The Story of the Yellow River and Chinese Acupuncture

If you're thinking about a career in acupuncture you'll want to learn how and where you can earn a certificate or degree in acupuncture. Perhaps you're already familiar with the field of acupuncture but if not you'll want to find out all you can both online and offline. It's thought that acupuncture has been practiced in China for at least 2,000 years and some think it's probably been practiced at least 3,000 years or so. First of all you'll want to choose an acupuncture school that offers consultation services for its graduates. The schools that do, allow graduates after graduation, to consult with instructors regarding care of their patients. You'll also want to check to see if your state is on the national list of about 49 acupuncture schools with accredited programs and you'll want to find an acupuncture school that offers smaller classes. Acupuncture schools that offer courses in traditional Chinese medicine often include related training or courses in traditional medicine, such as anatomy and physiology, body therapy, massage therapy, and other sciences. For naturopathy schools that offer acupuncture programs there is a list called the: List of Accredited Natural Medicine Colleges in North America. Check with the school you're considering making sure they have a wide selection of study resources available so you can have all the essential acupuncture materials for a broad learning experience. You'll also want to find out what the acupuncture training, school and program options are in your home area. Try to find a school whose program emphasizes courses in traditional Chinese medicine because acupuncture is just one element of traditional Chinese medicine. There are a few acupuncture schools that teach acupuncture practitioners the five-element Oriental medicine approach to acupuncture, which is often used in conjunction with the traditional Western medical practices. Acupuncture is used for: arthritis, headaches, migraines, to quit smoking, to lose weight , fertility, fibromyalgia, depression, insomnia, face lifts as in facial acupuncture, back pain, high blood pressure, pregnancy, cosmetic purposes, anxiety, panic attacks, Crohn's disease, asthma and on dogs and other pets or animals as in veterinary acupuncture. If you haven't experienced acupuncture make to visit an acupuncture clinic to learn more about acupuncture. You might want to talk to an acupuncture specialist or naturopath about a possible acupuncture career also. Talk to the financial aid counselors at the acupuncture school or college you're considering to see if they have any ideas or suggestions for scholarships, grants or education loans if you need to finance your training. Before you commit to any acupuncture school or to any acupuncture training you can check out the "Fundamentals of Chinese Acupuncture" by Ellis, Wiseman, and Bosson. This excellent textbook is used in many acupuncture schools and acupuncture training programs and will give you a better idea if you'd like to pursue acupuncture as a career. If you haven't checked already may sure to check and see if you need a license to practice acupuncture in your state. You may not need a license. Get the facts first on which states require licensing. Note that each state and each discipline has its own criteria about how alternative medicine practitioners are to be professionally licensed, if at all. Acupuncture programs in acupuncture schools can be expensive and usually require three years or so of classes and sometimes up to five years. If you have a naturopathic school in your area, email or give them a call to find out the licensing requirements in your state. If you do get financing help or aid in the form of federal assistance be sure to have selected a school that's accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM). An acupuncture career has great career growth potential. Just be sure to find out the length of the coursework and the expense upfront and know how you plan to handle it. Many have done it before you. If possible, intern in an acupuncture clinic in your neighborhood to get first hand experience before you decide. But make sure to learn about the licensing requirements for acupuncturists for your state before you do anything else.

The Story of the Yellow River and Chinese Acupuncture

1. Acupuncture: An extraordinary therapeutic method over two millennia old Acupuncture treats diseases by the insertion of fine needles into the body. In July of 1971, Dr. Henry A. Kissinger made a secret trip to China to prepare for President Nixon's historical visit. Among his entourage was James Reston, a journalist from the New York Times. While in China, Reston suffered an attack of acute appendicitis and underwent an appendectomy at the Beijing Union Medical College, established by the Rockefeller Foundation of New York in 1916. During the second night after the operation, Reston started to experience considerable discomfort in his abdomen. With his approval, an acupuncturist at the hospital inserted and manipulated three long thin needles, one into the outer part of his right elbow and one below each knee. There was noticeable relaxation of the abdominal pressure and distension within an hour, with no recurrence of the problem thereafter. James Reston included a detailed description of his experiences with acupuncture in his dispatches from Beijing. This was the first such report to reach the English-speaking citizens of the United States, at least the vast majority who had no daily contact with Asians. By contrast, acupuncture has been known and practiced in China for over 2300 years. Qin Yueren, the earliest recorded Chinese practitioner, is considered to be the founder of acupuncture. A biography of Qin Yueren is included in the Records of the Grand Historian (Shi Ji), the masterwork of the eminent Chinese historian Sima Qian (135 - ? BC). It is known that Qin Yueren lived around 407-310 BC, and was a contemporary of Hippocrates (c. 460-377 BC), the father of Western medicine. Qin Yueren traveled widely throughout the feudal states that compromised China during his time, treating men and women, old and young alike. As a result, he was given the auspicious appellation Bian Que, which means Wayfaring Magpie - a bird that flies here and there dispensing good fortune. Several carved stones, unearthed from a tomb dating back to the Eastern Han Dynasty (25-220 AD), portray him with a human head and a bird's body. On one occasion, while passing through the State of Guo (present-day Shan County in Henan