History of Acupuncture in China
or needle puncture, is a European term invented by Willem
Ten Rhyne, a Dutch physician who visited Nagasaki in Japan
in the early part of the seventeenth century. The Chinese
describe acupuncture by the character 'Chen', which literally
means 'to prick with a needle', a graphic description of
this therapeutic technique.
has a clearly recorded history of about 2,000 years, but
some authorities claim that it has been practiced in China
for some 4,000 years. The Chinese believe that the practice
of acupuncture began during the Stone Age when stone knives
or sharp edged tools, described by the character 'Bian',
were used to puncture and drain abscesses. In fact the Chinese
character 'Bian' means the 'use of a sharp edged stone to
treat disease', and the modern Chinese character 'Bi', representing
a disease of pain, is almost certainly derived from the
use of 'Bian stones' for the treatment of painful complaints.
The origin of Chinese medicine is a fascinating story and
acupuncture represents only one facet of their medical system.
first recorded attempt at conceptualizing and treating disease
dates back to about 1500 BC during the Shang dynasty. Tortoise
shells with inscriptions dating from that time have been
found, and it is thought that these were used for divination
in the art of healing.
acupuncture developed, the Bian stones were discarded and
needles of stone and pottery were used. These simple, primitive
needles are still used in some of the rural areas of China.
Eventually metal needles began to appear and these took
the form of the classical 'nine needles'. The 'nine needles'
needle for superficial pricking
needle for massaging
needle for knocking or pressing
edged needle for puncturing a vein
needle for draining abscesses
round needle for rapid pricking
needle, for needling in thin built males & most females
needle for thick muscles
needle for puncturing painful joints.
main needle now used for acupuncture is the filliform as
most of the others have been replaced by more sophisticated
surgical instruments, for instance, the sword-like needle
has been replaced by the scalpel. The 'nine needles' were
initially made of either bronze, or gold and silver, and
seem to have been first used about 2,000 years ago. The
tomb of the Prince of Chungshan, dating from the second
century BC, was excavated in 1968 and contained a set of
nine needles, four being of gold and five of silver. Some
acupuncturists use gold and silver needles but the majority
only stainless steel filliform needles.
discussion of the history of acupuncture is incomplete without
mentioning moxibustion. Moxa herb is burnt in close proximity
with the skin of the patient. The Chinese character 'Chiu'
is used to describe the art of moxibustion, and literally
means 'to scar with a burning object'. Moxibustion does
not now involve scarring, but moxa is still used to provide
local heat over acupuncture points. It is made from the
dried leaves of Artemisia vulgaris and the Chinese believe
that the older the moxa, the better its therapeutic properties.
Moxibustion developed as a medical practice completely separate
from acupuncture, although it is now very much a part of
current acupuncture practice in China.
used to treat specific types of disease and is applied over
the same body points (acupuncture points) as acupuncture
needles. Some of the acupuncture points, such as those around
the eye, are forbidden to moxa. In ancient China, moxa was
also burnt on specific acupuncture points to keep the body
healthy, and was said to act as a prophylactic against disease.
Moxa can be used in a variety of ways. Loose moxa is made
into a cone and burnt on the skin, the cone then being removed
when it is half burnt, to avoid blistering. It may also
be burnt on ginger or garlic so that the skin is isolated
from extreme heat, or a moxa stick may be used and burnt
a centimeter or two away from the skin.
exceptionally productive period of the Warring States also
gives us the first known and recorded therapeutic success
of acupuncture The Historical Records by Ssu-ma Ch'ien tells
how the physician Pien Cheuh used acupuncture to revive
the Governor of the State of Kuo from coma. In fact the
name of the physician was Chin Yenh-jen, but by taking the
legendary name of the famous Chinese physician, Pein Cheuh,
we can assess his prestige. In ancient China, as today,
an event like this is a powerful argument in favor of the
acceptance of any form of treatment.
