Treatment of Attention

Deficit Disorder
ADD/ HD
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As you read the information below, you will understand that this
condition is one that can be changed. This is something that leaves
parents questioning the typical medical response of a prescription drug.
They will seek out a practitioner that can help them sort through this.
This information is a beginning for you to understand what tools are
available for you as a practitioner.

What is Child Attention Deficit Disorder (ADD) and Attention

Deficit/Hyperactivity Disorder (AD/HD)?
The medical/pharmaceutical industry says it's a physiological condition
that responds well to drugs.
Psychologists says it's a behavioral disorder that responds well to some
combination of medication, counseling, or coaching.
The educational industry says it's a condition that causes disruption in
"normal" classrooms, and is best treated by separating the student into
special education classes.
As much as 10% of the U.S. population is believed to be affected,
which would make this one of America's most prevalent mental
disorders. Males are at least four or five times as likely as females to
have the disorder. With 5% of the world population, the United States
consumes 90% of its Ritalin. The "diagnosis" of hyperactivity or
Attention Deficit with and without hyperactivity has increased to the
point that on any school day in the United States about 4,000,000
children receive a dose of Ritalin, so that they will not upset the class
routine and allow these (wild and disruptive) children to concentrate
and learn. The only diagnostic criterion prescribing pediatricians and
psychiatrists have is: "If the Ritalin works, the child needs it."
Western medicine medications include Ritalin, AlbuterolT, DepakoteT,
WellbutrinT, and AdderallT.

Lets break this down and first talk about symptoms:

ADD Symptoms (also known as inattentive ADHD):

Failure to attend to details, written or spoken
Tendency to make careless mistakes when accomplishing tasks
Difficulty focusing or sustaining attention during work, school or
play
Drawn irresistibly to irrelevant or extraneous sensory input
Struggles with follow through on chores, homework, or on the job
Difficulty organizing activities and tasks
Tendency to avoid anything that requires prolonged mental exertion
Forgetfulness, absentmindedness
Tendency to lose things, especially things that are necessary to
complete work, like books or tools, pens and notebooks, etc.
Difficulty listening to, and carrying out, instructions
Can appear not to be listening when spoken to
A person with inattentive ADD symptoms tends to have extreme
difficulty focusing their mind on anything for a longer than a few
moments. They are easily bored, and may bounce from one task to
another without getting much accomplished . They struggle to organize
and complete jobs, but may be able to easily pay attention when doing
something they enjoy. People with ADD symptoms may not be
hyperactive or impulsive, but still often exhibit difficulty with focused
activities.

AD/HD Takes Three Primary Forms

Once broken down as Attention Deficit Disorder (ADD) and Attention
Deficit Hyperactivity Disorder (ADHD), these problems are now
classified as Attention Deficit/Hyperactivity Disorder (AD/HD). As
more work has been done to understand the condition it has become
clear that some people have only attention deficit, some are hyperactive
and some are affected by both aspects.
This is the new reclassification:
AD/HD-I (predominance of attention deficit or inattention)
AD/HD-HI (predominance of hyperactivity and impulsive behavior)
AD/HD-C (combination of behavioral criteria)
There has been clinical data suggesting that a percentage of
ADD/ADHD cases are related to food and environmental allergies.
I feel it is important to mention that ADD/ADHD is not a condition
with a long history. It is not a health problem which has been recorded
regularly for thousands of years, like many illnesses which have been
historically recorded in a traditional medicine paradigm. We should
also take note that ADD/ADHD is not reported in countries where
people continue to eat a traditional diet of unprocessed foods. Only in
countries where there has been a progressive shift to processed and
convenience foods, has ADD become a major problem.
Nutrition and ADD
Ben Feingold, M.D. was a pediatric physician that specialized in
allergies. In 1965 he began his observations of the link between certain
foods and additives and their effect on some individuals' behavior and
ability to learn. Feingold believed that hyperactivity was triggered by
synthetic additives - specifically synthetic colors, synthetic flavors and
the preservatives BHA, BHT (and later TBHQ) - and also a group of
foods containing a natural salicylate radical. He believed what he was

seeing in his patients was an immunological - not an allergic - response.

