EAR ACUPUNCTURE (version 5) Page 1

EAR ACUPUNCTURE Acupuncture: A Comprehensive Text from Shanghai College of Traditional Medicine

A large number of sites have been identified on the ear which become spontaneously tender or otherwise react to the presence of disease or injury elsewhere in the body. Stimulation of these ear points in turn exerts certain therapeutic effects on those parts of the body with which they are associated. The range of indications in ear acupuncture is broad, the method is relatively simple and economical, and there are few side effects.

DEVELOPMENT

The theoretical origins of auriculotherapy derive in the first instance from classical descriptions of the pathways of the channels.

6 Yang Channels traverse or skirt portions of the ear, either directly or through a branch channel

6 Yin Channels indirectly linked through their Inner/Outer relationships with the Yang channels

Among the Miscellaneous channels, the Yin and Yang Heel channels as well as the ______channel have connections with the ear.

POP QUIZ Three Primary Channels enter the Ear = ______, ______, ______

Channel Pathology (Handbook p.107)

SI SJ GB deafness deafness, tinnitus

Similarly, traditional medical literature abounds with references to the close relationship between the ear and specific Organs.

Spiritual Axis Ch. 28 “All the vessels congregate in the ear.” 靈樞(영추) Ch. 17 “The Kidney Qi communicates with the ear.” Ch. 4 “The opens at the ear.” Simple Questions “As for diseases of the liver... when there is Deficiency, the ears cannot hear... when the Qi is 素問(소문) Ch. 22 rebellious, there are and the ears are deaf.”

There are traditional references to treating certain diseases by direct manipulation of the auricle. The famous Tang Dynasty physician, Sun Simo, in his Thousand Ducat Prescriptions, recommended that a site corresponding to the modern Lower Abdomen point above the opening of the external auditory meatus be needled or warmed with moxa to treat jaundice and Cold contagious diseases most common in the summer.

The Ming Dynasty classic, Great Compendium of Acupuncture and Moxibustion, prescribed that moxa be burned at the apex of the ear to treat membranes on the eye. In addition, there are prescriptions in traditional folk medicine for treating redness of the eye by pricking the ear lobes or by letting blood from the posterior auricular vein in the treatment of and redness in the eye. The ear lobes were pulled upward as one means of coping with , or massaged in the treatment of infantile convulsions.

Lower Abdomen Ear Apex Ear Lobe

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Although it is true that many of the channels cross the ear and there are several important acupuncture potions around its perimeter, ancient practitioners did not place even one of the 365 traditional points on the auricle itself. Furthermore, although traditional Chinese doctors, like their Western counterparts, noted the relationship between diseases of the Organs and manifestations of the ear, these were by and large symptoms of the middle and inner ear such as tinnitus, deafness and vertigo rather than alterations on the auricle itself.

As a comprehensive system of diagnosis and treatment, however, ear acupuncture is of recent origin. A French physician by the name of Nogier, writing in a German acupuncture periodical in 1957, first drew serious attention to the correspondences between specific sites on the auricle and other parts of the body. After years of careful observation relating points of tenderness, reduced electrical resistance, morphological and coloration changes on the ear to disease elsewhere in the body, more than 200 sites were charted on the auricle by Chinese medical workers. Ear acupuncture is not only effective in the treatment of a wide range of common diseases, it can also be used with good results in the treatment of difficult diseases or as an during surgery.

French System German System Chinese System Frank Bahr and Beate Stritmatter Paul Nogier (1908‐1996) Adopted from French mapping discovered the frequency system and Created the first mapping of the ear system and developed lasers to treat conditions

LOCATION AND FUNCTION OF THE EAR POINTS

Surface Anatomy of Auricle Innervation of Auricle

Images from Acupuncture A Comprehensive Text Shanghai College of Traditional Medicine p.473

Unlike most traditional acupuncture points on the body, the ear points have been named according to their associated anatomical position or pathologic indications, e.g., the point or the Hepatitis point. Because their arrangement on the ear often parallels the anatomy of a fetus, the location of many of the principal points is relatively easy to learn. About 180 auricular points together with their primary indications are shown in “Acupuncture A Comprehensive Text Shanghai College of Traditional Medicine.” It is important to remember that because of the differences among ears on different individuals, the locations of the points vary somewhat from person to person.

Handbook p.297

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Most significant when exploring for the point are sites which are unusually sensitive or appear abnormal. ‘Point’ is perhaps a poor choice of words to describe a site which more often has a spatial dimension much larger than the head of a pin. Nevertheless, if a physician is unable to find an alteration in the region of the ear associated with the disease, he may still needle the ‘point’ he has learned here.

Surface Anatomy of Auricle Distribution of Auricular Points

Ear Body

Lobule Head and facial region

Scapha Upper limb

Superior & Inferior crus Lower limb

Antihelix Trunk

Cavum & Cymba conchae Internal organ

Handbook p.297

POP QUIZ Match the body areas to the correct auricular region. Shoulder, Elbow, Wrist, Fingers ■ □ Cavum conchae

Brain, Vertigo, Parotid Gland ■ □ Cymba conchae

Lung, Heart, Spleen ■ □ Scapha

sa Kidney, Liver, Colon ■ □ Antitragus

Tongue, Eye, Ear, Face ■ □ Triangular fossa

Neurogate, Uterus, Constipation ■ □ Lobule

Hip, Knee, Ankle, Heel ■ □ Inferior crus

Sacrum, Buttocks, Sciatic nerve ■ □ Superior crus

Ear Apex, Hemorrhoid, Anus ■ □ Helix

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SELECTION OF POINTS

The following methods should be considered when selecting points for a specific disease.

Point Selection Methods Examples According to the associated anatomical location of  Stomach point for stomach ache the disease  Elbow point for pain in the elbow According to Western physiological and pathological  Endocrine point for irregular menstruation relationships  Sympathetic and Cerebrum points for ulcers  Liver point for eye diseases (because the Liver is said to 'open' at the eyes) According to concepts of TCM  Lung point for cutaneous diseases (because the control the skin) According to points of clinically proven  Parotid Gland point for neurodermatitis effectiveness (i.e., points whose functions are varied or whose  Pricking the Ear Apex point to treat fever name bears little if any relation to the disease.)

The examples cited above chart are illustrative of the principles which should be considered when selecting a point. Usually, more than one point is chosen.

METHODS

Methods previously introduced for regular acupuncture points on the body such as simple needling, embedding or warming the needle, electro‐ and injection acupuncture, as well as moxibustion and blood letting can all be used on the ear. Below are some special considerations for auriculotherapy.

1)Once the point has been located, apply the head of the needle at the point, leaving a mark that can be found for inserting the needle. Then clean the area with alcohol. 2) Usually a #28 gauge needle, half an inch in length is used on the ear (larger and thinner needles tend to fall out). The needle is inserted with a quick motion to a depth of approximately 0.1 inch, reaching but not penetrating the ear cartilage. The needle is then twirled a few times to elicit the Qi sensation characteristic of acupuncture. The needle is usually retained, depending on the disease, from 30‐60 minutes. For certain acute, inflammatory or painful diseases as well as those characterized by seizures, the needle may be retained for longer periods (up to 2 hours). While the needle is in place it should be manipulated once every 5‐10 minutes. NEEDLING 3) Treatments are given once a day or on alternating days. Ten treatments is considered an average course, although most chronic diseases may require from 10‐20 treatments (acute cases, 5‐10). If another course or cycle of treatments is necessary, 5‐15 days should be allowed to elapse in between. 4) Unlike acupuncture on the body, needling the auricle often causes pain in addition to the characteristic sensations of soreness, distension, warmth, heaviness and perhaps numbness. 5)It is preferable to use only a few (3‐5) points at a single session. Usually only points on one ear corresponding to the side of the disease are selected, although in a minority of cases the opposite ear or both ears are used. 6)If the needle is inserted transversely, it is possible to join two or more neighboring points.  Special intradermal ear needles or tacks can be embedded in ear points and held in place with adhesive tape, usually from one day to a week or more. While in place, the patient should be instructed to press them several times each day so as to stimulate underlying tissues. The ear will otherwise adapt itself to the needle's pressure. Embedding the Care must be exercised to see that the ear is kept clean during this period so as to avoid infection. During hot needle weather or if the patient is engaged in strenuous physical activity, it is best not to use this method.  Embedding is utilized for certain chronic diseases, or diseases with repeated seizures. However, it is not considered as effective as regular needling.  Moxibustion (usually above the inserted needle) may be used in cases of chronic rheumatic or Cold diseases, if Moxibustion the physician so desires. Usually 3‐5 minutes of moxa warmth is sufficient.  Pricking auricular points with the tip of a surgical knife or pyramid needle to let blood is a common technique Pricking in the treatment of certain acute inflammatory diseases. Usually 3‐5 drops of blood is sufficient, once a day, with 3‐5 visits constituting a course of treatment Electro‐  When electrical stimulation is used for ear acupuncture, usually only two needles are utilized. The level of acupuncture stimulation is raised to the patient's tolerance and continued for 15‐30 minutes. Injection  Various substances are injected in amounts ranging from 0.1‐0.3 ml., daily or on alternating days. Indicated for therapy pulmonary tuberculosis, bronchial asthma, and

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Needling Ear Seed

Pricking Electro‐acupuncture

OTHER CONSIDERATIONS

 When the ear needles are in place there is usually a sensation similar to that of an insect bite (local soreness, warmth and distension). If this sensation is absent, it is generally believed that the effects of the treatment will be negligible. 1  For this reason, once the needle is in place, it should be manipulated from time to time so as to restore the needle sensation.

