The Chinese Ear Shenmen Point and the French Cosmonaut Point: Same or Different?

Gary Stanton ^*

1. Emerson Hospital, Concord, Massachusetts, USA

* Correspondence: Gary Stanton

Academic Editor: Gerhard Litscher

Special Issue: Auricular Medicine: Prevention, Auriculodiagnosis and Auriculotherapy using Evidence-Based Complementary Medical Methods

Received: August 18, 2024 | Accepted: October 10, 2024 | Published: October 22, 2024

OBM Integrative and Complementary Medicine 2024, Volume 9, Issue 4, doi:10.21926/obm.icm.2404061

Recommended citation: Stanton G. The Chinese Ear Shenmen Point and the French Cosmonaut Point: Same or Different? OBM Integrative and Complementary Medicine 2024; 9(4): 061; doi:10.21926/obm.icm.2404061.

© 2024 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

1. What Is the Most Appropriate Name of the Point?

The Chinese Ear Shenmen Point [1] is generally translated as “Spirit Gate.” In traditional medicine, Shen pertains to the Heart, which is the residence of the Spirit. In Japan and in Korea, it is known as Shin Mon. In English, there have been other translations. For example: Heavenly Gate [2], Point of Vitality [3], Opening to the Spirit [4], Divine Gate [5], and Neurogate [6].

The French Cosmonaut Point was described by Dr. René Kovacs, a principal disciple of Paul Nogier, M.D. (who created the first auriculotherapy cartography). Dr. Kovacs described a new point which he named “le Point des Cosmonautes” (the Point of the Cosmonauts) [7]. Among French and certain international auriculotherapists, this point is generally known as the Cosmonaut Point. This point has not been given alternative names, although many auricular acupuncturists equate it with Ear Shenmen point.

2. Who Discovered It First?

According to Marco Romoli, MD, Dr. Xu Zuo-Lin of Beijing, using the cartographies of Paul Nogier, MD, probably was the first to report several new auricular points in 1959 that were linked to Traditional Chinese Medicine. Dr. Romoli’s reference was: Huang Li-Chun. Auriculotherapy–diagnosis and treatment. Bellaire: Longevity Press; 1996. Xu Zuo-Lin named one point “Shen,” which Dr. Romoli translated as “the Point of Vitality.” Dr. Romoli indicated that the “Shen” point became known as the “Shen Men Point,” which then became included in several Western ear cartographies, leading to its widespread popularity among ear acupuncturists [3,8].

According to Dr. David Alimi, Dr. Kovacs identified this point the same year that Yuri Gagarin of the Soviet Union went into space [9]. Gagarin was launched into space in 1961.

3. What Is the Point Location in the Triangular Fossa?

Xu Zuo-Lin published a hand-drawn illustration of the Shen point [3,8]. This is located in the lateral third of the triangular fossa, in close relationship to the inferior border of the superior crus of the antihelix, and superior to the median that bisects the rostrocaudal axis of the triangle (Figure 1). This point is called “Neurogate” in a cartography published by O’Connor and Bensky [6] (Figure 2).

Figure 1 The Shen Point. Adapted from the original illustration by Mme. Xu Zuo-Lin [3,8] Hand drawn by G. Stanton.

Figure 2 The Neurogate Point. Shanghai College of Traditional Medicine, Ear Cartography. Editors J. O’Connor, D. Bensky [6]. Note this point’s proximity to the inferior margin of the superior crus of the antihelix. This is equivalent to the Shen Point.

Dr. René Kovacs published the location of the Cosmonaut Point (Figure 3). Although this point is also located in the lateral third of the triangular fossa, it is located on the median that bisects the rostrocaudal axis of the triangle, equidistant between the margins of the superior and inferior crus of the antihelix. This same location is seen as well in an ear cartography published by Dr. Bernard Leclerc (Figure 4).

Figure 3 The Cosmonaut Point. Dr. René J.H. Kovacs. L’auriculomédecine en consultation journalière. Tome 1. Maloine S.A. Editeur. Paris. 1983. Pages 155, 183 [7].

Figure 4 The Cosmonaut Point. LeClerc, B. Gesaurimed [in French]. Foxy Developpement. Nevers. 2005. [10].

Dr. David Alimi, who was a student of Dr. Kovacs, published illustrations of the Cosmonaut Point. According to Dr. Alimi, in comparison to Dr. Kovacs’ localization, the Cosmonaut point is placed somewhat more posteriorly and inferiorly to the median the bisects the rostrocaudal axis of the triangular fossa (Figure 5 and Figure 6).

