Acupuncture in Traditional Chinese Medicine - An Historical Review

This fundamental historical article, published in 1973 by Ilza Veith, offers a comprehensive analysis of the origins and theoretical foundations of acupuncture in traditional Chinese medicine. The work arose in the context of renewed American interest in acupuncture after the reopening of diplomatic relations with China, when Western visitors were impressed by the use of acupuncture as surgical anesthesia.

The author traces the origins of acupuncture to the Neolithic period, approximately 7,000 years ago, when the first needles were made of stone. The main text that grounds traditional Chinese medicine is the 'Huang Ti Nei Ching Su Wen' (The Yellow Emperor's Classic of Internal Medicine), attributed to the Yellow Emperor (2697-2597 BCE), although it was probably written between the 4th and 3rd centuries BCE.

The philosophical foundations of Chinese medicine are based on three essential concepts: the Tao (the Way), the Yin and Yang forces, and the five elements (water, fire, wood, metal, and earth). According to this cosmogony, the universe created itself through the Tao, which divided the original chaos into the complementary Yin and Yang forces. Human beings, created from the same elements as the universe, must maintain the balance of these forces to preserve health.

Traditional Chinese anatomy was limited due to religious taboos that prevented dissection. The body was described as having nine orifices, five storage organs (Tsang) — liver, heart, spleen, lungs, and kidneys — and six eliminating organs (Fu). The circulatory system included vessels that carried blood and others that conducted air or vital pneuma, later known as meridians.

Diagnosis was based primarily on pulse palpation, considered an extremely sophisticated art. The physician examined six pulses at each wrist, each connected to a specific organ. The technique was so refined that Western physicians who observed the practice reported its almost supernatural precision in diagnosing organic conditions.

Treatment followed five main methods: healing of the spirit (guidance toward the right way of life), nourishment of the body (diet based on the five elements), medicine (substances from the animal, vegetable, and mineral kingdoms), treatment of intestinal disorders (massage and adequate evacuation), and acupuncture with moxibustion.

Acupuncture involves the insertion of needles at specific points of the 365 locations where the meridians emerge on the body surface. Moxibustion uses cones of dried Artemisia vulgaris leaves burned on the skin. Both techniques aim to create openings to relieve the congestion of Ch'i (vital energy) caused by the imbalance of Yin and Yang.

The article also addresses modern attempts to scientifically explain the efficacy of acupuncture. Proposed theories include the correspondence between skin areas and the cerebral cortex (work by Rasmussen and Penfield), the 'gate control' theory of Melzack and Wall, and later developments such as the 'two-gate control' theory. These investigations seek to understand the neurological mechanisms by which stimulation of specific skin points can produce therapeutic effects.

The clinical implications are significant, as the article documents thousands of years of effective therapeutic use of acupuncture. The Chinese tradition has always emphasized preventive medicine, with the famous maxim that sages do not treat those already ill but instruct those still healthy. This holistic approach considers not only physical symptoms but also the emotional and moral state of the patient.

Veith's work is fundamental for contextualizing acupuncture within its original philosophical system, helping to understand why this medical practice persisted for millennia. Although the exact mechanisms are still the subject of scientific investigation, the clinical efficacy documented throughout history suggests that acupuncture offers real benefits, especially in pain relief and the treatment of various chronic conditions.