Ear Rubbing (Gûşmâl): From Tradition to Modern Neuroscience

Farzollah Gholizadeh and Fariba Bayrami

A comparative review of dalk and ghamz in Avicennian–Greek medicine, gûşmâl in Persian and Ottoman culture, Eastern medical traditions and Western–European medicine: historical foundations, temperament, benefits, method of application and an assessment from the perspective of modern neuroscience.

Summary

“Gûşmâl” — rubbing, squeezing or pulling the ear — is a concept that in today’s Persian is mostly used to mean “to punish, to discipline, to teach a lesson”. In Ottoman culture, too, expressions such as gûşmâl and “pulling someone’s ear” were used. Yet rubbing, squeezing, pulling, warming and stimulating the ear is not just a method of discipline or an idiom; it has a much broader history in different medical traditions.

In Avicennian–Greek medicine, dalk (rubbing and massage) and ghamz (applying controlled pressure) are among the important measures of hifz al-sihha (preservation of health). Although direct textual evidence would be needed to say that Avicenna used the ear-specific expression “dalk and ghamz of the ear” as the name of an independent treatment, applying the principles of dalk and ghamz to the ear area can be assessed within the framework of Traditional Medicine.

The outer ear is very rich in blood vessels and nerves. Modern anatomy and neuroscience show that different parts of the ear are supplied by branches of the trigeminal nerve, the cervical nerves and especially the auricular branch of the vagus nerve. So stimulating the ear does not just mean mechanically moving skin and cartilage; it can also create significant sensory input to the central and autonomic nervous systems.

In Traditional Chinese Medicine, Ayurveda, the Korean and Japanese medical traditions, Tibetan Medicine and the later Su Jok system, the ear has also been used in different ways for rubbing, pressure, warming or stimulation.

In the history of Western and European medicine, various interventions on the ear and the area around it have been made since Ancient Greek and Roman times; in later centuries, stimulation or cauterisation of certain areas of the ear was used to treat some diseases. This historical line played an important role in the formation of the modern Auriculotherapy system developed in the 20th century by the French physician Paul Nogier.

So the history of ear rubbing and ear stimulation can be examined under at least four main headings:

1. Avicennian–Greek Medicine: dalk, ghamz and measures relating to the ear.
2. Persian and Ottoman culture: gûşmâl and pulling the ear; cultural meanings ranging from a physical practice to warning, disciplining and preventing a mistake from being repeated.
3. Eastern medical traditions: Traditional Chinese Medicine, Ayurveda, Korea, Japan, Su Jok and Tibetan Medicine.
4. Traditional Western–European Medicine: Ancient Greece and Rome → Medieval and Renaissance Europe → stimulation and cauterisation of the ear → France → Paul Nogier → modern Auriculotherapy.

These four historical paths show that in different societies the ear has sometimes been regarded as an organ to be stimulated directly, and sometimes as a micro-system that can affect other areas of the body.

What Is Ear Rubbing?

Ear rubbing done for treatment and health preservation is a set of controlled movements applied to the outer ear.

These are:

• rubbing
• light pressure
• controlled squeezing
• gentle pulling
• massaging the edges of the ear
• gently pulling the earlobe
• moving the outer ear
• warming the ear

This method is not the same as forcefully twisting the ear, hurting it or giving physical punishment.

In Traditional Medicine sources, dalk — rubbing and massaging the body — is one of the important measures of health preservation. Physicians assessed dalk in different ways according to its intensity, duration and purpose.

Dalk can be applied lightly, moderately or more firmly; dry or with oil.

From this point of view, ear rubbing can be regarded as local dalk and ghamz applied to the ear area.

In the original text this method was expressed as “dalk and ghamz of the ear”. For historical accuracy, a distinction must be made: the existence of dalk and ghamz in Traditional Medicine is clearly documented, but direct textual evidence is needed to say that “dalk and ghamz of the ear” is the specific name of an independent treatment method in Avicenna’s works.

