The auricular acupuncture microsystem has been established as a key therapy in the acupuncture armamentarium. While general body acupuncture addresses the various pathophysiological problems through treating the corresponding meridians, the auricular acupuncture microsystem offers very specific localizations for the organs and structures involved in the pathology. Treating such somatotopic projections on the auricle frequently yields superior results. This paper focuses on the application of auricular needling to both enhance and suppress sexual desire.

Key Words:

Paul Nogier, René Bourdiol, Jerome Bosch, Sexual Desire, Auricular Therapy, Acupuncture


While many auricular therapy practitioners are familiar with the outstanding work of Paul Nogier and his colleagues, some may not be aware that many auricular points have been inspired by the fascinating artwork of painter Jerome (Hieronymus) Bosch (c.1450–1516). Bosch was considered a highly imaginative painter and was known for his portrayal of devils and monsters in his art. His paintings were overtly religious, presenting clear punishment implications for the evil of men.

“The Garden of Earthly Delights” is one of his most famous paintings (Figure 1). It depicts the earthly paradise, the creation of woman, the first temptation and sin, and eventually the fall of Adam and Eve. It clearly presents a picture of human sensuality and the pleasure-seeking world of man. Surprisingly, in many of his complex works, including “The Garden of Earthly Delights,” the ear is figured prominently reflecting these themes.


Considering the fact that cauterization of the ear has been known in Europe and the United States for centuries, Nogier and his colleague René Bourdiol took a hard look at the painting of “The Garden of Earthly Delights” (c.1500; Museo del Prado, Madrid), suspecting that it might have a hidden message about the ear in its role as a correspondence system.1 In this painting, a right ear and a left ear are joined together along their mastoid surfaces. A blade of a knife extends anteriorly from the junction site (Figure 1). The painting clearly portrays an overtly erotic presentation of the male sexual organs. On the right ear, a demon appears to thrust a needle or a spear into the ear. The spear pierces the ear at 2 different sites. It enters the ear at the junction of the scaphoid fossa and the lobule, and exits at the anterior border of the ascending branch of the helix near its junction with the upper part of the tragus. Intrigued by the idea that the painting may carry a hidden message concerning sexuality, Nogier and Bourdiol agreed to try this treatment on their patients. The site of entrance of the needle proved to be effective in suppressing the libido and was named the “Jerome” point. On the other hand, the site of exit of the needle proved valuable in enhancing sexual desire and was named the “Bosch” point. In effect, the Bosch Point corresponds to the projection site of the external genitalia (clitoris and glans penis) in Phase 1, and the pineal gland in Phase 3, both of which have a definitive effect on libido and sexuality. Conversely, the Jerome point is found at the projection site of the pons and midbrain in Phase 1.1,2 Serotonin produced in the pons and midbrain is believed to have an inhibitory effect on sexual functions.

