A brief history of acupuncture
Acupuncture is commonly traced to China, where it developed over thousands of years. Sharpened stone and bone tools have sometimes been interpreted as predecessors of acupuncture instruments, although their original uses are not always certain.
As the practice developed, bronze figures were used to illustrate acupuncture points, including examples from the fifteenth century. During the Ming Dynasty (1368–1644), The Great Compendium of Acupuncture and Moxibustion brought together written descriptions of the practice. Acupuncture gradually became an established part of Traditional Chinese Medicine (TCM).
In traditional Chinese acupuncture, practitioners select and apply needles according to an individual TCM assessment. This tradition describes health through concepts of energy and balance, including the complementary principles of yin and yang, historically described as negative and positive forces. Within this traditional framework, treatment aims to restore balance in the body.
European interest in acupuncture grew during the second half of the seventeenth century. A physician working for the Dutch East India Company encountered Japanese and Chinese practitioners and encouraged further investigation in Europe. His 1683 work, De Acupunctura, provided an early detailed account for European readers. The name “acupuncture” combines Latin words referring to a needle, acus, and puncturing or piercing, pungere.
Western Medical Acupuncture (WMA) developed from Chinese acupuncture but interprets needling through anatomy, physiology and contemporary medical reasoning. Practitioners may use points also described in traditional meridian systems, while basing their assessment on Western medicine rather than TCM diagnostic concepts.
Research into this approach examines nervous-system responses, including those involving the brain and spinal cord. Proposed explanations for pain modulation include the involvement of neurochemicals such as endorphins and serotonin. Preliminary research has also investigated melatonin and sleep. These are areas of investigation rather than guaranteed effects of a treatment on pain, sleep or well-being.
International attention increased during the twentieth century. In 1979, the World Health Organization (WHO) devoted an issue of its magazine World Health to acupuncture. In Sweden, the National Board of Health and Welfare issued regulations in 1984 accepting acupuncture within healthcare and dentistry, subject to professional requirements.
The World Federation of Acupuncture-Moxibustion Societies (WFAS) was established in 1987. Earlier figures for 2010, reported in HEGU’s Swedish history text, described acupuncture practice in 178 of the 192 United Nations Member States at that time, approximately 93%, with acupuncture organisations in 59 of those countries. A WFAS survey reported in 2013 subsequently recorded acupuncture use in 183 of 202 surveyed countries and reported acupuncture societies in 59 countries and regions. These figures describe historical reports of international spread.
The history of acupuncture needles
Needle-like instruments have a long place in the history of medicine. Their development is often discussed alongside early tools for tattooing, bloodletting, piercing and draining abscesses. Similarities between these tools suggest that some early instruments may have served more than one purpose.
Ötzi the Iceman, who lived more than 5,000 years ago, is one example discussed in this context. Early investigations documented groups of tattoos on his preserved body; the later complete inventory identified 61 individual tattoos. Some locations have been compared with acupuncture points associated with lower-back and abdominal complaints. Charcoal pigment has been identified in the tattoos.
The position of Ötzi’s markings has prompted suggestions that they had a therapeutic purpose, but their meaning remains uncertain. Tattoos on other ancient mummified bodies have also been interpreted in different ways, including as signs of status or possible traces of treatment involving substances introduced into the skin. These interpretations do not establish that the procedures were acupuncture as it is understood today.
Historical accounts describe early instruments made from stone, animal bone and bamboo. Stone and bone tools are associated with the Neolithic period, although identifying their precise function is difficult. Later instruments were made from metals including copper, bronze, gold, silver and iron.
Older needles were often thicker than the fine needles used today. Modern acupuncture needles are commonly manufactured from stainless steel and are available in different lengths and diameters. The material provides flexibility and resistance to corrosion. Handles may be made from copper or steel, or from plastic with colour coding to distinguish needle sizes.
Many modern acupuncture needles have diameters between 0.12 mm and 0.40 mm. Chinese-style techniques are often associated with thicker needles, while Japanese-style techniques commonly favour finer needles, although preferences vary between practitioners and treatments.
Ancient Chinese texts describe nine types of acupuncture instruments. The importance of the number nine in traditional Chinese symbolism has been suggested as one possible explanation for this classification.