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Soliman-Frank 3-Phase Hand Acupuncture
Nader E. Soliman, MD
Bryan L. Frank, MD
ABSTRACT
Acupuncture microsystems have established a firm place in the therapeutics of acupuncture practice. The auricular model as introduced by Dr Paul Nogier, with its 3-phase system, is the only system to date that delineates different projections on the ear based on the patho-physiological changes of illness. The authors have identified a similar 3-phase projection on the hand microsystem. Understanding the nature of the multiple phases as a reflection of the patho-physiological changes will lead to greater diagnostic and therapeutic benefits for the provider and patient alike.
KEY WORDS
Auricular Therapy, Paul Nogier, Tae Woo Yoo, Electromagnetic Field (EMF), Filter, Koryo Hand Therapy (KHT), Phases, Vascular Autonomic Signal (VAS)
INTRODUCTION
Acupuncture microsystems are fascinating biological presentations that offer a unique approach to the patient's health problems through which the practitioner, while addressing the overall energetic imbalance of the individual, can often address a particular anatomic region to bring stability to the overall Qi. These systems offer an energetic microcosm with potentials for diagnosis and treatment.
NOGIER'S AURICULAR MICROSYSTEM
Nogier's discovery, known as "Auricular Therapy," is defined as a physical reflex therapy system based on the detection and treatment of patho-physiologic and pain problems within the body at somatotopic correspondence zones on the auricle. The brilliant recognition of these 3 phases has enabled practitioners to treat patients more efficiently.
In the 1950s, Dr Paul Nogier (Lyon, France) introduced the Auricular Microsystem. He soon realized that every organ is projected onto the ear in 3 different locations.1 The 3 different projections were named "phases" which have been recognized as Phase 1, Phase 2, and Phase 3. In Phase 1, tissues are projected reflecting either a normal physiological status or early energetic or functional stage(s) of pathophysiological changes. This often reflects pathology of a duration ranging from minutes to days, although the pathophysiological nature is more important than the time frame of tissue insult. In Phase 2, tissues with a dense or degenerative pathophysiology are projected. This is commonly seen in chronic ailments, although it may occurquite quickly, as with a crushing trauma to a limb or more chronic illnesses such as rheumatoid arthritis and cancer. Phase 3 is considered an intermediate phase. Energetically, Phase 3 falls between Phase 1 and Phase 2. It projects organs with non-degenerative pathology, commonly inflammatory or transitional in nature. The pathology in this phase may be manifest from days to years, but has not progressed to a state of dense tissue degeneration. In essence, the 3 phases reflect functional energetic pathology (Phase 1), intermediate or inflammatory pathology (Phase 3), and dense, degenerative conditions (Phase 2).1,2
Korean Hand Therapy (KHT)
Korean Hand Therapy (KHT) is another acupuncture microsystem frequently used by acupuncture practitioners throughout the world. KHT was developed in Korea and introduced in 1971 by Dr. Tae Woo Yoo. This system uniquely maps the traditional acupuncture points, micro-meridians, and organs on the hands.3 Similar to the auricular system, KHT permits the application of many types of acupuncture treatment paradigms, including TCM acupuncture, classic acupuncture energetics, Five Elements, and neuro-anatomical models. KHT allows the use of needles, magnets, pellets, low-frequency electromagnetic stimulation, and electrical stimulation for treatment.4,5
Since it is important to understand microsystems and Nogier's Phases in order to understand the 3-phase hand therapy model, a brief discussion follows.
ACUPUNCTURE MICROSYSTEMS
Historically, microsystems have their origin within the premises of Chinese medicine. This system emphasizes the unity of the body, mind, and energy. An example is the tongue microsystem, though this is primarily used for diagnostic purposes and not often for therapeutic input.6
Microsystems are considered holographic images of the entire individual projected onto a particular part of the body. The ear, hand, scalp, foot, face, tongue, and the iris of the eye are some of the commonly recognized acupuncture microsystems.
The word "hologram" is Greek in origin and is composed of 2 parts: holo, meaning whole and gram, meaning message; thus, the word hologram literally means the whole message. This eloquently reflects the uniqueness of the acupuncture microsystems.
