A genuine
history of Acupuncture
Traditional
Chinese medicinal methods, including acupuncture, have been very recently
promoted as a system on par with, if not superior to, medicine in the
West. However, alongside the introduction of Chinese medical methods to
the West have come some pretty common and basic misconceptions about what
acupuncture is and was, and how it originated.
These
misconceptions seem to have acquired popular credibility. For example, the
statement may be made that Chinese medicine is more ‘holistic’ than Western
medicine, however, historical truth does not support such
attributions. Another basic misconception is that acupuncture, and other
aspects of Chinese medicine currently described as traditional Chinese
medicine, TCM, is a reflection of the traditional medicine that is most
commonly practiced in China, and, furthermore, that the medicine that is
practiced in China is a true reflection of the ancient practice. Neither
premise is accurate.
Indeed,
acupuncture, and ‘what is very much today an “alternative” Chinese medicine is
merely a minimum relic of concepts and practices… drawn from a fairly
astonishing range of medical philosophy, and augmented with current
components of Western reasoning …’The adaptation of Chinese medicine marketed
in China as zhongyi since the mid-1970s is, in reality, not an authentic
depiction of the tradition of Chinese medicine, measured from ancient times to
the present.
The evolution of
Chinese medicine The oldest traditions of Chinese medicine Shang dynasty, 17th
and11th century BC were tied to the beliefs of ancestors. Deceased
ancestors were capable of threatening or even destroying human life, and
healing methods aimed to repair not only the living but also the dead. As
traditional medicine diminished, magical, demonological, or supernatural
beliefs became the source of all sickness. The demons of the human body
may create such things as swellings, and the insertion of needles or stone
lancets, for example, could be utilized in an attempt to destroy or expel them.
The most
prominent formative phase of Chinese medical traditions was during the Han
Dynasty approximately 2nd century BC to 2nd century AD, roughly 2nd
century BC to 2nd century AD. It was around this time that the Chinese
intellectual elite first began to classify occurrences into a restricted set of
causes and consequences. Here, Chinese health care made a radical
shift. Natural laws, conceptualized in theories like ‘Yin-yang’ and ‘Five
elements,’ were employed to explain health and illness, and to design
preventative and therapeutic techniques. Although Han medical thinkers
probably addressed older conceptions of demonological and ancestral impacts on
human health, by contrast, their beliefs were more reasonable. But from that
time on, Chinese medicine coexisted and interacted with older kinds of health
care. However, Han Chinese beliefs were not pervasive, commonly
recognized, or consistent.
For example, one
school of Chinese thinking separated the two categories of yin and yang into four
yin and yang subcategories while a second school recommended three
subcategories for each. Both of these schools of thought, albeit
conflicting, seem to have concurred in their rejection of the ‘Five Phases'
notion that is crucial to other Chinese philosophies.
The Chinese
obviously never made any effort to address such discrepancies. This has
resulted in several factions within the area of ‘traditional’ Chinese medicine
and even more within the sphere of what eventually became acupuncture.
Over time, two
independent traditions of medical writing evolved in post-Han
China. Pharmaceutical and prescription literature was generated and
implemented without regard to what has been termed as notions of ‘systematic
correspondence.’ In contrast, the needling and moxa cautery literature
that arose extended such notions.
In this
literature, as conceptions of systematic connection gained prevalent, anatomy
and physiology tended to become less relevant and more metaphorical. As a
consequence, ‘in the history of Chinese medicine, rather than going from a
decent, if partial, understanding of the body to a more comprehensive one by
methodical dissection, the medical authors proceed in the other direction,
under the spell of the cosmologists, to a less accurate picture.’ Although
attempts to merge the pharmacological and needling traditions were undertaken,
notably in the 12th–15th centuries, such efforts were never effective.
Another crucial
aspect of the development of acupuncture and TCM has been the idea of ‘qi.’ However,
the notion of invisible, vapor-like agents that are responsible for
preserving life and health is not distinctively Chinese, rather, it is one of
the core principles of traditional medicine of practically every
culture. For example, the Greek doctors Praxagoras and Erasistratus
hypothesized that arteries transmitted the vital force pneuma and not
blood. This and other parallels have led to conjecture that much of
Chinese medicine may simply be an adaptation of Greek medicine, and, in view
of the exchanges that happened between China and the West in Han times, such
thinking is not unjustified. What can be claimed is that the passage of qi
inside channels is a very ancient, but not widely acknowledged, idea.