 If, while the needle is retained, there is suddenly pain at a location unrelated to the disease, the angle or position of the 2 needle can be changed slightly and the reaction should disappear.

 As with all medicine, proper diagnosis is essential in identifying the fundamental source of a disease. 3  If points are selected which only affect superficial symptoms, the physician may find that the patient shows some relief at first but no further improvement despite continued treatment.

 Similarly, although a patient may respond well to initial treatment and his condition appear to have been cured, he should 4 be encouraged to continue treatments through the duration of the recommended course.

 A physician should not be discouraged if, after apparent success, the condition returns. 5  Studies have shown that the condition is rarely as severe the second time, indicating that some progress has been made.

 Strict measures must be taken to assure that the ear is properly cleaned both before and after treatment Auricular 6 infections are quite serious and stubborn to cure.

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FINDING POINTS ON THE AURICLE

Examination of the ear can serve either as an aid in diagnosis, or, having already diagnosed a disease and selected appropriate points, examination can help to pinpoint the most sensitive or tender site within the selected area There are three general methods of finding the points:

Direct examination Probing Measuring electrical resistance

 The physician looks for alterations in the color or morphological changes on the surface of the skin. The ear should not be cleaned or otherwise disturbed prior to the examination.  Alterations which may be caused by disease should be distinguished from scars, marks, or diseases (boils, ulcers, etc.) which are purely local in nature. Often, the latter do not respond painfully to pressure and show no reduction in electrical resistance.  The site of an alteration may directly correspond to a pathologic change in the organ with which it is associated, or it may be related indirectly to a disease in a body system or through traditional Inner/Outer connections between important Organs.  Both ears should be examined, and features compared. The thumb and index finger can be used to palpate for Direct differences in thickness, ridges, etc., on the surface of the ear. The age, environment, and occupation of the examination patient must be taken into consideration before drawing any conclusions from the ears. Signs of Positive Response  The area has a different color than the surrounding region—either more pale, redder, or darker. If Color changes the color does not change upon pressure, then it is not a 'positive response' point (Le., the color is an intrinsic property of the area). Shape changes  The area may have a nodule, strand, protuberance or depression. Rashes  Often there is a white or red macular rash, or a small blister in the area  Normal wax or dirt accumulations in the ear are easily wiped away and have no significance. When Accumulations the accretions are not easily wiped away, they may be signs of a 'positive response' point

 Use a blunt‐tipped probe or head of a pin to lightly press against a site which the physician has determined through diagnosis to be related to a certain disease. The most tender spot, often quite painful, is the point used for therapy. Care must be taken to see that all points are probed with uniform pressure and for a similar length Probing of time, long enough for the patient to make a comparative judgment  If points of tenderness cannot be found, the physician may still needle those sites on the ear associated with the illness.

 A special electrical probing device, often included as an accessory on electro‐acupuncture machines, may be used to measure changes in the electrical resistance of the skin at various sites on the ear. Points at which the electrical resistance is significantly lower than other points are selected for therapy since this often indicates disease in the related Organ or region of the body. The probe is simple to use and the method is by and large painless.  The ear should be cleaned with alcohol and allowed to dry before beginning. The examination should take place in a quiet room. Electric current is adjusted to the individual patient by placing the probe on the Spinal Cord point at the back of the auricle and increasing the current until there is a slight stinging sensation. Measuring  There are several factors which have a considerable influence on the electrical resistance of the ear, including electrical changes in the weather (resistance greater in cold weather), age (younger people whose ears are more moist and soft have a lower resistance electrical resistance), and location (the Uterus, Bladder, Large Intestine, Esophagus, Triple Burner, and Endocrine points usually have low resistance; likewise, areas where overlying skin is relatively soft usually have a somewhat lower electrical resistance than more 'exposed' and less soft areas, e.g., the helix and tragus.) These factors must be kept in mind and compensated for in practice. Areas with typically lower electrical resistance are pressed with less force than those which are predictably higher.  Finally, if one point is probed repeatedly, or pressed too long, it will become tender and the electrical resistance will decline, causing it to be misinterpreted as a point for therapy.  It should be remembered that the physician is measuring a relative difference so as to discover those points which react most to a disease and whose manipulation might in turn be expected to affect that disease most significantly. It is not an absolute measurement, and other methods of observation should not be neglected.

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Images are from “Acupuncture: A Comprehensive Text from Shanghi College of Traditional Medicine” p.478

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HELIX AND HELIX-CRUS 耳輪(이륜)

NAME LOCATION INDICATIONS MIDEAR Center of crus of helix Indications not listed Spasm of diaphragm, hemorrhage, pruritis, hemorrhagic skin DIAPHRAGM On crus of the helix disorders, hemotological diseases BRANCH On crus of helix, midway between Bladder and Brain points Usually used for incontinence NERVOUS Superior aspect of crus of helix Indications not listed DYSFUNCTION DISTAL SEGMENT On helix, almost level with Large Intestine point on the cymba Hemorrhoids, anal fissure, prolapsed anus, dysentery, enteritis, RECTUM conchae constipation URETHRA On helix, level with Bladder point on the cymba conchae Urinary tract infection, incontinence On helix, midway between Distal Segment Rectum and Urethra ANUS Hemorrhoids, anal fissure, prolapsed anus, itching around anus points Sexual dysfunction, inflammation of scrotum or penis, EXTERNAL GENITALIA On helix, level with inferior crus of antehelix cervicitis, low , On the margin of helix, slightly anterior to superior margin of COMMON COLD Common Cold (Prick point) superior crus of antehelix HEMORRHOIDS On helix bordering lateral margin of triangular fossa Hemorrhoids, anal fissure  Prick point for fever, inflammation, hypertension, revival When ear is bent toward tragus, this point can be found at tip of EAR APEX from hepatic coma, or for analgesic or sedative effect. fold on superior aspect of helix  Moxibustion for keratitis TONSIL #1 On helix, posterior to Ear Apex point TONSIL #2 On helix, level with the Shoulder point of the scapula TONSIL #3 On the 'tail' of the helix Tonsillitis, Pharyngitis Six points evenly spaced along helix from inferior margin of HELIX #1‐6 Darwin's tubercle to inferior margin of ear lobe LIVER YANG #1 Superior border of Darwin's tubercle Chronic hepatitis LIVER YANG #2 Inferior border of Darwin's tubercle

Which technique is used on the Ear Apex for fever, inflammation, hypertension, revival from hepatic coma, or for an analgesic or sedative effect? A. Electro acupuncture B. Ear Seed C. Pricking D. Moxibustion

Which technique is used on the Ear Apex for keratitis (corneal inflammation)? A. Electro acupuncture B. Ear Seed C. Pricking D. Moxibustion

Which technique is used on the Common Cold point? A. Electro acupuncture B. Ear Seed C. Pricking D. Moxibustion

What are the common indications of Hemorrhoids, Anus, and Distal Segment Rectum points? A. hemorrhoid, anal fissure B. itching around anus C. dysentery, enteritis, constipation

What is the common indications of Helix #1‐6 and Tonsil #1‐4? A. sinusitis B. tonsillitis, pharyngitis C. chronic hepatitis

Which auricular point is located on the crus of the helix and is used to treat hemorrhage, hemorrhagic skin disorders, pruritis, and hemotological disease? A. Branch B. Midear C. Nervous Dysfunction D. Diaphragm

What is the common indication for Urethra (on helix) and Branch (on crus of helix)? A. urinary tract infection B. incontinence C.spasm of diaphragm

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SCAPHA 舟狀窩(주상와)

NAME LOCATION INDICATIONS FINGERS On scapha, above Darwin's tubercle Pain or hindered movement of finger joints WRIST On scapha, level with prominence on Darwin's tubercle Pain or hindered movement of the wrist ELBOW On scapha, midway between Shoulder and Wrist points Pain of elbow joint SHOULDER On scapha, level with supratragic notch SHOULDER JOINT On scapha, midway between Shoulder and Clavicle points Pain or hindered movement of shoulder SHOULDER PAIN On scapha, superior and medial to Shoulder Joint point CLAVICLE On scapha, level with point on antehelix Diseases of clavicle Swelling of subaxillary lymph glands and other diseases of this AXILLA On scapha, above Shoulder Pain point region APPENDIX #1 On scapha, midway between the Toe and Finger points APPENDIX #2 On scapha, midway between Shoulder and Elbow points Appendicitis APPENDIX #3 On scapha, medial and inferior to Clavicle point CHEST WALL On scapha, above Shoulder Joint point Pain of chest and , gallstones On scapha, above Shoulder point on border of antehelix and ABDOMINAL WALL Abdominal pain, pain in hypochondriac region, renal colic scapha ALLERGY On scapha, medial to Wrist point Allergic diseases Lateral an inferior to the Clavicle point, in the depression on NEPHRITIS Nephritis, pyelonephritis lower margin of scapha Regulates function of thyroid gland; May also be used in THYROID #1 On border of scapha, lateral to Neck point on antehelix shock to raise blood pressure

