Q:Is the ear really a map of the body? What is auriculotherapy and how does it work?
-Gala A., Pittsburgh, Pa.
A: Auriculotherapy (placing tiny stainless steel pellets or needles into acupuncture points on the ear) is an ancient medical art supported by modern science. Paul Nogier, MD, of Lyon, France was one of the leading researchers in auriculotherapy. Now his son, Raphael Nogier, MD, practices the therapy in Lyon and travels the world teaching auriculotherapy to medical professionals and acupuncturists.
The elder Nogier first tried a well-known traditional Chinese medicine (TCM) ear point for sciatic pain on a patient in the early 1950s. It worked
brilliantly, so he tried it on his next sciatica patient. Again, success. As he tried to understand why the ear point worked to treat his patients' pain, Nogier made a fascinating connection to early embryological development.
Why It's All About the Ears
The ear is innervated (has nerve supply) from three major sources: the vagus nerve, the third branch of the trigeminal nerve, and the superior cervical plexus. This is significant for many reasons, but two are particularly interesting.
First, the ear is the only surface area of the body fed by parasympathetic nerve fibers. All nerves have fibers that are either sympathetic, parasympathetic, or mixed. The sympathetic nervous system promotes the "fight or flight," adrenaline-pumping response. But parasympathetic nerves emerging from the cervical and sacral areas are tied to "feed and breed," calming reactions. This may be why stimulating these parasympathetic nerves through craniosacral therapy can be so balancing and relaxing.
Secondly, the three nerves that inform sensation on the ear derive from three different embryologic tissues (endoderm, mesoderm, and ectoderm), and, further, the ear is the only area of the body that has a nerve supply derived from all three of these layers. So clearly, the ears have something special going on.
When I first learned auriculotherapy during TCM training, I was presented with the idea of the ear representing a fetus: head down with the lobe corresponding with the head area and the spine demarcated along the inner arch of the ear, with all the internal organs in the central depression of the ear leading into the canal. But Nogier took these concepts much further.
A Mental & Emotional Connection
Nogier examined not only the physical correlates with points in the ear, but also the complex manifestation of human ailments that include the mental/emotional component of suffering. When he punctured (very gently) an ear point corresponding to a patient's condition, he could detect a change in the patient's wrist pulse, which allowed him to further develop his map of human pathology on the ear. In 1972, he published an ear chart localizing the brain on the lobe of the ear and the spine at the edge of the pinna (the visible part of the ear). This chart is widely used by auriculotherapists internationally today.
In 1987, however, Nogier realized that there was individual variation in ear points, and began to refer to the points as "areas of probability" that could be confirmed by pulse change, or an electronic beeping device, or by the patient confirming the point's tenderness.
From his son Raphael, I learned that point detection is much more accurate in the morning, and that serious illness should be addressed early in the day to minimize "background noise" that might show up in point detection later in the day. All acupuncture points, including in the ear, are surrounded by highly sophisticated immune cells called Langerhans cells, which is why acupuncture can have a profound impact on improving immune function-either stimulating white blood cell production as needed during an illness, or settling the immune system down in an autoimmune condition.
Although, as Nogier noted, there are variations from person to person, the basic areas of the ear are the same. The front of the ear is mostly useful to treat sensory problems (pain), whereas the back of the ear is good for treating motor problems (paralysis).
An exploration of the ear typically starts at the tragus (the fleshy doohickey next to the edge of the cheek), and continues with probing along the outer edge of the ear before moving inward in a spiral. This covers the brain, the skeletal system, and the organs. For metabolic problems (diabetes, hypothyroidism), treatments should be at least three weeks apart. For acute painful problems, twice weekly treatments are advised until the problem is resolved.
The body has other "maps," including the iris, the tongue, and even the palms. But using the ear as a map for targeted therapy is the most refined method, with a record of excellent clinical success.