Vol. 15, #1

Localization Of Auricular Projection Areas
Of The Stomach And Duodenum And Their Use
In The Monitoring Of Ulcer Disease
Jan Z. Szopinski, MD
Georg P. Lochner, BS
Jolanta Szkliniarz, MD
Iwona Karcz-Socha, MD
Anna Kasprzyk-Minkner, MD
Krzysztof Kielan, MD
Barbara Krupa-Jezierska, MD
Dariusz J. Nasiek, MD
Piotr Warakomski, MD

ABSTRACT
Background     Pathology of a particular organ causes related skin areas (organ projection areas [OPAs]) to rectify electrical currents (diode phenomenon), once the resistance breakthrough effect has been induced in the skin.
Objectives       To localize auricular projection areas of the stomach and duodenum, and to evaluate their usefulness in the monitoring of ulcer disease.
Design, Patients, and Setting     Case-control study comparing the degree of electrical rectification measured at various spots in the auricular concha region in 18 patients with gastric ulcers, 17 with duodenal ulcers, and 17 controls from the 4th Department of Internal Medicine, Silesian School of Medicine, Poland.
Intervention     Evaluation of electrical verification at OPAs on the auricular concha using a "rectification ratio" (normal range, 0%-60%; 0%=no rectification.
Main Outcome Measures       The location of skin areas where a statistically significant difference existed between the rectification ratios observed in patients vs controls.
Results     Locations were identified on ear auricles where the electrical rectification phenomenon displayed a dependence on the presence of ulcers. In patients with gastric ulcers, the rectification ratio in the stomach OPA was a mean (SD) of 87% (8%) while in other areas it was 37% (9%). After treatment, the rectification ratio in the stomach OPA decreased to 58% (12%). In patients with duodenal ulcers, the rectification ratio in the duodenum OPA was a mean (SD) of 84% (9%) while in other areas it was 41% (11%). After treatment, the rectification ratio in the duodenum OPA decreased to 52% (14%). In controls, no areas of high rectification ratio were observed (42% [8%]).
Conclusions     Stomach and duodenum OPAs exist on the ear auricle within the region of cymba conchae. The existence of gastric or duodenal ulcers causes these skin areas to display a higher degree of rectification which may be monitored.
KEY WORDS
Breakthrough Effect, Skin Resistance, Organ Projection Area, Acupuncture Point, Organ Electrodermal Diagnostics, Gastric and Duodenal Ulcers, Rectification

INTRODUCTION
  A correspondence exists between the state of health of specific internal organs and the electrical characteristics of related, although sometimes remote, skin areas. These skin areas are referred to as organ projection areas (OPAs) and include acupuncture points. Pathology of a particular organ causes a related OPA to rectify electrical currents once the resistance breakthrough effect has been induced in the skin.1-11 The breakthrough effect is a rapid reversible decrease in skin resistance that occurs under certain electrical stimulation conditions.Following the breakthrough effect, the skin resistance measured by means of a positively polarized point electrode is significantly higher for diseased organs' projection areas compared with the resistance for the same, but negatively polarized, measuring electrode (rectification/diode phenomenon). This phenomenon is not observed for healthy organs' projection areas. The ratio of these 2 measurements is not affected by the patient's muscular tension, emotional condition, skin hydration, procedure duration, environmental temperature and humidity, or the pressure of the measuring electrode. Many OPA/ acupuncture point maps are used in reflexive therapies, e.g., various maps of auricular OPA, plantar and palmar OPA, cranial zones, lingual zones, and nasal mucosa zones. Iridology uses changes in iris coloration for diagnostic purposes. However, significant differences exist between maps prepared by different authors.

We sought to determine precise locations of stomach and duodenum auricular OPAs using the electrical dynamics described above.

METHODS
We studied 35 inpatients diagnosed with gastric or duodenal ulcers as the only condition at the 4th Department of Internal Medicine, Silesian School of Medicine, Poland. Patients with additional pathologies were excluded. The 18 patients with gastric ulcers consisted of 8 women and 10 men, aged a mean (SD) of 36 (7) years. The 17 patients with duodenal ulcers consisted of 8 women and 9 men, aged a mean of 33 (6) years. Their diagnosis was based on history, physical examination, and the results of a gastroduodenoscopy. In 2 cases of asymptomatic gastric ulcers, incidental gastroscopy was the only criterion for inclusion. In all the patients, apart from the ulcers found, there was evidence of chronic inflammation of the mucosa (confirmed on biopsy). The control group consisted of 17 clinically healthy volunteers, mean age 34 (6) years, with no pathological changes on endoscopic examination. All subjects provided oral consent to participate in this study.

