Acupuncture is the strategic insertion of fine needles into points on the body’s surface for the purpose of stimulating healing.

An estimated 20,000 nationally certified acupuncturists are practicing in the United States. Although acupuncture is practiced throughout Asia, Europe and the United States, its history begins in China where it first developed thousands of years ago. The first known recorded reference of acupuncture is found in the ancient Chinese text entitled “Huang Di Nei Jing Su Wen”, also known as the “Yellow Emperor’s Classic of Internal Medicine Book of Common Questions”. Studies of dated printings of the “Huang Di Nei Jing Su Wen” and its companion text the “Ling Shu” suggest that acupuncture descends directly from bloodletting, a therapy used in every traditional medical system, including Early Western medicine.

Unedited texts recovered in 1975 in a Western Han dynasty tomb, sealed in 165 BC and presumably written around 200-220 BC, contain the earliest detailed picture of the vascular system found in Chinese literature. Channels, vessels, or meridians were seen as organic structures filled with blood and Qi. Diseases were identified with particular channels whose path or course coincided with presenting pain or disturbance. Removing blood from the channel also removed the actual pathogenic, or disease-causing, factor or substances occupying adjacent tissue directly associated with the disease-causing factor.

While the Han texts indicate a vessel system of circulating blood and Qi, therapies applied to vital points included bloodletting, cauterization, moxibustion and the application of herbal poultices, or heated paste. Sometime after 165 BC, it was discovered that Qi could be affected when a point on the body was punctured without producing blood. At this point, acupuncture developed into a distinct branch of Chinese medicine.

The first needles used to administer therapeutic effects were made of stone, as opposed to the stainless steel needles used today, and shaped like a tongue depressor. The sharpened stone was used to treat conditions affecting the skin, such as boils, abscesses and cysts, to let blood locally or distally. Other materials used in the early days of acupuncture include bone, silver, gold and bamboo shards.

In the sixth century, acupuncture was introduced to Korea and Japan where it became an integral part of each country’s health care system. From there, it made its way south to India and to Southeast Asian countries such as Vietnam. By positively affecting the health of many people across Asia, especially those of royal ancestry and high political standing, acupuncture successfully impacted the entire continent and in the 16th century, was introduced to Europe. Though acupuncture has been used in immigrant Asian communities throughout the US, it has been regulated as a profession only in the last 30 years.

The basis of acupuncture is expressed in the aphorism: ‘Bu tong ze tong, tong ze bu tong’ which means ‘free flow: no pain, no free flow: pain.’

In other words, any kind of pain represents an obstruction in the normal flow of Qi or life force. Simply put, acupuncture moves Qi, restoring free flow. Acupuncture point selection is based on information gathered from the four exams: looking, listening, asking and palpating. One of the unique characteristics of the Chinese medicine clinical encounter is that the four examinations are continually updated, even within the session. After applying needles and or techniques like Gua Sha, Tui Na, Plum Blossom, Cupping or Moxibustion, an area of the body may be palpated again, asking and feeling if its temperature, texture, tightness or tenderness has changed. The practitioner may feel the pulse two or three times to note any changes, or re-examine the Tongue.

Pathology is categorized according to its location and quality. The location can be described according to channel, organ, level, jiao, element of the five phases, or substances (Qi, Blood, Phlegm, Fluid, Food) and whether its nature is fixed or changing in terms of location. Qualities are recognized as wind, heat, cold, damp, dry, full or empty, waxing or waning, yin or yang. Location and quality continually shift. Rather than securing oneself to a firm diagnosis the clinical encounter becomes a circular interactive loop where the next move is guided by the changing terrain. Evaluation becomes treatment and treatment becomes evaluation. Because we are able to understand a phenomenon only by changing it, then more important than the diagnosis itself, is where it yields, and becomes something else. An adept practitioner has a sense of the direction of a disorder by the change in tongue, pulse, stool, urine, menses, sleep, mucous, thirst, sweat, sensation or pain, and even by changes in emotion on the part of patient. Acupuncture point prescriptions are continually modified to fit the changing patient presentation. Shaped by Daoist and Buddhist philosophy, Chinese acupuncture relies on the only constant is change.

Content last modified on Mar 14, 2003