So for now it is more accurate to use this expression as a descriptive term for applying the principles of dalk and ghamz to the ear.

Why Is the Ear an Important Area for Stimulation?

Although the outer ear looks simple from the outside, its nerve structure is quite complex.

Different areas of the outer ear receive nerve supply from several nerves. These include:

• the auriculotemporal nerve, a branch of the trigeminal nerve
• the great auricular nerve
• the lesser occipital nerve
• in some areas in particular, the auricular branch of the vagus nerve (ABVN)

Vagal innervation is especially important in parts of the concha and around the outer ear canal.

The vagus nerve plays an important role in communication between the brain and various organs of the body and in regulating the autonomic nervous system.

So when the ear is massaged, it is not just the skin that moves; many sensory receptors and nerve pathways are also stimulated.

This feature is one of the reasons why the ear is again being studied intensively in neuroscience today.

But ordinary ear massage should not be equated with direct vagus nerve stimulation. The location, type, duration and intensity of the stimulus are different.

The Ear and the Vagus Nerve: A Bridge Between Tradition and Neuroscience

One of the most important developments in this field in recent years is Transcutaneous Auricular Vagus Nerve Stimulation (taVNS).

In this method, small electrodes are placed on specific areas of the ear and controlled electrical stimulation is applied.

Researchers are studying the effects of this method on the autonomic nervous system, the brain and various neurological functions.

Possible nerve pathways include the Nucleus Tractus Solitarius (NTS) in the brainstem and its connections with other brain networks.

These findings show that the importance different cultures have given the ear throughout history has a physiological side worth researching.

But it is not right to treat concepts such as “temperament” in Traditional Medicine, “Qi” in Chinese Medicine or “Vata” in Ayurveda as identical to the neurophysiological mechanisms of modern neuroscience.

The Temperament of the Ear and the Effect of Ear Rubbing on Temperament

When assessing the temperament of the ear from the point of view of Traditional Medicine, the structure of its tissues must be taken into account.

The natural temperament of the ear

The outer ear is made up of skin, cartilage, connective tissue, blood vessels and nerves.

Because of its density and lack of fleshy tissue, the cartilaginous part can be regarded as more inclined to dryness and, to some extent, coldness in terms of temperament.

The earlobe, on the other hand, has no cartilage. Being rich in fat and soft tissue, it is softer and relatively moister than the cartilaginous areas.

So assigning a single temperament to the whole ear would be an oversimplification.

Put simply:

The cartilaginous part is more inclined to coldness and dryness; the soft, fatty tissue of the earlobe is relatively more inclined to moisture.

The effect of ear rubbing in terms of temperament

Rubbing creates friction, and friction creates local heat.

From the point of view of Traditional Medicine, ear rubbing:

• can create local warmth
• can reduce coldness in the area
• can increase the movement of blood and matter
• can help dissolve excess moisture (rutubet)
• can reduce sluggishness caused by coldness

So in terms of temperament, ear rubbing can be considered more meaningful especially in conditions marked by coldness, moisture, phlegm, heaviness and sluggishness.

Using Oil When Rubbing the Ear

In people with signs of coldness and moisture, a very small amount of chamomile oil, black seed oil or bitter almond oil can be applied to the outer ear, followed by massage.

The aim here is to lightly oil the outer surface of the ear and make the massage easier; it is not to pour oil into the ear canal.

In people with marked heat in the head area, very hot-natured oils may not be suitable.

In the Traditional Medicine approach, oils considered colder in temperament, such as violet oil, may be preferred when needed.

Important

Applying oil to the outer ear is not the same as dripping oil into the ear canal.

If there is ear pain, infection, discharge, a suspected perforated eardrum or previous surgery, no substance should be put into the ear canal without a specialist’s assessment.

Who May Benefit More from Ear Rubbing?

1. People thought to have excess coldness and moisture in the head area

Especially:

• heaviness in the head
• drowsiness
• sluggishness
• mental slowness
• reduced concentration
• absent-mindedness

are present, rubbing the ears until they are gently warm can be used as a simple stimulating measure.