Evolution of Acupuncture Points and Channels
there were no specific locations on the body for applying
either moxa or acupuncture but gradually, through empirical
experience, the use of specific points on the skin were
shown to be of value in particular diseases. Acupuncture
points are undoubtedly the end-product of millions of detailed
observations and as they were developed, they were given
a name and Chinese character, depending on its therapeutic
properties. Acupuncture points were subsequently grouped
into a system of channels which run over the body, conducting
the flow of vital energy through the body. The acupuncture
points on a channel are said to influence the flow of vital
energy through the channel, thereby influencing disease
processes in the body.
first clear reference to the points and channels is in the
Nei Ching Su Wen which defines the main channels and acupuncture
points. The Nei Ching Su Wen also makes the observation
'in pain, puncture the tender spot', and the use of painful
points probably represents the original method by which
many of the acupuncture points were discovered. Common painful
diseases consistently cause painful points to emerge in
well defined anatomical locations over the body. When this
point is stimulated the pain can be alleviated; hence the
idea of a point for treating pain. From this simple beginning
it is easy to see how a system of acupuncture points evolved.
The evolution of the channels connecting these acupuncture
points is more difficult to understand. These seem to have
evolved from an intuitive understanding of the flow of vital
energy through the body. It is unclear from where the idea
of channels originated, but for the last 2,000 years they
have formed an essential part of traditional Chinese medicine.
'New' Brozne Model for Teaching Acupuncture Points
of the confusion that had gone before him, Wei-yi collected
and collated all the information that was available to him
in the eleventh century. He redefined all the points and
channels and compiled an authoritative text called Illustrated
Manual on the Points for Acupuncture and Moxibustion on
the New Bronze Model. This text dates from AD 1026 and details
the use of 354 points on the body. A vast amount of information
is given about the location of the points, the method of
needle insertion into each point, and the clinical indications
for the use of specific points.
Arrival of the Europeans
the Ming dynasty contact was established with Europe, the
earliest date being 1504 when the Portuguese landed; Macao.
At about the same period, China's fleets began to visit
India, Persia and some of the Arab states. Cheng Ho led
the first recorded fleet of merchant ships to India in 1405,
but it is certain that other Chinese merchantmen had traveled
far off prior to this date. The overland 'silk route' to
China had been open for many centuries and merchants had
for some time traveled into China and central Asia, following
in the footsteps of Marco Polo. With the traders went priests
to convert the 'heathen'. It was through these priests,
and also various physicians who visited China, that the
idea of acupuncture began to filter through to the west.
The Jesuits were particularly active in collecting and disseminating
this information in Europe, but the process was far from
one-sided as the Jesuits also introduced Western science
to China. Dominique Parrenin, a missionary, translated a
textbook of anatomy into Mandarin but this was banned from
general circulation by the Emperor K'ang Hsi as he recognized
that many of the Western concepts contradicted those of
traditional Chinese medicine.
Decline of Acupuncture and the Rise of Western Medicine
– 1911: This was the time of chaos for the Chinese Empire.
Western influences pervaded a war-torn China, especially
during the nineteenth century when various Western nations
were given 'spheres of influence' on the Chinese mainland.
The Ching Emperors regarded acupuncture as 'a bar to progress'
Government decree eliminated acupuncture from the curriculum
of the Imperial Medical College. During this period a great
number of medical missionaries entered China to 'teach,
heal and preach'. The medicine they practiced in the early
part of the nineteenth century had little similarity to
the Western medicine of today, as there were no anaesthetics,
antibiotics or sepsis. The concept that bacteria caused
disease was only disseminated in the 1860's and 1870's,
and therefore the missionaries had very little real medical
skill to offer. Their main advantage was their understanding
of the elementary principles of surgery. The Confucian ethic
had blocked completely the progress of surgery, as the Chinese
felt that the dead must present themselves to their ancestors
with a whole body. They were afraid of surgery. The first
full-time missionary was Peter Parker who worked in Canton.
At first, the activity of the medical missionaries was limited
by hostility, money and manpower, but as Western influence
expanded the missionary work grew.
There were some 550 hospitals and out-patient clinics spread
over most of the provinces and cities in mainland China.
During this period the art of acupuncture was in decline.
Many acupuncturists seemed to be no more than 'pavement
physicians' with poor training. Their surgery was often
the market place, their knowledge of traditional Chinese
medicine was very limited, and their equipment was filthy
and of poor quality.
majority of 'respectable' Chinese doctors were practicing
herbal medicine and massage, rather than acupuncture and
moxibustion. In spite of its decline, and even at this low
level, acupuncture remained the medicine of the masses.
