The Chinese learned of Dr. Nogier's work through a German medical acupuncture article that arrived in China via Japan. The Chinese followed with thousands of clinical observations and developed auricular mappings which were similar to the early French system, though with some differences noted. This correspondence system was easy to teach "barefoot doctor" acupuncture technicians to readily assimilate into their paramedical practices.

Developmental Perspectives:
Dr. Nogier's original discovery led to the identification of the body mapping on the auricle which presented remarkable consistency with respect to anatomic and embryological considerations. Thus, the "inverted fetus" presents with the musculoskeletal (mesodermal) projections in the upper aspect of the ear including the antihelix, scaphoid fossa, and triangular fossa.1,5,7,8 Visceral (endodermal) organs present in the concha, and the head's (ectodermal) structures are located in the lobule in the earliest somatotopic mappings.9

Dr. Nogier eventually recognized that various organs' pain and dysfunction would present in different auricular zones, depending on the stage of the ailment. Phase 1 auricular zones correlate to normal physiology or acute pathology and is the presentation of the original "inverted fetus".(See figure 1) Phase 2 corresponds to degenerative conditions, and the "inverted fetus" is then transformed into an upright position. Phase 3 corresponds to subacute and chronic conditions, and the homunculus is in the transverse presentation with the head in the central auricle or concha. The location of a particular organ or anatomic structure's point will thus be identified in one or more locations depending on the stage of the disease process.3

The respective embryological tissues will shift in their auricular representation based on their Phase status. For example, the mesodermal structures occupy the upper ear in Phase 1, followed by the concha in Phase 2, then the lobule in Phase 3.(See figure 2)

While it is now known that illness progresses form Phase 1 to Phase 3 then to Phase 2, Phase 2 was discovered second and therefore was labeled "2". Recovery progresses in a reverse fashion, from Phase 3 to Phase 2 to Phase 1.1,3(See figure 3)

Because of the focus on functional observations, several organs in the Chinese auricular system differ from the French system. Further, the Chinese identified various points which had functional or metaphorical names, rather than anatomic descriptions. One notable example of this disparity is the placement of the organ heart. Commonly placed between the lungs on the Chinese charts, this placement does not conform to anatomic and embryological considerations. The French charts will place the Phase 1 heart on the antihelix along the region which corresponds to the upper thoracic vertebrae.(See figure 4) This placement respects the nature of the heart as a mesodermal organ in its location for normal physiology or acute pathology.

It is not surprising that the Chinese functional observations place the heart in the inferior concha, as that is the region for Phase 2 mesodermal structures. Patients with functional heart disease are likely to present with coronary arteriosclerosis, a degenerative condition of the coronary vessels, and thus in a Phase 2 state. Given that there may be clinical or sub-clinical manifestations as well, an active auricular point will likely be identified along the antihelix Phase 1 heart zone, as well. Phase 3 subacute or chronic heart conditions may be found in the lobule; any condition may present in one or more Phase locations.