2. Students and people doing intense mental work

People who study or do mental work for long periods may experience tiredness, drowsiness or loss of concentration after a while.

A short ear massage can be used as a method of sensory stimulation.

But it should not be claimed that this is a treatment that definitely strengthens memory.

3. Older people

In older people who feel coldness, sluggishness and reduced mental alertness, very gentle ear massage can be applied as part of general health-preservation measures.

But forgetfulness that is new, progressive or serious must always be assessed for its cause.

4. People experiencing stress and tension

Slow, rhythmic ear massage together with calm breathing exercises can help relaxation.

There is an important distinction here:

For alertness and liveliness → somewhat faster movements.

For relaxation and sleep → slower, softer and rhythmic movements.

Use in Preventing Illness and Supporting Treatment

Phlegmatic and some tension-type headaches

In the Traditional Medicine approach, creating movement and warmth is regarded as a useful supporting measure in some headaches that come with coldness, heaviness in the head, drowsiness and moisture.

So ear rubbing can be a supportive method in such cases.

In some tension-type headaches, too, gentle massage of the ear, temple and neck together with calm breathing can help reduce tension.

Headaches that start suddenly and are very severe, unusual or accompanied by neurological symptoms need medical assessment.

Sleep problems and insomnia

While fast, firm rubbing can be stimulating, slow, rhythmic pressure and massage applied with calm breathing may be more suitable for relaxation.

Mild dizziness and light-headedness

In some traditional systems, ear stimulation has been used for dizziness.

In modern physiology, the inner ear is one of the centres of the balance system. But rubbing the outer ear does not mean directly treating the vestibular system.

So rather than explaining the possible benefit as directly “bringing blood to the inner ear”, it is more accurate to assess it in terms of sensory and nervous regulation.

Recurring or severe dizziness that comes with weakness, double vision, speech problems or marked loss of balance needs urgent assessment.

Reducing daily sluggishness and excessive tiredness

Rubbing the ears relatively quickly until they are gently warm can create strong sensory stimulation and help a person shake off sluggishness.

Concentration and mental fatigue

Before study or mental work, a short ear massage can be used as a “sensory stimulation break”.

But it has not yet been shown with sufficient scientific evidence that simple ear massage permanently improves memory in healthy people.

Ear Rubbing, Memory, Absent-mindedness and “Making Many Mistakes”

One of the most interesting aspects of the subject is the historical relationship between gûşmâl and making mistakes.

In Persian culture, gûşmâl is not just a physical movement; over time it also took on the meanings of warning, drawing attention, disciplining and preventing the same mistake from being repeated.

Rumi says:

“When you commit wrongdoing, He sends a gûşmâl (an ear-pulling),

so that you may turn from deficiency towards perfection.”

That is, it carries the meaning of a “warning and discipline” that turns a person from deficiency towards perfection.

From a neuroscience perspective, too, sudden or marked stimulation of an area with a dense nerve network like the ear can briefly direct a person’s attention to the stimulus.

But this is not the same as treating memory.

So far, no direct source has been found showing that Avicenna or other great physicians gave an explicit instruction such as: “Take a person who makes many mistakes to the physician, and let the physician correct their memory by rubbing their ear.”

So it is more accurate to regard this story not as a definite prescription of Avicenna, but as a cultural tradition worth researching.

Gûşmâl in Persian and Ottoman Culture

The concept of gûşmâl does not belong only to modern Persian.

The Persian word gûşmâl was also used in Ottoman culture and literature.

In Ottoman Turkish and later in Turkish, the expression “to pull someone’s ear” was used to mean warning a person, disciplining them or making sure a behaviour is not repeated.

So in the Persian–Ottoman cultural sphere there is a historical link of meaning between: ear → pulling/rubbing → warning → attention → discipline → correcting behaviour.

This cultural continuity is quite striking.

But the presence of “pulling someone’s ear” or the concept of gûşmâl in Ottoman culture does not automatically mean that it was the Ottoman physicians’ standard medical treatment for forgetfulness.

