Acupuncture and Moxibustion: A Brief Introduction

A Brief Introduction
Acupuncture Icon 01 ✵The theories of acupuncture and moxibustion are primarily composed of the theory of acupuncture, the theory of the meridian system, acupoints (including meridian points and extra points), moxibustion, and other techniques derived from acupuncture.

Introduction to Acupuncture and Moxibustion

 Acupuncture Icon 02 Acupuncture and moxibustion is a discipline grounded in Traditional Chinese Medicine (TCM) theory. It studies meridians, acupoints, and acupuncture-moxibustion methods, and explores the application of these modalities in the prevention and treatment of diseases. Acupuncture and moxibustion constitute an essential component of TCM, encompassing meridians, acupoints, acupuncture and moxibustion techniques, clinical treatment, medical records, experimental acupuncture and moxibustion, and more. This modality offers advantages such as broad indications, marked therapeutic efficacy, operational convenience, cost-effectiveness, and safety.

 Acupuncture has a long history. It is believed that acupuncture and moxibustion therapy originated during the Neolithic Age. Ancient texts preserve several legends concerning its origin, all pointing to this era. As recorded in the ancient physician Huangfu Mi’s work Di Wang Shi Ji (Chronicle of Emperors and Kings): "Taihao Fuxi tasted one hundred herbs and fashioned nine needles." In his Zhenjiu Jiayi Jing · Xu (The ABC Classic of Acupuncture and Moxibustion · Preface), he further noted: "The Yellow Emperor consulted Qibo, Bogao, Shaoyu… Thus, the methods of acupuncture came into being."

Formation of the Acupuncture Theoretical System


 From the Warring States period through the Qin and Han dynasties, the ancient text Huangdi Neijing (The Yellow Emperor’s Inner Canon) marked a milestone in the development of acupuncture theory. Physicians had not only established the collateral and meridian theory as the core of their theoretical framework but also effectively applied acupuncture and moxibustion for disease prevention and treatment—integrating theory with practice, refining theory through clinical experience, and thereby initially establishing a distinctive acupuncture theoretical system comprising foundational theory, methodology, prescriptions, and acupoint selection.

 From the Spring and Autumn and Warring States periods to the Qin and Han dynasties, the influence of ancient philosophy facilitated the evolution of acupuncture and moxibustion from empirical practice to systematic theory. Acupuncture instruments evolved from stone, bone, and bamboo needles to metal needles, thereby expanding the scope of clinical application. According to the historical text Zuo Zhuan (The Spring and Autumn Annals), physicians during the Spring and Autumn and Warring States periods were skilled in acupuncture and moxibustion. Bian Que, a renowned pre-Qin physician, successfully revived a prince who had fallen into a death-like syncope (cadaverous coma): he instructed his disciple Ziyang to puncture the Wai San Yang Wu Hui points[1], enabling the prince to regain consciousness; then directed his disciple Zibao to apply moxibustion to the flanks, after which the prince sat up. This case demonstrates that acupuncture, moxibustion, and medicinal heat therapy (ironing) were already widely employed in treating various diseases during the pre-Qin period. Among the medical manuscripts unearthed in 1973 from Tomb No. 3 at Mawangdui, Changsha (Han Dynasty), two early works on meridians were discovered. These texts describe the circulation of eleven meridians, associated diseases, and moxibustion treatments. Based on naming conventions involving "foot and arm" and "Yin and Yang," they are titled Zu Bi Shiyi Mai Jiu Jing (The Eleven Vessels of Foot and Arm Moxibustion Classic) and Yin Yang Shiyi Mai Jiu Jing (The Eleven Yin-Yang Meridians Moxibustion Classic). These two texts represent the earliest extant formulations of the core meridian theory underlying acupuncture and moxibustion.

 Acupuncture Icon 03 The ancient text NeijJing (The Inner Canon) provides a thorough discussion of meridian theory. It not only clearly documents the courses of the twelve regular meridians and their associated collaterals—linking them to the zang-fu organs and listing their principal diseases—but also records the distribution, functions, and flow directions of the eight extraordinary meridians, the internal branches of the twelve channels, the fifteen connecting collaterals, the sinew channels (musculature) of the twelve meridians, and the cutaneous regions of the twelve channels. Furthermore, it details the "roots and knots" (gen-jie), etiology and symptoms of disease, the pathways of Qi, and the "four seas."