Soliman’s Axis of Sexual Desire

Additional observation by the author in 2000 reveals a second monster massaging the projection site of the genital organs in Phase 3. The projection of the genital organs in Phase 3 is superimposed on the area traditionally known as the “Eye Zone.” This is also the projection site of the genital organs in Phase 3. Massaging this site is expected to stimulate the projection site of the penis and the clitoris in this phase that reflects chronic sexual dysfunction. A third creature is shown piercing an area near the apex of the triangular fossa (the area is also known as the Shenmen Zone). The area of penetration corresponds to the projection sites of the thalamus and the cingulate gyrus in Phase 2. Both structures are known to deal with sexuality. In general, this painting of Jerome Bosch provides strong sexual themes and treatment suggestions for various sexual problems.3,4 While the above findings by Nogier and Bourdiol are interesting, the author in 2006 noticed that the trajectory of the spear traverses a group of structures in all 3 phases with aptitude to influence the sexual desire in both sexes. Starting at the site of entry, the spear’s trajectory traverses the following structures: the pons and midbrain in Phase 1, the cerebellum in Phase 1, the pons and midbrain in Phase 2, the pons and midbrain in Phase 3, the hypothalamus in Phase 3, the cerebellum in Phase 3, the amygdala in Phase 3, the hippocampus in Phase 3, the sympathetic chain in Phase 2, and the spinal cord (sacrococcygeal segment with their parasympathetic fibers) in Phase 2, the adrenal medulla in Phase 3, and finally, the pineal gland in Phase 3. The projection site of the cerebellum in Phase 2 also shares the site of projection of the pineal gland in Phase 3 (Figure 2).3,4 The role of the pons in suppressing sexual desire is mentioned above. The hypothalamus, the cingulate gyrus, and the hippocampus play an important role in regulating both the mood and the sexual desire. They are also recognized to be heavily sensitive to sex hormones. Studies suggest that specific structures in the hypothalamus and the hippocampus are important in either initiating or modulating proerectile pathways.5 The sympathetic fibers of the sympathetic chain are necessary to prepare the heart for the sexual activity while the parasympathetic fibers in the sacrococcygeal segment of the spinal cord are responsible for the increased blood flow to the erectile tissues and the genital organs. Significant activation during visual-evoked sexual arousal has been seen in the left anterior cingulate cortex.6 Studies have shown that many regions within the cerebellum are activated in response to visual sexual stimuli (Figure 2).7 “Soliman’s axis of sexual desire” provides the means to suppress excessive sexual desire as well as the means to boost this desire. Treatment of the sexually suppressive com- ponents of this axis may be beneficial in treating cases such as nymphomania and sexually aggressive individuals. Treating the sexually stimulating components of this axis may prove helpful in addressing low sexual desire, frigidity, premature ejaculation, and erectile dysfunction (Figure 2).


The auricular acupuncture microsystem has proven to be a sophisticated tool for the treatment of a wide variety of ailments. Compared to acupuncture meridian treatment, the auricular homunculus offers specific and precise somatotopic projections to the various organ and structures. In the 1960s, Nogier introduced the multi-phase system of auricular therapy, which is the natural evolution of the inverted fetus somatotopic presentation. The multi-phase system recognizes 3 different somatotopic presentations for each organ and structure. These additional phases closely reflect energetic changes under the persistent and prolonged assault of pathology. While Phase 1 reflects acute changes of short duration, Phase 3 reflects chronic but non-degenerative changes of the involved tissues. Phase 2 reflects a chronic pathology that succeeds in causing variable degrees of degenerative changes in the afflicted organs. Addressing the pathology through treatment of the phase or the phases involved allows effective means to address the pathology, regardless of its duration and its virulence.


The auricular acupuncture microsystem has proved to be a sophisticated tool for the treatment of many ailments. Though most of the mapping of this homunculus was the result of the relentless work of Nogier and many of his colleagues, some of the most interesting points were inspired by the fascinating paintings of Bosch.4 This may reflect the fact that the ear was known to be a treatment tool dating back to ancient Egypt. Both infertility and sexuality were frequently addressed by Egyptian physicians through cut- ting and bleeding the ear.


1. Nogier PFM, Nogier R. The Man in the Ear. Sainte-Ruffine, France: Maisonneuve; 1985.

2. Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers; 1995.

3. Soliman N. Soliman’s Atlas of Auricular Therapy. Rockville, MD: Alternative Medicine Publishers; 2006.

4. Soliman N. Soliman’s Auricular Therapy Textbook. Blooming- ton, IN: Authorhouse; 2007.

5. Song Y, Rajasekaran M. Effect of excitatory amino acid recep- tor agonists on penile erection after administration into the CA3 hippocampal region in the rat. Urology. 2004;64:1250–1254.

6. Stoleru S, Gregoire MC, Gerard D, et al. Neuroanatomical cor- relates of visually evoked sexual arousal in human males. Arch Sex Behav. 1999;28:1.

7. Mouras H, Stoleru S, Bittoun J, et al. Brain processing of vi- sual sexual stimuli in healthy men: a functional magnetic reso- nance imaging study. Neuroimage. 2003;20:855.a