Chinese Acupuncture

Early History
Acupuncture has a clearly recorded history of about 2,000 years, but some authorities claim that it has been practiced in China for some 4,000 years. The Chinese believe that the practice of acupuncture began during the Stone Age when stone knives or sharp edged tools, described by the character 'Bian', were used to puncture and drain abscesses. In fact the Chinese character 'Bian' means the 'use of a sharp edged stone to treat disease', and the modern Chinese character 'Bi', representing a disease of pain, is almost certainly derived from the use of 'Bian stones' for the treatment of painful complaints.

The origin of Chinese medicine is a fascinating story and acupuncture represents only one facet of their medical system. The first recorded attempt at conceptualizing and treating disease dates back to about 1500 BC during the Shang dynasty. Tortoise shells with inscriptions dating from that time have been found, and it is thought that these were used for divination in the art of healing. The philosophical basis of much of the very early Chinese medicine seems to have been to seek harmony between the living and their dead ancestors, and the good and evil spirits that inhabited the earth.

The Development of the Chinese Approach to Medicine and Science
The first known acupuncture text is the Nei Ching Su Wen and there is a great deal of controversy about the exact origins and authorship of this book. The Nei Ching Su Wen is divided into two main sections, the Su Wen, or simple questions and the Ling Shu, or difficult questions. The book is also known by a variety of alternative titles such as the Yellow Emperor's Classic of Internal Medicine, or the Canon of Medicine, but all these titles refer to the same basic text.

The initial section of the Nei Ching Su Wen involves a discussion between the Yellow Emperor, Huang Ti, and his Minister, Ch'i Pai. This discussion lays down the philosophical basis of traditional Chinese medicine, and makes the Nei Ching Su Wen more of a treatise on health and disease rather than a textbook of medicine. Early Greek texts on medicine are mainly of interest to the medical historian rather than the practicing physician. For instance, Hippocrates does make many excellent philosophical and practical observations about disease and the doctor-patient relationship, but for the most part these texts are recipe books for a variety of ill-defined diseases. The Nei Ching Su Wen is timeless and deals almost exclusively with philosophical concepts, many of which seem to be as important today as they were 2,000 years ago.

Professor Joseph Needham, one of the greatest living experts on Chinese scientific philosophy, describes some aspects of the ancient Chinese system of science as mediaeval and retrogressive He feels that many of these concepts have distorted that development and obvious potential of Chinese medicine There is undoubtedly an element of truth in this but there is still a great deal of useful and valuable information within the traditional Chinese approach to medicine.

The Western doctor observes the facts before him and uses the current physiological theories to explain them. Chinese medicine is based on a much wider world view, which is described in the Nei Ching Su Wen, and these ideas are woven into a complete and intact system based on a philosophy different from that of modern Western medicine. The concepts of Yin and Yang, and the number five, are two of the more important ideas that permeate much of traditional Chinese scientific thought.

Yin and Yang are opposite aspects of the material world. Like night and day they are interdependent, and the existence of one end of the spectrum presupposes the existence of the other aspect; i.e. Yin is necessary for Yang to exist, and vice versa. At first the idea of Yin and Yang seems very simplistic; it is not, it describes the fundamental fluctuating balance of nature. A modern concept that pre-supposes the existence of Yin and Yang is ecology, one of the main principles of which is that the forces of the environment must be in a fluctuating balance.

The number five is also very important to Chinese thought. For example, there are five notes in the musical scale, five tastes for food and five elements in the physical world (earth, fire, water, wood and metal). The five elements are not just atomic constituents of matter, they have also been described as the five transitional stages of all physical materials. It is these philosophical ideas that form the basis of much of the discussion in the Nei Ching Su Wen.

The authorship of the Nei Ching Su Wen is attributed to Huang Ti, the Yellow Emperor, but there is some doubt as to whether Huang Ti actually existed and a great deal more doubt about the claim that he wrote the Nei Ching Su Wen. Genealogies of the Chinese dynasties list him as the third of first five rulers of China, and ascribe the dates 2697-2579 B.C to him. Ssu-Ma Ch'ien, an historian of the second century BC begins the Historical Records with an account of Huang Ti and defines him as the founder of the Chinese civilization, and the first ruler of the Empire. He is one of three legendary Emperors who founded the art of healing; the others are Shen Nung and Hsi.

