Acupuncture and Moxibustion

Gold acupuncture needles of the 3rd century B.C. excavated in Mancheng County, Hebei Province.

Acupuncture and moxibustion (针灸疗法) are singular therapies developed by the ancient Chinese. No drugs are needed in these treatments. The curative effect is obtained simply by puncturing or applying heat to certain "points" of the human body.

Acupuncture originated in the New Stone Age out of the prac­tice of giving treatment by stimulating various parts of the body with stone slivers called bian. Moxibustion, the burning of moxa near the skin, came into use at roughly the same time. Metallic pins began to be employed in acupuncture in the 8th century B.C. Gold pins designed for this therapy were recently excavated in a tomb attributed to the 3rd century B.C. in Mancheng County, Hebei Province. It is thus evident that acupuncture and moxibustion have occupied important places among therapeutic techniques in traditional Chinese medicine for several millennia.

The advantages of acupuncture and moxibustion may be sum­med up as follows:

1. They are applicable in a wide variety of diseases and suit therapeutic needs in internal medicine, surgery, gynaecology, paedi­atrics, ophthalmology and otolaryngology, as well as in preventive medicine.

2. They produce prompt and appreciable cures, increase re­sistance to disease by providing stimulation at certain points, and alleviate or stop pain.

3. They are easily practised and mastered.

4. They involve little expense.

5. They produce no or slight side-effects, are generally safe, and can be employed together with other therapies.

History of Acupuncture and Moxibustion

Archaeological findings from a 3rd-century B.C. tomb near Mawangdui Village in Hunan Province provide convincing evidence that Chinese physicians had systematized clinical experience in both acupuncture and moxibustion more than 20 centuries ago. Exca­vated in 1973, this tomb revealed a series of medical works. Two of these entitled Zu Bi Shi Yi Mai Jiu Jing (Eleven Channels/or Moxibustion of the Arms and Feet) and Yin Yang Shi Yi Mai Yan Jing (Eleven Channels for Moxibustion in the Yin and Yang System) dis­course respectively on pain, spasm, numbness and swelling that may occur along the channels, mouth and sense-organ symptoms as well as symptoms of vexation, cold and drowiness, which are all amenable to treatment by moxibustion.

Later, in the 3rd century B.C., Nei Jing (Canon of Medicine) dealt in various ways with diseases curable by acupuncture and mox­ibustion and exemplified the application of these therapies to various visceral diseases, fevers, malaria and carbuncle. The Canon also offered detailed discourses on certain techniques in these treatments. Examples are: re-enforcing and reducing by manipulation, and puncturing the corresponding points on the left and right sides of the body alternately.

Among the physicians who specialized in acupuncture and moxibustion was Bian Que whose biography appears in Shi Ji (Records of the Historian). This doctor is said to have arrived in the state of Guo in what is now Baoji in Shaanxi Province at a time. when the crown prince of that state had just expired. Bian Que rushed with his apprentices to the royal palace, enquired concerning the prince's symptoms and pronounced his "death" reversible. The king was informed and lost no time in requesting Bian Que's help in saving his son. The physician examined and felt the pulse of the patient, enquired as to further symptoms and concluded that the prince was in a coma or a state of shock, and not dead at all. Acupuncture and moxibustion were included in the rescue, which resulted in the coming round and full recovery of the patient. News of Bian Que's remarkable "resurrecting of the dead" spread, the re­port indicating not only wide application of acupuncture and moxi­bustion between the 5th and 3rd centuries B.C. but that the methods were considerably improved.

Two medical works, Huang Di Ming Tang Jing (The Yellow Emperor's Classic on Acupuncture and Moxibustion) written towards the end of the 3rd century B.C. and Zhen Jiu Jia Yi Jing (A Classic of Acupuncture and Moxibustion) compiled in the 3rd century A.D., gave more reliable and comprehensive information on the experi­ences gained .in treating patients by these therapies. These works provided more systematic clarification on selection of "points" in treating different diseases as well as the therapeutic properties of the points. Besides these books, on which the development of these therapies in succeeding centuries was based, there were a number of other important medical writings illustrated to show the points for acupuncture or moxibustion.

During the period from the 4th to the 10th century, works dealing with these therapeutic techniques grew not only in number but also in variety. These centuries also saw the publication of col­oured charts and diagrams for acupuncture and moxibustion, special books on moxibustion, and writings on the veterinary application of these techniques. Sun Simiao (581-682) and Wang Tao (702- 772) were celebrated physicians whose works Qian Jin Yao Fang (The Thousand Golden Formulae) and Wai Tai. Mi Yao (Medical Secrets Held by an Official) especially emphasized acupuncture and moxibustion. Sun drew three large-size coloured charts showing the anterior, posterior and lateral views of the body. The 12 channels were marked out in coloured lines, the eight extra channels in green. Wang Tao's charts numbered 12, the lines representing the regular and extra channels also in different colours. At that time acupunc­ture and moxibustion were officially recognized as courses in the curriculum of the imperial medical college, while Canon of Medicine and The Yellow Emperor's Classic on Acupuncture and Moxibustion were among the textbooks selected. Such titles as master, assistant master, lecturer, technician and apprentice of acupuncture were accorded physicians of the Imperial Medical Bureau.

