Abstract. Claims for the antiquity of acupuncture are ubiquitous in both the human and veterinary acupuncture and popular literature. These claims are not supported by the historical record. Evidence for therapeutic “needling” (zhen) of any kind dates back at most just over 2100 years, and even this evidence is ambiguous. The earliest clear-cut references to human acupuncture can be reliably dated only to the fifth to eighth centuries C.E. There is no unmistakable evidence for what may be therapeutic “needling” in the Chinese veterinary tradition until around 1000 C.E., and it is not entirely clear what was meant by the term in the early literature. Material describing veterinary “needling” in more detail does eventually appear, but the references are clearly to bleeding, lancing, cauterization, and even surgical intervention, rather than to acupuncture in the modern sense. Contrary to the assumptions of modern acupuncture proponents, the term zhen, as used in the original literature, is not synonymous with acupuncture. Not only is there no evidence of widespread application of fine needle acupuncture in animals prior to the midto late 20th century, but the historical record has apparently been distorted or ignored. Examination of the original texts suggests that animal “needling” is more a Eurasian development than an original Chinese veterinary tradition.
To develop this review, we have employed the earliest available original source material. Modern versions of ancient Chinese medical and veterinary texts have apparently been revised to suit the needs of modern practitioners and political regimes.
THE EARLIEST EVIDENCE FOR THERAPEUTIC NEEDLING
Claims for the “validity” of acupuncture are based, at least in part, on the premise that it is “several thousand years old,” having therefore “withstood the test of time,”1–7 with at least one source claiming acupuncture was practiced in China in 8000 B.C.E.8 Some suggest that “stone and fish-bone needles” discovered at archeological sites in China constitute evidence that acupuncture was employed “during the Stone Age.”1,5,7(p148),9(p485)
In fact, to date no evidence has been discovered even suggesting the practice of acupuncture in China prior to the mid–second century B.C.E., and that evidence is ambiguous. In the 1970s four gold and five silver needles were excavated from the tomb of Han Dynasty Prince Liu Sheng (?–113 B.C.E.) in Hebei Province. Since these artifacts were found in association with other therapeutic instruments, they were presumably employed in therapeutic “needling” of some sort.10 However, the precise nature of this “needling” remains unclear since “needles” were used in ancient China not only for what is now construed as acupuncture, but for many other purposes, principally bloodletting and the lancing of various lesions. (Note that in classical Chinese the term zhen, conventionally translated as “needles” or “needling,” actually encompasses the widest possible range of interventions, from acupuncture to therapeutic phlebotomy, surgery, and various forms of cauterization. The objects in question can be needles, but also lancets, elongated blades, and even metal branding irons.)
EARLY CHINESE MEDICAL LITERATURE
The earliest Chinese medical texts known today, a total of fourteen texts written on silk and wood, were discovered in 1973 at the Mawangdui graves, sealed in 168 B.C.E.11–14 These documents provide a unique and apparently comprehensive picture of Chinese medicine as it existed during the third and early second centuries B.C.E. The Mawangdui documents are the only such comprehensive medical texts to have descended through the ages totally untouched and unmodified by subsequent editors and revisers. The documents describe cauterization (i.e., moxibustion: the burning of mugwort, Artemisia sp., next to the skin), compresses, fumigation, medicinal baths, minor surgery, magical incantations, ritual movements, massage, cupping, steaming, pressure with stones, and some 217 pharmaceutics. However, acupuncture is not mentioned in these texts.
The earliest literary reference to any kind of therapeutic needling (zhen) is found in the Shiji (Records of the Historian) of Sima Qian, written circa 90 B.C.E. No known Chinese source prior to this time refers unequivocally to any such technique.14(p33) Sima Qian mentions “needling” in passing three times, once in the biography of Bian Que and twice in the biography of Chunyu Yi, but offers no indication that “needling” was associated with a system of insertion points or with the fundamental system of conduits (described in later centuries) whose qi flow might be influenced by “needling.”
