Laser Auriculo Diagnostic

Paul Nogier (1908-1996) would today be very proud to see how many 'adoptive children' he has around the world. In my opinion, ear acupuncture is one of the most intriguing discoveries of the last 50 years.

Two lessons have ensued from Nogier's experience: the first is that even a single physician, without expensive and sophisticated instruments, can perform good research, following his clinical instinct and rigorously analyzing his observations. The second is that every revolutionary approach in the field of medicine has to struggle before being accepted by the scientific community. Over the last 20 years the great increase in complementary/ alternative methods has brought an equally increasing request among therapists and patients for evidence-based information on their efficacy. Ear acupuncture is no exception, and a full knowledge of the range of its possibilities needs to be brought to light.

It can be freely stated that there is still much work to do with both auricular diagnosis and auricular therapy. As regards diagnosis there are still portions of the auricle which have to be thoroughly explored, for example the ear lobe, the helix and the medial surface of the auricle. To imagine that the central nervous system is represented on the ear lobe does not mean that we have the key consistently to identify the areas corresponding to specific parts of the brain. The simplification expressed commonly by Western researchers that one auricular zone is the representation of one anatomical structure is probably wrong, and we should convince ourselves that the same organ can have multiple representations on the ear as has been expressed by both Chinese practitioners and Western physicians practicing auriculomedicine.

Therefore we need specific methodology to discover these associations with direct and indirect methods. The direct methods, through modern imaging techniques such as fMRI, PET, etc., could evaluate which structures of the brain are activated by auricular stimulation, either in healthy subjects or in patients with pain or other neurological disorders.

The indirect methods, however, using the diagnostic procedures proposed in this book, may help the clinician to identify recurrent auricular areas associated with different symptoms or syndromes. This is furthermore necessary because there is often no complete consensus between the different schools concerning the somatotopic representations of the body.

The interpretation of these multiple clusters of points brings to mind someone doing a jigsaw puzzle with no knowledge of the final picture.

One of the aims of this patient and perhaps endless work is to attribute finally much more importance to the autonomic nervous system which thus far seems so insufficiently investigated. Contemporary anatomists do not study the morphology of this system and it is unlikely that they are given adequate grants or funding for such research. Consequently medical students still receive the same information on a few pages of their anatomy books as they did 20-30 years ago. The autonomic nervous system, however, is essential for all functions of our body and auricular diagnosis gives us the opportunity to examine the concha which it should be remembered is the only zone of the body where the tenth cranial nerve comes to the surface.

As regards auricular therapy, there is a lot of work to do on the following aspects:

First, despite great interest in ear acupuncture throughout the world, there is still a lack of evidence-based information about the fields in which auricular treatment could be applied more advantageously. Some evidence has been found for the treatment of pain disorders such as lumbago, cervical pain and migraine. Further evidence has been found for the treatment of drug addiction and obesity as well as for anxiety and insomnia. Auricular therapy for the treatment of psychosomatic disorders seems to be promising and should in my opinion be proposed as a complementary therapy in association with psychoactive drugs.

Another interesting therapeutic combination could be the inclusion of ear acupuncture in rehabilitation programs, to reduce the number of sessions and the total cost of rehabilitation.

The second important aspect of auricular therapy, which has not yet been taken into consideration adequately, is the measurement of the therapeutic effect of non-invasive stimulation of the auricle such as massage, magnetic pearls, Vaccaria seeds, electrical and laser stimulation, etc. This is an important issue because many therapists are not medical doctors and in several countries are not allowed to insert needles. The peculiarity of the auricle from the neurophysiological point of view seems to support the hypothesis that light, non-invasive stimulation may have a significant therapeutic effect. There is an urgent need to face these issues in order to place ear acupuncture definitively among the evi-denced-based complementary therapeutic methods.