It is probable that the Nei Ching Su Wen was written by a variety of people and was updated by several important Chinese physicians. Some authorities date the Nei Ching Su Wen from 1000 BC whilst others, probably more correctly, date this text to the Warring States period (475-221 BC). The Ling Shu was almost certainly added during the Warring States period, and the twenty-four chapters that comprise the Nei Ching Su Wen were probably revised and re-written at this time.

The Development of Chinese Philosophy
The Warring States period is a particularly interesting time in Chinese history and has exerted a great deal of influence on Chinese thought. Two main philosophical ideologies became part of the mainstream of Chinese thought at this time, Taoism and Confucianism.

Confucianism defined the social status of prince and pauper within Chinese society and elected the Emperor a god. It result in a basically feudal and totalitarian system of government that still exists today, in an adapted form. Confucianism impinged on medicine in that it was opposed to the development of anatomy and surgery, one of its main tenets being that the whole body was sacred and should remain complete throughout life and also in death. The Confucians believed that it was important to present oneself to 'the ancestors' whole, and there-fore one of the most feared methods of execution in ancient China was decapitation. Acupuncture and related methods were the logical answer to this constraint, as they were able to cure internal disease with external means.

The Tao literally means the 'way' and the philosophy of Taoism is a method of maintaining harmony between man and his world, and between this world and beyond. The Tao, or the 'way', has been linked to a separate creed called Taoism but its basic naturalistic philosophies permeate all Chinese thought and religion, including Buddhism. Yin and Yang are very much part of the Tao, as the Book of Changes states, 'one Yin, one Yang, being called the Tao'. The religion of Taoism became formalized during the Warring States period and a book of poems entitled the Tao attributed to Lao Tsu (c. 500 BC ), describes many of the basic concepts within this philosophy.

The Taoist concept of health is to attempt to attain perfect harmony between the opposing forces of the natural world, between Yin and Yang, the belief being that the only way to be healthy is to adjust to the natural forces within the world and become part of their rhythm. It is further realized that the natural forces are completely dependent on each other; earth is dependent on rain and rain is dependent on heaven, which in turn cannot exist without the earth. In the same way Yin cannot exist without Yang, and yet the two are opposites. The concept of a unified, but at the same time polar force, governing natural events, is central to much of Chinese thought.

At first glance these concepts seem to be an irrelevant side-line to the development of a system of medicine, but acupuncture, and its development can only really be understood if the reader grasps the traditional Chinese approach to health and disease In essence, the ideal of health is perfect harmony between the forces of Yin and Yang; this represents the correct 'way' or Tao. Disharmony brings disease and death. Taoism is a passive philosophy, exalting the art of detailed and accurate observations. This was also an essential part of the development of Chinese medical thought and allowed detailed observations on organ structure and function to be made, as discussed in the first chapter.

Acupuncture Needles
As acupuncture developed, the Bian stones were discarded and needles of stone and pottery were used. These simple, primitive needles are still used in some of the rural areas of China. Eventually metal needles began to appear and these took the form of the classical 'nine needles'. The 'nine needles' comprised the arrowhead needle for superficial pricking, the round needle for massaging, the blunt needle for knocking or pressing, the three edged needle for puncturing a vein, the sword-like needle for draining abscesses, the sharp round needle for rapid pricking, the filliform needle, the long needle for thick muscles and the large needle for puncturing painful joints.

The main needle now used for acupuncture is the filliform as most of the others have been replaced by more sophisticated surgical instruments, for instance, the sword-like needle has been replaced by the scalpel.

The 'nine needles' were initially made of either bronze, or gold and silver, and seem to have been first used about 2,000 years ago. The tomb of the Prince of Chungshan, dating from the second century BC, was excavated in 1968 and contained a set of nine needles, four being of gold and five of silver. Some acupuncturists use gold and silver needles but the majority only stainless steel filliform needles.

Moxibustion
A discussion of the history of acupuncture is incomplete without mentioning moxibustion. Moxibustion is the burning on the skin of the herb moxa. The Chinese character 'Chiu' is used to describe the art of moxibustion, and literally means 'to scar with a burning object'. Moxibustion does not now involve scarring, but moxa is still used to provide local heat over acupuncture points. It is made from the dried leaves of Artemisia vulgaris and the Chinese believe that the older the moxa, the better its therapeutic properties.

