Ancient Acupuncture Theories

The understanding of how acupuncture works has evolved with its practice, but the descriptions set down a thousand years ago have largely been retained. The dominant function of acupuncture is to regulate the circulation of qi (vital energy) and blood. Approximately 2,000 years ago, the pre-eminent acupuncture text, Huangdi Neijing (Yellow Emperor’s Classic on Internal Medicine), was written. In it, acupuncture was described as a means of letting out excess qi or blood by making holes in the body along certain pathways, called jingluo (meridians). For some of these meridians, it was advised to acupuncture in such a way as to let out the blood but not the qi; for others, to let out the qi, but not the blood. Many diseases were thought to enter the body through the skin, and then penetrate inward through muscle, internal organs, and, if not cured in timely fashion, to the marrow of the bone. By inserting a needle to the appropriate depth—to correspond with the degree of disease penetration—the disease could be let out.

Prior to the time when there were microscopes by which people could envision individual cells and before autopsies revealed the intricate structures within the body, doctors and scholars projected the internal workings of the body from what they could actually experience, which was the world outside the body. On this basis, the workings of the body were described in terms similar to those used to describe the visible world. One of the critical aspects of nature for humans living a thousand years ago, when Chinese civilization was well developed, was the system of water courses, which included tiny streams, huge rivers, man-made canals and irrigation systems, and the ocean. It was envisioned that the body had a similar system of moving, life-giving fluid. This fluid was the qi, and the pathways through which it flowed were the meridians.

Instead of discussing acupuncture in terms of letting something out of the body, physicians began describing it in terms of regulating something within the body. The flow of qi through the meridians, just like the flow of water through a stream, could be blocked off by an obstruction—a dam across the waterway. In the streams, this might be a fallen tree or a mud slide; in humans, it might be caused by something striking the body, the influence of bad weather, or ingestion of improper foods. When a stream is blocked, it floods above the blockage, and below the blockage it dries up. If one goes to the point of blockage and clears it away, then the stream can resume its natural course. In a like manner, if the qi in the meridian becomes blocked, the condition of the body becomes disordered like the flooding and dryness; if one could remove the blockage from the flow of qi within a meridian, the natural flow could be restored.

In a blocked stream, just cutting a small hole or crevice in the blockage will often clear the entire stream path, because the force of the water that penetrates the hole will widen it continuously until the normal course is restored. In the human body, inserting a small needle into the blocked meridian will have a similar effect. Just as a stream may have certain points more easily accessed (or more easily blocked), the meridians have certain points which, if treated by needling, will have a significant impact on the flow pattern. Many acupuncture points are named for geological structures: mountains, streams, ponds, and oceans.

Although this description of the basic acupuncture concept is somewhat simplified, it conveys the approach that is taught today to students of traditional acupuncture: locate the areas of disturbance, isolate the main blockage points, and clear the blockage. Of course, many layers of sophistication have been added to this model, so that the needling—which might be carried out in several different ways—can be seen to have subtle and differing effects depending upon the site(s) needled, the depth and direction of needling, and even the chemical composition of the needle (such as gold, silver, or steel). For example, some needling techniques are used for the primary purpose of increasing the flow of qi in a meridian without necessarily removing any blockage; other techniques reduce the flow of qi in the meridians. These tonifying and draining methods, as well as transference methods that help move qi from one meridian to another, are part of the more general aim of balancing the flow of qi in the body.

Ultimately, all the descriptions of acupuncture that are based on the traditional model involve rectifying a disturbance in the flow of qi. If the qi circulation is corrected, the body can eliminate most symptoms and eventually—with proper diet, exercise, and other habits—overcome virtually all disease.