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Appendix 1

The auricular charts

The auricular charts in this appendix should be consulted cum grano salis (literally with a grain of salt; i.e. with discernment). They should not be considered as having absolute value but rather be interpreted freely, adapted and updated with regard to location, dimension and the intrinsic clinical value of each somatotopic area. This will depend on the personal experience of each practitioner and the

diagnostic method adopted. To offer readers an easy and advantageous comparison of the auricular representation of the body according to different medical traditions and schools of thought, the maps have been arranged in pairs, allowing face to face consultation of the French map on the left page with the corresponding Chinese map on the right-hand page.

No.

Representation

No.

Representation

1

Cervical spine C1-C7

1G

Elbow

2

Thoracic spine Th1-Th12

17

Arm

S

Lumbar spine L1-L5

1B

Shoulder

4

Sacrum-coccyx

19

Internal ear (internal surface)

S

Foot

2G

Occipital bone

G

Tibia-fibula

21

Parietal bone

7

Knee

22

Frontal bone

B

Thigh

2S

Frontal sinus

9

Hip

24

TMJ

1G

Diaphragm

2S

Upper jaw

11

Chest

2G

Lower jaw

12

Thumb

27

Tongue

1S

Fingers

2B

Lips

14

Wrist

29

Eye

1S

Forearm

SG

External nose

Fig. A1.1 The somatotopic representations of the body and of the cephalic extremity according to Nogier1,2,3,4 (z = point zero).

Accupreasure Point Lower Lip

External ear

External nose

External ear

External nose

Coded standardized area

Area in alphabetic order

gen

AH1 = heel

Abdomen = AH8

fu

zhi

AH2 = toe

Ankle = AH3

huai

huai

AH3 = ankle

Cervical vertebrae = AH13

jingzhui

xi

AH4 = knee

Chest = AH10

xiong

kuan

AH5 = hip

Clavicle = SF6

suogu

zuogushenjing

AH6 = sciatic nerve

Elbow = SF3

zhou

tun

AH7 = gluteus

Eye = LO5

yan

fu

AH8 = abdomen

Finger = SF1

zhi

yaodizhui

AH9 = lumbar-sacral vertebrae

Forehead = ATI

e

xiong

AH10 = chest

Gluteus = AH7

tun

xiongzhui

AH11 = thoracic vertebrae

Heel = AH1

gen

jing

AH12 = neck

Hip = AH5

kuan

jingzhui

AH13 = cervical vertebrae

Internal ear = LO6

neier

zhi

SF1 = finger

Internal nose = TG4

neibi

wan

SF2 = wrist

Jaw = LO3

he

zhou

SF3 = elbow

Knee = AH4

xi

jian

SF4,5 = shoulder

Lumbar-sacral vertebrae = AH9

yaodizhui

suogu

SF6 = clavicle

Mouth = CO1

kou

kou

CO1 = mouth

Neck=AH12

jing

e

AT1 = forehead

Occiput = AT3

zhen

nie

AT2 = temple

Sciatic nerve = AH6

zuogushenjing

zhen

AT3 = occiput

Shoulder = SF4,5

jian

ya

LO1 = tooth

Temple = AT2

nie

she

LO2 = tongue

Thoracic vertebrae = AH11

xiongzhui

he

LO3 = jaw

Toe = AH2

zhi

yan

LO5 = eye

Tongue = LO2

she

neier

LO6 = internal ear

Tonsil = LO7,8,9biantaoti

biantaotiLO7,8,9 = tonsil

Tooth = LO1

ya

neibi

TG4 = internal nose

Wrist = SF2

wan

Fig. A1.2 The somatotopic representations of the body and of the cephalic extremity according to the Chinese standardization.5,6

No.

Representation

1

Spinal cord (sensitive roots on the lateral surface)

2

Spinal cord (motor roots on the medial surface)

3

Intermediolateral nuclei of the lateral horn (till Th11)

4

Sympathetic lateral-vertebral ganglia

a) cervical superior ganglion

b) cervical middle ganglion (marvellous point)

c) cervical inferior ganglion

d) thoracic ganglia (Th10-L1)

5

Thalamus

6

Red nucleus

7

Cerebellum

8

Reticular formation

9

Medulla oblongata

10

Pons

11

Locus niger

12

Hypothalamus

13

Striatum

14

Amigdala

15

Cingular circonvolution

16

Hippocampus

17

Occipital cortex

18

Parietal cortex

19

Temporal cortex

20

Frontal cortex

21

Prefrontal cortex

22

Trigeminal nerve

23

Corpus callosum (so called Tragus Master-Point)

Fig. A1.3 The somatotopic representations of the nervous system according to Nogier1,2,3,4 (z = point zero).

