The Evolution of Acupuncture Needles and Tools

Posted on Posted in Acupuncture, General
This still has a 'saggital' or arrow-head tip, but it's been made more three-dimensional, like a rolled sheet of paper

If you have already had acupuncture at Meridians, you will know that much of Japanese acupuncture does not involve needle insertion. As well as using needles we also deploy a bunch of strange looking tools for touching, rubbing and pressing  the skin. These tools did not just spring into being. Like acupuncture itself, they are the result of a slow evolution from ancient forms, first described in the ancient medical literature.

One of humanity’s oldest medical textbooks comes from China. The Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing) was written in roughly 100BC in the form of a ‘dialogue’ between the (mythical) Yellow Emperor and his (equally mythical) minister, Qibo.

It is in one of the volumes of this book, the Ling Shu, that we first read about the nine kinds of acupuncture needle and their uses. