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[Three of the authors respond:]
We are grateful to Edzard Ernst for his comments concerning the origin and nature of auricular acupuncture, which we did not discuss in our recent article.1 The aim of our study was to test whether auricular acupuncture has analgesic properties, with groups of patients receiving acupuncture at specific acupuncture points or at nonacupuncture points (sham acupuncture). As we have now provided evidence for the effectiveness of auricular acupuncture1–3 we are planning to study the possible mechanisms underlying this therapy; it has been proposed that the endogenous opioid system plays a role.4
We mentioned the French origin of auricular acupuncture and our selection of Nogier's map of auricular points in our previous study,3 which we cited in our CMAJ article. One can certainly observe some parallels between auricular acupuncture, reflexology and iridology. However, when it comes to discussing potential mechanisms, we hesitate to compare auricular acupuncture, which has been shown to be effective in a number of animal studies and randomized clinical studies,1–4with iridology, which is used only for diagnostic purposes and is considered to signal genotypes associated with certain medical conditions.5