immediatewarmtingly
sensation throughout JJ’s left arm and hand. In the Nogier school of auriculotherapy,
musculoskeletal disorders are stimulatedwith a frequency of 10Hz, usually at 40 j.1A for 20 s.
Moreover, because muscle tension or weakness is related to a pathological disturbancewithin
mot or neurons, the cervical posterior groove and the posterior trianglewere also stimulated. These
posterior ear points lie immediately behind the acupointsfound on t he front surface of the auricle.
After only 3 weekly sessions, JJ report ed a 70% reduction in pain, as measured by the visual analog
Clinicalcase studies 263
264
scale, and was able to ret urnto his position as an accountant for a restaurantchain. While the
alleviation of pain had been fairly rapid, the improvement in muscular atrophywas initiallyjust
slight. Satisfactory improvement in mot or function required8 more weeks of auriculotherapy.
TM was a 28-year-old male graduat est udent who had been severely injuredby faulty wiring in a
piece of electronic equipment. A lethal jolt of electricity flowed from the wall cord of the
equipment up his left hand, spreadingto his head and down the left side of his body. His shoe was
completely melted aroundhis left foot. When I first saw him, he walked with a limp, dragging his
partiallyparalyzed left leg, and he could not fully use the fingers of his left hand. Auriculotherapy
t reat ment of his left external ear included points corresponding to the hand, the arm, the leg and
the brain.These sessions were continued for over 3 months. The reduction in pain sensations in his
hand and the enhancement of his mot or abilities and his memory was gradual, but steady. By the
last session, auriculotherapyhad assisted TM in being able to write more legibly andwithout
feeling pain in his fingers. His leg movements were more fluid and he could remember more details
of the academic topics he had studied before the accident. He was by no means completely healed,
as the neurological damage he had suffered seemed to result in permanent mot or dystrophy.
Nonetheless, auriculotherapyhad led to far great er improvements t han any of his medical doctors
had expected.
One of the most distinctive demonstrationsthat I had ever witnessed of the specificity of
auriculotherapywas with the t reat mentof a 46-year-old female diabeticpatientwith peripheral
neuropathy. HR had accumulated three volumes of UCLA medical records that described in detail
her multiple treatmentsfor multipleconditions resultingfrom a life history of diabetes mellitus. In
additionto the severe pain in her feet, HR experienced severe glaucoma, chronic back pain and
feelings of bitterness and despair. She had developed a rat herresentful, pessimistic and hostile
attitudetowardthe medical profession for failingto provide adequat erelief of her varied sources of
discomfort. Her negative reactions toward conventional medical t reat ment smade it seem unlikely
that she would respond any more favorably to alternativetherapies, but auriculotherapywas
recommended nonetheless. When HR ent ered the UCLA pain clinic, she walked with a limp,
requiringthe assistance of her husband, and there was a pronounced scowl upon her face. After the
initialinterview, she lay down upon the examinationtable and her external ears were scanned for
areas of decreased electrical resistance. There were reactive points on her right ear in auricular
regions t hat corresponded to the feet. These auricularpoints for the foot were electrically
stimulated first (10 Hz, 40 fLA, 30 s), followed by stimulationof the mast er points on the right ear
identified as Shen Men (10Hz, 40 fLA, 10 s), Point Zero (10 Hz, 40 fLA, 10s), and Thalamus(80 Hz,
40 fLA, 20 s). Within 2 minutesof the completion of this stimulationof acupoints on the right
auricle, a marked change appeared upon the patient’sface. Her negative frowns were replaced by
an almost peaceful countenance. HR quietly exclaimed that the pain in her right foot was
completely gone - for the first time in over 7 years. Interestingly, the pain in her left foot and on the
left side of her back was approximately the same. Itwas not until after reactive points on the left
external ear were stimulated that t here was a reduction of pain in her left foot and left back.
The significance of this differential effect observed in HR was profound. Ifthe auriculotherapy
were due to a general systemic effect, such as from a morphine injection, the pain relief should
have been experienced equally in bot h feet. IfHR had been given an intravenousinjection of
morphine it would not have t aken effect so quickly but would have t aken 10-20 minutes for her to
notice significant analgesia. Numerous scientific studies in humans and animalsindicatethat t here
is a systemic release of endorphinsfollowing auricularacupuncture. Localized pain relief in only
one foot of HR suggests t hat specific neurological reflex circuits more appropriatelyaccount for
this selective action of auriculotherapyrat hert hangeneral endorphinrelease. PatientHR
continued to improve over the next several months of weekly treatments. The pain in bot h
her feet graduallyret urnedto some degree, but with each successive auriculotherapyt reat ment it
diminished for longer periods of time. Her back pain and her ability to walk without assistance also
improved, and t here was a pronounced enhancement of her mood. By session 15, t here was only
minimal recurrent pain in her feet and interactionswith HR became more pleasant. She report ed
feeling optimistic about her health, even though she still suffered from diabetes and glaucoma.
Auriculotherapy has been used effectively for neuropat hicpainbot h from diabetes andfrom HIV
disease. JT was a 37-year-old man diagnosed with AIDS and suffering from neuropat hicpain in his
feet and lower legs for over 8 months, whereas RB was a 58-year-old man who had periodically
Auriculotherapy Manual
suffered from diabeticneuropat hyaffecting his feet. Even though t he source of their neuropathy
was very different, the auriculart reat ment of the neuropat hicpain was almost identical. For bot h
JT and RB, reactive ear pointswere identified on the uppermost regions of the auricle, which
represent the Chinese and European localizationsof the Feet. Ear acupointswere also stimulated
on the uppermost region of the helix tail, which corresponds to the LumbarSpinal Cord. The
somatic region of the auricle, representingcontrol of t he musculoskeletal tissues of the feet, is
stimulated at 10Hz. The helix tail region t hat represents neurological spinal tissue is stimulated at
40 Hz. Higher frequencies of stimulationare used for neurological tissue t han muscular tissue
according to a model first proposed by Nogier (1983). Similarto the findings from MRI scans,
resonant waveforms occur at different frequencies for different types of tissue. More recently
evolved tissue, such as t hat of the nervous system, is said to respond more optimally to higher
resonance frequencies t han more primitivetissue, such as muscles and internalorgans.
Stimulationof the Foot points and the LumbarSpinal Cord points on the auriclecont ribut edto
the complete eliminationof the peripheral neuralgiapainin the feet. Both JT and RB report ed
maintainedrelief of their peripheral neuralgiaaft er six sessions of auriculotherapy.
Herpes zoster, or shingles, is a different type of neuropat hicpain t hat is found in many AIDS
patientsas well as patientswith diabetes. TP was a 32-year-old man diagnosed with AIDS 5 years
prior to my first examininghim. He was initiallyseen for relief of the stress and anxiety associated
with his HIV infection. At a group therapy session, TP became extremely distressed aft er he
revealed his HIV+status. Even though the group was very supportive, TP felt enormous shame
and a deep sense of rejection. The next day he came down with shingles. The acute inflammation
of the T4 dermat ome abruptlyappearedon the right side of his chest, upper abdomen and upper
back. Reactive ear points were found on his antihelixbody, which represents the chest, and on the
thoracic spinal cord region of the helix tail. Aft er the first session of auriculotherapy,not only had
the pain sensations in the body been eliminated, but t here was a rapidreduction in the bumpy
swelling and redness of t he skin. Aft er 2 furt herweekly auriculotherapysessions, t here was no
further presence of the herpes reaction.
An almost identical response was exhibited by EO, a 76-year-old woman who became affected by
shingles as a reaction to her antihypertensive medication. The herpes zoster affected the Ll
dermat ome on her right side, manifested by blotchy red hypersensitive skin. She was given bipolar
auricularstimulation (10Hz, 40 /-LA, 60 s) to the antihelixcrus and antihelixbody regions, which
represent the musculoskeletal tissue of the lower spine, and faster frequency auricularstimulation
(40 Hz, 40 /-LA, 60 s) to the lumbarspinal cord region found on the upper helix tail. Monopolar
electrodes were also held on each side of the dermat omalzone t hat was inflamed. Low frequency
stimulationwas applied across the skin of the body for a furt her 10minutes. There was a gradual
lessening of heightened sensitivity, and aft er 2 days her blotchy red skin had almost completely
ret urnedto normal. Combiningbody stimulationwith auriculotherapyis a very effective
procedure for treatingbot h neuropat hiesand neuralgia.
Several case studies on the effect of auriculotherapyfor healingleg wounds were report ed by Fred
Swing at the 1999Int ernat ionalConsensus Conference on Acupuncture, Auriculotherapy, and
Auricular Medicine (lCCAAAM). JC was a 68-year-old male admit t edto a Texas hospital for
sepsis, pneumoniaand multiple large ulcers on bot h lower legs. Because of the sensitivity of the
wounds on the patient’slegs, only ear acupunct urewas allowed. The day aft er auriculotherapy,
increased presence of fluids and redness in the wound areaswas observed by the attendingnurse,
the feet were warmer, and the pat ient report ed great er sensations in his lower legs.
Auriculotherapy and traditionalwound care t reat mentwere cont inued for the next 4 months.
Aft er 50 ear treatments, the right leg was completely healed and the left leg was sufficiently
improved to permit successful skin grafting. The ear acupoints for t he Leg, Shen Men,
Sympathetic Autonomic, Lungs, and points for dermatological disorders were activatedby bot h
needles alone and by electrical stimulation. Since wound healing requires sufficient oxygen and
body nutrientsdelivered to the wound site, auriculotherapycan improve vasodilation of the small
arteriolest hat lead to delivery of oxygen to the lower legs.
The total number of points t reat edin each clinical case can vary from 5-10 ear points, depending
upon how many anatomicand mast er points are stimulated. The whole auricle is first examined
with a point locator, oft en revealing more t han 20 reactive ear points. Only the most electrically
conductive and most t ender of the points t hat specifically correspond to the pat ient ’scomplaints
are finally used. With transcutaneouselectrical nerve stimulationon t he auricle, each point is
stimulatedwith 20-40 /-LAs for only 10-30 s. The pract it ionert hen moves ont o the next point.
Clinical case studies 265
266
Needles inserted into the selected ear points are left in place for approximately 20 minutes, similar
to body acupuncture. Treatmentsare offered twice aweek for several weeks and t hen spaced out to
once aweek for several more weeks until t here is satisfactory improvement in symptoms. Both
practitionersand patientscontinue to be amazed t hat these different sites on the ear can have such
a profound pain relieving effect on complaints from ot her partsof the body.
8.5 Weight control
An intriguingpotential of auricularacupuncturehas been its clinical applicationin weight control.
Clinical studies demonstratingthe value of auricularacupuncturefor the t reat ment of obesity dat e
back to the 1970s(Cox 1975;Giller 1975). Sun & Xu (1993) t reat edobesity patientswith
otoacupoint stimulation, anot hert erm for ear acupressure. All patientswere also given body
acupuncturefor the 3-month period of the study. The acupunct uregroup consisted of 110patients
diagnosed as 20% or more above ideal weight. They were compared to 51 obesity pat ient sin a
control group given an oral medication for weight control. An electrical point finder was used to
determine the following auricularpoints: Mouth, Esophagus, Stomach, Abdomen, Hunger, Shen
Men, Lung and Endocrine. Pressure pellets made from vaccaria seeds were applied to the
appropriat epoints of bot h ears. Body acupuncturepoints needled included ST 25, ST 36, ST 40,
SP 6, and PC 6. The acupuncturegroup exhibited an average reduction in body weight of 5 kg,
which was significantly great er t hanthe average 2 kg reduct ion of body weight measured in the
control group. The percentage of body fat was reduced by 3% in the acupunct uregroup and by
1.54% in the control group, while the triglyceride blood lipid levels were diminished 67 units in the
acupuncturegroup and 38 units in the control group.
