Historical Artifacts and Foundations of Traditional Chinese Medicine

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


The earliest preserved historical texts of TCM (Traditional Chinese Medicine)

The question of when the specialty of TCM started has been a point of controversy, and used to downplay the importance of the Complementary and Integrative Medicine (CIM) specialty in Chinese, and in fact, human medical history. As the specialty finally became officially acknowledged in the West, with abundant scientific proof of effectiveness, and amazing safety, the attempts to negatively characterize the medical specialty increased dramatically, even to the point of denying its historical heritage. What most patients, and the public in general, do not realize, is that the debate concerning approaches in medicine that encourage an integrative, holistic and restorative philosophy, and those that focus on a narrow allopathic approach has been a strong theme in the business of medicine for many centuries in Europe, dating back to the early Greek physicians such as Hippocrates who wrote extensively on medical ethics and the need to integrate safe, conservative and holistic approaches before resorting to harsh medical treatment ("first do no harm"), and continuing through the start of the age of the modern scientific methods, with Paracelsus, a strong proponent of integrative holistic medicine. These attempts to negatively portray the history of integrative naturalist medicine and in effect destroy the obvious benefits to humanity from this study and practice, which was developed and practiced by many of the great minds of civilizations, is rooted in deep philosophical divisions that relate to the business of medicine, not the science. It has been easy to convince the public that this great realm of medicine is "quackery", but hopefully, a real exploration of the history, philosophy and science of CIM/TCM will change these negative opinions, and adopt the facts.

This strong historical attempt to in effect erase traditional medicine and the integrative holistic approach in favor of new technology reached a height in the twentieth century, and is a confusing and complex subject. The erasure of traditional medicine largely succeeded in Europe and the United States. The persistent popularity and success of Traditional Chinese Medicine (CIM/TCM) over many thousands of years obviously posed a problem, and even today we see a large campaign to negatively portray this medical specialty, both as a scientifically proven and very safe medical specialty today with an abundant array of treatment protocols, and historically. For instance, we still see most histories of TCM focus completely on needle stimulation, just one of the many treatment protocols in TCM, and we see repeatedly nonsensical histories of acupuncture in modern China in print and on the web, with statements that it was little used when the British controlled Guomintang government tried to declare it illegal in China in 1928, but was reinstated in 1929 due to a very large national petition campaign. Obviously, if it was unpopular and did not work, there would have been no large national petition to reverse this law, and no subsequent inclusion in the legal constitution of China to insure its legality. This official and legal support for TCM cited its long and important history in Chinese culture, and subsequently this history was challenged as well, with many historians writing that there was no actual proof that TCM even existed until the modern era, and could not have been linked with the foundations of Chinese culture and the important persons held as the leaders of this culture, such as Huang Di, Shen nong, Fu xi and Nu wa. The names of these cultural icons of Chinese culture were attached to most comprehensive texts in prehistorical China, and obviously this did not imply that they actually wrote the texts. Hopefully, this article will help dispel some of these misconceptions.

Most of us don't really understand what the term 'prehistorical' actually means. The earliest known written narrative history in China began around 500 BC, with the Zuo Zhuan, or Commentary of Zuo, and printed texts occurred after 100 AD, with the invention of block printing on hemp paper in China. This Commentary of Zuo covered the history of China from 722 to 468 BCE, and is widely regarded as the earliest focused historical writing in world history, in it is also known as Master Zuo's Spring and Autumn Annals (Zuoshi Chunqiu), attributed to Zuo Qiuming. The emperor of China in 213 BC, Qin Shi Huang, ordered that all books outside of his control should be destroyed. Since knowledge was the most valuable commodity in ancient China, Qin Shi Huang wanted all significant knowledge to be consolidated into a centralized state model that defined a new empire. Thus, the earliest surviving manuscripts of Traditional Chinese Medicine date from about 200 BC. The Qin Dynasty, 221-206 BC was a very violent and short-lived empire following the Warring States Period, but paved the way for the Han Dynasty, which lasted for four centuries and recreated the modern manuscripts in the tradition of the former kings of Zhou, who ruled from the eleventh century to the second century BC. These recreated manuscripts of the Han Dynasty make up what we know today as the classic texts of TCM. The practice of recording official dynastic histories for future generations was thus codified by Sima Qian of the Han Dynasty, the earliest known Grand Historian in China, and today, the Chinese rely on an extensive text called the Standard Histories (Zhengshi), or the 24 Histories, established in the Tang and Qing Dynasties (648-1912 AD or ACE), which now contains 3213 volumes and over 40 million words of historical documentation. This text is perhaps the greatest historical compilation in human history. The earliest preserved fragments of the Zuo Commentary are from the 3rd to 7th centuries AD (ACE). We clearly see that we can expect no preserved written histories of TCM to exist intact in the modern era, that this is common to all history, and does not negate the existence of TCM historically, as has been implied.