Moxibustion developed as a medical practice completely separate from acupuncture, although it is now very much a part of current acupuncture practice in China. It is used to treat specific types of disease and is applied over the same body points (acupuncture points) as acupuncture needles. Some of the acupuncture points, such as those around the eye, are forbidden to moxa. In ancient China, moxa was also burnt on specific acupuncture points to keep the body healthy, and was said to act as a prophylactic against disease.

Moxa can be used in a variety of ways. Loose moxa is made into a cone and burnt on the skin, the cone then being removed when it is half burnt, to avoid blistering. It may also be burnt on ginger or garlic so that the skin is isolated from extreme heat, or a moxa stick may be used and burnt a centimeter or two away from the skin.

Initial Therapeutic Success
The exceptionally productive period of the Warring States also gives us the first known and recorded therapeutic success of acupuncture The Historical Records by Ssu-ma Ch'ien tells how the physician Pien Cheuh used acupuncture to revive the Governor of the State of Kuo from a coma. In fact the name of the physician was Chin Yenh-jen, but by taking the legendary name of the famous Chinese physician, Pein Cheuh, we can assess his prestige. The Governor was treated by acupuncture and subsequently with herbal medicines. In ancient China, as today, an event like this is a powerful argument in favor of the acceptance of any form of treatment.

The Evolution of Acupuncture Points and Channels
Initially, there were no specific locations on the body for applying either moxa or acupuncture but gradually, through empirical experience, the use of specific points on the skin were shown to be of value in particular diseases. Acupuncture points are undoubtedly the end-product of millions of detailed observations and as they were developed so each of them was given a name and Chinese character, depending on its therapy properties.

Acupuncture points were subsequently grouped into a system of channels which run over the body, conducting the flow of vital energy through the body. The acupuncture points on a channel are said to influence the flow of vital energy through the channel, thereby influencing disease processes in the body. The first clear reference to the points and channels is in the Nei Ching Su Wen which defines the main channels and acupuncture points. The Nei Ching Su Wen also makes the observation 'in pain, puncture the tender spot', and the use of painful points probably represents the original method by which many of the acupuncture points were discovered. There is an instinctive urge to cause more pain over a painful area; the image of a person with toothache, pressing on the painful tooth, is a frequent cartoonists' joke. Common painful diseases consistently cause painful points to emerge in well defined anatomical locations over the body. When this point is stimulated the pain can be alleviated; hence the idea of a point for treating pain. From this simple beginning it is easy to see how a system of acupuncture points evolved. The evolution of the channels connecting these acupuncture points is more difficult to understand. These seem to have evolved from an intuitive understanding of the flow of vital energy through the body. It is unclear from where the idea of channels originated, but for the last 2,000 years they have formed an essential part of traditional Chinese medicine.

Acupuncture Texts and Teaching Methods
Another major text, the Classic of Acupuncture and Moxibustion, also made its appearance during the Warring States period. This was written by Huang Fu Mi in the third century BC Together with the Nei Ching Su Wen these two texts form the basis for the anatomical descriptions of the main channels, and some 349 acupuncture points on these channels. The Warring States period saw the coalescence of acupuncture, and indeed most of Chinese thought, in the mold in which it existed until the recent Communist revolution.

During the Sui dynasty (AD 561-618) the first medical college in China was founded. The Imperial Medical College was established to administer medical research and to train doctors. Acupuncture and moxibustion, as well as herbal medicine, formed the basis of the curriculum. According to the Old History of the Tang Dynasty the Imperial College had one professor of acupuncture, ten instructors, twenty needle craftsmen and twenty students. The main teaching texts were the Nei Ching Su Wen and the Classic of Acupuncture and Moxibustion. The bulk of the teaching and practice of traditional Chinese medicine, however, has never been based in formalized medical colleges, although these colleges have been in existence since the Sui dynasty. The medical arts have more often been handed down from father to son, or from master to apprentice. This type of medical apprenticeship has only recently died out, and in fact some of the older acupuncturists in China today have been trained in this way.

The Tang dynasty saw a great flowering of the art of acupuncture, and the Thousand Golden Remedies by Sun Szu-Miao was one of the products of this period. This text was the first to contain clear color charts of the channels with front, side and back views of the body; obviously a great boon to students and teachers of acupuncture. We are aware of the existence of these charts from the references made to them in a number of other texts, but unfortunately they have been lost.

