A hugely detailed history of acupuncture, in less than 1000 words
One of the more intriguing aspects of acupuncture, that we rarely get to discuss on foundation / CPD courses, is how acupuncture gradually made its way from Chinese folk medicine, to its present day position as one of the most popular, evidence-based interventions for a whole host of ailments. Acupuncture is likely to have begun with whittled stone, bamboo, and / or fish bones, before progressing to metal probably around 400 BC, yet it’s prominence throughout Chinese history is irrefutably omnipresent. This blog post is aimed at giving slightly more time to such a rich, informative journey, but those looking for an in-depth exploration, should head to the Celestial Lancets: A History and Rationale of Acupuncture and Moxabustion.
The oldest text relating to acupuncture / TCM medicine to exist is the Huangdi Neijing, or, The Yellow Emporers Classic of internal Medicine. It is thought to have been written between 100BC-100AD, with the Yellow Emperor himself being the scribe, yet it is still present in reading lists on TCM philosophy courses today. The format is a variety of philosophical discussions between ol’ Huangdi and his medicine minister, Qi Bo. Although H-unit is accredited with the book, it is clear throughout that Qi-dog is the true master of health, because he was supposedly trained by celestial beings. The teachings within this tome are considered to be the foundation of all understanding of the TCM approach to acupuncture, emphasizing the need to grasp the intricate nature of Yin and Yang and Qi (forces of nature which govern all things). The crux: follow the Tao and you’ll be alreet. Incidentally, whether Big Yella’ ever existed is up for debate, though it is irrefutable that if he did, he was born after a 24-month gestation period and could hold in-depth philosophical discussion just days after being born.
And yet, Huang Di isn’t even thought to be the founder of acupuncture: that crown belongs to none other than Fu Xi, who was believed to have lived 3000BC. Further indications that acupuncture predates the Neijing can be found in the Zuo Zhuan, which suggests acupuncture was being applied as early as 581BC, and another story about Bian Que in 500BC, who apparently brought a Prince back to life through needling an acupuncture point on the head (GV 20, Bai Hui). In 1973, in the Mawangdui tomb excavations (tomb 3 to be exact, for all you pub quiz lovers) uncovered a range of silk texts that dated to nearly 200BC, one of which outlined an early form of meridian lines. More tentative suggestions originate from some archaeological findings of sharp stone implements, known as Bian Shi, dating acupuncture as early as 6000BC, though whether these stones were for medicinal purposes is not without debate.
To muddy the waters further, maybe acupuncture was not exclusive to China. To this day, there are tribes in isolated Brazil, Eskimos in the Northern circumpolar region and the Bantu of South Africa who break the skin with sharp implements to treat disease. Furthermore, there is Otzi the Iceman. He was found in the Alps in 1991 by hikers, who had first thought they had found someone who had perished recently. I suppose he had, in a human-race-timeline perspective. Believed to date some 5300 years, tattoo’s on his body look very similar to meridians and known strong acupoints. It is thought that the tattoo’s were as a result of making incisions then rubbing with charcoal. Some of these points even overlap with acupoints considered to treat some of the ailments Otzi was suffering from.
What we do know, amongst fanciful tales of Semifers, immortal beings and a mummy, is that acupuncture was considered an intervention of utmost importance in China, so much so that successive dynasties from the 11th to 16th century insisted upon expert acupuncture clinicians within their courts, and set up teaching schools devoted to acupuncture. Regardless of the mechanism at play, it is clear that the ritual of acupuncture was beneficial to health. It however became unfashionable from 1600-1800s to use acupuncture, with herbal medicine taking the reigns as the numero uno intervention, which was further exacerbated by Emperor Dao Guang denouncing its use in the Royal Court. During the Republic of China years (1912-1949), acupuncture was completely outlawed, but by 1949, it returned with the installation of chairman Mao to power (for two purported reasons: one, to elicit an air of mystique, and second, a cheap way to provide public health strategies).
One recurrent theme throughout its colourful history, is that acupuncture evolved through the centuries. Although this may seem a trivial fact to raise, I feel that this is extremely important for contemporary acupuncture practice. To those who devote their practice to traditional concepts of Yin, Yang, Qi and meridians, I would argue that by not acknowledging scientific findings on how acupuncture works, is paradoxically NOT practicing as the early practitioners would, because each Grand Master built upon previous knowledge and added their own take following observation and changes in general beliefs. However, to those who pour scorn on acupuncture because of its roots in a primitive understanding of health, I point towards the development of acupuncture as something which shows it has stood the test of time, transcending cultures, philosophies and every change in belief of how we should approach healthcare. Meridians may or may not exist, but to understand the context of acupuncture, helps the clinician and researcher to appreciate its rich history in healthcare.
Dr. Carl Clarkson