The earliest preserved recorded histories in China are believed to be from the numerous oracle bones, though, dating to the 2nd millenium BCE, or between 2000 and 1000 BCE, that did not deteriorate like paper records. These Shang Dynasty bones were used in 'divination' rituals and thus many of them deal with questions of disease and treatments, and do mention both the use of needle stimulation and pricking to release drops of blood, as well as extensive herbal and nutrient medicine. This is often used to negatively portray the practice of acupuncture historically as purely a belief in 'magic' and demonic possession. Once again, although Western and Eurocentric historians are fond of characterizing this medical treatment of pricking veins with acupuncture needles to cause a few drops of blood to emerge as purely an insane belief in 'demonic spirits' by the Chinese, and the idea that all disease was caused by 'demonic possession', which by the way, were popular notions in European medicine for all neurological and psychological diseases until the 18th century, there is abundant explanation of the practice of pricking a vein to cause a therapeutic reaction in Chinese history, and abundant explanation of this practice even today in Traditional Chinese Medicine, and even in standard medicine with leeches. The practice is hardly seen clinically today in TCM, but still exists. Obviously, early needles in medical treatment were not like the fine filiform steel needles today, but were thicker, and made of various materials, and involved a different type of trigger point stimulation, sometimes not penetrating the skin, but pressing into the trigger point, and sometimes pricking a surface vein or capillary to elicit a reaction, which we now call 'bleeding'. These traditional acupuncture techniques did not involve purging a large amount of blood. In fact, the idea of letting out a large amount of blood in treatment may be first attributed to standard medical practices in the United States and Europe in the 1700s, and was a reactionary response to the traditional practice of pricking the veins to stimulate an 'acupuncture' response, which was a popular medical treatment at the time. I only mention this subject because it is frequently used in histories of TCM to incite a fear of the practice.

The practice of pricking a vein to let out a few drops of blood to analyze, and/or to stimulate a response, is recorded as a widespread medical treatment across the world throughout human history, and was associated with theories of the 'humours', or elemental types of bodily fluids in Greek and European medical history. Galen wrote extensively on many techniques and theories of bloodletting, while Hippocrates wrote that while bloodletting was effective, that one should first try treatments that could do no harm, such as dietary medicine, gentle herbal extracts, and physiotherapies. Obviously, the subject of 'bleeding' was a large and varied subject. Our history of the red and white striped barber pole in the modern era originated from this pole used as an advertisement in 18th century America that the barber was also a physician that practiced this pricking of veins to provide safe traditional treatment for common ailments. Even in standard medical texts in the United States in the 19th century bloodletting on veins of the thigh is mentioned as an effective treatment for menstrual cramps, and bloodletting was still mentioned in the standard William Osler medical text, The Principles and Practice of Medicine, in the United States in 1923. These techniques of medical doctors at this time did not involve bleeding out large amounts of blood. In fact, the practice of 'bloodletting' with leeches has returned in standard practice in hospitals, as there has been found no substitute for the reaction to the chemicals excreted by the leech as it lets out a few drops of blood. In the 19th century, France alone imported about 40 million leeches a year for medical treatment. Using the image of 'bloodletting' to incite a fear of acupuncture, and misrepresenting the history of this treatment has been widely used, but is inaccurate. Acupuncture is just a small part of the whole of TCM practice and has been shown to be the safest manual medical treatment in human history. Today, acupuncture involves hair-fine (filiform) needles and almost never involves even a drop of blood, just trigger point stimulation, and is usually combined with herbal and nutrient medicine, physiotherapy, and sound advice in dietary and therapeutic practices to achieve a complete approach. Characterization of it in other terms, as a practice rooted in magic, superstition and bleeding, is purely misleading.