The Allergy point is located on the scapha, medial to the ______point which is level with the prominence on Darwin’s tubercle. A. Finger B. Wrist C. Elbow D. Shoulder

Which of the following points is located on the scapha, level with supratragic notch? A. Shoulder Pain B. Shoulder Joint C. Shoulder

Which of the following points is located on the scapha, midway between the Toe and Finger points? A. Appendix #1 B. Appendix #2 C. Appendix #3

Thyroid #1 is located on? A. Tragus B. Antehelix C. Scapha

What is the indication for the auricular point located lateral and inferior to the Clavicle point, in the depression on lower margin of scapha? A. allergic disease B. nephritis, pyelonephritis C. hemorrhoid

Which of the following auricular points can be used if Finkelstein’s test positive? A. Wrist B. Elbow C. Shoulder

Which of the following auricular points can be used if Cozen’s test positive? A. Wrist B. Elbow C. Shoulder

Which of the following auricular points can be used if Hwakins‐Kennedy test positive? A. Wrist B. Elbow C. Shoulder

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ANTEHELIX CRUS (SUPERIOR AND INFERIOR) 對輪脚(대륜각)

NAME LOCATION INDICATIONS HEEL On the medial, superior angle of superior crus of antehelix Pain or functional hinderance of the heel On the medial, superior angle of superior crus of antehelix ANKLE Pain or functional hinderance of the ankle (below Heel point) TOES On the lateral, superior angle of superior crus of antehelix Pain or functional hinderance of the toes On the superior crus of antehelix, level with superior border of KNEE inferior crus of antehelix Pain or functional hinderance of the knee On the superior crus of antehelix, 1/3 the distance from the KNEE JOINT Ankle to the Knee point On the superior crus of antehelix, 1/3 the distance from the HIP JOINT Pain or functional hinderance of the hip Knee to the Ankle point On the superior crus of antehelix, medial and inferior to the GASTROCNEMIUS Pain or functional hinderance along the gastrocnemius muscles point POPLITEAL FOSSA On the superior crus of antehelix, medial to the Knee point Pain or functional hinderance in the popliteal fossa HOT On antehelix, directly below the Popliteal Fossa point Low‐grade fever LOWER ABDOMEN On antehelix, lateral and inferior to the Knee point Pain of lower abdomen Slightly lateral to mid‐point on superior margin of inferior crus BUTTOCKS Pain of hip and sacroiliac joints, atrophy of gluteal muscles of antehelix SCIATIC NERVE Slightly medial to mid‐point on superior margin of inferior crus Sciatica (ISCHIUM) of antehelix  Used for numerous diseases related to disruption in autonomic (both sympathetic and parasympathetic) nervous system  Strong analgesic and relaxant effect upon internal organs. (esp. for relieving pain associated with ulcers, stomach spasm, At the intersection of the superior border of the inferior crus of SYMPATHETIC roundworm in bile duct, gall and urethral stones) antehelix and the medial border of the helix  Dilates blood vessels  Useful in treating circulatory and ophthalmological diseases, and excessive sweating.  Important point of anesthesia

A patient reports pain, tingling, and numbness in the right buttock. He states that pain extends down through the sciatic nerve. The patient was diagnosed with Piriformis syndrome. Which part of the ear likely to be tender on palpation by probing? Superior crus of antehelix B. Inferior crus of antehelix C. Triangular fossa

Which of the following is NOT a function of the Sympathetic point? A. Constrict blood vessels B. Strong analgesic C. Relaxant effect upon internal organs

The Sympathetic point is used for? A. Sympathetic disruption B. Parasympathetic disruption B. Both A and B

Which of the following points is used for baker’s cyst? A. Hot B. Hip Joint C. Popliteal fossa

What is the indication for the point located in the superior crus of the antehelix, 1/3 the distance from the Ankle to the Knee point? A. Knee arthritis B. Hip arthritis

Which point is located on the superior crus of the antehelix, 1/3 the distance from the Knee to the Ankle point? A. Knee Joint B. Hip Joint

What is the indication for the point located on the medial, superior angle of superior crus of antehelix? A. Morton’s neurom B. Sprained ankle C. Plantar fasciitis

Point on antehelix directly below the Popliteal Fossa point can be used with? A. High fever B. Low‐grade fever

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ANTEHELIX 對輪(대륜)

NAME LOCATION INDICATIONS  These vertebral points are found along the curved, medial margin of the antehelix from a point level with the Urethra point (above) to Shoulder SACRAL, LUMBAR, Joint point (below). Each segment corresponds to pain or THORACIC AND  The curved line can be divided into four segments each corresponding to dysfunction along that part of the spine CERVICAL VERTEBRAE one of the vertebral groupings, from the Sacral (above) to the Cervical (below) On the prominence of the antehelix, level with Distal Segment of Rectum point Lower back pain LUMBAGO Near medial border of antehelix, level with Lumbar Vertebrae point Acute lower back sprain, chronic ABDOMEN (A) On the antehelix, level with the inferior border of the inferior crus of antehelix Pain of mid or lower abdomen ABDOMEN (B) On antehelix, between Lumbar Vertebrae and Chest points Pain of upper abdomen Intercostal , soreness of depressed CHEST () On antehelix, level with supratragic notch sensation in chest MAMMARY GLANDS Two points on antehelix, both below Chest point, one medial, the other lateral Acute mastitis, lumps in the breast NECK In notch at the intersection of the antehelix and antitragus Pain or dysfunction of the neck Regulates function of thyroid gland; May also THYROID #2 On medial margin of antehelix, medial to Neck point be used in shock to raise blood pressure (same as Thyroid #1)

What is the indication for the point located in notch at the intersection of the antehelix and antitragus? A. B. Intercostal neuralgia C. Lower back pain

Which of the following points is used for upper abdominal pain? A. Abdomen (A) B. Abdomen (B)

A patient suffers from an infection of the tissue of the breast during the time of breastfeeding. Which of the following auricular points can be used? A.On the prominence of the antehelix, level with Distal Segment of Rectum point B. Near medial border of antehelix, level with Lumbar Vertebrae point C. On antehelix, between Lumbar vertebrae and Chest points D. Two points on antehelix, both below Chest point, one medial, the other lateral

What is the point located on medial margin of antehelix, medial to the Neck point? A. Thyroid #1 B. Thyroid #2 C. Thyroid #3

Thyroid #4 is located on which part of the ear? A. Scapha B. Antehelix C. Cavum conchae D. Tragus

Thyroid #1 Thyroid #2 Thyroid #3 Thyroid #4 Scapha Antehelix Cavum conchae Tragus

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TRAGUS 耳舟(이주)

NAME LOCATION INDICATIONS EXTERNAL EAR In depression slightly anterior to supratragic notch Tinnitus, deafness HEART (HT) Ⓐ On tragus, posterior and inferior to External Ear point Tachycardia, arrhythmia, and other heart disorders TRAGUS APEX The prominence on superior part of tragus Inflammation, fever, hypertension, pain (in general), Prick point

 Functions to stimulate adrenalin and adrenocortical hormones  Used for inflammation, allergies, shock, rheumatism and serious At the prominence on inferior part of tragus (if the ear poisoning symptoms resulting form bacterial infection ADRENAL has only one such prominence, the point is on the  Affects the dilation and constriction of blood vessels, hypertension and inferior border) hypotension, capillary hemorrhage  Regulates excitation or inhibition of respiratory function  Used for fever, certain skin diseases, and chronic illnesses EXTERNAL NOSE At the middle of the anterior aspect of the tragus Brandy‐nose THIRST Above External Nose point on tragus Relieves thirst, diabetes, polyuria HUNGER Below External Nose point on tragus Relieves hunger, diabetes, compulsive eating CLEAR NOSE/EYES Behind Thirst point on tragus Acute and chronic rhinitis, eye inflammation HYPERTENSION Below Hunger point on tragus Hypertension THROAT On upper half of medial aspect of tragus Acute and chronic laryngitis, hoarseness, tonsillitis, edema of the uvula INNER NOSE On lower half of medial aspect of tragus Rhinitis, nosebleed Regulates function of thyroid gland; May also be used in shock to raise THYROID #4 Lateral and superior to Throat point on tragus blood pressure (same as Thyroid #1)

Where is the location of Adrenal point? A. The prominence on superior part of tragus B. The prominence on inferior part of tragus

For the people who have an ear with one prominence of the tragus, what is the location of the Adrenal point? A. On the superior border B. On the inferior border

Which of the following is NOT a function of the Adrenal point? A. Functions to stimulate adrenalin and adrenocortical hormones B. Used for inflammation, allergies, shock, rheumatism and serious poisoning symptoms resulting form bacterial infection C. Regulates excitation or inhibition of respiratory function D. Used for fever, certain skin diseases, and chronic illnesses E. Used for hypertension and contraindicated for hypotension

Which of the following points is used to relieving hunger, diabetes, and compulsive eating? A. Above External Nose point on tragus B. Below External Nose point on tragus

Which of the following points is used for hypertension? A. Above Thirst point on tragus B. Below Hunger point on tragus

Which of the following points is used for Atrial fibrillation? A. On tragus, posterior and inferior to External Ear point B. Above External Nose point on tragus C. Below External Nose point on tragus

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ANTITRAGUS 對舟(대주)