Figure 5 The Cosmonaut Point. Cartography of Statistical Ectodermal Representations in Somatotopy S1; DIU Auriculotherapy, Faculty of Medicine, University of Paris XIII, Dr. D. Alimi [11].

Figure 6 The Cosmonaut Point. Right lateral auricular segmentogram and points. Courtesy, Dr. David ALIMI [12]. Note that the Cosmonaut point is located just inferior to the axis of the French hip and knee points, which are located along a line bisecting the rostrocaudal axis of the triangular fossa. This is consistent with its localization in Figure 5. Note also its close proximity to the T12 vertebra point on the inferior crus of the antihelix (see below for discussion).

Further comparison of the localizations of the Shenmen and Cosmonaut Points by these and other authors indicate a general tendency towards depiction of the points in the lateral third of the triangular fossa, but with some variations (Figure 7).

Figure 7 Relative Localization of Shenmen and Cosmonaut Points. Publications by various authors. These have been adapted by G. Stanton to the sectogram of Dr. David Alimi [13], and are referenced to his designation of the Cosmonaut, knee, and hip points [12]. I regret any errors in my adaptation of these previously published points. Note that different authors have published somewhat differing locations for both the Shenmen and Cosmonaut Points [14,15].

4. What Are the Methods of the Detection of the Shenmen and Cosmonaut Points?

Here, too, are some differences of opinion. Dr. Raphael Nogier indicates that the Shenmen point can only be identified using electrodetection [16]. Frank and Soliman indicated that Shenmen may be identified by electrodetection and by local tenderness [2]. Abbate wrote that the Shenmen point is detected by palpation of a notch in the lateral aspect of the triangular fossa. The author writes that Shenmen is “located in the triangular fossa along the lateral border, superior to the junction of its inferior and superior borders. Place the ear probe in this juncture and then slide superiorly to the intersection. The probe will fall into a small depression; that is the point [17].” According to Romoli, Shenmen is identified by inspection for local telangiectasia in the lateral triangular fossa [3]. Some auriculotherapists may identify the Shenmen or Cosmonaut points by use of the French Vascular Autonomic Signal (VAS), a method described by Dr. Paul Nogier [18]. However, Dr. P. Nogier did not accept the existence of the Shenmen/Cosmonaut points, as discussed below.

5. What Methods of Acupoint Stimulation Are Used to Treat the Shenmen and Cosmonaut Points?

Many forms of ear stimulation have been described. However, their comparative value regarding the treatment of the Shenmen and Cosmonaut points is uncertain. In needle acupuncture, standard or ASP (aiguille semi permanente) needles may be used, with or without gold, silver, steel, or titanium metals. Alternative needling may involve press tacks, Spinex needles or ear stapling. Electroauriculotherapy may involve the direct stimulation of acupoints, or the stimulation of standard needles placed in acupoints. Laser auriculotherapy, thermal therapies using heat or cold stimulation (cryopuncture, Dr. David Alimi), acupressure (originally called by Nogier “massage”), magnets, beads, pellets, crystals, bleeding (a traditional acupuncture technique), light therapies (infrared LED; chromatic colors), ultrasound or vibration may be considered, among other techniques. See Round, Litscher, Bahr, 2013 [19]; Oleson, 1998 [5]; Frank and Soliman, 2005 [2]; Rouxeville, 2016 [20]; Alimi, 2017 [21].

6. What Are the Actions of the Shenmen and Cosmonaut Points?

The Ear Shenmen point is named after the traditional point on the Heart Channel, HE-7, and is considered to have generally similar actions. The HE-7 upper extremity point is a Shu-Stream, Yuan-Source, and Earth Point. The actions of the of the HE-7point include: calms the Spirit, regulates and tonifies the Heart. The Shenmen HE-7 (Spirit Gate) is the foremost acupuncture point to calm and regulate the spirit. According to the Spiritual Pivot, “the Heart is the residence of the spirit.” Deadman P, Al-Khafaji M with Baker K [22].

