Auriculotherapy

Auriculotherapy is a term used to describe the treatment of pain, muscular skeletal disorders, and a broad range of medical conditions by the application of massage, low energy laser or acupuncture needles to specific locations on the ear.

Auriculotherapy, and by extension, Auriculomedicine, was discovered and developed into a profoundly effective treatment protocol by Paul Nogier, a French doctor. In the early 1950’s he was able to determine the somatotopic presentation of the inverted fetus in the ear, the anatomic regions of the fetus corresponding to specific zones of the ear. This led to a lifetime of continued research which took auricular therapy from the initial simple reflexive treatments to a powerful therapy that can both identify and treat specific body systems, parts or functions that are in disharmony.
Although there are historical references to ear acupuncture in China, it was not until Dr Nogier’s discoveries that advances in ear acupuncture progressed in China. In respecting that, the Chinese acknowledged his contribution by describing him as the ‘Father of modern Ear Acupuncture’.
But Auriculotherapy is much more than ear acupuncture. Traditional Chinese Medical training provides a powerful background, a theoretical basis for diagnosis and an approach to treatment, but it is not Auriculotherapy or Auriculomedicine.
Dr Nogier noticed that there was a distinct change in the amplitude and dimension of the pulse when certain points on the auricle were stimulated. This occurs consistently and is both repeatable and measurable by modern equipment. Dr Nogier called it the Vascular Autonomic Sign (VAS). Being able to detect the VAS on the radial pulse of (generally) the patients’ left hand enables the practitioner to precisely determine the location of a point, whether there is a pathology in the region of the body that relates to specific points, and whether certain substances (foods, medicines, herbs, etc.) are indicated. Accurate employment of the VAS in diagnosis and treatment is essential to Auriculotherapy and Auriculomedicine.
Auriculotherapy uses the ear to help determine whether the right and left hemispheres of the brain are functioning as a dynamic whole, whether there are specific neurological, musculo-skeletal or organ systems that are in imbalance, and whether there are any blockages to treatment, such as scar tissue or emotional disorders. It is diagnostic. Treatment is specific and points are precisely located by reference to the VAS. Accuracy is important.
Auriculotherapy can be used to treat the same range of health conditions as Traditional Chinese Medicine. It is safe, comfortable and highly effective. It is important to note that painful conditions often respond very quickly to Auriculotherapy.

Differences between Auriculotherapy and the Chinese system of Auricular Therapy

The earliest records of auricular treatment for health conditions date from China (Su Wen) and Egypt (Hippocrates 450BC). More recent historical documentation occurs in Europe in the 17th and 18th centuries, detailing ear cautery for the treatment of various complaints including sciatica and sexual dysfunctions. There certainly appears to have been a continuity of this knowledge within the therapeutic communities since ancient times and it appears clear that those treatments were functional treatments of specific conditions, empirical formulae. However there was no systematic approach to the use of the auricle as a micro-system to treat the whole body until the discoveries of the French physician, Paul Nogier.
In the early 1950’s Paul Nogier, a French physician noted that some patients attending his clinic had a small scar from a burn on part of their ear. On enquiring into this, he was told that a very small area of their ear had been cauterized by a certain Madam Barrin for the treatment of sciatic pain - a treatment that proved very rapid and effective.
This first observation put Dr Paul Nogier on the search for an explanation, a quest that led to the discovery and development of Auriculotherapy and Auriculomedicine. His first great insight was the recognition of the homunculus, “the man in the ear”, of the representation and anatomical correlation of the inverted fetus in the ear. Points on the body, for example the knee, corresponded precisely with the fetal representation of the knee in the auricle.
Dr Paul Nogier tells the story of this discovery in his book (now out of print) called “The Man in the Ear.” (Maionneuve 1985) He collaborated with a group of medical colleagues who, in a spirit of cooperation and discovery, shared their experiences. One of those colleagues, Dr Jacques Niboyet, convinced Nogier to introduce his discoveries to the Congress of the Mediterranean Society of Acupuncture in February of 1956. Attending that Congress was Dr Gérard Bachmann who published his research, translated into German, in a German Acupuncture journal in 1957. This journal had an international circulation and it was not long before Japanese acupuncturists became familiar with Nogier’s reflex system. The discovery of the system spread to China and led to intensive research by the Chinese medical authorities at a time of renewed interest in Traditional Chinese Medicine. The outcome of that research was very positive and resulted in the utilization of this therapy by the “Barefoot Doctors” of the Cultural Revolution. The Chinese published an Ear Chart remarkably similar to that of Dr. Nogiers in 1958.
Nogier acknowledged that the Chinese had been using ear points for acupuncture prior to his discovery, but these had been considered empirical points for particular treatments and were not associated with a somatotopic representation of the homunculus in the ear. This oversight appears to have inhibited an awareness that options lay open to recognize and treat other points in the ear following an anatomical relationship to the points already known at the time.
In recognition of Nogier’s discoveries and research on the auricle, the Chinese Government honored him by awarding him a formal title “Father of Modern Auricular Therapy.”The Chinese charts of the auricular points were published in 1958 and these have been the basis and reference point for teaching Auricular Therapy in China. The first to apply this form of auricular therapy were the Barefoot Doctors, young medical trainees who, during the Cultural Revolution, were sent out to provide basic traditional medical care for the masses.

