Ancient text rewrites the history of medicine

Proving a point: The manuscript shows acupuncture developed from the study of anatomy. © Alamy

Is acupuncture based on science? Despite its popularity, the scientific evidence for traditional Chinese medicine is mixed. But new research reveals its origins in ancient human dissection.

Few of us look forward to a visit to the doctor, especially if we know needles will be involved. But millions of people choose to be pricked by dozens of fine needles in a traditional Chinese medical practice known as acupuncture. Critics call it quackery with no basis in science.

However, researchers have discovered the world’s oldest surviving anatomical atlas, preserved for 2,000 years in the tomb of an ancient Chinese aristocrat. If accurate, the findings will change “our understanding of the basis of acupuncture”.

According to traditional Chinese medicine, the needles help balance a person’s Qi, the life force that connects humans to the world. Qi flows through the body along meridian pathways, past 365 “acupoints” where the needles are inserted. An acupuncturist leaves these needles in the patient for up to an hour.

Historians of medicine traditionally considered these ideas to be a religious belief system and not part of the development of modern medicine. They assumed acupuncture was based purely on Chinese philosophy, and not on empirical observations of how the body works.

Instead, the history of anatomy usually begins in the second century with the Greek physician Galen. Through his animal dissections and observation of the wounds of gladiators, he developed theories that were accepted for 1,500 years. Then, during the Renaissance, scholars like the Flemish anatomist Andreas Vesalius began to make methodical maps of the human body.

Researchers believe the Han Dynasty manuscript challenges this eurocentric version of history. They were able to carry out dissections following the Chinese text, proving that the ancient observations were based on a practical knowledge of anatomy. They concluded that the Chinese were engaged in scientific research.

These findings come as acupuncture becomes more popular outside China. It is officially recognised by the World Health Organization and taught at medical schools in Europe and the United States. The US Army uses it to treat pain from injuries, and doctors prescribe it as a complementary therapy for depression, arthritis and back pain.

However, many medical professionals criticise alternative medicine, arguing that there is very little scientific evidence that these techniques work. In clinical trials, they often fail to outperform the placebo, implying that patients only perceive the benefits.

Supporters argue that this misses the point. Acupuncture treats pain, a complex interaction between mind and body that is not fully understood. The holistic treatments of traditional Chinese medicine encourage patients to feel more relaxed and in control. They say it is an entire experience and is not just about needles.

For opponents, this only confirms the suspicion that it is a pseudoscience. However, this latest discovery suggests that the history of medicine and acupuncture may be more interwoven than previously thought, and traditional Chinese medicine cannot be so easily dismissed.

So is acupuncture based on science?

A stab in the dark

Some say yes, acupuncture is more than just a set of traditional beliefs. This research shows how ancient anatomists developed Chinese medicine through scientific observation. Now, researchers are taking acupuncture more seriously, using brain scans to find out how it works and designing more extensive clinical trials to distinguish the placebo effect from the real thing.

Others say no, acupuncture is quackery and pseudoscience. It has its basis in phenomena - Qi, meridians and acupoints - that no one has ever seen. Just because it has been practised for thousands of years does not make it legitimate. To be accepted by modern science, it must pass rigorous clinical trials. And so far, it has failed to do so.

You Decide

  1. What would you think if your doctor offered you acupuncture?
  2. Is it essential for medical treatments to be based on science?

Activities

  1. Create an informational poster to explain acupuncture to patients new to traditional Chinese medicine.
  2. Research the arguments for and against acupuncture and write a paragraph summarising each side of the debate.

Some People Say...

“I am not accustomed to saying anything with certainty after only one or two observations.”

Andreas Vesalius (1514 - 1564), Flemish physician and founder of modern human anatomy.

What do you think?

Q & A

What do we know?
It is generally agreed that modern medicine is founded on the scientific method. This approach is empirical, relying on observations of the natural world rather than making assumptions based on logic, ideas or belief. Scientists make predictions based on these observations and then repeatedly test and improve their theories. This empirical approach to knowledge can be traced back through philosophers like Isaac Newton and Francis Bacon to Aristotle and his study of biology.
What do we not know?
One main area of debate is around the placebo effect. When scientists test a new drug, they want to measure its effectiveness, not whether the patient thinks it works. So they try to eliminate the placebo effect in laboratory conditions. This is difficult to achieve with acupuncture, and some argue that it is not really useful. Like other alternative therapies (e.g. meditation and counselling), the patient’s belief in the treatment plays a vital role in its effectiveness.

Word Watch

Quackery
The promotion of fraudulent and fake medical treatments gets its name from an obsolete Dutch word, quacksalver, which meant a “hawker of salve.” Medieval charlatans would “quack” (shout) about their miracle cures in the marketplace.
Anatomical atlas
The Mawangdui medical manuscripts were discovered in 1973, but only recent translation and analysis has revealed their significance as an empirical study of the human body.
Traditional Chinese medicine
The foundational text is The Yellow Emperor’s Canon of Internal Medicine, written around 300 BC. It takes the form of a dialogue between the mythical Yellow Emperor and his doctor, discussing health, disease and treatment.
Renaissance
The “rebirth” of Western learning began in the late 15th century, as European scholars rediscovered ancient manuscripts and began to make developments in science and art.
Han Dynasty
The golden age of Ancient Chinese civilisation lasted from 202BC to 220AD. Among their world-changing discoveries, the Han invented paper, the suspension bridge, the wheelbarrow, stirrups for riding horses and rudders for directing boats.
Complementary therapy
Health practitioners will often recommend techniques like acupuncture, yoga, massage and meditation to complement other medical treatment.
Placebo
Patients may report feeling better after taking treatments with no medical value. This is called the placebo effect. In order to distinguish between perceived and actual effects of a new treatment, researchers will test a placebo or “sham” alongside the real treatment – and compare the results.

Subjects

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