✵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 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.
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.
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.
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 renowned acupuncturist, re-examined and clarified the locations of 354 acupoints and their associated meridians, supplemented the principal therapeutic indications for each acupoint, and authored the book Tong Ren Shu Xue Zhen Jiu Tu Jing (The Illustrated Manual of Acupoints on the Bronze Figure) in 1026 CE; the engraved edition was promulgated by the government the following year. In 1027 CE, Wang Weiyi designed two bronze human models featuring inscribed internal viscera and meridians, intended for teaching and examination purposes.
Wang Zhizhong, an acupuncturist of the Southern Song dynasty, wrote Zhen Jiu Zi Sheng Jing (The Classic of Nourishing Life through Acupuncture and Moxibustion), which emphasized practical experience and exerted great influence on later generations.
In the Yuan dynasty, the eminent medical scientist Hua Shou, based on his study of Jin Lan Xun Jing Qu Xue Tu Jie (The Golden Orchid Illustrations of Selecting Acupoints along Channels), investigated the circulation of meridians and collaterals and their relationship with acupoints, and compiled Shi Si Jing Fa Hui (The Elaboration of the Fourteen Meridians). He was the first to collectively designate the Ren channel, the Du channel, and the twelve regular meridians as the “Fourteen Meridians”, thereby further advancing the theory of meridians and acupoints. During this period, numerous renowned herbalists and physicians skilled in acupuncture emerged, and many related texts were produced.
Works such as Bei Ji Jiu Fa (Moxibustion for Urgent Treatment), Yong Ju Shen Mi Jiu Jing (Moxibustion Classics for Mysterious Ulcers), and Gao Huang Shu Xue Jiu Fa (Moxibustion and Acupoint Therapy for the Inter Cardiodia-Phragmatic Part) marked the further development of acupuncture across various specialized branches.
In the early Southern Song dynasty, the physician Xi Hong and his family had practiced acupuncture for generations. The text Xi Hong Fu (The Poems of Xi Hong), transmitted from generation to generation, placed special emphasis on acupuncture. At the same time, the physician Dou Cai authored Bian Que Xin Shu (The Heart Book of Bian Que) and strongly advocated moxibustion therapy—recommending dozens, or even hundreds, of moxa cones per treatment session. At that time, Yang Jie and Zhang Ji personally observed autopsies and advocated using anatomical knowledge to guide acupoint selection.
In the Jin dynasty, the physicians He Ruoyu and Yan Mingguangn-who compiled the work Zi Wu Liu Zhu Zhen Jing (The Midnight-Noon Ebb-flow Acupuncture Classics), advocated the principle of acupoint selection on time. Dou Hanqing, a physician active during the Jin and Yuan dynasties, advocated not only the midnight-noon ebb-flow method but also the eight-methods ebb-flow system and other time-based acupoint selection principles. His compilation, Biao You Fu (The Poems of Marking the Hidden), became one of the most celebrated acupuncture verse texts.
Introduction of the Moxibustion
Moxibustion is a kind of thermotherapy closely related to fire. It originated with the application of fire and developed continuously through its practical use. When ancient people heated themselves by burning fire, they occasionally alleviated certain diseases due to accidental burns, thereby gaining the insight that burning could treat illnesses—this marks the origin of moxibustion.
The word “灸” (jiǔ, moxibustion) is interpreted as “灼” (zhuó, burning) in the ancient text Shuo Wen Jie Zi, meaning burning the body for therapeutic purposes. Initially, branches and firewood were used for burning, cauterizing, scalding, and other heat-based interventions to eliminate disease.
Later, Artemisia leaf (moxa) was gradually selected as the primary material for moxibustion. Ai (Artemisia vulgaris) has grown abundantly across China since ancient times, owing to its aromatic scent, warm nature, and high flammability, as well as its moderate, steady flame when burned—qualities that led it to replace branches and become the optimal material for moxibustion.
According to the ancient text Zuo Zhuan (Tso Chuan: A Commentary on the Spring and Autumn Annals), in the tenth year of Duke Cheng of Lu (581 BCE), Duke Jing of the Jin Kingdom fell ill. Yi Yan, the Imperial Physician (Tai Yi) from the Qin state, came to treat him and stated: "The disease is untreatable. It lies above the Huang (the region between the heart and diaphragm) and below the Gao (the intracardiac space); neither moxibustion nor acupuncture can be applied." In the Han Dynasty, Zhang Zhongjing’s Shanghan Zabing Lun (Treatise on Cold-Induced and Miscellaneous Diseases) also contains discussions noting “fire may be used” and “fire must not be used,” where “fire” refers specifically to moxibustion.
The term “灸” (moxibustion) first appears in extant texts in Zhuangzi · Dao Zhi (Chuang Tzu · Robber Zhi). For example, Confucius admonished Liu Xiaozhi: “Qiu has no illness, yet he applies moxibustion to himself.” The ancient text Mengzi · Li Lou (Mencius · Li Lou) likewise records: “Nowadays, people aspire to become kings as if suffering from a seven-year illness while seeking three-year-aged moxa”—clearly referring to moxibustion. This suggests that moxibustion was already quite prevalent during the Spring and Autumn and Warring States periods.
