This document provides a study guide for auriculotherapy, four needle technique, and extra points. It details ear anatomy and locations of points on the ear that correspond to different body systems and conditions. The four needle technique is described as a way to balance meridians based on tonifying or sedating points depending on if there is an excess or deficiency pattern. Zang and fu organ five shu points are also listed.

1. Points III, Midterm II
A comprehensive study guide to auriculotherapy, four needle technique, and
extra points.

2. Auriculotherapy (Ear Acupuncture)
Auriculotherapy is based on the fact that the ear is a microsystem that reflects
the entire body, represented on the auricle, the outer portion of the ear.
Conditions affecting physical, mental, or emotional health are treatable by
stimulation of the surface of the ear.
Similar practices include reflexology, that the feet represent the entire body,
and through stimulation of different areas, different illnesses can be
addressed.

3. Ear Anatomy
Darwin’s Tubercle
Supratragic notch
Infratragic notch

4. Scapha
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.
Allergy - On scapha, medial to Wrist point. Allergic
diseases.
Shoulder - On scapha, level with supratragic notch.

5. Scapha
Elbow - On scapha, midway between Shoulder and
Wrist points. Pain of elbow joint.
Clavicle - On scapha, level with Neck point on
antihelix.

6. Triangular Fossa
Uterus - Slightly above the parting of the two crura of
the antihelix, in the triangular fossa. Obstetrical and
gynecological diseases, sexual dysfunction in males.
Pelvic Cavity - In the lateral angle of the triangular
fossa near the intersection of the superior and inferior
crura of the antihelix. Pelvic cavity inflammation,
painful menstruation.

7. Triangular Fossa
Neurogate / Shenmen - In the triangular fossa, medial
and superior to the Pelvic Cavity point. Regulates
excitation and inhibition of the cerebral cortex.
Sedative, analgesic, anti-allergy effects. Used for
neuropsychiatric disorders (hysteria, psychosis, etc.),
hypertension, coughing, allergic asthma, itching
symptoms, and pain. Important point for anesthesia.

8. Triangular Fossa
Wheezing- In the triangular fossa, between the Uterus
and Pelvic Cavity points. Anti-allergy, suppresses
wheezing, bronchial asthma.
Hepatitis - In the triangular fossa, between the
Wheezing and Pelvic Cavity points. Acute and chronic
hepatitis.
Hip Joint - In the triangular fossa, below the Hepatitis
point. Often used for pain of lower limb joints or
buttocks.

9. Triangular Fossa
Constipation - In the triangular fossa, below the Adnexa
point. Constipation, bleeding from hemorrhoids.
Lower Blood Pressure - In the superior angle of the
triangular fossa where the superior crus meets the helix.
Hypertension, headache (due to hypertension).
(New) Distal Segment Rectum - At the inferior angle of
the triangular fossa where the inferior crus of the
antihelix meets the helix. Enteritis, constipation,
hemorrhoids, prolapsed anus.

10. Triangular Fossa
(New) Urethra - In the triangular fossa, medial to Uterus point
and near the border of helix. Frequent and urgent urination,
painful urination, incontinence, retention of urine.
(New) External Genitalia - In the triangular fossa, anterior and
superior to Uterus point. Sexual dysfunction, leukorrhea,
excessive menstruation.
(New) Proximal Segment Rectum - In the triangular fossa,
above the (new) Urethra Point. Functional disturbance of the
colon.

11. Superior Crus of Antihelix
Toes - On the lateral, superior angle of superior crus of
antihelix. Pain or functional hindrance of the toes.
Ankle - On the medial, superior angle of superior crus of
antihelix. Pain or functional hindrance of the ankle.
Heel - On the medial, superior angle of superior crus of
antihelix.
Knee - On the superior crus of antihelix, level with superior
border of inferior crus of antihelix. Pain or functional
hindrance of the knee.

12. Superior Crus of Antihelix
Knee Joint - On the superior crus of antihelix, ⅓ the
distance from the Ankle to the Knee point. Pain or
functional hindrance of the knee.
Hip Joint - On the superior crus of the antihelix, ⅓ the
distance from the Knee to the Ankle point. Pain or
functional hindrance of the hip.

13. Superior Crus of Antihelix
Sympathetic - At the intersection of the superior border of
the inferior crus of antihelix and medial border of the
helix. Used for numerous diseases related to disruption in
autonomic (both sympathetic and parasympathetic)
nervous system. Strong analgesic and relaxant effect
upon internal organs. Specifically, for relieving pain
associated with ulcers, stomach spasm, round worm in
bile duct, gall and urethral stones. Dilates blood vessels.
Useful in treating circulatory and ophthalmological
diseases, and excessive sweating. Important point of
anesthesia.

