Notes on needling auricular points: Nogier: 1) Needle rotation in the clockwise direction results in vasoconstriction and is invigorating / tonifying.

In the anticlockwise direction needle rotation results in vasodilatation and is dispersing / sedating. If one is unsure whether invigoration or dispersion is required, good results often follow from rotating in both directions. 2) If a limb or organ is usually relatively pain-free when at rest, while relatively painful when put to use, one needs to invigorate the depleted energy in the limb/organ. Alternatively, one needs to disperse the excess energy in a limb or organ that is painful at rest but relatively pain-free when active. 3) Disperse points that are small islands of insensitivity within a surrounding tender region. Applying pressure to the point results in an intense radiating pain. 4) Invigorate points that lie within pain-free areas and which are extremely difficult to locate. Upon needle insertion a sharp sting is perceived. 5) If the needle is being rotated in the correct direction the pain should decrease, not increase. A few seconds of rotation is usually sufficient. 6) It is best to leave the needle in for at least 3-5 minutes, if not for 15-20 minutes. If the needle is removed almost immediately then one finds that clockwise rotation results in dispersion and anti-clockwise rotation results in invigoration. 7) It is preferable to use fewer, well selected needles (i.e.: points that are most tender and which best correspond to ones diagnosis) than many. Results are more immediate with ear manipulation, and a little slower with either massage, needling, or cauterization. Lasting results can be expected after just one or two treatments, but more typically after some six-plus sessions. T.Oleson: Treat no more than 3 disorders at any one time. Use just 2-6 points selected with a Point Finder, using Local Points, Master Points, and Functional Points. Leave needles in place for 20-30 minutes and treat 1-3 times a week. If using electro-stimulation, use alternating current If using a TENS device (without needles) select up to 5-15 points (but as few as possible), treating each point for 8-24 seconds; or even up to 2 minutes. Stimulate longer if the patient experiences warmth in the related symptomatic area. Frequency Settings: 10Hz 20Hz 40Hz 80Hz 160Hz Helix Tragus Helix Tail Lateral Lobe Medial Lobe Anti-helix Anti-helix Anti-tragal Central Lobe Anti-tragus Wall Wall Scaphoid & Triangular Fossae Tonification is achieved with 6-10 seconds stimulation with +ve electrical polarity (especially using Master & Functional Points) on the ipsilateral side. Sedation is achieved with 12-30 seconds stimulation with ve electrical polarity (especially using local points) on the contralateral side. 2.5Hz Subtragus 5Hz Concha

Notes on needling auricular points: Dr. Huang: Strong needle stimulation disperses excess conditions (reducing method). Mild stimulation is best for chronic conditions and weakened, deficient patients or children (reinforcing method). 3 types of stimulation with a needle: 1) Simply retain the needle without manipulating it after insertion (reinforcing method for children and chronic conditions and weakened constitutions) 2) 20-30 seconds of back & forth needle twirling, producing medium stimulation usually for chronic conditions. 3) Lifting & Thrusting the needle perpendicularly after insertion for acute or painful conditions. To add to the level of stimulation the needle can also be twirled when removed. Deep insertion, even into the cartilage, produces higher intensity stimulation and may be especially effective for excess heat syndrome, painful &/or acute inflammatory conditions. Oblique/Transverse needle at 15% to the skin can be used to reach and stimulate more than one point at once. Other than when treating children, needles should be retained for 30-60 minutes or even longer.