Table Of ContentAuriculotherapy
Manual
For Elsevier
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FOURTH EDITION
Auriculotherapy
Manual
Chinese and Western Systems
of Ear Acupuncture
Terry Oleson
PhD
Professor of Psychology, Ryokan College;
Director of Doctoral Studies, Emperor’s College of Traditional Oriental Medicine,
Los Angeles, California, USA
Foreword by
Richard C. Niemtzow
Illustrations by
Justin Schaid and Andrew Dickinson
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2014
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First edition 1996
Second edition 1998
Third edition 2003
Fourth edition 2014
ISBN 978-0-7020-3572-2
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such
information or methods they should be mindful of their own safety and the safety of others, includ-
ing parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their
own experience and knowledge of their patients, to make diagnoses, to determine dosages and the
best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products, instruc-
tions, or ideas contained in the material herein.
Printed in China
Foreword
I am humbled and honored to have the privi- demonstrating the neurobiological basis of acu-
lege to write the Foreword for Terry Oleson’s puncture. As a practicing clinician, the clinical
4th Edition of Auriculotherapy Manual: Chinese case reports presented in chapter 8 are particu-
and Western Systems of Ear Acupuncture. Since larly inspiring to see specific applications of
1994, over a span of 19 years, I have referred auriculotherapy for difficult health conditions for
to and marveled over his various editions gain- which alternative treatment options are not avail-
ing in-sight and knowledge to the vast field of able. The most note-worthy change in chapter 3
auriculotherapy. If suddenly I was transported to was to add sophisticated 3-D images of the ear
a remote place in the world to practice auriculo- and to add 5 more auricular landmarks that indi-
therapy and only allowed one book, this is it! The cate the relationship between the different depths
development and design of my own well-known and contours of the external ear. As a result of
“Battlefield Acupuncture” and “Xerostomia” the utilization of this 3-D ear imagery, there is
techniques which has favorably impacted thou- greater detail to assist the clinician in identifying
sands of patients around the world were signifi- the specific localization of auricular acupuncture
cantly influenced by his well organized, in-depth points. This feature of incorporating 3-D images
and rational information found in previous man- of the auricle has allowed greatly improved
uals. I am one of the many thousands of clini- identification the ear images presented in chap-
cians that will keep re-turning to his manuals for ter 7 and chapter 9 to the actual ears of human
its vast repository of wisdom. patients. These updates reflects the fact that mod-
ern auriculotherapy is not a stagnating discipline,
How does the 4th edition of the Auriculotherapy
but one in constant evolution.
Manual compare to the 3rd edition? In other
words, how does one make a superb manual even There are many journeys to take in the field of
better? The overall organization of this book acupuncture. In particular, auriculotherapy will
into specific chapters on the history of this field, astonish you. There are many intriguing con-
microsystem theories, auricular anatomy, auricu- cepts to learn and clinical skills to acquire. Think
lar zone systems, auricular diagnosis, auriculo- of Terry Oleson as your master personal guide.
therapy treatments, the location and function of He will lead and expedite you through every
individual ear points, clinical case reports, and facet of auriculotherapy that will be enjoyable
treatment protocols, all remain essentially the and intriguing. It will be an invigorating and
same. At the same time, each chapter has been enlightened journey as you read through chap-
reorganized to include specific objectives, updated ter after chapter. You will enjoy the coherent and
information based upon international conferences succinct reading with many pictures and illustra-
held in 2010 and 2012, a succinct definition of tions. It will be a lengthy, but smooth trip. One
terms used in that chapter, and review questions that will make many stops, but you will ulti-
to assess one’s understanding of the material. mately finish with a modern integrative perspec-
tive of auriculotherapy. Most intriguing will be
What is new in this edition of the Auriculotherapy
where Terry Oleson’s impetus will lead us next in
Manual? Chapter 1 has included additional infor-
future editions of auriculotherapy.