That would require a separate, direct medical source.

The Ear in Traditional Chinese Medicine

The ear has an important place in Traditional Chinese Medicine.

Classical texts such as the Huangdi Neijing discuss the ear’s relationship with the body’s channels and functions.

In TCM, the ear is linked directly or indirectly to the meridian network, and stimulating it is used to regulate Qi and blood.

Throughout history, the following have been used on the ear:

• massage
• pressure
• needles
• bloodletting
• moxa and warming
• in more recent times, ear seeds

An important historical correction

Some popular sources claim that in Ancient China the ear was mapped exactly as an “inverted foetus”.

This statement is not historically accurate.

Although the ear’s relationship with the body has long been known in Chinese Medicine, the systematic ear map in the shape of an inverted foetus was developed in the 20th century by the French physician Paul Nogier.

Chinese researchers later studied this map and combined it with and developed their own auricular systems.

The Ear in Su Jok Therapy

Su Jok was developed by the Korean Park Jae Woo.

In this system, it is believed that small areas of the body contain “correspondence systems” or “reflection systems” of the whole body.

The hands and feet are Su Jok’s most basic correspondence systems; with the development of the micro-system approach, the ear has also been taken into account.

In this approach, stimulating specific areas through massage and pressure is used to:

• help reduce pain
• manage stress
• support the body’s overall balance
• support the regulation of some endocrine functions
• balance organ functions

It should be remembered that these are Su Jok’s theoretical and clinical claims, and that the level of scientific evidence for each practice must be assessed separately.

Ear Massage in Ayurveda

In Ayurveda, the ear is closely linked to Vata Dosha.

Vata is associated with movement, nervous activity, the senses, and the elements of air and space.

So gentle massage of the ear with suitable oils is used especially in practices aimed at calming Vata.

Sesame oil is one of the common oils. Some practices may also use herbal oils containing Brahmi.

Traditional aims include:

• calming the mind
• reducing anxiety and tension
• reducing dryness and coldness
• calming the nervous system
• helping sleep
• supporting ear and hearing health

Ayurveda also has a separate method called Karna Purana, which involves applying oil specifically to the ear.

But Karna Purana is not the same as outer-ear massage. It should not be applied casually in people who may have an infection, discharge, pain or eardrum damage.

Ear Massage in Japanese Traditions

Japan has different traditional or developed treatment systems such as Kampo, Japanese acupuncture and Shonishin.

In some Japanese practices, extremely light stimulation of the skin and body points is important.

In some contemporary Japanese self-care practices, ear massage is also used for:

• warming the ear
• providing sensory stimulation
• supporting local circulation
• relaxing
• increasing a sense of vitality

In some popular Japanese health sources, ear massage is also linked to long life and general health.

But direct historical sources are needed before presenting the claim that “ear massage lengthens life or clears deep toxins from the head and neck” as a definite principle of classical Kampo or Shonishin teaching.

The Ear in Traditional Korean Medicine

In Traditional Korean Medicine, as in other East Asian medical traditions, a link is made between the ear, the kidneys and the body’s basic energy.

In traditional and contemporary practice, warming and massaging the ears is used for:

• creating warmth
• reducing a feeling of coldness
• reducing fatigue
• increasing vitality
• supporting concentration

In some traditional interpretations, because of the “kidney–ear” relationship, ear stimulation has also been linked to physical strength and sexual energy.

But this is that medical system’s own theoretical explanation; simple ear massage should not be presented as a scientifically established treatment that increases sexual vigour.

The Ear in Traditional Tibetan Medicine

In Tibetan Medicine, health is linked to the balance of basic elements and regulating systems.

One of the most important of these is rlung, or “wind”.

Rlung is associated with movement, mental activity and many nervous functions.

According to traditional explanations, an imbalance of this system can show up as:

• restlessness
• anxiety
• sleep problems
• dizziness
• mental unsteadiness

Massage, oil application and heat are among the methods used in some rlung imbalances.

