Auricular acupuncture Lecturer: Qu Hongyan

Contents Relationship between the ear, channels and zang-fu organs 2. The anatomy of the auricle 3. The concept and distribution of auricular points 4. Locations and indications of some points 5. Exploration of auricular points

Concept Auricular acupuncture is one of the acupuncture therapies used to prevent and treat diseases. It is done by needling or stimulating areas on the ear.  a wide range of indications  a good therapeutic effect  convenient for everyday use and easy to perform  safe and no side effect Features

The origin of auricular acupuncture Auricular diagnostic and therapeutic methods were first recorded in Chapter 20 of Ling Shu that “when pathogenic factors attack the liver, it will cause pain in the hypochondria…needle the blue vessels around the ear to relieve the dragging pain.” In the 24th chapter of Ling Shu it says, “for the deaf who can’t hear, needle the center of the ear.” It is also recorded in Qian Jin Yao Fang( Prescriptions Worth a Thousand Gold (Invaluable ) for Emergencies that needling Point “Center” is an appropriate treatment for jaundice, diseases due to cold, summer-heat or epidemic, pathogenic factors. In other classic medical literary texts there are descriptions of stimulating the ears and certain auricular areas with needles, moxibustion, massage and herbal suppositories to treat and prevent diseases; as well as inspecting and palpating the auricles to assist in disease diagnoses. These methods are still used as folk remedies, which demonstrates that auricular therapy has a very long history associated with the diagnosis and treatment of diseases in China.

Relationship between the ear and channels The channels of the hand-taiyang, hand-shaoyang, foot-shaoyang and the collateral of the hand-yangming enter the ear; The channels of foot-yangming and foot-taiyang travel to the front of the ear and above the ear respectively; The divergent channel of the hand-jueyin comes out from the back of the ear; The vessels of the yang heel and yin heel go to the back of the ear; The six-yin meridians connect to the ear by means of their divergent channels that separate, enter, resurface and finally join their interior-exterior related yang channels respectively.

Relationship between the ear and zang-fu organs The ear has close relation with zang-fu organs as well. According to records in Nei Jing, the ear links to the five-zang organs physiologically. In Li Zheng An Mo Yao Shu(The Extensive Techniques of Massage) the back of the ear is divided into five parts that correspond to the five-zang organs respectively.

The anatomy of the auricle

The concept and distribution of auricular points Auricular points are the specific areas distributed over the ear. When there is an illness in the body, it may manifest on the ear as tenderness, deformities, discoloration, and disturbance in the skin’s electrical properties. concept

Points related to the portion of the head are located on the ear lobe; Points related to the upper limbs are located on the scapha; Points related to the trunk and lower limbs are located on the body of the antihelix and superior and inferior antihelix crus; Points related to the organs in the abdomen are located on the cymba concha; Points related to the organs in the chest are located on the cavum concha; Points related to the digestive tract are distributed around the helix crus Regularities

Locations and indications of some points

Points on the Helix Erjian(HX6,7 ) ear apex 【Location】 At the apex where the ear is folded forward at the juncture of area 6 and 7 of the helix 【Indication】 Fever, hypertension, ocular sty, acute conjunctivitis, toothache

Points on the Antihelix Jiaogan(AH6) sympathesis 【Location】 At the junction of the end of the inferior antihelix crus and the medial edge of the helix in the front of area 6 of the antihelix 【Indication】 spasm of the stomach and intestines, angina, biliary colic, ureterolith, functional disorders of autonomic nerves

Points on the Triangular fossa Shenmen(TF4) 【Location】 At the upper part of the posterior 1/3 of the triangular fossa, at area 4 of the triangular fossa 【Indication】 Insomnia, profuse dreaming, withdrawal syndrome, epilepsy, hypertension, neurasthenia, pain disorders

Neifenmi(CO18) endocrine Points on the concha Neifenmi(CO18) endocrine 【Location】 On the inside of the notch of the intertragus and anterioinferior part of the cavum concha at are 18 of the concha 【Indication】 dysmenorrhea, irregular periods, menopause syndrome, acne, malaria, hyperthyroidism or hypothyroidism

Exploration of auricular points  Inspection  Detection of the tender spot Measurement of electrical resistance

Inspection Auricular inspection is to check for abnormal changes on the ear in order to diagnose diseases or disorders. The most commonly seen positive changes include deformities, discoloration, pimples, desquamation, nodules, congestion, depression blister and so on.