NAME LOCATION INDICATIONS FOREHEAD On anterior, inferior part of antitragus Frontal headache, rhinitis  Used for neuropsychiatric disorders and symptoms due to meningeal irritation: convulsions, locked jaw, stiffness along nape of neck, OCCIPUT On posterior, superior part of antitragus psychosis, etc.  Also useful in preventing motion or sea sickness  Used for various skin and eye diseases, inflammation, pain, shock TEMPLE On antitragus, between Forehead and Occiput points Headache at the temple, migraine headache, vertigo, lassitude On antitragus, between and below Temple and Occiput VERTEX Headache at the vertex, vertigo points At apex to angle of antitragus (if angle unclear, mid‐point  Regulates excitation or inhibition of respiratory center STOP WHEEZING on medial border of antitragus  Used for coughing, panting, and/or itching  Parotitis, obstruction of parotid ducts PAROTID GLAND On antitragus, medial to Stop Wheezing point  Relieves itching symptoms of many skin diseases  Regulates excitation or inhibition of the cerebral cortex On antitragus, between Stop Wheezing and Brain Stem BRAIN  Used for disease of nervous, digestive, endocrine, and urogenital points systems; hemorrhage  Disorders of the cerebral blood vessels and meninges (e.g., On the border of the lower segment of the antitragus, near apoplexy, hemiplegia, convulsions, stiffness along nape of neck, etc.) BRAIN STEM Neck point  Also used for sequelae of cerebral shock, incomplete development of the brain VERTIGO On antitragus, between Brain point and Brain Stem point Aural vertigo, prevents motion sickness THROAT & TEETH On antitragus, superior and posterior to Occiput point , swelling of gums, pharyngitis, tonsillitis VISION #1 Inferior and anterior to the intertragic notch Glaucoma, atrophy of optic nerve, diseases below the eyes VISION #2 Inferior and posterior to the intertragic notch Astigmatism and other ophthalmological diseases  Regulates disturbance of endocrine function, aids in metabolic function of absorption and excretion At the extreme anterior portion in the bottom of the ENDOCRINE  Has antiallergic and antirheumatic function intertragic notch  Used for gynecological and urogenital diseases, for dysfunction of the digestive system, blood and skin diseases, malaria Irregular menstruation, painful menstruation, infertility, developmental OVARIES On anterior, inferior part of the inner wall of the antitragus gynecological disorders  Regulates excitation and inhibition of cerebral cortex  Often used for insomnia, lassitude and other neuropsychiatric SUBCORTEX On anterior side of the inner wall of the antitragus disorders  Also for inflammation, excessive sweating, and pain HORMONE On medial side in the bottom of the intertragic notch Inflammation, allergies, shock, rheumatism TESTICLES On superior part of inner wall of antitragus Sexual dysfunction, orchitis, eczema of scrotum EXCITATION On inner wall of antitragus below Testicles point Narcolepsy, depression, emotional withdrawal On inner wall of antitragus, below and posterior to Facial nerve paralysis, severe muscle weakness, oculomotor nerve NERVE Excitation point paralysis On inner wall of antitragus, below and posterior to Nerve TOOTHACHE Toothache point  Regulates function of pituitary  Used for dwarfism, acromegalic gigantism, polyuria PITUITARY At the bottom of inner wall of antitragus  Also used for shock, improper contraction of uterus after childbirth, sexual dysfunction, and disease resulting from disturbances of endocrine function

Which of the following points can be combined with the Toothache point for treating a toothache? A. Maxilla + Mandible + Tragus Apex B. Inner Nose, Adrenal, Endocrine

The Brain + Subcortex + Occiput + Neurogate + Heart + Kidney + Stomach combinations is used for: A. Hypertension B. Epilepsy C. Hyperthyroidism

Which of the following combinations is used for diabetes mellitus with frequent urination? A. Endocrine + Lung + Thirst B. Endocrine + Stomach C. Endocrine + Kidney + Bladder

Which of the following auricular point combinations is used for Epidemic Parotitis (Mumps)? A. Parotid gland + Face area + Subcortex B. Parotid gland + Lung + Kidney + Stop wheezing

The Eye + Vision #1 + Vision #2 + Liver combination is used for: A. Glaucoma B. Electric opthalmia C. Optic neuritis D. All of the above

Which of the following points is NOT used for Whooping Cough (Pertussis)? A. Lung B. Stop Wheezing C. Neurogate D. Sympathetic E. Brain

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TRIANGULAR FOSSA 三角窩(삼각와)

NAME LOCATION INDICATIONS Slightly above the parting of the two crura of the antehelix, in Obstetrical and gynecological diseases, sexual dysfunction in the UTERUS the triangular fossa male In the lateral angle of the triangular fossa near the intersection PELVIC CAVITY Pelvic cavity inflammation, painful menstruation of the superior and inferior crura of the antehelix

 Regulates excitation and inhibition of cerebral cortex  Sedative, analgesic, anti‐allergy effects NEUROGATE In the triangular fossa, medial and superior to the Pelvic Cavity  Neuropsychiatric disorder (hysteria, psychosis, etc), hypertension, (EAR‐SHENMEN) point coughing, allergic asthma, itching symptoms, and pain  Important point for anesthesia In the triangular fossa, between the Uterus and Pelvic Cavity WHEEZING Anti‐allergy, suppresses wheezing, bronchial asthma points In the triangular fossa, between the Wheezing and Pelvic HEPATITIS Acute and chronic hepatitis Cavity points HIP JOINT In the triangular fossa, below the Hepatitis point Often used for pain of lower limb joints or buttocks ADNEXA In the triangular fossa, lateral and inferior to the Uterus point Inflammation of the adnexa, painful menstruation CONSTIPATION In the triangular fossa, below the Adnexa point Constipation, bleeding from hemorrhoids LOWER BLOOD In the superior angle of the triangular fossa where the Hypertension, headache (due to hypertension) PRESSURE superior crus meets the helix (NEW) DISTAL At the inferior angle of triangular fossa where the inferior crus Enteritis, constipation, hemorrhoids, prolapsed anus SEGMENT RECTUM of the antehelix meets the helix In the triangular fossa, medial to Uterus point and near the Frequent and urgent urination, painful urination, incontinence, (NEW) URETHRA border of helix retention of urine (NEW) EXTERNAL In the triangular fossa, anterior and superior to Uterus point Sexual dysfunction, leukorrhea, excessive menstruation GENITALIA (NEW) PROXIMAL In the triangular fossa, above the (New) Urethra point Functional disturbance of the colon SEGMENT RECTUM

The Neurogate point is used for: A. Hypertension B. Skin itching B. Cough and Asthma D. Hysteria E. All of the above

Which of the following points is the BEST for inflammation of the fallopian tubes, ovaries, and ligaments? A. Uterus B. Urethra (New) C. Adenxa

Which of the following point at the triangular fossa is used for headache due to Liver Yang Rising? A. In the superior angle of the triangular fossa where the superior crus meets the helix B. In the triangular fossa, between the wheezing and Pelvic cavity points

Which of the following Auricular points is located in the triangular fossa, between the Wheezing and Pelvic Cavity points? A. Uterus B. Neurogate C. Hip Joint D. Hepatitis

Which of the following points is MOST suitable to be combined with ST36 + RN6 + DU20 + DU1 and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for prolapsed anus? A. Proximal Segment Rectum B. Distal Segment Rectum

Which of the following points is NOT an important point for anesthesia? A. Neurogate B. Sympathetic C. Relax Muscle D. Endocrine

Which of the following points is located at the bifurcation point between the superior and inferior antihelix crus, and at the lateral 1/3 of triangular foassa? A. Ear‐Shenmen (Neurogate) B. Uterus C. Constipation

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CONCHAE (CAVUM AND CYMBA) 耳甲介腔(이갑개강)

NAME LOCATION INDICATIONS On superior, posterior wall of the opening of the external MOUTH Ulcers in the mouth, stiffness in the temporomandibular joint meatus In the cavum of conchae, below Midpoint of the crus of Functional constipation of larynx, difficulty in swallowing due to ESOPHAGUS helix hysteria, belching In the cavum of conchae, below the crus of helix and Pyloric spasm, belching, constriction of diaphragm causing PYLORUS posterior to the Esophagus point regurgitation In the cavum of conchae, where the crus of helix Diseases of ST including indigestion, acute and chronic gastritis, STOMACH (ST) 'disappears' peptic ulcer, distension of ST, belching, insomnia, etc. In the cymba of conchae, above the ST point and posterior PROLAPSE Prolapse of the viscera to the Duodenum point DUODENUM In the cymba of conchae, between Prolapse and SI points Duodenal ulcer, pyloric spasm, hypoacidic ST SMALL INTESTINE (SI) In the cymba of conchae, above midpoint of crus of helix Indigestion, enteritis, distension of intestine by gas, heart disease In the cymba of conchae, above crus of helix, anterior to Enteritis, dysentery, diarrhea, constipation, hemorrhoids, diseases of LARGE INTESTINE (LI) SI point APPENDIX In the cymba of conchae, between LI and SI points Acute and chronic appendicitis COLON #1 In the cymba of conchae, between LI and UB points In the cymba of conchae, between Appendix and Ureter These 3 points treat allergic colitis, ulcer of the colon, intestinal COLON #2 points polyps, bleeding in lower digestive tract, diarrhea due to schistosomiasis In the cymba of conchae, between the Prostate and LI BLOOD BASE points Prostatitis, urinary tract infection, blood in the urine, painful PROSTATE In the cymba of conchae, medial to the UB point urination, spermatorrhea, premature ejaculation Cystitis, frequent and urgent urination, incontinence, retention of BLADDER (UB) In the cymba of conchae, above the LI point urine, enuresis, low back pain, neck pain