Province), Bian Que learned that the Prince of Guo had died and his subjects were preparing to inter him. After careful examination, Bian Que believed that the prince had merely experienced a type of deep coma known as deathlike reversal. He successfully resuscitated the patient by needling an acupoint on the vertex of his head, and become known for bringing the dead back to life. This was the first recorded use of acupuncture in China. Acupuncture is extraordinary. Needles have historically been among the most common tools of daily life, used for constructing garments all over the world. Just as needles are used to sew clothes, they are also utilized medically to suture incisions. While hollow syringes are used to inject fluids into the body or to draw them out, pricking the body with a solid acupuncture needle to treat illness seems quite incomprehensible. Most people prefer not to be punctured with needles, and associate needling with pain and injury. No wonder, to "needle" a person means to displease or to irritate in English. By trial and error, healers throughout the world have independently discovered similar treatments for pain and disease, including herbs, roots, wraps, rubs, blood-letting, massage, meditation, or surgery. But the invention of acupuncture is unique to China. Why did the ancient Chinese begin to treat disease by puncturing the body with bare needles? A generally accepted answer to this question is that acupuncture evolved as a natural outgrowth of daily life in the Neolithic Age (c. 8000-3500 BC), through a process of fortuitous accident and repeated empirical experience. According to this theory, people noticed cases in which physical problems were relieved following an unrelated injury. This led to the discovery of the principle that injury to a certain part of the body can alleviate or even cure a pre-existing disease or disorder in a different part of the body. It is thought that with this discovery, Neolithic Chinese people eventually started to use stones, animal bones, or pieces of bamboo to deliberately induce injury to relieve physical problems. The traumatic nature of acupuncture, which seems quite crude by modern standards, as well as its long history in China, seem to lend credence to the theory of its prehistoric origins. However, if acupuncture did indeed arise from repeated empirical experience of accidental injury, it should have developed all over the world, rather than solely in China. 2. Meridians of the Body: The rivers of the Earth in microcosm According to traditional Chinese medicine, a network known as "meridians" is distributed throughout the human body, carrying Qi (vital energy) and blood to nourish the organs and tissues. Meridians of the human body are very similar to rivers of the earth in both structure and function. Rivers are the meridians of the Earth in macrocosm. They are the channels that contain the flow of water, the life force of our planet. On the microcosmic scale, the meridians of the human body are the channels that contain the flow of Qi and blood, the life force of living beings. The ancient Chinese found that there are twelve Regular Meridians in the human body. The Neijing or Huangdi Nejing (the Yellow Emperor's Inner Classic of Medicine) (compiled between 104-32 BC) is the seminal work of traditional Chinese medicine and the earliest extant medical exposition of acupuncture. The chapter entitled "Regular Watercourses (Jingshui)" deals specifically with the correspondences between the twelve Regular Meridians and the twelve major rivers in China. The rivers mentioned are located in the basins of the Changjiang River and the Yellow River. The techniques and terminology of flood control offer a vivid analogy of the therapeutic mechanisms of acupuncture. Blockages in these "energy rivers" act as dams, obstructing the flow of Qi and blood and causing it to back up in connecting channels. Needling the acupoints removes the obstructions, curing disease by reestablishing the regular flow of Qi and blood. In the same way, dredging a river by clearing away sediment prevents flooding by allowing the water to flow freely. Similar descriptions of flood control and acupuncture have been used since acupuncture first appeared as a comprehensive system of healing early in China's Western Han Dynasty (206 BC-24 AD). Such hydraulic terminology has been employed not simply for its evocative imagery. Rather, it indicates the understanding the Chinese ancestors have attained by this time of the correspondences between Nature and Human, river and meridian, flood and disease. 3. Dredging rather than Diking: The unparalleled mastery of flood control attained by the Chinese ancestors China is located on an immense and steep continental slope, unlike any other in the world. The Qinghai-Tibet Plateau, located in the western part of China, is the highest and geologically youngest plateau on Earth. It is known as the Roof of the World, with an average elevation of 4000-4500 meters. A Chinese saying states, "The higher the mountain towers, the higher the water rises." The vast and cloud-kissed Qinghai-Tibet Plateau is the largest and highest natural water tower on Earth, storing snow precipitated from water vapor emitted by the world's oceans and seas. As the compacted snow melts away under the sun, drop by drop, the liberated water flows naturally downward to the east and accumulates into tiny streams, which then converge into mighty torrents that empty back into the ocean. China's two longest rivers, the Yangtze River and the Yellow River, originate in the heights of the Qinghai-Tibet Plateau. They have been essential to agricultural development and population growth throughout China's history. But due to the tremendous drop in altitude from the Qinghai-Tibet Plateau to sea level, water in these rivers flows extremely rapidly and may easily cause flooding. The Yellow River, the world's muddiest river, is especially infamous for its destructive floods. The Yellow River's name refers to the vast quantities of yellow silt, or loess soil, it carries. Loess formations are extremely vulnerable to erosion by water. As the Yellow River winds through the Loess Plateau in northwestern China, the raging torrent picks up yellow silt in unusually large amounts and sweeps it downstream. As the river reaches flatter areas the current slows, depositing massive amounts of yellow silt and elevating the riverbed. Attracted by the fertile lands of the Yellow River's middle and lower reaches, the prehistoric ancestors of the Chinese people settled down along its banks to