Printing and Language
China developed the art of printing in the Sui and Tang dynasties, although it was not widely used during these periods as most books were copied by hand. Early Chinese printing is rather like a lino-cut, the characters being carved on stone and hand-made prints taken from each block. During the Sung dynasty (AD 960-1280), printing techniques were improved and used extensively. This gave a great boost to acupuncture as far more books became available. Many of the pre-Sun, books suffered from repetition and confusion, especially over the location of various points and channels. These books were copied by non-medical calligraphers and this led to a great deal of confusion over the exact meaning of some of the characters in the text.

Chinese characters can change their meaning completely with a slight change in the text, and therefore a transcription error can easily change the sense of the text. The ambiguity of Chinese characters still poses a great problem in the translation of classical Chinese; for instance the character 'Ni' can mean to disobey, or to be in accord with someone. Exact translations therefore require the translator to understand the sense of the text and translate in accordance with this. The advent of more efficient printing techniques led to a more exact and faithful copy of the author's work, and therefore a clearer interpretation of the meaning of the characters. It is interesting to note that in Chinese philosophy all things have their natural opposites inherently within them (there is Yin in Yang, and Yang in Yin), and this is also displayed in the language as each of the characters may have a diametrically opposite translation.

The 'New' Bronze Model for Teaching Acupuncture Points
Because of the confusion that had gone before him, Wei-yi collected and collated all the information that was available to him in the eleventh century. He redefined all the points and channels and compiled an authoritative text called Illustrated Manual on the Points for Acupuncture and Moxibustion on the New Bronze Model. This text dates from AD 1026 and details the use of 354 points on the body. A vast amount of information is given about the location of the points, the method of needle insertion into each point, and the clinical indications for the use of specific points. There are also illustrations in the text to assist teaching and to act as a method of swift reference for the acupuncturist.

The Chinese were so impressed by this book that a statue was erected with the whole text on it! Two huge stone tablets were carved, some two metros high and seven metros wide, containing all the characters in Wang Wei-yi's book. These tablets stood in the capital of the Sung dynasty, now the city of Kaifeng in Honan province, where they could be read directly, or used like a brass-rubbing to make a permanent copy of the book.

Wang Wei-yi also directed foundry men to create two life sized bronze models for acupuncture. These hollow models had on them the exact locations and names of the acupuncture points, and were used for teaching. Chou Mi, of the southern Sung dynasty, records in the Historical Anecdotes the way in which these models were used to examine students. The model was coated with wax and then filled with water, the student being given the name of an acupuncture point and a needle. If the point was punctured correctly the student was soaked as a fountain erupted from the model; failure to achieve this result meant that the acupuncture point had been missed.

In the Yuan dynasty (AD 1280-1368) the capital of China was moved to Tatu, now better known as Peking. The stone tablets and the bronze model were moved to the Imperial Medical College in Peking, but they were very worn and overused. Reproductions were therefore made in the mid-thirteenth century. Until fairly recently, the original model and tablets were thought to have been lost, but in 1971 five fragments of the original stone tablets were found in Peking, with much of the information still legible.

The Consolidation of Acupuncture Techniques
Acupuncture grew and developed over the next three hundred years; no new concepts evolved, but the old ones were refined. During the Ming dynasty (AD 1368-1644), Chinese society underwent the beginnings of an industrial revolution as paper mills, and textile and iron workshops began to emerge; Ming means 'bright' and this was undoubtedly a bright period of Chinese history. Acupuncture and related medical arts were encouraged, as were all the arts and crafts in China.

Li Shih-chen, one of the most outstanding physicians of this period, wrote and compiled the classical Chinese Materia Medica describing the pharmacology and botany of many indigenous herbs. He was also an expert acupuncturist and wrote a treatise on the Eight Extra Channels, describing their course and the indications for their use. Kao Wu collected the essential principles from many of the old acupuncture texts, editing the material into A Summary of the Writings on Acupuncture and Moxibustion. He soon found a great demand for this text and in 1537 he went further, compiling a similar but more detailed and complete text entitled Essential Readings in Acupuncture and Moxibustion. Some of the observations in Kao Wu's book give us a amusing insight into the mores and morals of Chinese society The Chinese seem very reluctant to allow a doctor to remove their clothing, and this habit is as widespread today as it was in the Ming dynasty. Kao Wu makes a point of disapproving strongly of the method of needling a patient through the clothing, but perhaps the fact that a patient can be diagnosed without removing clothing is one of the unsung benefits of Chinese pulse diagnosis!