 Strengthening point, beneficial to the cerebrum, kidneys, and hematopoietic system  Used for incomplete development of brain, amnesia, neurasthenia, vertigo, headache, lassitude, nerve deafness, KIDNEY (KD) In the cymba of conchae, above SI point tinnitus, advancing deafness, loss of hair, diseases of the eyes, gynecological and urogenital system diseases, assists in bone mending, loose teeth, aplastic anemia, leukemia, edema, chronic pharyngitis, electrolyte imbalance, etc. URETER In the cymba of conchae, between UB and KD points KD stones, renal colic ASCITES In the cymba of conchae, above the SI points Electrolyte imbalance, ascites, cirrhosis of liver, intestinal adhesions Acute and chronic pancreatitis, diabetes, indigestion, pancreatic PANCREAS In the cymba of conchae, above Duodenum point diarrhea

 Used for relaxing muscles, and is important point in anesthesia RELAX MUSCLES In the cymba of conchae, posterior to ST point  Also for hepatitis and cirrhosis of LV LEFT HEPATOMEGALY Above Relax Muscle point and lateral to Prolapse point Hepatitis, enlargement of LV (hepatomegaly) AREA (approximately 5mm long and 2mm wide) Acute and chronic hepatitis, eye diseases, iron deficient anemia and other blood diseases, arthritic pain, neuralgia, headache, vertigo, ST LIVER (LV) In the cymba of conchae, above Left Hepatomegaly Area gas and pain, gas in the GI tract, hemiplegia, seizures, muscle spasms PANCREAS/GALL Indigestion, pancreatitis, diabetes, cholecystitis, GB stones, In the cymba of conchae, between LV point and KD point BLADDER (GB) roundworm in bile duct, chest and pain RIGHT HEPATOMEGALY In the cavum of conchae, between Relax Muscle and SP Hepatitis, enlargement of LV (hepatomegaly) AREA points (approximately 5mm long and 2mm wide) A straight line from Relax Muscle point to the Right Cirrhosis of LV due to schistosomiasis, as well as enlargement of SCHISTOSOMIASIS LINE Hepatomegaly Area in the cavum of conchae SP, diarrhea, indigestion Between ST point and Right Hepatomegaly Area in the HEPATITIS AREA Acute and chronic hepatitis cavum of conchae Indigestion, muscle atrophy (in general), blood diseases, abnormal Between Blood point and Right Hepatomegaly Area in the SPLEEN (SP) uterine bleeding, prolapsed anus, weakness following a disease, cavum of conchae prolapse of viscera, muscle weakness In the cavum of conchae, below the SP point and level BLOOD Hemorrhagic diseases with the Neck point

 Strengthens HT, anti‐shock, regulates blood pressure HEART (HT) Ⓑ In depression at the center of the cavum of conchae  Used for various mental diseases, HT diseases, glossitis, Buerger's disease, anemia

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UPPER LUNG (LU), Two points, one above and one below the HT point, near LOWER LUNG (LU) the center of cavum of conchae  Various respiratory system and skin diseases, rhinitis, mutism, night sweats, spontaneous sweating Posterior to and between the LU points, near the cavum LATERAL LUNG (LU)  Also used as analgesic points in acupuncture anesthesia of conchae Two points anterior to and between the LU points, near BRONCHI Acute and chronic bronchitis, asthma the center of cavum of conchae Between and below the Esophagus and Pylorus points, NEW EYE Ametropia, disease below the eye above the LU point TRACHEA Between and medial to the two Bronchi points Diseases of trachea Below Trachea point, above Bronchiectasis point, in the Hepatitis, tracheal disorders, diseases affecting mesentery or TRIPLE BURNER cavum of conchae peritoneum; diuretic function BRONCHIECTASIS Above Hormone point in the cavum of conchae Bronchiectasis Anterior and inferior to Pituitary point in the cavum of EMPHYSEMA Emphysema, wheezing conchae

 Various respiratory system and skin diseases, rhinitis, mutism, night sweats, spontaneous sweating LUNG (LU) Posterior to the Pituitary point  Also used as analgesic points in acupuncture anesthesia (Same as other LU points)

Which of the following auricular points is located on the Cavum Conchae? A. Duodenum B. Pancreas C. Liver D. Spleen

Which of the following auricular points is located on the Cymba Conchae? A. Right Hepatomegaly B. Left Hepatomegaly C. Hepatitis Area D. Hepatitis

Which of the following points is used for jaw pain, difficulty chewing as well as clicking and locking of the jaw joint? A. Eye B. Tonuge C. Mouth D. Inner Ear

Which three points are used together to treat allergic colitis? A. Colon #1 + Colon #2 + Blood Base B. Colon #1 + Colon #2 + Allergy

Which of the following points is used for allergic colitis (with Colon #1 and #2), ulcer of the colon, intestinal polyps, bleeding in lower digestive tract and diarrhea due to schistosomiasis? A. Blood B. Blood Base

Which point is located in the depression at the center of the cavum of conchae? A. Stomach B. Lung C. Tragus Apex D. Heart

The Triple Burner point is located in: A. the cavum conchae B. the cymba conchae

Auricular acupuncture has been used extensively in substance abuse treatment programs, hospitals, and prisons throughout the USA and the world for the past 40 years. In the mid‐1970s, a medical doctor at Lincoln Hospital in the South Bronx area of New York, modified an existing system of auricular acupuncture into a simple technique for the treatment of many common drug addictions as an alternative to methadone. This selection of ear points proved to be extremely effective in the treatment of addictions, and became what is now referred to as the “NADA (National Acupuncture Detoxification Association) protocol.” The points used in the NADA protocol are: A. Neurogate, Endocrine, Kidney, Liver, Lung B. Neurogate, Endocrine, Kidney, Liver, Large Intestine C. Neurogate, Sympathetic, Kidney, Liver, Lung D. Neurogate, Sympathetic, Kidney, Liver, Large Intestine

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EAR LOBE 耳垂(이수)

NAME LOCATION INDICATIONS If the earlobe from below the intertragic notch is divided by three parallel, 9 SECTIONS horizontal lines, then sub‐divided by two parallel vertical lines, the lobe will  be comprised of 9 sections (numbered left to right, top to bottom). EYE The Eye point is in section 5 Eye diseases TOOTH EXTRACTION One Tooth Extraction Anesthetic point is in section 1, and the other Tooth Toothache, anesthesia for tooth extraction ANESTHETIC Extraction Anesthetic point in section 4 NEURASTHENIA This point is between sections 1 and 4 Neurasthenia TONGUE This point is in the center of section 2 Glossitis, nervous aphasia

UPPER AND LOWER The Lower Palate point is in the anterior, superior part of section 2; and  These points are used for toothache, swelling PALATE the Upper Palate point in the posterior, inferior part of section 2 of gums, stiffness in TMJ, ulcers in the mouth, MAXILLA AND The Mandible point is at the top of section 3; the Maxilla point in the swelling of submaxillary lymph glands MANDIBLE lower part of section 3  Also anesthesia points for tooth extraction INNER EAR This point is in section 6 Aural vertigo, tinnitus, deafness TONSIL #4 This point is in section 8 Tonsillitis, pharyngitis An elongated region stretching between the Eye and the Inner Ear points Facial paralysis, spasms of facial muscles, FACE AREA on the earlobe trigeminal neuralgia, parotitis SPECIAL TUMOR AREA A line extending from Helix #4 to Helix #6 on the earlobe Definite analgesic effect for pain from tumors

In the auricular acupuncture, the ear lob will be comprised of ______sections. A. 3 B. 6 C. 9 D. 10

The Eye point is in section ____ of the earlobe in auricular acupuncture. A. 1 B. 2 C. 3 D. 5

Which section of the earlobe must be searched with probe for treating Meniere’s disease, vertigo, tinnitus, and deafness? A. 2 B. 4 C. 6 D. 8

Tooth Extraction Anesthetic points are composed of two points and they are used for toothache, before or after the dental procedure. Which two sections of earlobe consist of these points? A. Section 1 and 4 B. Section 2 and 5 C. Section 3 and 6 D. Section 7 and 9

Which of the following points can be used for the condition resulting from an exhaustion of the central nervous system's energy reserves which presents with fatigue, anxiety, headache, heart palpitations, high blood pressure, neuralgia, and depressed mood? A. Ear Apex, Tragus Apex, Liver, Heart, Spleen, Lung, Kidney B. Neurogate, Sympathetic, Subcortex, Endocrine, Heart, Kidney, Spleen

Shanghai CAM Neurogate, Subcortex, HT, KD, Endocrine Sympathetic, SP Brain, LV

Which of the following points can be used for Toothache? A. Tooth Extraction Anesthetic B. Maxilla and Mandible C. Tragus Apex and Ear Apex D. All of the above

Shanghai CAM Maxilla, Mandible, Tragus Apex Ear Apex

Which of the following area has an analgesic effect for pain from tumors? A. A line extending from Helix #1 to Helix #2 on the helix B.A line extending from Helix #4 to Helix #6 on the earlobe

Fill in the blank with the correct section number.

