AURICULOTHERAPY HANDOUT

Compiled by Michael Young, L.Ac.

Younghealthcare.com

INTRODUCTION – HISTORY OF AURICULOTHERAPY

Use of the auricle for treatment goes back to ancient Egypt, Greece and has permeated
folk medicine.
Chinese Ear Points and Theory regarding the Ear and Auricle Nogier’s discovery of the
auricular homunculus, “Treatise on Auriculotherapy” published in 1972; information
then influenced researchers and practitioners worldwide, most notably the Nanking Army
Research Hospital.
Dr. Wen’s serendipitous discovery; origins of Lincoln Detox center with subsequent
formation of NADA.
“Acupuncturists Without Borders” application of NADA protocol to patients suffering
from trauma in onsite settings such as post hurricane Katrina.

CAUTIONS/CONTRAINDICTATIONS OF AURICULOTHERAPY

Do not provide palliative treatment for pain patterns that are needed to diagnosis
underlying serious medical conditions (e.g. myocardial infarction, appendicitis, etc.)
Many texts state that one should not treat pregnant women although this is usually
acknowledged as being for liability reasons. As with all treatments during pregnancy
discussing potential risks vs. benefits and obtaining informed consent from the patient is
essential. If treatment is performed, using Seirin green needles, suing extremely gentle
technique and avoiding points that could have a strong impact on the Hypothalamic
Pituitary Ovarian Axis are all recommended.
Do not use electrical point finders or stimulators on ear (or body) points on patients with
cardiac pacemakers.
Some patients may become sleepy, euphoric and or dizzy after Auriculotherapy
treatments. If it is their first time and they appear “dopey” encourage them to rest in your
waiting room before driving. This is especially true for extremely weak or “hypo
adrenal” patients. While most of these patients tolerate and benefit from Auriculotherapy
the dosage of treatment is a variable that has to be determined experimentally and erring
on the side of caution in the beginning will prevent the likelihood of adverse events.
If you choose to use press needles inform the patient of the potential risk of
infection as well as the fact that the needles can fall out and become a biohazard for
others. Daily monitoring of the ear needle is essential. If it becomes either excessively
uncomfortable or becomes itchy, red or hot it should be removed. Also if it interferes
with their sleep it is better to remove it.
For more information and contraindications see Terry Oleson’s text.

THE ANATOMY OF THE EAR AND ITS CORRELATIONS WITH

HOMUNCULUS

EAR AS MICROSYSTEM

AURICULOTHERAPY APPLICATIONS AND INDICATIONS IN THE TCM

CLINIC

BASIC AURICULAR THEORIES (WESTERN AND TCM)

ARUICULAR DIAGNOSIS METHODS

Electrical
Visual
Palpatory (patient subjective) – degree of tenderness, other sensations
Palpatory (patient objective) – careful observation of tissue reaction to
pressure.
The V.A.S. (Nogier’s pulse changes)
Other feedback systems

TREATMENT MODALITIES
Massage
Plasters
Pellets/Seeds
Needles
Bloodletting
Injection therapy
Moxibustion
Heated needles

GENERAL TREATMENT GUIDELINES

Treat a maximum of three problems at a time, treating the primary problem first.
Acupuncture focuses the patient’s energy towards resolution of a particular imbalance. If
the patient’s presenting complaints are manifestations of the same underlying
imbalance then it is often a non-issue. However if there are multiple problem areas, such
as in certain injuries where the patients presents with trauma to multiple extremities and
the spine, attempting to treat to many areas in one treatment will usually be less effective
than prioritizing the top 1 to 3 problem areas and focusing on them.
The consensus among auriculotherapists is that the best results are obtained when
the order of treatment is from local to general; i.e. for shoulder pain treat the local
shoulder point first and then any appropriate master points and supportive points. In
Chinese energetic terms sedating the most excess region first is most effective.
Only treat those points that are “active” diagnostically, i.e. are tender, electrically
“hyper” in relation to Shen Men, and/or reveal long-term pathology by the local tissue
response to palpation.
Different opinions exist with regards to most aspects of acupuncture
Auriculotherapy including what gauge of needle is best and what number of needles per
treatment is allowable. In general the wider the gauge, the stronger the amount of
stimulation “Te Qi” that is elicited and the larger the number of points that are needed,
the more sedating, in both western and Chinese medical uses of the term, the treatment
will be.
As with body acupuncture there are some practitioners that believe the ideal is to
find one point that will trigger a dramatic therapeutic reaction in the patient. Many
practitioners select 3 to 5 points per treatment. I have had good results using relatively
large numbers of auricular needles (10 to 20) for over 15 years although I do not use this
many needles until after I have seen the patient response to more conventional protocols.
Various factors influence the choice of the number of points selected. These
include the strength of the patient, the number of active points, the gauge of the needle
you are using, the depth of insertion, whether and to what extent “Te Qi” will be part of
the treatment and whether you will select points bilaterally or unilaterally. In my opinion
the most important factor is your treatment history with a particular patient. If they have
responded well to a certain number of needles then you may want to gradually increase
the number or gauge and monitor their reaction. Some respond favorably with a greater
number of needles while others it might be to sedating. If you are using Chinese style
needles, thicker gauge, treating first time Auriculotherapy patients and/or eliciting
extended “Te Qi” responses through manual or electrical stimulation, I recommend you
use less than 5 needles in order to prevent excess sedation or other side effects.
If the practitioner is going to perform Auriculotherapy treatments that attempt to
address imbalances of the deep limbic system it is important to have a basic awareness of
posttraumatic stress disorder, PTSD, the nature of trauma therapies and the possible range
of patient response to these therapies. Essentially, in the treatment of patients with PTSD,
when the outcome is positive the patient can have a powerful resolution and release of
traumatic memories. However, in some patients, the same or similar treatment can
exacerbate their PTSD by bringing things up without resolution, i.e. bring to conscious
awareness memories or issues that are difficult for the patient process and this can result
in acute episodes of depression, anxiety and dysphoria with exacerbations of behaviors
such as substance abuse or suicidal ideation. In both types of patients awareness of the
fact that patients process traumatic memories differently and a respect for these individual
differences is important. Related issues for the practitioner that wishes to treat these
imbalances include ethics, informed consent, development of cross referral networks, as
well as an awareness of the nature of transference. In my experience it is important to
screen patients for ego stability in a manner that is similar to the other trauma therapies
such as EMDR prior to treatment. Taking a thorough history that includes the presence
of traumatic events and being aware of the symptoms and signs of PTSD is essential for
proper screening. The initial intake allows for the clinician to assess the patients’ ego
stability and the presence of a solid support network should the treatments bring things
up. Also of note, I have found that there is a powerful synergism with using injectable
Trammel and catalyzes the process of traumatic memory processing.