Among the silk manuscripts unearthed in 1973, three texts document meridians and moxibustion—the earliest extant medical documents predating the Nei Jing (Huangdi Neijing, The Inner Canon).
Moxibustion was first systematically recorded in medical literature in the Nei Jing, "In the north, people dwell on elevated land where heaven and earth are closed off, the wind is cold, the populace lives in the wild and consumes dairy; their zang-fu viscera are cold and disease-ridden—hence moxibustion is indicated. Thus, moxibustion originated in the north." This passage indicates that moxibustion emerged in close connection with the living habits, environmental conditions, and disease patterns of northern Chinese populations.
Thereafter, numerous acupuncture-moxibustion texts appeared across successive dynasties: Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion) (completed in 259 CE) by Huangfu Mi of the Jin Dynasty; the Zhen Jiu Jing (Classic of Acupuncture and Moxibustion) cited and recommended in Sun Simiao’s Qian Jin Yao Fang (Invaluable Prescriptions for Emergencies) of the Tang Dynasty; and Wang Tao’s Wai Tai Mi Yao (Medical Secrets of an Official), which advocated moxibustion without acupuncture—highlighting its growing importance. Subsequently, moxibustion received sustained scholarly attention in works such as Wang Zhizhong’s Zhen Jiu Zi Sheng Jing (Classic of Nourishing Life with Acupuncture and Moxibustion, 1220 CE) of the Song Dynasty; Gao Wu’s Zhen Jiu Ju Ying (Collection of Gems of Acupuncture and Moxibustion, 1529 CE) of the Ming Dynasty; Yang Jizhou’s Zhen Jiu Da Cheng (Great Compendium of Acupuncture and Moxibustion, 1601 CE); and Liao Runhong’s Zhen Jiu Ji Cheng (Integration of Acupuncture and Moxibustion) of the Qing Dynasty.
There are numerous monographs on moxibustion from past dynasties. For example, in the 3rd century CE, Cao Shi Jiu Fang (Cao’s Moxibustion Methods) appeared; in the Tang Dynasty, Gu Zheng Bing Jiu Fang (Moxibustion Prescriptions for Bone-Steaming Syndrome) was compiled; in the Song Dynasty, works such as Huang Di Ming Tang Jiu Jing (Moxibustion Classics of the Yellow Emperor), Jiu Gao Huang Shu Xue Fa (Moxibustion Method for Acupoints in the Infracardio-supradiaphragmatic Region), and Bei Ji Jiu Fa (Emergency Moxibustion Methods) were produced; and in later dynasties, texts including Yong Ju Shen Mi Jiu Jing (Secret Moxibustion Classics for Carbuncles and Abscesses), Tai Yi Shen Zhen (The Miraculous Acupuncture of Tai Yi), and Shen Jiu Jing Lun (The Miraculous Classics of Moxibustion) were published.
In early moxibustion practice, ancient practitioners used direct moxibustion with relatively large moxa cones and a greater number of applications (i.e., the number of moxa cones burned per session). As noted in the Taiping Shenghui Fang (Peaceful Holy Benevolent Prescriptions): "Although the number of applications is sufficient, if the sore suppurates and breaks open, the disease will subside; if the sore fails to break, the disease will not resolve." At the same time, the ancient Chinese highly valued suppuration-inducing moxibustion—not only for treating disease but also for health preservation and prevention. Modern moxibustion techniques have advanced significantly: to reduce patient discomfort, smaller moxa cones and fewer applications are now used, and diverse methods have evolved—including moxa stick moxibustion, medicated stick moxibustion, warm moxibustion, warm needle moxibustion, and others. Depending on clinical conditions, indirect moxibustion is frequently employed, using interposing materials such as ginger slices, garlic slices, salt, prepared soybean paste cakes, and processed aconite root cakes. Thus, moxibustion has made substantial contributions to human healthcare.
For thousands of years, acupuncture-moxibustion medicine has played a vital role not only in safeguarding the health of the Chinese people but also in spreading abroad over an extended period—making meaningful contributions to global healthcare. Around the 6th century CE, acupuncture was introduced to Korea, and the Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion) served as a standard textbook in medical education. In 562 CE, both the Ming Tang Tu (Illustrations of the Hall of Light) and the Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion) were transmitted to other parts of East Asia. Since the late 17th century, acupuncture spread to Europe. Today, acupuncture and moxibustion are practiced, scientifically studied, and taught in over 120 countries and regions worldwide. The World Health Organization (WHO) recommends acupuncture for the treatment of 43 conditions. Consequently, China’s distinctive acupuncture-moxibustion system has become an integral component of global medical science, exerting broad and positive influence.
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
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.
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."
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.
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.
In the Yuan dynasty, the eminent medical scientist Hua Shou, based on his study of Jin Lan Xun Jing Qu Xue Tu Jie (The Golden Orchid Illustrations of Selecting Acupoints along Channels), investigated the circulation of meridians and collaterals and their relationship with acupoints, and compiled Shi Si Jing Fa Hui (The Elaboration of the Fourteen Meridians). He was the first to collectively designate the Ren channel, the Du channel, and the twelve regular meridians as the “Fourteen Meridians”, thereby further advancing the theory of meridians and acupoints. During this period, numerous renowned herbalists and physicians skilled in acupuncture emerged, and many related texts were produced.
