Kajsa Landgren Published by Churchill Livingstone Elsevier, 2008 Hardcover, 248 pages, RRP £34.99
(Reviewed by Mike Cassidy, EJOM Vol. 6 No. 1)
I received my copy of ‘Ear Acupuncture’ by Kajsa Landgren with some interest, mainly because there is clearly a need for a good up-to-date textbook on the subject. Previous texts have been written by Oleson, Nogier and Strittmatter, and I was interested to see how the author viewed her work in relation to these existing books.
In the preface, the author states that the book is aimed at body acupuncturists, doctors, nurses, midwives, physiotherapists, reflexologists and patients. I was therefore a little surprised when she went on to say that it was written so that it could be understood by readers with no prior medical knowledge, as one would expect the majority of her intended audience to have at least a basic grounding in medicine. Having since read the book, I think her decision to pitch the book at this most basic level has handicapped its potential.
The first chapter gives a brief history of the development of modern ear acupuncture which focuses mainly on the work of Nogier. Although a later chapter is devoted to the NADA protocol, I thought it would have been useful to include a historical perspective on NADA at this stage as this is arguably how the majority of modern practitioners first encounter ear acupuncture.
The next two chapters give a very disappointing and somewhat irrelevant introduction to TCM and comparison between body and ear acupuncture. A book that is most likely to be read by acupuncture graduates should assume a basic knowledge of TCM and stay focused on its core subject. I was particularly disappointed to see a supposed advantage of ear acupuncture summarised as it being cheaper to learn than body acupuncture. Although she mentions group treatment as an advantage, there is no explanation of why group treatment can be so effective (because it creates a fundamentally yin supportive environment).
Following a brief outline of other microsystems of treatment (reflexology, Korean hand therapy etc), she shifts somewhat randomly into a chapter on acupuncture research, double-blind testing and neuroscientific models of how acupuncture might work. Her supposed target reader with no previous knowledge of medicine will be boggled by a lightning tour through neuropeptides and subcortical structures on one page before being presented on the next by the rather odd analogy that the ear’s relation to the brain is like the screen and keyboard’s relation to the computer (‘We can lose or damage an ear without destroying the brain/computer, but in so doing we lose the possibility of reading on the screen – diagnosing – and programming – treating – via the ear.’).
A brief overview of a western approach to how ear acupuncture may work could certainly be interesting, but her overview is disjointed and contains almost no useful references to the large and important literature on acupuncture research that might be useful to a practitioner wanting to learn more at a later time.
At the end of the next (again oversimplified) chapter on basic ear anatomy, we finally arrive at point functions and locations. She states that she is basing her descriptions on those found in the books by Nogier, Oleson, Strittmatter and others, leading one naturally to wonder if it might be better to go to these original sources. Some of her point descriptions are confusing, in that she refers to a number of landmarks outlined in Oleson’s text, but doesn’t clearly explain where the landmarks are. Other point descriptions refer to anatomical landmarks that are not marked on the nearby figure, so you have to constantly flip through the book to try and find them.
A classic problem with (this and previous) texts on ear acupuncture is the ability to learn to transpose maps of points from an idealised drawing of an ear to real physical ears. Ideally, to do this well one needs concrete anatomical landmarks to learn a core set of points, which can then be extended to new points, using the first set of points learnt as further landmarks, and so on. I suspect that practitioners with no experience of ear acupuncture who try to use this book to locate new ear points will become frustrated quite quickly or feel unsure about their point location.
Later chapters on the examination of the ear, how to locate active points and different methods of auricular stimulation read much better, as does the final chapter on the NADA protocol. There are useful tips in the book, such as using a head-worn lamp to help visibility if lighting is poor, or how to test a person’s dominant side to help with ear selection for treatment, and there is a discussion of the more esoteric techniques of ear acupuncture such as threading, bleeding, electro-stimulation, burning etc. For practitioners who need ideas for possible points to treat for different conditions, broad selections are given to choose from.
Overall though, if the author had stayed focused on the aspects of ear acupuncture that would be of practical clinical interest to practitioners, the book could have been half the size and much more effective. Trying to make the scope of the book too broad, and pitching the narrative to all levels of medical competence, lets it down.
Mike Cassidy Mike Cassidy has been practising acupuncture in London for the past four years. Since graduating from CICM in 2004, he also trained in ear acupuncture at the Yuan College and has been working on a weekly basis with ear and body acupuncture in a group setting at City Roads, a residential alcohol and substance abuse clinic.
