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Acupuncture is a traditional Chinese medical practice involving the insertion of thin needles into specific points on the body to balance the flow of qi (vital energy). This timeline traces acupuncture's evolution from early texts like the Huangdi Neijing through its spread to Japan and Korea, its decline and revival in China, and its eventual acceptance as a complementary therapy worldwide. More Less
200 BC - 199 BC
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The Mawangdui texts, believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses and moxibustion, but not for acupuncture.
Image source: Acupuncture
1 AD - 99 AD
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In the 1st century AD, many of the first books about acupuncture were published and recognized acupuncturist experts began to emerge. In the first half of the century, acupuncturists began promoting the belief that effectiveness was influenced by the time of day or night, the lunar cycle, and the season.
250
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The Zhen Jiu Jia Yi Jing, published in the mid-3rd century, became the oldest acupuncture book that is still in existence in the modern era.
Image source: Acupuncture
400
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Numerous additional documents were published over the centuries introducing new acupoints. By the 4th century AD, most of the acupuncture sites in use today had been named and identified.
650
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In the mid-7th century, Sun Simiao published acupuncture-related diagrams and charts that established standardized methods for finding acupuncture sites on people of different sizes and categorized acupuncture sites in a set of modules.
Image source: Sun Simiao
1601
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Nine needles were recommended in the Great Compendium of Acupuncture and Moxibustion from 1601, possibly because of an ancient Chinese belief that nine was a magic number. By the time it was published during the Ming dynasty, most acupuncture practices used in the modern era had been established.
600
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Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, beginning with France. Acupuncture use was commonplace in Korea by the 6th century.
800 - 900
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Acupuncture spread to Vietnam in the 8th and 9th centuries. As Vietnam began trading with Japan and China around the 9th century, it was influenced by their acupuncture practices as well.
1279
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By the end of the Song dynasty (1279 AD), acupuncture had lost much of its status in China. It became rarer in the following centuries, associated with less prestigious professions like alchemy, shamanism, midwifery, and moxibustion.
1600 - 1700
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Japanese acupuncturists use extremely thin needles that are used superficially, sometimes without penetrating the skin, and surrounded by a guide tube (a 17th-century invention adopted in China and the West).
1757
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By the 18th century, scientific rationality was becoming more popular than traditional superstitious beliefs. By 1757, a book documenting the history of Chinese medicine called acupuncture a "lost art".
1822
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In 1822, the Chinese Emperor signed a decree excluding the practice of acupuncture from the Imperial Medical Institute. It was restored for a time, but banned again in 1929 in favor of science-based medicine.
1949
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In China, the popularity of acupuncture rebounded in 1949 when Mao Zedong took power and sought to unite China behind traditional cultural values. New practices were adopted in the 20th century, such as using clusters of needles, electrified needles, or leaving needles inserted for up to a week.
1550 - 1600
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France was an early adopter among the West due to the influence of Jesuit missionaries, who brought the practice to French clinics in the 16th century.
1683
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The first elaborate Western treatise on acupuncture was published in 1683 by Willem ten Rhijne, who created the term "acupuncture" in his work De Acupunctura, providing the first in-depth description of acupuncture for a European audience.
Image source: Willem ten Rhijne
1800 - 1900
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By the 19th century, acupuncture had become commonplace in many areas of the world. Americans and Britons began showing interest in acupuncture in the early 19th century, although interest waned by mid-century.
1810 - 1816
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The French doctor Louis Berlioz (the father of composer Hector Berlioz) is usually credited with being the first to experiment with acupuncture in Europe in 1810, before publishing his findings in 1816.
Image source: Hector Berlioz
1955
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In France, the Académie Nationale de Médecine (National Academy of Medicine) has regulated acupuncture since 1955.
1971
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In 1971, New York Times reporter James Reston published an article on his acupuncture experiences in China, which led to more investigation of and support for acupuncture in the United States. President Richard Nixon visited China in 1972.
Image source: James Reston
1972 - 1973
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In 1972, the first legal acupuncture center in the US was established in Washington DC, and in 1973 the American Internal Revenue Service allowed acupuncture to be deducted as a medical expense.
1990
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In New Zealand in 1990, acupuncture was included into the Governmental Accident Compensation Corporation (ACC) Act, giving it official recognition.
1992 - 1997
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The US Congress created the Office of Alternative Medicine in 1992, and the National Institutes of Health declared support for acupuncture for some conditions in November 1997. In 1999, the National Center for Complementary and Alternative Medicine was created within the NIH.
Image source: National Center for Complementary and Integrative Health
1999
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In Hong Kong, the practice of acupuncture is regulated by the Chinese Medicine Council, which was formed in 1999 by the Legislative Council.
Image source: University of Hong Kong
2006
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In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia.
2010
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In 2010, UNESCO inscribed "acupuncture and moxibustion of traditional Chinese medicine" on the UNESCO Intangible Cultural Heritage List following China's nomination.
Image source: Intangible cultural heritage
2017 - 2023
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The global acupuncture market was worth US$24.55 billion in 2017. It was estimated in 2021 that the industry would reach a market size of US$55 billion by 2023.
2022
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CDC clinical practice guidelines from 2022 list acupuncture among the types of complementary and alternative medicines physicians should consider in preference to opioid prescription for certain kinds of pain.
Image source: Centers for Disease Control and Prevention
2009
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A 2009 overview of Cochrane reviews found acupuncture is not effective for a wide range of conditions. A 1998 review had also found that trials originating in China, Japan, Hong Kong, and Taiwan were uniformly favourable to acupuncture, as were ten out of eleven studies conducted in Russia.
2011 - 2012
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A 2011 assessment concluded that the methodological quality of most randomized controlled trials on traditional Chinese medicine, including acupuncture, was generally poor. A 2012 review of 88 systematic reviews published in Chinese journals found less than half tested for publication bias, with most journals having impact factors of zero.
2011 - 2013
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A 2011 systematic review found that serious complications following acupuncture continue to be reported; between 2000 and 2009, ninety-five serious cases including five deaths were reported. A 2013 review found 295 cases of infections, with mycobacterium the pathogen in at least 96%, and reports of infection transmission increased significantly in the prior decade. A 2011 systematic review also found 26 cases of cardiac tamponade resulting in 14 deaths.
2014
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A 2014 review in Nature Reviews Cancer found that contrary to claims of redirecting qi through meridians, researchers usually found it does not matter where the needles are inserted or whether they are actually inserted; sham acupuncture generally produces the same effects as real acupuncture. The same review analyzed mouse studies suggesting acupuncture relieves pain via local release of adenosine triggering nearby A1 receptors.
2021
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As of 2021, many thousands of papers had been published on the efficacy of acupuncture for various adult health conditions, but there was no robust evidence it was beneficial for anything except shoulder pain and fibromyalgia.
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