His main focus was an elimination diet. You can read more about his
studies at http://www.feingold.org
Hertha Hafer was a German pharmacist that did extensive research on
ADD/ADHD. She believed that phosphate was the hidden ingredient
that caused this effect. Her book, The Hidden Drug - Dietary
Phosphate, is very informative.
Phosphate is a very common ingredient in modern diets. It is a highly
versatile food-additive which food manufacturers use in abundance. It
is used in the form of preservatives, emulsifiers, stabilizers, and
thickeners. It is added to self-raising flours; it is put into soda and cola
drinks in the form of phosphoric acid and the list continues.
Lendon H. Smith, M.D., made an effort towards a more scientific
diagnosis, by testing children for nutrient deficiencies. He found that
most were deficient in magnesium and calcium. (In line with what
Hertha Hafer showed us about phosphorus, take note that an excess of
phosphorus can cause calcium to leech out of your bones).
They also needed zinc, vitamin B6, and essential fatty acids.
Supplementing the diets of these children plus removing dairy products
and excess sugar, made a big difference in their ability to focus and sit
still. Dietary changes are slow to accomplish the desired results;
Ritalin works in about 20 minutes.
Science Daily has published articles that show that higher levels of
phosphate in the blood are linked to increased levels of calcium in the
coronary arteries, a key indicator of atherosclerosis and future
cardiovascular disease risk. They have also published articles that
suggest that a high dietary intake of phosphate may promote tumor
development and contribute to tumor growth in skin cancer.
A 1994 study at Purdue University found that boys diagnosed with
ADHD had lower levels of the omega-3 essential fatty acid DHA
(American Journal of Clinical Nutrition)

A 1997 study found that 95% of ADHD children tested were deficient
in magnesium (Magnesium Research, 1997,10)
A 1996 study found that ADHD children had zinc levels that were only
2/3 the level of those without ADHD (Biological Psychiatry 40, 1996)
Dietary changes that you can recommend include:
Provide fatty acid supplements (as in fish oil, flax oil, DHA/EPA
supplements, primrose oil, borage oil.
Adjustment to the types of fats (good fats are olive oil, fish oil, canola
oil and flax oil; reduce all others). Ban trans-fats
Avoid food additives and highly processed foods
Supplement with a high quality multivitamin that contains trace
minerals and other supplements, especially calcium, magnesium, zinc,
and B vitamins.
Reduce the amount of sugar, eat whole grains and increase the amount
of fresh fruits and vegetables. Think about the product, is it real food,
read labels. Sugar is added to most processed foods, ie; ketchup,
peanut butter, yogurt, salad dressing, breakfast cereals, canned soup,
granola bars to name but a few. Its even in juice, bread, crackers. If
you are trying to limit sugar you must read labels. As an example, one
soda contains 40 gms or 10 tsp of sugar!
We must be able to give confidence to parents, changing the entire
families diet may prove a challenge. This is for everyones benefit, not
jus the person with ADD, and only if you understand nutritious foods
yourself, will you be able to impart this. Parents must take in to
consideration that any prescription is affecting organs and overall
health and is a short range fix.

For a long range effect, a wholesome diet without unnecessary

additives will benefit them throughout their life. Understanding what
is going on will help them change for the better. Society is becoming
more aware of food quality and it is a positive move.
I have found that dietary changes are very important and should
be made for the acupuncture treatments to be most effective. It
isnt necessarily a formula, or a special diet to follow.
Understanding that food in its natural form is always the best.
Packaged and manufactured foods, in general, will have unknown
and unrecognizable additives. Cooking fresh food daily is
sometimes a challenge in todays fast paced world, but it is
essential for optimum health.

TCMs Interpretation of the Three Forms: Please take into account

each patients individual case as this is general.
In Traditional Chinese Medicine we know that development is linked
to the Kidneys, specifically Kidney Essence, affecting brain
development. All forms of AD/HD may reflect Kidney Deficiency as
it may indicate developmental issues. With the yin aspect of the kidney
showing deficiency, we can understand that it could lead to an
excessive expression of yang. This would manifest as the
hyperactivity and wandering of the mind.
AD/HD-Inattention: Heart and Spleen Qi Deficiency.
If this were the case, there would be most likely be a lack of
concentration, a tendency to be off in ones own world (a day dreamer),
poor memory and slow mental reaction.
Phlegm can cloud thinking, so dampness may be a factor. SP 9, ST 40.
The spleen and stomach provide the postnatal energy that is stored and
distributed by the Kidneys. SP4 and SP6 both tonify Spleen and
Kidneys

AD/HD-Hyperactivity/Impulsiveness:
Kidney Yin Deficiency, sometimes with Liver Yang Ascending.
Patient may exhibit irritability, loud and boisterous behavior, being
easily excited with an inability to sit still. Treatment may include
nourishing the kidney yin, opening the heart orifices (which are the
passages that affect the brain function), and settling the agitated yang.
LV3 calms spirit GV20. SP6, K6 for deficient Kidney yin
AD/HD-Combination:
Because this could be a combination of patterns, you must be careful
with your assessment, making sure your diagnosis and treatment plan
fit the patient and their symptoms.
In 2011, an analysis in the journal Pediatrics, (see link below)
concluded that acupuncture was safe for kids when performed by
appropriately trained practitioners. Officials at pediatric hospitals
estimate that at least a third of U.S. pain centers for children offer
acupuncture alongside traditional treatments. The federal
governments National Health Interview Survey, which last asked
about acupuncture in 2007, estimated that about 150,000 children
were receiving the needle treatment annually for conditions such as
pain, migraine and anxiety.

Be aware that many children with ADD are very ticklish.

http://pediatrics.aappublications.org/content/early/2011/11/16/peds.201
1-1091.abstract?rss=1

Adding Chinese Herbal Formulas:

This is an excellent explanation of why certain herbs are used and will
help you understand the treatment, which is a very important
component of success. I advise you to not just prescribe acorus tablets
but to understand why you would do so.
According to the studies of Subhuti Dharmananda:
There have been numerous studies of the effects of Chinese herbs on
ADD, with a remarkable degree of consistency in the selection of herbs
used to treat this condition. Some Chinese physicians rely on
differential diagnosis, with selection of somewhat different formulas
for each syndrome classification, while others use a standard
preparation with few or no modifications.
From the traditional perspective, the marrow and essence is the
foundation of the brain, and the early problems with mental
development indicate deficiency of the vital essence. The main herbs
used for nourishing the kidney in children with this syndrome are
rehmannia, tortoise shell, deer antler gelatin, lycium, and cornus.
These are ingredients of the traditional Zuo Gui Wan (Left Restoring
Pill) used to treat kidney yin deficiency when there are deficiencies of
"marrow and essence."
Phlegm obstruction of the heart orifices usually leads to confusion,
inability to concentrate, and poor memory. It occurs for a variety of
reasons, but often because of weak digestion and/or poor diet, coupled
with emotional disorders, especially agitation. The main herbs for
clearing the heart orifices and enhancing the mental function are acorus,
polygala, curcuma, and alpinia. Acorus is said to "open the orifices,
vaporize phlegm, and quiet the spirit." Polygala is said to "expel
phlegm and clear the orifices, calm the spirit and quiet the heart."
Curcuma, which promotes movement of qi and invigorates the blood,
is used to "treat hot phlegm that obstructs the heart orifices when there
are symptoms of anxiety, agitation, or mental derangement."

The Chinese name for alpinia, yizhiren, means "the seed that benefits
intelligence." It aids digestion (preventing phlegm accumulation),
astringes the kidney to restrain the essence, and prevents the
development of heat from deficiency of kidney; the deficiency heat can
cause phlegm to become a "mist that obstructs the heart orifices."
To settle the agitated yang energy (which may manifest as
hyperactivity and insomnia) the so-called "heavy sedating agents" are
used. The traditional concept is that these mineral-rich substances
bear down on the rising and disordered yang. The main substances
given for ADD by Chinese doctors are dragon bone or dragon teeth,
oyster shell or mother of pearl, succinum, and cinnabar. In some cases,
herbs to purge deficiency fire that accompanies yin deficiency
syndrome might be employed. Phellodendron and anemarrhena are the
most commonly used items for this purpose.
As an example of applying these methods, 30 children with ADD were
treated with a syrup, along with a powder, for two to four months, with
the result that 22 of them (73%) showed improvements. The syrup was
made with alpinia, ho-shou-wu, lycium, dragon bone, oyster shell,
acorus, curcuma, and salvia, boiled down to a thick liquid and
preserved with benzoic acid.
Three times per day, the children would take 25 ml of the liquid and 2
grams of deer antler powder. A similar method was used in a study of
50 children with ADD who consumed a decoction of acorus, polygala,
dragon bone, and oyster shell, modified by adding three to six herbs
according to symptoms, and who also consumed a powder of succinum.
The duration of therapy was not specified but 38 of the children (76%)
showed improvements.