What are essential in the preserved records of TCM history, though, are the more extensive medical texts that were copied over time. What we are left with today concerning surviving, or preserved, TCM medical texts thus derives mainly from the Qin Dynasty. Most of these extensive preserved texts of the Qin and Han Dynasties (100 BC to 250 AD) still attributed the foundation knowledge of TCM mainly to the physicians assembled by one of the sovereigns of Chinese culture, named Huang Di, or the Yellow Emperor, in about 2800 BC. Other preserved medical texts of this era attributed the knowledge and theories to a physician or group of physicians referred to as Bian Que, who followed the medical practices of Qin Yueren, from around 310 BCE. Bian Que was said to be the patriarch of medicine in Chinese culture, dating from the time of the Yellow Emperor in about 2800 BCE, and Qin Yueren was called Bian Que to honor his skill and knowledge. There is still debate over whether some of these historical figures, such as Huang Di and the physician Qi Bo, or the physician Bian Que, were representative or actual persons in history since oral histories are known to create mythological characterizations. The Chinese government maintains the tomb of Huang Di, though, and still treats this historical figure as an actual historical personage. It is purported that the actual physical remains of Huang Di do not exist, which may be attributed to the fact that the body was not preserved from this extremely early date in history, or we may believe the historical texts concerning alchemical practices, that gives us the lore that Huang Di ended his life by going to a famous mountain top, performing alchemical rituals, and ascending to heaven. This may be unbelievable to many people, but it is curious that this same type of story is attributed to both Jesus and Mohammed later in history. Did the story of Huang Di ascending to heaven lead to these later stories? It is hard to say for sure, but this Chinese tale preceded the story of the Ascension in Christian lore by thousands of years.

The foundation text of TCM in these Western Han manuscripts uncovered in 1973 at the Mawangdui tomb, as stated, was the Inner Canon of Huang Di, commonly called the Huang Di Nei Jing. Of the numerous preserved medical texts found in the scholar's tomb, we see bits and pieces related to the modern Huang Di Nei Jing. We may see that the contents of the Huang Di Nei Jing preceded this time period of 200 BC by centuries, though, since another famous medical text, the Nan Jing, or Classic Text of Difficult Questions (concerning the Nei Jing) was written by a famous physician Bian Que, also known as Qin Yueren, (or a group of scholars that used the name Bian Que in the text), who lived in the Zhou or early Han Dynasty around the 3rd century BCE, or who compiled these medical discussions between the sixth and third century BC. Thus a text that dealt with complicated questions of theory from the Nei Jing existed at least one hundred years before the earliest preserved known text of the Nei Jing. This is considered by many historians as proof that the Nei Jing content existed prior to the Mawangdui manuscript. What medical scholars do know for sure is that the information, or science, is quite substantial in these texts ascribed to Huang Di and the early physicians, and remains useful to physicians today. This implies that a long history of development of theory and practice of acupuncture and Traditional Chinese Medicine must have preceded the text from the Mawangdui manuscripts, although some historians are quite firm in their relatively new belief that these manuscripts imply that the science itself dates from this time period in the Han Dynasty. The debate presents interesting historical perspectives that are all unproven and must be judged by those interested in this historical debate.

It is curious to note that the preserved medical texts of the Mawangdui tomb were discovered in 1973, yet controversies surrounding the use of these texts to deny the rich history of TCM prior to this date did not occur in print until the TCM practice became accepted as a standard competing medical practice in the late 1990s. The public needs to thoughtfully assess what the standard historians are saying about the history of TCM with a perspective that both a Eurocentric view, and a commercial interest in portraying acupuncture and TCM as a poor science, come into play when we read statements that characterize TCM in a less than favorable light.

"Traditional Chinese Medicine is as old as the civilization itself and reflects the idea of a unified underlying naturalist philosophy, or Daoism, that unites the billion and a half Chinese citizens today."

The theories and philosophy of TCM are integral to the cultural and scientific foundations of Chinese culture and science, and thus this medicine study is called Zhong Yi Xue, while the country of China is called Zhong Guo, or actually the People's Republic of Zhong Guo. This central philosophy and science of Chinese culture is generally called Daoism (often written as Taoism), referring to the historian Lao Zi's (Lao Tze) famous synopsis of Chinese thought written in about 500 BC, called Dao De, or commonly, the Dao De Jing. TCM is considered a Daoist science, and is somewhat unique in this regard. Today, even the modern Chinese flag reflects these historical and philosophical roots of Daoism, with a design featuring simply 5 stars on a red flag, mirroring historic Daoist concepts such as the 5 elements (wu xing) and the red color of mercury. This flag design is indeed called Wu Xing.

