Celestial Lancets

A History and Rationale of Acupuncture and Moxa

Gwei-Djen Lu, Joseph Needham

• Publisher: Routledge
• Year: 2012
• ISBN:
  9781136612558
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Using modern knowledge to shed light on ancient techniques, this text examines two of the earliest therapeutic techniques of Chinese medicine: acupuncture and moxibustion. Acupuncture is the implantation of very thin needles into subcutaneous connective tissue and muscle at a great number of different points on the body's surface; moxibustion is the burning of Artemisia tinder (moxa) either directly on the skin or just above it.

For 2500 years the Chinese have used both techniques to relieve pain and to heal a wide variety of illnesses and malfunctions. Providing a full historical account of acupuncture and moxibustion in the theoretical structure of Chinese medicine, Doctors Lu and Needham combine it with a rationale of the two techniques in the light of modern scientific knowledge.

(1) INTRODUCTION

ACUPUNCTURE and moxibustion (chen chiu¹) are two of the most ancient and characteristic therapeutic techniques of Chinese medicine. The one may be defined broadly as the implantation of needles to different depths at a great variety of points on the surface of the human body, points gathered in connected arrays according to a highly systematised pattern with a complex and sophisticated, if still essentially medieval, physiological theory behind it; this technique was anciently called chen shih,² pien shih³ or chhan shih⁴.^a The needles unquestionably stimulate deep-lying nerve-endings, hence their evocation of some far-reaching results; though the classical theory was based on conceptions, still of much interest, of a continuous circulation of chhi⁵ and blood (hsüeh⁶) round the body.^b The other technique consists in the burning of Artemisia (ai⁷) tinder (moxa), either in the form of incense-like cones (whether or not directly on the skinj, or as cigar-shaped sticks held just above it, the points chosen for application being in general identical with those of the acupuncture system; this is called ai jung chiu^8c or ai chiug⁹.^d Depending on the degree of heat applied it may be either a mild thermal stimulus like a fomentation, or alternatively a powerful counter-irritant cautery. Very broadly speaking, the acupuncture technique was from ancient times onwards thought most valuable in acute diseases, while the moxa was considered more appropriate in chronic ones.^e

It is interesting to take note of an ancient tradition that the main components of traditional Chinese medicine originated in different geographical parts of the homeland. At least two chapters of the Nei Ching^f enlarge on the theme that varying methods of treatment had been found appropriate for people living in the diverse conditions of the several provinces and the four quarters.^a Different environments gave rise to different incidences of endemic disease, hence the invention of different therapeutic methods (i fa fang i¹). Thus moxibustion (chiu jo²) came mainly from the North, materia medica and pharmacy (tu yao³) from the West, and gymnastics, remedial exercises and massage (tao yiny,⁴ an chhiao⁵) from the Centre. But acupuncture (pien shih⁶) originated in the East, where people suffered greatly from boils and carbuncles; while its elaborations (in the form of the nine needles, chiu chen⁷)^b came up from the South. As for apotropaics (exorcisms, magical spells, and sacrifices to the gods and ancestors, chu yus⁸), this, it was considered, had been fairly universal from the earliest times. In part, it may be, this ancient proto-historical presentation was following the system of symbolic correlations, five types of medical treatment being analogised with the fivefold classification and especially the five directions of space, but there may be rather more to it than that.^c For we know that ancient Chinese society was built upon, or greatly influenced by, a number of ‘local cultures’, environing societies which brought various distinguishable traits into the eventual common Sinic stock.^d In this case, acupuncture would have been associated with the south-eastern quasi-Indonesian aquatic element, while moxa would have come down to join it from the northern quasi-Tungusic nomadic element, and the pharmaceutical influence would have come from the western Szechuanese and quasi-Tibetan element. Further research will doubtless sift the plausibility of this interpretation.