Figure 1. Measurement of the Rectification Ratio


Most reflexotherapeutic maps localized stomach and duodenum projection areas within the auricular concha region.12-19 The examinations were performed with a (Diagnotronics) prototype measuring device (Figure 1). The measurements were done with a dry brass-point electrode (diameter, 1 mm) placed on a particular skin spot on the cymba conchae, and a brass reference electrode (area about 2 cm2 covered with a conductive gel) placed on the patient's hand. The point electrode was mounted on a spring to ensure that the pressure applied was constant and repeatable; it was polarized negatively and the potential increased until the breakthrough effect was observed (usually between 7-15 V). The current was then adjusted to 25 mA and the skin resistance was measured. The polarity of the point electrode was inverted (set to the same voltage at which the skin resistance measurement was done, but positively polarized), and a 2nd resistance measurement done.

Figure 2. Location of Auricular Projection Areas of Stomach (1) and Duodenum (2)



These 2 measurement values, taken from the same skin point, were used to calculate the final result using the formula: Rectification Ratio=[1-(1st Measurement)/(2nd Measurement)] x100%.
This measurement regimen was performed automatically by the device with the final rectification ratio reflecting the pathology intensity (normal range, 0%-60%). Measurements were taken on a grid of points, approximately 2 mm apart, covering the whole surface of the cymba conchae.

The resistance measurements were performed after the 1st gastroscopy (ulcers and gastritis/duodenitis present) and repeated after the final gastroscopy (healed ulcers, reduced inflammation). In the control group, the resistance measurements were performed only once after gastroscopy. To prevent bias, a group of independent examiners with different medical backgrounds was appointed to perform the measurements. A 2-tailed t test assuming unequal variances was used to calculate significance.

RESULTS
A high degree of rectification in an area 2-3 mm in diameter was observed on evaluation of the electrical resistance of the auricular concha in 18 patients with gastric ulcers and gastritis before treatment.

This area is located at the bottom of cymba conchae, next to the end of crus helices (Figure 2). The rectification ratio in this area measured a mean (SD) of 87% (8%) while in the remaining examined areas, it was 37% (9%) (Figure 3). Statistically, there was no other spot in the examined region in which the rectification ratio was higher than 60%. After successful treatment, rectification ratios in the area described decreased to 58% (12%). The ratios in other areas did not change significantly (P>.05).

A high degree of rectification in an area 2 mm in diameter was observed on evaluation of the electrical resistance of the auricular concha in 17 patients with duodenal ulcers and duodenitis before treatment. This area is located at the upper level of the cymba conchae, next to the anthelix (Figure 2). The rectification ratio in this area measured a mean (SD) of 84% (9%) while in the remaining examined areas it was 41% (11%) (Figure 3). Statistically, there was no other spot in the examined region in which the rectification ratio was higher than 60%. After successful treatment, rectification ratios in the area described decreased to 52% (14%). The ratios in other areas did not change significantly (P>.05).

In the control group, no areas with a high degree of rectification were observed (rectification ratios were 42% [8%]). These bioelectrical measurements of the skin did not result in any observed adverse effects.

DISCUSSION
Many authors have investigated the effect of particular organ pathology on the electrical parameters of corresponding skin areas.10,17-26 Diagnostic methods based on measurements of electrical potential, resistance, and impedance of these zones have been proposed; however, their diagnostic accuracy has not been proven and reproducibility has not been consistent. Some of these methods use specific bioelectrical properties of acupuncture points.10,17-19,21-26 These include electroacupuncture diagnostic-therapeutic systems,10,17-19,21-24 many types of auricular electroacupunctural diagnostics,10,12,17,18 and some methods based on corporal acupuncture point impedance measurements.10,17,18,23 Many measurement techniques, current parameters, and OPA maps are used in the above-mentioned methods. The results often depend on perspiration, which is influenced by the patient's muscular tension, emotional condition, skin hydration, procedure duration, environmental temperature and humidity, and the pressure of the measuring electrode. Therefore, these methods are not widely used in contemporary medicine.