A randomizedcontrolled trial by Richards & Marley (1998) also found t hat weight loss was
significantly great er for women in an auricularacupuncturegroup t hanin a control group. Women
in the auriculargroup were given surface electrical stimulationto the ear acupointsfor Stomach
and Shen Men, whereas women in the control group were given t ranscut aneouselectrical
stimulationto the first joint of the thumb. Auricular acupunct urewas theorized to suppress
appetiteby stimulatingthe auricularbranchof the vagal nerve and by raising serot onin levels, bot h
of which increase smooth muscle t one in the gastric wall. Rat her t han examine changes in weight
measurements, Choy & Eidenschenk (1998) examined the effect of tragus clips on gastric
peristalsis in 13volunteers. The durat ionof single peristalticwaves was measured before and after
the applicationof ear clips to the tragus. The frequency of peristalsis was reduced by one thirdwith
clips on the ear and was ret urnedto normal levels with clips off. The ear clips were said to produce
inhibitionof vagal nerve activity, leadingto a delay of gastric emptying, which would t hen lead to a
sense of fullness and early satiety. These obesity studies on human subjects have received potential
validationfrom neurophysiological research in animals.
Clinical observations by Niemtzow (1998) showed t hat blood assays in 42 patientssuffering from
obesity showed a significant decrease in physiological measures of lipid levels as well as significant
reductions in physical weight. The patientswere requiredto maintaina high prot ein diet while they
were receiving the weekly auricularacupuncturetreatments. Needles were inserted intothe
following ear points: Appet it e Control, Shen Men, Point Zero, and Tranquilizer.The needles were
held in bot h ears for a period of 15 minutes. Over a 12-week period, mean weight decreased
significantly from 206 pounds to 187pounds, triglycerides changed significantly as well, and t here
was a marked but statistically significant reduction in total cholesterol. Pat ientinterviews
conducted aft er the study was completed suggested t hat compared to ot her times when at t empt ing
to diet, auriculotherapyseemed to help t hem feel more comfortable while they were trying to
discipline themselves in t heir eating.
8.6 NADA addiction protocol
One of the fastest growing applicationsof auriculotherapyin the healthcarefield is the use of ear
acupuncturepoints for the treatmentof various addictions. The NationalDetoxification and
Addiction Association (NADA) was founded upon the pioneeringwork of Dr HL Wen of Hong
Kong and the early applicationof this procedure by Dr Michael Smith of New York City. Wen
(Wen & Cheung 1973,Wen 1977) found t hat placing one needle in the Lung point alone was
sufficient to withdrawa heroin addict from his addiction, but he also needled the Shen Men point to
produce general calming. DrMichael Smith (Smith 1979, 1990;Smith et al. 1982) developed a
5-point protocol for substance abuse recovery that included the Lung, Shen Men, Sympathetic
Autonomic, Kidney and Liver points on the ear. NADA was formed in 1985(Brewington et al. 1994)
Auriculotherapy Manual
to allow organizationand trainingopportunitybeyond t hat offered by Smith at Lincoln Hospital.
The first open meeting of NADA was held in Washington DCand the NADA boardwas formed.
The first NADA conference occurred in Miami in 1990because many people were interested in
seeing the DrugCourt t hat had been developed in Miami in 1989.Similar drug courts t hat
incorporatereferral to NADA practitionershave now been developed in many ot her states. NADA’s
official website is http://www.acudetox.com. Controlled clinical trialshave shown t hat the five ear
points used in the NADA protocol are effective in the t reat ment of alcoholism (Bullock et al. 1989),
cocaine addiction(Margolin et al. 1993a, 1993b), and morphinewithdrawal(Yang & Kwok 1986).
Toobtaintrainingand certification in NADA, t here is a 70-hourcourse. This trainingincludes 30
didactichours of instructionand 40 clinical hours workingwith clients. Trainingalso includes
at t endanceat 12-step meetings. Great emphasis is placed on clinical experience so t hat NADA
practitionerscan become comfortable workingwith an addict population. At Lincoln Recovery
Center, most trainees are chemical dependency counselors. They spend much of their time getting
comfortable with doing acupunctureas a physical procedure. St udent slearn about the ’yin nat ure
of the NADA at mosphere,’which is int endedto be supportive and non-confrontational.For
acupuncturists, the trainingcovers definitionsof addiction and ment al healt h treatments. They are
instructed to speak the same language as the chemical dependency counselors, the criminaljustice
system, and medical professionals in those environments.
One of the most import antlessons t hat bot h acupuncturistsand counselors have to learn is to be
quiet and let the acupunctureneedles do the work. Bot h groups are used to spending time talking
to evaluatepat ient progress. The NADA protocol encourages a non-verbal approach to t reat ment .
Substance abusers often feel shame, guilt, anger or ot her issues t hat they do not know how to cope
with verbally. Without acupuncture, the only therapy availableis talk therapy, eit her individually
or in a group setting. NADA trainingalso includes learningabout various drugs, t heir
pharmacological effects and various types of setting intowhich acupunct urehas been integrated.
As a grassroots movement, most NADA programs were st art edbecause doors were knocked on
and administratorswere convinced of t he value. Over 4000 practitionerst hroughout the world
have been taught this protocol for the t reat ment of various types of substance abuse.
8.7 Alternative addiction protocols
While the 5-point NADA protocol has become the most commonly employed t reat mentprogramin
the Unit ed States, it is not the only auriculotherapyprocedure to be developed. The ear points used
for NADA t reat ment are principallybased on Chinese ear charts, but additionalauricularpoints for
addictionhave been derived from European t reat mentplans. Orient almedicine focuses upon the
use of the auricularLung point for detoxification, the Kidney point for yin deficiency, and the Liver
point for nourishment. The Shen Men and Sympathetic Autonomic points are int endedto alleviate
psychological distress and imbalanceof spirit. Europeanpractitionersof auricularmedicine focus
upon treatingear points t hat activate the Nogier vascular autonomicsignal (N-VAS). Repeat ed
experience with many substance abuse patientshas led to the discovery of ear points additionalto
those developed at Lincoln Hospital. Drs Jay Holder (Holder et al. 2001) and Kenneth Blum
(Blum et al. 2000) were instrumentalin developing the American College of Addictionology and
Compulsive Disorders (ACACD) based in Miami Beach, Florida. The ACACD protocol includes a
total of six auricularpoints: Point Zero, Shen Men, Sympathetic Autonomic, Kidney, Brain, and
Limbic System. Twoaddictionaxislines were emphasized t hat connect these different t reat ment
points. A primaryaxiscould be vertically drawn between the Shen Men, Kidney, Point Zero, and
Brainpoints, whereas a secondary axisline could be indicatedwhich connected the Sympathetic
Autonomic point and Limbic point. The ACACD approachemphasizes that only reactive ear points
are to be stimulated. There has been no controlled scientific research to verify whet her the NADA
protocol or the ACACD t reat mentis more effective in working with addicts.
While smoking cessation has been t reat edfrequently with ear points Lung and Shen Men (Regrena
et al. 1980), ot her ear points have also been successful (Oleson 1995).
8.8 International ConsensusConference on Acupuncture,
Auriculotherapy, and Auricular Medicine (ICCAAAM)
In 1999,not ed authoritiesin the field of auricularacupunct urefrom China, Europe and America
were gat hered in Unit ed States to arriveat a consensus on internationalperspectives of
auriculotherapy. Forty speakers with professional expertise in the field discussed varying
Clinical casestudies 267
268
Box 8.1 Survey of professional opinions on auriculotherapy
%
f - - ~ ~ ~ ~ ~ - _ . ~ ~ ~ ~ ~ ~ ~ . ~ - - - ~ ~ ~ ~ ~ ~ ~ ~ ~ - - ~ ~ - - -
Conditions bet t ert reat edwith auriculotherapyt han body acupuncture
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
Conditions not effectively t reat edwith auriculotherapy
AIDS and HIV disease 45
Cancer or tumors 43
Schizophrenia 38
Nerve impairment 35
Strokes 33
Spinal spurs 30
Deteriorated disks 28
viewpoints before an audience of over 400 attendees at the ICCAAAM meeting in Las Vegas,
Nevada. Representatives from China, Japan, France, Germany, Belgium, Holland, Israel, Canada
and the United States discussed both Orientaland Western approaches to the auricular
microsystem and auricularacupuncturetreatments. Participantsat this conference were asked to
complete a survey of their experience with auriculotherapyand to comment on different
theoretical perspectives of this procedure. A summary of some of these results is present ed in
Box 8.1. Ot her partsof this consensus questionnaireare described in t he text that follows. A total
sample size of 42 professionals completed the 100items on the questionnaire.There were 24 males
and 18females, with a mean age of 50.2years. Their mean number of years of auriculotherapy
practicewas lOA years. The dat aare present ed as percentage scores.
The majorityof respondents, 70%, felt t hat auriculotherapycould be combined with body
acupunctureor used alone, whereas 20% of the survey participantsthought it was bet t er to
combine auriculotherapywith body acupuncturein most circumstances. Most of the practitioners,
45%, felt t hat auricularstimulationproduced faster painrelief t hanbody acupuncture, and an
equal number of respondents believed t hat the long t erm benefits of auriculotherapywere equal to
body acupuncture. Most health conditions were thought to be alleviated within t hree to five
sessions of auriculotherapy,with t reat mentsessions typically one visit per week. The usual
durationof an auriculotherapysession was said to last 21 to 30 minutes. The most common fee for
such sessions was thought to be $40to $55. Electrical point locators were thought to provide the
most accurateprocedure for findingreactive auricularpoints by 73% of the professionals, whereas
20% stated that use of the N-VAS is the most accuratemeans for conducting auriculardiagnosis.
Orientalpulse diagnosis was used by 45% of the surveyed practitionersand was seen to be a
valuable complement to auriculardiagnosis. A majority (53%) of respondents believed that the
auricularmicrosystem interactswith the macro-acupuncturemeridiansof classical Chinese
medicine, and 63% believed t hat there is an invisible energy such as qi t hat is affected by
auriculotherapy.At the same time, 63% of the professionals believed that the effectiveness of
auricularpoints is due to t heir connections to central nervous system pathways and 65% thought
that the inverted fetus pat t ernon the ear is connected to the somatotopic organizationof the brain.