mation regarding the history of auricular acu-
puncture in both China and in Europe. Chapter 2
has been revised to highlight the intriguing rela- Richard C. Niemtzow, MD, Ph.D, MPH
tionship between the holographic model and Director
the energetic theories of classical acupunc- United States Air Force Acupuncture Center
ture, and there is more recent scientific research Joint Base Andrews, Maryland
ix
Preface
When I was first asked to develop a fourth edi- completing my graduate studies at the University
tion of the Auriculotherapy Manual: Chinese and of California at Irvine (UCI). The presentation
Western Systems of Ear Acupuncture, neither by UCLA professor John Liebeskind focused
I nor the publisher realized what an extensive upon his pioneering research on a concept that
endeavor that would lead to. While the field of was completely new to the field of neuroscience
auricular acupuncture has remained essentially in 1972. His studies had demonstrated that in
the same as when I developed the first edition of addition to neurophysiological pathways for the
this text in 1990, the clinical and basic research on perception of pain, there were separate brain
auriculotherapy has continued to grow since the pathways that could inhibit pain. He and his col-
first scientific study that I conducted on auricu- leagues had demonstrated in rats, then cats and
lar diagnosis was published in the medical journal monkeys, that electrical stimulation of the peri-
Pain in 1980. Besides reorganizing the structure aqueductal gray of the brainstem could sup-
of each chapter in this book to allow for an ini- press behavioral reflexes to painful stimuli, yet
tial outline of topics, chapter objectives, updated not alter any other aspect of the animal’s con-
information on auriculotherapy, and a section scious functions. It was several years later that
on the definition of key terms used in that chap- subsequent studies would lead to the discovery
ter, I have added educational sample questions of endorphins, the morphine-like substances
at the end of the chapters. A major revision has that serve as the body’s naturally occurring, opi-
been to develop images of the external ear based ate analgesic. I wrote to Dr. Liebeskind after
upon 3-D technology that is able to reveal hidden the lecture, met with him at UCLA, and soon
surfaces of the auricle from different perspectives. submitted an application for a federally funded
With the addition of close-up photographs of the post-doctoral scholarship working in his labora-
external ears of a number of individuals and the tory. As my doctoral dissertation examined the
inclusion of these 3-D images of the auricle, it has firing patterns of neurons in the somatosensory
been possible to distinguish additional landmarks pathways and auditory pathways of the brain
on the external ear that are highly useful in inden- during Pavlovian conditioning, my post-doctoral
tifying the specific location of different ear acu- grant sought to examine neural firing patterns in
points on a structure as small and as convoluted the brain pathways related to the inhibition of
as the ear. In response to reader comments regard- pain sensations.
ing the second and third editions of this manual,
I began my work in Dr. Liebeskind’s labora-
the visual images of ear acupoints have been
tory after receiving my PhD in Psychobiology
placed in close proximity to the verbal descrip-
in 1973. It so happened that the neurosci-
tions of the location and function of those same
ence laboratories at the UCLA Department
ear acupoints. A consistent format for the naming
of Psychology were located in the basement
and numbering of each individual ear acupunc-
of the building. If one walked down a long,
ture point according to clinical systems developed
underground hallway, one arrived at the UCLA
in China and in Europe has been further elabo-
Acupuncture Research Group. UCLA was the
rated from previous presentations of this text. The
first medical school in the United States that
intended purpose of these changes has been to
sponsored scientific research on acupuncture.
make this book both more informative, yet more
While I conducted animal research experiments
user-friendly, than the earlier editions.
during the day on brain research related to the
My personal exploration of the field of auriculo- inhibition of pain, I was also able to study the
therapy started with a lecture that I heard while clinical effects of acupuncture for alleviating the
xi
xii Preface
pain conditions of human patients. The UCLA Dr. Tsun-Nin Lee sponsored a presentation by
pain clinic successfully treated hundreds of Dr. Nogier in San Francisco, and it was then
chronic pain patients with acupuncture, biofeed- that I first had the opportunity to meet this
back, hypnosis, guided imagery, and nutritional great man. Dr. Nogier only spoke in French, so
counseling. The Directors of the UCLA clinic, Dr. Joseph Helms needed to translate the mate-
Dr. David Bresler and Dr. Richard Kroening, rial into English. As Dr. Nogier had read about
invited me to their offices one afternoon and my research on auricular diagnosis, he made a
asked me to be their Research Director. It was special invitation to meet with me. I had three
like an invisible energy force pushed me from more opportunities to personally interact with
behind as I leaped at the opportunity. I did not him at international symposiums in Europe,
have any acupuncture skills, but as a psycholo- and it was always a great honor. I feel very for-
gist, I had extensive training in conducting tunate to have received individual guidance
research. And thus began an amazing journey. on understanding the underlying mechanisms
that can account for the impressive benefits of
The first research project that we undertook was
auriculotherapy.
