Acupuncture in China

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Acupuncture in China

Overview

Acupuncture, the insertion of thin needles into specific points of the body in order to relieve pain or treat illness, is an ancient Chinese art first developed more than 4,000 years ago. Acupuncture was used to help restore a healthy balance of energy throughout the body and, along with herbal remedies, was the cornerstone treatment offered by traditional Chinese medicine. Although the origin of acupuncture predates written history, acupuncture's evolution through the ages remains grounded in the ancient Chinese naturalistic philosophies of Taoism.

Background

Evidence of practices similar to acupuncture are found in Chinese relics dating back to the New Stone Age (8000-2000 b.c.). During this time the first acupuncture needles were crudely shaped and made from stone. Known as bian stones, they were used to apply pressure to the body, treat wounds, and lance infectious lesions. Later, needles replaced the bian stones. The first written reference to acupuncture is found in The Yellow Emperor's Inner Cannon of Medicine (Nei Ching Sue Wen) written in approximately 200 b.c., but assumed to include writings from much earlier times. There are numerous sections in Nei Ching Sue Wen, addressing core subjects of medicine such as the physiological constitution of the body, diagnosis, fevers, and treatments (including acupuncture) based on the wisdom and experience of earlier sages. The work contains a dialogue between the ancient "yellow emperor" Huang-yi (c. 2650 b.c.) and his chief minister that sets down the philosophical basis of traditional Chinese medicine embraced by acupuncture.

Traditional Chinese medicine holds that the body contains an essential life energy known as qi (pronounced "chee"). Chinese language scholars maintain that the concept of qi is greater than any type of energy described by Western science. Qi was described in the Nei Ching Sue Wen as being responsible for change, movement, and life itself. All mental and physical aspects of life were made possible by the flow of qi throughout the body. Qi flowed through the body in channels or meridians which were arranged in a mostly symmetrical pattern. There were 14 main meridians running up and down the length of the body. Early references portray the meridians as nonphysical, unique energy pathways in the body. When the pathways became obstructed or inefficient, the flow of qi was interrupted and an imbalance in the body could occur, resulting in illness. Traditional Chinese physicians practiced acupuncture to restore that balance.

Qi was composed of two parts, yin and yang. The concepts of yin and yang, both fundamental to Taoist philosophy, can be used to describe all that is in the universe, including every part and function of the body. Yin and yang are complimentary opposites that, when balanced, work together to form a whole. Yin and yang are interdependent, and their relationship was used to describe the fluctuating balance in nature. Man, for example, (masculine attributes are synonymous with yang) is dependent upon woman for his birth, while woman (female attributes are associated with yin) is dependent upon man to conceive. In the body, the yang element represents the capacity for action and transformation. The yin element represents the capacity for circulation, nourishment, and growth. The Taoist concept of health emphasizes the aspiration to attain perfect harmony between the opposing forces of the natural world, between yin and yang. Any imbalance of the yin or yang elements of the body could interrupt the flow of qi, bringing pain or disease. With his acupuncture needles, the Chinese physician restored the balance of yin and yang, and the flow of qi.

When considering acupuncture treatment for a patient, the Chinese physician first took time to ask questions and record specific physical observations of the patient, much like the patient history of modern times. The physician used his five senses to gather much of the information relevant to his diagnosis. Most afflictions were considered internal ones (even skin disorders and some injuries), thereby lending themselves to acupuncture treatment. Needles were inserted at acupuncture points along the meridians. Acupuncture points are specific locations where meridians come to the surface of the skin and are easily accessible with acupuncture needles. The needles were inserted at various angles and depths, depending upon the desired effect. Often the needles were twisted, tapped, or warmed with burning wool placed at the tip. A paste made of the Chinese mugwort plant was heated and placed at the insertion site in the process of moxibustion (the burning of small cones of dried leaves on certain points of the body). Frequently, acupuncture, moxibustion, and herbal remedies were prescribed to be carried out at the same time.

Impact

Events during the "Warring States" period of Chinese history (475-221 b.c.) helped to secure the practice of acupuncture as a mainstay of Chinese medicine. Taoism and Confucianism both became mainstream ideologies and exerted great influence on Chinese thought. Confucianism held that the body was sacred as a whole, and that it was vital to present oneself to one's ancestors intact upon death. Amputation and execution by decapitation, therefore, held an even greater fear than death. Acupuncture offered a logical method of treating internal disease while maintaining an intact body. Taoism was a more passive philosophy, and its balance of the yin and yang coincided with the medical concept of acupuncture for maintaining the balance and flow of qi for health. Throughout the periodic wars of the next 700 years which established and strengthened the feudal system in China, acupuncture proved an easily portable method of medical treatment during turmoil.

As the ancient practice of acupuncture found an enduring position in Chinese traditional medicine, the tools to administer it improved as technological skills developed. Crude bian stones gave way to more skillfully shaped needles made of pottery. With the development of metallurgical techniques, the metal needle superseded the pottery needles and bian stones. Metal needles (mostly iron) originated in about 100 b.c., and greatly enhanced the practice of acupuncture. Metal needles could be refined for a specific purpose, and several distinct designs were created. In the excavated tomb of the Prince of Chungshan, dating from about 115 b.c., nine distinctly designed needles were unearthed, some made of silver, others made of gold. Needles that followed eventually took one of the nine classic forms found in the tomb: the arrowhead needle for pricking just beneath the skin; the sharp, round needle for rapid or repetitive pricking; a needle shaped specifically for draining abscesses; the multi-edged needle for piercing a vein; the longer needle for deep muscles; the large needle for the joints; a blunt-edged needle for applying small pressure points; the round needle for massaging; and the filliform needle. New acupuncture points and channels were found to accommodate the improved needles. By the end of the third century a.d., nearly all of the major channels and almost 400 insertion points had been identified. The basics of acupuncture therapy were solidified, and (with the exception of further needle technology and insertion points) acupuncture remained essentially unchanged for 1,500 years.

From approximately 220 b.c., traditional Chinese medicine offered a nature-based explanation to illness, rather than contributing illness to evil spirits or other supernatural causes. Qi was perceived as a natural substance, and acupuncture was a rational method of maintaining and restoring its balance. Personal responsibility for keeping the body's qi in balance came into favor, as the Chinese adopted a long-lasting culture of disciplined moderation in the everyday ways of life. Through acupuncture and moderation in diet, physical activity, sexual practices, and spiritual meditation, the Chinese practiced some of the world's first preventive medicine. The Chinese concepts of yin and yang made Chinese medicine the first holistic medicine, as no ailing function or part of the body was considered separate from the whole person.

Ultimately, traditional Chinese medicine took a different branch in its evolutionary process than Western medicine. While both Eastern and Western medicine embarked upon a system that sought its answers in nature at approximately the same time (approximately 200 b.c.), Western medicine eventually sought facts brought about by the scientific method, while Eastern medicine continued with a holistic approach. The upholding of traditional Chinese values and ancient texts of medicine and philosophy ensured acupuncture's place in Chinese medicine through modern times.

BRENDA WILMOTH LERNER