Auriculotherapy Manual
Box 8.2 Conditions successfully t reat ed by certified professionals int he
Auriculotherapy CertificationInstitute
Health condition
Chronic pain
Back pain, sciatica, hip pain
Pain in leg, arm, wrist, elbow, knee, foot
Neck and shoulder pain
Migraines and tension 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, morphine abuse
Psychological disorders
Anxiety or stress
Sleep disorders, insomnia
Depression, mood disorders
Chronic fatigue syndrome
Attention deficit disorder, dyslexia
Childhood problems, bedwetting
Internal 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, skin disorders
Visual impairment, eye disorder
Epilepsy, palsy, Parkinson’s, motor tremors
Stroke, head injury,muscular dystrophy, polio
Olfactory disorders, dry mouth
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-profit organizationfor trainingandcertifying practitionersof
auriculotherapywas established in Los Angeles, Californiain 1999.The website is at
www.auriculotherapy.org. As part of the certification requirements, applicantsare asked to
describe 20 clinical cases in which they have used auriculotherapyor auricularacupuncture.The
most common conditionswhich 16different practitionersreport ed t hat they have successfully
treatedare presented in Box 8.2. In most cases, effective alleviationof the health condition was
achieved within five auriculotherapysessions. The most common conditions t hat were t reat ed
were back pain, pain in the extremities, and neck and shoulder pain. Headaches, smoking
cessation, stress, anxiety, and respiratorydifficulties were the next most frequently t reat ed
problems. There were a number of ot her disorders t hat were seen less frequently, but still could be
effectively t reat edby auriculotherapy.Applicants for certification also need to pass a writtenexam
which covers academic knowledge of auricularanatomyand the location and function of different
ear acupoints used in the Chinese and European schools of auriculotherapy.A practicumexam
with an ACI certified professional is given to determine the hands-on capabilityof t he applicant.
All individualswho fulfil t he requirementsof certification are listed on the ACI website.
Auriculotherapy Manual
II
Auriculotherapy t reat ment
protocols
CONTENTS
9.1 Addictive behaviors and drug detoxification
9.2 Acute and chronic pain inupper and lower limbs
9.3 Back painand body aches
9.4 Head and neck pain
9.5 Dental pain
9.6 Neurological disorders
9.7 Stress-related disorders
9.8 Psychological disorders
9.9 Eyesight disorders
9.10 Hearingdisorders
9.11 Nose and throat disorders
9.12 Skin and hairdisorders
9.13 Heart and circulatory disorders
9.14 Lungand respiratory disorders
9.15 Gastrointestinaland digestive disorders
9.16 Kidney and urinarydisorders
9.17 Abdominal organ disorders
9.18 Gynecological and menstrual disorders
9.19 Glandulardisorders andsexual dysfunctions
9.20 Illnesses, inflammationsand allergies
Standard treatment plans: The following t reat mentplans indicatet hose ear reflex pointst hat have
previously been used for effective t reat mentof t hat healt h condition. This selection of earpointswas
originally derived from t reat mentplans developed in China, but was modified by auriculotherapy
discoveries in Europe. Practitionersof auricularacupunct ureshould not t reat t he ent ireearpoints
listed for a given disorder. Only stimulatethose reactive ear pointswhich are appropriat efor t hat
pat ient ’ssymptoms and underlyingconditions. Consider t he earpoints listed for each t reat mentplan
as guidelines, not definite requirement st hat must be rigidly followed. Moreover, some patientsmay
have ot her ear points needing t reat mentt hat are not listed on these pages. Earpoints for each plan
are designated by one of t he following two categories: primaryear points and supplementalear points.
Primary ear points are the initialset of pointson t he auriclelisted immediately undert he nameof the
t reat mentof a disorder in a particularbody organ or a specific physiological dysfunction. Primaryear
points for a given condition are indicatedon the ear chartsby underlining.
Supplemental points are t hose areas of t he ear for alt ernat ivet reat mentof a given condit ion or for
facilitationof t he action of t he primaryear points.
Reactive ear reflex points: For all of t he t reat mentplans listed, t he pract it ionershould limit t he
t reat mentto t hose auricularpoints t hat aremost reactive, as indicatedby increased skin conduct ance
or height ened tenderness to applied pressure. Ifa point which is listed in t hese plans is neit her
electrically reactive nor t ender to touch, t hen it should not be included in t he t reat mentplan.
Treatment protocols 271
272
9.1 Addictive behaviors and drug detoxification (Figure 9.1)
9.1.1 Alcoholism
Primary: Alcoholic point, Liver, Lung 1, Lung 2, Brain, Occiput, Forehead, Kidney.C, Point
Zero, Shen Men, Lesser Occipital nerve.
Supplemental: Thirst point, Sympathetic Autonomic point, Endocrine point, Tranquilizerpoint,
Master Cerebral, Master Oscillation, Limbic System, Aggressivity, Ant idepressant point.
9.1.2 Drug addiction, drug detoxification, substance abuse
Primary: Lung 1, Lung 2, Shen Men, Sympathetic Autonomic point, Liver, Kidney.C, Brain.
Supplemental: Occiput, Adrenal Gland.C, Limbic System.
9.1.3 Nervous drinking
Primary: Alcoholic point, Thirst point, Kidney.C, Brain, Shen Men, SympatheticAutonomic point,
Point Zero, Endocrine point, Thalamuspoint, Master Cerebral, Tranquilizerpoint, Nervousness.
9.1.4 Smoking cessation
Primary: Nicotine point, Lung 1, Lung 2, Mouth, Point Zero, Shen Men, Sympathetic Autonomic
point, Brain. (Electrically t reat Lung points at 80 Hz for 2 minutes, or needle for 20 minutes.)
Supplemental: Adrenal Gland.C, Aggressivity, Limbic System.
9.1.5 Weight control
Primary: Appetite Control, Stomach, Mouth, Esophagus, Small Intestines, Shen Men, Point Zero.
Supplemental: Thalamuspoint, Mast er Sensorial, Mast er Cerebral, Endocrine point,
Antidepressant point, Adrenal Gland.C, Brain, San Jiao.
AuriculotherapyManual
Shen Men
Brain
Smoking cessation
Mout h
Adrenal
Gland.C
Nicotine
point
Point Zero
Limbic _
System
Sympathetic
Autonomic
point
Aggressivit y----+--=:u
NADA addict ion prot ocol
Sympathetic Autonomic
point
Lung
Liver
Kidney.C
Shen Men
Addict ion axis lines Weight control
Shen Men
Kidney.C
Primary
axis
I
Secondary
axis
Sympathetic Autonomic
point
Small Intestines
Point Zero
Mout h
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.
Treatment protocols 273
274
9.2 Acute andchronic pain inupperandlower limbs (Figures 9.2 and 9.3)
Corresponding body area This phrase refers to ear reflex points for the hip, knee, ankle, heel,
toes, shoulder, elbow, wrist, handor fingers which correspond to the part of the actual body where
the patient experiences some pain, pathology, tension or weakness. Ift here is only limited
t reat mentsuccess for relieving the problem in a particularlimb, the practitionershould stimulate
Phase II and Phase III points and also examine for obstacles, toxic scars and dental foci.
9.2.1 Bone fracture
Primary: Correspondingbody area, Shen Men, Kidney.C, Adrenal Gland.C, ParathyroidGland.
9.2.2 Dislocated joint
Primary: Correspondingbody area, Shen Men, Thalamuspoint, Adrenal Gland.C, Liver,
Spleen.C.
9.2.3 Joint inflammation,joint swelling
Primary: Correspondingbody area, Endocrine point, Kidney.C, Adrenal Gland.C, Point Zero,
ShenMen.
Supplemental: Allergy point, Apex of Ear, Apex of Tragus, Omega 2, Helix 1, Helix 2, Helix 3,
Helix 4, Helix 5, Helix 6, Occiput, Prostaglandin1, Prostaglandin2.
9.2.4 Muscular atrophy, muscular dystrophy, motorparalysis
Primary: Correspondingbody area, Spinal Mot or Neurons, FrontalCortex, Cerebellum,
Spleen.C, ParathyroidGland.
9.2.5 Muscle spasms, muscle tension, muscle cramp
Primary: Correspondingbody area, Muscle Relaxation point, Thalamuspoint, Point Zero,
Shen Men.
9.2.6 Muscle sprain, sports injuries
Primary: Correspondingbody area, Heat point, Point Zero, Shen Men, Thalamuspoint,
Adrenal Gland.C, Liver, Spleen.C, Kidney.C.
9.2.7 Peripheral neuralgia
Primary: Correspondingbody area, Spinal Sensory Neurons, Thalamuspoint, Point Zero,
ShenMen.
Supplemental: Brain,Sympathetic chain, Adrenal Gland.C, Master Sensorial.
9.2.8 Shoulder pain, frozen shoulder, bursitis
Primary: Shoulder, Shoulder Phase II, Master Shoulder, Clavicle.C, Clavicle.E, Cervical Spine,
ThoracicSpine.
Supplemental: Point Zero, Shen Men, Thalamuspoint, Muscle Relaxation point, Adrenal
Gland.C, Kidney.C, Lesser Occipital nerve.
9.2.9 Tennis elbow
Primary: Elbow Phase I, Elbow Phase II, Elbow Phase III, Forearm, Arm, ThoracicSpine, Point
Zero, Shen Men, Thalamuspoint, Muscle Relaxation point, Adrenal Gland.C, Kidney.C, Occiput.
9.2.10 Carpal tunnel syndrome, wrist pain
Primary: Wrist Phase I, Wrist Phase II, Wrist Phase III, Forearm, Hand,ThoracicSpine, Point
Zero, Shen Men, Thalamuspoint.
AuriculotherapyManual
Shen Me
Shen Me
Point Zer
Muscle
Relaxation
Adrenal
Gland.C
Shoulder pain
Kidney.C
Lesser
Occipit al
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
Post erior arm point s
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.
Treatment protocols 275
Hip pain Knee pain
Shen Men
Kidney.C ...
Point Zero
Muscle --t -.......
Relaxation
Lumbar Spine
Knee.E
Point Zero
Muscle
Relaxation
Adrenal ---1-_.1>"
Gland.C
Knee.F2
Thalamus
point
Knee.C1
Shen Men
Knee.C2
Kidney.C
Thalamus
point
Knee.F3
Post erior leg point s
Foot.C 4
Lumbar
Spine.F4
Ankle.F4
Hip.C4 -+----n
Lumbar
Spinal
Mot or
Neurons
Knee.C4
Ankle.F3
Shen men
Ankle.C
--:r-+-I---- Toes .F2
Foot and ankle
Kidney.C
Point Zero
Thalamus
point
Muscle
Relaxation
Figure 9.3 Lower limb treatment protocols.
276 Auriculotherapy Manual
9.3 Back pain andbodyaches (Figure 9.4)
9.3.1 Abdominal pain, pelvic pain
Primary: Abdomen, Pelvis, Vagus nerve, Sympathetic Autonomic point, Shen Men, Point Zero.
9.3.2 Amyotrophic lateralsclerosis
Primary: Correspondingbody area, Spinal Mot or Neurons, Medulla Oblongata, Brain,
Brainstem, Shen Men, Point Zero, Sympathetic Autonomic point, Endocrine point, Occiput,
Kidney.C, San Jiao.
9.3.3 Back pain
Primary: ThoracicSpine, Lumbosacral Spine, Buttocks, Sciatic nerve, Lumbago, LumbarSpine
Phase II on concha ridge, LumbarSpine Phase III on tragus, Point Zero, Shen Men, Thalamus
point.
Supplemental: Darwin’spoint, Muscle Relaxation point, Liver, Bladder, Adrenal Gland.C.