In our main work the system of acupuncture, unique to Chinese medicine, has been mentioned from time to time, but not so far fully discussed. It is among the most ancient components of Chinese medical art, and constitutes perhaps its most complicated feature. It is a system of therapy—and the relief of pain—which has been in constant use throughout the Chinese culture-area for some two and a half thousand years; and the labours of a multitude of devoted men through the centuries have given it a highly developed doctrine and practice. Nevertheless its study presents great difficulties, partly because the books on acupuncture written in different dynasties have been elements in a long and gradual development, not always self-consistent and not free from loop-line elaborations now more or less abandoned; but even more because the physiology and pathology of the system are themselves so ancient that the clear-cut definitions and conceptions of modern science cannot be expected. As the centuries passed, different masters emphasised somewhat different aspects and procedures as a result of their own deep study and practical expertise (hsin tê¹);^a and they handed on their understanding as clearly as they could to their particular disciples or in the schools of medicine by means of personal instruction and demonstration. Some wrote down specific guidance in the form of mnemonic rhymes (fu² and ko³) which the student could learn by heart and recite.^b Since the revolution of 1949, however, a new phase has appeared in that the instruction given in the schools of traditional Chinese medicine is now being systematically set forth in volumes of the chiang i⁴ (or lecture-notes) type, and these are of great value to all who wish to occupy themselves with the subject.^c Moreover, as is well known, China has developed a system in recent decades by which some physicians fully trained in modern-Western medicine continue their studies in colleges of traditional-Chinese medicine, while conversely others beginning with traditional medicine, including acupuncture, go on to qualify in modern medicine afterwards.

At the present time the traditional medical men in China are working side by side with the modern-Western-trained physicians in full cooperation. This is a very remarkable fact, which we ourselves have seen during four extended stays in China since the revolution. It has been brought about by the revaluation of all national traditions in the country’s mid-century renaissance, the convictions of her political leaders, the social needs and conditions, especially rural, and the relative paucity of medical men trained in modern scientitic medicine. The two types of physicians have joint consultations and joint clinical examinations, and there is the possioility for patients to choose whether they will have their treatment in the traditional way, including acupuncture, or the modern way; in other cases the physicians themselves decide which is best and proceed to apply it. There is, moreover, a steadily growing tendency to take all that is best from both traditions and combine them—elsewhere we shall discuss, for example, the treatment of fractures, where prolonged consideration has decided that in fact there were many valuable features in the traditional methods,^d and what is now practised is a mixture of the two, the Chinese and the Western. Such fusion is destined, we believe, to occur more and more, giving rise to a medical science which will be truly modern and oecumenical, not qualifiedly modern- Western. And an example outstandingly relevant here is the successful application of acupuncture in recent years to induce analgesia in major surgery. This we shall discuss later on in its place (pp. 218 ff.), but it certainly constitutes a remarkable marriage between traditional-Chinese and modern-Western medicine.

Acupuncture then is a method of therapy (including sedation and analgesia), developed first during the Chou period (—1st millennium), which involves the implantation of very thin needles (much thinner than the familiar hypodermic needles)^a into the body in different places at precisely specified points according to a charted scheme based on ancient and medieval yet intelligible physiological ideas. Indeed the theory and the practice were, one finds, already well systematised in the —2nd century, though much development was to follow. We ourselves have many times seen the way in which the implantation or the needles is done, attending acupuncture and moxa clinics in several Chinese cities (and in Japan also); and one can say that the technique remains in universal use in China at the present day. It also permeated centuries ago all the neighbouring countries of the culture-area, and for three hundred years past has awakened interest, together with a certain amount of practice, throughout the Western world.^b In what follows we shall describe first the ching-lo¹ circulation system and its classical theory, then delineating the historical growth and development or the specialist literature concerning it, and studying the effect which the technique had in other cultures. We shall go on to examine its role in Cninese medicine, and finally take up the possible physiological interpretations which look like giving it a rationale in terms of modern science.

That acupuncture is a system of cardinal importance in the History of Chinese medicine is not disputed by anyone, but its actual value in objective terms remained until recently, and to some extent still remains, the subject of great differences of opinion. It is possible to find in East Asia modern-tr...