Pricking Your Patient into A Scared Dog or A Sleeping Cat: Acupuncture in China and Japan

In TCM acupuncture world, torturing patient by aggressively stabbing and telling patients “no pain no gain” is a clinic golden rule called “de qi”.

The Change of A Patient's Pulse

But the needling therapy in Neijing (NJ) era never required today's patient-torturing “de-qi”. When NJ says “Effective needling depends on the coming of qi”(刺之要,气至而有效) (LS 1 ), the “coming of qi” means “the change of the pulse” of the patients after the needle insertion. Such pulse change was felt only by the physicians but not by the patients.

Furthermore, in NJ era, the “coming of qi” was only needed for the illness that is located on the pass way of a Jing Mai vessel where usually the beating of an artery is visible on the skin surface such as wrists or the dorsal side of feet. For all other ailments not residing on a Jing Mai vessel, “Miu Ci” (non-meridian pricking) was always employed which does not need any pulse palpation to feel “coming of qi” ( SW63).

So, in NJ era, you just let the needles quietly stay and the patient relax after needle insertion (SW 27): 静以久留, 无令邪布, 吸则转针, 以得气为故. That's all, so simple.

The Origin of A Bizarre Idea

But where that bizarre “patient-torturing” idea came from? It was initially introduced by Chinese medicine (CM) physician Dou Hanqing 窦汉卿 (1196—1280) in his essay Biaoyoufuv标幽赋, later further developed in Jinzhenfu 金针赋 (1439) by Xu Feng 徐凤 (1390-1450) and in Zhenjiudacheng 针灸大成 (1601) by Yang Jishou 杨继洲 (1522 – 1620).

Thus, a complicated set of “stabbing techniques” were invented. These techniques requires a physician with his/her fingers to feel how a needle inserted into the body is grabbed or pulled by the patient's cramped muscle, which is a result of aggressively stabbing with a variety of fancy manipulatioin of the needles.

The Fancier The “De Qi”, The Faster The Acupuncture's Decline

The background of the emergence of such “stabbing techniques” was that the poor performance of acupuncture in post-Nejing era had been plaguing Chinese physicians and they tried to find a way through.

However, ironically, the fancier the stabbing techniques became, the less interest aroused in patients. The decline of acupuncture in China thereafter had sped up until 1780s to the point that the eminent physician Xu Dachun (1693–1771) in his essays “On the Origins of Medicine (1775) lamented “the true healing art of acupuncture is lost”.

In 1822, acupuncture was flatly banned from Imperial Medical Institute of Qing Dynasty, officially marking the death of acupuncture in China. Further in 1929, the practice of acupuncture came to the point being outlawed in China, at a time when a healer who uses needles was seen as no different from a fortune teller.

Acupuncture That Does Need De Qi

In terms of the intensity of “de qi”, on the other end of the spectrum there is Japanese acupuncture in which:

1. Patient does not feel anything when needled. Physicians must treat patients as if taking care of a sleeping cat without waking it up;
2. It is the physician who are required to feel “arrival of qi” by palpation of the pulse or the skin textures.

An American veteran acupuncturist, Felice Dunas, PhD, hit the point (2006):

“Chinese needling technique works on the premise of 'no pain, no gain'. In Japan, the opposite is true. If the patient even feels needle insertion, the treatment is less effective. If the patient experiences pain upon the rising of chi, you may as well pack up and go home, because no benefit will come from the work.

“The Chinese practitioner fails if the patient feels nothing; the Japanese practitioner fails if the patient feels anything. Same patient; same syndromes. Go figure.”

Sounds interesting? But why such differences?

Treat You Patient into A Sleeping Cat or A Scared Dog

The Japanese acupuncture is actually, somewhat like Tung's acupuncture, a small piece of live fossil of Neijing acupuncture introduced from China in 600s. Note, this is a time prior to when, in China, Dou Hanqing (1200s), Xu Feng (1400s) and Yang Jizhou (1600s) invented the “stabbing techniques”.

Now a question. As a needle healer, treat your patient as gently as not waking up a sleeping “cat”, or make your patient alert like a scared “dog”, which modality you would prefer in harmonizing the yin & yang, the rhythm of nature, or the interaction between heaven & earth ...?

Reference

Felice Dunas, 2006, Adventures With Captain X, Acupuncture Today.

Huangdi Neijing: LS 1 九针十二原.

Huangdi Neijing: SW 27 离合真邪论.

Huangdi Neijing: SW 63 缪刺论.

Dou Hanqing 窦汉卿, 1220? 针经指南 - 标幽赋.

Xu Feng 徐凤, 1439, 针灸大全 – 金针赋.

Xu Dachun 徐大椿，1775，The Lost Tradition of Acupuncture, On the Origins of Medicine (医学源流论：针灸失传论).

Yang Jishou 杨继洲, 1601, Zhenjiudacheng 针灸大成.