9.3.4 Fibromyalgia
Primary: ThoracicSpine, Lumbosacral Spine, Muscle Relaxation point, Antidepressant point,
Psychosomatic Reactions 1, Point Zero, Shen Men, Thalamuspoint.
Supplemental: Abdomen, Kidney.C, Sympathetic chain, Mast er Oscillation point, Vitality point,
Tranquilizerpoint.
9.3.5 Intercostal neuralgia
Primary: Chest, ThoracicSpine, ThoracicSpinal Cord, Point Zero, Shen Men, Thalamuspoint.
Supplemental: Occiput, Liver, Gall Bladder, Lung 1, Lung 2.
9.3.6 Osteoarthritis, osteoporosis
Primary: Correspondingbody area, ParathyroidGland, Parathyrotropin, Point Zero, Shen Men.
Supplemental: Endocrine point, Adrenal Gland.C, Adrenal Gland.E, ACTH, Omega 2, Allergy
point, Apex of Ear.
9.3.7 Rheumatoid arthritis
Primary: Correspondingbody area, Omega 2, Prostaglandin1, Prostaglandin2, Allergy point,
Adrenal Gland.C, Point Zero, Shen Men, Thalamuspoint, Endocrinepoint.
Supplemental: Master Oscillation point, Kidney.C, Spleen.C, Occiput, San Jiao, Apex of Ear,
Helix 1, Helix 2, Helix 3, Helix 4, Helix 5, Helix 6.
9.3.8 Sciatica
Primary: Sciatic nerve, 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, Lung 1, Lung 2, Point Zero, Shen Men, Thalamuspoint,
Occiput, External Genitals.C.
Treatment protocols 277
Point
Zero
Muscle
Relaxation
Shen Men
Sympathetic
chain
Antidepressant
point
Abdomen
\ .:""--_-+--I--j’-Thoracic
Spine
Fibromyalgia
SacralSpine
Lumbar Spine
Darwin’s
point
Kidney.C
Vitality
point
Mast er--›
Muscle Oscillation
RelaxationThalamus
I’oint
Thalamus
point
Back pain and sciatica
Shen men
Hip.C
Buttocks
Lumbago
Abdomen
Calf
SacralSpine
Sciatic nerve
Lumbar Spine
Bladder
Kidney.C
Thoracic Spine
Point Zero
Adrenal
Gland.C
Tranquilizer
point
Rheumatoid arthritis Osteoarthritis
Fingers
Wrist
Adrenal
Gland.E
,.""I-----.L Elbow
;.... Parathyroid
Gland
Apex of Ear
Omega 2
Knee.E
Shen Men
Point Zero
Parathyrotropin _-v.....,
Kidney.C
Master
Spleen.C Oscillation
Adrenal
Gland.C
ACTH
o Prostaglandin 2
Allergy point
Shen Men
Adrenal
Gland.C
Apex of Ear
Omega 2
Point Zero
SanJiao
Endocrine
point
Thalamus
point
Prostaglandin 1
Master
Oscillation
Helix 6
Figure9.4 Back pain and body aches treatment protocols.
278 AuriculotherapyManual
9.4 Headand neck pain (Figures 9.5and 9.6)
9.4.1 Facial nerve spasms
Primary: Trigeminal Nucleus, Facial nerve, Face, Occiput, Temples, Forehead, Liver, Point Zero,
Shen Men, Thalamuspoint, Master Sensorial, Cervical Spine, Lesser Occipital nerve, Stomach.
Supplemental: Muscle Relaxation, Adrenal Gland.C, Mast er Cerebral, Tranquilizerpoint.
9.4.2 Facial paralysis
Primary: Trigeminal Nucleus, Face, Occiput, Point Zero, 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, Vagus nerve, Shen Men, Kidney.C, Thalamuspoint,
Cervical Spine.
Supplemental: Sympathetic Autonomic point, Point Zero, Tranquilizerpoint, Mast er Oscillation,
Master Sensorial, Master Cerebral, Muscle Relaxation.
9.4.4 Sinusitis
Primary: InnerNose, 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, Point Zero, Shen Men.
Supplemental: Thalamuspoint, Endocrinepoint, Trigeminal Nucleus, Muscle Relaxation.
9.4.8 Whiplash
Primary: Neck, Cervical Spine, Clavicle.C, Clavicle.E, Shoulder, Point Zero, Shen Men.
Supplemental: Muscle Relaxation, Thalamuspoint, Mast er Cerebral.
Treatment protocols 279
Tension headaches Migraineheadaches
MasterCerebral
Forehead
Muscle
Relaxation
Kidney.C
Shen Men
Lesser
Occipital
nerve
Master Sensorial
Thalamuspoint

Cervical
1,--...1 ,L-..I--r-
Spine
Vag\ Jd
nerve
Master
Oscillation
Tranquilizer_ .... ,--..1
point
Shen Men
Sympathetic
Autonomic
point
Cervical
Spine
Master
Shoulder
Occiput
Master
Cerebral
Muscle
Relaxation
Tranquilizer
point
Thalamus
point
Facialparalysis or facial nerve spasms Posterior ear points for facial nerve
Shen Men
Point Zero
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.
280 Auriculotherapy Manual
TMJ dysfunction and bruxism
Torticollis and neck strain
Clavicle.E
Neck
Clavicle.C
CervicalSpine
__ Trigeminal
Nucleus
Thalamus----1r----f--JL--llII---""----›
point
Endocrine
point
Master Sensorial
TMJ
Lower Jaw
UpperJaw
Irigeminal
nerve
Point Zero
Shen Men
SanJiao
Thalamus
point
Muscle
Relaxation
Psychosomatic
Reactions 1
Master Cerebral
Whiplash Posterior ear points for neck and jaw pain
Shoulder
Cervical
Spine
\ __ OcciRut
Fadal -+_---1
nerve
Trigeminal
Nucleus
Shoulder
Clavicle.E
CervicalSpine
Neck
Clavicle.C
Point Zero
Shen Men
Muscle
Relaxation --+-.....----4f’j
Thalamus
Point
Master Cerebral
Figure9.6 TMJ and neck pain treatment protocols.
Treatment protocols 281
282
9.5 Dental pain (Figure 9.7)
9.5.1 Dental Analgesia
Primary: Dent alAnalgesia 1, Dent alAnalgesia 2, Upper Jaw, Lower Jaw, Toothache 1,
Toothache 2, Toothache 3, Trigeminal nerve.
Supplemental: TMJ, Point Zero, Shen Men, Thalamuspoint, Tranquilizerpoint, Stomach,
Master Sensorial, Occiput, Kidney.C.
9.5.2 Dental surgery
Primary: Upper Jaw, Lower Jaw, Toothache 1, Toothache 2, Toothache 3, Trigeminal nerve, Point
Zero, Shen Men, Palate.
9.5.3 Dry mout h
Primary: Salivary Gland.C, SalivaryGland.E, Thirst point, Mouth, Posterior pituitary,Point
Zero, Shen Men, Sympathetic Autonomic point.
9.5.4 Gingivitis, periodontitis, gum disease, bleeding of gums
Primary: Upper Jaw, Lower Jaw, Mouth, Palate,Adrenal Gland.C.
Supplemental: Point Zero, Shen Men, Kidney.C, Spleen.C, Diaphragm,Stomach, Large
Intestines.
9.5.5 Mout h ulcer
Primary: Mouth, Tongue.C, Tongue.E, Face, Point Zero, Shen Men.
9.5.6 Toothache
Primary: Toothache 1, Toothache 2, Toothache 3, Upper Jaw, Lower Jaw, Dent al Analgesia 1,
Dent alAnalgesia 2, Trigeminal nerve, Shen Men.
Supplemental: Occiput, Kidney.C, Point Zero, Cervical Spine, Mast er Sensorial.
9.5.7 Trigeminal neuralgia, facial neuralgia
Primary: Trigeminal nerve, Face, Upper Jaw, Lower Jaw, Mouth, Occiput, Shen Men, San Jiao.
Supplemental: Point Zero, Thalamuspoint, Mast er Sensorial, Mast er Cerebral, Temples,
Shoulder, Brainstem, Liver, Lesser Occipital nerve, Mast er Oscillation, Wind Stream.
Auriculotherapy Manual
Dental analgesia Drymout h
Salivary
Gland.E
Posterior
Pituitary
Salivary
Gland.C
Thirst
point
Shen Men
Sympathetic
Autonomic point
Point Zero
Kidney.C
TMJ
Lower Jaw
Toothache 1
.upp-er Jgw
Trigeminal
nerve
Point Zero
Shen Men
Stomach
Tranquilizer ......./---l---t --t - Toothache 3
point Toothache 2
Thalamus--\ ---l:’--I--a’>!::’HrT/L.--Occiput
point
Dental
Analgesia 1
Dental
Analgesia 2
MasterSensorial
Toothache Trigeminal neuralgia and facial neuralgia
Shen Men
Point Zero
Dental
Analgesia 1 J
MasterSensorial
Kidney.C
Cervical
Spine
Toothache 3
Toothache 2

Occiput
Toothache 1
Trigeminal
nerve
UpperJaw
Shen Men
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.
Treatment protocols 283
284
9.6 Neurological disorders (Figure 9.8)
9.6.1 Attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD)
Primary: Hippocampus, Amygdala, Thyrotropin, Thyroid Gland.C, Thyroid Gland.E, Shen Men,
Posterior Shen 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, Point Zero, 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: Point Zero, 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, Corpus Callosum, Point Zero, Shen Men, Reticular
Formation, Yintangpoint on forehead.
9.6.9 Meningitis
Primary: Brainstem, Point Zero, Shen Men, Thalamuspoint, Occiput, Forehead, Kidney.C,
Stomach, Heart.C, Lesser Occipital nerve, Thymus Gland, Vitality point.
9.6.10 Multiple sclerosis
Primary: Correspondingbody area, Brainstem, Medulla Oblongata, Master Oscillation, Point
Zero, Shen Men, Thalamuspoint, Occiput, Thymus Gland, Vitalitypoint.
Supplemental: Lesser Occipital nerve.
9.6.11 Parkinsonian tremors
Primary: MidbrainTegmentum, Striatum,Adrenal Gland.C,ACTH, Point Zero, Shen Men.
9.6.12 Polio and post-polio syndrome
Primary: Correspondingbody area, Spinal Mot or Neurons, Medulla Oblongata, Mast er
Cerebral, Point Zero, Posterior Shen Men, Endocrine point.
Supplemental: Thalamuspoint, Adrenal Gland.C, Occiput.
9.6.13 Stroke orcerebral vascular accident
Primary: Correspondingbody area, Brain, Adrenal Gland.C, Adrenal Gland.E, ACTH, Shen
Men, Sympathetic Autonomic point, Mast er Cerebral, Endocrine point.
9.6.14 Tremors
Primary: Spinal Mot or Neurons, Striatum,Cerebellum, Point Zero, Shen Men.
