The somatotopic presentation of the body within the ear was first
recognized through persistent clinical investigations of Dr. Paul
Nogier, of France. 1,4,5 Nogier first recognized that the point commonly
known as "sciatic point" correlated, in fact, to the lower
lumbar vertebral segments. With this starting reference point, he
hypothesized and confirmed the primary auricular correspondence system,
known as the "inverted fetus". 6,7,8 (See figure 1) Early
in the development of the French auricular microsystem, the Zero Point
(See figure 2) was recognized and identified on auricular charts.
Auricular Medicine practitioners' understanding of the significance
and meaning of Zero Point has evolved through the years, while most
auriculotherapy practitioners' continue without these newer developments
of Zero Point's significance. Developmental perspectives: Nogier's
identification of the Zero Point initially occurred because of its
perceived functional value. This point served as a reference point
to "zero" or set the sensitivity of early auricular electro
diagnostic devices. Within
several years, however, this point was recognized to be pathologic
in many patients, thus it does not serve well as a reference point
as originally considered. 6 Nogier and his colleagues continued to
investigate auricular correspondences, and pursued identification
of points through anatomic and embryologic understandings.
original presentation of auricular correspondence or the "inverted
fetus" presentation came to be recognized as a somatotype which
corresponds to normal physiology or to acute pain or dysfunction.
In this model, the musculoskeletal (mesodermal) structures present
in the upper aspect of the ear, covering the helix, antihelix, scaphoid
fossa, and triangular fossa. 1,3,7,9,10(See figure 3) Visceral organs
(endoderm) are identified in the concha, and the cephalic structures
(ectoderm) present in the lobule. 11,13
In time, Nogier recognized that chronic and degenerative conditions
presented in alternate auricular presentations, depending on the
stage of illness. The respective embryologic tissue layers will
shift in their auricular representation based on their Phase status.
3 According to this model, degenerative conditions are identified
in Phase 2 presentation, wherein the fetus presentation "morphs"
to an upright position. 3,5 (See figure 4) In Phase 2, the mesoderm
presents in the concha, the endoderm in the lobule, and the ectoderm
in the upper ear.(See figure 3) Degenerative conditions are more
dense in their pathological presentation and represent the most
serious progression of a pain or functional problem. Generally,
though with exceptions, progression to Phase 2 will take weeks to
months from the onset of the injury or illness.
Chronic conditions are identified as Phase 3 auricular correspondences.
Phase 3 presents with the mesoderm in the lobule, the endoderm in
upper ear, and the ectoderm in the concha.(See figure 2) The homonculus
is now seen in a transverse presentation.(See figure 4) Chronic
presentations will generally emerge within several days or weeks
of the initial insult or injury. Depending on the stage of a patient's
illness, the pathology may be identified in one or more locations
within the ear. 3,5
As disease progresses, it is now known that the auricular reflection
will shift from Phase 1 to Phase 3 to Phase 2. Phase 2 was recognized
second, and it is thus labeled"2", in spite of the fact
that Phase 2 represents a condition more chronic and degenerative
than those seen in Phase 3. Recovery of illness follows the reverse
pattern, from Phase 2 to Phase 3 to Phase 1. 1,5 (See figure 4)
Through extensive clinical observation, Nogier and his colleagues
also identified 7 zones of the auricle which demonstrate favorable
response to specific frequencies of electrical stimulation.(See
figure 5) These zones are further influenced by specific Master
Points within the respective zones, which exert generalized influence
over their zone. In this model, the concha is identified as Zone
"B" and includes the location of Zero Point. 1,5 (See
figure 6) Specifically, Zero Point corresponds to the Master Point
of Zone B and therefore has influence over the entire concha.
Often a physician's confusion regarding the significance of an
auricular point will become clear when the anatomy and embryology
is considered within these Phase dynamics. Further, a study of the
auricular neurology and an appreciation of the influence of the
zonal Master Points may lead to greater understanding of the clinical
efficacy of various auricular points.
Functionally, the Zero Point was used early as a reference point
for auricular point electrodetection, as noted above. Zero Point
has also been referred to as the "umbilicus", "vitelline
duct", or "solar plexus" of the ear1,11, indicating
its central physiologic importance for many body functions.
Anatomically, Zero Point lies in an area of innervation by the
Vagus Nerve. Stimulation of the point may yield a significant parasympathetic
effect which may be important for all endodermal structures found
in the concha. Included in the superior concha are the Phase 1 representations
of the abdominal viscera, including the small and large bowels,
gall bladder, pancreas, et cetera; within the inferior concha are
the lungs.(See figure 7) This parasympathetic effect has also been
recognized to effect the auricular energetics, in general. Clinically,
the parasympathetic tone may be enhanced or diminished depending
on the specific direction of auricular massage. A centrifugal massage
will diminish the parasympathetic tone as a probe or rod is used
to massage outward from the Zero Point. Conversely, a centripital
massage toward the Zero Point will enhance the parasympathetic tone
of the ear. 1 The point has also been used to treat panic attacks
by needling the non-dominant ear (generally ipsilateral to the dominant
The location of Zero Point also corresponds to the Phase 2 cerebullum
zone (See figure 8). Cerebellar functions include coordination of
somatic motor activity, regulation of muscle tone, and mechanisms
of equilibrium2,12. Its positive effects on emotional status and
drug detoxification have been recognized among auricular therapists.
11 With such significant impact on the body's fundamental coordinating
functions, it is not surprising that this point may be identified
as an active point through electrostimulator detection in patients
with pain or functional problems.
The Zero Point location is also shared by the Phase 3 corpus callosum
(See figure 9). The role of the corpus callosum as neural relay
is imperative for proper neurophysiological function. Abundant fibers
connect to the cortex from the lower brainstem and spinal cord,
and integration of information between the hemispheres is vital
to to carry information which is essential to proper brain function.
Disturbances of this neural integration may manifest as ADD/ADHD,
stuttering, dyslexia, confusion with directions, and visual and
auditory processing disturbances. 2 Chronic pain or functional illness
may thus be represented at the Zero Point location because of the
disturbance of corpus callosum.
Practicing advanced Auricular Therapy, with consideration of Phase
dynamics rather than just the simple "inverted fetus",
will thus give further clarification to the nature of the presenting
pain or illness. Specific and definitive identification to the Phase
of presentation is only made through the energetic techniques of
Auricular Medicine, using the Vascular Autonomic Signal (VAS) of
the radial pulse, and the electromagnetic field (EMF) signal of
the auricle. 5 While further detail of Auricular Medicine is beyond
the scope of this article, it is important to note that these are
the techniques used to specifically identify the exact nature of
the disturbance. With advanced Auricular Therapy techniques, clinicians
have much greater information to be able to recognize an active
auricular zone as a disturbance in one of 3 Phase presentations,
rather than as a single point on the basic auricular somatotopic
The significance of Zero Point may be more specifically recognized
when the physician understands the neurological, anatomical and
embryological implications, rather than simply the functional importance
of this zone.3,7 Additionally, this advanced auricular acupuncture
approach will lead to clearer diagnostic interpretation of a presenting
illness as it is represented in one or more areas on the auricle.
Ultimately, more enduring clinical effects may be realized with
treatment of properly identified points. Proper identification and
treatment of auricular points is encouraged for the physician to
treat the patients' auricle in a true medical model rather than
in a cursory technical approach.
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Reprinted with permission from the American
Academy of Medical Acupuncture. This article originally appeared
in Medical Acupuncture, the journal of the American Academy of Medical
Images are reprinted from the Atlas
of Auricular Therapy and Auricular Medicine.