Nevertheless,
acupuncture and Chinese medicine, as understood by Western authors, at least
offer to cure the ‘energy’ issue inside the individual's own body. In
truth, the ancient meaning of the term qi has little resemblance to Western
ideas of energy. However, by translating qi as ‘energy’, and by explaining
sickness in terms of ‘energetic disturbances', the newly formed Chinese
medicine has acquired legitimacy. This plausibility, however, emerges out
of conceptual adaptation to Western worries, not because of the historical
actuality of Chinese thought.
Acupuncture in
China
The history of
acupuncture is pretty well known but over a rather uneven
period. Assertions that acupuncture is many thousands of years old are
doubtful; no archaeological nor historical evidence shows acupuncture was
practiced in China prior to the mid-2nd century BC at the oldest, and those
claims are up for controversy. Indeed, precisely when acupuncture may be
considered to have originated in China relies on two things: the readiness
to accept the early dates of historical writings and ii the meaning of
‘needling.’ If the use of any form of the piercing device ‘needling’ is termed
acupuncture, then acupuncture originated early in China but also in
contemporaneous societies, who also utilized bleeding and cautery at places on
the human body.
The oldest
archaeological discovery, from the 1970s, is four gold and five silver needles,
found in the tomb of Han Dynasty Prince Liu Sheng 154 BC–113 BC in Hebei
Province. Since these items were discovered in combination with other
therapeutic tools, they may have been utilized in therapeutic ‘needling’ of
some type. However, the specific nature of this ‘needling’ is unknown and
it may not have been employed for reasons that we think of today as acupuncture
for example, according to the Chinese classic medical literature Huang Di
neijing, ‘needles' were also used to extract ‘water’ from joints or to lance
abscesses.
The oldest
Chinese medical literature known today was found at the Mawangdui burials,
sealed in 168 BC and the Zhangjiashan burial site closed between 186 and 156
BC.
These
manuscripts include the earliest descriptions of mai, mythical ‘channels' that
were related to diagnosis and therapy. However, in these works,
therapeutic procedures, or needling, are never discussed. The oldest
literary mention of any type of therapeutic ‘needling’ Zhen is found in a
historical, rather than a medical, work, the Shiji, Records of the Historian,
of Sima Qian, written 90 BC. The Shiji describes one incident of
‘needling’ in the writings but that needling was not coupled with a system of
insertion sites or with the basic system of conduits detailed in later
centuries whose qi flow may be altered by such needling. Indeed, the myth
of resuscitating a dead prince with a needle implanted in the back of his skull
may, in reality, only represent the lancing of a boil or abscess.
The classic work
Huang Di neijing presented the practice and theoretical foundations of what
obviously became human acupuncture in the historical meaning i.e. the
manipulation of qi flowing in vessels or conduits by means of needling
i.e. the manipulation of qi flowing in vessels or conduits by means of
needling. The book, which today encompasses three unique redactions, is
built up from literary bits by many writers writing in various
eras. Although it is not clear when individual pieces were written or
included in the larger textual tradition, the main content of the book dates
from later centuries, and the earliest recoverable versions date to
between the 5th and 8th centuries AD, although the Han Dynasty origins are
claimed for the Huang Di neijing, they are based on dubious
bibliographical references that may or may not have anything to do with
existing versions of the texts although Han Dynasty origins are claimed for the
Huang Di neijing, they are based on dubious bibliographical references
that may or may not have anything to do with existing versions of the
texts. Most of the writings extant now went through final modification as
late as the 11th century AD and such alterations may not represent previous
work.
The Huang Di
neijing established the notion that the body comprised functional centers
‘depots' and ‘palaces' linked by a number of main and secondary conduits that
enabled influences qi to travel inside the body and to come from
outside. Older portions of the text are inspired by instructions to cure
disease through bloodletting.
It has been
theorized that bloodletting ultimately morphed into acupuncture and the
emphasis moved from eliminating visible blood to controlling unseen
qi. Interestingly, the book primarily overlooks precise skin sites at
which needles may be put. In truth, needling is a minor tradition in the
book and most of the treatment detailed in the text involves minor surgery,
bloodletting, and massage.