Daoism generally refers to the knowledge of the patterns of natural law that pervade all the universe. The term Dao literally means the Way (of natural science). TCM diagnosis relies on knowledge of the patterns and relationships in the body, and the holistic interconnection of the various systems in the body, as well as the connections between the body and mind, or spirit. In TCM, the realization that everything affects everything else and is in constant flow and change, a sort of quantum physics approach to biology, guides all the perspectives of diagnosis, physiology and treatment. This perspective is expressed by the terms Qi, Yin and Yang, which refers to the ever changing function from substance to activity and back to substance. These terms do not signify a specific substance or function in the body, but are terms that can be applied to physiology and anatomy in a wide variety of contexts. Qi, Yin and Yang are concepts more than they are objects, and help the TCM physician to understand difficult conceptual aspects of pathophysiology in a fluid, rather than static, manner. This type of thinking and approach is Daoist. Later in history, Daoism assumed a number of forms, some scientific, some philosophical, and some of a religiocultural aspect, obscuring the meaning of the term. Those sages and physicians from early Chinese history that we now call Daoist preceded the term Daoism, and certainly did not consider their study of natural science a religion, or even a structured philosophy as we define philosophy today. In fact, early historical sages, or scientists, did not define their study in terms of specialties as we do now, and were more concerned with a total and interconnected understanding of all of the sciences, religion, physical and metaphysical aspects of nature.

The importance of empirical science in early history, and the preservation of empirical scientific findings in the age of modern scientific method

While modern biological science wants to view everything in a static state, preferably in a laboratory test tube or microscope slide, TCM has always looked to the ever changing nature of the living organism. Hence, much of TCM is based on empirical, or observed, scientific evidence, rather than reproduced laboratory experiment. If something occurs the same way thousands of times, we assume that this is proven, or evidenced. It is often difficult to recreate this evidence in the laboratory setting because the quantum of biological factors needed to recreate the biological action is too complex to recreate. Laboratory evidence may be simpler to verify objectively, but has its limitations. Science and scientific theory is not limited to that evidence that can be recreated in the laboratory. Nature's laboratory is infinitely complex and interconnected in ways that human scientists may never be able to replicate. TCM has thus accumulated its medical evidence for nearly 6000 years by collecting empirical evidence from Nature's laboratory, eliminating all that appears untrue. Of course, this does not imply that TCM rejects modern scientific method or laboratory analysis. Today, laboratory research and human clinical trials are useful tools to verify the rich empirical evidence in TCM, and do verify the efficacy and explain the physiological effects of herbs and acupuncture very concretely. Randomized controlled human clinical trials (RCTs) designed to provide evidence that new pharmaceutical drugs showed greater benefit than risk have become the benchmark for modern evidence in medicine, but this study design is easily manipulated, and does not present the complete scientific evidence of efficacy. The exclusion of all other scientific evidence of effect is unscientific, yet widely accepted, albeit in a cynical manner. A logical viewpoint would see these randomized controlled human clinical trials in medicine as just one part of the big picture, not the sole determinant of scientific validity. Such tactics have been devised to claim that traditional science is not actually science for centuries, and is seldom questioned.

Today, modern medicine is largely based on limited laboratory evidence and clinical trials that we often see are also tainted by falsifying the results for monetary gain. Unfortunately, this is touted as the "scientific method", and all other scientific evidence is often dismissed. Much of today's medical evidence is created by the pharmaceutical companies that seek to profit from the results, and the big pharmaceutical profits are enormous. This aspect of greed in a capitalist system is the dark side that is ignored when we look at the advantages of a profit motive driving modern research. Modern TCM utilizes both its rich history of empirical evidence and this modern scientific evidence to support the practice, with a growing body of scientific studies elucidating and supporting modern TCM treatment and approach. The National Institute of Health (NIH) in the United States, the World Health Organization (WHO), and many governmental health institutes now support and fund the scientific research in Traditional Chinese Medicine (TCM). Since TCM is not a highly profitable practice, the possibility of falsified study generated to support the practice is remote. The possibility that the extremely profitable pharmaceutical and medical equipment industry would generate falsified study data to eliminate TCM as a monetary competitor is highly likely. While the general public and standard medicine largely continue to support the belief that traditional medicine is "unscientific", this has been dispelled thoroughly by modern research, and yet the almost religious belief persists in our scientific circles.