14. Inferior Crus of Antihelix
Sciatic Nerve - Slightly medial to mid-point on
superior margin of inferior crus of antihelix.
Sciatica.
Buttocks - Slightly lateral to midpoint on superior
margin of inferior crus of antihelix. Pain of hip and
sacroiliac joints, atrophy of gluteal muscles.

15. Antihelix
Lumbar Vertebrae - On the prominence of the
antihelix, level with Distal Segment of Rectum point.
Low back pain.
Thyroid #2 - On medial margin of antihelix, medial to
Neck point. Regulates function of thyroid gland; may
also be used in shock to raise blood pressure.

16. Cavum Concha
Mouth - On superior, posterior wall of the opening of the
external meatus. Ulcers in the mouth, stiffness in the
temporomandibular joint.
Esophagus - In the cavum concha, below midpt of the crus
of helix. Functional constriction of larynx, difficulty in
swallowing due to hysteria, belching.
Pylorus - In the cavum concha, below the crus of helix and
posterior to Esophagus point. Pyloric spasm, belching,
constriction of diaphragm causing regurgitation.

17. Cavum Concha
Stomach - In the cavum concha, where the crus of
helix ‘disappears’. Diseases of the stomach
including indigestion, acute and chronic gastritis,
peptic ulcer, distension of stomach, belching,
insomnia, etc.
Hepatitis Area - Between Stomach point and Right
Hepatomegaly Area, in cavum concha. Acute and
chronic hepatitis.

18. Cavum Concha
Spleen - Between Blood point and Right Hepatomegaly
Area, in the cavum concha. Indigestion, muscle atrophy (in
general), blood diseases, abnormal uterine bleeding,
prolapsed anus, weakness following a disease, prolapse of
viscera, muscle weakness.
Heart - In depression at center of the cavum concha.
Strengthens heart, anti-shock, regulates blood pressure.
Used for various mental diseases, heart disease, glossitis,
Buerger’s disease, anemia.

19. Cavum Concha
Upper Lung, Lower Lung - Two points, one above and one
below the Heart point, near the center of cavum concha.
Various respiratory and skin diseases, rhinitis, mutism,
night sweats, spontaneous sweating. Also used as
analgesic points in acupuncture anesthesia.
Bronchi - Two points anterior to and between the Lung
points, naer the center of cavumconcha. Acute and chronic
bronchitis, asthma.
Trachea - Between and medial to the two Bronchi points.
Diseases of the trachea.

20. Cymba Concha
Prolapse - In the cymba concha, above the Stomach
point and posterior to the Duodenum point. Prolapse
of the viscera.
Duodenum - In the cymba concha, between Prolapse
and Small Intestine points. Duodenal ulcer, pyloric
spasm, hypoacidic stomach.
Small Intestine - In the cymba concha, above midpoint
of crus of helix. Indigestion, enteritis, distension of
intestine by gas, heart disease.

21. Cymba Concha
Large Intestine - In the cymba concha, above crus of helix,
anterior to Small Intestine point. Enteritis, dysentery,
diarrhea, constipation, hemorrhoids, diseases of
respiratory system.
Appendix - In the cymba concha, between Large and
Small Intestine points. Acute and chronic appendicitis.
Blood Base - In the cymba concha, between the Prostate
and Large Intestine points. Allergic colitis, ulcer of the
colon, intestinal polyps, bleeding in lower digestive tract,
diarrhea due to schistosomiasis.

22. Cymba Concha
Prostate - In the cymba concha, medial to the
Bladder point. Prostatitis, urinary tract infection,
blood in the urine, painful urination, spermatorrhea,
premature ejaculation.
Bladder - In the cymba concha, above the Large
Intestine point. Cystitis, frequent and urgent
urination, incontinence, retention of urine, enuresis,
low back pain, neck pain.

23. Cymba Concha
Kidney - In the cymba concha, above the Small
Intestine point. Strengthening point, beneficial to the
cerebrum, Kidneys, and hematopoietic system. Used
for incomplete development of brain, amnesia,
neurasthenia, vertigo, headache, lassitude, nerve
deafness, tinnitus, advancing deafness, loss of hair,
diseases of the eyes, gynecological and urogenital
system diseases, assist in bone mending, loose teeth,
aplastic anemia, leukemia, edema, chronic pharyngitis,
electrolyte imbalance, etc.

24. Cymba Concha
Ureter - In cymba concha, between Bladder and Kidney
points. Kidney stones, renal colic.
Pancreas - In cymba concha, above Duodenum point.
Acute and chronic pancreatitis, diabetes, indigestion,
pancreatic diarrhea.
Liver - In cymba concha, above Left Hepatomegaly Area.
Acute and chronic hepatitis, eye diseases, iron deficient
anemia and other blood diseases, arthritic pain, neuralgia,
headache, vertigo, stomach gas and pain, gas in the Gi
tract, hemiplegia, seizures, muscle spasms.