ES GUIDELINES FOR AURICULOTHERAPY (NOGIER)

Concha 1 to 5 HZ
Sub Tragus 2.5 HZ
Musculoskeletal 10 HZ
Tragus 20 HZ
Helix 40 to 80 HZ
Lobe Area 80 to 160 HZ

COMMONLY USED CHINESE POINTS

Adrenal – inflammation, hormonal regulation, shock, infection and cough.

Chinese adrenal gland is on the tip of the tragus on the face side. Stimulation leads to
release of adrenal hormones for dealing with stress.

Brain – regulates excitation or inhibition of the cerebral cortex.

Disease of the nervous , digestive, endocrine, urogenital system, hemorrhage.
Affects hypothalamic control of the pituitary, endocrine glands, addictions,
asthma and sleep. (P. 126 Oleson)
Sub cortex – regulates excitation and inhibition of the cerebral cortex. Insomnia,
lassitude, neuropsychiatric disorders, inflammation, pain, excessive sweating, shock,
swelling, and prolapse. This is the same as MB3, Thalamus.
Occiput – neuro psychiatric disorders, convulsions, lockjaw, stiffness along the nape,
psychosis, sea sickness prevention, pain, shock, inflammation, eye diseases,
nervous system regulation and motion sickness. (P. 78 Oleson)
Brainstem (medulla oblongata) – disorders of the cerebral blood vessels and
meninges, apoplexy, hemiplegia, convulsions, stiffness along the nape,
sequelae of cerebral shock and incomplete development of the brain. (P. 125
Oleson)
Sympathetic – strong analgesic, relaxant effect upon the sympathetic nervous system
relieves pain associated with ulcers, stomach spasm, gall bladder and urethral stones,
dilates blood vessels, anesthesia point, circulatory diseases, hyperhidrosis,
ophthalmologic diseases, pain, organ contraction and dilation of vessels. This is the same
as the Autonomic Point and is the most important point for treating pain, according to
Chinese research.