One historical writing, from the third century BC, noted by the famed modern historian Joseph Needham, in his seven volume Science and Civilization in China, quotes the general of the armed forces of the king of Cho-hsiang, who is also a renowned physician, on the subject of approaches in medicine. This quote elucidates the modern difference between standard allopathic medicine and TCM. The general, Phang Hsuan, refers to a conversation with a great physician, Pien Chhueh, on medical approaches. Pien Chhueh (Bian Que), whose two brothers are also physicians, is asked who is the best physician among the brothers. Pien Chhueh replies, "The eldest is the best, then the second, and I am the least worthy of the three." When asked to explain, he replied, "My eldest brother, in dealing with disease, is attentive to the spirit or vitality (Shen). Before any symptoms have formed, he has already rid the disease. Thus his fame has never reached beyond our own clan. My next brother treats disease when its signs are most subtle, so his name is unknown beyond our own village. As for myself, I use stone needles on the blood vessels, prescribe strong drugs, and fortify the skin and flesh (surgically). Thus my name has become known among all the feudal lords." This passage, perhaps allegorical, reflects the history of modern medicine eloquently. The TCM physicians, especially those that treat with emphasis on preventative medicine and wellness, receive little recognition or reward. The specialists that treat allopathically after the disease or injury has become severe, with harsh pharmaceuticals, surgery etc. have become rich and respected. Even in the early history of TCM this fact was well known. The physicians that persevered with these approaches of Complementary and Integrative Medicine did so not to gain the most success, but because of a respect for the quality of the outcomes of this approach, and a true respect for the Daoist science that underlies this preventative and holistic approach in medicine.

Empirical science and traditional medicine have a long history of derision in the modern medical community, and this continues today. Civilization is always looking to modern technology to find better healthcare, as it indeed should, but this has too often resulted in a fervor to deny the efficacy of the medical science that is traditional. In the European history of medicine we see this derision of traditional medicine many times in recorded history, and the defense of Integrative Medicine, recognizing and incorporating traditional cures into the modern protocol, by such revered medical doctors as Hippocrates, Paracelsus, etc. The famed Hildegard von Bingen, declared a saint after her death, was highly criticized for this, and Florence Nightingale was highly criticized in the modern era for touting the efficacy of herbal medicine. There are many such examples. This debate on whether to include or integrate traditional medicines into European standard medicine culminated in the origin of the term "Scientific Method" in the 1500s. The modern interpretation of this idea purports that much of medical science at that time was still based on unproven concepts, and that we chose to accept only scientific facts that could be reproduced in the laboratory for the future. The question of scientific methodology in medicine is not a simple subject, though, as one of the main proponents of scientific laboratory verification in the 1600s, Paracelsus, also touted the need to integrate traditional medicine into standard practice. Of course, this continued use of the term "Scientific Method" is just a modern historical perspective that obscures the real debate, as history so often does.

Thus, the history of scientific methodology in medical science is anything but clear and simple, and has been greatly distorted. In fact, the touted physician Francisco Sanches, often cited for this creation of the modern scientific method, utilized the writings of the famed Sextus Empiricus to challenge the prevailing scientific ideology rooted in Skepticism, a popular concept of denying scientific validity that was based on more abstract theory. This would be analogous to scientists in the present era denying the validity of theoretical physics. This new empirical school of thought touted by Francisco Sanches took up the work of the famed physician Niccolo Lenonicero, also frequently cited to tout "scientific method", who pointed out the errors in such basic texts as Pliny's Natural History, and derided much of the "folk" knowledge in the Materia Medica, or the prevailing text of herbal and mineral pharmacopia. Around the same time, the influential Paracelsus was teaching and writing, helping to establish the greater use of laboratory science in medicine, but also touting the importance of integrating traditional medicine into standard practice and treatment guidelines. This history of scientific method is thus anything but clear, and in 2014, a new school of thought is now once again touting the end of the "Scientific Method" doctrine, and the use of what they call "Big Data" to guide medical practice, going full circle back to an empirical science, but this time utilizing a complex cloud of data available with modern computer data collection and advanced biochemical, genetic and epigenetic testing. Phytochemical databases using reverse engineering are being created to better collect evidence of the efficacy and uses of herbal chemistry. Empirical science is not dead. The truth of the matter is that human science still relies on a number of systems, including observation of natural science, formulation of theory, testing of the theory, clinical data gathering, and when possible, confirmation of this clinical data in the laboratory and in human clinical trials. None of these scientific steps should be taken alone as dogma, though. The complete package of science involves thoughtful analysis of all information, and eventually a complex human decision making. Hopefully, our binary attitudes in modern science will finally be eliminated, and a more holistic, or quantum, mindset adopted.

