How Old is Acupuncture?
Challenging the Neolithic Origins Theory
Acupuncture has generally been considered to be an outgrowth of China's Neolithic Age (c. 8000-3500 BC). The currently accepted theory 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. 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, 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 (see “Did acupuncture using metal needles develop from bian stone therapy?”). It is also clear that repeated experience of fortuitous accidental injury was not a primary factor in the development of acupuncture (see “Was acupuncture invented as a result of repeated empirical experience?”). 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.
Prior to the 1970's, the earliest references to acupuncture were found in China's oldest known medical treatise, The Inner Classic oftheYellow Emperor, (The Huang Di Nei Jing, hereafter referred to as the Nei Jing). The Nei Jing consists of two parts: The Plain Questions (Su Wen) and The Spiritual Pivot (Ling Shu), also known as The Classic of Acupuncture (Zhen Jing). Though authorship of the Nei Jing has been attributed to the mythical Yellow Emperor, Huang Di (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 to 32 BC, late in the Western Han dynasty (206 BC-24 AD)1. Due to the comprehensive and highly developed nature of the medical system presented in the Nei Jing, it was assumed that needle therapy has an extremely long history, probably reaching back to primitive times. Furthermore, the original versions of the ancient texts used in the compilation of the Nei Jing were lost, and with them the opportunity to further illuminate the question of when acupuncture actually first appeared.
However, startling new archaeological finds were made in China in the early 1970s, revealing the true state of medicine prior to the Nei Jing. In late 1973, fourteen medical documents, known as the Ancient Medical Relics of Mawangdui, were excavated from Grave No. 3 at Mawangdui, Changsha, Hunan Province. Ten of the documents were hand-copied on silk, and four were written on bamboo slips.The exact age of the Ancient Medical Relics of Mawangdui has not been determined. However, a wooden tablet found in the grave states that the deceased was the son of Prime Minister Li Chang of the state of Changsha, and that he was buried on February 24, 168 BC. The unsystematic and empirical nature of the material contained in the documentsindicates that they were written well before their interment in 168 BC, probably around the middle of the Warring States Period (475-221 BC)2. In any event, it is certain that these medical documents pre-date the Neijing (compiled c. 104-32 BC), making them the oldest known medical documents in existence. These documents were probably lost sometime during the Eastern Han Dynasty (25-220 AD), since no mention of them has been found from this time until their rediscovery in 1973.
Another valuable medical find, The Book of the Meridians (Mai Shu), was excavated from two ancient tombs at Zhangjiashan in Jiangling county, Hubei Province in 1983. These ancient texts, written on bamboo slips and quite well preserved, were probably buried between 187 and 179 BC, around the same time as the Mawangdui relics3.There are five documents in all, three of which (The Classic of Moxibustion with Eleven Yin-Yang Meridians, Methods of Pulse Examination and Bian Stone, and Indications of Death on the Yin-Yang Meridians) are identical to the texts found at Mawangdui.
There is abundant evidence to show that the authors of the Neijing used the earlier medical texts from Mawangdui and Zhangjiashan as primary references, further indicating the antiquity of these relics. For example, Chapter 10 of the Lingshu section of the Neijing contains a discussion of the meridians and their disorders that is very similar, in both form and content, to that found in the Classic of Moxibustion with Eleven Yin-Yang Meridians, one of the documents found at both Mawangdui and Zhangjiashan.
Of course, the Neijing did not simply reproduce these earlier documents, but rather refined and developed them, and introduced new therapeutic methods. The earlier Classic of Moxibustion with Eleven Yin-Yang Meridians is limited to moxibustion, while Chapter 10 of the Lingshu section of the Neijing mentions needling therapy, or acupuncture, for the first time. Although the medical texts preceding the Nejing discuss a wide variety of healing techniques, including herbal medicine, moxibustion, fomentation, medicinal bathing, bian stone therapy, massage, daoyin (physical exercises), xingqi (breathing exercises), zhuyou (incantation), and even surgery, these earlier documents contain no mention of acupuncture.