25. Cymba Concha
Pancreas/Gall Bladder - In cymba concha, between Liver
point and Kidney point. Indigestion, pancreatitis, diabetes,
cholecystitis, gall stones, round worm in bile duct, chest
and rib pain.

26. Tragus
Adrenal - At the prominence on inferior part of tragus (if
the ear has only one such prominence, the point is on the
inferior border). Functions to stimulate adrenalin and
adrenocortical hormones, used for inflammation,
allergies, shock, rheumatism and serious poisoning
symptoms resulting from bacterial infection. Affects the
dilation and constriction of blood vessels, hyper and
hypo-tension, capillary hemorrhage. Regulates excitation
or inhibition of respiratory function. Used for fever,
certain skin diseases, and chronic illnesses.

27. Infratragic Notch
Endocrine - At the extreme anterior portion in the
bottom of the intertragic notch. Regulates disturbance
of endocrine function, aids in metabolic function of
absorption and excretion. Has antiallergic and
antirheumatic function. Used for gynecological and
urogenital diseases, for dysfunction of the digestive
system, blood and skin diseases, malaria.

28. Antitragus
Parotid Gland - On antitragus, medial to Stop
Wheezing point. Parotitis, obstruction of parotid ducts.
Effective in relieving itching symptoms of many skin
diseases.
Brain - On antitragus, between Stop Wheezing and
Brain Stem points. Regulates excitation or inhibition of
cerebral cortex. Used for disease of nervous, digestive,
endocrine, and urogenital systems; hemorrhage.

29. Antitragus
Brain Stem - On the border of the lower segment of the
antitragus, near Neck point. Disorders of the cerebral
blood vessels and meninges, e.g., apoplexy,
hemiplegia, convulsions, stiffness along nape of neck,
etc. 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.

30. Antitragus
Ovaries - On anterior, inferior part of the inner wall of
the antitragus. Irregular menstruation, painful
menstruation, infertility, developmental gynecological
disorders.
Subcortex - On anterior side of the inner wall of the
antitragus. Regulates excitation and inhibition of
cerebral cortex. Often used for insomnia, lassitude and
other neuropsychiatric disorders. Also for
inflammation, excessive sweating, and pain.

31. Antitragus
Pituitary - At the bottom of inner wall of antitragus.
Regulates function of pituitary. Used for dwarfism,
acromegalic gigantism, polyuria. Also used for shock,
improper contraction of uterus after childbirth, sexual
dysfunction, and disease resulting from disturbances
of endocrine function.

32. Helix
Diaphragm - On crus of the helix. Spasms of
diaphragm, hemorrhage, pruritus, hemorrhagic skin
disorders, hematological diseases.
Branch - On crus of helix, midway between Bladder
and Brain points. Usually used for incontinence.
Midear - Center of crus of helix. No indications.

33. Helix
Ear Apex - When ear is bent toward tragus, this point
can be found at tip of fold on superior aspect of helix.
Prick point for fever, inflammation, hypertension,
revival from hepatic coma, or for analgesic or sedative
effect. Use moxibustion for keratitis.
Ear apex

34. Lobe

35. Four Needle Technique
Four Needle Technique is a procedure to balance the meridians based on
elements theory. The first step is to determine which organ is out of balance,
the next is to identify whether it’s an excess or deficient imbalance.
For excess patterns, sedate the son & tonify the grandma.
For deficient patterns, tonify the mother & sedate the mother-in-law.

36. Deficient Example
You’re presented with a case of a deficient Large Intestine. In ‘deficiency’ cases, we
tonify the mother, and sedate the mother-in-law.
Tonify Mother = Find the master point of the LI channel (LI-1) and find its mother = LI-11.
Tonify Mother’s Channel = Because LI-11 is an Earth point, we’ll tonify the Earth master
point = ST-36.
Sedate Mother-in-Law = Find the master point of the LI channel (LI-1) and find its mother-
in-law = LI-5.
Sedate Mother-in-Law’s Channel = Because LI-5 is a Fire point, we’ll sedate the Fire
master point = pick between SI-5 or SJ-6.

37. Excess Example
You’re presented with a case of Heart excess. What do you do?
(Excess = sedate son, tonify grandma.)
T: HT-3 (Water point)
T: KD-10 (Master Water point)
S: HT-7 (Earth point)
S: SP-3 (Master Earth point)

38. Zang Organs - Five Shu Points
Jing-Well
Wood
Ying-Spring
Fire
Shu-Stream
Earth
Jing-River
Metal
He-Sea
Water
LU (metal) LU-11 LU-10 LU-9 LU-8 LU-5
SP (earth) SP-1 SP-2 SP-3 SP-5 SP-9
HT (fire) HT-9 HT-8 HT-7 HT-4 HT-3
KD (water) KD-1 KD-2 KD-3 KD-7 KD-10
PC (fire) PC-9 PC-8 PC-7 PC-5 PC-3
LV (wood) LV-1 LV-2 LV-3 LV-4 LV-8