A hologram is a 3-dimensional image of a given object that is created by energy interference patterns. A holographic image is produced by projecting a laser beam on a subject, and via a reflecting mirror, so that a 3-dimensional image of that subject will be formed on a holographic plate. Figure 1A shows the formation of a 3-dimensional image of a dog. If a small piece of this 3-dimensional image is cut out and then subjected to a decoding laser beam, the resulting image will be that of the whole subject.7 Each fragment of the hologram will always display a picture of the entire dog even if the fragment contained no apparent visible piece of the dog at all (Figure 1B). If we consider the image of the dog to represent the whole body, and the small piece cut to represent the ear, foot, or hand (or any acupuncture microsystem), it is apparent how the ear or the hand can project the entire body's structures and organs.
Karl Pribram, a neurophysiologist at Stanford University, concluded in 1975 that the brain was holographically structured.8,9 The holographic image demonstrates an interesting principle that simply states, "Every piece contains the essence of the whole." This should not be surprising when we realize that the same principle applies to the science of cloning; here it is obvious that every cell contains a copy of the master DNA blueprint. This same principle is also the basis of acupuncture microsystems.
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Figure 1A. Laser images.
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Figure 1B. Laser fragments.
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NOGIER "PHASES"
Phases, as introduced by Nogier, are defined as transitory holographic projections of the entire body and all the organs on an acupuncture microsystem. These projections are dependent on the integrative abilities of the brain in response to continuous processing of energetic, physiological, and pathological information received from the various organs of the body, including the brain itself.10 The 3 phases are superimposed on each other with a distinct projection, and multiple phases may exist simultaneously. For example, a non-degenerative, inflammatory arthritis condition in the knee may exist simultaneously with an acute flare-up of the same tissue; this reflects the presence of both Phase 1 and Phase 3 concurrently.
The following 3 essential principles were utilized by Nogier and his colleagues for identification of phases:
- Changes in the pulse (Vascular Autonomic Signal or VAS)
- The Electromagnetic Field of the ear (EMF)
- The use of filters.
The above principles were crucial to identifying the projections of the organs on the ear in their 3 phases and laid down the foundations for the discovery of a more sophisticated system known as "Auricular Medicine." This presents as an energetic reflex therapy system. This system offers invaluable information to help with diagnosis and additional unique ways to help with the treatment of pathological problems at somatotopic correspondence points on the auricle. It is entirely based on the study of changes of the arterial pulse as perceived by the thumb on the radial artery; pulse characteristics vary when the body is exposed to various biological stresses.
THE VASCULAR AUTONOMIC SIGNAL (VAS)
Discovered by Dr. Rene Leriche and applied clinically by Nogier, the Vascular Autonomic Signal (VAS) is simply a change in the quality of the pulse in response to various stressors to which the body may be exposed.1 The pulse is known to be a stationary wave resulting from the intersection of the waves generated through the pumping action of the heart and similar waves that have already been reflected from points of branching and of tapering of the blood vessels into small resistance vessels (capillaries).11 Consequently, the intensity of the pulse will change depending on the status of the vascular resistance of the capillaries. The reflecting wave either reinforces or weakens the incoming wave. Nogier called a reinforced pulse wave a "positive VAS," which is described as being fuller, vibrant, bulging, or harder. He called the weakened pulse wave a "negative VAS" which is described as soft, hollow, or dull.1 The VAS may be defined as a physiologic response of the vascular system brought on by exposure to macro-information as well as micro-information. Such a response is mediated by the autonomic nervous system, causing changes in the amplitude of the peripheral pulses.
The VAS changes are best felt over the radial artery in the manner described in Figure 2. Obviously, any stressor that the body perceives will stimulate the autonomic nervous system, leading to increased sympathetic tone, which results in vasoconstriction of the peripheral blood vessels, including the capillaries. This will re-enforce the reflecting wave leading to an increase in the amplitude of the stationary pulse wave, which Nogier labeled as "positive VAS."
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Figure 2. VAS examination.