The Huangdi neijing (The Yellow Emperor’s Inner Classic of Medicine, sometimes incorrectly translated as The Yellow Emperor’s Classic of Internal Medicine) is the earliest work describing in depth the practice and theoretical underpinnings of what clearly is acupuncture in the modern sense (i.e., the manipulation of qi or vapors flowing in vessels or conduits by means of needling). Veterinary sources commonly date this work to between 400 and 200 B.C.E. or earlier.5(p13),7(p148),9(p485),15–19 However, there is no historical reference to a text by this name until the late first century B.C.E., and the book mentioned may or may not have been a version of one of the surviving texts.11(pp4–5),20 Today there are three distinct texts known collectively as the Yellow Emperor’s Inner Canon, and the earliest surviving recensions date to between the fifth and eighth centuries C.E.21
Interestingly, the information presented in the Huangdi neijing is not necessarily even Chinese in origin. The hypothesis has been advanced that Qi Bo, the most important interlocutor of the Yellow Emperor in the Huangdi neijing, may actually be Hippocrates of Cos. The figure Qi Bo has no background in Chinese history or mythology, and this fact, together with the Han-period pronunciation of his name (G’ieg Pak), allows speculation that the fame of the Greek physician reached China two centuries after his death.14(p12)
ANCIENT ELEPHANT ACUPUNCTURE?
Several veterinary sources claim or imply that acupuncture was practiced on elephants in India and/or Sri Lanka as early as 5000 B.C.E.3(p1),4(pv),7(p148),9(pp485–486) These claims appear to stem from a 1979 paper wherein the author claims that “a treatise on veterinary acupuncture (dealing with Indian Elephants), estimated to have been written some 3,000 years ago, has recently been discovered in Sri Lanka (Ceylon).”22
Indian and Sri Lankan mahouts (elephant keepers) have, since antiquity, controlled elephants by means of touching traditional points called nila, which are distributed over the elephant’s body. Nila provide a nonverbal means for communicating commands. There is nothing in any literature to suggest they have ever been associated with acupuncture or any other therapeutic modality.
Even the statement that an extant Sri Lankan treatise on elephants is 3000 (to 7000) years old is unsupportable. The art of writing in Sri Lanka can be traced back to approximately the third century B.C.E., and the date of authorship of known Sri Lankan literary works cannot be assigned to a period before the fourth century C.E. (Prof. R. A. L. H. Gunawardana [firstname.lastname@example.org], e-mail, June 25, 1999). The earliest Indian treatise on elephants (Gaja Sastra/Gajayurveda Samhita) by the sage Palkapya dates to between 300 B.C.E. and 300 C.E. It does not mention acupunctur (Jayantha Jayewardene, Biodiversity and Elephant Conservation Trust [email@example.com], e-mail, June 18, 1999).
BO LE (OR BAI-LE) AND VETERINARY ACUPUNCTURE
According to some veterinary sources, “one of the first veterinary textbooks, Bai-le’s Canon of Veterinary Medicine,” was “written around 650 B.C. [sic], [and] was based primarily on acupuncture.”2,3(p8),8(p426),23 This statement conflicts with known historical fact.
Bo Le, also known as Sun Yang, is described in a fanciful work of stories from the second century B.C.E. (Huainan zi [The Philosopher Huainan]) as a historical figure who lived in the seventh century B.C.E. Bo Le is also mentioned in another early philosophical text, the Zhuang zi (The Works of Philosopher Zhuang), attributed to a fourth-century-B.C.E. philosopher but dating, in its present form, from perhaps 700 years later. Bo Le is said to have been knowledgeable in the “cure of horses,” but no text known to have been written by him is known to exist, and those texts associated with his name first appear in the historical record more than a thousand years after his death. A now-lost work, the Bo Le zhima zabing jing (Bo Le’s Canon on Treating the Various Illnesses of Horses), is one of several veterinary medical texts listed in the bibliographic section of the Suishu, The Official History of the Sui Dynasty (581–618 C.E.). Although this is the oldest known title referring to a Bo Le as author, the title provides few hints as to the therapeutic methods emphasized.
Bibliographical sections such as that of the Suishu were often included in the early dynastic histories, but their interpretation is extremely difficult when the listed books have been lost, as is most often the case. In fact, such entries are sometimes highly misleading. Even when works bearing the same name exist it is often difficult to link them to the early bibliographical entries without detailed information regarding the history of their transmission. This is, in large part, due to the propensity of the ancient Chinese to supply missing texts through either fanciful reconstruction or outright forgery. Therefore, entries in such bibliographies must be viewed with great circumspection.
In any case, the Bo Le zhima zabing jing of Sui times (578–618 C.E.) certainly had nothing to do with the historical figure of Bo Le. As was quite often the case in China, rather than revealing their own names, authors would publish their books under the name of famous historical or even legendary figures living centuries if not millennia earlier. Certainly nothing in the title Bo Le zhima zabing jing in any way links the book to acupuncture.