Historical artifacts of acupuncture predate even 2800 BCE

Evidence of the use of metal needles in treatment predates the 2800 BC origins of the medical science, and evidence of stone needles in treatment predates this by hundreds or thousands of years, with continued use up to 300 BC. The ancient Chinese symbol for acupuncture needling uses the characters for bamboo and penetrate, implying that the earliest needles were perhaps made of bamboo slivers, which deteriorated over time, and hence we find no archeological remains. The other ancient name was bian zhen, or bian shi, meaning stone needles, or stone points, respectively. Examples of some of these stone needles, at least the thicker and more durable types, have been found in ancient archeological sites, and reflect a medical purpose rather than an industrial use with analysis of their design.

Needling therapy was also recorded in Egyptian history of 1500 BC, as well as a meridian system of trigger points similar to the Chinese system. It is well substantiated by DNA evidence that people traveled great distances, bringing important knowledge and skills, in these prehistoric times, and these records of Egyptian acupuncture practice and theory may show that this knowledge was obtained from Chinese scholars at a very early date, or that development of needle stimulation as a medical practice was perhaps widespread throughout the world.

Archeological evidence of copper and bronze needles extend to about 5000 BC, and the history of the needle as a common medical or early surgical tool is well documented. Currently, we now are aware of over 30 distinct cultures that were in existence in China around 5000 BCE, with evidence of interaction among these clans, as well as distinguishing cultural styles exhibited in ceramic designs and jade sculptures. The use of copper and stone needles and various medicinal extracts was passed on as a working medical science crucial to survival among these various distinct cultures. Artifacts of vessels containing medicinal alcohol extracts have been found that date to this early neolithic period in China.

The earliest evidence of support for the use of metal needle stimulation in medicine, and historical development of needle stimulation with bamboo, bone and stone needles that predated the use of fine metal instruments

Historically, it is written in the foundation text of Traditional Chinese Medicine, the Nei Jing de Huang Di (Ling Shu I): "I regret that all my people must stop paying in taxes and labor because of illness. My desire is that we no longer give them medicines that poison them and that we discontinue use of the ancient stone needles. My wish is that we utilize only the mysterious metal needles by which energy is directed." This statement was attributed to the sovereign Huang Di in his conversation with the chief physician Qi Bo in the text, but reflects the prevailing government ideas of the time. This text, the Nei Jing, is attributed to the 28th century BCE in its origins, if not in its exact words, which are from a number of surviving personal manuscripts from 400-100 BCE. Hence, a few slightly different versions of the Nei Jing exist today. To confuse matters further, the first emperor to conquer most of China, around 250 BCE, was named Qin Shi Huang, and many historians refer to him as Qin Shi Huangdi, confusing him historically with the sovereign Huang Di. There are many medical texts in prehistoric and early historic China that describe the various concepts and treatments in what became Traditional Chinese Medicine, though, and a surprising number of them have the name Huang Di as part of their title, and many of them include the theories and practice of needle stimulation, or acupuncture.

Historical collections of acupuncture needles exist in a number of countries. Some examples of ancient bone needles and stone points are seen from this Korean museum collection, albeit crude points. Fine stone shard needles were, of course, destroyed in use or over time. It was also written in the 16th century text, Zhen Jiu Da Cheng (Great Compendium of Acupuncture and Moxibustion) that stone needles originated in the Eastern cultures, while moxibustion, or stimulating the acupuncture points with heat, originated in the Northern cultures. The text states: "The bian zhen, stone-point needles, or bian shi, points of stone, came from the eastern sea. In that area, a mountain called Gao Feng (High Peak) had stones of a form similar to needles with jade heads. They were naturally long and rounded. They were ground to a sharp point so they could be used as needles in order to effectively cure disease." This 10 volume text was written by Yang Jishi of Weijin and is still an important resource text in TCM. Today, jade is still seen as a healing stone worn by many Chinese citizens and elaborate jade sculpture is often seen in key positions in the home, adhering to principles of Feng Shui.