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Figure 3. Sympathetic and parasympathetic zones.
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The Electromagnetic Field (EMF) of the Ear
The EMF of the ear is the 2nd concept used by Nogier and his colleagues in the development of Auricular Medicine. Since all of our cells are electrically charged, EMF surround the cells as well as the organs. Since the ear is a microsystem, an EMF is expected to surround that microsystem. The EMF reflects the energetic status of the body and all its tissues and organs. Consequently, any disturbed tissue or organ will cause a change in the overall EMF of the ear (or any other microsystem). Nogier's work identified an EMF specific to the ear extending (perpendicular to "Zero Point") out to a distance of approximately 1 cm beyond the ear itself in resting, non-stressed, normal physiological conditions.5 This reflects a normal energetic resting status for the microsystem. Any change in the pathophysiological status of any organ will result in stress that is then reflected as an overall expansion of this auricular EMF beyond the resting position.
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Figure 4. Black and white hammer. ©Acupuncture Arts & Press, LLC
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Filters
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Figure 5. Hand zones.
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Figure 6. Hand, Phase 3.
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Figure 7. Hand, Phase 3.
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Figure 8. Hand, Phase 3.
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Figure 9. Hand, Phase 2.
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Figure 10. Hand, Phase 3.
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Figure 11. Hand, Phase 2
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Figure 12. Hand, Phase 2.
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The 3rd principal used by Nogier was the use of filters. Filters consist of a rubber holder containing a pair of inert plastic plates that hold a particular substance to be used as a potential stressor. Filters are made of diseased tissues, toxic substances, or any pathological organisms.
Nogier also experimented with different colors and was able to identify particular grades of colors with frequencies resonating with different body organs. He also identified certain colors whose frequencies resonated with the 3 different phases previously mentioned. In addition, Nogier was able to identify particular areas of the body surface that appeared to have more of a sympathetic tone than a parasympathetic tone, and vice versa. The arms, legs, posterior neck, and posterior trunk are found to exhibit a rather dominant sympathetic tone compared to the anterior chest, anterior abdomen, anterior neck and the head, which exhibit a more dominant parasympathetic tone1 (Figure 3).
By applying filters to different parts of the body, the skin will receive micro-information concerning the content of the filter while simultaneously and temporarily ignoring all other micro-information available. Depending on whether that skin area is sympathetic or parasympathetic in nature as classified above, the micro-information received will be processed differently. If the filter is applied to a sympathetic area of the body surface, the micro-information appears to be temporarily amplified. In contrast, if the filter is applied to an area of the body that exhibits more parasympathetic tone, the micro-information appears to be temporarily reduced, minimized, or even cancelled.
The above information becomes instrumental when trying to localize the projection of any body organ or tissue on the acupuncture microsystem. If, for example, one tries to localize the projection of the kidney onto the ear or the hand, it is appropriate to apply a filter containing kidney tissues on a sympathetically oriented body surface (the arms or the legs). If the patient does have kidney pathology, this filter would be considered a stressor to that particular patient. As a result, the stress induced would lead to 2 different reactions. First, the stress would change the EMF of the kidney as a result of the body's resonance with the filter's contents. Consequently, the projection of the kidney on the microsystem would reflect that stress. The stress would lead to the expansion of the EMF of the microsystem of the ear (or the hand) beyond the resting potential of 1 cm. Secondly, the autonomic nervous system will react to the stressor. The stress will stimulate the sympathetic nervous system leading to changes in the caliber of the capillaries in the hand. This in turn will lead to a positive VAS, as described above. A positive VAS indicates that the filter used is a stressor. Since the filter contains kidney tissues, a positive VAS strongly suggests an energetic disturbance of the kidneys.
By identifying the EMF of the ear or the hand, an expansion beyond the resting position is perceived in response to stress. By using a reflecting object called a black/white hammer, the source of that energetic stress may be identified (Figure 4). When its white tip is positioned vertically and directly above the source of energetic stress, it will reflect that energy back to its source; this will exacerbate the degree of stress of that source point. This is immediately identified through change in the pulse wave that becomes stronger, fuller, and more vibrant, i.e., a positive VAS. By identifying the source of the energetic stress, the practitioner is in effect identifying the projection site of the kidney. Depending on the patient's history as well as by utilizing certain filters introduced by Nogier, the practitioner will be able to identify the exact phase of the kidney pathology. Nogier also introduced certain color filters that resonate with each of the phases, thus facilitating the identification of the exact phase of an organ or tissue's pathophysiology. In this manner, it is possible to identify the projection sites of any organ or tissue in any of the 3 positions or projections on any microsystem.
SOLIMAN-FRANK 3-PHASE HAND ACUPUNCTURE
Soliman-Frank have used similar investigative principles applied by Nogier to identify the 3 phases of the auricular system (including the VAS, the EMF, and tissue and color filters) to determine whether the hand microsystem possesses similar phases for organ projection. In addition, Soliman and Frank found a similar electromagnetic field for the hand microsystem with characteristics similar to that of the auricular microsystem. Thus, under normal physiological conditions, an EMF surrounds the whole hand; this EMF extends vertically perpendicular to the surface of the hand to a distance of about 1 cm beyond the hand itself. Any energetic disturbances of any of the organs in any phase will result in expansion of that EMF beyond the normal resting position of 1 cm.
Furthermore, applying Nogier's methodology, Soliman and Frank further describe the existence of the projections of all 3 phases of each structure and organ on the hand. To prevent unnecessary confusion when comparing the 2 microsystems, we added the auricular phase identification as introduced by Nogier to the 3-phase hand acupuncture system.
By identifying the localization of the organ multi-phase projections on the hand, the KHT (as introduced by Tae Woo Yoo in the 1970s), is found to comply with Phase 1 (normal physiological status or early energetic or functional stages of pathophysiological changes). Fur-
ther, we also found the somatotopy of the body tissues or organs in Phase 2 (dense or degenerative pathophysiology) and in Phase 3 (non-degenerative, transitional, or inflammatory pathophysiology).
To visualize the projections of the various organs in Phases 2 and 3, the hand is divided into different segments as follows:
- A line is drawn from PC 7 to the inter-digital space between the 3rd and 4th fingers.
- Two lines are drawn proximally and distally where the base of the thumb joins the hand at the carpo-metacarpal joint. The 2 lines should run transversely and parallel to the distal crease of the wrist to reach the ulnar side of the palm.
- A line is drawn from LI 3 to SI 3.
These divisions create 8 compartments that will facilitate the visualization of the projections of the different organs in both Phase 2 and Phase 3 (Figure 5).
Phase 3 Projections
Phase 3 represents pathology that is non-degenerative, transitional, or inflammatory in nature. The head and its structures are projected on the entire thenar eminence of the hand, occupying both compartments 3 and 4 (Figure 6). These projections show a side view of the head with the forehead, eyes, nose, mouth, and chin near the center of the palm and the occiput lying along the radial border of the thenar eminence. The cervical vertebrae extend from the base of the head along the distal wrist crease. The practitioner can identify cervical ver-tebrae 6 (C6) at the traditional site of the acupuncture point PC 7. The vertebral column continues distally along the ulnar border of the hypothenar eminence of the hand. The Sacro-coccygeal bones may be identified just proximal to the site of SI 3 (Figure 10).
The thoracic organs are projected onto the hypothenar eminence in an antero-posterior anatomical view. They occupy compartment 5. Most of the stomach and the upper half of the liver are also projected onto this compartment. In compartment 6, all the abdominal organs, including the kidneys, are projected in an anatomical manner with the exceptions noted above. The right side of the abdomen is projected towards the middle of the palm and the left side of the abdomen is projected along the ulnar side. Compartment 7 will house the projections of the pelvic viscera with the coccyx projected on the ulnar end of the line drawn from LI 3 to SI 3. Approximately 1 cm laterally on the same line, the rectum is projected. Immediately lateral to it is the vagina/penis and the female urethera (Figure 7).
