Ironic History of Acupuncture

Advancement of Acupuncture Science in China: From Climax to Demise. How & Why?

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Since late 1990s, scientists worldwide started to test acupuncture using randomized controlled trials (RCT). The results of the trials have been largely inconclusive or disappointing.

Among thousands of trials, the best results was obtained in a trial (n=1,162) conducted in Germany in 2001 – 2005. The trial found that, after weeks of treatment at 1-2 session /week, the response rate (pain reduction > 33%) of patients was no more than 50% (Haake et al, 2007), meaning that in every 10 patients with low back pain, there are 5 for whom acupuncture is useless.

Therapy Like Flipping A Coin

"Five hundred RCTs have been done to test acupuncture. If you count up the positive and negative results, it turns out to be fifty-fifty. It's random, like flipping a coin", says Ted Kaptchuk, one of the founders of American Chinese medicine, now professor of Medicine at Harvard Medical School (L. Barnes, 2005).

True Ancient Wisdom and A Distorted Stray

However, 2000 years ago by Huangdi Neijing era (200 BC), acupuncture in China had already advanced to such a point that it was widely practiced as a magically effective and highly reliable medicine. It was so successful that the authors of Neijing strongly believed that the herbs, most of them are poisonous, should be replaced by needles (Lingshu 1 of Neijing).

But history turned out a huge irony: Acupuncture in China had struggled its way from its best time (prior to 200 BC) to its demise (in 1822 – 1929), finally ended up being replaced back by herbs (1950s).

How come this happened? It was mostly due to the poor efficacy of a fundamentally distorted acupuncture shaped by the physicians of post-Neijing era all through the last 2000 years. This distorted acupuncture strayed far away from the true ancient Chinese wisdom of healing art – the technique called Miu-Ci (繆刺).

A Forgoten Jewel of Wisdom

Miu Ci, the true jewel of wisdom from ancient Chinese physicians, was mostly described in Suwen (素问) of Neijing, but also has been briefly mentioned in Lingshu (灵枢), Zhenjiu Jiayijing (针灸甲乙经) (282 AD), and as late as in Zhenjiudacheng (针灸大成) (1601). Thereafter however, it gradually fell into oblivion (Unschuld P., 2011).

The Death of Acupuncture in 1820s

In fact, interest in acupuncture itself continued to decline. In 1822 it was flatly banned from Imperial Medical Institute (太医院) of Qing Dynasty, and in 1928 the practice was essentially outlawed in China.

So what caused acupuncture being eventually abandoned? Three reasons are conceivable.

Few Understand What Miuci Is

First, very few people in the last 2000 years have been able to use Miu-Ci because no one (except very few) correctly understood it even it was recorded in Neijing.

Many intelligent scholars failed in grasping the true meaning of Miu Ci. The famous Neijing commentator Wang Bin said it means "A"(763 AD), the well-known Chinese medicine scholar Zhang Jiebin argued it means "B" (1624), ... a scholar of today Gao S.S. hold it as "X"(1980), but the physician Hu T.X read it as "Y"(1991) ...Sadly, none had got the soul of it.

Without using Miu-Ci, clinically the chances you can get magical result is no more than 0.1%, the rest 99.9% of the odds is you would fail in at least 50% of cases statistically, or only get very poor results if not completely fail, as demonstrated by thousands of RCT trials conducted in the last half century.

A Smart Conjecture Shadowed Jewels

Secondly, the fundamental idea of Miu-Ci is to prick anywhere on the body regardless of Jing Mai vessels (today's meridians). This was a common sense to all physicians prior to Neijing era. But the situation suddenly changed when the chapter of Lingshu 10 (经脉) of Neijing came into place, in which a blood circulation hypothesis was proposed by one of the authors of Neijing.

He or she creatively connected in tandem the 11 Jing Mai (blood) vessels independent to each other known at that time, plus an additional one (today's Lung meridian) coined by him/herself, thereby a loop composed of 12 Jing Mai vessels was invented.

Although it was purely a conjucture without any anatomical tests to support, the looped 12 Jingmai vessels soon became the infallible pillar stone of acupuncture in China ever since. Every one in acupuncture world today can recite the sequence of the Jingmai vessels in the loop: It starts from Lung, next enters large Intestine, then Stomach....ended at Liver, thereafter goes back to Lung, on and on...

This 12 Jing Mai loop looked so beautiful in that it wonderfully matched yin-yang theory, the 12 months of a year, the symetry of the body, the harmony of heaven and earth... It was such a brilliant structure that "shadowed" all of the jewels scattering in Neijing acupuncture. It attracted every one's attention and thereafter few has ever thought of needling a spot deviating from the 1 mm wide lines where these 12 Jing-Mai vessels run.

A Medicine Relying on Torturing Patients

Thirdly, the poor efficacy of needling without using Miu Ci forced physicians to resort to stronger and stronger aggressive pricking to force patient to feel de-qi, to the extent of using red-hot, match stick-thick needles to stab, for example, the acupoints BL13, 14, LR14 on abdomen, ..not to speak without any disinfection at that time.

We don't know how many deaths caused by such barbarous stabbing at that era, but we can image how willing a patient would be to accept such a torture.

"Advancing" From Climax to Demise

The poor performance of acupuncture in post-Neijing era was told by the history. Zhang ZJ (张仲景) in his masterpiece Shanghanlun (伤寒论) (210 AD) rarely used needles, rather he repeatedly warned the danger of needling. Wang T ( 王涛), in the famous medical encyclopedia he compiled (Waitaimiyao 外台秘要, 752), kicked out needling but only kept moxa.

In 1026, Wang WY (王惟一) assigned originally scattering 354 points onto 12 lines (the imaged Jing Mai vessels) depicted in his Bronze Statue (针灸图经). In 1400s, Hua Shou (滑寿) "precisely" assigned these acupoints onto the 12 Jingmai vessels in a looped form invented by the author of Lingshu 10. This assignment of acupoints is what we see in today's TCM text book used worldwide.

Both Wang WY and Hua Shou were brilliant scholars. However, their diligent work only made acupuncture further derailed from the true jewel of wisdom.

In 1700s, scholars such as Yang J Z in his Zhenjiudacheng (针灸大成) (1601) collected a plethora of complicated stabbing (de-qi) techniques trying to improve the performance, but to no avail.

Ironically, the decline of interest in acupuncture had sped up thereafter. In 1760s, the eminent physician Xu Dachun (1693–1771) in his Essays on the Origins of Medicine (1775) lamented "the lost tradition of acupuncture"(针灸失传论).

In 1822, acupuncture was flatly banned from Imperial Medical Institute of Qing Dynasty, officially marking the death of acupuncture in China. Further in 1929, the practice of acupuncture came to the point being outlawed in China, at a time when a healer who uses needles was seen as no different from a fortune teller or an astrologer..." (Wang JM et al, 1932).

A Historical Irony

Acupuncture in China did have narrowly escaped the fate of being eradicated in 1950s, only by rendering itself becoming a small tailpiece of herb medicine (known as TCM acupuncture).

Did the authors of Neijing, the father of Chinese medicine, make a huge mistake in their belief that needles should replace herbs?

Reference

Barnes, Linda, 2005, American Acupuncture and Efficacy.

Hua Shou, 十四经发挥. 1341

Michael Haake et al, 2007, German Acupuncture Trials (GERAC) for Chronic Low Back Pain …

Paul U. Unschuld, 2011, Huang Di Nei Jing Su Wen...

Wang JM and Wu LT, History of Chinese Medicine, 1932

Zhenjiudacheng, 针灸大成, 1601

 Acupuncture's Ironic History