Allergic Conditions On The Auricle

due to the intake of drugs or foods. The diagnostic clues offered by auricular diagnosis are, however, of two types: the sensitization of some recurrent non-specific areas, regardless of the type of allergy, and the sensitization of some specific areas associated with the end organ involved in the allergic mechanism. We may therefore note that in a limited number of cases there is an evident sensitiza-tion of sectors 16, 17 and 18 on the scapha and on the aligned points on the helix. What was said in Chapter 4 regarding the possibility of individuating an 'allergic constitution' in patients who have not yet presented allergic symptoms is also applicable to PPT diagnosis.

As already mentioned, the identified areas correspond to the representation of the wrist and elbow, areas which never have been related to allergy before. On the Chinese map, however, the 'Wind stream' point fengxi, which carries the whole repertory of indications such as asthma, allergic rhinitis, eczema, urticaria and itching of uncertain origin, is located at the juncture between the hand and the wrist area. It has to be said that before standardization fengxi had been drawn by several authors as a larger area called 'urticaria area' (Fig. 5.29). In my opinion the importance given to this area by the Chinese is correct and is moreover confirmed by the indication for cutaneous pruritus given to the whole superior groove of the anthelix.

As regards the specific areas representing the end organs of an allergic reaction, it may be noticed that patients with seasonal rhinoconjuncti-vitis due to grass pollen, besides the Shen men area, show two further areas tender to pressure (Fig. 5.30A). The first is an area presumably representing the liver; we know about the importance given by TCM to the Liver meridian for treating eye dysfunctions. Another sensitized area is that around the intertragic notch which in my opinion represents the end organ eye-nose of the allergic reaction. According to the Chinese, the anterior and posterior intertragal notches hold indications related to the eye, for example glaucoma and conjunctivitis, but the representation of the nose below the intertragic notch has never been reported by the main schools (see also below).

As regards patients with atopic asthma, in those seen before any intake of oral or inhaled cortico-steroids, besides the Shen men area I identified an evident cluster of tender points on the central posterior portion of the antitragus (Fig. 5.30B). This group of points may coincide either with the occiput area, which holds the indication of asthma, and the apex of the antitragus duipingjian, which is indicated for asthma and itching. In my opinion the limited number of aligned points of the concha compared to the antitragus indicates that the most interesting points for diagnosing and treating asthma are probably located out of the commonly accepted representation of the lung. This phenomenon again could be related to the activation of an area belonging to the brainstem as proposed by Durinyan in his representation of 'respiratory centers' of reticular formation (see Fig. 5.16).

As regards contact allergy, the patients in Figure 5.30C show a scattered distribution of points on the whole auricle; this phenomenon may be interpreted with the large extension of the skin as a target organ of the allergic reaction. It is possible, however, that a higher number of patients with dermatitis provoked by contact with metals or other chemical compounds could identify some specific cluster of points.

Generally speaking the set of areas proposed by the Chinese seems exhaustive and fits quite consistently with my data. It is possible that these authors discovered earlier than in the West the antihistamine properties of some points for reducing itching. My experience of this subject has been very positive as the stimulation of some points is indeed able to reduce itching in a few minutes. In my opinion in every allergic reaction releasing his-tamine and other mediators of inflammation there is a sensitization of the basic areas of allergy belonging to sectors 16-18. The more histamine is released, the more the helix becomes sensitized, extending also to sectors 20 and 21 where Nogier placed his allergy master point (see Fig. A1.17).

Nogier considered further actions of his allergy master point on 'cellular metabolism' and affectiv-ity. He proposed a double location of the point and wrote:

this point is found at the top of the auricle, almost at the intersection of its internal and external surface. It is therefore accessible from two sides relatively close together, which actually give two points: the first one, hidden, is located under the helix border, and the second one, on the border of the upper part of the auricle.57

However, Nogier also proposed, beyond his master point, further points for treating allergic conditions such as the representation of the nose, eye, thymus and ACTH.

Auricular Acupuncture

Fig. 5.29 Chinese standardized points/areas indicated for asthma (darker pink): AT3 = occiput; CO16 = trachea; CO10 = kidney; TF3 = middle triangular fossa; apex of antitragus; upper (R1) and lower (R3) ear root on the medial surface. Standardized points/areas for various allergic conditions and/or pruritus (paler pink): CO14 = lung; CO18 = endocrine; HX1 = ear center; urticaria area; Wind stream; adrenal gland; brainstem; P2 = lung and groove of the anthelix.

Fig. 5.29 Chinese standardized points/areas indicated for asthma (darker pink): AT3 = occiput; CO16 = trachea; CO10 = kidney; TF3 = middle triangular fossa; apex of antitragus; upper (R1) and lower (R3) ear root on the medial surface. Standardized points/areas for various allergic conditions and/or pruritus (paler pink): CO14 = lung; CO18 = endocrine; HX1 = ear center; urticaria area; Wind stream; adrenal gland; brainstem; P2 = lung and groove of the anthelix.

Summing up this section, it has to be said that we are far from having interpreted the whole range of allergic disorders on the auricle. It would also be interesting to carry out diagnostic research into the various diseases in which autoimmunity is demonstrated or supposed; it is possible that such a systematic study could give us useful information for increasing the therapeutic potentialities of ear acupuncture.

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