Auriculotherapy Manual
Attention deficit hyperactivity disorder
Shen Men
Posterior
Shen Men
Point Zero
Brainstem
Master
Oscillation
Brain
Thyrotropin
MasterCerebral
Multiple sclerosis
Shen men
Forehead
Epilepsy, seizures or convulsions
’----+---+-+_ Liver
'----1-+-+-1--- Spleen.C
Brainstem
~ i i ~ ~ ~ - Occiput
Brain
Temporal
Cortex
Polioandpost-poliosyndrome
Shen Men
Point Zero
Vitalitypoint
Thalamus
point
Lesser Occipital
nerve
.--+-’-I------,/- Brainstem
’J->’--- Medulla
Oblongata
Occiput
$Rinal
Motor
Neurons
Medulla --.4.-I
Oblongata
Occiput
Posterior
Shen Men
Adrenal
Gland.C
Thalamus
point
Endocrine
point
Master
Cerebral
Figure9.8 Neurological disorders treatmentprotocols.
Treatment protocols 285
286
9.7 Stress-related disorders (Figure 9.9)
9.7.1 Aut onomic excessive act ivit y
Primary: Sympathetic Autonomic point, Sympathetic chain on concha wall, Thalamuspoint,
External Genitals.C, External Genitals.E, Kidney.C.
9.7.2 Chronic fatigue syndrome
Primary: Vitality point, Antidepressant point, Brain, ACTH, Adrenal Gland.C, Adrenal
Gland.E, Point Zero, Shen Men, Master Oscillation, Mast er Cerebral.
9.7.3 Drowsiness
Primary: Excitement point, Alertness, Insomnia 1, Insomnia2.
9.7.4 Heat stroke
Primary: Thalamuspoint, Occiput, Heart.C, Heat point, Adrenal Gland.C, Adrenal Gland.E,
Lesser Occipital nerve.
9.7.5 Hyperhydrosis or excessive sweating
Primary: Fingers, Hand, Forehead, Sympathetic chain on concha wall, Sympathetic Autonomic
point, Endocrine point, Point Zero, Shen Men, Adrenal Gland.C, Adrenal Gland.E, Occiput,
Heart.C.
9.7.6 Hysteria, hysterical disorder
Primary: Correspondingbody areafor 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: Insomnia 1, Insomnia2, Pineal Gland, Heart.C, Master Cerebral, Point Zero, Shen
Men, Thalamuspoint, Forehead, Occiput, Brain, Kidney.C.
9.7.8 Jet lag or circadian rhyt hm dysfunction
Primary: Pineal Gland, Insomnia 1, Insomnia2, Point Zero, Shen Men, Endocrine point.
9.7.9 Psychosomatic disorders
Primary: Psychosomatic Reactions 1, Psychosomatic Reactions 2, Mast er Cerebral, Point Zero,
Shen Men, Sympathetic Autonomic point, Thalamuspoint, Occiput.
Supplemental: Heart.C, External Genitals.C, External Genitals.E, Endocrine point.
9.7.10 Reflex sympathetic dystrophy
Primary: Sympathetic Autonomic point, Sympathetic chain, 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, Point Zero, 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 Reactions 2.
Supplemental: Endocrine point, Ant erior Hypothalamus, Occiput, Posterior Hypothalamus.
AuriculotherapyManual
Chronic fat igue syndrome Insomnia
Insomnia 2
Insomnia 1
Forehead
Kidney.C
Brain
Master
Cerebral
Thalamus
point
Pineal
Gland
Shen Men
Point Zero
Master
Cerebral
Point Zero
Vit alit y
point
Master
Oscillation
Adrenal
Gland.C
ACTH
Shen Men
Psychosomat ic disorders Stress and st rain
Tranquilizer
point
ACTH
Psychosomatic
Reactions 1
b
Adrenal
Gland.E
Muscle
Relaxation
Posterior
Hypothalamus
Ant erior
Hypot halamus
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
Aut onomic
point
External
Genitals.E
Heart.C
Psychosomatic
Reactions 2
Endocrine point
Master Cerebral --_.L.’-.,.
Figure 9.9 Stress-related disorders treatment protocols.
Treatment protocols 287
288
9.8 Psychological disorders (Figure 9.10)
9.8.1 Anxiety
Primary: Nervousness, Master Cerebral, Tranquilizerpoint, Occiput, Heart.C, Point Zero, Shen
Men, Sympathetic Autonomic point.
Supplemental: Stomach, Adrenal Gland.C, Vagus nerve.
9.8.2 Depression
Primary: Antidepressant, Brain, Excitement point, Pineal Gland, Master Cerebral, Shen Men,
Sympathetic Autonomic point.
Supplemental: Point Zero, Endocrine point, Master Oscillation, Occiput, External Genitals.C,
External Genitals.E.
9.8.3 Irritability
Primary: Aggressivity, Master Cerebral, Point Zero, 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: Point Zero, Master Cerebral, Brainstem, Stomach.
9.8.7 Nightmares, disturbing dreams
Primary: Pons, Psychosomatic Reactions 1, Psychosomatic Reactions 2, Nervousness, Master
Cerebral, Thalamuspoint, Heart.C,Shen Men, Point Zero, Insomnia 1, Insomnia2, 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 Reactions 2, Hippocampus, Shen Men,
Heart.C.
9.8.10 Schizophrenia and psychosis
Primary: Master Cerebral, Brain, Thalamuspoint, Occiput, Heart.C, Kidney.C, Stomach,
Brainstem, Lesser Occipital nerve.
Supplemental: Point Zero, Shen Men, Nervousness, Forehead, Liver, Apex of Ear.
Auriculotherapy Manual
Anxiety Depression
Shen Men
Sympathetic
Aut onomic
point
Point Zero
Vagus nerve
Adrenal Gland.C
Tranquilizer
p-oint
Master Cerebral
Nervousness
Shen Men
External
Genitals.C
Sympat het ic
Aut onomic
point
External
Genitals.E
Point Zero
Master
Oscillat ion
Excitement
p-oint
Pineal Gland
Endocrine point
Master Cerebral
Occiput
Antidepressant
point
Memory problems or poor concentration Schizophrenia and psychosis
Apex of Ear
Lesser
Occipit al
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.
Treatment protocols 289
290
9.9 Eyesight disorders (Figure 9.11)
9.9.1 Astigmatism
Primary: Eye, Eye Disorders 2, Opticnerve, Kidney.C, Liver, Occiput, Shen Men.
9.9.2 Blurred vision, poor eyesight
Primary: Eye, Eye Disorders 2, Eye Disorders 3, Opt icnerve, Occipital Cortex.
Supplemental: Shen Men, Master Sensorial, Brain, Occiput, Kidney.C, Liver, Lung 2.
9.9.3 Conjunctivitis
Primary: Eye, Shen Men, Liver, Skin Disorders.C, Occiput, Adrenal Gland.C, Adrenal Gland.E.
9.9.4 Eye irritation
Primary: Eye Disorders 1, Eye Disorders 2, Shen Men, Endocrine point.
9.9.5 Glaucoma
Primary: Eye, Eye Disorders 1, Eye Disorders 2, Shen Men, Occiput, Kidney.C, Liver, Apex of
Ear.
9.9.6 Myopia
Primary: Eye, Eye Disorders 2, Eye Disorders 3, Opt icnerve, 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- Lu ng 2
Brain --t -----jL--_.. ""’\
Opt ic nerve __
Disorders 2
Disorders 3
---j---....
Glaucoma Myopia
Kidney.C
Liver
Occiput
Spleen.C
Forehead
_--::"’"-",.,,_---- Apex of Ear
Opt ic nerve

Disorders 3
Disorders 2 ---Y’---t c\ ..J
Kidney.C
Apex of Ear
Shen Men
Disorders 2
Disorders 1

Figure 9.11 Eyesightdisorders treatment protocols.
Treatment protocols 291
292
9.10 Hearingdisorders (Figure 9.12)
9.10.1 Dizziness, vertigo
Primary: Dizziness point, InnerEar.C, InnerEar.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: InnerEar.C, InnerEar.E, External Ear.C, Kidney.C, Point Zero, Shen Men.
Supplemental: Master Oscillation, Master Cerebral, Adrenal Gland.C, Occiput, San Jiao, Apex
of Ear.
9.10.3 Impaired hearing
Primary: InnerEar.C, InnerEar.E, External Ear.C, Kidney.C, Occiput, Point Zero, Shen Men.
9.10.4 Mot ion sickness, car sickness, sea sickness
Primary: InnerEar.C, InnerEar.E, Stomach, Occiput, Point Zero, Shen Men, Lesser Occipital
nerve, Mast er Oscillation.
9.10.5 Mut ism, st ut t ering, difficult yspeaking
Primary: Mutism, Inner Ear.C, Tongue.C, Tongue.E, Kidney.C, Mast er Oscillation, Point Zero,
Shen Men, Thalamuspoint, Heart.C.
Supplemental: External Ear.C, Master Cerebral.
9.10.6 Sensorineural deafness
Primary: InnerEar.C, External Ear.C, Auditory nerve, Temporal Cortex, Auditory line, Adrenal
Gland.C, Adrenal Gland.E, Kidney.C, Shen Men, Point Zero, Master Sensorial, Occiput, San Jiao.
Treat the four walls of the ear canal directly with a probe or needle, or fill the ear canal with saline
and place a monopolar auricularprobe into the saline. With either method, t reat a range of
frequencies, from 1 Hz to 320Hz, stimulatingeach point at 150f.LA for 30 seconds.
Also treat active ear reflex points along t he auditoryline on the lobe inferiorto the antitragus,and
8 points on the areaof the skull which surroundsthe ear. Patientssuffering from deafness need to
make a minimumcommitment to 20sessions of 3D-minutetreatments.
9.10.7 Sudden deafness
Primary: InnerEar.C, InnerEar.E, Brain, Brainstem, Point Zero, Shen Men, Thalamuspoint.
9.10.8 Tinnitus
Primary: InnerEar.C, External Ear.C, Auditory nerve, Kidney.C, Point Zero, Shen Men, Master
Sensorial, San Jiao.
Supplemental: Cervical Spine, Master Oscillation, Adrenal Gland.C, Adrenal Gland.E, Occiput,
Shoulder, Lesser Occipital nerve.
Auriculotherapy Manual
Sensorineural deafness and t innit us
Surface view
Sensorineural deafness and t innit us
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 vert igo
Mut ism and st ut t ering
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 (Figure 9.13)
9.11.1 Allergic rhinitis
Primary: Inner Nose, Apex of Ear, Adrenal Gland.C, Forehead, Endocrine point, Lung I, Lung 2,
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, Endocrine point, Heart .C, Lung 1,
Lung 2.
9.11.4 Laryngitis
Primary: Larynx.C, Larynx.E, Tonsil 1, Tonsil 2, Tonsil 3, Tonsil 4, Point Zero, Shen Men,
Endocrine point, Palate, Lung 1, Lung 2.
9.11.5 Nose bleeding
Primary: InnerNose, Forehead, Lung 1, Lung 2, Apex of Ear, Shen Men, Adrenal Gland.C.
9.11.6 Pharyngitis
Primary: Throat.C,Throat .E, Point Zero, Shen Men, Endocrine point, Lung 1, Lung 2, Adrenal
Gland.C.
9.11.7 Rhinitis, running nose
Primary: InnerNose, External Nose, Point Zero, Forehead, Kidney.C, Shen Men, Endocrine
point, Adrenal Gland.C, Lung 1, Lung 2, Spleen.C, Allergy point.