Raise BP Tongue, Palates Maxilla/Mandible Eye Inner Ear Tonsil #4 Section 1 Section ___ Section ___ Section ___ Section ___ Section ___

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BACK OF EAR 耳介背(이개배)

NAME LOCATION INDICATIONS LOWER BLOOD In trough along the backside of antehelix on the back of ear. This groove is Hypertension (prick point) PRESSURE GROOVE divided into Upper, Middle and Lower segments UPPER BACK On back of ear, on lower cartilaginous prominence MIDDLE BACK On back of ear, between Upper and Lower Back points Acute sprain of lower back, back pain; pruritus LOWER BACK On back of ear, on upper cartilaginous prominence VAGUS ROOT At midpoint on back of ear where the auricle intersects the mastoid process Diseases of internal organs SUPERIOR ROOT OF At intersection of superior border of auricle with the skin of face AURICLE Hemiplegia, hardening of funiculus lateralis spinalis INFERIOR ROOT OF At intersection of inferior border of auricle with the skin of face AURICLE SPINAL CORD #1 Posterior border of superior auricular root Muscle atrophy, paralysis SPINAL CORD #2 Superior border of inferior auricular root YANG LINKING Lateral and inferior to Vagus Root point, on back of ear Tinnitus

Which of the following points regulates parasympathetic control of the cardiac, respiratory, and digestive tract? A. Vagus root – At midpoint on back of ear where the auricle intersects the mastoid process B. Yang Linking – Lateral and inferior to Vagus Root point, on back of ear C. Vagus root – Lateral and inferior to Vagus Root point, on back of ear D. Yang Linking – At midpoint on back of ear where the auricle intersects the mastoid process

Which of the following auricular points is used for spinal cord injury? A. Superior Root of Auricle B. Inferior Root of Auricle C. Spinal Cord #1 and #2 D. All of the above

What is the indication of the point located on upper cartilaginous prominence on back of the ear? A. Upper Back pain B. Middle Back pain C. Lower Back pain

Upper Back Middle Back Lower Back on lower cartilaginous prominence between Upper and Lower Back points on upper cartilaginous prominence

The Lower Blood Pressure Groove in the back of the ear located: A. In the trough along the backside of Antehelix on the back of ear. B. In the trough along the backside of Scapha on the back of ear. C. In the trough along the backside of Cavum and Cymba Conchae on the back of ear.

What is the indication of the Auricular point located at the lateral and inferior to the Vagus Root point, on back of ear? A. Conjunctivitis B. Tinnitus C. Epistaxis D. Glossitis

Which of the following points is used for the tinnitus and deafness? A. External Ear B. Inner Ear C. Both A and B

Shanghai CAM External Ear, KD Inner Ear, Neurogate, Endocrine, Occiput LV

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PRECAUTION OF AURICULAR ACUPUNCTURE

 If sudden dizziness, nausea, stuffiness of the chest or other fainting symptoms occur during treatment, the patient should be 1 managed in the same manner as during ordinary body acupuncture  During initial visits, patients should be in a reclining position in order to avoid fainting

 STRICT ANTISEPSIS is necessary to avoid infection of the auricle  In case of inflammation or redness of the needle hole or distension and pain of the auricle, timely and appropriate measures 2 should be taken such as applying 2% iodine or oral administration of anti‐inflammation drugs  Needling is contraindicated if frost‐bite or inflammation is present on the auricle in order to avoid diffusion or inflammation

 Ear acupuncture is not advisable for WOMEN DURING PREGNANCY IF THERE IS A HISTORY OF MISCARRIAGE 3  Aged and weak patients with hypertension and arteriosclerosis should have proper rest before and after needling  While there are extensive indications for ear acupuncture, it still has its limitations 4  The therapeutic effects for some diseases are not satisfactory, or only symptomatic relief is achieved, therefore, in treating some disorders, it is necessary to combine some other therapies

TERMINOLOGY COMPARISON SHANGHAI VS. CAM

SHANGHAI CAM Adrenal Infratragic Apex Allergy Interior Tubercle Brain Middle Border Diaphragm Middle Ear Endocrine Intertragus Lower Blood Pressure Groove Groove of inferior Antihelix crus Neurogate Ear‐shenmen Parotid Gland Antitragic Apex Siactic Nerve Ischium Stop Wheezing Antitragic Apex Sympathetic End of inferior Antihelix crus Uterus Depression in Triangular Fossa Vagus Root Root of Auricular vagus Vision #1 Anterior Tragic Notch Vision #2 Posterior Tragic Notch

Ear acupuncture is NOT advisable for: A. women during pregnancy B. women during pregnancy if there is a history of miscarriage C. women with a history of miscarriage D. women during menstruation

What is the alternative name for Lower Blood Pressure Groove in auricular acupuncture? A. Groove of inferior antihelixs crus B. Infratragic Apex C. End of inferior Antihelix crus D. Root of Auricular Vagus

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EAR ACUPUNCTURE PRESCRIPTION Minibook (Source: Shanghai)

DISEASES EAR POINTS Amenorrhea Endocrine, KD, LV, SP, Neurogate, Subcortex Appendicitis Sympathethic, Neurogate Arthritis Sympathetic, Neurogate, Point of tenderness on the ear associated with the location of pain Aural Vertigo (Meniere’s Disease) Forehead, HT, Sympathetic, Neurogate, KD, Endocrine, Adrenal, Occiput Bacterial Dysentery LI, SI, Subcortex, Sympathetic, Neurogate Bronchial Asthma LU, KD, Adrenal, Sympathetic, Stop Wheezing (during an asthma attack) Bronchitis LU, KD, Stop Wheezing Buerger’s Disease Sympathetic, KD, Adrenal, LV, Endocrine, Occiput, HT, Subcortex, point corresponding to affected limb Cerebrovascular Accident (Stroke) KD, Brain Stem, Neurogate, HT, Occiput, Subcortex Chronic Sinusitis External Nose, Inner Nose, Adrenal, Endocrine, Forehead Coma HT, Subcortex, Neurogate, Brain, Sympathetic Common Cold LU, Bronchi, Inner Nose, Throat, Forehead Conjunctivitis Prescrip. 1: LV, Eye, Vision #2 / Prescrip. 2: Temple, Ear Apex, Lower BP Groove, Posterior auricular veins Convulsions Subcortex, Occiput, HT, LV, Neurogate (if there is high fever), Ear Apex (prick) Diabetes Mellitus Thirst: Endocrine, LU, Thirst / Hunger: Endocrine, ST / Frequent urination: Endocrine, KD, UB Disease Affecting the Soft Tissues of Shoulder Point of tenderness in the shoulder area of the ear, Subcortex, Neurogate, Adrenal Disease of Biliary Tract Pancreas/GB, LV, Sympathetic, Neurogate, Subcortex Dysmenorrhea Ovaries, Neurogate, Endocrine, Allergy Eczema LU, Neurogate, Adrenal Electric Opthalmia Eye, LV, Vision #1, Vision #2, Subcortex Enuresis Sympathetic, Brain, KD, UB, Occiput, Urethra, Other points of tenderness on the ear Epidemic Parotitis (Mumps) Parotid Gland, Face Area, Subcortex, Point of tenderness Erysipelas Neurogate, Adrenal, Subcortex, Occiput Fainting HT, Subcortex, Adrenal, Neurogate Furuncle (Boil) Neurogate, Adrenal, Subcortex, Occiput, Point associated with the affected site Glaucoma Principal: Allergy, LV, Eye, Lower Blood Pressure Groove / Supplementary: Vision #1, Vision #2 Headache Subcortex, Forehead, Occiput, KD, Pancreas/GB and other points of tenderness on the ear Heat Exhaustion or Sunstroke Neurogate, Subcortex, Sympathetic, HT, Adrenal, Occiput, Ear Apex (prick to let blood) Hemorrhoids Distal Segment of Rectum, Neurogate, Subcortex Hiccup Neurogate, Diaphragm, Subcortex Hypertension Subcortex, Lower Blood Pressure Groove, Neurogate, HT, Sympathetic Hyperthyroidism Neurogate, Subcortex, Endocrine, Thyroid, Stop Wheezing Hysteria HT, KD, Subcortex, Brain Stem, Neurogate Impotence External Genitalia, Testicles, Endocrine, Subcortex, Neurogate Indigestion Sympathetic, Neurogate, ST, LI, Other tender points Induction of Labor Uterus, Endocrine Infectious Hepatitis Hepatitis, LV, SJ, Sympathetic, Pancreas/GB, LV Yang Intercostal Neuralgia Thorax, Neurogate, Sympathetic, Occiput, LU and other points of tenderness in the ear Intestinal Obstruction LI, SI, ST, Abdomen, Sympathetic, Neurogate, Subcortex Irregular Menstruation Ovaries, KD, Endocrine, Uterus Leukorrhea Uterus, UB Low Back Pain Lumbar Vertebrae, Lumbago, Neurogate, Subcortex, Adrenal Malaria Adrenal, Subcortex, Endocrine, Neurogate, SP Mastitis Mammary Glands, Neurogate, Occiput, Adrenal, Subcortex Morning Sickness LV, ST, Neurogate, Sympathetic Multiple Neuritis Neurogate, Sympathetic, Points associated with affected area Neurasthenia Subcortex, Sympathetic, HT, KD, SP, Endocrine, Neurogate Neurodermatitis (Chronic Lichen Simplex) LU, Neurogate, Adrenal, LV, Subcortex Optic Neuritis or Atrophy Eye, LV, Vision #1, Vision #2, Subcortex Perforation of Gastric/Duodenal Ulcer ST, Abdomen, Neurogate, Sympathetic, Subcortex Prolapse of Uterus Uterus, KD, Subcortex Prolapsed Rectum Distal Segment of Rectum, Subcortex Prostatitis KD, UB, Urethra, Pelvic Cavity Psychosis (Schizophrenia) Sympathetic, Neurogate, HT, LV, Subcortex, Endocrine, ST, Occiput Pulmonary Tuberculosis LU, Occiput, Sympathetic, Neurogate, Stop Wheezing Renal Colic KD, Ureter, Subcortex, Sympathetic Rhinitis Inner Nose, Adrenal, Endocrine Sciatica Ischium, Adrenal, Buttocks, Neurogate, Lumbar Vertebrae, Sacrum Seizures (Epilepsy) Neurogate, HT, KD, Occiput, ST, Subcortex, Brain Shock Principal: Adrenal, Raise BP, Subcortex, HT / Supple.: Thyroid, Hormone, Neurogate, LU, LV, Sympathetic Simple Goiter Endocrine, Thyroid and other appropriate points Spermatorrhea KD, UB, Urethra, Pelvic Cavity Sprain of Lower Back Lumbar Vertebrae, Lumbago, Neurogate, Subcortex, Adrenal Stenosing‐Tenosynovitis of Radial Styloid Process Wrist, Neurogate, Subcortex Stiff Neck Neck, Cervical Vertebrae Stomachache ST, Sympathetic, Subcortex, Duodenum Tendinitis of the Elbow Point of tenderness in the Elbow Area, Subcortex, Neurogate, Adrenal Tetanus Subcortex, Occiput, HT, Brain, Neurogate Tinnitus and Deafness Ear, Inner Ear, Neurogate, KD, Endocrine, Occiput Tonsillitis Prescription 1: Throat, Tonsils / Prescription 2: Helix #1, #2, #3, Posterior auricular veins Toothache Maxilla, Mandible, Tragus Apex Trigeminal Neuralgia Forehead, Mandible, Maxilla, Sympathetic Urinary Retention and Incontinence UB, Urethra, Sympathetic, External Genitalia Urinary Tract Infection KD, UB, Urethra Urticaria Point corresponding to the site of the urticaria on the body, Endocrine, LU, Adrenal Uterine Bleeding Uterus, Subcortex, Endocrine, Ovaries Whooping Cough (Pertussis) LU, Stop Wheezing, Neurogate, Sympathetic