The shoulder joint is projected near the site of C6-C7 and the arm extends from this point along a line ulnar border of the palm to the projection of the elbow. The elbow is projected along the ulnar border of the palm just proximal to where the middle transverse line reaches the ulnar border of the palm. From this point, the forearm is projected and extends to a point where the line drawn vertically in the middle of the palm intersects with the middle line drawn transversally. At this point, we find the projection of the hand itself.
The hip is projected along the ulnar border of the palm occupying the ulnar one-third of compartment 7. The thigh is projected across the whole compartment to end just shy of the vertical midline with the projection of the knee. The foot is projected onto the distal half of compartment 8, along the crease at the junction of the fingers and the palm. While the heel is projected just proximal to the interdigital space between the 4th and the 5th finger, the toes and the front two-thirds of the foot are projected along the junction with the ring finger. The leg is projected between the knee and the foot (Figure 8).
Phase 2 Projections
In a similar fashion, the organs and structures are projected onto the hand in Phase 2, presenting in a reversed manner. The head is projected onto compartments 5 and 6, again with the face facing the center of the palm. The cervical vertebrae extend from the base of the head along the distal wrist crease. Cervical vertebrae 6 (C 6) are identified at the traditional site of the acupuncture point PC 7. The vertebral column continues distally along the radial border of the thenar eminence of the hand. The sacro-coccygeal bone may be identified just proximal to the site of LI 3 (Figure 12).
The thoracic organs are projected onto the thenar eminence in an antero-posterior anatomical view. They occupy compartment 4. Most of the stomach and the upper half of the liver are also projected onto this compartment. In compartment 3, all the abdominal organs including the kidneys are projected in an anatomical manner with the exceptions noted above (Figure 9). The left side of the abdomen is projected towards the middle of the palm and the right side of the abdomen is projected along the radial side. Compartment 2 will house the projections of the pelvic viscera with the coccyx projected on the radial end of the line drawn from LI 3 to SI 3. Approximately 1 cm medially on the same line, the rectum is projected. Immediately medial to it is the vagina (penis) and the female urethra (Figures 9, 11).
The shoulder joint will be projected about the site of C 6-C 7; the arm extends from this point to the mid point of the root of the thumb along a line that is an extension to the lateral border of the palm beyond the thumb. From this point, the forearm is projected and extends to a point where the line drawn vertically in the middle of the palm intersects with the middle line drawn transversally. At this point, we find the projection of the hand itself. The hip is projected along the radial border of the palm occupying the radial one-third of compartment 2. The thigh is projected across the whole compartment to end just shy of the vertical midline with the projection of the knee. The foot in Phase 3 is projected onto the distal half of compartment 1, along the crease at the junction of the fingers and the palm. While the heel is projected at the junction with the index finger, the toes and the front one-third of the foot is projected along the junction with the middle finger. The leg is projected between the knee and the foot.
DISCUSSION
The hand acupuncture microsystem presents a sophisticated tool of diagnosis and treatment through its multi-phase projection. While KHT has been popular, it only reflects projections of organs with early, energetic, or functional pathophysiology. KHT is thus a projection of the basic anatomy and physiological status of the body organs, considered to be Phase 1. This phase may be active in many nondegenerative or inflammatory conditions as well as dense, degenerative conditions. In these situations, KHT demonstrates the presence of energetic, functional pathology on top of more aggressive pathology. KHT (Phase 1) is ideal to treat functional conditions as well as acute inflammatory conditions existing on top of more dense pathology. However, treating this phase alone is inadequate to fully address the more dense or aggressive pathological changes. Such changes are projected onto the hand in Phase 2 and/or Phase 3. The dynamics of phases offer a sophisticated understanding of the patient's energetic changes and consequently a superior treatment approach.
While addressing the pathophysiology in all 3 phases would yield fulfilling results, practitioners may further improve their hand acupuncture microsystem skills by utilizing the changes in the pulse (VAS) and the EMF of the hand. This would allow sharper accuracy in identifying the phases. This would also provide invaluable information to assist in determining disease etiology.