The Ear Shenmen and Cosmonaut Points may also be considered from the point of view of auriculotherapy (the Paul Nogier system, conceived in biomedical terms). Here are examples of four published explanations:

1. According to Dr. D. Alimi, the Cosmonaut point represents the auricular somatotopic localization of the T12 sympathetic chain ganglion [21]. Therefore, its actions are primarily upon the sympathetic nervous system, and are understood in biomedical terms. The lateral auricle T12 ganglion is the point of entry of qualitative stress; point stimulation there lowers sympathetic tone (in the right ear in the “cartesian” person, and in the left ear in the “affective” person). The medial auricle T12 ganglion is related to entry of quantitative stress. The latter assertion implies the existence of a medial ear Cosmonaut point in Dr. Alimi’s opinion, although this is not indicated in his cartographies. 
2. According to Frank and Soliman [2], the actions of the Shen Men area are best understood biomedically in terms of the Nogier phases: “Shen Men is, in effect, the zone of potential projection of different organs or tissues in all three different phases.” The Shen Men area of the lateral triangular fossa corresponds to: Phase 1 mesodermal musculoskeletal structures and spleen; Phase 2 ectodermal thalamus, hypothalamus, and hippocampus; and Phase 3 endodermal liver and pancreas. This explains the extensive actions of the Shen Men area points from an auriculotherapeutic perspective. 
3. According to Dr. M. Romoli [3], the Shen Men area covers Paul Nogier’s radii of T12-L2. Within these radiculotomes exist overlapping anatomical structures. The sympathetic system in the abdomen is located at L2, L3 levels, innervating plexi with continuous cranial and caudal connections. Therefore, the vast actions of Shen Men point stimulation are primarily upon the sympathetic nervous system, and are understood in biomedical terms.
4. According to Dr. R. Pahwa [4], the Shenmen point is located in the Nogier system region that corresponds to tissues of mesodermal origin; this includes the biomedical heart (although the Chinese localize the traditional medicine Heart to the conchal region). The Shen Men area receives the branches of the auriculotemporal nerve from the mandibular division of the trigeminal nerve. This observation may explain the role of the Shenmen point in calming the spirit and the heart, and its role in the treatment of facial, as well as lateral and frontal head problems. Close inspection indicates that the Shenmen area is also innervated by branches of the greater auricular nerve, which is a branch of the superficial cervical plexus. “As this relates to the Nogier system region that corresponds to tissues of ectodermal origin, it may be the reason why Shenmen is used to treat skin and nervous system problems.”

More recent research has been published. Young-Chang P. Arai et al reported that auricular acupuncture at the Chinese Shenmen Point and French Point Zero induced parasympathetic activation during the postoperative period in patients who had undergone hemicolectomy [23]. In contrast, Chi-Chuan Tseng et al reported that auricular acupuncture on the Ear Shenmen point had no significant effect on autonomic cardiac modulation in healthy women, and that further studies are needed to fully determine the validity of auricular acupoint Ear Shenmen [24].

7. What Are the Clinical Indications of the Shenmen and Cosmonaut Points?

In traditional acupuncture, the HE – 7 point is indicated for following: insomnia, frequent sleep talking, poor memory, mania-depression, epilepsy, dementia, desire to laugh, mad laughter, insulting people, sadness, fear and fright, disorientation, restless Zang disorder, agitation of the Heart, malaria accompanied by agitation of the Heart, loss of voice, Heart pain, palpitations, fright palpitations, pounding of the Heart, throat painful obstruction, dry throat with no desire to drink, vomiting blood, spitting blood, yellow eyes, pain of the lateral costal region, red face, heat of the palms, dyspnea with heat in the body, shortness of breath, cold shivering, and enuresis [22].

In Chinese auricular acupuncture, the following indications have been reported for Ear Shenmen point: neurasthenia, insomnia, anguish, troubled sleep, mental problems, hysteria, melancholic schizophrenia, inflammation and pain of the five senses of the face, of the internal organs, and four limbs (for example: headache, facial pain, odontalgia, throat pain, hepatic colic, stomach cramps, dysmenorrhea, neuritis, and neuralgia), arterial hypertension, and for anaphylactic disorders (for example, acute and chronic urticaria, drug allergies, eczema, neurodermatitis, asthma, and pruritic disorders) [25].

In auriculotherapy (the Nogier system), the following indications have been reported for Shenmen point stimulation: pain syndromes; the treatment of apprehension, fear, anxiety, and regulation of the sympathetic nervous system; addiction therapy; and treatment of inflammation. In addition, “the presence of an electrically active or tender Shen Men is regarded by the Chinese auricular acupuncturist as an indication of neurasthenia, or the presence of pain [2].”

One more indication of the Shenmen point is in electrodiagnosis: “some instruments require you to first set a threshold level by raising the sensitivity of the unit so that you can detect Shenmen…reactive points are typically more active than Shen Men [5].” Of note, in auriculotherapy, points may be alternatively electronically calibrated based on reactivity to the omega points, which in principle are always reactive [21].