Ifneedling therapy did indeed originate much earlier than the Neijing (c. 104-32 BC), the medical documents unearthed from Mawangdui and Zhangjiashan, very probably used as primary references by the Neijing's authors, should also contain extensive discussions of acupuncture. However, they do not. This clearly indicates that acupuncture was not yet in use at the time that the Mawangdui and Zhangjiashan documents were compiled. Of course, it is not possible to draw a detailed picture of the state of acupuncture early in the Western Han Dynasty (206 BC-24 AD) based solely on the medical relics from Mawangdui and Zhangjiashan. But the fact that these documents were considered valuable enough to be buried with the deceased indicates that they do reflect general medical practice at the time.
The Historical Records (Shi Ji)4 by Si Maqian, compiled circa 104-91 BC, contains evidence that acupuncture was being used approximately one hundred years before the Nei Jing (c. 104-32 BC).The Historical Records (Shi Ji) (c. 104-91 BC) contains biographies of the two earliest known Chinese medical practitioners, Bian Que and Cang Gong. The Historical Records states that Bian Que successfully resuscitated the prince of the State of Guo using a combination of acupuncture, fomentation, and herbal medicine. This is the first case of acupuncture practice recorded in Chinese documents. However, Bian Que's life was surrounded by an aura of mystery that makes it difficult to separate history from legend. More solid evidence connects Chunyu Yi (c. 215-140 BC), popularly known as Cang Gong, with the birth of acupuncture. Cang Gong's biography in the Historical Records discusses twenty-five of his cases, dating from approximately 186 to 154 BC. These medical cases, the earliest in recorded Chinese history, give a clear picture of how disease was treated over twenty-two hundred years ago. Of the twenty-five cases, ten were diagnosed as incurable and the patients died as predicted. Of the fifteen that were cured, eleven were treated with herbal medicine, two with moxibustion in combination with herbal medicine, one with needling, and one with needling in combination with pouring cold water on the patient's head. It can be seen that Cang Gong used herbal medicine as his primary treatment, and acupuncture and moxibustion secondarily.
A thorough reevaluation of all extant literature, as well as documents and archeological relics unearthed since the 1970s, confirms that acupuncture is not as ancient as has generally been assumed, and that it did not, in fact, appear and gradually develop during China's Neolithic Age (c. 8000-3500 BC). Rather, this great invention arose quite suddenly and rapidly developed approximately two millennia ago. All evidence indicates that acupuncture first appeared during the Warring States Period (475-221 BC), during the time of Bian Que, developed during the early Western Han Dynasty (206 BC-24 AD), during the time of Cang Gong, and had fully matured by the latter part of the Western Han Dynasty, at the time of the compilation of the Nei Jing (c. 104-32 BC).
Notes and References:
1. Hebei Medical College, et al., Collation and Annotation of the Lingshu (Lingshujing Jiaozhu灵枢经校注) (c. 104-32 BC). Beijing: People's Health Press, 1984, Vol. 1, p. 6.
2. Ma Jixing (contemporary), Study and Annotation of the Ancient Medical Relics of Mawangdui (Mawangdui Guyishu Kaoshi). Hunan: Hunan Science and Technology Press, 1992, pp. 8
3. Ibid., pp. 158
4. Si Maqian (c. 135 BC-?), The Historical Records (Shi Ji 史记) (c. 100 BC), ed. Liu Xinglin, et al. Beijing: China Friendship Publishing Company, 1994, pps. 486-494. The Historical Records, compiled by the great historian Si Maqian (c. 135 BC-??), is the first comprehensive Chinese history book. It contains a series of biographies, from the legendary Yellow Emperor Huang Di (c. 2650 BC) to the eighth emperor of the Western Han Dynasty, Wu Di (156-87 BC), and is famous for the completeness and accuracy of its contents.
The copyright of the article How Old ia Acupuncture: Challenging the Neolithic Origins Theory is owned by Bai Xinghua. Permission to republish the article in print or online must be granted by the author in writing.
