A brief history of acupuncture.

Acupuncture is generally held to have originated in China, being first mentioned in documents dating from a few hundred years leading up to the Common Era. Sharpened stones and bones that date from about 6000 BCE have been interpreted as instruments for acupuncture treatment [1, 2], but they may simply have been used as surgical instruments for drawing blood or lancing abscesses [3]. Documents discovered in the Ma-Wang-Dui tomb in China, which was sealed in 198 BCE, contain no reference to acupuncture as such [3], but do refer to a system of meridians, albeit very different from the model that was accepted later [4]. Speculation surrounds the tattoo marks seen on the ‘Ice Man’ who died in about 3300 BCE and whose body was revealed when an Alpine glacier melted [5]. These tattoos might indicate that a form of stimulatory treatment similar to acupuncture developed quite independently of China. The first document that unequivocally described an organized system of diagnosis and treatment which is recognized as acupuncture is The Yellow Emperor’s Classic of Internal Medicine, dating from about 100 BCE. The information is presented in the form of questions by the Emperor and learned replies from his minister, Chhi-Po [6]. The text is likely to be a compilation of traditions handed down over centuries [7], presented in terms of the prevailing Taoist philosophy, and is still cited in support of particular therapeutic techniques [8]. The concepts of channels (meridians or conduits [3]) in which the Qi (vital energy or life force) flowed are well established by this time, though the precise anatomical locations of acupuncture points developed later [9]. Acupuncture continued to be developed and codified in texts over the subsequent centuries and gradually became one of the standard therapies used in China, alongside herbs, massage, diet and moxibustion (heat) [2]. Many different esoteric theories of diagnosis and treatment emerged, sometimes even contradictory [3], possibly as competing schools attempted to establish their exclusiveness and influence. Bronze statues from the fifteenth century show the acupuncture points in use today, and were used for teaching and examination purposes (Fig. 1) [2]. During the MingDynasty (1368–1644),TheGreat Compendium of Acupuncture and Moxibustion was published, which forms the basis of modern acupuncture. In it are clear descriptions of the full set of 365 points that represent openings to the channels through which needles could be inserted to modify the flow of Qi energy [7]. It should be noted that knowledge of health and disease in China developed purely from observation of living subjects because dissection was forbidden and the subject of anatomy did not exist. Interest in acupuncture among the Chinese declined from the seventeenth century onwards as it came to be regarded as superstitious and irrational [2, 6]. It was excluded from the Imperial Medical Institute by decree of the Emperor in 1822. The knowledge and skill were retained, however, either as an interest among academics or in everyday use by rural healers. With China’s increasing acceptance of Western medicine at the start of the twentieth century, final ignominy for acupuncture arrived in 1929 when it was outlawed, along with other forms of traditional medicine [2]. After the installation of the Communist government in 1949, traditional forms of medicine including acupuncture were reinstated, possibly for nationalistic motives but also as the only