Auricular Acupuncture ThalamusActh Repr Sentation

Fig. A1.4 The representation of some areas related to symptoms/disorders of the nervous system according to the Chinese standardization.5,6

Pinched Nerve Symptoms

No.

Representation

1

Ovary/testicle (internal surface)

2

Adrenal gland

3

Adrenocorticotropic hormone

(ACTH) multiple points

4

Pancreas

5

Mammary gland, twice represented

6

Thymus, twice represented

7

Parathyroid

8

Thyroid

9

Hypophysis

10

Prolactin

11

Somatotropic hormone (STH)

12

Thyroid-stimulating hormone (TSH)

13

Luteotropic hormone (LTH)

14

Follicle-stimulating hormone (FSH)

15

Gonadotropic or genital area

16

Epiphysis

Fig. A1.5 The somatotopic representations of the endocrine system according to Nogier1,2,3,4 (z = point zero).

Endocrine Disorders And Obesity ChartActh Point Ear Acupuncture

Coded area and name

Symptom

CO4 wei = stomach

Obesity

CO10 shen = kidney

Menstrual disorders

CO11 yidan = pancreas-gallbladder

Diabetes

CO12 gan = liver

Menstrual disorders, premenstrual syndrome, climacteric syndrome

CO13 pi = spleen

Obesity, menstrual disorders

CO17 sanjao = triple energizer

Obesity

CO18 neifenmi = endocrine

Hypopituitarism, menstrual disorders, hyperthyroidism

TG1 shangping = upper tragus

Diabetes

TG2 xiaping = lower tragus

Obesity, hyperthyroidism

Adrenal gland shenshangxian

Asthenia, hypotension, inflammatory diseases, allergic diseases

Central rim yuanzhong

Acromegaly

P5 erbeishen = kidney of the medial surface of the auricle

Menstrual disorders

The following points of the auricle belong historically to the auricular chart preceding the standardisation:

Mammary gland (double representation) ruxian

Premenstrual syndrome

Thyroid gland jiazhuangxian

Thyroid gland disorders

Testicle gaowan (on the internal surface of the antitragus)

Hypogonadism

Excitation xingfen (on the internal surface of the antitragus)

Hypogonadism

Ovary luanchao (on the internal surface of the antitragus)

Menstrual disorders, hypogonadism

Fig. A1.6 The representation of some areas related to disorders of the endocrine system and the metabolism according to the Chinese standardization5,6 (in pale pink the areas associated with diabetes and obesity).

Jiaogan Ear

No.

Representation

1

Heart (medial and lateral surface)

2

Heart (internal surface)

S

Circulatory system

Fig. A1.7 The somatotopic representations of the cardiovascular system according to Nogier1,2,3,4 (z = point zero).

Fig. A1.7 The somatotopic representations of the cardiovascular system according to Nogier1,2,3,4 (z = point zero).

Ear apex

Ear apex

Auricular Acupuncture Metabolism

Sympathesis

Cardiac point

Groove of the anthelix

Sympathesis

Cardiac point

Groove of the anthelix

R3

Apex of antitragus

Hypertension point

Coded area and name

Symptom

Ear apex erjian

Hypertension

HX8 HX12

Hypertension

Sympathesis jiaogan (hidden on the anthelix)

Angina pectoris

TF1 jiaowoshang = superior triangular fossa

Hypertension

CO6 xiaochang = small intestine

Arythmia

CO12 gan = liver

Hypertension

CO15 xin = heart

Angina pectoris, arythmia

Apex of antitragus duipingjian

Hypertension

P1 erbeixin = heart of the medial surface

Tachycardia, hypertension

Groove of the anthelix (also called groove of the medial surface) erbeigou

Hypertension

The following points belong historically to the auricular chart preceding the standardization:

Cardiac point xinzangdian

Atrial fibrillation

Hypertension point gaoxueyadian

Hypertension

Fig. A1.8 The representation of some areas related to symptoms/disorders of the cardiovascular system and hypertension according to the Chinese standardization5,6 (in pale pink the areas associated with hypertension).