 Neijing also contains numerous treatises on acupoint theory, documenting approximately 160 commonly used acupoints and offering detailed expositions—especially a comprehensive discussion—of the Five-Shu (Transport) points.

 Regarding needling techniques, Neijing elaborates extensively on methods of reinforcement (tonification) and reduction (sedation), including: puncturing along or against the direction of meridian flow; slow versus rapid insertion and withdrawal; synchronizing needle manipulation with the patient’s respiration; and the opening-closing method—reinforcing by pressing the puncture site after needle withdrawal, and reducing by enlarging the puncture aperture during withdrawal.

 In terms of treatment principles, Neijing articulates foundational concepts such as "excess conditions require purgation; deficiency conditions require tonification." It also proposes specific strategies for acupoint selection and combination, including the use of converging points (hui points) and front-mu points, as well as distal point selection. Over 100 diseases are recorded in Neijing, most of which are indicated for treatment by acupuncture and moxibustion.

 The classical medical text Nanjing (The Classic of Difficult Issues) is considered a work of equal stature to Neijing. Though traditionally attributed to Bian Que, its authorship remains uncertain. Its content is concise yet profound, further enriching the theoretical framework of acupuncture and moxibustion. Notably, its discussions on the eight extraordinary meridians and primordial Qi (yuan-qi) supplement gaps left by Neijing. It also introduces the Eight Influential Points (Ba Hui Points, or the Eight Strategic Nerve Points) and elaborates on the Five-Shu points through the lens of the Five Phases (Wu Xing, or the Five Elements) theory.

 Zhang Zhongjing’s Shanghan Zabing Lun (The Treatise On Cold-Induced and Miscellaneous Diseases) not only presents outstanding herbal prescriptions but also offers distinctive insights and contributions to acupuncture. The text includes 69 passages directly addressing acupuncture and moxibustion, advocating integrated treatment combining herbal medicine and acupuncture, and emphasizing syndrome differentiation–based therapy.

 The lost work Mingtang Kongxue Zhenjiu Zhiyao (Essentials of Acupuncture and Moxibustion from the Mingtang Cavity Points), also known as Huangdi Mingtang Jing (The Yellow Emperor’s Mingtang Classic), was likely the first monograph dedicated exclusively to acupoints during this period.

 Hua Tuo—renowned for his surgical expertise—was also highly skilled in acupuncture and moxibustion. He established the famous "Huatuojiaji" points and authored Zhenzhong Jiu Ci Jing (The Acupuncture and Moxibustion Classic from the Pillow), now lost.

 Cao Xi, a physician active during the Three Kingdoms period, excelled in moxibustion. His Cao Shi Jiu Jing (Cao’s Moxibustion Classic) is likewise lost.

Development of the Acupuncture Theoretical System


 From the Wei and Jin dynasties through the Southern and Northern Dynasties, the Sui and Tang dynasties, and into the Five Dynasties—a span of over 700 years—the political, economic, and cultural advancements of this era fostered significant progress in acupuncture and moxibustion theory and technique. Numerous influential medical texts emerged, substantially advancing the systematic development of acupuncture theory.

 Portrait of Huangfu Mi During the Ganlu era of the Wei-Jin period (256–260 CE), the pharmacologist Huangfu Mi compiled the acupuncture and moxibustion content from three foundational works—Su Wen (The Plain Question), Lingshu (The Spiritual Pivot) and Mingtang Kongxue Zhenjiu Zhiyao—selecting essential theories and key acupoints to compile the Zhenjiu Jiayi Jing (A-B Classic of Acupuncture and Moxibustion). Comprising 12 volumes and 128 chapters, the text documents a total of 349 acupoints. Its organization follows a logical sequence: zang-fu organ systems, qi and blood, meridians and acupoints, pulse diagnosis, needling and moxibustion techniques, and clinical disease categories. As one of the earliest systematically structured acupuncture texts, it represents a major synthesis following Neijing and played a pivotal role in consolidating and transmitting the tradition. Ge Hong, a famous physician of the Jin Dynasty, wrote Zhou Hou Bei Ji Fang (Prescriptions for Emergent Use, or Handbook of Prescriptions for Emergencies), which recorded 109 acupuncture prescriptions, 99 of which were moxibustion prescriptions—thus further advancing moxibustion. His wife, Bao Gu, was also skilled in moxibustion. The Xu Xi family, spanning the late Jin Dynasty to the Northern and Southern Dynasties, practiced medicine for generations. Xu Qiufu, Xu Wenbo, and Xu Shuxiang were all prominent figures in the history of acupuncture.