9.11.8 Sneezing
Primary: Sneezing point, InnerNose, 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: Lung 1, Lung 2, Adrenal Gland.C, Adrenal Gland.E, Point Zero, Shen Men,
Thalamuspoint, Prostaglandin1, Prostaglandin2, Mast er Oscillation.
9.11.10 Sunburned nose
Primary: External Nose.C, External Nose.E, Skin Disorder.C, Skin Disorder.E, Point Zero, Shen
Men, Thalamuspoint, Lung 1, Lung 2.
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, Thyroid Gland.C, Thyroid Gland.E.
Auriculotherapy Manual
Thalamus point
Sore t hroat
o Prostaglandin 2
Tonsil 1
Adrenal
Gland.E
Shen Men
Point Zero
Mout h
Throat E
Tonsil 2
Throat.C
Thyroid
Trachea
Gland.E
Thyroid
Adrenal
Gland.C
Gland.C
Tonsil 3
Master
Oscillation
Shen Men
Laryngit is and t onsillit is
Apex of Ear
Tonsil 1
Endocrine
point
Palate
Point Zero
bill:)tnx.E
Throat E
lir,ynx.C
Throat.C
Lung 1
Lung 2
Apex of Ear
Allergy point
Sneezing
Shen Men
Ant ihist amine
point
Rhinit is and allergic rhinit is
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
Lung 2
Asthma
Endocrine
Forehead
point
Figure 9.13 Nose and throat disorders treatment protocols.
Treatment protocols 295
296
9.12 Skin and hairdisorders (Figure 9.14)
9.12.1 Acne
Primary: Face, Skin Disorder.C, Skin Disorder.E, Lung 1, Lung 2, Point Zero, Shen Men.
Supplemental: External Genitals.C, External Genitals.E, Gonadotropins, Endocrine point.
9.12.2 Boil, carbuncle
Primary: Correspondingbody area, Lung 1, Lung 2, Occiput, Endocrine point, Point Zero, Shen
Men, Adrenal Gland.C, Adrenal Gland.E.
9.12.3 Cold sores (herpes simplex)
Primary: Lips, Mouth, Lung 1, Lung 2, Occiput, Salivary Gland.C, Salivary Gland.E, Point Zero,
Shen Men.
Supplemental: Adrenal Gland.C, Adrenal Gland.E, ACTH, Skin Disorder.C, Skin Disorder.E.
9.12.4 Dermatitis,hives, urticaria
Primary: Correspondingbody area, Skin Disorder.C, Skin Disorder.E, Endocrine point, Shen
Men.
Supplemental: Adrenal Gland.C, Kidney.C, Lung 1, Lung 2, Occiput, Point Zero, Mast er
Sensorial, Thyroid Gland.C, Thyroid Gland.E, Apex of Ear.
9.12.5 Eczema, itching, pruritus
Primary: Correspondingbody area, Skin Disorder.C, Skin Disorder.E, Lung 1, Lung 2.
Supplemental: Occiput, Large Intestines, Adrenal Gland.C, Point Zero, Shen Men, Endocrine
point, Psychosomatic Reactions 1, Psychosomatic Reactions 2.
9.12.6 Frostbite
Primary: Correspondingbody area, Occiput, Heat point, Adrenal Gland.C, Adrenal Gland.E.
Supplemental: Point Zero, Shen Men, Lung 1, Lung 2, Spleen.C, Spleen.E.
9.12.7 Hairloss, baldness, alopecia
Primary: Occiput, Endocrine point, Lung 1, Lung 2, Kidney.C, Point Zero, Shen Men.
9.12.8 Poison oak, poison ivy
Primary: Correspondingbody area, Skin Disorder.C, Skin Disorder.E, Lung 1, Lung 2, Point
Zero, Shen Men, Endocrine point, Apex of Ear, Allergy point.
9.12.9 Postherpetic neuralgia
Primary: Chest, ThoracicSpine, Skin Disorder.C, Skin Disorder.E, Point Zero, Shen Men,
Endocrine point, Kidney.C.
9.12.10 Rosacea
Primary: External Nose.C, External Nose.E, Lung 1, Lung 2, Endocrine point, Adrenal Gland.C,
Adrenal Gland.E, Spleen.C, Apex of Ear.
9.12.11 Shingles (herpes zoster)
Primary: Correspondingarea, Chest, ThoracicSpine, Skin Disorder.C, Skin Disorder.E, Endocrine
point, Lung 1, Lung 2, Occiput, Adrenal Gland.C, Adrenal Gland.E, Kidney.C.
Supplemental: Point Zero, Shen Men, Ant erior Pituitary,Apex of Ear, Allergy point.
9.12.12 Sunburn
Primary: Correspondingbody area, Skin Disorder.C, Skin Disorder.E, Thalamuspoint,
Kidney.C.
Supplemental: Shen Men, Endocrine point, Adrenal Gland.C, Lung 1, Lung 2.
AuriculotherapyManual
Dermat it is, hives, urt icaria and eczema Sunburn
Shen Men
Psychosomatic
Reactions 1 0
Kidney.C
Large
Intestines
Point Zero
Adrenal ---I------\ --IJ
Gland.C
Endocrine
point
Psychosomatic ~
Reactions 2
Shen Men
Skin
Disorder.C
Kidney.C
Skin
Disorder.E
Lung 1
Lung 2
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
Mout h _ __>__---.
Skin
Disorder.C
Thoracic
Spine
Skin
Disorder.E
Occiput
Herpes zost er and post herpet ic neuralgia
Apex of Ear
Allergy point
Adrenal
Gland.E
Adrenal
Gland.C
Shen Men
Ant erior
Pituitary
Endocrine
point
Kidney.C
Point Zero
Lungj
Lungl
Figure 9.14 Skin and hair disorders treatment protocols.
Treatment protocols 297
298
9.13 Heart and circulatory disorders (Figure 9.15)
9.13.1 Anemia
Primary: Heart.C1,Heart.C2,Heart .E, Liver, Spleen.C, Spleen.E, Endocrine point, Stomach,
Small Intestines, Diaphragm.C,Kidney.C.
9.13.2 Angina pain
Primary: Heart.C1, Heart.C2,Heart .E, Vagus nerve, Sympathetic Autonomic point, Point Zero,
Shen Men, Thalamuspoint, Lung 1, Lung 2, Stomach.
9.13.3 Bradycardia, pulselessness
Primary: Heart.C1,Heart.C2, Heart .E, Sympathetic Aut onomic point, 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, Sympathetic Autonomic point, Shen Men, Vagus
nerve, Adrenal Gland.C,Adrenal Gland.E,Thalamuspoint.
Supplemental: Point Zero, Kidney.C, Liver, Stomach, Small Intestines.
9.13.6 Heartattack, coronary thrombosis
Primary: Heart.C1,Heart.C2,Heart .E, Sympathetic Autonomic point, Endocrine point, Point
Zero, Shen Men, Thalamuspoint, Small Intestines, Kidney.C, ACTH.
9.13.7 Hypertension (high blood pressure)
Primary: Hypertension 1, Hypertension 2, Hypertensive groove, Heart.C1,Heart.C2,Heart .E,
Marvelous point, Sympathetic Autonomic point, Point Zero, Shen Men, Sympathetic chain.
Supplemental: Vagus nerve, Thalamuspoint, Adrenal Gland.C,Apex of Ear.
9.13.8 Hypotension (lowblood pressure)
Primary: Hypotension, Heart.C,Heart.E,Vagus nerve, Thalamuspoint, Endocrinepoint, Shen
Men, SympatheticAutonomic point, Point Zero.
Supplemental: Adrenal Gland.C, Liver, Spleen.C, Spleen.E.
9.13.9 Lymphatic disorders
Primary: Spleen.C, Spleen.E, Thymus Gland, Point Zero, Shen Men, Vitality point.
9.13.10 Myocarditis
Primary: Heart.C1,Heart.C2,Heart .E, Sympathetic Autonomic point, Shen Men, Occiput,
Small Intestines, Spleen.C.
9.13.11 Premature ventricular contraction
Primary: Heart.C1,Heart.C2,Heart .E, Sympathetic Autonomic point, Thalamuspoint, Small
Intestines.
9.13.12 Tachycardia, heart palpitations
Primary: Heart.C1,Heart.C2,Heart .E, Sympathetic Autonomic point, Point Zero, Shen Men,
Thalamuspoint, Small Intestines, 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, Heat point, Sympathetic Aut onomic point, Endocrine
point, Adrenal Gland.C, Adrenal Gland.E, Lesser Occipital nerve.
Supplemental: Shen Men, Thalamuspoint, Sympathetic chain, Occiput, Liver, Spleen.C,
Auriculotherapy Manual
Hypertension Hypotension
Apex of Ear
!::!yp.ertension 1
Shen Men

Autonomic
point
Sympathetic
chain
PointZero
Heart.C2 __
Heart.Cl
Adrenal Gland.C__+-_r)I
Hypertension 2 ----t -(
Vagus nerve
Angina pain
Shen Men
Sympathetic
Autonomic
point
Point Zero
HeartE
Vagus nerve
Adrenal Gland.C
Endocrine
point
t:!yp-otension
Thalamuspoint
rr:....,..-...JL Spleen.E
Liver
Spleen.C
Heart.C
Thalamuspoint
Cardiacarrhythymias
Shen Men
Sympathetic
Autonomic
point
PointZero
Heart.C2
Lung 1
Vagus nerve __-+-_
Heart.Cl
Lung 2
Shen Men
$YlDp-athetic
Autonomic
p-oint
Small Intestines
Point Zero
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.
Treatment protocols 299
300
9.14 Lung and respiratory disorders (Figure 9.16)
9.14.1 Asthma
Primary: Asthma, Antihistamine, Lung 1, Lung 2, Bronchi, Sympathetic Autonomic point, Point
Zero, Shen Men, Allergy point, Apex of Ear.
Supplemental: Adrenal Gland.C, Tranquilizerpoint, Master Cerebral, Kidney.C, Occiput,
Spleen.C, Spleen.E, Psychosomatic Reactions 1.
9.14.2 Bronchitis
Primary: Bronchi, Trachea, Asthma, Antihistamine, Shen Men, Point Zero, Adrenal Gland.C,
Adrenal Gland.E, Sympathetic Autonomic point, Occiput.
9.14.3 Bronchopneumonia
Primary: Asthma, Antihistamine, Bronchi, Point Zero, Shen Men, Sympathetic Autonomic
point, Adrenal Gland.C, Adrenal Gland.E, Endocrinepoint, Occiput.
9.14.4 Chest pain, chest heaviness
Primary: Lung 1, Lung 2, Chest, Heart.C,Asthma, Adrenal Gland.C, Sympathetic Autonomic
point, Point Zero, Shen Men.
9.14.5 Cough
Primary: Asthma, Antihistamine, Throat.C,Throat .E, Lung 1, Lung 2, Adrenal Gland.C,
Adrenal Gland.E.
Supplemental: Sympathetic Autonomic point, Shen Men, Point Zero, Trachea, Occiput,
Spleen.C, Spleen.E.
9.14.6 Emphysema
Primary: Lung 1, Lung 2, Bronchi, Chest, Asthma, Antihistamine, Point Zero, Shen Men,
Sympathetic Autonomic point, Adrenal Gland.C, Adrenal Gland.E, Occiput.