An even greater number of writings on acupuncture and moxi­bustion were published from the 7th century to modern times. Best known among these are Tong Ren Yu Xue Zhen Jiu Tu Jing (Illustrated Manual on the Points for Acupuncture and Moxibustion on the Bronze Figure) compiled under the supervision of the imperial physician Wang Weiyi of the 11th century, and Zhen Jiu Da Cheng (Compendium of Acupuncture and Moxibustion) by Yang Jizhou of the 16th century.

When Wang Weiyi was preparing his Illustrated Manual in 1027 he headed a group that cast two bronze figures inscribed with the acupuncture channels and points. Besides serving as teaching materials, the figures were used in examinations given to students of acupuncture. The examinee was asked to puncture the figure, which was filled with mercury, coated over with wax, and clothed. The accuracy of the student’s puncturing was easily determined by whether or not the mercury leaked.

Such bronze figures proliferated, some cast by imperial hospitals, others by civilian doctors or apothecaries. Many of these valuable figures were destroyed in wars, while some were seized by imperialist powers in their aggressive military campaigns against China. The one cast by the Imperial Hospital towards the middle of the 15th century was among looted items taken out of the country by the Russian army that invaded China in 1900 along with seven other imperialist powers. This invaluable bronze figure is still being held by the Leningrad Museum in the USSR.

Improvements in the materials and technique used in acupunc­ture and moxibustion over the centuries include red-hot needling, warm needling and plum-blossom needling. Moxibustion was enriched and refined by applying heat from burning cones of drug or rush and the use of "moxa rolls".

The Theory of Channels and Collaterals

The effectiveness of acupuncture and moxibustion in treating a wide range of diseases depends among other factors on the nature and intensity of the stimulation produced by puncturing or applying heat. It also depends on the point selected, and the organism's power to transmit the stimulation resulting from the acupuncture or moxibustion. The distinctly Chinese traditional theory of channels and collaterals elucidates this. Long experience in treating disease lies behind and substantiates the theory.

Named in the 3rd-century B.C. medical books found in the tomb near Mawangdui Village are the "tooth channel", "ear channel" and "shoulder channel", all taken from the main transmission route of the stimulation produced by acupuncture or moxibustion at a certain point on one of the channels. This nomenclature was the forerunner of the theory of channels and collaterals. The authors of such ancient medical works as Eleven Channels for Moxibustion of the Arms and Feet pioneered in dealing systematically with the channels and numbering them as 11. They went further to rename and classify the channels, basing themselves on the theory of the upper and lower extremities of the body and also the theory of yin and yang.

Canon of Medicine carried these researches to a new level by establishing the number of channels as 12. It also modified the discourses on the specific route of each channel and its diagnostic and therapeutic significance. The Canon thus laid down the scientific principles of acupuncture and moxibustion by developing the theory of channels and collaterals.

The main features of the theory of channels and collaterals are the view that these routes exist over the entire human body, and their function as transmitters of vital energy and coordinators of the different parts of the body. The whole network of channels and collaterals reaching every part of the body extend deep .into the visceral organs. There is circulation along these routes. Channels are the trunks, while the collaterals and the sub-collaterals are their branches and sub-branches. Besides this system of 12 channels there are eight extra channels.

Physicians named the acupuncture points over the body on the basis of the theory of channels and collaterals. The authors of Canon of Medicine located all these points as along the channels. A Classic of Acupuncture and Moxibustion set the total of these points at 654.

Chinese physicians of later generations steadily clarified the thera­peutic value of each point and the relationship between points and the visceral organs. Improvement continued in therapeutic effec­tiveness of acupuncture and moxibustion with the identification of additional points.

The Spread of Acupuncture and Moxibustion from China

Playing an important role in the advance of Chinese medical science, acupuncture and moxibustion have also served to promote medical and health work world-wide.

China's friendly trade relations and cultural exchanges with Korea, Japan and the southeastern and central Asian countries date from the 3rd century B.C. Chinese medical science, essentially acu­puncture and moxibustion, were introduced into those countries at that time and won recognition by both rulers and people. The Chi­nese doctor Yang Er went to Japan as a professor of medicine in A.D. 513, while Zhi Cong took medical writings and acupuncture and moxibustion diagrams to Japan when he went as a doctor in 550. In 552 the Emperor Wen Di of the Liang Dynasty presented Zhen Jing (Canon of Acupuncture) to the Japanese court. This was followed by visits to China by Japanese students of medical science including acupuncture and moxibustion. The Taihō Code promulgated by the Imperial Government of Japan in 701 stipulated that medical institutes include compulsory courses based on The Yellow Emperor’s Classic on Acupuncture and Moxibustion and A Classic of Acupunc­ture and Moxibustion. Measures were appended to ensure enforce­ment of this stipulation. There thus grew up in Japan a circle of Japanese physicians and writers specializing in these methods, and institutes of acupuncture and moxibustion were founded.

In what is now Korea the ancient kingdoms of Silla, Paekehe and Koguryo adopted a civil examination system comparable to China’s between the 7th and 10th centuries, making Canon of Acu­puncture, The Yellow Emperor’s Classic on Acupuncture and Moxi­bustion and A Classic of Acupuncture and Moxibustion compulsory reading for medical students,

The development of navigation after the 10th century favoured China's trade and other exchanges with Africa and Europe. Acu­puncture and moxibustion were among the Chinese techniques taken to those parts of the world. English, French, German, Dutch and Austrian physicians took up these techniques in their clinical practice and research. Textbooks on these branches of medical science were translated from Chinese into a number of other languages.