Detection of the tender spot This method searches for the tender spots on the ears with a probe, the head of an acupuncture needle handle, or the end of a matchstick by pressing and moving on the surface of the ear gently and smoothly.

Measurement of electrical resistance This technique detects decreased electrical resistance in points with an electrical detector that has an indicator lamp or special sound.

Clinical application of auricular acupuncture 1. Assistant diagnosis 2. Principles for selecting auricular points 3. Indications of auricular acupuncture 4. Manipulations 5. Retaining and withdrawing of needles

Assistant diagnosis When there is an illness in the body, especially the organic disease, it may manifest on the ear as positive reactions. There maybe tenderness, deformities, discoloration, and disturbance in the skin’s electrical properties. We can establish the diagnosis according to these reactions combined with symptoms, signs and medical history.

Principles for selecting auricular points  Choosing the corresponding point to the location of the diseased or affected part of the body e.g. Select the stomach (CO4) for the treatment of stomachache  Choosing the points based on the visceral manifestation theory e.g. Choose the kidney (CO10) for alopecia Choose the lung (CO7) and large intestine (CO14) for skin diseases

Principles for selecting auricular points  Choosing the points based on the channel pattern identification e.g. Select the bladder (CO9) or pancreas and gallbladder (CO11) for sciatica Choose the large intestine (CO7) for toothache  Choosing the points based on modern medical theory e.g. Choose Shenmen (TF4) and Subcortex (AT4) for painful conditions and inflammation Select the endocrine (CO18) for irregular periods

Principles for selecting auricular points  Choosing the points based on clinical experience e.g. Select external genital (HX4) for pain in the lower back and legs Ear apex (HX6,7i) for bloodletting and for red, swollen and painful eyes.

Indications for auricular acupuncture Painful disorders Inflammatory and infectious diseases Allergic diseases Endocrinal and metabolic disorders Others Beauty therapy, smoking and drug addiction, anti-aging and disease prevention

Manipulation Select points According to the diagnosis to determine the prescription and appropriate auricular points Disinfection Beside disinfect the needles and fingers of doctors, the auricular points should be swabbed with 2% iodine first and then with 75% alcohol as routine asepsis.

Treatment methods Manipulation Filiform needles that are 0.5 cun in length or specially made thumbtack type needles are selected for auricular acupuncture. To begin with the procedure, stablize the ear with the left hand and insert the needle with right hand; for the thumbtack type intradermal needle insertion, the needle should be fastened to the ear with a piece of adhesive tape and kept in place for 2 to 3 days. The points may also be treated with the ear-pressing method. Magnetic beads or wang bu liu xing are fastened to the ear with a piece of adhesive tape on the auricular points and kept in place for 3 to 5 days. The patient is asked to press the selected points 2 to 4 times a day.

There will be local pain or heat sensation in most of the patients after the needle insertion. They may experience soreness, numbness, heaviness or coldness due to the needling sensation traveling along certain channels. General speaking, patient who experience these sensations obtain a relatively better therapeutic outcome.

Retaining and withdrawing of needles Filiform needles are allow to be retained for 20 to 30 minutes. However, they may be prolonged by 1 to 2 hours or even longer for chronic conditions. During the needle retention, the needles should be rotate intermittently, when removing the needles, stabilize the ear with the left hand, and withdraw the needles with the right hand and press the needle opening quickly with dry cotton balls if bleeding occurs.

Precautions The ears should be disinfected carefully to prevent infection Filifrom needling on auricular areas may produce strong pain, so explanation is necessary before treatment in order to obtain cooperation from patients When treating a sprain or other soft tissue injuries, the patient should be encouraged to move the affected part in order to increase the therapeutic outcome Needling fainting should also be prevented from happening during auricular acupuncture. Prompt intervention is needed if this happens.

Contraindications Auricular acupuncture should be contraindicated for pregnant women or women who are prone to abortion; This therapy is not advisable for patients with frostbite, ulceration, eczema and so on; It is not recommended for patients with severe diseases or bad anemia; In the treatment of severe heart disease or severe hypertension, strong stimulation should be avoided