In 1929 the practice of acupuncture was outlawed in China;
the passage of acupuncture has not always been smooth, even
Support for Acupuncture
1928 the Communist party of China was formed, under the
leadership of Chairman Mao. A long guerrilla war ensued
and the Communist party finally took power in 1949. The
Communists realized that there were little or no medical
services in the 'liberated areas' and actively encouraged
the use of traditional Chinese remedies to keep their troops
on the move. These remedies were cheap, acceptable to the
Chinese peasants, and utilized the skills already available
in the countryside. Acupuncture gained new momentum.
the early 1950's many hospital opened clinics to provide,
teach and investigate the traditional methods, the main
research institutes being in Peking (Beijing), Shanghai
and Nanking. This renaissance of acupuncture, combined with
a sophisticated scientific approach, has allowed the development
of many new methods of acupuncture.
ideas Based on Traditional Chinese Medicine
acupuncture has been used and developed by the French and
the Chinese as a form of therapy and also, specifically
by the Chinese, for acupuncture anesthesia. Many people
in the West think of acupuncture as being synonymous with
acupuncture anesthesia. The application of acupuncture as
a form of anesthetic is a relatively new development, and
a direct product of the impetus given to acupuncture by
acupuncture was first used by the Chinese to control post-operative
pain and it then began to be used as an anesthetic for simple
operations. This technique was found to be effective and
its use expanded quickly. In China it is now used for a
wide variety of major and minor operations. Acupuncture
anesthesia has many advantages including safety and swift
post-operative recovery; however, it does not always provide
complete pain relief, and whilst a small failure rate is
acceptable to the Chinese it would not be acceptable in
most Western societies. It is obviously better to use a
site far away from the area of the operation when applying
acupuncture anesthesia, and this makes ear acupuncture the
method of choice for anaesthetics. The concept of the homunculus
is one that the Chinese have developed further. There are
complete representations of the body on the hand, foot,
face and nose. Each of these represents complete 'micro-acupuncture'
system, capable of treating ailments throughout the body.
Acute back pain can be relieved by stimulating the points
on the hand that represent the back. Perhaps this can be
equated with the fact that each cell in the body has the
information potential to duplicate the whole human. The
genetic material in each of our cells is exactly the same
as the information in the cell from which we all originated,
the fertilized egg.
Ideas Based on Western Medicine
Chinese have also applied a variety of Western techniques
within the field of acupuncture. They have established research
institutes and these, particularly in Shanghai and some
other Chinese cities, measure up to any found in the West.
acupuncture, a technique invented in the last decade, is
a direct development from the neuro-anatomy of the central
nervous system. When the brain is damaged, in diseases such
as a stroke, the scalp is stimulated superficially over
the area of damaged brain. Although there is no clear connection
between the nerves in the skin of the scalp, and the brain,
this method does seem to produce an effect on the brain
and the Chinese claim that they are able to alleviate some
of the symptoms of a stroke with this procedure. Modern
medicine has undoubtedly provided the stimulus for the development
of this type of acupuncture.
points can also be treated by injection with ordinary injection
needles, this method having been used in the West for some
time although not called acupuncture. Tender, painful areas
often occur in and around arthritic joints. Recent research
work has shown that most of these 'tender points' are acupuncture
points, and that injection therapy relieves the pain. Is
it perhaps the needle insertion, rather than the fluid injection,
that alleviates the pain?
is the stimulation of acupuncture needles with small electrical
currents, and its growth and development has been pioneered
by the Chinese over the last thirty years. Throughout long
operations, under acupuncture anesthesia, electrical machines
have been used to avoid prolonged, continual manual stimulation
of acupuncture needles. Electroacupuncture is now widely
used in many acupuncture clinics, for acupuncture therapy
as well as for anesthesia.
Chinese are well aware of the current scientific explanations
of acupuncture and its mode of action, and through their
research institutes they are contributing to this field.
The cultural heritage of the Chinese has made it possible
for them to accept the contradictions inherent in the practice
of acupuncture; science versus philosophy. The concepts
of traditional Chinese medicine allow the acupuncturist
to approach and treat a patient. Eventually science will
provide a logical explanation for these empirical findings,
but, until such time as that happens, science and traditional
ideas will both play an equal part in helping patients by
the use of acupuncture.