 From the Sui to the early Tang Dynasty, renowned physicians Zhen Quan and Sun Simiao were both proficient in various branches of traditional Chinese medicine. Zhen Quan authored works including Zhen Fang (Acupuncture Prescriptions), Zhen Jing Chao (Compendium of Acupuncture Classics), and Ming Tang Ren Xing Tu (Anthropomorphic Charts of the Mingtang). Sun Simiao compiled Bei Ji Qian Jin Yao Fang (The Invaluable Prescriptions for Emergencies), Qian Jin Yi Fang (The Supplement to the Invaluable Prescriptions); he was the first to record the ashi point (ashi acupuncture point, living acupoint), introduced finger-length measurement, extensively collected acupuncture clinical experience from earlier generations, and drew the Ming Tang San Ren Tu (The Three Anthropomorphic Charts of the Mingtang)—in which the twelve regular meridians are depicted in five colors and the eight extraordinary meridians in green, totaling 650 acupoints across the three charts. This represents the earliest known color-coded meridian illustration in history.

 In addition, Yang Shangshan of the Tang Dynasty, based on Huang Di Ming Tang Jing (The Mingtang Classic of the Yellow Emperor), compiled Huang Di Nei Jing Ming Tang Lei Cheng (Categorized Compilation of the Mingtang Section of the Yellow Emperor’s Inner Canon), listing acupoints in the order of the twelve regular meridians and the eight extraordinary meridians.

 Physician Wang Tao compiled Wai Tai Mi Yao (Medical Secrets of an Official), which records numerous moxibustion methods from various schools. During this period, specialized monographs on specific diseases also appeared. For example, Gu Zheng Bing Zhi Fang (Moxibustion Prescriptions for Bone-Steaming Disease) by Cui Zhiti of the Tang Dynasty introduced acupuncture and moxibustion treatments for consumption. The book Xin Ji Bei Ji Jiu Jing (Newly Compiled Acupuncture Classics for Emergencies), published before 862 CE, is the earliest extant medical text printed using woodblock printing and focuses on moxibustion treatment for urgent conditions.

 The Imperial Medical Academy of the Tang Dynasty administered medical education, offering four medical specialties and one pharmaceutical specialty; acupuncture was one branch within the medical specialties. Its staffing included “one acupuncture professor, one acupuncture assistant professor, ten acupuncture physicians, twenty acupuncture practitioners, and twenty acupuncture disciples”—thus establishing formal school-based education in acupuncture and moxibustion.[I]

 Portrait of Wang Weiyi During the Song, Jin, and Yuan Dynasties, the extensive application of printing technology promoted the accumulation of medical literature and accelerated the spread and development of acupuncture and moxibustion. With the support of the Northern Song government, Wang Weiyi, a famous acupuncturist, re-examined and clarified the positions and its meridians of 354 acupoints, supplemented the main therapeutic indications of acupoints, and wrote the book Tong Ren Shu Xue Zhen Jiu Tu Jing(the Illustrated Manual of Acupoints on the Bronze Figure) in the year 1026 A.D., the engraved edition was promulgated by the government the second year. In the year 1027 A.D., Wang Weiyi designed two bronze models of human beings with internal viscera and meridians inscribed on them for teaching and testing purposes. Wang Zhizhong, an acupuncturist in the Southern Song Dynasty, wrote the book Zhen Jiu Zi Sheng Jing(the Classic of Nourishing life with Acupuncture and Moxibustion), which emphasized practical experience and exerted great influence on later generations.

