Although westerners often think of this traditional Chinese treatment modality as a “new” form of alternative medicine, acupuncture is so ancient in China that its origins are unclear. According to Huangfu Mi (c. 215-282 AD), author of The Systematic Classic of Acupuncture and Moxibustion, needling therapy was first used during China’s Bronze Age, over five thousand years ago. He attributes its invention to either Fu Xi or Huang Di (the Yellow Emperor), two legendary figures of the Five Emperors Period (c. 3000-2070 BC). Modern scholars generally believe that acupuncture is much older, originating more than ten thousand years ago during China’s Neolithic Age (c. 8000-3500 BC).
In actuality, acupuncture may not be as ancient as has generally been assumed. A reconsideration of all extant documents and recent archaeological finds indicates that acupuncture may date back a mere 2100 to 2300 years, first appearing during China’s Warring States Period (475-221 BC) and rapidly maturing during the Western Han Dynasty (206 BC-24 AD).
Questioning the generally accepted origins theory.
The currently accepted theory concerning the Neolithic origins of acupuncture is based on two premises. The first holds that bian shi, specialized sharp-edged stone tools that appeared during China’s Neolithic Age, were used for an early form of needling therapy, prior to the invention of metal smelting. It is known that bian shi stone tools were utilized for a number of early medical procedures, starting during the Neolithic Age and continuing through the Western Han Dynasty (206 BC-24 AD). A number of descriptions of bian shi stone therapy appear in one of China’s earliest medical works, The Yellow Emperor’s Inner Classic of Medicine (Huang Di Neijing, hereafter referred to as the Neijing) (c. 104-32 BC). It has been thought that these Neolithic stone medical instruments were precursors of the metal acupuncture needles that came into use during China’s Iron Age.
However, historical documents and new archaeological evidence clearly indicate that bian shi stone tools were flat and knife-like in form, used primarily to incise abscesses to discharge pus, or to draw blood (1). They were applied as surgical scalpels to cut, rather than as needles to puncture, and had nothing to do with needling therapy. According to the Code of Hammurabi, the ancient inhabitants of Mesopotamia used similarly shaped bronze knives to incise abscesses over 4000 years ago.
Prehistoric Chinese people possessed needles made of various materials, ranging from crude thorns and quills to bone, bamboo, pottery, and stone. But just as the history of the knife is not the history of surgery, so the invention of needles and that of acupuncture are two entirely different things. Needles have historically been among the most commonly used tools of daily life for constructing garments all over the world. Medically, needles are used to suture incisions just as making up clothes with darners, hollow syringe needles (as differentiated from a solid needle used in acupuncture) are applied to inject fluids into the body or draw them from it, but pricking a solid needle into the body to treat illness seems very strange and enigmatical. In English, “to give somebody the needle” means to displease or irritate someone. Most people prefer not to be punctured with needles, and associate needling with pain and injury. Many plants and animals have evolved thorns or quills as powerful weapons for protection or attack. Needles were even used for punishment in ancient China. By trial and error, healers throughout the world have found treatments for pain and other diseases independently, for instances, herbs, roots, wraps, rubs, blood-letting and surgery, but acupuncture alone is unique to Chinese. Considering the unique Chinese origin of acupuncture, it is reasonable to assume that the invention of acupuncture was not related to the availability of either sewing needles or bian shi stone scalpels during China’s Neolithic Age.
The second premise supporting the theory of the Neolithic origins of acupuncture holds that acupuncture evolved as a natural outgrowth of daily life in prehistoric times. It is thought that through a process of fortuitous accident and repeated empirical experience, it was discovered that needling various points on the body could effectively treat various conditions. However, this assumption is lacking in both basic historical evidence and a logical foundation.
It is known that ancient people were aware of situations in which physical problems were relieved following unrelated injury. Such a case was reported by Zhang Zihe (c. 1156-1228 AD), one of the four eminent physicians of the Jin and Yuan Dynasties (1115-1368 AD) and a specialist in blood-letting therapy: “Bachelor Zhao Zhongwen developed an acute eye problem during his participation in the imperial examination. His eyes became red and swollen, accompanied by blurred vision and severe pain. The pain was so unbearable that he contemplated death. One day, Zhao was in teahouse with a friend. Suddenly, a stovepipe fell and hit him on the forehead, causing a wound about 3-4 cun in length and letting copious amounts of dark purple blood. When the bleeding stopped, a miracle had occurred. Zhao’s eyes stopped hurting; he could see the road and was able to go home by himself. The next day he could make out the ridge of his roof. Within several days, he was completely recovered. This case was cured with no intentional treatment but only accidental trauma (2).”