create a culture based on planting, fishing and hunting. However, these trailblazers were soon threatened by the river's severe and protracted flooding. During the early stages, they may have resided on natural or artificial uplands or led nomadic lives to avoid flooding, while also imploring supernatural forces for help. But as their population increased, they had no other choice but to strive to harness the river's enormous power. This defining aspect of Chinese culture is reflected in one of China's oldest and most popular legends, the story of how Great Yu controlled the flood. It is said that during the Wudi or Five Emperors Period (c. 2700 to 2000 BC), severe flooding spread over the country and brought great disaster to the people. Emperor Yao appointed his minister Gun to harness the river and control the waters. However, Gun's attempts to obstruct the flood by erecting dikes and dams failed. Gun's son Yu was appointed by the next emperor, Shun (c. 2100 BC), to continue his father's work. Drawing a lesson from his father's failure, Yu noticed and took advantage of the downward flowing nature of water. He dredged canals according to the physical features of the terrain, to lead the water finally to the sea. After thirteen years of hard work, the floods subsided. It may be difficult to separate fact from legend in the case of Great Yu, but China's long history of flood control is indisputable. The most valuable principle the ancient Chinese learned from their work with flood control was that dredging or diverting water to flow naturally downward is superior to diking or other attempts to obstruct the water's passage. The Dujiang Canal (Dujiang Yan), the most famous water conservancy project of ancient China and the entire ancient world, is a prime example of the use of dredging and water diversion for flood control. Completed in 256 BC, approximately contemporaneous with the appearance of acupuncture, the Dujiang Canal represents the peak of ancient Chinese hydraulic engineering. It has continued to play an important role in flood control, irrigation, and shipping up to the present day. The oldest operational water conservancy project in the world, the Dujiang Canal was added to UNESCO's list of World Heritage sites in 2000. The long history and unique mastery of flood control attained by the Chinese ancestors, exemplified by the Dujiang Canal, was a direct outgrowth of the geographical conditions they faced. Destructive floods are depicted in the myths and legends of many ancient nations, for instance, the story of Noah and the Flood in the Bible. However, there are no legends concerning flood control. This is a direct result of the physical environment of these ancient peoples. Egypt has depended on the Nile River in both ancient times and modern times. Like a silver strip, the Nile flows across the Saharan desert, creating a corridor of life. Water is invaluable in the desert, creating oases wherever it appears. For the Egyptians, the yearly flooding of the Nile is a blessing rather than a disaster, irrigating and fertilizing the farmland of the Nile River Valley. This yearly flood is so vital to survival that the ancient Egyptians viewed it as the annual renewal of the first act of creation. If the waters did not rise high enough to innundate the surrounding farmland with water and fertile alluvial soil, drought and famine would result. The ancient Egyptians therefore never developed flood control methods, and in fact prayed for the flood if it did not occur on time. Believing that the Nile god Hapi controlled the floods, they celebrated the yearly "Arrival of Hapi" and worshipped him with offerings, hoping that the Nile would rise up enough to provide both water and silt for the farmland. The two rivers, the Yellow River and the Nile River, bring different gifts to their residents. While the flooding of the Nile River fertilizes farmland in Egypt directly, "China's Sorrow" inspired ancient people to create a unique healing method. 4. Clearing the Meridians with Needles: Using the laws of the Nature to cure the ills of the human body A fundamental concept of Chinese philosophy is the "Unity of Humanity and Heaven." It implies that Humanity, Society, and Nature form an integrated system, and that each part is similarly constituted and governed by the same laws. Laozi (c. 6th century BC), the founder of Daoism, states: "Humanity is modeled upon Earth, Earth is modeled upon Heaven, Heaven is modeled upon the Dao, and the Dao is Nature itself." This holistic model of thinking was widely applied in the field of medicine. The early Chinese physicians were philosophers as well. They believed that the processes of the human body may be understood by observing and analyzing the phenomena of the universe, and that the disorders of Humanity can be managed using the principles of Nature. Therefore they held that medical practitioners should not only study the human body, but also should "know Heaven above and Earth below." The ancient Chinese philosopher-physicians realized that since the rivers and meridians are similar in structure, the flow of water in the rivers and the flow of Qi and blood in the meridians adhere to the same rules, and that their disorders can therefore be similarly managed. If a river course becomes silted up, the water in the river, which by nature flows downward, will overflow and result in flooding. If a meridian is obstructed, the Qi and blood it carries, which by nature flow in a circulatory path, will become stagnant and various disorders may occur. The healers of the human body therefore cleared the meridians by puncturing with needles to promote the flow of Qi and blood and cure disease, just as the healers of the Earth dredged the river courses using picks and shovels to direct the waters and control the flood. The twelve Regular Meridians are distributed throughout the body, forming a network that links the upper and lower, and the internal and external, into an organic whole. The Qi and blood flow through the meridians to nourish the entire body. Furthermore, specific sites, called Caves of Qi (qixue) or acupoints, are located on the skin along the pathways of the meridians. These sites are often located in small depressions, usually between the muscles, tendons, bones, or in bony holes. When one is ill, the flow of Qi and blood slows, tending to stagnate at the indented sites which lead to obstruction of the meridians. Insertion of fine needles into these points can effectively promote the flow of Qi and blood and remove obstructions, promoting recovery. Clearing the