In ancient times smooth flint needles were used, later they were substituted by metal ones, still later by silver or gold and finally by steel and stainless steel needles.
Nine types of acupuncture needles were known in history, but today only three types are in use: the needle haozhen, sanlingzhen and pifuzhen.The most common type is the needle haozhen. It is either made of gold, silver or stainless steel, of different lengths and different thicknesses according to the required insertion, depth and intensity of stimulation. The length is 7 fens, 1 cun, 1 cun 5 fens, 2 cuns, 2 cuns 5 fens, 3 cuns or 3 cuns 5 fens.
The thickness is designated by numbers 26 (the thickest one), 28 or 30. Most often the needles of middle thickness are used. The acupuncture needle consists of three parts: the handle, around which a fine wire is wound so thickly so that it can be turned more easily; the neck and the body of the needle with the point. The sanlingzhen needle is triangular and usually is used for bloodletting. It is inserted 1/2 – 1 fen. The skin needle pifuzhen is sometimes called children’s needle. It is a small mallet with six or seven tiny needles on an area of one square cm. It is mainly used with children for light tapping in the area of the points. It can be used with women, people suffering from chronic diseases or those afraid of normal acupuncture needles. Light tapping twice or three times evokes mild stimulation, six times it evokes stronger stimulation.
Gold and silver needles were said to produce a special effect but today this theory is repudiated. Gold and silver needles can be bent easily, but do not break, while the steel needles cannot be bent, but can break easily. The steel needles, however, are preferred. Being elastic, they cannot be deformed easily.
The Angle of the Needle during Insertion
During insertion the needle may form:
- 90 degrees angle in right insertion (zhizhen) used for most points.
- 12-15 degrees angle in reclining insertion (hengzhen) used for some points on the head and chest, but very rarely. The acupuncture needle penetrates just the skin but does not reach the muscle.
- 45 degrees angle in bevel insertion (xiezhen) used for all the points lying below the seventh thoracic vertebra.
The physician must first ask the patient whether he has had any experience with acupuncture. If not, he must acquaint him with the sensation after insertion and tell him about the eventual possibility of fainting or even shock. In the case the patient feels sick or dizzy, he must inform the physician immediately so that the needles could be extracted in time or their number reduced to the minimum. Later on, after the patient gets accustomed, the number of the acupuncture needles can be increased.
In the case of patients of weak constitution or patients suffering from anemia, the needles should be inserted while the patient is lying. In both these cases strong stimulation should be avoided and lying insertion should be employed. The number of the needles should not be more than three.
If after insertion muscle cramps appear and the needle can neither be inserted further nor turned, it should also not be pulled out forcibly.
Sometimes the patient’s skin is either too relaxed or too tightened. Such skin is not suitable for needling and the insertion would be painful. In the former case the physician must try to tighten up the skin, in the latter case light massage is recommended.
The Process of Insertion in Acupuncture
The patient must be put into the correct position. An incorrect position can lead to a wrong localization of the points and sometimes even cause breaking of the needles. Next it is necessary to sterilize the acupuncture needle and the skin with 70% alcohol. Then the physician locates the point, exerting a certain pressure on it and using his nail he indicates a cross on the skin within an area of 5mm in diameter, in which the needle can be inserted. By means of the thumb and forefinger of the right hand the physician grasps the handle of the needle, while the belly of his middle finger and the nail of the forefinger of his left hand rests on the neck of the needle so that it could neither be vibrated not bent, then he puts the point of the needle to the skin and inserts it to the depth of about 1 mm. By turning it the needle is pressed down to the proper depth.
The insertion itself is almost not painful at all, but when the needle turns a slight pain is to be felt. The sensation of pain almost entirely depends on the skill of the physician. The Chinese put a great stress on exercising the strength of the fingers by piercing several sheets of paper or by inserting the acupuncture needle into a ball of thread. In the case the needle has already reached, the necessary depth and no reaction, i.e. no sensation of tingling occurs, the needle must be either pulled out carefully, or its tip must be turned to another direction as the respective spot has been evidently missed.
The Extraction of the Needle
When extracting the needle the muscles should be relaxed so that the needle could be pulled out easily by slightly turning it. If the needle is withdrawn quickly, the spot of insertion can be slightly painful and sometimes even blood appears, while by pulling out the needle slowly the patient feels only a slight pain which disappears completely afterwards. In this case blood does not appear.
If the needle cannot be pulled out smoothly, it should not at any rate be extracted by force. This is because of the following reasons:
- Bloodletting (dianci). The physician inserts the acupuncture needle into the respective point 1/2 – 1 fen, immediately draws it out and lets the blood flow. After the needle had been withdrawn, no bandage should be applied, but the physician should press the surrounding region with his fingers in order to squeeze out the blood. After black blood has flown out, sterilized cotton is put on the wound. In lumbar pain the point weizhong B 54 is used; in long lasting paralysis the painful spots are used, while in paralysis of the throat the point shaoshang L 11 and in cholera, sunstroke and apoplexy shixuan EP 11 is used.
- Dispersed puncture (sanci). This method is mostly used in swellings and inflammations. The affected place is pierced through several times and after massage the bad blood is pressed out.