The present study was designed to experimentally evaluate the claims by French and Chinese acupuncturists that a somatotopic mapping of the body is represented upon the external ear. According to this system of diagnosis, areas of the auricle where there is increased electrical conductivity and heightened tenderness to touch correspond to specific areas of the body where there is some pathological condition. The hypothetical map of different bodily regions appears on the external ear as an inverted fetus, with the head represented towards the lower lobule, the hands and feet represented at the uppermost portion of the auricle, and the body in between. Forty patients were medically examined to determine areas of their body where there was musculoskeletal pain. Each patient was then draped with a sheet to conceal any visible physical problems. The physician conducting the auricular diagnosis had no prior knowledge of the patient's medical condition, but simply examined the patient's ear for areas of elevated skin conductivity or tenderness. The concordance between the established medical diagnosis and the auricular diagnoses was 75.2%. Both quantified readings of electrical current flow and subjective ratings of dermal tenderness were statistically significant in arriving at accurate diagnoses. These results thus support the hypothesis that there is a somatotopoic organization of the body represented upon the human auricle.
Forty-eight patients underwent electrical stimulation of the brain for treatment of chronic pain between 1978 and 1983. Average pain duration prior to treatment was 4.5 years. Before selection for this procedure patients underwent pain treatment in a multidisciplinary pain center, intensive psychological and psychiatric evaluation, and assessment of pain responsiveness to intravenous administration of placebo, morphine, and naloxone. A total of 71 electrodes were placed in the 48 patients at a variety of stimulating targets, including the periaqueductal gray matter, periventricular gray matter, thalamus, and internal capsule. Seventy-two percent of patients experienced complete or partial pain relief. In addition, 59% of patients were able to discontinue narcotic usage. Twenty-five percent of patients returned to normal physical activities and another 33% showed marked improvement in functional capacity. Follow-up periods ranged from 2 to 60 months; with a mean follow-up period of 20 months. A variety of relatively minor complications occurred, but no mortality or permanent sequelae were experienced. No patient's pain was made worse as a result of electrical stimulation. Electrical stimulation of the brain offers a safe and relatively effective method for the treatment of chronic pain in appropriately selected patients, who are unresponsive to other forms of therapy.
Three essential factors for achieving effective therapeutic results utilizing acupuncture are described: (1) Immune/inflammatory reactions are mobilized when any area of the skin is sufficiently stimulated. (2) Peripheral nerual stimulation accurs when specific acupuncture loci are mechanically, electrically, chemically activated. Precise stimulation of specific loci (i.e. peripheral neural receptors) may modulate central nervous system regulation of sepcific physiological functions in the body. (3) Psychological support is well known to be an important factor in all healing experiences, and that includes acupuncture therapy. The authors suggest that the most effective applications of acupuncture involves sufficient stimulation of properly selected and precisely localized acupuncture loci combined with a dedicated concern for health that is clearly communicated to patients.
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