meridians of the human body with needling to allow the free circulation of the body's energy is a direct application of the central principle of effective flood control - encouraging the desired flow by clearing channels rather than by erecting barriers. The authors of the Neijing express the correspondence between flood control and acupuncture in this way: "Those versed in the laws of Nature excavate a pond at its lowest point, so that the water within the pond can be drained off and strenuous labor avoided. According to the same logic, they dredge the meridians at the acupoints, the cave-like depressions where Qi and blood deposits. In this way, the meridians can be freed with ease." 5. Acupuncture: A true symbol of traditional Chinese culture Rivers originate from mountains and empty into the seas. The erosion of soil at the upper reaches is the principal cause of flooding, so the most effective means of flood control is to conserve water and soil at the upper reaches. The meridians originate at the ends of limbs and end at the abdomen, chest, and head. Therefore, when using acupuncture to treat disease, headache is not treated by needling the head, but rather by needling the feet. Acupuncture, in its use of the laws of Nature to cure the ills of the human body, offers a visible expression of the concepts of Chinese holistic philosophy. The practice of needling the lower part of the body to cure the upper, and treating the outer to heal the inner is nothing less than holism made visible. Acupuncture developed into its full form no later than the 2nd century BC, around the same time that the Chinese ancestors perfected their principles of flood control in the great Dujiang Canal water conservancy project. Just as water always flows downward, the theory and practice of acupuncture have never undergone fundamental change. Since its inception, satisfactory results have been achieved by puncturing the same sites with the same instruments. An acupuncture needle may seem unromantic, but it represents the essence of traditional Chinese culture. Acupuncture is not merely a healing art, but a vivid symbol of thousands of years of Chinese culture. Acupuncture is unique, original and representative. Not only does acupuncture exemplify the height of traditional Chinese culture, but its continued use over thousands of years confirms the value of the Chinese holistic principles that it embodies. The stability and vitality of acupuncture demonstrate why Chinese civilization has endured for over five thousands years. 6. Acupuncture: Over 1500 years of globalization The worldwide dissemination of acupuncture can be divided into four stages. Acupuncture has spread to at least 140 countries and areas to date. First Stage: By around the 6th century AD, acupuncture had begun to spread to the neighboring lands of Korea, Vietnam, and Japan. Particularly in Japan, the fundamental texts of acupuncture were imported, absorbed, and studied with great care. 541 AD: Chinese practitioners are dispatched to Korea by the Chinese government. 552 AD: The emperor of China presents Japan a copy of the Classic of Acupuncture (a section of the Yellow Emperor's Classic of Internal Medicine (Huangdi Neijing). 562 AD: Monk Zhi Cong brings the Manual of Channels and Acupoints (Mingtang Tu) and the Systematic Classic of Acupuncture and Moxibustion (Zhenjiu Jiayijing) to Korea and Japan. 754 AD: Jian Zhen, a high official of the Tang Dynasty (618-907 AD), crosses the sea to Japan to promulgate Buddhism and Chinese medicine. Second Stage: By around the 12th century AD, acupuncture had started to reach the Middle East via the Silk Road. Third Stage: By the late 1500's to early 1600's, acupuncture had begun to filter into Europe by way of Japan and the Maritime Silk Road, transmitted by the Jesuits in particular. 1671 AD: Harvieu, a Jesuit monk, produces the first French translation of a work on acupuncture when he returns to France from Macao and Beijing. 1683 AD: Willem Ten Rhyne, a Dutch physician who visited Nagasaki in Japan in the early part of the 17th century, publishes Dissertatio de Arthride: Mantissa Schematica de Acupunctura, a Latin dissertation on acupuncture, in London and invents the European term "acupuncture." 1810 AD: The first recorded use of acupuncture in Europe occurs at the Paris School of Medicine when Dr. Berlioz employs it to treat a young woman suffering from abdominal pain. The Paris Medical Society describes this as a somewhat reckless form of treatment. 1823 AD: Acupuncture is mentioned in the first edition of the Lancet. Fourth Stage: Since the early 1970s, acupuncture has spread dramatically throughout the world, catalyzed by Nixon's historic visit to China and popularized by the World Health Organization (WHO). 1971: James Reston reports on his experience with acupuncture in Beijing in the New York Times. This article represents the first news of acupuncture to reach the English-speaking citizens of the United States, or at least the vast majority who have no daily contact with Asians. 1973: The American Journal of Acupuncture starts publication, playing an important role in the clinical practice and study of acupuncture in the West. 1976: Dr. Bruce Pomeranz, a professor in the Department of Zoology at the University of Toronto, publishes an original article stating that analgesia in acupuncture is mediated by endorphins. His research is the first to utilize the Western scientific paradigm to explain why acupuncture works. 1979: An international conference on acupuncture, moxibustion, and acupuncture anesthesia sponsored by WHO is held in Beijing and attended by participants from twelve countries. Its purpose is to discuss ways in which priorities and standards for acupuncture may be determined in the areas of clinical practice, research, training, and transfer of technology. The conference draws up a provisional list of diseases that lend themselves to treatment with acupuncture. 1987: The World Federation of Acupuncture Societies (WFAS) is founded in Beijing. Today, the WFAS has 76 branches representing over 70,000 members from 43 countries and regions. 1997: The National Institute of Health (NIH) of the United States acknowledges the effectiveness of acupuncture in the treatment of a number of diseases. 1998: The Journal of the American Medical Association (JAMA) launches a column devoted to alternative and complementary therapies. 2000: The British Medical Association (BMA) delivers a report on acupuncture and concludes that acupuncture is safe and effective for treating a number of diseases and disorders.