Yang Chi-chou edited the Compendium of Acupuncture and Moxibustion during this period. Kao Wu's books were really short summaries for acupuncture students, but the Compendium was a complete collection of all the available material on this subject. It is copiously annotated and integrates the herbal remedies used with acupuncture and moxibustion. The Compendium was first published in 1601 and is still used as reference text. Many of the source materials for this book have subsequently disappeared and consequently the Compendium represents an invaluable reference for those interested in acupuncture.

The Arrival of the Europeans
During the Ming dynasty contact was established with Europe, the earliest date being 1504 when the Portuguese landed; Macao. At about the same period, China's fleets began to visit India, Persia and some of the Arab states. Cheng Ho led the first recorded fleet of merchant ships to India in 1405, but it is certain that other Chinese merchantmen had traveled far afield prior to this date. The overland 'silk route' to China had been open for many centuries and merchants had for some time traveled into China and central Asia, following in the footsteps of Marco Polo.

With the advent of renewed interest in China, and also the wish of various European nations to 'discover and colonize' the non-European world, the Portuguese began to establish trading settlements in mainland China. With the traders went priests to convert the 'heathen'. It was through these priests, and also various physicians who visited China, that the idea of acupuncture began to filter through to the west. The Jesuits were particularly active in collecting and disseminating this information in Europe, but the process was far from one-sided as the Jesuits also introduced Western science to China. Dominique Parrenin, a missionary, translated a textbook of anatomy into Mandarin but this was banned from general circulation by the Emperor K'ang Hsi as he recognized that many of the Western concepts contradicted those of traditional Chinese medicine.

The Decline of Acupuncture and the Rise of Western Medicine in China
The Ching dynasty (A.D.1644-1911) was a time of chaos for the Chinese Empire. Western influences pervaded a war-torn China, especially during the nineteenth century when various Western nations were given 'spheres of influence' on the Chinese mainland. The Ching Emperors regarded acupuncture as 'a bar to progress' and in 1822 a government decree eliminated acupuncture from the curriculum of the Imperial Medical College.

During this period a great number of medical missionaries entered China to 'teach, heal and preach'. The medicine they practiced in the early part of the nineteenth century had little similarity to the Western medicine of today, as there were no anaesthetics, antibiotics or sepsis. The concept that bacteria caused disease was only disseminated in the 1860's and 1870's, and therefore the missionaries had very little real medical skill to offer. Their main advantage was their understanding of the elementary principles of surgery.

The Confucian ethic had blocked completely the progress of surgery, as the Chinese felt that the dead must present themselves to their ancestors with a whole body. They were afraid to submit themselves to surgery in case they died and went to their ancestors with part of the body missing; surgery was therefore the province of the medical missionary and the basis on which their medical skills were accepted. The first full-time missionary was Peter Parker who worked in Canton. At first, the activity of the medical missionaries was limited by hostility, money and manpower, but as Western influence expanded the missionary work grew. By the 1920's, growth had reached a peak and there were some 550 hospitals and out-patient clinics spread over most of the provinces and cities in mainland China.

During this period the art of acupuncture was in decline. Many acupuncturists seemed to be no more than 'pavement physicians' with poor training. Their surgery was often the market place, their knowledge of traditional Chinese medicine was very limited, and their equipment was filthy and of poor quality. The majority of 'respectable' Chinese doctors were practicing herbal medicine and massage, rather than acupuncture and moxibustion. In spite of its decline, and even at this low level, acupuncture remained the medicine of the masses. The Imperial denigration of acupuncture reflected not only the poor standard of practice but also the fact that some of the educated Chinese were looking to the West for progress. After the pneumonic plague of 1910 the Viceroy of Manchuria, Hsi Liang, remarked, 'The lessons of the epidemic are great . . . if railways, telegraphs and other modern inventions are indispensable to the material welfare of this country, we should also make use of the wonderful resources of Western medicine.'

Western medical colleges were set up by the missionaries, the first being in Canton. The missionaries translated Western medical books into Chinese and in 1886 began to print the China Medical Missionary Journal which was the first scientific journal in China. Another medical college was established shortly afterwards in Tientsin and there was a gradual increase in the number of Western-trained Chinese doctors. In 1929 the practice of acupuncture was outlawed in China; the passage of acupuncture has not always been smooth, even in China!

Communist Support for Acupuncture
In 1928 the Communist party of China was formed, under the leadership of Chairman Mao. A long guerrilla war ensued and the Communist party finally took power in 1949. The Communists realized that there were little or no medical services in the 'liberated areas' and actively encouraged the use of traditional Chinese remedies to keep their troops on the move. These remedies were cheap, acceptable to the Chinese peasants, and utilized the skills already available in the countryside.