 Portrait of Hua Shou In the Yuan Dynasty, the famous medical scientist, Hua Shou, studied the circulation of meridians and collaterals, and their relationship with the acupoints, based on his study of the book Jin Lan Xun Jing Qu Xue Tu Jie(the Golden Orchid Illustrations of Selecting Acupoint along Channel), compiled the book Shi Si Jing Fa Hui(the Elaboration of the Fourteen Meridian), for the first time named the Ren channel, the Du channel, and the twelve meridians together as the fourteen meridians, which further developed the theory of meridians and acupoints. During this period, there were many famous herbalists and physicians who were good at acupuncture, and many books were written. Books such as Bei Ji Jiu Fa(Moxibustion for Urgent Treatment), Yong Ju Shen Mi Jiu Jing(Moxibustion Classics for Mysterious ulcer), Gao Huang Shu Xue Jiu Fa(Moxibustion and Acupoint of the inter cardiodia-phragmatic part), marked the further development of acupuncture in various branches. In the early period of the Southern Song Dynasty, physician Xi Hong and his family devoted to acupuncture for generations. The book Xi Hong Fu(the Poems of Xi Hong) handed down from generation to generation, paid special attention to acupuncture. At the same time, physician Dou Cai wrote the book Bian Que Xin Shu(the Heart Book of Bian Que), and highly recommended the method of burning moxibustion, dozens of strong even hundreds of strong moxibustion each time. At that time, Yang Jie and Zhang Ji personally observed the autopsy and advocated using anatomical knowledge to guide acupuncture point selection. In the Jin Dynasty, physician He Ruoyu and Yan Mingguang, who wrote the book Zi Wu Liu Zhu Zhen Jing(the midnight-noon ebb-flow acupuncture classics), advocated the principle of acupoint selection on time. Dou Hanqing, a famous physician in the Jin and Yuan dynasties, advocated not only the midnight-noon ebb-flow, but also eight-methods ebb-flow, and the principle of acupoint selection on time, the works compiled by him named Biao You Fu(the poems of marking the hidden) was one of the most famous acupuncture songs.

Introduction of the Moxibustion.


 Moxibustion is a kind of thermotherapy, which is closely related to fire. Moxibustion sprouts with the application of fire and develop continuously in its application practice. When the ancient people were heating by burning fire, they occasionally got rid of some diseases due to being accidentally burned by fire, and thus got the revelation that burning can cure diseases, which is the origin of moxibustion. The word "灸(moxibustion)" is interpreted as "灼(burning)" in ancient works Shuo Wen Jie Zi, which means burning body for treatment. At the earliest, branches and firewood could be used for burning, ironing, burning, and scalding to eliminate the disease. Later, Artemisia leaf(moxa) was gradually selected as the main moxibustion material. Ai, or Artemisia vulgaris grows everywhere since ancient times in China, because of its scent, nature warm and flammable, moderate fire when burning, then replace the branches, and became the best material for moxibustion. According to ancient works Zuo Zhuan(Tso Chuan: a commentary on the Spring and Autumn Annals), in the tenth year of Duke Cheng of Lu (581 B.C.), Duke Jing of the Jin Kingdom fell ill. The Tai Yi(Imperial Physician) Yi Yan of Qin came to treat him. He said, "The disease could not be treated. It locates above the Huang(the region between heart and diaphragm) and below the Gao(the intracardial space), could not use moxibustion, could not use acupuncture." In the Han Dynasty, Zhang Zhongjing's works Shang Han Za Bing Lun also had treatises with records of "can use fire" and "can not use fire", and the fire he said also refers to moxibustion.

 The word "灸(moxibustion)" was first mentioned in the extant works in Zhuangzi·Dao Zhi(Chuang Tzu·Robber Zhi). For example, Confucius persuaded Liu Xiazhi that "Qiu has no disease and moxibustion himself". The ancient works Meng Zi·Li Lou(Meng Tzu·Li Lou) also recorded: "now people want to be the king, similar to seven years of disease, seek for three years of moxa", apparently also refers to moxibustion. It can be inferred that moxibustion was quite popular in the Spring and Autumn Period and the Warring States Period. Among the silk manuscripts unearthed in 1973, 3 articles record meridian and moxibustion, which are the earliest precious documents before the works Nei Jing(the Inner Canon). In medical works, moxibustion was first recorded in Nei Jing(the Inner Canon),"In the north, people live in a high land where the heaven and the earth are closed, the wind is cold, the folk lives in the wild and milk is taken, the viscera is cold and full of diseases, they should be treated with moxibustion. Therefore, moxibustion is also prescribed from the north." It shows that the emergence of moxibustion is closely related to the living habits, conditions, and disease characteristics of people in northern China.