Massage of the head and the area around the ears, together with breathing and relaxation practices, can also be considered in this context.

But direct sources are needed before attributing a detailed “ear point map” or a standard ear massage protocol for all rlung disorders to classical Tibetan Medicine.

Ancient Greece and the Hippocratic Tradition

Ancient Greek medical texts mention various interventions on the ear and on the vessels behind the ear.

Sources on the history of auriculotherapy report that some bloodletting practices in the ear area were used for conditions such as sexual problems and limb pain.

The important point here is this:

More than two thousand years ago, the Mediterranean medical tradition already held the idea that an intervention on the ear area could affect a disease outside the ear.

Galen and Greco-Roman Medicine

Galen developed many principles of Greek medicine, and his works deeply influenced medicine in both Europe and the Islamic world.

This point is especially important, because part of the two paths we now regard as “Avicennian–Greek Medicine” and “Traditional European Medicine” shares a common Hippocratic–Galenic heritage.

So the four historical paths are not entirely independent of one another.

The Ear in Medieval and Renaissance Europe

In later periods, stimulation and cauterisation of certain areas of the ear continued in Europe.

One of the most striking practices was cauterising the ear for sciatica pain.

In the 17th century, the physician Zacutus Lusitanus mentioned cauterising the ear in the treatment of sciatica.

There are also records of this practice in Europe in the following centuries.

From the point of view of today’s medicine, burning or cauterising the ear is not a self-care method and can cause burns, infection and tissue damage.

Its importance here is entirely historical:

Europeans used the ear to affect pain in distant parts of the body centuries before modern Auriculotherapy appeared.

Valsalva and Treating Toothache Through the Ear

The famous Italian physician and anatomist Antonio Maria Valsalva examined the anatomy and diseases of the ear in detail in his work De Aure Humana Tractatus, published in 1704.

Historical records of auricular treatment report that in this period stimulation or cauterisation of the antitragus area was used for toothache.

Here again we meet an interesting principle:

The intervention is made on the ear, but the aim is to reduce pain in an area outside the ear.

This principle would later become much more systematic in modern Auriculotherapy.

The Ear and Sciatica Treatment in Europe

In the 18th and 19th centuries, cauterising certain points of the ear for sciatica continued to be practised in some parts of Europe.

This tradition partly survived especially around the Mediterranean and in southern France.

This practice would become one of the important observations that paved the way for modern ear therapy in the 20th century.

Paul Nogier and the Birth of Modern Auriculotherapy

The French physician Paul Nogier (1908–1996) worked in Lyon.

In the early 1950s, he noticed that some patients who came to him with sciatica had small burn scars in the same area of the ear.

The patients said that this point had been burned by a practitioner to reduce their sciatica pain.

Instead of ignoring this observation, Nogier began to investigate it systematically.

He asked this question:

If a specific point on the ear is related to the lumbosacral region, could other areas of the ear be related to other areas of the body?

As a result of years of observation and study, he developed a specific model.

The “Inverted Foetus” Model

Nogier likened the representation of the body on the outer ear to an upside-down foetus.

In this model, broadly:

• Earlobe → head and face
• Antihelix → spine
• Upper areas → limbs
• Concha → some internal organs

Nogier’s model was published in the 1950s and soon attracted interest in Europe as well as in China and other countries.

The important point from the point of view of medical history is this:

The systematic “inverted foetus” ear map is based not on Ancient China but on Paul Nogier’s work in France in the 20th century.

Although Chinese Medicine has a much older tradition of ear treatment, Nogier’s map was later studied in China and integrated with China’s own auricular system.

Modern Auriculotherapy

After Nogier, ear treatment became a more systematic field of study.

Today, ear stimulation is carried out with:

• pressure
• massage
• ear seeds
• needles
• electrical stimulation
• laser

In the late 20th century, the World Health Organization also carried out work to standardise the naming of auricular acupuncture points.