In his textbook on auriculotherapy, Dr. D. Alimi includes the Cosmonaut point in treatment strategies included in but not limited to the following clinical indications: acne, arterial hypertension, alopecia, chronic arthropathy, cluster headache, depression, dyslexia, eczema, female infertility, gastroduodenal ulcer, hiccup, hyperactivity, irritable bowel syndrome, menopause, movement disorders (medial ear equivalent aspect of the lateral ear Cosmonaut point), myocardial ischemia, ocular disorders, peripheral neuropathy, premenstrual syndrome, Raynaud syndrome, scleroderma, sinus disease, temporomandibular joint syndrome, tinnitus, and tobacco withdrawal [21].

8. What Are the Contraindications of the Shenmen and Cosmonaut Points?

According to Abbate [17], contraindications to Ear Shenmen Point include “…congestive heart failure and bronchitis characterized by excess phlegm, not phlegm or dampness that may be part of other health disorders.” This is because the Shenmen point has Earth energetics (Ht-7 is the Earth point of the heart meridian), and thus Ear Shen Men also has a dampening effect. By stimulating the Shenmen point, one can add undesirable Dampness to another illness caused by Damp.

The author is not aware of published contraindications to Cosmonaut point stimulation.

9. What Are the Therapeutic Effects of the Shenmen and Cosmonaut Points?

According to Romoli [3], auricular Shenmen has a similar activity to Ht-7, but has a broader range of therapeutic effects. Romoli cited Dr. Huang Li-Chun (1996). The therapeutic effects include: relieving pain, notably in ear acupuncture anesthesia; relieving convulsions, cough, asthma, itching, and vomiting; tranquilizing the mind; lowering blood pressure; reducing the heart rate; and relieving sore throat.

According to Abbate [17], “because of its energetics on grounding, balancing, and anchoring the spirit…, Shenmen should be the first point treated in the ear for almost every ear prescription...”

According to Oleson [5], “Shenmen is used to support all other auricular reflex points.”

Regarding the therapeutic effects of Cosmonaut point, Dr. Alimi wrote in a personal communication: “My teacher René Kovacs called this point Cosmonaut. He had, along with his team, discovered its properties. These properties are: anxiolytic, analeptic [restorative], and psychic stimulatory. The physiology involves diminishing inhibitory inputs into the limbic system, and consequently, augmenting positive projections [9].”

10. Are the Shenmen and Cosmonaut Points the Same or Different?

Close inspection of the cartographies of Mme. Xu Zuo-Lin and Dr. René Kovacs show these points to be clearly spatially separate. Many of the indications and therapeutic effects of these points overlap.

11. Does the Shenmen Point Exist?

Frank and Soliman wrote, in their textbook [2]: “Thus, the authors emphasize that there is, in fact, no Shen Men” (pages 259-260). They explained that this is because treatment of the Shen Men area produces therapeutic benefits which are accounted for by stimulation of the 3 Nogier phases of the lateral auricle, and not by one functional property of a single point.

According to Romoli [3], “neither Nogier nor his pupil René Bourdiol ever accepted this point because apparently it had no anatomical or embryological consistency. Nevertheless, Shen Men was progressively accepted and introduced in several Western maps.” And Romoli added: “even so, the puzzle still remains and only hypotheses can be put forward.”

12. Discussion and Conclusions

The original descriptions of the Shen and Cosmonaut points indicate that both points are located in the posterolateral aspect of the triangular fossa, but the precise points as illustrated are not identical. Furthermore, additional adjacent points in the same auricular zone have been called Shenmen and Cosmonaut points by various authors.

It is unclear if the original points have identical or in some ways dissimilar properties. This possibility should be kept in mind when evaluating the results of clinical and physiological studies of these points. In evaluating research citing stimulation of the Shenmen or Cosmonaut points, the reader should strive to determine the exact location of the point stimulated in a given publication, and if possible, its mode of detection and stimulation.

Furthermore, the dissimilar published localizations of the Shenmen and Cosmonaut points should be considered if one or the other is used for the purpose of calibration of an auricular electrodetection instrument (see Oleson).

An implication of the above is that the auricular acupuncturist should carefully evaluate the entire lateral aspect of the triangular fossa, including the superior crus of the antihelix, for point reactivity prior to administering treatment meant to include Shenmen or Cosmonaut points.

Clinical trials comparing these two points for reactivity and efficacy may be worthwhile.

Author Contributions

Gary Stanton is the sole author of this manuscript.

Competing Interests

The authors have declared that no competing interests exist.