CHENESE TREATMENT STRATEGIES – From “Auricular Diagnosis, Treatment,

and Health Preservation”
Diseases of the skin, hair and Wei Qi
 Chief points – lung, adrenal and the corresponding points
Adjuvant Points – occiput, Liver, Shen Men and Endocrine
Diseases of the muscles – Flaccidity, Paralysis and Hemiplegia
Chief points – Lung, Adrenal and the corresponding points
Adjuvant Points – Occiput, Liver, Shen Men and Endocrine
Diseases of the tendon and bone, spasms of tendon, atrophic debility of
bones, fractures, injury of tendons and muscles.
Chief points – Spleen, Liver, Sub Cortex and the corresponding points.
Adjuvant Points – Lung, Spleen, Sympathetic and Sub Cortex.
Diseases of the heart, palpitation, angina, insomnia, neurasthenia, intermittent
pulse and sore tongue.
Chief points – Heart, Kidney, Sympathetic, Lung and Sub Cortex
Adjuvant points – Adrenal, Small Intestine, Shen Men and Thorax (chest)
Diseases of the liver, hypochondriac pain, distension of the lower abdomen,
emotional abnormality, vertigo, dizziness, distending pain in the
head, convulsive seizures, menstrual disorders and eye problems.
Chief points – Liver, Spleen, Pancreas – Gallbladder, Sympathetic and Shen
Men.
Adjuvant points – Occiput, Liver-Yang, Endocrine, and San Jao.
Diseases of the spleen, abdominal distension with insidious pain, loose stools,
obesity, pail tongue with whitish coating, slow and weak pulse.
Chief points – Spleen, Liver, Stomach, Endocrine and San Jiao
Adjuvant points – Sub cortex, Sympathetic and San Jiao
Diseases of the lung, cough, asthma, phlegm, pain in the chest and
hemoptysis.
Chief points – Lung, Trachea, Adrenal and Kidney
Adjuvant points – Occiput, Large Intestine, Shen Men, Middle Border and
heart.
Diseases of the Kidney and Urinary Bladder, pain in the waist and legs,
tinnitus and loss of hearing, loosening of teeth, shedding of hair,
impotence and seminal emission, edema, urination and bowel
movement abnormalities.
Chief points – Kidney, Urinary Bladder, Endocrine and Sub Cortex
Adjuvant points – Adrenal, Shen Men, Heart Spleen and San Jiao
Diseases of the stomach and duodenum, epigastric pain, belching, acid
regurgitation, poor appetite, vomiting, hematemesis and hemafaecia.
Chief points – Stomach, Duodenum, Spleen, Sub Cortes and Sympathetic
Adjuvant points – Lung, endocrine, middle border, Pancreas, Gallbladder and
Liver.
Diseases of the large and small intestine, abdominal pain, diarrhea,
abdominal distension and tenesmus.
Chief points – Large Intestine, Small Intestine and Sympathetic
Adjuvant points – Endocrine, San Jiao and Lung
Diseases of the Esophagus, Dysphagia, burning sensation while taking
 food, hiccup, etc.
Chief points – Esophagus, Cardiac, Sympathetic and Adrenal
Adjuvant points – Lung, Shen Men and middle border
Diseases of the Pancreas, Gallbladder, loss of appetite, aversion to grasy food,
epigastric or right upper abdominal pain, jaundice and fever.
Chief points – Pancreas, Gallbladder, Liver, Duodenum, Sympathetic and Sub
Cortex.
Adjuvant points – Shen Men, Endocrine, Adrenal and Abdomen
Diseases of the Diaphragm hiccup and dysphagia
Chief points – Diaphragm, Sympathetic, Liver and Stomach
Adjuvant points – Shen Men, Endocrine, Adrenal and Abdomen
Diseases of the Genitalia, sterility, female infertility, irregular menstruation,
impotence and seminal emission.
Chief points – Internal Genitalia, Kidney, Endocrine and liver
Adjuvant points – Adrenal, Sympathetic and middle border
Diseases of the External Eyes, acute inflammation of the eye lacrimation and
blurred vision.
Chief Points – Eye, Eye 1, Eye 2, Liver and Lung
Adjuvant points – Adrenal, Endocrine and spleen
Diseases of the Internal Eyes, various cataract disease characterized by
diminution of vision.
The above protocol is modified as follows:
Liver and Kidneys are added to improve eye congestion and intraocular
pressure.
Sympathetic and Middle Border are added to adjust the pupil and regulate
the optic nerve.
Diseases of the Ear, tinnitus, deafness, otalgia and suppurative ear diseases.
Chief points – Internal Ear, Kidney, Endocrine and Pancreas – Gallbladder
Adjuvant points – Adrenal, external ear, shen men and occiput.
Diseases of the nose, nasal obstruction, running nose with purulent
discharge.
Chief points – internal nose, lung and adrenal
Adjuvant points – endocrine, external nose and forehead
Diseases of the mouth, bleeding from stomatous ulcers and oroglassal sores
Chief points – mouth, lung, spleen and stomach
Adjuvant points – heart, endocrine and adrenal
Diseases of the throat – sore throat, globus hystericus
Chief points – throat, tonsil and heart
Adjuvant points – endocrine, adrenal and shen men
Diseases of the tooth – toothache, gingival swelling and pain
Chief points – tooth, jaw liver, kidney and stomach
Adjuvant points – occiput and adrenal
Diseases of the Brain – neurasthenia, dizziness, headache, disturbance of
conscious and coma.
 Chief points – sub cortex, occiput, forehead, kidney and heart
Adjuvant points – liver, shen men, adrenal and stomach

NOGIER’S DEVELOPMENT OF AURICULOTHERAPY

Master Points
Laterality and Oscillation
The ACR
The VAS
Phases
“Auriculomedicine”
grounding point (elbow on body) and wire
JAPANESE TREATMENT STRATEGIES to most active corresponding point on ear)
Somato-Auricular Therapy (SAT)
1. needle ah-shi
Mapping Meridians on the ear 2. connect to auricular corresponding point
(e stim YOU WANT patient to feel it in the ear xcommanding consciousness)
OTHER IMPORTANT POINTS
Amygdala/Aggressivity
Anterior Hypothalamus
Hippocampus
Posterior Hypothalamus
Cingulate Gyrus
Uterus
Ovaries
Adrenal (French)
Anti-Depressant
TMJ
Appetite Control
Inner Nose
Master Shoulder
Heart
Mouth
Esophagus
Stomach
Small Intestines
Large Intestines
Liver
Kidney

TREATMENT PROTOCOLS
Addictions
Pain
Neuroendocrine regulation
Trauma and psychiatric