to examine auricular diagnosis. At that time, and
to this very day, most members of the American
Dr. Richard Kroening had once told me that in
medical profession have devalued acupuncture
medical school that when one is learning a new
as simply a placebo effect. In contrast, a diag-
medical procedure, the educational motto is as
nostic study could not be contaminated by a
follows: “See one, do one, teach one.” While not
patient’s desire to please their practitioner, thus
progressing quite that fast, I have now had the
there could be no placebo effect. It took several
occasion to observe gifted practitioners of auric-
years to design the research and collect the data,
ulotherapy, treat clients with auriculotherapy,
but there was an energizing atmosphere to every-
and teach courses on auriculotherapy at colleges
one participating in the project. I was surprised
and universities across the United States. The
myself when the results were finally analyzed
adage that one learns from one’s students con-
and there was such a strong statistical finding
tinues to apply, even after 30 years of teaching.
supporting the veracity of auricular diagnosis.
Students come to me and inform me of patients
By just examining the external ear, yet blind to
they have successfully treated with auriculother-
a patient’s diagnosis, a trained physician could
apy for unusual conditions that I have only stud-
identify which parts of the external ear corre-
ied in books, thus the spread of this knowledge
sponded to specific parts of the body that the
continues even beyond my experience. I also had
patient had reported musculoskeletal pain.
the good fortune to connect with Dr. Jim Shores,
It was only after I presented the results of the who co-sponsored the International Consensus
auricular diagnosis research to the International Conference on Acupuncture, Auriculotherapy,
Society for the Study of Pain in 1980 that I and Auricular Medicine in 1999 (ICCAAM’99).
learned of the whole field of auricular medicine It was my continued efforts to integrate this
that is practiced in Europe. American doctors unconventional clinical procedure that has led to
seem more impressed by the electrical detection this most recent edition. It has not seemed either
and electrical treatment of acupuncture points intellectually nor intuitively obvious that stimu-
than Asian doctors, and several electronic equip- lation of the external ear could affect medical
ment manufacturers sponsored seminars that conditions in other parts of the body. Even after
incorporated the work of European as well as treating hundreds of patients with auriculother-
Chinese acupuncturists. I had read about the apy, it continues to amaze me that it can work.
pioneering auriculotherapy work of Dr. Paul The purpose of this book is to explain both the
Nogier, but I began studying with physicians theoretical basis and the clinical practice of auric-
who had actually studied with him in France. ulotherapy so that others may know of its value.
1
Overview and History
of Auriculotherapy
CONTENTS 1.1 Introduction to Auriculotherapy
1.0 Overview and History of Auriculotherapy 1
Auriculotherapy is a health care modality
1.1 Introduction to Auriculotherapy 1
whereby the external surface of the ear, or auri-
1.2 Health Care Practitioners Utilizing
cle, is stimulated to alleviate pathological condi-
Auriculotherapy 1
tions in other parts of the body. The discovery
1.3 Historical Overview of Auricular
of this therapy is partially based on the ancient
Acupuncture in the Far East 2
Chinese practice of body acupuncture, yet it is
1.4 Auriculotherapy and Auricular also derived from the discoveries by a French
Medicine in the West 8 physician in the 1950s. Dr. Paul Nogier and col-
1.5 Comparison of Ear Acupuncture to leagues demonstrated that specific areas of the
Body Acupuncture 16 external ear were associated with pathology in
specific parts of the body. Many texts on the
topic of auriculotherapy tend to focus either
1.0 | O verview and History of
on the Chinese approach to auricular acupunc-
Auriculotherapy
ture or on the European practices of auricu-
lar medicine. Following my work at the UCLA
CHAPTER 1 LEARNING OBJECTIVES
Pain Management Center in the 1980s, the pres-
1. To describe the applications of ent text strives to integrate both Chinese and
auriculotherapy by various health care European styles of auriculotherapy.
practitioners.
