Acupuncture is a method of treating certain disorders by inserting needles into various parts of the body. Most Western practitioners of traditional acupuncture leave the needles in place for 20 minutes or more. The treatment consists the insertion of needles, but there is nothing distinctive about the use of needles themselves; they are merely one effective means of stimulating the peripheral nervous system. Pressing the tissues or burning them may have similar effects; ‘acupressure’ and moxibustion are applications of this principle. On the basis of these examinations the physician decides which organs are out of balance. Needles are then inserted to ‘stimulate’ or ‘sedate’ the relevant organs by adjusting the flow of qi. This is essentially a hydraulic concept; the acupuncturist is thought of as a kind of engineer, opening and closing the valves as appropriate. In most cases today a number of needles are inserted and left in for 20 minutes or so. (Certain ancient texts say that a really expert practitioner needs to insert only one needle.) Much emphasis is laid on the accurate placement of the needles. The location of the acupuncture points is specified in terms of the cun, or ‘Chinese inch’, which is a variable measurement based on the dimensions of the particular patient. A great deal of attention is paid to obtaining various types of sensations from the patient as the needles are inserted, and the physician also experiences various sensations as he manipulates the needle. These phenomena, which are collectively called de qi, are supposed to be due to tapping into the flow of qi. About how to insert needles into a patient may relieve symptoms.

Indeed, such evidence as does exist mostly shows no differences according to whether the needles are inserted at ‘correct’ acupuncture points or elsewhere. We are therefore still obliged to rely on personal experience in this matter, and mine suggests that the non-traditional version is at least as effective as the traditional. It is now possible to put forward a reasonable explanation of how stimulating the nervous system via needles might have therapeutic effects. In relation to acupuncture, it has the consequence that almost any kind of needle stimulus may be expected to produce a certain amount of pain relief, whether or not it is done at a recognized acupuncture point. Bacterial infections are very rare indeed provided disposable needles are used. The needles should not, of course, be inserted through areas of skin that are obviously infected. Needles should also not be inserted into joint cavities unless full antiseptic precautions are taken, but this form of treatment is in any case unnecessary and undesirable.

By definition, acupuncture consists in the use of needles disposable needles have become widely available and are quite inexpensive; they are also better in quality. The needles in common use have a shaft and a handle, so that they somewhat resemble a small rapier. Previously the handle was made of fine wire wound round the needle; this type is still available, but there are also needles whose handles are made of plastic. These are equally satisfactory provided electrical stimulation is not needed. The shaft of the needle is normally made of steel; gold and silver needles are also available and are said by some to have special properties, but there is no good evidence for this. Other types of needles exist. Very short needles are used to treat the ear; these are shaped like small drawing pins made of wire and project only about 1 mm into the skin. They can be used in other locations than the ear when very superficial stimulation is required. Practitioners of traditional acupuncture sometimes use a ‘plum blossom hammer’; this is a mallet with short needles set in its face, which allows scarification of the skin over an area. Sterilization of these instruments is difficult. Needles come in varying lengths and thicknesses. The most useful needle is 30–40 mm in length and either 0.25 mm or 0.30 mm in diameter. The thicker needles are easier to insert but more painful for the patient. The technique of inserting the needles is simple but requires practice if it is to be done skilfully and relatively painlessly. The technique of inserting the needles is simple but requires practice if it is to be done skilfully and relatively painlessly. Once the needle is inserted a number of things may happen. Different teachers of acupuncture have quite divergent ideas about how to choose which points to needle, as well as about the duration and intensity of needling and other matters. To needle the right side for the treatment of disease on the left side, and how to needle the left side for the treatment of disease on the right side.{Acupuncture in Practice Beyond Points and Meridians by Anthony Campbell.}