39. Fu Organs - Five Shu Points
Jing-Well
Metal
Shu-Stream
Water
Ying-Spring
Wood
Jing-River
Fire
He-Sea
Earth
LI (metal) LI-1 LI-2 LI-3 LI-5 LI-11
ST (earth) ST-45 ST-44 ST-43 ST-41 ST-36
SI (fire) SI-1 SI-2 SI-3 SI-5 SI-8
UB (water) UB-67 UB-66 UB-65 UB-60 UB-40
SJ (fire) SJ-1 SJ-2 SJ-3 SJ-6 SJ-10
GB (wood) GB-44 GB-43 GB-41 GB-38 GB-34

40. Extra Points
These are acupoints without a meridian to call home.

41. Taiyang
Migraine headache

42. Yintang
3rd eye
Stops infantile convulsions
0.3-0.5

43. Shanglianquan
1 cun below border of jaw between hyoid bone
For speech problems and snoring
Oblique 0.8-1.2 toward root of tongue

44. Erjang
Ear apex
For nebula (abnormal covering of the eye)
Prick to bleed

45. Yuyao
Above eyebrow in line with pupul.
For twitching of upper eyelids.
Subcutaneous 0.3-0.5

46. Sishencong
Vertex of the head, 1 cun anterior, posterior,
and lateral.
Poor memory.
Four points, four needles!

47. Qiuhuo
In the same vicinity as
ST-1 (lateral ¼ of
infraorbital margin)
Eye disease
0.5-1.2 perpendicular

48. Jiachengjiang
1 cun lateral to Ren 24 (@ chin)
Facial paralysis, deviation of mouth
Oblique 0.5-1

49. Jinjin (L) and Yuye (R)
Underside of tongue on two veins
Swelling of tongue
Prick to bleed

50. Bitong
Commonly used with LI-20
Highest point on nasal groove
Sinus problems

51. Qianzheng
0.5 anterior to ear lobe
Clear HT fire: mouth ulcers
Oblique 0.5-1

52. Yiming
1 cun posterior to SJ-17
Eye and ear problems
Perpendicular 0.5-0.8

53. Anmian
Between SJ-17 and GB-20
Empirical point for insomnia
Perpendicular 0.5-0.8

54. Dingchuan
0.5 cun lateral to Du-14 (C7)
Dingchuan
Perpendicular 0.5-0.8

55. Huatuojianji
0.5 cun lateral to any vertebrae
T1-T4: LU and upper limb problems
T4-T7: HT
T7-T10: LV & GB
T10-T12: SP & ST
L1-L2: KD
L3-L5: UB, LI, SI, uterus, lower limbs
All perpendicular. Depths vary:
Thoracic = 0.5-1. Lumbar = 1-1.5.

56. Bailao
2 points!
1 cun lateral & 2 cun above Du-14 (C7)
0.3-0.5

57. Weiguanxiashu
1.5 cun lateral to lower level of T8
Located on UB channel.
Empirical point for diabetes
Oblique 0.5-0.7

58. Shiqizhuixia
Below L5
Local back problems & dysuria
Perpendicular 1.8-2

59. Yaoqi
2 cun above tip of coccyx
Constipation
Subcutaneous upward 1-2

60. Pigen
3.5 cun lateral to L1
Hepatosplenomegaly
Perpendicular 0.5-0.8

61. Yaoyan
3.5-4 cun lateral to L4
Lumbar pain
Perpendicular 0.8-1.2

62. Zigongxue
4 cun below & 3 cun lateral to
umbilicus (Ren 3)
Benefits uterus, promotes conception
Perpendicular 0.8-1.2

63. Jianqian
Between LI-15 & anterior axillary
fold
Shoulder problems
Perpendicular 0.8-1.2

64. Shixuan
Tip of any of the ten fingers
Prick to bleed after strokes

65. Sifeng
8 points!
Located on palm of hands.
Midpoint of proximal interphalangeal joints
Prick to bleed

66. Zhongkui
Midpoint of
interphalangeal joint
on middle finger
Stops reverse flow of
qi
Moxa only

67. Baxie
8 points!
Margins of the web between
fingers (typically Ying-Spring
pts...good for heat!)
Pain or swelling of the hands and
fingers
Oblique 0.3-0.5 or prick to bleed

68. Luozhen
Dorsum of hand between 2nd & 3rd
joints
Invigorates qi & blood in neck
Make loose fist

69. Yaotongxue
2 points!
Dorsum of hand between 2nd/3rd or
4th/5th fingers
Good for acute low back pain
Oblique 0.5-1

70. Zhongquan
Between SJ-4 and LI-5
Epigastric and chest
problems
Perpendicular 0.3-0.5