Figure 3. Comparison of Rectification Ratios of Various Auricular Regions in Successive Stages of Ulcer Disease

Our findings confirm that the skin resistance characteristics of specific locations are dependent on the state of health of corresponding internal organs. However, in contrast to previous attempts by others, the breakthrough effect was the key to obtaining electrical skin resistance measurements that correlate with the condition of a related organ. The breakthrough effect probably reflects the electrical current's penetration through the lipid layers of the stratum corneum.27 The skin resistance measured via a positively polarized electrode is then significantly higher for the diseased organs' projection areas compared with the resistance for the same but negatively polarized measuring electrode.1-11 The ratio of these 2 measurements is not affected by all the factors that influence the actual skin resistance values; therefore, a universal point of reference is established.

By measuring the degree of rectification of various skin areas in diagnosed patients, the precise location of a particular OPA can be determined. We used this method to establish the locations of the stomach and duodenum auricular OPA. Evaluation of the resistance characteristics of these specific skin areas could become a useful criterion for further investigation such as gastroscopy. For example, when the gastric or duodenal OPA displays a higher degree of rectification, a gastroscopy would be highly recommended, even without significant clinical symptoms (asymptomatic ulcers). After a gastroscopy rules out malignancy, further unpleasant and expensive investigations could be replaced by bioelectrical measurements.

The method used in this study could be applied to the practical individual selection of optimal skin zones (acupuncture points) for reflexive therapies. The efficacy of these therapies could be increased and the foundation for scientific acupuncture could be created.

This research contributed significantly to the development of organ electrodermal diagnostics,1-11 the 1st method of this kind that has undergone double-blind clinical trials with positive results.6,7 It appears that organ electrodermal diagnostics may enable noninvasive access to the body's information network, the nervous system, in an attempt to obtain precise data about the health of internal organs.9

CONCLUSION
Stomach and duodenum OPAs exist on the ear auricle within the region of the cymba conchae. The existence of gastric or duodenal ulcers causes the resistance characteristics of these skin areas to display a higher degree of rectification once the skin resistance breakthrough effect has been induced. Evaluation of the electrical resistance characteristics of stomach and duodenum projection areas may allow for noninvasive monitoring of ulcer disease.

ACKNOWLEDGEMENT
We thank Professor G. Jonderko, Head of the 4th Department of Internal Medicine of the Silesian Medical School, Poland, for his assistance and advice.

REFERENCES

  1. Szopinski J, Sierak T, Niezbecki A, Kaniewski M. Influence of selected internal diseases on electrical parameters of acupuncture points (Polish). In: Sapinski W, ed. Diary of 1st National Conference on Acupuncture, 23-24 September, Warsaw.
  2. Szopinski J, Sierak T, Szopinska H, Ciszek M. Bioelektrische und bionergetische Eigenschaften und morphologische Strukturen der Akupunkturpunkte und Akupunkturmeridiane. In: Bischko J, ed. Handbuch der Akupunktur und Aurikulotherapie. Part 25.2.0. Heidelberg, Germany: Haug Verlag; 1985:105.
  3. Szopinski J, Sierak T, Kaniewski M, Niezbecki A. Der Einfluss ausgewahlter Krankheiten aufdie Bioelektrischen Eigenschaften der Akupunkturpunkte. Dtsch Z Aku. 1988;3:51.
  4. Sierak T, Szopinski J. Universal device for electrodermal organ diagnostics and electrotherapy (Polish). Probl Tech Med. 1987;18:255.
  5. Sierak T, Szopinski J. Universelles elektronisches Gerat fur die automatische Elektropunkturdiagnostik und Elektroreflextherapie. Dtsch Z Aku. 1988;5:112.
  6. Szopinski J. Application of the Organ Electrodermal Diagnostics Own Method in Chosen Internal Diseases [thesis]. Katowice: Silesian Medical Academy; 1985.
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  9. Szopinski J, Sierak T, Lochner G. Neurophysiological foundations of organ electrodermal diagnostics, acupuncture, TENS and other reflexive therapies. Pain. In press.
  10. Szopinski J. The use of bioelectrical properties of skin for organ diagnostics [in Polish]. Wiad Lek. 1989;42:697.
  11. Ciszek M, Szopinski J, Skrzypulec V. Investigations of morphological structure of acupuncture points and meridians. J Tradit Chin Med. 1985;5:289-292.
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  17. Portnov F. Electropuncture Reflexotherapy. (Russian). Riga: Zinatne Publishing House; 1982.
  18. Tabeyeva 0. Manual of Acupuncture Reflexotherapy. (Russian). Moscow: Meditsina; 1980.
  19. Garnuszewski Z. Acupuncture in Contemporary Medicine. (Polish). Warsaw, Poland: Amber; 1997.
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AUTHORS' INFORMATION
Dr Jan Z. Szopinski heads the Pain Clinic, Mayo Centre of South Africa, Johannesburg. Dr Szopinski's PhD was the first doctorate in the field of electroacupuncture in Poland.
Jan Z. Szopinski, MD, PhD*
P O Box 1042
Fontainebleau 2032
South Africa
Phone/Fax: 027 11 475 8185

