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What Does Acupuncture Treat?
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Does Acupuncture Work?
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A Brief Travel Through The History of Chinese Medicine
The History of Chinese Medicine is very long, with its beginnings dating to well before the life of Christ. Here in 21st century Canada, it is difficult and perhaps even impossible for us to fully grasp the nature of such a time scale of development. The earliest archaeological evidence of acupuncture indicates beginnings over 2000 years before Sir John A. Macdonald was born! Chinese Medicine was not developed at one point in time or by one person. It has been developed by an entire civilisation over centuries of revision, refinement and adjustment to different social, cultural, political and scientific trends . Many physicians and clinicians have contributed to the full body of knowledge known today as Chinese Medicine. This synopsis gives a brief overview of some of the more seminal moments in the history of this Medicine, running chronologically through each era of Chinese history.
The Periods of Chinese History
Much of premodern China is demarcated historically as a series of dynasties.
The major dynasties and modern eras are listed below.
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Era
Xia
Shang
Zhou Dynasty
Qin Dynasty
Han Dynasty
6 Dynasties
Sui Dynasty
Tang Dynasty
5 Dynasties
Song Dynasty
Yuan Dynasty
Ming Dynasty
Qing Dynasty
Republic of China
People's Republic of China
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Period
2100-1523 BC
1523-1027 BC
1027-221 BC
221-206 BC
206 BC - 220 AD
220-589
590-617
618-906
907-960
960-1264
1264-1368
1368-1643
1644-1911
1911
1949
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The eminent sinologist, Paul Unschuld has noted a distinct difference between how we handle knowledge in modern Western societies and how traditional Chinese society handled knowledge. The evolution of ideas in Western cultures is characterised by Replacement. That is, if a previously held idea is inconsistent with the prevailing paradigm or worldview, it is rejected/discarded. The evolution of ideas in Traditional Chinese culture is characterised by Accumulation (syncretism). The Chinese are traditionally a highly practical people. If an idea works, it will continue to be used even if it is inconsistent with newer models of reality. So the full body of Chinese Medicine is characterised by many different theories, ideas and principles which often contradict one another but which remain in use due to their clinical effectiveness and profound insights.
Shang Dynasty (1523 BC - 1027 BC)
Dominated by themes of shamanic and ancestral Medicine
Community consisted of all the Living and Dead.
Health was perceived to depend on harmony between the Living
and the Dead
The only recognised 'natural' cause of illness was Wind
Zhou Dynasty (1027 BC - 221 BC)
Confucianism arose in the middle Zhou Dynasty.
Key Confucian themes included
- Impacts of Human Behaviour on Social Outcomes
- Importance of Moderation in Lifestyle
- Shifted thinking away from demonic illness causation to human action
Taoism arose in the late Zhou. A key Taoist theme was the notion that the
Laws of Nature were ultimately beyond Human Comprehension
Qin Dynasty (221 BC - 206 BC)
All books except those on Medicine, Agriculture, Oracles were burnt
Standardisation of weights, measures, road width.
Han Dynasty (206 BC - 220 AD)
This was such a productive and creative period that even today, the Chinese people are sometimes referred to as 'People of the Han'
This period saw the complete development of a Medicine of Systematic Correspondence (the basis of much of Chinese Medicine) over its full 400 year period
Ma Wang Dui Texts
Written in the late -3 to -2 Century, these texts were excavated by
archaeologists in 1973 from the tomb of a Han Dynasty Prince in Hunan
Province. They had been buried in 168 BC.
They are now considered to represent a reasonable boundary for the
point in time at which Medicine became distinct from Religion.
These texts contain descriptions of 11 of the 12 Separate Acupuncture
Channels (Pericardium channel is missing).
Each Channel is associated with specific symptoms
Some channels are even named after their symptomatic focus.
For example, the Large Intestine Meridian is called 'the tooth
meridian'.
These texts contain medical theories describing the idea that channels
are subject to repletion, vacuity, and undesirable movement. These
ideas remain central to acupuncture practice today.
No mention of points are found, indicating that the concept of channels
predates the concept of acupuncture points.
No mention of needles, only moxibustion; indicating that moxibustion
predated needling as a therapy.
No mention of the idea of Qi circulation
No disease theory
Huang Di Nei Jing (Yellow Emperor's Canon of Internal Medicine)
Written in -2 to -1 Century.
This text is arguably the single most important text in the
canon of Chinese Medicine. In legend, it is dated to -2700 to -2600, the
time of the Yellow Emperor. The text is written as Dialogue between
Huang Di and Minister Qi Bo.
The Nei Jing, as it is known, has 2 parts, each with 81 Chapters.
The Nei Jing Su Wen (Fundamental Questions) contains medical
theory.
Nei Jing Ling Shu (Spiritual Axis) is an acupuncture manual.
Yin Yang theory and 5 Phase theory are present in the Nei Jing.