Subsequently,
presumably in Song times, AD 960–1279, acupuncture, or at least a prototype
thereof, became progressively systematized, as illustrated by the work of
Wang Weiyi in conjunction with his acupuncture bronze figure.
Later further,
notions of systematic correspondence were combined with acupuncture. The
last phase, taking place no earlier than the late Qing period AD 1644–1911 was
the creation of fine steel needles. Still, throughout Chinese history,
acupuncture was a small practice, and only in the past few decades has it
become a dominating tradition, even to the near exclusion of Chinese
herbal medicine which was, traditionally, far more significant.
Doubts
concerning the effectiveness of needling treatment develop early. Repeated
quotations stating, that if one does not believe in needling, one should not
employ it, exist throughout Han period works. Subsequently, for
unexplained reasons, needling lost most of its attractiveness by the middle of
the second millennium. By at least 1757, the ‘loss of acupuncture
tradition’ was regretted and it was observed that the acupuncture sites, channels, and
methods in use at the time were considerably different from those detailed in
the ancient scriptures.
Eventually the
Chinese and other Eastern civilizations made efforts to attempt to abolish the
practice completely.
In an effort to
modernize medicine, the Chinese government sought to outlaw acupuncture for the
first of multiple occasions in 1822, when the Qing administration banned
the teaching of acupuncture and moxa cautery in the taiyiyuan. The
Japanese formally abolished the practice in 1876. By the 1911 revolution,
acupuncture was no longer a topic for examination at the Chinese Imperial
Medical Academy.
During the Great
Leap Forward of the 1950s and the Cultural Revolution of the
1960s, Chairman Mao Zedong promoted acupuncture and traditional medical
techniques as pragmatic solutions to providing health care to a vast population
that was terribly undersupplied with doctors and as a superior alternative
to decadent ‘imperialist’ practices even though Mao apparently eschewed such
therapies for his own personal health. Here they remained until unearthed in
the most recent surge of interest in Chinese medical methods, dating from US
President Richard Nixon's 1972 visit to the People's Republic of
China, which ended almost a quarter-century of China's isolation from the
USA.
Acupuncture in
the West
Chinese medicine
was first described in Western literature as early as the 13th century AD in
the travels of William of Rubruck, but the Western world became aware of
needling a few centuries later. In the late 16th century, a few stray
manuals, presently housed by the Escorial in Madrid, Spain, had reached
Europe. Accounts of real practice quickly emerged, some fairly
detailed. It entered the USA slightly later.
It has since
been rejected, forgotten, and rediscovered again in at least four major waves,
including the current one. For a period, acupuncture became very well
established in areas of Europe, notably in France and Germany concurrent
with Chinese efforts to outlaw the practice concurrent with Chinese attempts to
ban the practice.
Several renowned
French physicians embraced acupuncture in the 18th and 19th centuries, but
other equally distinguished doctors were not pleased, accusing proponents
of raising a foolish theory from well-deserved obscurity.
Nineteenth-century
England also had a short period of popularity for acupuncture; one 1821
journal observed that acupuncture consisted of ‘inserting a needle into the
muscular regions of the body, to the depth, occasionally, of an inch.
’ However, by
1829 the editor of the Medico-Chirurgical Review was able to write: ‘A short
while ago the town rang with “acupuncture”, everyone spoke of it, everyone was
healing incurable ailments with it; but today scarcely a word is uttered
concerning the subject.’Georges Souli de Morant, a French diplomat living
in China who got attracted to acupuncture as a therapy for cholera and later
published his important book L'Acupuncture Chinoise in 1939, sparked the
first of the 20th-century waves of interest in acupuncture. Souli de
Morant was key in constructing the myth of acupuncture, for example introducing
the word ‘meridian,’ now frequently used in Western acupuncture literature to
indicate pathways along which qi travels, although there is, regrettably, no direct
counterpart in Chinese literature.
In the USA,
acupuncture experienced a short period of popularity during the first half of
the 19th century, notably among doctors in the Philadelphia region.