Excellent results were claimed in a small study of 15 children treated

with a decoction of ligustrum, peony, lycium, mother-of-pearl, and
polygonum stem (each ingredient 10-15 grams), modified with
addition of some herbs for specific symptoms of blood deficiency (add
rehmannia and gelatin), spleen deficiency (add hoelen and
atractylodes), or restless sleep (add zizyphus). The total daily dose was
about 60 grams of herbs, the decoction taken in three divided doses.
All 15 children were apparently cured with treatment times of 15 to 60
days, and no recurrence within six months. Another high dosage
decoction, based on the traditional Sanjia Fumai Tang, containing raw
rehmannia, ophiopogon, tortoise shell, peony, pseudostellaria, gelatin,
baked licorice, curcuma, polygala, cnidium, oyster shell, acorus, and
dragon bone, each ingredient 6-12 grams (except 20 grams oyster shell),
was given to 68 children with ADD. This combination, with over 120
grams of crude herbs per day, taken as a single dose, was said to
improve the condition of 64 of 68 children treated (with 61 declared
"cured"). In a large-scale study of 326 cases of ADD (267 boys and 59
girls), three different formulas were used; two were decoctions and the
third a large honey bolus (six grams per pill). The overall effective rate
was 93%, with 103 claiming to be cured.
One formula, as decoction, was basically a qi tonic prescription, with
astragalus, codonopsis, atractylodes, dolichos, licorice, cinnamon,
oyster shell, and dragon bone. The other decoction was a formula for
resolving phlegm-dampness, with pinellia, arisaema, agastache, acorus,
polygala, eupatorium, soja, hoelen, coptis, and gardenia. The pill was a
kidney tonic, with rehmannia, tortoise shell, dioscorea, cornus, hoelen,
phellodendron, anemarrhena, polygala, acorus, and dragon teeth.
The large honey pills and bitter and acrid decoctions, as well as
the syrups and powders, would not be acceptable in the West, but it is
instructive to see that these methods can be used in China with good
results: 70-100% of cases treated were said to be improved or cured.

An example of a potentially more practical approach is manufacture of

a sugar paste. Two formulas were made in this form, Zhili Tangjiang,
comprised mainly of acorus and polygala, and Kangyi Tangjiang,
which contains those two herbs plus tortoise shell, hoelen, dragon bone,
alpinia, dioscorea, and lotus seeds. The dose of these pastes was 10-15
ml each time, and they were taken two to three times per day. Of 170
cases (two studies), 132 (77%) were improved. Treatment time was
about one month. It was pointed out that the paste could be
encapsulated for purposes of easier administration.
Early in 1993, ITM prepared an experimental small tablet (Acorus
Tablets, 300 mg) based on the work done in China for treatment of
ADD. The formula contains acorus, polygala, fu-shen, alpinia, curcuma,
raw rehmannia, dragon bone, dragon teeth, oyster shell, bamboo sap,
tortoise shell, and succinum. In contrast to Ritalin, the formula contains
no stimulants. Several reports of its use have been favorable though
much more study needs to be done to determine the extent of response.
As a general rule, herb powders are taken in a dose of 1/10 to 1/5 that
of decoctions. Since 60 grams (or more) is typical for ADD decoctions
in China-mainly given to children 7-13 years old-a daily dose of about
6 grams of the tablets (20 tablets) would be a reasonable minimum for
this age range. The dosage method developed at ITM is to give one
tablet per year of age (up to a maximum of 7-8 tablets) each time, three
times per day.
For older children and adults, larger size tablets (700 mg) have been
prepared, with a recommended dosage of 3-6 tablets each time, three
times daily. Seven of the small tablets contain the same amount of
herbal material as three of the large tablets. It is important to note that
one formula, even if well designed, will not be ideal for all children.
Following the traditional differential diagnosis, phlegm-resolving, fire
purging, qi-tonifying, or other combinations may be necessary as
adjuncts or substitutes for a basic ADD formulation.

