One of the better known divergences between Nogier's and the Chinese auricular map is the representation of the kidney.
It is unclear why Nogier felt it was necessary to move the representation of this organ from the upper concha to the upper part of the helix. Nogier described its location in the following way:
it is situated on the triangular fossa axis, under the rim edge. This localisation is linear and extends in front, under the helix knee, and in the back, up to the Darwin point, under the auricle rim.
This unusually long somatotopic representation of the kidney was probably the result of collaboration with Bourdiol (Fig. 5.44). This author said 'it is thought that this whole zone represents a relic of the metanephros'. Beyond this embryological hypothesis, however, it is difficult to imagine the kidney far from the representation of the bladder and the urethra which maintained the same position in both maps.
My own experience concerning the representation of the kidney is limited to 14 cases with ureter-olithiasis in which the progress of calculi in the ureter was troublesome despite medication. Only in 11 of the 14 cases did ultrasound demonstrate the presence of calculi; in all cases PPT detected tender points on the same side as the pain which were not in a fixed position but tended to shift forward along a line passing through the Chinese ureter point shuniaoguan located at the junction of the
kidney and bladder area. The application on average of 2.8 single-use steel implants (ASP) reduced pain by 70-80% in eight cases and by 40-70% in four cases; in two cases this had no effect at all. The reduction of colic and the presumed relaxation of the smooth muscle of the ureter favored the expulsion of calculi in the following hours/days; however, this was demonstrated in only eight out of 14 cases. The diameter of the calculi in no case exceeded 5-6 mm; on examination six calculi were found to be of calcium oxalate, two of uric acid. In only one of these cases did I find tenderness on Nogier's kidney and ureter point.
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