9.14.7 Hiccups
Primary: Diaphragm.C, Diaphragm.E, ParasympatheticCranialnerves, San Jiao.
Supplemental: Point Zero, Shen Men, Thalamuspoint, Esophagus, Liver, Occiput.
9.14.8 Pleurisy
Primary: Lung 1, Lung 2, Chest, Point Zero, Shen Men, Endocrine point, Adrenal Gland.C,
Adrenal Gland.E, San Jiao.
9.14.9 Pneumonia
Primary: Lung 1, Lung 2, Chest, Adrenal Gland.C, Adrenal Gland.E, Endocrine point, Point
Zero, Shen Men, Thalamuspoint, San Jiao.
9.14.10 Shortness of breath, breathing difficulties
Primary: Inner Nose, Lung 1, Lung 2, Chest, Forehead, Adrenal Gland.C, Adrenal Gland.E,
Shen Men.
9.14.11 Tuberculosis
Primary: Tuberculosis, Lung 1, Lung 2, Point Zero, Shen Men.
9.14.12 Whooping cough
Primary: Asthma, Antihistamine, Bronchi, Adrenal Gland.C, Adrenal Gland.E, Sympathetic
Autonomic point, Occiput.
AuriculotherapyManual
Asthma Cough
Shen Men
Sympathetic
Autonomic
point
Antihistamine
Shen Men
Adrenal
Gland.E
Occiput
Asthma
Spleen.E
Trachea
Adrenal
Gland.C
Apex of Ear
Allergy point
-,----jr...-I-..f- LungJ

Kidney.C
Point Zero
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
Shen Men
Thalamuspoint
Point Zero
fl’::>""d-----IH-r
Esophagus
Parasympathetic ->---T""’_
Cranialnerves
Adrenal
Gland.E
Chest
Sympathetic
Autonomic
point
Bronchi __+-_
PointZero
Shen Men
Antihistamine
Adrenal Gland.C
Figure9.16 Lung and respiratory disorders treatmentprotocols.
Treatment protocols 301
302
9.15 Gastrointestinal and digestive disorders (Figure 9.17)
9.15.1 Abdominal distension
Primary: Stomach, Small Intestines, Large Intestines, Abdomen, PelvicGirdle, Ascites.
Supplemental: Solar plexus, Point Zero, Shen Men, SympatheticAutonomic point, San Jiao.
9.15.2 Colitis, enteritis
Primary: Small Intestines, Large Intestines, Point Zero, Shen Men, SympatheticAutonomic
point, Stomach.
Supplemental: Rectum.C, Shen Men, Spleen.C, Occiput.
9.15.3 Constipation
Primary: Constipation, Large Intestines, Rectum.C, Rectum.E, Omega 1, Abdomen.
Supplemental: Thalamuspoint, San Jiao, Stomach, Spleen.C, SympatheticAutonomic point.
9.15.4 Diarrhea
Primary: Small Intestines, Large Intestines, Point Zero, Shen Men, SympatheticAutonomic point.
Supplemental: Rectum.C, Rectum.E, Omega 1, Spleen.C, Kidney.C, Occiput.
9.15.5 Dysentery
Primary: Small Intestines, Large Intestines, Rectum.C, Shen Men, SympatheticAutonomic point.
Supplemental: Endocrine point, Lung 1, Lung 2, Occiput, Adrenal Gland.C, Kidney.C, Spleen.C,
Vitality point.
9.15.6 Flatulence, ascites
Primary: Ascites, Large Intestines, Small Intestines, Abdomen, Sympathetic Autonomic point,
San Jiao.
9.15.7 Fecal incontinence
Primary: Rectum.C, Rectum.E, Large Intestines, Shen Men.
9.15.8 Gastritis, gastric spasm
Primary: Stomach, Abdomen, Point Zero, Shen Men, Sympathetic Autonomic point, Spleen.C.
Supplemental: Large Intestines, Liver, Lung 1, Lung 2, Lesser Occipital nerve.
9.15.9 Hemorrhoids
Primary: Hemorrhoids.C1, Hemorrhoids.C2, Rectum.C, Rectum.E, Large Intestines, Spleen.C,
Thalamuspoint, Point Zero, Shen Men, Adrenal Gland.C.
9.15.10 Indigestion
Primary: Stomach, CardiacOrifice, Small Intestines, Sympathetic Autonomic point, Pancreas,
Spleen.C, Shen Men, Point Zero, Omega 1, Large Intestines, Abdomen, San Jiao, Liver, Occiput.
9.15.11 Irritable bowel syndrome
Primary: Small Intestines, Large Intestines, Rectum.C, Rectum.E, Abdomen, Omega 1,
Constipation,Point Zero, Shen Men, Stomach.
Supplemental: Sympathetic Autonomic point, Pancreas, Occiput, San Jiao.
9.15.12 Nausea, vomiting
Primary: Stomach, Esophagus, Omega 1, Point Zero, Shen Men, Sympathetic Autonomic point,
Thalamuspoint, Occiput.
9.15.13 Stomach ulcer, duodenal ulcer
Primary: Stomach, Duodenum, Small Intestines, Abdomen, Shen Men, Sympathetic Autonomic
point, Point Zero.
Supplemental: Psychosomatic Reactions 1, Thalamuspoint, Master Cerebral, Aggressivity,
Occiput, Spleen.C, Lung 1, Lung 2.
Auriculotherapy Manual
Stomach ulcer or duodenal ulcer Irrit ablebowel syndrome and colit is

Shen Men
Psychosomatic
Reactions 1
o
Sympathetic
Autonomic
point
Small
Intestines
Duodenum
Point Zero
Stomach
Lung 1
Lung 2
Aggressivity __
Master ---’r\ J
Cerebral
Const ipat ion
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.
Treatment protocols 303
304
9.16 Kidney and urinarydisorders (Figure 9.18)
9.16.1 Antidiuresis, waterimbaLance
Primary: Bladder, Kidney.C, Kidney.E, San Jiao, Posterior Pituitary,Occiput.
Supplemental: Point Zero, Shen Men, Sympathetic Autonomic point, Heart.C, Spleen.C,
Spleen.E, Adrenal Gland.C, Adrenal Gland.E.
9.16.2 Bedwetting
Primary: Bladder, Kidney.C, Kidney.E, Urethra.C, Uret hra.E, Occiput, Excitement, Shen Men.
Supplemental: Point Zero, Thalamuspoint, Brain, Hypogastric nerve, Spleen.C, Liver, San Jiao.
9.16.3 BLadder controL probLems
Primary: Bladder, Kidney.C, Kidney.E, Urethra.C,Uret hra.E,Ovariesor Testes.C, Ovaries or
Testes.E, Brain, Thalamuspoint, Shen Men, Point Zero, Spleen.C, Liver.
9.16.4 Diabetes insipidus
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Uret hra.E,Thirst point, Brain, Posterior
Pituitary,Sympathetic Autonomic point, Adrenal Gland.C,Adrenal Gland.E, Spleen.E.
Supplemental: Point Zero, Shen Men, Endocrine point, Spleen.C, Liver.
9.16.5 Frequent urination, urination probLems
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Uret hra.E,Excitement point, Thalamus
point.
Supplemental: Endocrine point, Point Zero, Shen Men, Adrenal Gland.C, Adrenal Gland.E.
9.16.6 Kidney pyelitis
Primary: Kidney.C, Kidney.E, Bladder, Urethra.C,Uret hra.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, Endocrine point, Sympathetic
Autonomic point, Adrenal Gland.C, Adrenal Gland.E, Spleen.C, Liver.
Supplemental: Shen Men, Point Zero, Spleen.E, Thalamuspoint.
9.16.9 Uresiestesis
Primary: Urethra.C,Urethra.E,Bladder, Kidney.C, Kidney.E, Shen Men, Sympathetic Autonomic
point, Thalamuspoint, External Genitals.C, External Genitals.E.
9.16.10 Urinary disorders
Primary: Kidney.C, Kidney.E, Bladder, Ureter.C, Uret er.E, Urethra.C, Uret hra.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,Uret hra.E, Ureter.C, Uret er.E, Endocrine
point, External Genitals.C, External Genitals.E, San Jiao.
9.16.12 Urinary infection, cystitis
Primary: Bladder, Urethra.C, Urethra.E,Ureter.C, Uret er.E, Kidney.C, Kidney.E, Shen Men,
Occiput.
Supplemental: Point Zero, Sympathetic Autonomic point, Adrenal Gland.C, Adrenal Gland.E.
Auriculotherapy Manual
Shen Men
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
Kidneyst ones
Bladder
Shen Men
Ureter.C
Adrenal
Gland.E
Spleen.C
Occiput
Thalamuspoint
r----t--+---I---- Live r
Nephritis
Endocrine
point
Adrenal
Gland.E
Bladder
Spleen.E
Point Zero
. .,---j.--.,.I---,f.-- Liver
Diabetes insipidus
Bladder Shen Men
KidneYi Kidney£
Sympathetic
Autonomic
point
KidneY•I-
Posterior
---
Pituitary
Endocrine
point
Adrenal --4-_,
Gland.C
Shen Men
PointZero
- - - - f - - - ~ ~
Thirstpoint ----I-(
Sympathetic
Autonomic
point
Urethra.E
Urethra.C _ - - - . . ~ _ ~
Figure9.18 Kidneyand urinary disorders treatmentprotocols.
Treatment protocols 305
306
9.17 Abdominal organ disorders (Figure 9.19)
9.17.1 Appendicitis
Primary: Appendix, Appendix Disorder 1, Appendix Disorder 2, Appendix Disorder 3, Large
Intestines, Sympathetic Autonomic point.
Supplemental: Abdomen, San Jiao, Point Zero, Shen Men, Thalamuspoint.
9.17.2 Cirrhosis
Primary: Hepatitis, Liver, Liver Yang 1, Liver Yang 2, Sympathetic Autonomic point, Spleen.C,
ShenMen.
Supplemental: Gall Bladder, Stomach, Ovaries or Testes.C, Ovaries or Testes.E.
9.17.3 Diabetes mellitus
Primary: Pancreas, Pancreatitis,Brain, San Jiao, Appet it e Control, Point Zero, Shen Men,
Endocrine point, Liver, Spleen.C.
9.17.4 Edema
Primary: Kidney.C, Kidney.E, Bladder, Heart.C, Liver, Sympathetic Autonomic point,
Endocrine point.
9.17.5 Gall stones, gall bladder inflammat ion
Primary: Gall Bladder, Endocrine point, Point Zero, Shen Men, Sympathetic Autonomic point,
Liver, Lung 1, Lung 2, San Jiao.
9.17.6 Hepatitis
Primary: Hepatitis1, Liver, Liver Yang 1, Liver Yang 2, Point Zero, Shen Men, Thalamuspoint,
Sympathetic Autonomic point, Abdomen, San Jiao, Adrenal Gland.C.
Supplemental: Endocrine point, Kidney.C, Gall Bladder, Stomach.
9.17.7 Hernia
Primary: Abdomen, Large Intestines, Prostate.C, Prostate.E, Point Zero, Shen Men, Endocrine
point, Thalamuspoint, Spleen.C.
9.17.8 Hypoglycemia
Primary: Pancreas, Stomach, SympatheticAutonomic point, Thalamuspoint, Adrenal Gland.C,
Kidney.C, Kidney.E, Liver, Point Zero, Shen Men, Heart.C,Spleen.C, Spleen.E.