It is not until almost half a millennium later that any clear association is made between Bo Le and “needling”(the latter often being misconstrued by modern advocates as equivalent to verum acupuncture). The Simu Anji Ji (Collection of Herdman’s Ways for Pacifying Horses), an early veterinary text that dates only to 1385 in its present form but which may include earlier material, is the first to cite a text entitled Bo Le zhen jing (Bo Le’s Canon of “Needling”).24 The essential question becomes: What was meant by zhen, “needling,” when the Bo Le zhen jing was written? Judging from the use of the term in the Simu Anji Ji (where Bo Le’s “needling” is clearly cauterization or phlebotomy) and in other early veterinary texts such as the 1608 Yuan Heng liaoma ji (Treatise on Treating Horses of Yuan and Heng), discussed below, it had little or nothing to do with acupuncture. Therefore, there is no reason to associate the Bo Le zhen jing with acupuncture.
EQUINE ARROWHEAD ACUPUNCTURE?
One veterinary author points out that “a sculpture from Tang Dynasty (580–900CE) Emperor Taizong’s tomb is widely purported to be the first illustrated use of acupuncture in horses.”5(p581) Another states that “a rock carving from the Han dynasty [sic] (about 200 B.C. [sic]) shows soldiers using arrows to perform acupuncture on their horses to stimulate them before battle,”7(p149),9(p486) and the claim has been repeated by others.2,7(p169) Two examples of the rock carvings in question are on display in the Chinese Rotunda at the University of Pennsylvania’s Museum of Archaeology and Anthropology. The following description is available there and on the museum’s Web site:
The two bas reliefs of horses [from the Tang dynasty] (circa 618–906 A.D. [sic]) on the rotunda’s west wall were two of six reliefs commissioned by Emperor T’ai-tsung [Taizong],* founder of the T’ang [Tang] Dynasty, for his mausoleum. The portraits of the six favorite horses T’aitsung had ridden in his battles to secure the empire’s borders are well known in Chinese history and literature. Each horse is identified by the position of its arrow wound. The pictured relief shows General Ch’iu Hsingkung [Qiu Xinggong], who had given up his own unwounded horse to the Emperor, pulling an arrow from the chest of Autumn Dew, the Emperor’s wounded charger. (Figure 1)25
The relief has nothing whatsoever to do with acupuncture.
ANCIENT ACUPUNCTURE DRAWINGS
Recently published veterinary acupuncture texts contain many reproductions of animal charts from traditional Chinese sources identifying alleged acupuncture points. However, a closer examination of these drawings leads to rather different conclusions. For example, a chart from the famous Ming dynasty (1368–1644) manual of horse medicine, the Yuan Heng liaoma ji, has been claimed to show lateral acupuncture points.5(p14) However, the accompanying text indicates that such points are, in fact, areas where feces accumulate and cause colic (Figure 2).26 A subsequent illustration in the same text even shows an arm inserted rectally in an effort to remove the impaction. Illustrations elsewhere in the text show points associated with cauterization, bleeding, physiognomy assessments, and divination using hair whorls. What is entirely lacking in the text accompanying these drawings of equine “points” is any mention of the other constructs historians generally associate with the practice of acupuncture.
HYEZA AND THE NIHON SHOKI
One veterinary author claims that “Hyeza, a Buddhist monk, was teaching veterinary acupuncture in Japan in 595 C.E.,” but cites no primary sources.3(p9) The story of Hyeza is, indeed, recorded in the Japanese chronicles known as the Nihon Shoki (Annals of Japan), written in the late seventh or early eighth century C.E., and this is the only likely source from which such an account might have been derived (Clark Sorensen [firstname.lastname@example.org], e-mail, June 1, 1999). Acupuncture is not mentioned in the Nihon Shoki.27
THE “NEEDLING” OF ANCIENT VETERINARY TEXTS
Among the other books on veterinary medicine listed in the bibliography of the Suishu is one entitled Majing kongxue tu (Chart of Hollows from the Horse Canon[s]). The word jing means not only a canon of literature but also a blood vessel, and more recently an associated circulation tract. Thus, it is also possible to translate the title Chart of the Hollows of Horse Major Blood Vessels. Accordingly, the “hollows” mentioned could refer to either “needling” or moxibustion points (Nathan Sivin [email@example.com], e-mail, January 1, 1999). Therefore, this text might be interpreted as a very early reference to equine acupuncture.