2. To highlight the historical origins of auricular
1.2 Health Care Practitioners
acupuncture in ancient China.
Utilizing Auriculotherapy
3. To demonstrate awareness of ear
acupuncture procedures in modern China.
Acupuncturists: The practice of classical acu-
4. To summarize the historical origins of
puncture and Traditional Chinese Medicine
auriculotherapy discoveries in the West.
(TCM) includes the insertion of needles into ear
5. To evaluate the discoveries of Dr. Paul Nogier,
acupoints as well as body acupuncture points.
the Father of Auriculotherapy.
Stimulating acupuncture points on the body or
6. To examine research and clinical studies of on the ear can be done in the same treatment
auriculotherapy in the United States. session or in different sessions. Some acupunc-
7. To compare the similarities and differences turists stimulate ear reflex points as the sole
between body acupuncture and ear method of their acupuncture practice, whereas
acupuncture. other acupuncturists do not include any use of
1
2 Auriculotherapy Manual
ear acupoints. The majority of American acu- of acute muscle sprains, and the reduction of
puncturists have only been trained in the Chinese unwanted side effects from narcotic medications.
localization of ear points, but the integration Because auriculotherapy treatments can be con-
of Chinese and Western ear reflex acupoints ducted in a relatively brief period, this type of
has become a more preferred approach. Many acupuncture can effectively complement other
acupuncture schools in the West provide only medical procedures.
minimal training in auricular acupuncture or in
Naturopathic Doctors: Naturopathic practition-
microsystem models; thus, the present text seeks
ers include auriculotherapy in the pursuit of
to demonstrate the considerable value for acu-
homeopathic, nutritional, and preventive aspects
puncturists to take the time to add ear acupunc-
of medicine. Auricular diagnosis can determine
ture points into their treatment plans.
sources of specific allergies and appropriate
Biofeedback Therapists: Electrophysiological herbal recommendations.
biofeedback equipment facilitates the training of
Nurses: The standard medical care provided by
self-control techniques to achieve general relax-
nurses can be greatly assisted by the application
ation and stress management. Auriculotherapy
of auriculotherapy for the systematic relief of
augments biofeedback procedures by producing
pain and pathology that is not adequately allevi-
more immediate relief of myofascial pain and
ated by conventional medications or procedures.
visceral discomfort as a patient progressively
learns to relax. Osteopathic Doctors: Auriculotherapy has been
utilized to facilitate the correction of misaligned
Chiropractic Doctors: Stimulation of auricular
vertebrae, to reduce severe muscle spasms, and to
reflex points reduces the mechanical resistance
augment pain management procedures.
to chiropractic adjustments intended to release
muscle spasms and correct misaligned postural Physical Therapists: Auriculotherapy is a pow-
positions. Auriculotherapy can be applied before erful adjunct to transcutaneous electrical nerve
an adjustment or following a manipulative treat- stimulation, traction, ultrasound, and therapeu-
ment in order to stabilize the chiropractic proce- tic exercises for the treatment of acute whiplash
dure. Manual therapy techniques more directly injuries, severe muscle spasms, or chronic back
balance the biomechanical structure of the body pain.
and are a very useful complement to the reduc-
Psychotherapists: Psychiatrists and psycholo-
tions in muscle tension and the improvement
gists have utilized auriculotherapy for the reduc-
of blood circulation that can be facilitated by
tion of anxiety, depression, insomnia, alcoholism,
auriculotherapy.
and substance abuse.
Dentists: Auriculotherapy can achieve mild,
Reflexologists: Tactile manipulation of reflex
dental analgesia for the relief of acute pain
points on the ear can be combined with pressure
from dental drilling or for basic teeth cleaning
applied to tender regions of the feet and hands
procedures. As many patients experience con-
to relieve specific body aches and internal organ
siderable nervousness prior to certain dental
disorders.
procedures, auriculotherapy can effectively alle-
viate such anxiety. Treatment of chronic head-
aches and TMJ dysfunction are both facilitated
1.3 Historical Overview of Auricular
by the combination of auriculotherapy with trig-
Acupuncture in the Far East
ger point injections, dental splints, and occlusal
work.