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AURICULAR ACUPUNCTURE PRESCRIPTION Handbook (Source: CAM)

COMMON DISEASES EAR POINTS (SHANGHAI TERMINOLOGY) Ascariasis in the biliary duct LV, GB, Duodenum, Vagus Root Bacterial dysentery LI, SI, Lower Portion of Rectum Bronchial asthma LU, Trachea, Adrenal, Stop wheezing, Neurogate / Vagus Root, KD, SJ, LI Bronchitis LU Trachea, Neurogate, Occiput, Adrenal, Vagus Root Cholecystitis and gallstones Ⓡ Neurogate→Abdomen, Sympathetic, GB, 0.2mm below GB→Duodenum / Ⓛ GB→Duodenum Chronic gastritis ST, Sympathetic, LU / LV, SP, Mouth, Endocrine Colic pain due to urethral calculus KD, Abdomen, Sympathetic, Subcortex Congestive glaucoma Bloodletting on Lower Blood Pressure Groove, Ear Apex / Eye, LV, Vision #1, Vision #2 Conjunctivitis Bloodletting on Ear Apex or on Minor Veins of Retroauricle / Eye, Neurogate, Ear Apex Diarrhea LI (3 needles), ST Dysmenorrhea Uterus, Endocrine, Vagus Root Electric ophthalmalgia & snow blindness Eye / Eye, LV, KD Enuresis KD, UB, LV, Subcortex / Endocrine, Brain, Urethra Epidemic parotitis (mumps) Parotid Gland, Cheek, Subcortex Facial neuritis Eye, Cheek, LV, Mouth / SP, Forehead, Neurogate, Adrenal Functional bleeding of uterus Uterus, Endocrine, Neurogate / SP, Subcortex, LV, Diaphragm Gastric or duodenal ulcer ST, Duodenum, Sympathetic, Subcortex, Mouth / SJ, Neurogate, LV, SP, Diaphragm Headache Forehead, Occiput, Subcortex, Brain, Neurogate Herpes zoster LU, Subcortex, Endocrine, Corresponding areas Hiccough Sensitive spots near Diaphragm or Vagus Root Hoarseness LU, Throat, Neck, Trachea, HT, LI, KD Hypertension Adrenal, Lower Blood Pressure Groove, Helix, Neurogate / Endocrine, Forehead, Temple, LV, KD Hysteria HT, Subcortex, Occiput, Brain / LV, Endocrine, Neurogate, Corresponding points Insufficient lactation Chest (Puncture most sensitive spot) Itching of the skin Neurogate, LU, Subcortex, Adrenal, Allergy / LV, SP, HT, Endocrine, Pancreas and GB Migraine Forehead, Temple, Occiput, Neurogate / Neck, HT, LV, Ear Apex, Helix #6 Neurasthenia Neurogate, HT, Subcortex, Brain / KD, LV, Endocrine Neurodermatitis LU, Adrenal, Endocrine, Corresponding points Pain caused by or tumor Subcortex, HT, Ear Apex, Corresponding areas / Sympathetic, LV, Neurogate Paroxysmal tachycardia HT, Sympathetic, Neurogate, Subcortex Perifocal inflammation of the shoulder Shoulder, Shoulder Joint, Clavicle, Adrenal / LV, SP, Brain, Tender spots in the cavum conchae Phantom limb pain Neurogate, Forehead, Subcortex, Corresponding areas Postoperative abdominal distension LI, SI, ST, Sympathetic, SP Postoperative incision pain Neurogate, Subcortex, Ear Apex, LU, Corresponding areas Sciatica Sciatic Nerve Sequelae of cerebrovascular accident Subcortex, Brain, LV, SJ, Corresponding areas / Aphasia: HT, SP / Dysphagia: Mouth, Vagus Nerve, Throat Sprain Neurogate, Subcortex, Sprained area (Tender spot) Stiff neck Forehead, Cervical Vertebrae (Tender spot) Stye Ear Apex / Vision #1, Vision #2 Tertian malaria Adrenal, Subcortex, Endocrine Tinnitus and impaired hearing Ear, LV, KD Tonsillitis Bleeding the Veins of Retroauricle, Ear Apex, or Helix #3,4,6, Toothache Ear Apex Transfusion reaction Neurogate, Adrenal, Subcortex Urticaria Allergy, Adrenal, Parotid Gland, LV Verruca plana Neurogate, LU, Subcortex, LI, Occiput, Endocrine Vomiting ST, LV, SP, Neurogate

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EAR ACUPUNCTURE PRESCRIPTION SHANGHAI (BLUE) + CAM (RED)