How Old is Acupuncture? Challenging the Neolithic Origins Theory

Although westerners often think of this traditional Chinese treatment modality as a "new" form of alternative medicine, acupuncture is so ancient in China that its origins are unclear. According to Huangfu Mi (c. 215-282 AD), author of The Systematic Classic of Acupuncture and Moxibustion, needling therapy was first used during China's Bronze Age, over five thousand years ago. He attributes its invention to either Fu Xi or Huang Di (the Yellow Emperor), two legendary figures of the Five Emperors Period (c. 3000-2070 BC). Modern scholars generally believe that acupuncture is much older, originating more than ten thousand years ago during China's Neolithic Age (c. 8000-3500 BC). In actuality, acupuncture may not be as ancient as has generally been assumed. A reconsideration of all extant documents and recent archaeological finds indicates that acupuncture may date back a mere 2100 to 2300 years, first appearing during China's Warring States Period (475-221 BC) and rapidly maturing during the Western Han Dynasty (206 BC-24 AD). Questioning the generally accepted origins theory. The currently accepted theory concerning the Neolithic origins of acupuncture is based on two premises. The first holds that bian shi, specialized sharp-edged stone tools that appeared during China's Neolithic Age, were used for an early form of needling therapy, prior to the invention of metal smelting. It is known that bian shi stone tools were utilized for a number of early medical procedures, starting during the Neolithic Age and continuing through the Western Han Dynasty (206 BC-24 AD). A number of descriptions of bian shi stone therapy appear in one of China's earliest medical works, The Yellow Emperor's Inner Classic of Medicine (Huang Di Neijing, hereafter referred to as the Neijing) (c. 104-32 BC). It has been thought that these Neolithic stone medical instruments were precursors of the metal acupuncture needles that came into use during China's Iron Age. However, historical documents and new archaeological evidence clearly indicate that bian shi stone tools were flat and knife-like in form, used primarily to incise abscesses to discharge pus, or to draw blood (1). They were applied as surgical scalpels to cut, rather than as needles to puncture, and had nothing to do with needling therapy. According to the Code of Hammurabi, the ancient inhabitants of Mesopotamia used similarly shaped bronze knives to incise abscesses over 4000 years ago. Prehistoric Chinese people possessed needles made of various materials, ranging from crude thorns and quills to bone, bamboo, pottery, and stone. But just as the history of the knife is not the history of surgery, so the invention of needles and that of acupuncture are two entirely different things. Needles have historically been among the most commonly used tools of daily life for constructing garments all over the world. Medically, needles are used to suture incisions just as making up clothes with darners, hollow syringe needles (as differentiated from a solid needle used in acupuncture) are applied to inject fluids into the body or draw them from it, but pricking a solid needle into the body to treat illness seems very strange and enigmatical. In English, "to give somebody the needle" means to displease or irritate someone. Most people prefer not to be punctured with needles, and associate needling with pain and injury. Many plants and animals have evolved thorns or quills as powerful weapons for protection or attack. Needles were even used for punishment in ancient China. By trial and error, healers throughout the world have found treatments for pain and other diseases independently, for instances, herbs, roots, wraps, rubs, blood-letting and surgery, but acupuncture alone is unique to Chinese. Considering the unique Chinese origin of acupuncture, it is reasonable to assume that the invention of acupuncture was not related to the availability of either sewing needles or bian shi stone scalpels during China's Neolithic Age. The second premise supporting the theory of the Neolithic origins of acupuncture holds that acupuncture evolved as a natural outgrowth of daily life in prehistoric times. It is thought that through a process of fortuitous accident and repeated empirical experience, it was discovered that needling various points on the body could effectively treat various conditions. However, this assumption is lacking in both basic historical evidence and a logical foundation. It is known that ancient people were aware of situations in which physical problems were relieved following unrelated injury. Such a case was reported by Zhang Zihe (c. 1156-1228 AD), one of the four eminent physicians of the Jin and Yuan Dynasties (1115-1368 AD) and a specialist in blood-letting therapy: "Bachelor Zhao Zhongwen developed an acute eye problem during his participation in the imperial examination. His eyes became red and swollen, accompanied by blurred vision and severe pain. The pain was so unbearable that he contemplated death. One day, Zhao was in teahouse with a friend. Suddenly, a stovepipe fell and hit him on the forehead, causing a wound about 3-4 cun in length and letting copious amounts of dark purple blood. When the bleeding stopped, a miracle had occurred. Zhao's eyes stopped hurting; he could see the road and was able to go home by himself. The next day he could make out the ridge of his roof. Within several days, he was completely recovered. This case was cured with no intentional treatment but only accidental trauma (2)." If acupuncture did, in fact, gradually develop as the result of such fortuitous accidents, China's four thousand years of recorded history should include numerous similar accounts concerning the discovery of the acupoints and their properties. But my extensive search of the immense Chinese medical canon and other literature has yielded only this single case. Actually, this story offers at