Classical texts on the practice of acupuncture
Medical Doctors: Physicians specializing in anes- are attributed to the Yellow Emperor's Classic
thesiology, surgery, internal medicine, and fam- of Internal Medicine (Veith, 1972). The Yellow
ily practice have utilized auriculotherapy for emperor, Huang Di, purportedly came to power
the management of chronic pain, the treatment in 2698 BCE and reigned until 2598 BCE. The
Overview and History of Auriculotherapy 3
Haung Di Nei Jing was composed as a dialogue as meridians or channels. Insertion of fine needles
between the emperor and his health ministers. into specific acupuncture points was thought to
Current scholars, however, suggest that the Nei facilitate the circulation of this invisible energy
Jing was not written down until the second cen- through acupoint “holes” in the skin. The Haung
tury BCE. This classic text is probably a collec- Di Nei Jing text attributed to the Yellow Emperor
tive work by many health care practitioners that described 360 such holes as suitable for needling.
was compiled over many centuries, representing a The earliest records of Chinese medicine have
compendium of medical knowledge accumulated been found on turtle shells and bamboo strips
in ancient China during a period of 4000 years. dated to 400 BCE, as paper was not invented in
According to this text, all six yang meridians China until 150 CE. Acupuncture needles were
connect to the face, whereas the six yin meridians first made from bones and stones, and later from
only reach the chest and abdomen. Yin channels bronze metal. In 1027 CE, a full-sized figure of a
connect to the ear indirectly, through their cor- man was cast in bronze to guide medical practi-
responding yang meridian. Those reactive ear tioners. A replica of this bronze statue is shown in
acupoints that were tender to palpation were Figure 1.1. Over the surface of this bronze statue
referred to as “Yang Alarm” points, which indi- was located a series of holes that corresponded
cated a yang excess pathological disorder. The to the locations of acupuncture points. Oriental
ancient Chinese ear acupuncture charts, however, medicine was a complete treatment system based
were not arranged in any anatomically organized on empirical findings that examined the clinical
pattern. Rather, they were depicted as acupoints efficacy of needling acupuncture points.
on the ear in a scattered array, with no apparent,
Dr. Gong Sun Chen (Chen and Lu, 1999), of the
logical order.
Nanjing Medical University, has reported that
The historical roots of Chinese medicine have the Nei Jing included numerous references to
been comprehensively documented in Paul the unique, healing qualities of the auricle. The
Unschuld’s 1943 text, Medicine in China. Other ear was not considered an isolated organ, but
excellent texts on this history are found in Chen’s was intimately connected with all organs of the
History of Chinese Medical Science (Hsu and body, the five viscera (liver, heart, spleen, lungs,
Peacher, 1977), in Peter Eckman’s 1996 In the and kidneys) and the six bowels (stomach, small
Footsteps of the Yellow Emperor, and in Huan intestine, large intestine, gall bladder, bladder,
and Rose’s 1999 Who Can Ride the Dragon? As and san jiao or triple warmer). Evaluation of the
with primitive, medical practice in other areas of external ear could predict the onset of specific
the world, Chinese shamans sought to ward off ailments and the recovery from disease. Ear acu-
evil demons that they perceived were the source puncture was used to treat a variety of disorders,
of diseases. The philosophies of Taoism (also including headaches, eye disease, asthma, facial
spelled Daoism), Confucianism, and Buddhism nerve paralysis, and stomachaches. According
were incorporated with physical medicine as an to Huang (1974), the Nei Jing stated that “blood
integral part of health care practice in China. and air circulate through the 12 meridians and
Metaphorical references to light and dark, sun their 365 accessory points to infiltrate the five
and moon, fire and earth, hot and cold, dry and sense organs, seven orifices, and brain marrow.”
damp all contributed to the Chinese understand- Huang further noted that
ing of disease. The microcosm of mankind was
the meridians of the lesser yang of the hand
associated with the macrocosm of the universe,
were said to extend upwards toward the back
which were said to demonstrate the systematic
of the ear. The meridian of the great yang of
correspondences between the visible and the
the foot extended to the upper corner of the
invisible worlds.
ear. The circulation of the six yang meridians
Human pain and pathology were attributed to passed directly through the ear, while the six
disturbances in the flow of “qi” (pronounced yin meridians joined with their corresponding
“chee”) along distinct energy channels referred to yang meridians.