DISEASES EAR POINTS (SHANGHAI TERMINOLOGY) Amenorrhea Endocrine, KD, LV, SP, Neurogate, Subcortex Appendicitis Sympathethic, Neurogate Arthritis Sympathetic, Neurogate, Point of tenderness on the ear associated with the location of pain Ascariasis in the Biliary Duct LV, GB, Duodenum, Vagus Root Aural Vertigo (Meniere’s Disease) Forehead, HT, Sympathetic, Neurogate, KD, Endocrine, Adrenal, Occiput Bacterial Dysentery LI, SI, Lower Portion of Rectum Bacterial Dysentery LI, SI, Subcortex, Sympathetic, Neurogate Bronchial Asthma LU, Trachea, Adrenal, Stop wheezing, Neurogate / Vagus Root, KD, SJ, LI Bronchial Asthma LU, KD, Adrenal, Sympathetic, Stop Wheezing (during an asthma attack) Bronchitis LU Trachea, Neurogate, Occiput, Adrenal, Vagus Root Bronchitis LU, KD, Stop Wheezing Buerger’s Disease Sympathetic, KD, Adrenal, LV, Endocrine, Occiput, HT, Subcortex, point corresponding to affected limb Cerebrovascular Accident (Stroke) KD, Brain Stem, Neurogate, HT, Occiput, Subcortex Cholecystitis and Gallstones Ⓡ Neurogate→Abdomen, Sympathetic, GB, 0.2mm below GB→Duodenum / Ⓛ GB→Duodenum Chronic Gastritis ST, Sympathetic, LU / LV, SP, Mouth, Endocrine Chronic Sinusitis External Nose, Inner Nose, Adrenal, Endocrine, Forehead Colic pain due to Urethral Calculus KD, Abdomen, Sympathetic, Subcortex Coma HT, Subcortex, Neurogate, Brain, Sympathetic Common Cold LU, Bronchi, Inner Nose, Throat, Forehead Congestive Glaucoma Bloodletting on Lower Blood Pressure Groove, Ear Apex / Eye, LV, Vision #1, Vision #2 Conjunctivitis Bloodletting on Ear Apex or on Minor Veins of Retroauricle / Eye, Neurogate, Ear Apex Conjunctivitis Prescrip. 1: LV, Eye, Vision #2 / Prescrip. 2: Temple, Ear Apex, Lower BP Groove, Posterior auricular veins Convulsions Subcortex, Occiput, HT, LV, Neurogate (if there is high fever), Ear Apex (prick) Diabetes Mellitus Thirst: Endocrine, LU, Thirst / Hunger: Endocrine, ST / Frequent urination: Endocrine, KD, UB Diarrhea LI (3 needles), ST Disease Affecting Soft Tissues of Shoulder Point of tenderness in the shoulder area of the ear, Subcortex, Neurogate, Adrenal Disease of Biliary Tract Pancreas/GB, LV, Sympathetic, Neurogate, Subcortex Dysmenorrhea Uterus, Endocrine, Vagus Root Dysmenorrhea Ovaries, Neurogate, Endocrine, Allergy Eczema LU, Neurogate, Adrenal Electric Ophthalmalgia & Snow Blindness Eye / Eye, LV, KD Electric Opthalmia Eye, LV, Vision #1, Vision #2, Subcortex Enuresis Sympathetic, Brain, KD, UB, Occiput, Urethra, Other points of tenderness on the ear Enuresis KD, UB, LV, Subcortex / Endocrine, Brain, Urethra Epidemic Parotitis (Mumps) Parotid Gland, Face Area, Subcortex, Point of tenderness Epidemic parotitis (Mumps) Parotid Gland, Cheek, Subcortex Erysipelas Neurogate, Adrenal, Subcortex, Occiput Facial Neuritis Eye, Cheek, LV, Mouth / SP, Forehead, Neurogate, Adrenal Fainting HT, Subcortex, Adrenal, Neurogate Furuncle (Boil) Neurogate, Adrenal, Subcortex, Occiput, Point associated with the affected site Gastric or Duodenal ulcer ST, Duodenum, Sympathetic, Subcortex, Mouth / SJ, Neurogate, LV, SP, Diaphragm Glaucoma Principal: Allergy, LV, Eye, Lower Blood Pressure Groove / Supplementary: Vision #1, Vision #2 Headache Subcortex, Forehead, Occiput, KD, Pancreas/GB and other points of tenderness on the ear Headache Forehead, Occiput, Subcortex, Brain, Neurogate Heat Exhaustion or Sunstroke Neurogate, Subcortex, Sympathetic, HT, Adrenal, Occiput, Ear Apex (prick to let blood) Hemorrhoids Distal Segment of Rectum, Neurogate, Subcortex Herpes Zoster LU, Subcortex, Endocrine, Corresponding areas Hiccup Sensitive spots near Diaphragm or Vagus Root Hiccup Neurogate, Diaphragm, Subcortex Hoarseness LU, Throat, Neck, Trachea, HT, LI, KD Hypertension Subcortex, Lower Blood Pressure Groove, Neurogate, HT, Sympathetic Hypertension Adrenal, Lower Blood Pressure Groove, Helix, Neurogate / Endocrine, Forehead, Temple, LV, KD Hyperthyroidism Neurogate, Subcortex, Endocrine, Thyroid, Stop Wheezing Hysteria HT, Subcortex, Occiput, Brain / LV, Endocrine, Neurogate, Corresponding points Hysteria HT, KD, Subcortex, Brain Stem, Neurogate Impotence External Genitalia, Testicles, Endocrine, Subcortex, Neurogate Indigestion Sympathetic, Neurogate, ST, LI, Other tender points Induction of Labor Uterus, Endocrine Infectious Hepatitis Hepatitis, LV, SJ, Sympathetic, Pancreas/GB, LV Yang Insufficient Lactation Chest (Puncture most sensitive spot) Intercostal Neuralgia Thorax, Neurogate, Sympathetic, Occiput, LU and other points of tenderness in the ear

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Intestinal Obstruction LI, SI, ST, Abdomen, Sympathetic, Neurogate, Subcortex Irregular Menstruation Ovaries, KD, Endocrine, Uterus Itching of the Skin Neurogate, LU, Subcortex, Adrenal, Allergy / LV, SP, HT, Endocrine, Pancreas and GB Leukorrhea Uterus, UB Low Back Pain Lumbar Vertebrae, Lumbago, Neurogate, Subcortex, Adrenal Malaria Adrenal, Subcortex, Endocrine, Neurogate, SP Mastitis Mammary Glands, Neurogate, Occiput, Adrenal, Subcortex Migraine Forehead, Temple, Occiput, Neurogate / Neck, HT, LV, Ear Apex, Helix #6 Morning Sickness LV, ST, Neurogate, Sympathetic Multiple Neuritis Neurogate, Sympathetic, Points associated with affected area Neurasthenia Subcortex, Sympathetic, HT, KD, SP, Endocrine, Neurogate Neurasthenia Neurogate, HT, Subcortex, Brain / KD, LV, Endocrine Neurodermatitis (Chronic Lichen Simplex) LU, Neurogate, Adrenal, LV, Subcortex Neurodermatitis LU, Adrenal, Endocrine, Corresponding points Optic Neuritis or Atrophy Eye, LV, Vision #1, Vision #2, Subcortex Pain caused by Cancer or Tumor Subcortex, HT, Ear Apex, Corresponding areas / Sympathetic, LV, Neurogate Paroxysmal Tachycardia HT, Sympathetic, Neurogate, Subcortex Perforation of Gastric/Duodenal Ulcer ST, Abdomen, Neurogate, Sympathetic, Subcortex Perifocal Inflammation of the Shoulder Shoulder, Shoulder Joint, Clavicle, Adrenal / LV, SP, Brain, Tender spots in the cavum conchae Phantom Limb Pain Neurogate, Forehead, Subcortex, Corresponding areas Postoperative Abdominal Distension LI, SI, ST, Sympathetic, SP Postoperative Incision Pain Neurogate, Subcortex, Ear Apex, LU, Corresponding areas Prolapse of Uterus Uterus, KD, Subcortex Prolapse of Rectum Distal Segment of Rectum, Subcortex Prostatitis KD, UB, Urethra, Pelvic Cavity Psychosis (Schizophrenia) Sympathetic, Neurogate, HT, LV, Subcortex, Endocrine, ST, Occiput Pulmonary Tuberculosis LU, Occiput, Sympathetic, Neurogate, Stop Wheezing Renal Colic KD, Ureter, Subcortex, Sympathetic Rhinitis Inner Nose, Adrenal, Endocrine Sciatica Sciatic Nerve Sciatica Ischium, Adrenal, Buttocks, Neurogate, Lumbar Vertebrae, Sacrum Seizures (Epilepsy) Neurogate, HT, KD, Occiput, ST, Subcortex, Brain Sequelae of cerebrovascular accident Subcortex, Brain, LV, SJ, Corresponding areas / Aphasia: HT, SP / Dysphagia: Mouth, Vagus Nerve, Throat Shock Principal: Adrenal, Raise BP, Subcortex, HT / Supple.: Thyroid, Hormone, Neurogate, LU, LV, Sympathetic Simple Goiter Endocrine, Thyroid and other appropriate points Spermatorrhea KD, UB, Urethra, Pelvic Cavity Sprain of Lower Back Lumbar Vertebrae, Lumbago, Neurogate, Subcortex, Adrenal Sprain Neurogate, Subcortex, Sprained area (Tender spot) Stenosing‐Tenosynovitis of Radial Styloid Process Wrist, Neurogate, Subcortex Stiff Neck Neck, Cervical Vertebrae Stiff Neck Forehead, Cervical Vertebrae (Tender spot) Stomachache ST, Sympathetic, Subcortex, Duodenum Stye Ear Apex / Vision #1, Vision #2 Tendinitis of the Elbow Point of tenderness in the Elbow Area, Subcortex, Neurogate, Adrenal Tertian malaria Adrenal, Subcortex, Endocrine Tetanus Subcortex, Occiput, HT, Brain, Neurogate Tinnitus and Deafness Ear, Inner Ear, Neurogate, KD, Endocrine, Occiput Tinnitus and impaired hearing Ear, LV, KD Tonsillitis Bleeding the Veins of Retroauricle, Ear Apex, or Helix #3,4,6, Tonsillitis Prescription 1: Throat, Tonsils / Prescription 2: Helix #1, #2, #3, Posterior auricular veins Toothache Ear Apex Toothache Maxilla, Mandible, Tragus Apex Transfusion Reaction Neurogate, Adrenal, Subcortex Trigeminal Neuralgia Forehead, Mandible, Maxilla, Sympathetic Urinary Retention and Incontinence UB, Urethra, Sympathetic, External Genitalia Urinary Tract Infection KD, UB, Urethra Urticaria Allergy, Adrenal, Parotid Gland, LV Urticaria Point corresponding to the site of the urticaria on the body, Endocrine, LU, Adrenal Uterine Bleeding Uterus, Subcortex, Endocrine, Ovaries Uterine Bleeding (Functional) Uterus, Endocrine, Neurogate / SP, Subcortex, LV, Diaphragm Verruca Plana Neurogate, LU, Subcortex, LI, Occiput, Endocrine Vomiting ST, LV, SP, Neurogate Whooping Cough (Pertussis) LU, Stop Wheezing, Neurogate, Sympathetic

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