Acupuncture

The use of acupuncture in medical practice
An abridged version of an article written in the CME Journal 1992
By Dr Peter R Smith MB ChB

Historical perspectives
Acupuncture has a long and interesting history in the East (stretching back over 4000 years) compared with a somewhat fitful one in the West spanning the last 300 years. Tradition has it that acupuncture originated in northern China, with archaeological evidence of its existence going back at least 4000 years.

Speculation regarding the discovery of acupuncture points on the body surface continues to the present day. Theories include the observation of the effect of scars (e.g. battle wounds) which may produce regional pain or conversely relieve a long-standing condition, e.g. headaches. The acupuncture points also show a high concordance with trigger points and it might also have been noted that tender muscular points may appear spontaneously during an illness, only to disappear when the condition clears.

The practice of acupuncture spread to Japan, from where the first clear explanation of acupuncture was brought to the West. In 1683 Willem Ten Rhyne, a Dutch ship’s surgeon, following a tour of duty in Nagasaki, published a treatise which included a description of the use of acupuncture in arthritis. Ten Rhyne coined the word ‘acupuncture’ from acus = a needle and punctura = to puncture.

The presence of approximately 600 North American medical students and doctors in Paris during the first half of the 19th century, including a certain Dr Ringer, led to the therapy being taken to America. Ringer’s most famous pupil, was the doyen of American medicine, Sir William Osler, who, in his monumental work The Principles and Practice of Medicine first published in 1892 (and to this day one of the standard texts for students and practitioners alike), wrote: ‘For lumbago acupuncture is. in acute cases, the most efficient treatment.” Despite several changes in editorship and the introduction of multiple authorship, references concerning the use of acupuncture remained right up to the 16th edition, published in 1947. From that time. however, the references were edited out of ensuing editions, possible victims of the Sinophobia of the age (with its McCarthyism and academic ‘purges’ of liberal thinkers). The succeeding generations of North American doctors ‘forgot’ about acupuncture and so the scene was set for its ‘discovery’ in the 1970s.

Acupuncture was taken to the UK early in the 1800s and in fact, the first issue of The Lancet (5 October 1823) contained a case report of a patient successfully treated with acupuncture. Leeds Infirmary became well known in the mid-19th century for its use of acupuncture in the treatment of chronic rheumatism.