The Nei Jing is not rigorously structured or systematic.
It has clearly been written by many authours.
12 regular channels identified.
295 acupuncture points identified (670 presently).
An internal anatomy composed of 11 organs (5 Zang and 6 Fu) is
recognised.
Therapy discussed in the Nei Jing includes Bloodletting, Needle
Insertion, and Moxibustion at specific points; all tending to be quite
localised.
Beyond Wind, the Nei Jing recognises other Internal and External
causes of disease, including climatic factors and emotions.
Treatment is allopathic
Terminology used in the Nei Jing reflects political, social and
engineering structures of the day.
Nan Jing (Classic of Difficulties)
Written in the 1st century, the Nan Jing has 81 Chapters.
It contains a mature development of Medicine of Systematic
Correspondence. The Nan Jing integrates all aspects of health care
into Yin-Yang and 5 Phase doctrines. All Channels connected in one
circuit of Qi circulation. The Nan Jing contains a highly formal
development of positional pulse diagnosis at the wrist, with
3 identified depths at each of 3 positions on each wrist for a total
of 18 wrist locations where pulse quality has interpretable significance.
Demonology and Magic are entirely absent in the Nan Jing.
The choice of Acupoints is based on systematic understanding of Qi
circulation. The goal of treatment in the Nan Jing is not so much to
treat a disease or symptom but to adjust Qi to an ideal state.
Shang Han Lun (Discourse on Cold-Induced Disorders)
Written around 198 by Chinese physician, Zhang Zhong-Jing
This is the 1st major text of Herbal Medicine.
Details progression of epidemic acute febrile disease through 6 levels.
The Shang Han Lun is a major foundation of modern day Traditional
Chinese Herbal Medicine
Hua Tuo
Hua Tuo was a famous physician, surgeon, and diagnostician.
He developed a physical exercise known as the 5 Animal Frolics.
Six Dynasties (220 - 589)
Zhen Jiu Jia Yi Jing (The Systematic Classic of Acupuncture
and Moxibustion)
This text was written by Chinese physician, Huang Fu Mi in 282.
It is a complete technical book on Acupuncture and Moxibustion.
This text was the first to focus on Acupuncture for Disease prevention
(the idea that the superior physician treats disease before it arises).
It establishes a modern text book format (each channel, points on the
channel, locations, needling specifics, actions and effects)
Mai Jing (Pulse Classic)
Written by Chinese physician, Wang Shu He, in 280, the Mai Jing
established 24 pulse qualities
First Export of Medical Practices to Neighbouring Countries
Korea, Japan, Vietnam
Tang Dynasty (618 - 906)
Qian-jin Yao fang (Thousand Ducat Prescriptions) 652
Qian-jin Yi fang (Supplement to Thousand Ducat) 682
Written by famous Chinese physician, Sun Si Miao
These are mostly Herbal Texts with many new formulae for febrile
diseases and Women's diseases. Sun Si Miao developed the format
for Acupuncture Charts still in use (front, side, back views) today.
He systematised the Body Inch (cun) Acupoint location system
Sun Si Miao developed the use of Ashi points (an early trigger
point concept).
He described 13 'ghost points' with specific applications for
psychiatric conditions.
Search for Immortal Elixirs was the focus of much Herbal work
7 of 22 Tang rulers died from formulas intended to impart immortality
Four specialised types of Doctor recognised during the Tang Dynasty.
Physician (herb doctor), Acupuncturist, Masseur, Exorcist
Korea and Japan formalised Medical education with establishment of
Medical Colleges during this time period.
Nei Jing, Nan Jing, Zhen Jiu Jia Yi Jing were core of curriculum
Practice of Acupuncture was, for first time, related to seasonal and
other cycles of Chinese Calendar (The Tang dynasty edition of the
Nei Jing Su Wen contained chronobiological concepts).
Song Dynasty (960 - 1264)
Bronze Man
This famous life size model was constructed in 1026, after the Emperor
ordered life size bronze statue with holes. During the qualifying
examination for physicians, it was filled with water and covered in wax.
When the correct point locations were needled, it would leak.
Zhen Jing Zhi Nan (Compass Bearings for Acupuncture and
Moxibustion)
Written by Chinese physician, Dou Han Jing in 1241.
Contains an elaboration on Diurnal, Monthly, Seasonal, Annual cycles
of Qi according to which Acupuncture is performed
Zi Wu Liu Zhu Zhen Jing
Written by Chinese physician, He Rou Yu
Contains specific Biorhythmic treatments
The Four Schools
Cold and Cooling School
Led by Liu Wan Su (1120 - 1200)
Attacking School
Led by Zhang Zhe (1156 - 1228)
Dominated by the theme that we are sick because of toxins.
This school advocated that tonics were overused.
Therapies promoted sweat to cool and expel toxins, induced vomitting
to expel poison and promoted bowel movements to expel toxins.
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