Treatment times reported in the Chinese literature are generally two

weeks to two months. When using a low dosage form, one would
expect to undertake a longer term of treatment, perhaps four months.
Fortunately, some degree of improvement is said to be observed in a
relatively short time, so a decision to continue such therapy might be
made after just one month (as is the cases with Ritalin). Among reports
received by ITM regarding effects of Acorus Tablets or similar herbal
preparations, the beneficial effects are noted during the first month of
therapy.
Significant adverse effects have not been reported with use of Acorus
Tablets. A small number of individuals have reported tiredness after
using them. However, it is not clear whether this is an adverse effect of
the herbs or a withdrawal symptom from Ritalin or the result of feeling
an underlying tiredness from lack of adequate sleep that might not have
been brought to awareness with the hyperactivity.
Seven Forests Herbal Formulas are developed by ITM. This is their
website. http://www.itmonline.org/sf.htm

NOTE: The clinical trials mentioned in this paper were described in Chinese language
literature. Rough translations of the information were prepared by Heiner Fruehauf, Ph.D.,
L.Ac., at the Institute for Traditional Medicine.

Some patent herbal remedies in use are the following:

I have added the herbal properties so that you can compare it to
symptoms.

Hyperactivity Capsule - Oral Liquid for ADHD

-
Duodongning Jiaonang
Indications: attention deficit, wayward impulses, irritability
Ingredients: rehmannia root (sheng di huang) enrich yin, nourish
blood
tortoise shell (gui ban) enriches yin, subdues yang, supplements
kidney and fortifies bones
milkwort (polygala root / yuan zhu) expels phlegm,Pacifies the Heart
and Calms the Spirit
sweetflag rhizome (acorus / Shi Chang Pu) Opens the orifices,
vaporizes phlegm, quiets the spirit - sensory orifice disorders due to
phlegm
dogwood (shan zhu yu / Cornus officinalis) supplements liver and
kidney; astringes essential qi and checks vacuity
yam (Dioscoreae /shan yao) fortifies spleen, secures kidney and boosts
essence. Used in crude form it enriches yin.
fossil bone (long gu) Calms the spirit - emotional distress, insomnia,
palpitations, anxiety, seizures. Bone strength.
poria cocos mushroom (fu ling / poria) tranquilizing, inhibits bacteria,
relaxing effect on smooth muscles, improves immune system . Not
suitable for patients with yin xu (yin deficient) condition as it is a fairly
strong diuretic
cork tree bark (phellodendron/huang bo) heat due to yin vacuity,
drains fire
silkworm larvae (bombyx batryticatus / bai jiang can) Extinguish wind
and stop spasm, dispel wind and alleviate pain, resolve phlegm and
dissipate accumulation.

Jing Ling Oral Liquid

Jingling Koufuye
Indications: lax attention, hyperactivity, wayward impulses, learning
difficulties, rapid pulse.
Ingredients: rehmannia root, yam, poria cocos mushroom, tree peony
bark (mu dan pi), water plantain rhizome (ze xie / Rhizoma Alismatis),
milkwort, fossil bone, privet fruit ( Nu Zhen Zi), cork tree bark
/anemarrhena rhizome, schisandra fruit, sweetflag rhizome/acorus
As you can see, most of the herbs in these two formula are for clearing
empty heat, calming the spirit and fortifying yin.
Children Intellectual syrup

Xiaoer Zhili Tangjiang

Indications: to regulate and fortify yin and yang; resuscitate
intelligence; for children with minimal brain dysfunction.
Ingredients: sweetflag rhizome, rooster, fossil bone, milkwort, tortoise
shell.

The use of Auriculotherapy for ADD/HD:

The overall effect of auriculotherapy is to create a more balanced
condition throughout the body. By correcting pathological reflex
centers in the brain, stimulation of the auricular acupuncture
microsystem can lead to a homeostatic state whereby any form of stress
or pain is lessened. Stimulation of the specific ear reflex points that
correspond to a particular area of the body leads to either a reduction of
excess stimulation or an enhancement of diminished under activity of
the affected region. Typically, patients are given two treatments per
week for two to three weeks, then once a week for several more weeks.
The frequency of sessions progressively decreases to once a month as
the disorder becomes less pronounced.