Modern scientific research is studying the effects of Auricular Therapy on:

• pain
• anxiety
• sleep problems
• various other conditions

Although the results in some areas are promising, the level of evidence is not the same for all diseases and all ear points.

The Four Historical Paths of Ear Rubbing

With what we know today, we can examine ear rubbing and ear stimulation within at least four main historical paths:

The First Path: Avicennian–Greek Medicine

Dalk → ghamz → local warming and stimulation → measures relating to the ear, head, nerves and senses

The Second Path: Persian–Ottoman Culture

Gûşmâl → pulling the ear → warning → attention → discipline → preventing the mistake from being repeated

The Third Path: Eastern Medical Traditions

• Chinese Medicine → Qi and meridians
• Ayurveda → Vata and oil massage
• Korea → kidneys, basic energy and ear stimulation
• Su Jok → correspondence and reflection systems
• Japan → light stimulation and self-care practices
• Tibet → rlung, relaxation, oil and heat

The Fourth Path: Western–European Medicine

Ancient Greece and Rome → interventions around the ear → Middle Ages and Renaissance → ear cauterisation → sciatica treatment → France → Paul Nogier → inverted foetus model → modern Auriculotherapy

These four paths are not entirely independent of one another.

Avicennian Medicine and European Medicine share important parts of a common Hippocratic–Galenic heritage.

For centuries, Ottoman culture interacted with both Persian culture and Avicennian Medicine.

Chinese Medicine has an old tradition of ear treatment, but Nogier’s map reached China in the 20th century and influenced the development of the modern Chinese auricular system.

How to Rub the Ears: Step-by-Step

1. Preparation

Wash your hands.

Warm your palms by rubbing them together for 10–20 seconds.

If needed, spread one or two drops of an oil suited to your temperament on your fingers.

2. Warming the whole ear

Take each ear between your palms and fingers.

Gently rub the front and back surfaces for about 20–30 seconds.

The aim is to create a pleasant warmth.

3. The earlobe

Hold the earlobe between your thumb and index finger.

Massage it a few times with circular movements.

Then pull it very gently downwards and outwards.

4. The outer rim

Take the outer rim of the ear, the helix, between your thumb and index finger.

Rub it section by section from bottom to top.

5. The upper part of the ear

Holding the upper part of the outer ear, gently pull it upwards and outwards a few times.

6. The middle part

Gently massage the reachable folds and hollows of the outer ear with your fingertip.

Do not put any object into the ear canal.

7. Moving the outer ear

Gently move the outer ear forwards and backwards.

The movement should not cause pain.

8. Final massage

Finally, rub both ears relatively quickly but gently with your palms and fingers.

At the end, the ear may feel warm, slightly flushed and relaxed.

But there should be no pain, marked burning, swelling or bruising.

Duration and Frequency

The original article gave a total of 5–10 minutes for both ears. This duration can be used for a full massage session.

But for daily self-care, for most healthy people:

2–5 minutes is enough.

In a more thorough session, a total of 5–10 minutes can be applied for both ears.

There should be no pain or overstimulation.

Generally, it can be done 1–2 times a day.

The Best Times for Ear Rubbing

After waking up in the morning

To reduce morning sluggishness, the movements can be made a little faster.

Before study or mental work

A fast but gentle massage of about 1–3 minutes can be used for sensory stimulation.

During mental fatigue

Instead of continuing to work while sluggish, taking a short break to regulate your breathing and rub your ears can break the sensory monotony.

Before sleep

Here the method should be different.

The movements should be slow, soft and rhythmic, supported by calm breathing.

Simple rule:

For alertness → faster and warming.

For relaxation → slower, softer and rhythmic.

Who Should Not Rub Their Ears, or Should Be Careful?

Firm ear massage should not be done in the following cases:

• acute ear inflammation
• outer ear infection
• a wound or boil
• a burn
• a recent injury
• severe ear pain of unknown cause
• discharge with pus or blood

If there is a perforated eardrum or one is suspected, oil or any other substance should not be put inside the ear casually.