But there are several problems with this interpretation. The first is that in the overwhelming majority of equine veterinary texts where the phrase majing occurs it simply means “horse canon,” a title that appears in the medical literature in association with various books, including various equine veterinary texts and all of the titles cited by the Suishu. Translating majing as“horse major blood vessels” is thus almost certainly overtranslation.
However, even if one accepts the less likely translation of the title, it requires an even greater assumption to assert that the title refers to acupuncture or even to therapeutic “needling.” Simple cauterization is not acupuncture, nor is what is now known as moxa-cautery (using prepared Artemisia.) The word kongxue, “hollows,” can refer to any of these practices. Thus, asserting that this text refers to equine acupuncture requires both a forced translation of the title and an assumption about the meaning of the term “hollows” not justified in view of the known usage of the period.
THE GRAND CHINESE TRADITION OF VETERINARY MEDICINE
In view of the uncertain nature of references to veterinary acupuncture in the early historical sources, the essential question becomes: When did the tradition of veterinary acupuncture begin in China? To the best of the authors’ knowledge, it never did. Veterinary acupuncture, as now practiced, is not a traditional Chinese practice but a modern invention. Indeed, what is purported to be acupuncture in earlier sources clearly is neither acupuncture nor, for the most part, even Chinese.
The key to determining when “needling” becomes acupuncture is its theoretical basis. According to historians, for therapeutic “needling” (zhen) to be acupuncture, it must be associated with theories involving qi and with the mai, or “vessels,” containing qi11(p5),14(pp92–99). Using a needle to lance blood vessels or abscesses is not acupuncture, nor is “needle” cauterization, even though such cauterization may have been ancestral to human acupuncture in China.11(p5)
With that thought in mind, it is instructive to examine directly a few of the classic veterinary manuals of China. Contrary to the general perception, most of these works are late. Bits of information in earlier works do survive: for example, the veterinary chapters in the fifth-century Qimin yaoshu. However, in this source, there is nothing resembling acupuncture and very little on what may be moxa-cautery. So far as the authors of this paper have been able to determine, the first veterinary therapeutic tradition involving “needling” of any sort appears to begin largely in Song times, perhaps around 1000 C.E. or, more likely, somewhat after. Among Song sources calling for the “needling” of animals is the Fanmu zuan yanfang (Compendium of Efficacious Recipes from the Nomadic Tradition), compiled by Wang Yu in either the late 11th or early 12th century C.E. (although the surviving version is from the late 13th or early 14th century) and dealing with camel medicine.28 But however one reads this work, the “needling” described therein is very much a minor tradition and, like the “needling” of the more detailed manuals of the 17th and 18th centuries, is clearly not associated with the kind of theoretical underpinnings necessary to call it acupuncture.
In equine veterinary medicine, the key works date from the 17th and 18th centuries. The most important of them is the Yuan Heng liaoma ji, published in 1608 by the brothers Yuan and Heng (we have used it in the 1785 edition of Guo Huaixi).26 While a full synopsis of the contents of the Yuan Heng liaoma ji, or of any other major texts of the period, is beyond the scope of this paper, two facts are relevant. One is the wide application of “needling” in various forms in the text (although always strictly secondary to herbal treatments, primarily in the form of drenches). The other is the clear evidence that this “needling” had little or nothing to do with acupuncture. In fact, the authors of the Yuan Heng liaoma ji seem intent on putting the maximum distance possible between acupuncture and other human medical traditions and those of veterinary medicine. For example, they quote an earlier source (the Simu Anji Ji, mentioned above) to show that the points on a horse used in “fire needling” (a form of cauterization that is, in fact, the most important form of “needling,” in any sense of the word, in the text) are different from the acupuncture points of humans. These differences are attributed to the fact that “[t]he human is the divine element among the myriad things, [but] as for animals, they are things.” The author calls the human points jingle, a term still in use, distinguishing 360, but here refers to those of the animal (used for “fire needling”), in this case the horse, as mingtang, “bright temples,” and counts 159 in all.26(pp107–109)
