Acupuncture is the procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes. Chinese has practised acupuncture for more than 2000 years. Huangdi Neijing is the first Chinese book that described acupuncture and its usage.
Acupuncture is the procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes. The earliest written record of acupuncture is the Chinese text Shiji (史記, English: Records of the Grand Historian) with elaboration of its history in the second century BC medical text Huangdi Neijing (黃帝內經, English: Yellow Emperor's Inner Canon). Different variations of acupuncture are practiced and taught throughout the world.
Acupuncture has been the subject of active scientific research both in regard to its basis and therapeutic effectiveness since the late 20th century, but it remains controversial among medical researchers and clinicians. Research on acupuncture points and meridians is preliminary and has not conclusively demonstrated their existence or properties. Clinical assessment of acupuncture treatments, due to its invasive and easily detected nature, makes it difficult to use proper scientific controls for placebo effects.
Evidence supports the use of acupuncture to control some types of nausea and pain but evidence for the treatment of other conditions is equivocal and several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain through the placebo effect.
The World Health Organization and the United States' National Institutes of Health (NIH) have stated that acupuncture can be effective in the treatment of neurological conditions and pain, though these statements have been criticized for bias and a reliance on studies that used poor methodology. Reports from the USA's National Center for Complementary and Alternative Medicine (NCCAM), the American Medical Association (AMA) and various USA government reports have studied and commented on the efficacy (or lack thereof) of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles, and that further research is needed.
Acupuncture's origins in China are uncertain. One explanation is that some soldiers wounded in battle by arrows were cured of chronic afflictions that were otherwise untreated, and there are variations on this idea. In China, the practice of acupuncture can perhaps be traced as far back as the Stone Age, with the Bian shi, or sharpened stones. In 1963 a bian stone was found in Duolun County, Inner Mongolia, China pushing the origins of acupuncture into the Neolithic age. There are evidences of needles made of fish bone and stone found in Korea, dating approximately to 3000 BC. Hieroglyphs and pictographs have been found dating from the Shang Dynasty (1600-1100 BC) which suggest that acupuncture was practiced along with moxibustion.
Despite improvements in metallurgy over centuries, it was not until the 2nd century BC during the Han Dynasty that stone and bone needles were replaced with metal. The earliest records of acupuncture is in the Shiji (史記, in English, Records of the Grand Historian) with references in later medical texts that are equivocal, but could be interpreted as discussing acupuncture. The earliest Chinese medical text to describe acupuncture is the Huangdi Neijing, the legendary Yellow Emperor's Classic of Internal Medicine (History of Acupuncture) which was compiled around 305–204 B.C.
The Huangdi Neijing does not distinguish between acupuncture and moxibustion and gives the same indication for both treatments. The Mawangdui texts, which also date from the second century BC (though antedating both the Shiji and Huangdi Neijing), mention the use of pointed stones to open abscesses, and moxibustion but not acupuncture. However, by the second century BC, acupuncture replaced moxibustion as the primary treatment of systemic conditions.
In Europe, examinations of the 5,000-year-old mummified body of Ötzi the Iceman have identified 15 groups of tattoos on his body, some of which are located on what are now seen as contemporary acupuncture points. This has been cited as evidence that practices similar to acupuncture may have been practiced elsewhere in Eurasia during the early Bronze Age.
Around ninety works on acupuncture were written in China between the Han Dynasty and the Song Dynasty, and the Emperor Renzong of Song, in 1023, ordered the production of a bronze statuette depicting the meridians and acupuncture points then in use. However, after the end of the Song Dynasty, acupuncture and its practitioners began to be seen as a technical rather than scholarly profession. It became more rare in the succeeding centuries, supplanted by medications and became associated with the less prestigious practices of shamanism, midwifery and moxibustion.
Portuguese missionaries in the 16th century were among the first to bring reports of acupuncture to the West. Jacob de Bondt, a Danish surgeon travelling in Asia, described the practice in both Japan and Java. However, in China itself the practice was increasingly associated with the lower-classes and illiterate practitioners.
The first European text on acupuncture was written by Willem ten Rhijne, a Dutch physician who studied the practice for two years in Japan. It consisted of an essay in a 1683 medical text on arthritis; Europeans were also at the time becoming more interested in moxibustion, which ten Rhijne also wrote about. In 1757 the physician Xu Daqun described the further decline of acupuncture, saying it was a lost art, with few experts to instruct; its decline was attributed in part to the popularity of prescriptions and medications, as well as its association with the lower classes.
In 1822, an edict from the Chinese Emperor banned the practice and teaching of acupuncture within the Imperial Academy of Medicine outright, as unfit for practice by gentlemen-scholars. At this point, acupuncture was still cited in Europe with both skepticism and praise, with little study and only a small amount of experimentation.
In the early years after the Chinese Civil War, Chinese Communist Party leaders ridiculed traditional Chinese medicine, including acupuncture, as superstitious, irrational and backward, claiming that it conflicted with the Party's dedication to science as the way of progress. Communist Party Chairman Mao Zedong later reversed this position, saying that "Chinese medicine and pharmacology are a great treasure house and efforts should be made to explore them and raise them to a higher level."
Acupuncture gained attention in the United States when President Richard Nixon visited China in 1972. During one part of the visit, the delegation was shown a patient undergoing major surgery while fully awake, ostensibly receiving acupuncture rather than anesthesia. Later it was found that the patients selected for the surgery had both a high pain tolerance and received heavy indoctrination before the operation; these demonstration cases were also frequently receiving morphine surreptitiously through an intravenous drip that observers were told contained only fluids and nutrients.
The greatest exposure in the West came when New York Times reporter James Reston, who accompanied Nixon during the visit, received acupuncture in China for post-operative pain after undergoing an emergency appendectomy under standard anesthesia. Reston was so impressed with the pain relief he experienced from the procedure that he wrote about acupuncture in The New York Times upon returning to the United States. In 1973 the American Internal Revenue Service allowed acupuncture to be deducted as a medical expense.
In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anaesthesia. It was later revealed that the patient had been given a cocktail of weak anaesthetics that in combination could have a much more powerful effect. The program was also criticised for its fanciful interpretation of the results of a brain scanning experiment.
Acupuncture anesthesia for surgery has fallen out of favor with scientifically trained surgeons in China. A delegation of the Committee for the Scientific Investigation of Claims of the Paranormal reported in 1995: We were not shown acupuncture anesthesia for surgery, this apparently having fallen out of favor with scientifically trained surgeons. Dr. Han, for instance, had been emphatic that he and his colleagues see acupuncture only as an analgesic (pain reducer), not an anesthetic (an agent that blocks all conscious sensations).
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