 After that, many works on acupuncture appeared in successive dynasties, such as Zhen Jiu Jia Yi Jing(A-B Classic of Acupuncture and Moxibustion, year 259) by Huangfu Mi in the Jin Dynasty, and the Classic Of acupuncture and moxibustion recorded and recommended in Qian Jin Yao Fang(the Invaluable Prescriptions for Emergencies) by Sun Simiao in the Tang Dynasty, Wang Tao's works Wai Tai Mi Yao(the Medical Secret of an Official) recommended moxibustion without acupuncture, indicating the importance of moxibustion. Since then, attention has been paid to moxibustion from Wang Zhizhong's works Zhen Jiu Zi Sheng Jing(the Classic of Nourishing life with Acupuncture and Moxibustion, the year 1220) in the Song Dynasty, Gao Wu's works Zhen Jiu Ju Ying(A Collection of Gems of Acupuncture and Moxibustion, the year 1529) in the Ming Dynasty, Yang Jizhou's works Zhen Jiu Da Cheng(the Great Compendium of Acupuncture and Moxibustion, the year 1601), and Liao Runhong's Zhen Jiu Ji Cheng(Integration of acupuncture and moxibustion) in the Qing Dynasty. There are many monographs of moxibustion in the past dynasties, for example, in the 3rd century AD there are Cao Shi Jiu Fang(the Cao's Moxibustion Methods), In the Tang Dynasty there are Gu Zheng Bing Jiu Fang(the Moxibustion Prescription for bone steaming), in the Song Dynasty there are Huang Di Ming Tang Jiu Jing(the Moxibustion classics of the Yellow Emperor), Jiu Gao Huang Shu Xue Fa(the Moxibustion method for infracardio-supradiaphragmatic space acupoints), Bei Ji Jiu Fa(Method of Preparation for Emergency moxibustion), in later dynasties works Yong Ju Shen Mi Jiu Jing(the Secret Moxibustion Classics for carbuncle-abscess), Tai Yi Shen Zhen(the Miraculous Acupuncture of Tai Yi), Shen Jiu Jing Lun(the Miraculous Classics of Moxibustion), etc.

 Moxibustion treatment, initially the ancient people used direct moxibustion, and moxa cone is larger, more strong numbers (the time for burning a moxa cone), such as Taiping Shenghui Fang(the Peaceful Holy Benevolent Prescriptions) pointed out: "Although the numbers are enough, sore rotten with pus, the disease is relieved; If the sores do not break, the disease will not recover." At the same time, the ancient people highly valued the application of festering moxibustion for health care and disease prevention. The Modern moxibustion method has made great progress, to reduce the pain of patients receiving moxibustion, the use of small moxibustion cone with fewer numbers, and evolved a variety of moxibustion methods, such as moxa stick moxibustion, medicinal stick moxibustion, warm moxibustion, warm needle moxibustion, etc. According to the different conditions, indirect moxibustion is often used, separated by ginger slices, garlic slices, salt, lobster sauce cakes, aconite cakes, and so on. Moxibustion has made a great contribution to human health care.

 For thousands of years, acupuncture and moxibustion medicine has not only played an important role in the health care of the Chinese people but also spread abroad for a long time and made certain contributions to the health care of other countries. In about the sixth century, acupuncture was introduced to Korea, and the book Zhen Jiu Jia Yi Jing(A-B Classic of Acupuncture and Moxibustion) was used as a schoolbook for teaching. At year 562 A.D., the book Ming Tang Tu(The Illustrations of Ming Tang) and Zhen Jiu Jia Yi Jing(A-B Classic of Acupuncture and Moxibustion) were introduced to other areas of East Asia. Since the late 17th century, acupuncture spread to Europe. At present, more than 120 countries and regions have carried out acupuncture and moxibustion medical treatment, scientific study, and education. The WHO (World Health Organization) recommends acupuncture to countries around the world for the treatment of 43 diseases. Today, the unique acupuncture and moxibustion of China has become an important part of the world medical science and has produced a positive and wide impact.
 
Explanatory Notes:
  • 1. Wai San Yang Wu Hui refers to Taiyang, Shaoyang, Yangming, and five acupoints: baihui (GV20), xionghui (danzhong, CV17), tinghui (GB2), qihui (guanyuan, CV4), naohui (TE13).
References:
  • 1. Acupuncture and Moxibustion: A Brief Introduction
  • 2. Di Wang Shi Ji (Chronicle of Emperors and Kings), by Huangfu Mi
  • 3. Zhenjiu Jiayi Jing · Xu (The ABC Classic of Acupuncture and Moxibustion · Preface), by Huangfu Mi
  • 4. Zuo Zhuan (The Spring and Autumn Annals), by Zuo Qiuming

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