most an example of blood-letting therapy, which differs in some essential regards from acupuncture. The point of blood-letting therapy is to remove a certain amount of blood. But when puncturing the body with solid needles, nothing is added to or subtracted from the body. Blood-letting therapy is universal. Throughout recorded history, people around the world have had similar experiences with the beneficial results of accidental injury, and have developed healing methods based on the principle that injuring and inducing bleeding in one part of the body can relieve problems in another area. The ancient Greeks and Romans developed venesection and cupping based on the discovery that bleeding is beneficial in cases such as fever, headache, and disordered menstruation. Europeans during the Middle Ages used blood-letting as a panacea for the prevention and treatment of disease. Detailed directions were given concerning the most favorable days and hours for blood-letting, the correct veins to be tapped, the amount of blood to be taken, and the number of bleedings. Blood was usually taken by opening a vein with a lancet, but sometimes by blood-sucking leeches or with the use of cupping vessels. Blood-letting using leeches is still practiced in some areas of Europe and the Middle East. However, nowhere did these blood-letting methods develop into a detailed and comprehensive system comparable to that of acupuncture. If acupuncture did indeed arise from repeated empirical experience of accidental injury, it should have developed all over the world, rather than just in China. Both historical evidence and logic indicate that there is no causal relation between the development of materials and techniques for making needles and the invention of acupuncture. It is also clear that repeated experience of fortuitous accidental injury was not a primary factor in the development of acupuncture. Therefore, the generally accepted theory concerning the Neolithic origins of acupuncture, based as it is upon such faulty premises, must be incorrect. It is now necessary to reconsider when acupuncture did, in fact, first appear and subsequently mature. Reconsidering the evidence If acupuncture did indeed originate during China's Neolithic Age, references to it should appear throughout China's earliest written records and archaeological relics. However, this is not the case. Early cultures believed the world to be filled with the supernatural, and developed various methods of divination. During China's Shang Dynasty (c. 1500-1000 BC), divination was practiced by burning animal bones and tortoise shells with moxa or other materials. Oracular pronouncements were then inscribed on the bone or shell, based on the resulting crackles. These inscriptions have survived as the earliest examples of written Chinese characters. Among the hundreds of thousands of inscribed oracle bones and shells found to date, 323 contain predictions concerning over twenty different diseases and disorders. However, none of these inscriptions mention acupuncture, or any other form of treatment for that matter. Rites of the Zhou Dynasty (Zhou Li), written during the Warring States Period (475-221 BC), records in detail the official rituals and regulations of the Zhou Dynasty (c. 1000-256 BC), including those concerning medicine. Royal doctors at that time were divided into four categories: dieticians, who were responsible for the rulers' food and drink; doctors of internal medicine, who treated diseases and disorders with grains and herbs; surgeons, or yang yi, who treated problems such as abscesses, open sores, wounds, and fractures using zhuyou (incantation), medication, and debridement (using stone or metal knives to scrape and remove pus and necrotic tissue); and veterinarians, who treated animals. But this document as well contains no references to acupuncture. Neijing (c. 104-32 BC) is the first known work concerning acupuncture. The classic consists of two parts: Suwen - Simple Questions, and Lingshu - the Spiritual Pivot, also known as The Classic of Acupuncture (Zhen Jing). Both are concerned primarily with the theory and practice of acupuncture and moxibustion. Although authorship of the Neijing is attributed to Huang Di, the legendary Yellow Emperor (c. 2650 BC), most scholars consider that this master work, which contains excerpts from more than twenty pre-existing medical treatises, was actually compiled between 104 BC and 32 BC, during the latter part of the Western Han dynasty (206 BC-24 AD). The comprehensive and highly developed nature of the medical system presented in the Neijing has led scholars to believe that needling therapy has an extremely long history, probably reaching back to prehistoric times. The original versions of the ancient texts used in the compilation of the Neijing have been lost, and with them the opportunity to further illuminate the question of when acupuncture actually first appeared. However, startling new archaeological evidence, unearthed in China in the early 1970s and 1980s, reveals the true state of Chinese medicine prior to the Neijing, and challenges existing assumptions concerning the Neolithic origins of acupuncture. In late 1973, fourteen medical documents, known as the Ancient Medical Relics of Mawangdui, were excavated from Grave No. 3 at Mawangdui, Changsha, Hunan Province. Ten of the documents were hand-copied on silk, and four were written on bamboo slips. The exact age of the Ancient Medical Relics of Mawangdui has not been determined. However, a wooden tablet found in the grave states that the deceased was the son of Prime Minister Li Chang of the state of Changsha, and that he was buried on February 24, 168 BC. The unsystematic and empirical nature of the material contained in the documents indicates that they were written well before their interment in 168 BC, probably around the middle of the Warring States Period (475-221 BC). In any event, it is certain that these medical documents pre-date the