If acupuncture did, in fact, gradually develop as the result of such fortuitous accidents, China’s four thousand years of recorded history should include numerous similar accounts concerning the discovery of the acupoints and their properties. But my extensive search of the immense Chinese medical canon and other literature has yielded only this single case. Actually, this story offers at most an example of blood-letting therapy, which differs in some essential regards from acupuncture. The point of blood-letting therapy is to remove a certain amount of blood. But when puncturing the body with solid needles, nothing is added to or subtracted from the body.
Blood-letting therapy is universal. Throughout recorded history, people around the world have had similar experiences with the beneficial results of accidental injury, and have developed healing methods based on the principle that injuring and inducing bleeding in one part of the body can relieve problems in another area. The ancient Greeks and Romans developed venesection and cupping based on the discovery that bleeding is beneficial in cases such as fever, headache, and disordered menstruation. Europeans during the Middle Ages used blood-letting as a panacea for the prevention and treatment of disease. Detailed directions were given concerning the most favorable days and hours for blood-letting, the correct veins to be tapped, the amount of blood to be taken, and the number of bleedings. Blood was usually taken by opening a vein with a lancet, but sometimes by blood-sucking leeches or with the use of cupping vessels. Blood-letting using leeches is still practiced in some areas of Europe and the Middle East. However, nowhere did these blood-letting methods develop into a detailed and comprehensive system comparable to that of acupuncture. If acupuncture did indeed arise from repeated empirical experience of accidental injury, it should have developed all over the world, rather than just in China.
Both historical evidence and logic indicate that there is no causal relation between the development of materials and techniques for making needles and the invention of acupuncture. It is also clear that repeated experience of fortuitous accidental injury was not a primary factor in the development of acupuncture. Therefore, the generally accepted theory concerning the Neolithic origins of acupuncture, based as it is upon such faulty premises, must be incorrect. It is now necessary to reconsider when acupuncture did, in fact, first appear and subsequently mature.
Reconsidering the evidence
If acupuncture did indeed originate during China’s Neolithic Age, references to it should appear throughout China’s earliest written records and archaeological relics. However, this is not the case.
Early cultures believed the world to be filled with the supernatural, and developed various methods of divination. During China’s Shang Dynasty (c. 1500-1000 BC), divination was practiced by burning animal bones and tortoise shells with moxa or other materials. Oracular pronouncements were then inscribed on the bone or shell, based on the resulting crackles. These inscriptions have survived as the earliest examples of written Chinese characters. Among the hundreds of thousands of inscribed oracle bones and shells found to date, 323 contain predictions concerning over twenty different diseases and disorders. However, none of these inscriptions mention acupuncture, or any other form of treatment for that matter.
Rites of the Zhou Dynasty (Zhou Li), written during the Warring States Period (475-221 BC), records in detail the official rituals and regulations of the Zhou Dynasty (c. 1000-256 BC), including those concerning medicine. Royal doctors at that time were divided into four categories: dieticians, who were responsible for the rulers’ food and drink; doctors of internal medicine, who treated diseases and disorders with grains and herbs; surgeons, or yang yi, who treated problems such as abscesses, open sores, wounds, and fractures using zhuyou (incantation), medication, and debridement (using stone or metal knives to scrape and remove pus and necrotic tissue); and veterinarians, who treated animals. But this document as well contains no references to acupuncture.
Neijing (c. 104-32 BC) is the first known work concerning acupuncture. The classic consists of two parts: Suwen – Simple Questions, and Lingshu – the Spiritual Pivot, also known as The Classic of Acupuncture (Zhen Jing). Both are concerned primarily with the theory and practice of acupuncture and moxibustion. Although authorship of the Neijing is attributed to Huang Di, the legendary Yellow Emperor (c. 2650 BC), most scholars consider that this master work, which contains excerpts from more than twenty pre-existing medical treatises, was actually compiled between 104 BC and 32 BC, during the latter part of the Western Han dynasty (206 BC-24 AD). The comprehensive and highly developed nature of the medical system presented in the Neijing has led scholars to believe that needling therapy has an extremely long history, probably reaching back to prehistoric times. The original versions of the ancient texts used in the compilation of the Neijing have been lost, and with them the opportunity to further illuminate the question of when acupuncture actually first appeared. However, startling new archaeological evidence, unearthed in China in the early 1970s and 1980s, reveals the true s