We've successfully utilized this multi-phase approach to address dense pathological changes in our patients. For example, we studied 26 patients with chronic non-degenerative arthritic conditions who were treated once weekly for 6 weeks using the basic KHT approaches. Improvement in their conditions ranged between 20%-30% by the end of the treatment course. Multiple phase treatment was then started for the next 3 weeks. By using the appropriate phases, we further improved their condition. Following this short course of treatment, the pain level decreased by 60%-70%. Additionally, 14 children being treated for Attention Deficit/Hyperactivity Disorder (ADHD) utilizing the basic KHT system over 3 months resulted in improving their attentive abilities and decreasing their hyperactivity by an estimated 20%-30%. Another group of children (15) was treated for a similar period using the multi-phase system. The overall improvement was considerably higher in the last group with an overall improvement ranging from 50%-75%. The multi-phase system appears to offer more flexibility in addressing the correct projections of the brain structures that are involved in ADHD.
CONCLUSIONS
The sophistication of the Soliman-Frank 3-Phase Hand Acupuncture offers a new paradigm for understanding the pathophysiology and the energetics of the living system. It opens the door for a new era in medical acupuncture and for exciting ways to improve the welfare of our patients.
ACKNOWLEDGEMENT
We wish to thank Dr Richard Niemtzow for his assistance with
this article.
REFERENCES
- Nogier PF. From Auricular Therapy to Auricular Medicine. Maisonneuve, Sainte-Ruffin, France; 1983.
- Bourdiol RJ. Elements of Auriculotherapy. Maisonneuve, Sainte-Ruffin, France; 1982.
- Treatises in Celebration of the 7th Korea-Japan Koryo Sooji Chim: August 16-17, 1985, Seoul, Korea. Koryo Sooji Chim Institute and Eum Yang Mek Jin Publishing Company, Seoul, Korea.
- Jodorkovsky R. Effective abbreviated acupuncture in children. Medical Acupuncture. Fall/Winter 1997-1998;9(2):7-10.
- Yoo TW, Eckman EY, Ed. Hand Acupuncture. Seoul, Korea, Jin Publishing Co; 1988.
- Huang Die Nei Jing Su Wen. (The Essential Questions of the Yellow Emperor's Classic of Chinese Medicine).
- Talbot M. The Holographic Universe. Harper Perennial; 1991/1992.
- Pribram KH. Language of the Brain: Experimental Paradoxes and Principles in Neuropsychology. Brandon House, New York, 1982 and Earlbaum Associates, Hillsdale, NJ; 1990.
- Pribram KH. Toward a Holonomic Theory of Perception. Gestalttheorie in der Modernen Psychologie. Steinkopff, Darmstadt, Germany; 1975.
- Frank BL, Soliman NE. Auricular Therapy: A Comprehensive Text. Bloomington, IN: AuthorHouse; 2005.
- West JB, Ed. Best and Taylor's Physiology Basics of Medical Practice, 12th edition. Philadelphia: Williams & Wilkins; 1990.
AUTHORS' INFORMATION
Dr Nader Soliman is Immediate Past President of the AAMA (2003-2005), and President of the Integrated Pain Management Center of Rockville, Maryland, and has authored or co-authored numerous texts, atlases, chapters, and articles. He regularly teaches Auricular Therapy, Auricular Medicine, and acupuncture around the USA.
Nader E. Soliman, MD, FAAMA*
President, Acupuncture Arts & Press, LLC
15001 Shady Grove Rd, Ste 100
Rockville, MD 20850
Phone: 301-251-2335 • E-mail: NaderSolimanMD@yahoo.com
Dr Bryan Frank, past AAMA President (1999-2001), serves as President of ICMART (2004-2006), and has authored or co-authored numerous texts, atlases, chapters, and articles. Dr Frank regularly teaches around the world in acupuncture and medical symposia and congresses, and serves as a medical missionary overseas as Executive Director of Global Mission Partners, Inc., a 501-c-3 charitable organization.
Bryan L. Frank, MD, FAAMA
President, Acupuncture Arts & Press, LLC
PO Box 30415
Edmond, OK 73003-0007
Phone: 405-623-7667 • Fax: 405-341-5342 • E-mail: BFrankMD@aol.com
*Correspondence and reprint requests
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