Neijing (compiled c. 104-32 BC), making them the oldest known medical documents in existence. These documents were probably lost sometime during the Eastern Han Dynasty (25-220 AD), since no mention of them has been found from this time until their rediscovery in 1973. Another valuable medical find, The Book of the Meridians (Mai Shu), was excavated from two ancient tombs at Zhangjiashan in Jiangling County, Hubei Province in 1983. These ancient texts, written on bamboo slips and quite well preserved, were probably buried between 187 and 179 BC, around the same time as the Mawangdui relics. There are five documents in all, three of which (The Classic of Moxibustion with Eleven Yin-Yang Meridians, Methods of Pulse Examination and Bian Stone, and Indications of Death on the Yin-Yang Meridians) are identical to the texts found at Mawangdui. There is abundant evidence to show that the authors of the Neijing used the earlier medical texts from Mawangdui and Zhangjiashan as primary references, further indicating the antiquity of these relics. For example, Chapter 10 of the Lingshu section of the Neijing contains a discussion of the meridians and their disorders that is very similar, in both form and content, to that found in the Classic of Moxibustion with Eleven Yin-Yang Meridians, one of the documents found at both Mawangdui and Zhangjiashan. Of course, the Neijing did not simply reproduce these earlier documents, but rather refined and developed them, and introduced new therapeutic methods. The earlier Classic of Moxibustion with Eleven Yin-Yang Meridians is limited to moxibustion, while Chapter 10 of the Lingshu section of the Neijing mentions needling therapy, or acupuncture, for the first time. Although the medical texts preceding the Neijing discuss a wide variety of healing techniques, including herbal medicine, moxibustion, fomentation, medicinal bathing, bian stone therapy, massage, daoyin (physical exercises), xingqi (breathing exercises), zhuyou (incantation), and even surgery, these earlier documents contain no mention of acupuncture. If needling therapy did indeed originate much earlier than the Neijing (c. 104-32 BC), the medical documents unearthed from Mawangdui and Zhangjiashan, very probably used as primary references by the Neijing's authors, should also contain extensive discussions of acupuncture. However, they do not. This clearly indicates that acupuncture was not yet in use at the time that the Mawangdui and Zhangjiashan documents were compiled. Of course, it is not possible to draw a detailed picture of the state of acupuncture early in the Western Han Dynasty (206 BC-24 AD) based solely on the medical relics from Mawangdui and Zhangjiashan. But the fact that these documents were considered valuable enough to be buried with the deceased indicates that they do reflect general medical practice at the time. The Historical Records (Shi Ji) (c. 104-91 BC) by Sima Qian contains evidence that acupuncture was first used approximately one hundred years prior to the compilation of the Neijing (c. 104-32 BC). The Historical Records, China's first comprehensive history, consists of a series of biographies reaching from the time of the legendary Yellow Emperor (c. 2650 BC) to Emperor Wudi (156-87 BC) of the Western Han Dynasty. Among these are biographies of China's two earliest medical practitioners, Bian Que and Cang Gong. Bian Que's given name was Qin Yueren. It is known that he lived from 407-310 BC, during the late Warring States Period (475-221 BC), and was a contemporary of Hippocrates (c. 460-377 BC), the father of Western medicine. Bian Que's life was surrounded by an aura of mystery which makes it difficult to separate fact from legend. His name means Wayfaring Magpie - a bird which symbolizes good fortune. It is said that an old man gave Bian Que a number of esoteric medical texts and an herbal prescription, and then disappeared. Bian Que took the medicine according to the mysterious visitor's instructions. Thirty days later, he could see through walls. Thereafter, whenever he diagnosed disease, he could clearly see the internal organs of his patients' bodies. Like the centaur Chiron, son of Apollo, who is sometimes regarded as the god of surgery in the West, Bian Que is considered to be a supernatural figure, and the god of healing. A stone relief, unearthed from a tomb dating back to the Han Dynasty (206 BC-220 AD), depicts him with a human head on a bird's body (3). The Historical Records states that Bian Que successfully resuscitated the prince of the State of Guo using a combination of acupuncture, fomentation, and herbal medicine. Bian Que is thus considered to be the founder of acupuncture, and to have made the first recorded use of acupuncture during the Warring States Period (475-221 BC). More solid evidence connects the birth of acupuncture with the famous ancient physician Chunyu Yi (c. 215-140 BC), popularly known as Cang Gong. Cang Gong's life and work are described in detail in the Historical Records. The Historical Records state that in 180 BC, Cang Gong's teacher gave him a number of precious medical texts that had escaped the book-burnings of the last days of the Great Qin Empire (221-207 BC). At that time, adherents of all opposing schools of thought were executed or exiled, and almost all books not conforming to the rigid Legalist doctrines that dominated the Qin Dynasty were burned. Although medical texts escaped the disaster, their owners still feared persecution. The banned books that Cang Gong received might have included a number whose titles appear in the Ancient Medical Relics of Mawangdui, such as the Classic of Moxibustion with Eleven Yin-Yang Meridians, Classic of Moxibustion with Eleven Foot-Arm Meridians, Method of Pulse Examination and Bian Stone, Therapeutic Methods for 52 Diseases, Miscellaneous Forbidden Methods, and The Book of Sex. Cang Gong's biography in the Historical Records discusses twenty-five of his cases, dating from approximately 186 