Acupuncture Point Co15

No.

Representation

1

Lung

2

Bronchi

S

Pharynx

4

Larynx

Fig. A1.9 The somatotopic representations of the respiratory system according to Nogier1,2,3,4 (z = point zero).

Auricular Acupuncture

Fig. A1.10 The representation of some areas related to symptoms/disorders of the respiratory system according to the Chinese standardization.5,6

Acupuncture Point Co11

No.

Representation

1

Rectum

2

Large intestine

S

Small intestine

4

Pancreas

S

Spleen

G

Liver

l

Gallbladder

B

Duodenum

9

Stomach

1G

Esophagus

Fig. A1.11 The somatotopic representations of the digestive system according to Nogier1,2,3,4 (z = point zero).

Acupuncture For Gallstones

Fig. A1.12 The representation of the areas related to the digestive system according to the Chinese standardization.5,6

Coded area and name

HX2 zhichang = rectum_

HX5 gangmen = anus_

CO2 shidao = esophagus_

CO3 benmen = cardia_

CO4 wei = stomach_

CO5 shierzhichang = duodenum_

CO6 xiaochang = small intestine_

CO7 dachang = large intestine_

CO11 yidan = pancreas-gallbladder_

CO12 gan = liver_

CO13 pi = spleen_

Appendix lanwei_

P3 erbeipi = spleen of the medial surface P4 erbeigan = liver of the medial surface The following points belong historically to the auricular chart preceding the standardization: Hepatitis point ganyandian Constipation point bianmidian

Gallstone point danguan_

Pancreatitis point yixianyandian_

Diaphragm point (now erzhong = ear center)

Fig. A1.12 The representation of the areas related to the digestive system according to the Chinese standardization.5,6

No.

Representation

1

Kidney (on the internal surface of the helix)

2

Ureter (on the internal surface of the helix)

S

Uterus/prostate (on the internal surface of the helix)

4

Vagina (on the internal surface of the helix)

S

External genitals

G

Ovary/testicle (on the internal surface of the helix)

l

Urethra

B

Bladder

Fig. A1.13 The somatotopic representation of the genitourinary system according to Nogier1,2,3,4 (z = point zero).

Region Auricular Pelvis

Coded area and name

HX3 niaodao = urethra_

HX4 waishengzhiqi = external genitals

TF2 neishengzhiqi = internal genitals (uterus/prostate)

TF5 pengqiang = pelvis_

CO8 tingjiao = angle of sup. concha (prostate) CO9 pangguang = bladder COlO shen = kidney

CO13 pi = spleen Ureter shuniaoguan

P5 erbeishen = kidney of the medial surface

The following points/areas of the auricle belong historically to the auricular chart preceding the standardization: Nephrolithiasis region jieshiqu Nephritis point shenyandian

Fig. A1.14 The representation of the areas related to the genitourinary system according to the Chinese standardization5,6 (in pale pink the areas associated particularly with disorders of the female genital apparatus).

2

No.

Representation

1

Omega 2 (somatic stress)

2

Reactional Point (point R) of Bourdiol

S

Omega 1 (visceral stress)

4

Anxiety point

S

Sympathetic cervical ganglia

G

'Jérôme' point

7

Hypothalamus

B

Aggressiveness

9

Fear area

10

Omega (psychological stress)

11

Sadness point

Fig. A1.15 The somatotopic representations of some points/areas related to mental disorders according to Nogier and Bourdiol1,2,3,7 (z = point zero).

Acupuncture Points For Eating Disorders
Fig. A1.16 The representation of the areas associated to mental disorders according to the Chinese standardization5,6 (in pale pink the areas associated with the drug withdrawal syndrome).
Genital Acupuncture Points
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