New Universal Nomenclature in Auriculotherapy
The Journal of Alternative and Complementary Medicine. January 2018, 24(1): 7-14.
David Alimi, MD,1 and Jacques E. Chelly, MD, PhD, MBA1,2
1Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA.
2Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA .
ABSTRACT
Objectives: To propose at the auriculotherapists a New Universal Nomenclature of Auriculotherapy, able to receive any mapping whatsoever.
Design: We built this proposition by using electronic database search to find the different formulations of Auricular Acupuncture Points (AAPs), by studying neuroradiology methods describing reliable and reproducible marks able to adapt to all brain morphologies, by studying the analysis of brain dissections, showed us the internal organization of the brain; and after having proved the neurophysiological correlations between auricular displays and their brain correspondences.
Results: Since the 1950s, the study of Auriculotherapy by Paul Nogier and his students regularly progressed. The World Health Organization recognized it in 1987 and developed the First International Nomenclature in 1990. The number of therapeutic zones of the ear, in proportion to the constant progress in neurophysiology, never stops growing. This growth presents a major problem: all the first classifications became inappropriate and unfit. We propose a Universal Nomenclature of Auriculotherapy which is a biomathematical model of the brain anatomic organization, with 189 areas on the lateral ear and 89 areas on the medial ear.
Conclusion: The Universal Auriculotherapy Nomenclature we proposed to the World Federation of Chinese Medicine Societies and which approved it at its International Convention in September 2011 in London, gives accurate Cartesian Marks and is able to receive any mapping whatsoever. Dispatching around 57 countries (Europe, America, China, Russia and Africa) and 195 Acupuncture Societies, it will facilitate the work of auriculotherapists and allow a scientific progress of the subject worldwide. This progress will allow the largest number of people to have a common tool for education, research, and publications of the discipline.
http://online.liebertpub.com/doi/abs/10.1089/acm.2016.0351Excerpts:
“Auricular acupuncture (Auriculotherapy) has gone through the centuries, and, in particular, the last 40 years, going from traditional to modern. By word of mouth, from empirical practice to efficient medicine, it was slowly approved, thanks to neuroimaging progress, and has become, at least, a part of neuroscience.
“Since the rediscovery of Auriculotherapy by Paul Nogier in 1957 in Lyon (France), and his brilliant vision of a fetus curled up in the ear pavilion, presaging the understanding of his somatotopic bases, modern neuroscientific knowledge has allowed us, as neurophysiologists, to bring understanding of the neurophysiological bases of its action.
“Since this scientific certification, its development, universal propagation, and academic education have never stopped developing, just like the multiplication of clinical and experimental study publications.
“After Dr. Paul Nogier's initial cartography of the ear, multiple cartographies have been developed by different authors/countries/schools. Until recently, the construct of these cartographies was anatomically based. Basically, the ear was divided in anatomic zones (helix, Antihelix, Tragus, Lobule, etc.) and each zone was subdivided in areas. This led to the description of each point by a letter referring to the zone and a number referring to an area within the zone.
“The World Health Organization (WHO) recognized it in 1987 and developed its first International Nomenclature in 1990 (Fig. 1). Its continuous development currently requires an update of its international standardization.
“The universal nomenclature we proposed is a biomathematical model of the brain neuroanatomic organization, on which the ear pavilions are connected. It was ratified by the World Federation of Chinese Medicine Societies (WFCMS) during its 8th Convention in London, on September 2 and 3, 2011, with the actual participation of Dr. Qi Zhang, MD, Coordinating of the Traditional Medicine Department, at the WHO.”
“The number of AAPs, in proportion to constant discoveries of neurophysiology, never stops growing. This increase presents a major problem: the first classification has become insufficient and unfit. In fact, dating back to more than 20 years, it can no longer report the quasi doubling of the number of points, resulting from the progress of the neurophysiological knowledge.
“Most authors who publish on the topic make several remarks:
• they confirm the pluripotency of points (‘one point for several diseases, or one disease with several points’), while noticing a precise location of points is the key of efficiency and of its world distribution,7
• they lament the diversity of used mappings and nomenclatures, and the lack of universal standardization, acting as a brake to the development of the discipline,8,9
• or they regret the time spent to try and find the point location, on account of a lack of clarity and accurate and universal classification.10
“Others try to redefine the anatomic limits of ear pavilions, in the hope of discovering a new nomenclature.11 Finally, others, by reviewing the indications and action mechanisms of auricular acupuncture, denounce the lack of international nomenclature, which may adapt to with any mapping whatsoever. Finally, the ultrastructural nature specifies targets reached by the contact with ear reflex zones,12,13 the power of their action,14–16 their specific electrophysiological characteristics,17 and the extent of age of patients who may benefit from possible auriculotherapy,18–20 rendering absolutely necessary the publication of an international nomenclature of auriculotherapy zones.
“All the more so as current nomenclatures do not enable to locate precisely all zones of the modern scientific auricular mapping! For instance, the ‘AH8' location of the current standardization of WFAS and WFCMS, is called ‘abdomen,’ yet modern scientific data locate this zone at the basis of 2 hemi-concha and locate in this ‘AH8' area no <8 points!”
“The French Academic Scientific School of Auriculotherapy, which I have the honor to run, identifies more than 190 zones: it is impossible to place them in the current nomenclatures!”
“The analysis of brain dissections, made by one of our students, an anatomist, Mr. Jean Castellier, MD, showed us that the middle of the corpus callosum was the epicenter of the somatotopic organization of the brain homunculus (Fig. 2) and the latter was divided into 20 segments.25,26
“At the same time, we proved the neurophysiological correlations existing between auricular displays and their brain correspondences.27,28
“We used all these data to finalize ‘Auriculogram,’ the Universal Nomenclature we proposed to the WFCMS is based on neuroembryological and neurophysiological data.24–33
“We calculated the ideal angle of this auriculogram, by taking as a base is the anatomic structures of the ear which are constant in all human beings. Our works led us to record that the ties of the helix knee and the lobule to the face are always aligned on a perfect straight line, which always goes through the auricular representation of the corpus callosum (Fig. 3).”
“This International Auriculotherapy Nomenclature, approved by the WFCMS, allows 57 countries (Europe, America, China, and Russia) and 195 societies to be represented. It allows homogeneity in the education, research, and publication fields; gives accurate Cartesian marks; and is able to receive any mapping whatsoever. It will facilitate the work of auriculotherapists and allow a scientific progress of the subject worldwide.”