Acupuncture gained new momentum; in 1940 Yang Shao proposed to 'scientificize, "Sinocize" and popularize' traditional Chinese medicine. During the early 1950's many hospital opened clinics to provide, teach and investigate the traditional methods, the main research institutes being in Peking, Shanghai and Nanking. This renaissance of acupuncture, combined with a sophisticated scientific approach, has allowed the development of many new methods of acupuncture.

New Ideas Based on Traditional Chinese Medicine
Ear acupuncture is a particularly useful new acupuncture method. The Ling Shu states: 'The ear is the place where all the channels meet', and with this statement the Chinese justify the origin of ear acupuncture. The external ear is an homunculus, or little man, with all the organs and parts of the, body being represented on the ear. Puncturing the external ear at a specific point allows a disease to be treated in the body; for instance, if the arm is hurting then needling the arm point on the, external ear will alleviate the pain in the arm.

Ear acupuncture has been used and developed by the French and the Chinese as a form of therapy and also, specifically by the Chinese, for acupuncture anesthesia. Many people in the West think of acupuncture as being synonymous with acupuncture anesthesia. The application of acupuncture as a form of anesthetic is a relatively new development, and a direct product of the impetus given to acupuncture by the Communists. In 1958 acupuncture was first used by the Chinese to control post-operative pain and it then began to be used as an anesthetic for simple operations. This technique was found to be effective and its use expanded quickly. In China it is now used for a wide variety of major and minor operations.

Acupuncture anesthesia has many advantages including safety and swift post-operative recovery; however, it does not always provide complete pain relief, and whilst a small failure rate is acceptable to the Chinese it would not be acceptable in most Western societies. It is obviously better to use a site far away from the area of the operation when applying acupuncture anesthesia, and this makes ear acupuncture the method of choice for anaesthetics.

The concept of the homunculus is one that the Chinese have developed further. There are complete representations of the body on the hand, foot, face and nose. Each of these represents complete 'micro-acupuncture' system, capable of treating ailments throughout the body. Acute back pain can be relieved by stimulating the points on the hand that represent the back. Perhaps this can be equated with the fact that each cell in the body has the information potential to duplicate the whole human. The genetic material in each of our cells is exactly the same as the information in the cell from which we all originated, the fertilized egg.

New Ideas Based on Western Medicine
The Chinese have also applied a variety of Western techniques within the field of acupuncture. They have established research institutes and these, particularly in Shanghai and some other Chinese cities, measure up to any found in the West. Scalp acupuncture, a technique invented in the last decade, is a direct development from the neuro-anatomy of the central nervous system. When the brain is damaged, in diseases such as a stroke, the scalp is stimulated superficially over the area of damaged brain. Although there is no clear connection between the nerves in the skin of the scalp, and the brain, this method does seem to produce an effect on the brain and the Chinese claim that they are able to alleviate some of the symptoms of a stroke with this procedure. Modern medicine has undoubtedly provided the stimulus for the development of this type of acupuncture.

Acupuncture points can also be treated by injection with ordinary injection needles, this method having been used in the West for some time although not called acupuncture. Tender, painful areas often occur in and around arthritic joints. Recent research work has shown that most of these 'tender points' are acupuncture points, and that injection therapy relieves the pain. Is it perhaps the needle insertion, rather than the fluid injection, that alleviates the pain?

Electro-acupuncture is the stimulation of acupuncture needles with small electrical currents, and its growth and development has been pioneered by the Chinese over the last thirty years. Throughout long operations, under acupuncture anesthesia, electrical machines have been used to avoid prolonged, continual manual stimulation of acupuncture needles. Electroacupuncture is now widely used in many acupuncture clinics, for acupuncture therapy as well as for anesthesia.

Contradictions Resolved?
The Chinese are well aware of the current scientific explanations of acupuncture and its mode of action, and through their research institutes they are contributing to this field. The cultural heritage of the Chinese has made it possible for them to accept the contradictions inherent in the practice of acupuncture; science versus philosophy. The concepts of traditional Chinese medicine allow the acupuncturist to approach and treat a patient. Eventually science will provide a logical explanation for these empirical findings, but, until such time as that happens, science and traditional ideas will both play an equal part in helping patients by the use of acupuncture.