In 1826, three
local doctors started tests with acupuncture as a potential technique for
resuscitating drowned individuals, based on reports by European
experimenters that they had successfully resurrected drowning kittens by
putting acupuncture needles into their hearts.
Those same
doctors were unable to reproduce their accomplishments and later ‘gave up in
disgust.’The 1829 edition of Tavernier's Elements of Operative Surgery has
three chapters on how and when one may conduct not just acupuncture but
also ‘electro-acupuncturation.’ Publications promoting the method emerged on
occasion throughout the following 20 years.
Although none of
the early American tales of acupuncture make any mention of acupuncture points,
channels, or meridians, they all claim great success as a consequence of
placing needles directly into, or in the near vicinity of, painful or
otherwise diseased places. However, by the second half of the 19th
century, Western practitioners had mostly abandoned acupuncture. In 1859
it was judged that ‘its benefits have been considerably overstated, and
the practice… has fallen into disrepute.
’The Index
Catalogue of the Surgeon-library General has just half-a-dozen works on the
topic for the whole half-century of 1850–1900. The 1913 edition of
Webster's unabridged dictionary describes acupuncture only as, ‘The insertion
of needles into the living tissues for remedial purposes,’ and
acupressure, another modern transmogrification, as a mode of arresting
hemorrhage resulting from wounds or surgical operations, by passing under the
divided vessel a needle, the ends of which are left exposed externally on
the cutaneous surface.’
Conclusions
Twentieth-century
researchers have conceptualized a trial and error pattern of evolution wherein
information was collectively amassed into a medical ‘system.’ One
interpretation has been that, over time, crude stone lancets were replaced
with tiny metal needles, and acupuncture sites and channels were standardized,
leading to a new era of medical expertise.
However, there
are currently many questions regarding the existence of a trial and error
system, as well as the assumption that ‘needling,’ as described in medieval
Chinese medical writings, represents today's acupuncture.
Indeed,
notwithstanding antecedent concepts and practices, contemporary acupuncture,
which includes innovative varieties such as electroacupuncture, may never
have existed in ancient China in anything like the manner in which it is
performed today.
Notes systematic
correspondences' followed a system of ‘magic correspondences' in history.
In magic
correspondences, the Chinese sought to organize the universe in terms of
intricate sympathetic magic. For example, the ancient Chinese saw a walnut
and envisioned an open brain; they do look alike.
Hence people in
antiquity concluded that they must be linked. To expand the correlation,
it may also be suggested that if one were to consume walnuts, the brain would
be enhanced. Magic correspondence has numerous
elements; nevertheless, the key idea is that the universe was considered
as a composite of innumerable independent, i.e. mutually unconnected pairs of
correspondences.
In early Han
times came the big conceptual jump: all world occurrences, tangible or not,
were connected via a system of correspondences. In this approach, any
occurrences might be impacted by changes elsewhere in the system.
The body and its
functions were, of course, also part of the systematic
correspondences. The medicine of systematic correspondences was, as a
result, constructed on this form of organization of the universe.
All emotions,
all functions, and all morphological entities are regarded as part of the wider
encompassing universe of systematic correspondences; the organism in all
its functions and morphological components is related to the seasons, the
surrounding physical environment, etc. To disregard this system may result in
sickness, for example, if in winter one acts as one should in summer,
negative things could ensue.be title Huang Di neijing has been the subject of
various English translations.
The material,
which is really three independent volumes, may be translated in numerous
ways. Some disagreement regarding the title seems to arise from a
mistranslation by Dr. Ilza Veith, who, in her translation of the
book, proposed that the title be translated as The Yellow Emperor's
Classic of Internal Medicine.
However, the
term merely means the ‘Inner Classic of Huang Di’. Huang Di is the name of
the fabled ‘Yellow Emperor’, originally a deity of the Yellow Springs of Hades,
therefore his hue. He is also sometimes referred to as the ‘Yellow
Thearch’ Thearch = god-ruler. The ‘inner’ Chinese nei signifies an
inner or esoteric tradition transferred from master to pupil as opposed to wai,
an ‘outer’ tradition for public consumption. The Chinese term jing
signifies ‘canon’ or ‘classic’. Accordingly, any translation referring to
this material as being relevant to ‘internal medicine’ is
absolutely erroneous.
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