Excess heat and bile in the head

If the ear is very hot and red, or the person has a hot, throbbing headache, very firm massage and very hot-natured oils may make the complaint worse.

In the Traditional Medicine approach, if massage is needed it can be applied more lightly, and oils regarded as cooler, such as violet oil, can be used.

Very high, crisis-level blood pressure

In a hypertensive crisis, ear rubbing is not a treatment for blood pressure.

The priority is medical assessment and the necessary treatment.

What Ear Rubbing Does Not Do

From a scientific point of view, it is also necessary to know the limits of the method.

Ear rubbing:

• is not a treatment for ear infection
• is not a definitive treatment for Alzheimer’s or dementia
• is not a treatment for all dizziness
• is not, on its own, a treatment for hypertension
• has not been proven to permanently improve memory in healthy people after a few minutes of massage

On the other hand, in suitable people it can be used as a simple self-care method to create local warmth, provide sensory stimulation, reduce feelings of sluggishness and fatigue, help relaxation and increase a sense of vitality.

Why Have Different Cultures Valued the Ear?

Perhaps this is the most interesting question of this article:

Why did Iranians, Ottomans, Chinese, Indians, Koreans, Japanese, Tibetans and Europeans take an interest in stimulating the ear at different times?

It is not possible to attribute all these traditions to a single cause.

Some of the similarities can be explained by knowledge passing between civilisations.

Others may be the result of independent observations.

The ear is:

• easily reachable
• very sensitive
• rich in nerves
• well supplied with blood
• an area whose response to massage, pressure, pulling and heat is easily felt

Modern neuroscience has today added a new field of research to these historical observations:

The rich nerve network of the outer ear and the relationship of some of its areas with the auricular branch of the vagus nerve.

So some of the effects observed throughout history may have neurophysiological counterparts.

But this does not mean that all traditional ear maps or all treatment claims have been scientifically proven.

Conclusion

Ear rubbing is not just an old idiom meaning “to punish”.

When we consider the history of medicine and culture together, at least four important paths appear:

Avicennian–Greek Medicine, Persian–Ottoman culture, Eastern medical traditions and Western–European medicine.

In the Avicennian medical tradition, dalk and ghamz are important bodily measures, and applying them to the ear can be assessed in terms of warming, stimulation and creating movement.

In Persian and Ottoman culture, gûşmâl and pulling the ear took on meanings such as drawing attention, warning, disciplining and preventing a person from repeating a mistake.

In Traditional Chinese Medicine, Ayurveda, Korea, Japan, Su Jok and Tibetan Medicine, the ear has been used in different ways for pressure, rubbing, warming or stimulation.

In the West, from Ancient Greece and Rome to modern Europe, the ear has been an area where various treatment attempts were made; the tradition of cauterising the ear for sciatica later paved the way for Paul Nogier’s observations and the development of modern Auriculotherapy.

Modern neuroscience also shows that the outer ear has a rich nerve network and that some of its parts are related to the auricular branch of the vagus nerve. The development of taVNS shows that the ear is still a serious field of neuromodulation research today.

So gentle ear massage, done in a suitable person and with contraindications taken into account, can be used as a simple health-preservation and self-care method to create local warmth, provide sensory stimulation, reduce sluggishness and, when done slowly, support relaxation.

The basic principle is this:

Ear rubbing for therapeutic purposes is not about hurting, twisting or punishing the ear; it is about rubbing, pressing and gently pulling the ear in a controlled, gentle and mindful way.

In a scientific assessment, three areas must also be kept apart:

what traditional physicians and medical schools said; what historical and cultural experience shows; and what modern scientific research has confirmed so far.

Considering these three areas together without mixing them up shows that a practice as simple-looking as “gûşmâl” is in fact a fascinating subject where medical history, Traditional Medicine, culture, massage therapy, auriculotherapy and modern neuroscience meet.

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Which practice suits you depends largely on your temperament. To find out your temperament, you can take our free temperament test , and for another traditional method related to coldness and circulation, see our article on nettle urtication .