In researching the points Chinese medical authorities treated thousands of patients and outlined a prescriptive approach for the treatment of many conditions. A TCM diagnosis was unnecessary. Points could be found, as Nogier had noted, by palpation; tender points indicated a dysfunction or pathology. Later, electrical point detectors were used to find points that exhibited different electrical resistance to the skin immediately adjacent to the point. This was also an indication of a pathological point.
This is where the Chinese approach to auricular therapy stands today. Points are either identified by visual reference to a chart and or a grid system, by palpation for tender points or by electrical detection.
Another interesting difference between the Chinese and Nogier approach is in the identification of different locations for similar points. At first this may seem strange and contradictory until an awareness of Nogiers later research is understood.

The Vascular Autonomic Signal and the Phases.

Two further highly significant discoveries by Nogier advanced the European practice of Auricular therapy towards an extremely sophisticated methodology. It also, almost as a by-product, added the ‘art’ back into medicine. This is the epitome of the good doctor, a scientist, researcher and artist. A healer. I digress.
Nogier was adept at reading the Chinese pulses and with this skill, a considerable measure of patience and his incredible powers of observation, he recognized a distinct change in the patient’s pulse as points were investigated and as substances were brought close to the skin. The pulse change was consistent and reproducible. This was in 1966. Nogier called the pulse the ACR (auricular cardiac reflex) but changed this to the Vascular Autonomic Sign (or signal), the VAS, when he realized that it was a generalized autonomic signal that appeared on all arteries in the body. The ability to detect the VAS allows the practitioner to accurately locate active points, identify dysfunctional points that are not painful to palpate, test for and locate areas of blockage to healing that are reflected in the auricle and to question and identify hemispheric laterality. The VAS is essential in identifying substances that provoke an allergic response or are toxic to the human organism.
Nogier found that on occasions the same point, would present in more than one place. He postulated that the point might change according to the progression of the disease from acute to chronic to degenerative. The outcome of this was validation of the phases or the representations of the homunculus according to the phase of the illness. The pathology may present in more than one phase, but possibly only one phase is tender to palpation. The VAS can be used to check for pathology in any of the phases and is an indicator of the progression of the pathology and of the importance of a comprehensive treatment to receive a satisfactory outcome.
The phases may well explain how a point appears at one place on a European chart and at another on a Chinese chart.
Another reason is that the Chinese have named some points according to their functional outcome e.g. Shenmen. These points may overlay anatomical zones of organs, glands or neurological structures that produce those functions.
The Nogier system recognizes the fluid dynamic of points that are found in zones rather than being fixed points. The projection, or neurological representation of a particular organ or anatomical entity is not a fixed point but is found within a zone. Its location within each phase and zone varies with the changes in pathology and/or physiology of the dysfunction. The precise point is found with the VAS. This is in contrast to the Chinese system that identifies fixed points in fixed locations in a single phase.
The original Nogier system of auricular therapy and its development into auricular medicine leaves all other systems wanting. Being able to ask of the organism a question that can be answered with that organism’s own response, the VAS; being aware of the progression of a pathology through the phases and being able to detect its location with the VAS, allows for a quantum leap in therapeutic effectiveness and validity. This is the legacy of Doctor Paul Nogier.
References:
Nogier P. and Nogier R. The Man in the Ear (Maionneuve, 1985)
Nogier. From Auriculotherapy to Auricular Medicine (Maionneuve, 1983)
LeBel Marc Lecture Notes Australia 1996
Bryan Frank M.D. and Nadir Soliman M.D. Auricular Therapy a Comprehensive text (author house 2005)
Strittmatter B. Identifying and Treating obstacles to healing (Thieme 2004)
Oleson T. Auriculotherapy Manual (Churchill Livingstone 2004)
Ackerman J The Biophysics of the VAS, The Phenomenon of Healing, The integration of the VAS techniques with Traditional Western Medical Techniques. (publications du Glem)
Symposium proceedings and workshop notes, various authors, 4th and 5th GLEM International Symposiums 2000 and 2006.
Dr Rouxeville, Yves translated extract “Cahiers de Biothérapie” June 2003
© Jim Chalmers

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