BC to 154 BC. These cases studies, the earliest in recorded Chinese history, give a clear picture of how disease was treated over 2100 years ago. Of the twenty-five cases, ten were diagnosed as incurable and the patients died as predicted. Of the fifteen that were cured, eleven were treated with herbal medicine, two with moxibustion in combination with herbal medicine, one with needling, and one with needling in combination with pouring cold water on the patient's head. It can be seen from this material that Cang Gong used herbal medicine as his primary treatment, and acupuncture and moxibustion only secondarily. His use of moxibustion adheres strictly to the doctrines recorded in the medial relics from Mawangdui and Zhangjiashan. Although only two of Cang Gong's moxibustion cases are recorded in the Historical Records, it is known that he was expert in its use, and that he wrote a book called Cang Gong's Moxibustion. Unfortunately, this book has been lost. In comparison with his wide-ranging utilization of herbal medicine and moxibustion, Cang Gong applied needling therapy very sparingly. Neither of Cang Gong's two recorded acupuncture cases mentions specific acupoints or how the needles were manipulated, indicating that needling therapy at the time was still in its initial stage. Although acupuncture was not in common use during Cang Gong's day, his two recorded acupuncture patients were cured with only one treatment, indicating the efficacy of the nascent therapy. The rapid development of acupuncture was soon to follow. By the time the Neijing was compiled (c. 104-32 BC), approximately one hundred years after the time of Cang Gong, acupuncture had supplanted herbs and moxibustion as the treatment of choice. Only thirteen herbal prescriptions are recorded in the Neijing, compared with hundreds utilizing acupuncture. Archaeological excavations of Western Han Dynasty (206 BC-24 AD) tombs have yielded a number of important medical relics related to acupuncture, in addition to the Neijing and Historical Records. In July of 1968, nine metal needles were excavated at Mancheng, Hebei Province from the tomb of Prince Liu Sheng (?-113 BC) of Zhongshan, elder brother of Emperor Wu Di (156-87 BC) of the Western Han Dynasty (206 BC-24 AD). Four of the needles are gold and quite well preserved, while five are silver and decayed to the extent that it was not possible to restore them completely. The number and shapes of the excavated needles indicate that they may have been an exhibit of the nine types of acupuncture needles described in the Neijing. This possibility is supported by the fact that a number of additional medical instruments were found in the tomb. These included a bronze yigong (practitioner's basin) used for decocting medicinal herbs or making pills, a bronze sieve used to filter herbal decoctions, and a silver utensil used to pour medicine (4). Although many prehistoric bone needles have been unearthed, the fact that they have eyes indicates that they were used for sewing. Some scholars have inferred that prehistoric Chinese people may have used bone needles found with no eyes or with points on both ends for medical purposes. However, I believe that it is rash to draw such a conclusion based solely on relics that have lain buried for thousands of years. Rather, it is likely that the eyes of these needles have simply decayed over the millennia. Conclusion A thorough reevaluation of all extant literature, as well as documents and archaeological relics unearthed since the 1960s, confirms that acupuncture is not as ancient as has generally been assumed, and that it did not, in fact, appear and gradually develop during China's Neolithic Age (c. 8000-3500 BC). Rather, this great invention arose quite suddenly and rapidly developed approximately two millennia ago. All evidence indicates that acupuncture first appeared during the Warring States Period (475-221 BC), during the time of Bian Que, developed during the early Western Han Dynasty (206 BC-24 AD), during the time of Cang Gong, and had fully matured by the latter part of the Western Han Dynasty, at the time of the compilation of the Neijing (c. 104-32 BC). The Western Han Dynasty (206 BC-24 AD) provided fertile ground for the rapid growth and maturation of acupuncture as a comprehensive medical system. The previous centuries had seen the blossoming of Chinese culture during the intellectual give-and-take of the Spring and Autumn (770-476 BC) and Warring States (475-221 BC) periods. The subsequent territorial unification of China by the Qin Dynasty (221-207 BC) laid a foundation for the cultural integration of the diverse states. Taken in the context of China's four thousand years of recorded history, the Western Han Dynasty was a period of intensive social and cultural advancement. Acupuncture is unique. Its invention of acupuncture in China at this time was the result of the development and unique convergence of several aspects of Chinese culture during this time, including natural science, social structure and human relations, and most importantly, holistic philosophy. References and notes: 1. Bai Xinghua, et al., Acupuncture: Visible Holism. Oxford: Butterworth-Heinemann, 2001, pps. 15-20. 2. Zhang Zhihe (1156-1228 AD), Confucians' Duties to Their Parents (Rumen Shiqin). Quoted in Selection and Annotation of Medical Cases Treated by Past Dynasties' Eminent Acupuncturists (Lidai Zhenjiu Mingjia Yian Xuanzhu), ed. Li Fufeng. Harbin: Heilongjiang Science and Technology Publishing House, 1985, p. 143. 3. Liu Dunyuan. Stone Relief Showing Practice of Acupuncture and Moxibustion from the Eastern Han Dynast. Archaeology, 1972; (6): 47-51 4. Zhong Yiyan, Medical Instruments Unearthed from the Western Han Dynasty Tomb of Liu Sheng. Archaeology, 1972, (3): pp. 49-53.

What Happens During an Acupuncture Session?

Acupuncture in Medicine  is a bi-monthly  peer-reviewed   medical journal  covering aspects of  acupuncture  and related techniques. The...