Bian Que and Cang Gong: Two pioneers of acupuncture practice in China
Who was the first to prick the body with a solid needle on purpose of treatment? This question seems unanswerable. The Historical Records (Shi Ji) (c. 104-91 BC) consists of the biographies of China's two earliest medical practitioners, Bian Que and Cang Gong1. Both of them have relation to acupuncture practice and may be considered as the pioneers of acupuncture practice.
Bian Que's given name was Qin Yueren. It is known that he lived from 407-310 BC, during the late Warring States Period (475-221 BC), and was a contemporary of Hippocrates (c. 460-377 BC), the father of Western medicine. Qin Yueren traveled widely throughout the feudal states that compromised China during his time, treating men and women, elders and youths. As a result, he was given the auspicious nickname Bian Que, which means Wayfaring Magpie – a bird that flies here and there dispensing good fortune. Several carved stones, unearthed from a tomb dating back to the Eastern Han Dynasty (25-220 AD), portray him with a human head and a bird's body2.
Figure Bian Que practicing acupuncture
Bian Que's life was surrounded by an aura of mystery that makes it difficult to separate fact from legend. It is said that an old man gave Bian Que a number of esoteric medical texts and an herbal prescription, and then disappeared. Bian Que took the medicine according to the mysterious visitor's instructions. Thirty days later, he could see through walls. Thereafter, whenever he diagnosed disease, he could clearly see the internal zangfu organs of his patients' bodies. The Historical Records states that on one occasion, while passing through the State of Guo (present-day Shan County in Henan Province), Bian Que learned that the Prince of Guo had died and his subjects were preparing to inter him. After careful examination, Bian Que believed that the prince had merely experienced a type of deep coma known as deathlike reversal. He successfully resuscitated the patient by needling an acupoint on the vertex of his head, and become known for bringing the dead back to life. This was the first recorded use of acupuncture in China.
More solid evidence connects the birth of acupuncture with the famous ancient physician Chunyu Yi (c. 215-140 BC), popularly known as Cang Gong. Cang Gong's life and work are described in detail in the Historical Records. The Historical Records state that in 180 BC, Cang Gong's teacher gave him a number of precious medical texts that had escaped the book-burnings of the last days of the Great Qin Empire (221-207 BC). At that time, adherents of all opposing schools of thought were executed or exiled, and almost all books not conforming to the rigid Legalist doctrines that dominated the Qin Dynasty were burned. Although medical texts escaped the disaster, their owners still feared persecution. The banned books that Cang Gong received might have included a number whose titles appear in the Ancient Medical Relics of Mawangdui, such as the Classic of Moxibustion with Eleven Yin-Yang Meridians, Classic of Moxibustion with Eleven Foot-Arm Meridians, Method of Pulse Examination and Bian Stone, Therapeutic Methods for 52 Diseases, Miscellaneous Forbidden Methods, and The Book of Sex.
Cang Gong's biography in the Historical Records discusses twenty-five of his cases, dating from approximately 186 BC to 154 BC. These cases studies, the earliest in recorded Chinese history, give a clear picture of how disease was treated over 2100 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 from this material that Cang Gong used herbal medicine as his primary treatment, and acupuncture and moxibustion only secondarily. His use of moxibustion adheres strictly to the doctrines recorded in the medial relics from Mawangdui and Zhangjiashan.
In the first case, a man with tooth decay, moxibustion was applied to the Hand Yangming Meridian to relieve pain, followed by gargling with a decoction of Flavescent Sophora to clean the mouth and kill worms. According to both the Classic of Moxibustion with Eleven Foot-Arm Meridians and the Classic of Moxibustion with Eleven Yin-Yang Meridians (which names the Large Intestine Meridian "Teeth Meridian") from the Ancient Medical Relics of Mawangdui, toothache is the foremost disorder of the Hand Yangming Meridian, and moxibustion should be used on the affected meridian to relieve pain. The second case was a woman who suffered from difficult urination with yellow urine, accompanied by swelling and pain in the lower abdomen. Cang Gong diagnosed the condition as a disorder of the Foot Jueyin Meridian, and applied moxibustion on this meridian bilaterally. The pain was relieved immediately following the first treatment. This treatment is identical to that recorded in the Classic of Moxibustion with Eleven Yin-Yang Meridians from Mawangdui.
Although only two of Cang Gong's moxibustion cases are recorded in the Historical Records, it is known that he was expert in its use, and that he wrote a book called Cang Gong's Moxibustion. Unfortunately, this book has been lost.
In comparison with his wide-ranging utilization of herbal medicine and moxibustion, Cang Gong applied needling therapy very sparingly. One case describes a king's mother who complained of hot feet and depression. Cang Gong diagnosed the condition as rejue, heat reversal, caused by overindulgence in alcohol. He therefore needled three areas on the sole of each foot, pressing the treated areas after withdrawal of the needles to avoid bleeding. All symptoms disappeared immediately after treatment. The other case was a man suffering from headache, fever, and restlessness. After taking his pulse, Cang Gong ascertained that the condition was upward reversal of yang qi, which he believed was brought on by the patient going to bed with wet hair. He sprinkled cold water on the patient's head and needled three areas on the bilateral sides of the Foot Yangming Meridian in order to clear heat. The patient had a full recovery after one treatment. Neither of Cang Gong's two recorded acupuncture cases mentions specific acupoints or how the needles were manipulated, indicating that needling therapy at the time was still in its initial stage.
The only two cases in which Cang Gong used acupuncture mention neither specific points nor how the needles were manipulated, indicating that needling therapy at the time was still in its initial stage. However, both cases were cured with only one treatment, indicating the efficacy of acupuncture, and its rapid development was soon to follow.
By the time the Nei Jing was compiled (c. 104-32 BC), approximately one hundred years after the time of Cang Gong, acupuncture had supplanted herbs and moxibustion as the treatment of choice. Only thirteen herbal prescriptions are recorded in the Nei Jjing, compared with hundreds utilizing acupuncture.
Notes and References:
1. Si Maqian (c. 135 BC-?), The Historical Records (Shi Ji) (c. 100 BC), ed. Liu Xinglin, et al. Beijing: China Friendship Publishing Company, 1994, pp. 486-494.
2. Liu Dunyuan. Stone Relief Showing Practice of Acupuncture and Moxibustion from the Eastern Han Dynast. Archaeology, 1972; (6): 47-51