Mr Georg Lochner is an Electronic Engineer. He is completing his Masters Degree in Bioelectronic Engineering at the Department of Electronic Engineering, University of Pretoria, South Africa.
Mr G. P. Lochner, BS
P O Box 32459
Glenstantia 0010
South Africa
Phone: 027 129931505
E-mail: lgeorg@xsinet.co.za

Dr Jolanta Szkliniarz heads the Department of Geriatry, Provincial Teaching Hospital in Tychy, Poland. She is a Specialist Physician, Specialist Geriatrist, and Specialist of Infectious Diseases.
Jolanta Szkliniarz, MD
ul. Edukacji 102
43-100 Tychy
Poland
Phone: 048323254302

Dr Iwona Karcz-Socha is a Specialist Physician in the Internal Medicine Department of the Strzeice Opolskie Regional Hospital, Poland.
Iwona Karcz-Socha, MD
Internal Medicine Dept
Strzeice Opolskie Regional Hospital
ul. Opolska 34
47-100 Strzeice Opolskie
Poland
Phone: +48 77 4694054

Dr Anna Kasprzyk-Minkner is a Specialist in Pediatric Neurology at the Provincial Centre for Mother and Child Health Care in Czestochowa, Poland.
Anna Kasprzyk-Minkner, MD
Provincial Centre for Mother
and Child Health Care
ul. Sobieskiego 7A
Czestochowa
Poland
Phone: +48 34 3249539

Dr Krzysztof Kielan is a Specialist Psychiatrist at the 1st Department of Psychiatry, Silesian Medical School, Poland.
Krzysztof Kielan, MD
1st Department of Psychiatry
Silesian Medical School
ul. Ziolowa 45/47
40-635 Katowice-Ochojec
Poland
Phone: +48 32 2059260

Dr Barbara Krupa-Jezierska is a Specialist Pediatrician in private practice affiliated with Maciejow-Zabrze Medical Centre, Poland.
Barbara Krupa-Jezierska, MD
ul. Kondratowicza 1 C
41-804 Zabrze
Poland
Phone: +48 32 2711348
Fax: +48 32 2761429 E-mail: dkrupa@eurometalkhp.pl

Dr Dariusz J. Nasiek is Consultant Anesthesiologist at Newport Hospital in Newport, Rhode Island. Dr Nasiek is also a specialist in Pain Management, Anti-Aging Medicine, and licensed Acupuncturist in private practice.
Dariusz J. Nasiek, MD
1 Seaview Ave, #3
Newport, RI 02840
Phone: 401-847-6441
E-mail: saranasiek@hotmail.com

Dr Piotr Warakomski is a Neurologist with the Department of Physiology, Silesian Medical School, Poland.
Piotr Warakomski, MD
Department of Physiology
Silesian Medical School
ul. Jordana 19
40-808 Zabrze
Poland
Phone: +48 32 2723262
Fax: +48 32 2804956 E-mail: katfizjr@slam.katowice.pl

*Correspondence and reprint requests

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