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In this issue
  1. Adrian White

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Auricular acupuncture (AA): valid therapy or fascinating fantasy? Perhaps the most contentious aspect is the claimed correspondence between the ear zones and the body organs. Enthusiasts for AA claim that the evidence speaks for itself. Sceptics argue that there is no anatomical basis for it, and in particular no real justification for the body to be represented upside down: it seems to be based on analogy with the homunculus in the cerebral cortex but this is more ‘inside out’ than truly upside down. This correspondence is critical: many trials compare ‘correct’ and ‘incorrect’ sites: if there is no such thing as an ‘incorrect’ point, then no difference will be seen and the conclusion will be that AA is ineffective. So it seems important to make a clear distinction between AA diagnosis, which rests wholly on the correspondence, and AA as treatment which may or may not use the correspondence concept.

This issue contains a handful of articles on AA: we have a piece of serious diagnostic research on correspondences, undertaken by Romoli and his colleagues in Italy; and a thoughtful commentary on the paper by Usichenko in Germany, with a suggestion for an anatomical principle that might explain the correspondences; we have a letter from Volf describing a remarkable clinical application of AA in simulated space flight over France; and we have a summary of a meta-analysis of AA for pain (which is positive) in the Research Shorts. And finally, I have searched four modern textbooks of AA high and low for an explanation of the correspondences in terms of anatomy and embryology, and reviewed them at the back of the journal.

One clear advantage of AA is convenience and efficiency for treatment, and Simcock and Jenkins chose to use it in the treatment of irradiation-induced xerostomia in their trial which is in progress. They have kindly provided the figure here, and in this issue they comment on a systematic review of the literature on acupuncture for xerostomia by O'Sullivan and Higginson.

Turning to our clinical trials, the first by Landgren et al explores a use for acupuncture that seems to be accepted in Scandinavia – infant colic, and the results hold out some hope for both the infants and the parents in this miserable condition. In the second, Madascha et al explored acupuncture for assisted reproduction for infertility: while the results are negative in this study, they do suggest that future studies should concentrate on a particular subgroup of women in which acupuncture may have a better effect.

The next two studies look at different aspects of the usage of acupuncture: Hopton and colleagues discover that patients in the York chronic back pain trial would be prepared to put up with some side effects of acupuncture as long as it worked for them, though as many as 9% would not be willing to try acupuncture again. And Vincent and colleagues document the conditions for which patients are referred for acupuncture treatment in an academic centre in The Mayo Clinic.

Auricular acupuncture treatment for xerostomia

Our research methodology paper describes a new sham control for cupping, devised by Lee and colleagues – the editors debated whether cupping falls within the scope of the journal, and concluded that it did because it is another form of sensory stimulation and it has historically been integral with acupuncture.

We end with another letter in which Shockert explores a different microsystem, scalp acupuncture, and the case report of whiplash-type injury treated by Rosted and Jørgensen.

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