9.17.9 Jaundice
Primary: Hepatitis, Liver, Liver Yang 1, Liver Yang 2, Sympathetic Autonomic point, Spleen.C.
Supplemental: Gall Bladder, Stomach, Ovaries or Testes.C, Ovaries or Testes.E.
9.17.10 Liver dysfunction
Primary: Liver, Liver Yang 1, Liver Yang 2, Sympathetic Autonomic point, Endocrine point,
Adrenal Gland.C.
Supplemental: Point Zero, Shen Men, Spleen.C, Spleen.E, Kidney.C, Kidney.E, Gall Bladder,
Stomach, Ovaries or Testes.C, Ovaries or Testes.E.
9.17.11 Pancreatitis
Primary: Pancreas, Pancreatitis,Point Zero, Shen Men, Endocrine point, Sympathetic
Autonomic point.
Auriculotherapy Manual
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
Hepatitisand liver dysfunction
Hepatitis1
Shen Men
Stomach
Liver
Yang1.
Abdomen
Gall -\ ---1---4--4_
Bladder
Thalamus
point
Gallstones and gall bladder inflammation Diabetes mellitus and pancreatitis
GallBladder
Liver
Shen Men
Sympathetic
Autonomic
point
Point Zero
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.
Treatment protocols 307
308
9.18 Gynecological andmenstrual disorders (Figure 9.20)
9.18.1 Breasttenderness
Primary: MammaryGland.C, MammaryGland.E, Chest, Endocrine point, Shen Men, Thalamus
point.
Supplemental: Point Zero, 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: Point Zero, Endocrine point, Thalamuspoint, Thymus Gland.E, Vitality point.
9.18.3 Dysmenorrhea, irregular menstruation
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Abdomen, Endocrine point, External
Genitals.C, External Genitals.E, Prostaglandin1, Prostaglandin2.
Supplemental: Point Zero, Shen Men, Sympathetic Autonomic point, Thalamuspoint, Adrenal
Gland.C, Brain, Kidney.C.
9.18.4 Endometriosis
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Shen Men, Endocrine point, Point Zero,
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, Endocrine point, 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, Pelvic Girdle, Endocrine point.
Supplemental: External Genitals.C, External Genitals.E, Lung 1, Lung 2.
9.18.7 Labor induction
Primary: Uterus.C, Uterus.E, Abdomen, Point Zero, Shen Men, Sympathetic Autonomic point,
Thalamuspoint, LumbarSpine, Spleen.C, Spleen.E.
9.18.8 Lactation stimulation
Primary: Prolactin, MammaryGland.C, MammaryGland.E, Endocrine point, Spleen.C,
Kidney.C.
9.18.9 Mammary gland swelling
Primary: MammaryGland.C, MammaryGland.E, Chest, Endocrine point, Adrenal Gland.C.
9.18.10 Menopause
Primary: Ovary.C, Ovary.E, Uterus.C, Uterus.E, Endocrine point, 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, Sympathetic Autonomic point, Thalamuspoint, LumbarSpine, Spleen.C.
9.18.12 Premenstrual syndrome
Primary: Uterus.C, Uterus.E, Ovary.C, Ovary.E, Endocrine point, Shen Men.
Supplemental: Point Zero, Sympathetic Autonomic point, Thalamuspoint, Adrenal Gland.C,
Brain, Kidney.C, Abdomen.
9.18.13 Vaginismus
Primary: Vagina, Ovary.C, Ovary.E, Point Zero, Shen Men, Endocrine point.
Supplemental: Adrenal Gland.C, Lung 1, Lung 2, Brain, Occiput, Kidney.C, Abdomen.
Auriculotherapy Manual
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 menst ruat ion
o Prostaglandin 2
Uterus .C Shen Men
Sympathetic
Autonomic
point
External
Genitals.C
Breast t umor. ovarian cancer Infert ilit y
Mammary
Gland.C
Shen Men
Brain
Endocrine
point
Uterus.C
External
Genitals.C
Mammary
Gland.E
Thalamus
point
Thymus
Gland.E

Vit alit y
!’oint
Point Zero
Shen Men
Endocrine
point
Figure 9.20 Gynecological and menstrual disorders treatment protocols.
Treatment protocols 309
310
9.19 Glandular disorders andsexual dysfunctions (Figure 9.21)
9.19.1 Calcium metabolism
Primary: ParathyroidGland, Parathormone,Endocrine point, Shen Men.
9.19.2 Dwarfism
Primary: Ant erior Pituitary,Kidney.C, Kidney.E, Point Zero, Shen Men, Endocrine point.
Supplemental: Ovaries or Testes.C, Ovaries or Testes.E, Brain.
9.19.3 Goiter
Primary: Thyroid Gland.C, Thyroid Gland.E, Thyrotropin, Point Zero, Shen Men, Endocrine
point.
9.19.4 Hypergonadism, hypogonadism
Primary: Ovariesor Testes.C, Ovary or Testes.E, Point Zero, Shen Men, Endocrine point, Brain.
9.19.5 Hyperthyroidism, hypothyroidism
Primary: Thyroid Gland.C, Thyroid Gland.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: Shen Men, Brain,Sympathetic Autonomic point, 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, Endocrine point.
9.19.8 Prostatitis
Primary: Prostate.C, Prostate.E, Testes.C, Testes.E, Pelvic Girdle, Shen Men, Endocrine point.
Supplemental: Point Zero, Adrenal Gland.C, Bladder, Occiput, Skin Disorder.C, Skin
Disorder.E.
9.19.9 Scrotal rash
Primary: External Genitals.C, External Genitals.E, Skin Disorder.C, Skin Disorder.E, Master
Sensorial.
9.19.10 Sexual compulsion
Primary: Sexual Compulsion, Aggressivity, Excitement point, Ovaries or Testes.C, Ovaries or
Testes.E, Point Zero, Shen Men, Tranquilizerpoint, Mast er Cerebral, Thalamuspoint.
9.19.11 Testitis
Primary: Testes.C, Testes.E, External Genitals.C, External Genitals.E, Pelvic Girdle, Shen Men.
Supplemental: Prostate.C, Prostate.E, Point Zero, Endocrine point, Adrenal Gland.C, Hip.C,
Hip.E, Occiput, Liver.
Auriculotherapy Manual
Ovariesor
Testes.C
Endocrine
point
External
Genitals.C
Brain
Ovariesor
Testes.C
Impotency, frigidity, lackingsexual desire Prostatitisand testitis
Bladder Shen Men
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
Shen Men
PointZero
Thalamuspoint
Ovariesor
Testes.C

Brain
Figure9.21 Glandulardisorders and sexualdysfunctionstreatmentprotocols.
Treatment protocols 311
312
9.20 Illnesses, inflammationsandallergies (Figure 9.22)
9.20.1 AIDS, HIVdisease
Primary: Thymus Gland, Vitalitypoint, Spleen.C, Spleen.E, Point Zero, Shen Men, Endocrine
point, Thalamuspoint, Sympathetic Autonomic point, Heart.C, Occiput, Thyroid Gland.E.
9.20.2 Allergies
Primary: Apex of Ear, Allergy point, Omega 2, Inner Nose, Asthma, Antihistamine, Thymus
Gland, Point Zero, Shen Men, Sympathetic Autonomic point, Endocrine point.
Supplemental: Adrenal Gland.C, Thyroid Gland.C, Thyroid Gland.E, Kidney.C,
San Jiao, Lung 1, Lung 2, Brain, Spleen.C, Spleen.E.
9.20.3 Anaphylaxis hypersensitivity
Primary: Asthma, Lung 1, Lung 2, Large Intestines, Thymus Gland, Shen Men, Endocrine point,
Thalamuspoint, Adrenal Gland.C, Adrenal Gland.E.
9.20.4 Antiinflammatory
Primary: Apex of Ear, Allergy point, Omega 2, Occiput, Point Zero, Shen Men, Sympathetic
Autonomic point, Thalamuspoint, Adrenal Gland.C, Adrenal Gland.E.
9.20.5 Antipyretic
Primary: Apex of Ear, Omega 2, Liver, Large Intestines, Adrenal Gland.C, Shen Men.
9.20.6 Cancer
Primary: Correspondingbody area, Thymus Gland, Vitality point, Heart.C, Point Zero, Shen
Men, Thyroid Gland.E.
9.20.7 Chicken pox
Primary: Lung 1, Lung 2, Point Zero, Shen Men, Endocrine point, Adrenal Gland.C, Occiput.
9.20.8 Common cold
Primary: InnerNose, Throat.C,Throat.E, Forehead, Lung 1, Lung 2, Asthma, Antihistamine,
Prostaglandin1, Prostaglandin2, Apex of Ear.
Supplemental: Point Zero, Shen Men, Adrenal Gland.C, Adrenal Gland.E, Occiput, Thalamus
point, Thyroid Gland.C, Thyroid Gland.E.
9.20.9 Fever
Primary: Vitality point, Occiput, Point Zero, Shen Men, Thalamuspoint,
Endocrine point, Adrenal Gland.C, ACTH, Apex of Ear, Omega 2, Prostaglandin1,
Prostaglandin2.
9.20.10 Influenza
Primary: Forehead, Lung 1, Lung 2, Point Zero, Shen Men, Adrenal Gland.C, Thymus Gland,
Apex of Ear.
Supplemental: Apex of Tragus, Helix 1, Helix 2, Helix 3, Helix 4, Helix 5, Helix 6, Omega 2,
Prostaglandin1, Prostaglandin2.
9.20.11 Lowwhiteblood cells
Primary: Liver, Spleen.C, Heart.C, Kidney.C, Adrenal Gland.C, Endocrine point, Shen Men.
Supplemental: Diaphragm, Occiput, Sympathetic Autonomic point, Vitality point.
9.20.12 Malaria
Primary: Thalamuspoint, Endocrine point, Adrenal Gland.C, Liver, Large Intestines, Spleen.C.
9.20.13 Mumps
Primary: Face, SalivaryGland.C, Salivary Gland.E, Thalamuspoint, Endocrine point.
9.20.14 Weather changes
Primary: Weather point, Point Zero, Shen Men.
Auriculotherapy Manual
Apex of Ear
Common cold
o Prostaglandin 2
Apex of Ear
Influenza
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
Helix 4
Helix 6
Allergies
Apex of Ear
AIDS, HIV disease, 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
Aut onomic
point
Adrenal
Gland.C
Lung 1
Lung 2
Point Zero
San [lao
Endocrine
point

Antihistamine
Sympathetic
Aut onomic
point
Figure 9.22 Illnesses, inflammations and allergies treatment protocols.
Treatment protocols 313
Wrist
Arm
Elbow
Master
Shoulder
Fingers
Hand
TMJ
Lower Jaw
Upper Jaw
Inner Ear.C
Face
Chest
__--1-_ Shoulder
.......,._l-_Neck
Nogier Phase I and Chinese 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/ and Chinese ear points
Foot.F3
Cervical
Spine.F3
External
Genitals.C
Diaphragm.C
External
Genitals.E
Lumbar
Spine.F3
Thoracic
Spine.F3
Nogier Phase" and 11/ 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.
314 Auriculotherapy Manual