14 Ear acupuncture a part of the ear with a hot metal probe has also been reported among certain tribes in Arabia. This is probably a vestige of the acupuncture practiced in ancient Egypt and Saudi Arab. The Ebers papyrus of 1550 B.C. (now in the British Museum) describes a system of channels and vessels in the body which approximates more closely to the Chinese system of channels than to any known system of blood vessels, lymph vessels or nerves. The Egyptologist Alexandre Varille (1909–1951) has documented that women in ancient Egypt who did not want any more children, had their external ear pricked with a needle or cauterized with heat. Gold earrings worn by Mediterranean sailors were not just used as decorations, but were said to improve vision. Hippocrates, the father of of Greek medicine, reported that doctors made small openings in the veins situated behind the ear to facilitate ejaculation and reduce impotency problems. Cutting of veins situated behind the ear was also used to treat leg pain. The Greek physician Galen introduced Hippocratic medicine to the Roman empire in the second century CE, and commented on the healing value of scarification at the outer ear. After the fall of Roman empire, the medical records of Egyptian, Greek and Roman medicine were best pre- served in ancient Persia and Arabian world. Included in these Persian records were specific references to medical treatments for sciatic pains and sexual related disease produced by cauterization of the external ear. During Renaissance sporadic clinical reports in Europe describe the use of ear cauterizations to relieve leg pain. The Dutch East India Company actively engaged in trade with China from 1600s to 1800s, and its merchants brought Chinese acupuncture practices back to Europe. Doctors working with the company had become impressed by the effectiveness of needles and moxa, and cauterization of the external ear, or by cutting the veins behind the ears for relieving conditions such as sciatic pains and arthritis of the hip. In 1637 probably for the first time in Europe was described by the Portugese physician Zacatus Lusitanus the treatment of sciatic pain by cauterization of the ear after that bloodletting had failed. The Italian anatomist and surgeon Antonio Maria Valsalva (1666–1723), who made the first modern anatomical description of the ear; in 1717 published the Aura Humanus Tractatus, where he describes the treatment of toothache by scarification of antitragus. In 1810 Prof. Ignazio Colla of Parma, Italy, reported the observation of a man stung by a bee in the antehelix which resulted in dramatic relief of pain in the legs, and in the same year Dr Cecconi, another Italian physician, performed cauterization to help treat- ment of sciatic pain. In 1850 the French Journal des connaissainces medico-chirurgicales reported 13 different cases of sciatic pain that had been treated by cauteriza- tion with a hot iron applied to the ear. Only one of the Figure 1. This drawing illustrates the concept of an inverted fetus map on the external ear. patients did not improve completely. But it was not until a century later that Paul Nogier rediscovered this type of treatment. Dr Paul Nogier: The Father of Ear Acupuncture In 1957, Dr Paul Nogier a physician resident in Lyons, France, first presented his observations of the somato- topic correspondences of the ear. He is actually considered the Father of modern auricolotherapy. Dr Nogier (2) originated the concept of an inverted fetus map on the external ear (Fig. 1). He developed this theory after noticing that some patients attending his clinic had a small scar from a burn on part of their ear. On inquiring into this, he was told that a very small area of their ear had been cauterized by a certain Madame Barrin for treatment of sciatic pain—a treatment that they proved very rapid and effective. Later his first great insight was the recognition of the homunculus, ‘the man in the ear’, the representation and anatomical correla- tion of the inverted fetus in the ear. Points on the body, for example the knee, corresponded precisely