Traditional acupuncture
There are different styles of acupuncture. These can be divided into three broad categories: traditionally based systems of acupuncture, western medical acupuncture, and microsystems: eg, ear acupuncture.
British Acupuncture Council members are trained in one or more traditionally based system of acupuncture: such as TCM, Five Elements, Stems and Branches, Japanese Meridian Therapy, and many others. These styles differ slightly in needling and diagnostic techniques, but all trace their roots back to the classical texts such as the Yellow Thearch’s Canon of Internal Medicine: huangdi neijing (黄帝内经).
The Chinese word for acupuncture is zhenjiu (针灸). The first character ‘zhen’ means needle, the second character ‘jiu’ means moxibustion. Moxibustion is the burning of a herb called moxa (Chinese Mugwort, Artemisia argyi) to warm specific parts of the body, including acupuncture points. Archaeological evidence suggests that moxibustion was the most commonly practised method of stimulating the points when acupuncture first began [1]. The use of moxibustion is perhaps one of the most obvious differences between traditional and medical acupuncture. Other techniques such as cupping, guasha and tuina massage have also been used alongside acupuncture for thousands of years. In addition, acupuncturists may make dietary recommendations or suggest specific exercises such as tai ji quan and qi gong. In short, the traditional practice of acupuncture involves more than the insertion of needles.
Traditional styles of acupuncture utilise an understanding of health and illness that has developed for over 2000 years. This theoretical knowledge guides the diagnosis, selection of points and whether to use moxibustion or needles. In traditional acupuncture there is no mind-body split. In other words, the physical, emotional and mental aspect of life are seen as interdependent. The mind-body is seen as a system and understanding the relationship between the various parts is central to making a diagnosis and treatment plan. The focus is on the whole individual rather than a particular sign or symptom in isolation. In practice this means when treating headache, for example, an acupuncturist may wish to understand whether there are any problems with the digestion. If there are problems, this will change the diagnosis and result in the selection of different acupuncture points.
A brief history
Acupuncture first developed in China. The most famous book about the practice of acupuncture is popularly known as the Yellow Emperor’s Canon of Internal Medicine. However, strictly speaking Yellow Thearch would be a better translation of the original Chinese: Huangdi (黄帝). The book comprises two parts the Suwen (素问) or Simple Questions and the Lingshu (灵枢) or Numinous Pivot. The book is most likely a collection of shorter pieces that were written in the 1st and 2nd century BCE [1]. The Yellow Thearch’s Canon of Internal Medicine along with another text the Classic of Difficulties Nanjing (难经), compiled in the 1st centuries 2nd AD, contain the foundational theories of acupuncture. These books introduce the acupuncture points, the meridians, needle techniques, the causes of disease, and methods of diagnosis such as taking the pulse.
The use of acupuncture spread throughout China where it has been in constant use for over 2000 years. Acupuncture at times enjoyed Imperial patronage for example during the Tang dynasty (618-906) with a National University and an Imperial Medical Office. Centrally regulated medical education declined with the collapse of the empire but then was re-established during the Song dynasty by Wang Anshi between 1068-85 [2]. Alongside the official education system were family lineages, with knowledge being passed down through the generations. In the 1950s the some of the differing traditions were unified to form what is now called Traditional Chinese Medicine (TCM). This is the style of practice found in Chinese hospitals today.
By the 6th century AD acupuncture had reached neighbouring countries such as Japan and Korea. In the later-half of the 17th century European traders started to write accounts of acupuncture. Jacob de Bondt surgeon general for the Dutch East India company wrote the results with acupuncture ‘surpass even miracles’ [3]. Acupuncture was further spread across the globe by migrants from China and other Asian countries: for example Vietnamese migrants took acupuncture to France [4]. In 1971 James Reston, a journalist who had accompanied Nixon to China, published an article in the New York Times describing his experience of acupuncture in a Chinese hospital. The article sparked a great deal of interest. On the one hand this led to more scientific research into the effects of acupuncture. On the other hand it also led to greater scrutiny of the profession and who should be allowed to practice. In 1974 an immigrant from Singapore, Miriam Lee, was prosecuted for practising acupuncture without a medical licence in California. Many of her patients came to her defence at her trial, then governor Ronald Reagan established acupuncture as an experimental procedure [4].