The actual historical timeline of needle stimulation, or acupuncture, in Chinese history can be inferred from our knowledge of artifacts from archeological sites. Besides the stone needles, a large number of specialized metal needles of copper, iron, and bronze in various shapes have been found, and the 9 needle shapes pictured here are well documented, with only 2 of them representing the fine pointed needles that we use today. The stone needle points and needle shards, as well as most of these thicker metal needles were obviously used to stimulate points or lines on the skin surface and muscle, as well as to make fine cuts into the skin to apply herbal and mineral medicines to stimulate the acupuncture points and meridians. Gold and silver needles and needle points were highly prized as reactive, and elaborate preparation of these needles involving magnetizing techniques were recorded as well.

Steel is a form of refined iron and carbon, and the earliest examples so far come from a site in Anatolia, or Turkey, but records of ancient steel from Northern India, even mentioned by Alexander the Great in the third century BCE show that refined steel originated in Asia. Fine steel needles were first made in China and this manufacture spread then to the Middle and Near East, with many examples of fine alloy needles made in Damascus and Antioch for the Roman Empire (27 BC -476 AD). Thus the modern type of fine steel acupuncture needle existed during the Han Dynasty and the extent of the existing version of the Huang Di Nei Jing in about 200 BC. The history of various other types of needles in medical use, from the bamboo sliver and finely carved bone, to jade or quartz points, to bronze or copper alloy needles, and so on can be derived from our knowledge of archeological findings and inferences from writings, and since these needles did not have ends that were looped to hold thread, they were certainly not sewing needles. Of course, most of the stone shards and points were broken or deteriorated with time. Serious modern archeological research purportedly did not occur in China till about 1920, though, when European archeologists such as J.G. Andersson started to accumulate this data. A detailed history of ancient China was kept in an ordered Confucian manner, but often not validated by tangible archeological evidence, or much of these collected artifacts lost in historical purges, or stolen when central governments were overthrown. Certainly, Western historians and archeologists gave little regard for the validity of acupuncture, which hampered the collection of data relating to acupuncture needles in these earlier twentieth century excavations. Chinese historians, on the other hand, have collected a much greater body of evidence of early examples of acupuncture needles from more recent excavations, which has been often been discounted by Western scholars. The subject of Eurocentricity and Western arrogance continues concerning our view of China and Chinese history.

Needles are relatively rare finds in archaeological sites because of the difficulty in preservation due to rusting of the common iron needles in early history. Nevertheless, many examples of metal pins and needles have been preserved from archaeological sites. Copper alloy needles were thus found more often in a preserved state, but these were less fine, and not useful for domestic sewing, lacking a hook or loop. Bronze is an alloy of copper and tin, and bronze deterioration, or tarnish, will result in a product that is the same as copper, making them hard to distinguish in archaeological sites. The Bronze Age timeline is disputed, but generally we may assume that fine bronze tools and needles were produced from about 5000 BC onward, with examples of fine bronze implements from tombs dated as far back as 2300 BC, and bronze statues and bowls found that were dated back to 3500 BC. Most of the needles found in archaeological sites were actually pins, lacking the eye needed to confirm use as a sewing implement. This fact could point to the probable use of these many early pin-like needles in China as medical implements useful in the early practice of acupuncture. This history of the early needle finds can be found in the book by Mary Beaudry, professor of archaeology and anthropology at Boston University, titled Findings. Bronze needles lacking the eye needed for threading, and with biconical and rounded heads, have been found extensively in burial mounds and grave sites. The reasons that these ancient peoples would bury such pins with the dead needs to be reviewed. Certainly, these artifacts could be assumed to have some significance as medical instruments, which would give them the importance necessary to include in the burial collection. The biconical and rounded heads could be construed as trigger point stimulators, and are similar in design to the classic nine needle types mentioned in the Huang Di Nei Jing, Ling Shu.