ADD / ADHD
Protocol Information / Point Information
Amygdala:
Affects the area of the brain controlling behavioral and psychiatric
conditions: anxiety, fear, aggressiveness, anger, gut response, and
uncontrollable sexual desires.
Be Happy (Posterior):
Used for emotional disorders; depression, anxiety, stress, nervousness.
Brain:
Affects the cerebral cortex: memory, attention, thought, awareness,
consciousness, intelligence; blood supply to the brain; affects the
pituitary; central nervous system: headache, loss of feeling, memory
loss, muscle weakness, tremors; digestive system disorders; endocrine
disorders; relieves pain; eases the mind.
Brain Stem:
Regulates breathing, body temperature, heart function, cough; calms
the mind. Improves the contraction of peripheral arteries to raise blood
pressure. When treating electrically, the common frequency for this
point is 80 Hz.
Hippocampus:
Eases emotions associated with painful physical memories, helps
release traumatic memories such as nightmares and flashbacks
associated with senses such as sound, smell, etc.
Kidney.C:
Stimulates the secretion of renin and angiotensin to increase blood
pressure.

Master Cerebral:
Addresses pre-frontal lobe of brain. Affects decision making and
initiates conscious action. Used for nervous anxiety, fear, worry,
obsessive-compulsive disorders.
Master Oscillation:
Balances right and left cerebral hemispheres. Needling this point
before treatment helps individuals with laterality dysfunction
("Switched"). Used for dyslexia, learning disabilities, ADD, and
unusual/sensitive reaction to medications. When treating electrically,
the common frequency for this point is 2.5 Hz.
Occiput:
This point is very dynamic and is one of the most-used points on the
ear. The occiput is a region that connects directly with the brain and the
spinal cord; thus its list of functions is nearly endless. Tranquilizes the
mind, addresses headache, temporomandibular joint dysfunction,
emotional disorders, anxiety; lowers blood pressure; treats neurological
disorders: seizures, epilepsy, facial spasms, dizziness, vertigo, shingles,
tinnitus; vision and hearing disorders.
Point Zero:
Brings the whole body to homeostatic balance; balances energy,
hormones, and brain activity; supports the actions of other points;
controls visceral organs through the peripheral nerve ganglia. Promotes
willpower.
Shen Men:
Tranquilizes the mind, allows a connection to one's spirit; alleviates
stress, pain, convulsions, tension, anxiety, depression, insomnia,
restlessness, excessive sensitivity; reduces coughs, fevers,
inflammatory diseases, epilepsy, high blood pressure. Helps all other
auricular points work better. *Key point for alleviating pain.

Shen Men (Posterior):

**Attention Deficit Disorder: Tranquilizes the mind, allow a
connection to one's spirit; alleviates stress, pain, convulsions, tension,
anxiety, depression, insomnia, restlessness, excessive sensitivity;
reduces coughs, fevers; inflammatory diseases; epilepsy; high blood
pressure; helps all other auricular points work better. *Key point for
alleviating pain.
Thyroid Gland.C:
Used for hypothyroidism, hyperthyroidism, goiter, and sore throat.
Thyroid Gland.E:
Used for hypothyroidism, hyperthyroidism, goiter, and sore throat.

Protocol for using

electric stimulation
with or without
needles on auricular
points.

Software and apps available for auriculotherapy:

https://www.miridiatech.com/shop/
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QUESTIONS FOR ADD/HD:

1. As much as ____________ of the U.S. population is believed to
be affected which would make this one of America's most prevalent
_____________________________________.

2. Males are at least ______________________________________

as likely as females to have the disorder.
3. Name some of the symptoms that present with this disorder:

_______________________________________________________
_______________________________________________________

4. The three categories for the newer classification are:

_______________________________________________________
_______________________________________________________
_______________________________________________________

5. What common formula is used to treat kidney yin deficiency

when there are deficiencies of "marrow and essence" ?
____________________________________________________
6. The main herbs for clearing the heart orifices and enhancing the
mental function are :
___________________________________________________
7. The overall effect of auriculotherapy is to _________________
___________________________________________________.
8. By correcting pathological reflex centers in the brain, stimulation
of the auricular acupuncture microsystem can lead to a
_______________________________________ whereby any
form of stress or pain is lessened.
9. Typically, how many treatments and what frequency is the
protocol for auricular treatment?
___________________________________________________
____________________________________________________
____________________________________________________

10.

List five ear points that are used in the protocol.

____________________________________________________
____________________________________________________
____________________________________________________

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