Over the past 50 years acupuncture has enjoyed increasing recognition in many Western countries. Professional organisations have been formed such as the British Acupuncture Council (BAcC). In the UK today there are different styles of acupuncture these can be divided into three broad categories traditionally-based systems of acupuncture which include: TCM, Five Elements, Stems and Branches, Japanese Meridian Therapy, and others. These styles have their roots in the classic texts such as the Yellow Thearch’s Canon of Internal Medicine. There are also contemporary styles of acupuncture such as western medical acupuncture. The third category is microsystems, for example ear acupuncture.
The BAcC is a professional body for those trained in traditionally based systems of acupuncture.
- Unschuld, P.U., Huang Di Nei Jing Ling Shu: The Ancient Classic on Needle Therapy. 2016: University of California Press. 798.
- Sivin, N., ed. Volume 6, Biology and Biological Technology; Part 6 Medicine. Science and Civilisation in China, ed. J. Needham and G.-D. Lu. Vol. 1 edition. 2000, Cambridge University Press.
- Lu, G.-D. and J. Needham, Celestial lancets: a history and rationale of acupuncture and moxa. 2002, London: RoutledgeCurzon. 427.
- Hinrichs, T.J. and L.L. Barnes, Chinese medicine and healing: an illustrated history. 2013, Cambridge, Mass.: Belknap Press of Harvard University Press. 464.
Qi and the meridians
The traditional acupuncture theories of health and illness are based on the concept of Qi (气).
Qi has been translated using ancient Greek terms such as pneuma and has also been described as life-force, vitality or energy. In Chinese, Qi has lots of different meanings depending on the context. It is a commonly used word within day-to-day language as well as an integral part of Chinese philosophy. In truth, it is probably best not to try and translate the term at all. Instead, a few examples can give a sense of the meaning of Qi in Chinese medicine. In Chinese, anger is shengqi 生气 – which literally means ‘growing’ Qi. This is what is depicted by cartoonists to illustrate a character getting angry with the head and upper body swelling and the face growing red. Disheartend or discouraged is xieqi 泄气 – which could be literally translated as ‘let out’ or ‘leak’ Qi. This is like the English expression to feel ‘deflated’. Through questioning and observation acupuncturists will assess the state of a person’s Qi. This assessment can be related to the ‘organs’ or zangfu (脏腑). We normally use the biomedical names such as Lungs, Kidney and Liver for the zangfu. It is important to note, the Lungs and Kidneys ecetera are defined differently in Chinese medicine to the biomedical lungs and kidneys, although there is some overlap. If a person feels tightness in the chest, they have a quiet voice and catch colds easily these are signs and symptoms that inform the acupuncturist about the Qi of the Lungs.
The traditional theory describes Qi flowing around the body along the meridians. Commonly seen acupuncture charts depict the 14 meridians that have acupuncture points. However, the Chinese word for meridian is jingluo (经络) and relates to two concepts. Jing refers to the familiar main meridians. Luo means ‘resembling a net’ and refers to smaller meridians that cover the entire body. This is similar to the way in which the main arteries divide into the capillaries. In the traditional theory illness can be described in terms of deficiency of Qi, excess of Qi, or blockage of Qi within the meridian (jingluo) and organ (zangfu) system. Acupuncture seeks to move the Qi within this system to tonify deficiency, reduce excess and clear blockages.
What to expect
A BAcC acupuncturist will take your medical history, read your pulses, may examine the site of your symptoms, and look at your tongue. Your individual treatment plan will be based on your state of health and lifestyle. Your acupuncturist will decide which combination of points is right for your whole body as well as your symptoms.
Sometimes acupuncture needles are inserted for just a second or two, or you may be left to rest for a while before the needles are removed. The needles are so fine that most people don’t feel them being inserted. It is normal to feel a mild tingle or dull ache as your acupuncturist adjusts the needle. Many people feel deeply relaxed during the treatment.
Normally, people will have a course of treatment. Weekly sessions are quite usual to begin with, for perhaps five or six treatments, reducing in frequency as your body responds. Your BAcC acupuncturist will suggest how often you should come for treatment.
