“To the Man with a Hammer…” (the Nine Acupuncture Needles)

“To the man with a hammer…everything looks like a nail.” This quote from Mark Twain asks us to consider carefully what our objective is before selecting the tool for the job.

The Nine Needles* The ‘bible’ of acupuncture’ (Yellow Emperor’s Classic of Internal Medicine) describes 9 types of needle. Of these, only 6 can be inserted into the body. The remaining 3 are used to stimulate your body without breaking the skin’s surface. Take a look at the image and you will see what I mean!

This forces us to re-evaluate our ideas of what is a ‘needle’ and to consider why we use them at all. Lets start with the premise that our over-arching goal is to generate / promote a state of health in the patient.

Health What then is “health”? Here is a definition selected from a quick google search:

The general condition of a person’s mind and body, usually meaning to be free from illness, injury or pain.

This isn’t bad, but Health as defined by absence of disease is not so useful when we want to know what we are aiming for rather than simply what to avoid. Here is a working definition which I find useful from a clinical perspective:

A sufficient and unobstructed flow of good quality blood and Ki** to every tissue of the body.

This definition may appear to ignore the emotional & mental, but actually poor health in these aspects, over time, either results in, or is a result of, an issue with the flow or quality of blood and Ki. Separation of “body, mind & spirit” is an illusion!

So why Needles? The objective of treatment is then to generate health according to this definition. Any intervention or tool which produces this result should be considered.

The early development of oriental medicine is shrouded in the mists of time. But we can be pretty certain that long before objects were inserted into the skin (to promote health rather than death, at least!), our forebears used massage (and warmth***).

Over time, various tools developed to help with such rubbing, pressing etc. With refinement and the emergence of medical theory, massage evolved into a more targeted stimulation of the body in specific areas and in specific ways.

What we now call “needles” emerged – in their various shapes and forms – as the best and most efficient tools to achieve the necessary stimulation:

Minimum Effective Dose However intricate we believe our understanding of the workings of the body, nature is still many many steps ahead!

In any treatment (be it western or oriental) we should always try to achieve the desired effect with the least possible intervention or disruption. We can call this the “minimum effective dosage” (“MED”). Voltaire put it somewhat more poetically:

“The art of medicine consists of amusing the patient while nature cures the disease.”

Surface As much as possible, we stimulate only at the level of the largest, most accessible organ: the skin. This remarkable organ provides us with a huge amount of information as to the state of the interior; And a huge surface area rich in connections through which to fine tune the workings of the internal organs.

Tools therefore evolved specifically to work at this level. These are called “needles” but do not (and could not due to their blunt and rounded forms) pierce the skin! The use of the term “puncture” in the English word “acupuncture” is misleading and generates a limited understanding of this medical system.

Children & Babies Children and babies, in particular, are very sensitive and their homeostasis easily influenced. Subtle stimulation to the skin using such pressing, brushing and rubbing tools is often sufficient to powerfully resolve dis-ease.

Note that for these age-groups a high proportion of dis-eases arise due to their as yet under-developed respiritory and digestive systems: Being literally a continuation of the skin’s surface within the body, these two systems are easily understood to be closely related to (and therefore strongly affected by stimulation to) the skin.

Interior Where stimulation within the skin or muscles is required, the appropriate tool finally begins to accord with the common idea of a “needle”. Here the super-fine needles of acupuncture can be considered as the ultimate in key-hole surgery! Working on the interior without damaging the exterior (MED once again).

Wholeness The word ‘health’ actually derives from the old English ‘hale’ meaning ‘whole; not-separated’. In this context we can think of these needles as tools which re-connect us: Internally by improving the quality of our blood & Ki flows; Externally with our surroundings/ fellow man.

This is literally so: when a needle is inserted it breaks across the boundary that we usually consider as our outer limit and acts as a kind of antenna or ‘bus-bar’. In the case of surface-needling we are regulating the opening & closing of the pores inducing better ‘communication’ with the exterior.

Figuratively, the effect of good treatment should be to return one to a state of relaxed ease with oneself and a feeling of being at one with the greater society and environment. This sense is also included in the Japanese the word for health: 健康 (kenkou). The left hand character refers mostly to the physical. The right hand character adds the sense of being at ease/ peace.

Painless With these concepts in mind, the use of our needles should be a painless, pleasant experience which induces relaxation! Good acupuncture should produce various subtle sensations, both at the site of stimulation and/ or at other locations connected by your meridians. It is said that you should ‘feel more of the practitioner’s hand, and less of the needle’.

Just a Needle? Finally, for a deeper understanding of what these tools represented in the day of the Yellow Emperor, I defer to the skill of my teacher in illuminating the etymology**** of the Chinese character for ‘acupuncture needle’:

The character for (acupuncture) needle, 鍼, has two sides. The left side is the character for metal, 金. The right side is a combination of the characters for mouth, 口, and for a weapon used to silence an opponent with great force, 戎. So the right half of the character has the sense of silencing or sealing in.

The total character refers to a metal implement for sealing in tightly the Ki of a patient and for silencing his or her pain and suffering. This character conveys a depth of meaning not contained in the character, 針, which is a needle used for sewing or piercing.

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Notes * Interested practitioners will find an excellent translation & in-depth discussion on the Nine Needles in A Long Road Vol. II by Edward Obaidey. ** Ki (Qi or “Chi” in Chinese) is a concept and reality of oriental medicine/ philosophy/ life. It is commonly translated as ‘energy’; ‘spark of life’ etc. This is a limited understanding. Please read The Ki to Life for further discussion. *** Such instinctual use of warming for therapeutic ends developed into moxibustion. **** Translation (by Edward Obaidey) of Sibasaki sensei’s etymology, extracted from A Long Road Vol. III.