In the numerous illustrations in the Yuan Heng liaoma ji associated with “needling,” it is significant that, although individual points are often associated with organs, as in human acupuncture, there is no indication whatever of the types of links associating a connected series of points (e.g., conduits or conduit vessels). That is to say, the points are individual and the theoretical system developed in human acupuncture is entirely lacking. Also apparently lacking is simple “needling” using very fine “needles” of the type found in human acupuncture, except in a very few surgical interventions, such as cataract removal.29(p116) Instead, what is primarily found is bleeding (therapeutic phlebotomy), or lancing abscesses and other lesions, using “needles” that are often clearly wide-bladed, and even barbed lancets, the latter type being employed to clamp skin back during surgery. Cauterization is the second most common intervention and is effected using not only hot “needles,” but even large cauterizing branding irons familiar to contemporary European veterinarians, some apparently with Arab-style multiple plates (also called, interestingly, “needles”).29(pp44–45,227) A large number of clearly surgical interventions are described in the text; these, too, are described as “needling.”29(pp44–45,116)
The Yuan Heng liaoma ji and similar texts thus describe “needling” (bleeding, lancing, etc.) traditions that have little or nothing in common with acupuncture as practiced in human Chinese medicine or in modern veterinary medicine. The genuine nature of the “needling” traditions of the Yuan Heng liaoma ji becomes clear when it is viewed in a wider Eurasian context. While China certainly has its own traditions of veterinary medicine, much of what is found in the Yuan Heng liaoma ji is not Chinese at all. The tradition of Tibetan veterinary medicine, for example, closely parallels that of China of late Ming (1368–1644) times. It not only includes many of the same treatment methods (cauterization, “fire needling,” bleeding, applied in an almost identical manner) but, more importantly, is based primarily upon Indian and more distantly Arabic and even Greek theory, and is much older than its Chinese counterpart.29 If any tradition is derivative in these areas, it is that of China.
Based upon careful examination of the existing major texts, it is quite clear that the great tradition of Chinese equine veterinary manuals and the associated “fire needling” and the like first gained prominence just after the Mongol era (1279–1368), when Western influence in China was at a maximum. One example of this Western influence is the highly developed Chinese variant of Islamic medicine manifested in the Huihui yaofang (Muslim Medicinal Recipes), fragments of which survive in a Ming copy. This work includes, among other things, an extensive discussion of Arabic-style cauterization and even uses Persian terminology. Accordingly, the “fire needling” and bleeding of the Yuan Heng liaoma ji may be seen as more or less unvarnished Western traditions that have been given little more than a veneer of Chinese respectability by the brothers Yuan and Heng, their immediate predecessors, and later authors (who may have referred to the practices as “needling” in order to associate them more strongly with the Chinese tradition). The traditions involved are, in any case, quite late and certainly do not substantiate any ancient tradition of veterinary “acupuncture” in China.
Historian of medicine D. C. Epler, Jr, has observed:
The technique [acupuncture] is said to be over 2,000 years old and contemporary authors continue to cite ancient ever, when these ancient texts are approached as historical texts when describing its theoretical foundations.30 However, when these ancient texts are approached as historical documents, rather than as source books that can be continually reinterpreted for medical practitioners, then they indicate vast differences between the early use of needles and the present form of acupuncture. What is now known as acupuncture is thus the result of a long development and bears little resemblance to its ancestral version.13(p338)
Claims for the extreme antiquity of human and veterinary acupuncture are widely reported in the veterinary acupuncture literature, but are not supported by the historical record. The evidence for therapeutic “needling” dates back just over 2100 years (to the Shiji and the Liu Sheng tomb needles, which may or may not be acupuncture needles, per se). Acupuncture was either unknown or at the very least not widely employed in human medicine in China prior to the mid–second century B.C.E. There is likewise no unmistakable evidence for what may be therapeutic “needling” in the Chinese veterinary tradition until Song times (960–1278 C.E.), and it is not possible to be entirely sure what was meant by “needling” in the early literature. Eventually, material describing veterinary “needling” in more detail does appear, but the references are clearly to bleeding, lancing, cauterization, and even surgical intervention, rather than to acupuncture as such. References to what is clearly “fine needle” animal acupuncture do not appear in the Chinese veterinary literature until the mid–20th century. When the original texts are examined in detail, the entire practice appears more a Eurasian construct than any Chinese tradition of veterinary acupuncture.
* Pinyin forms are bracketed.
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The authors would like to acknowledge the invaluable assistance and constructive criticism offered by: Paul Unschuld, Nathan Sivin, Elisabeth Hsu, Volker Scheid, Don Harper, Keiji Yamada, Christopher Cullen, Robert Dunlop, A. L. H. Gunawardana, Jayantha Jayewardene, Clark Sorenson, Herbert Franke, Andrea von den Dreisch, and Eugene N. Anderson. However, these individuals are in no way responsible for any errors in this paper.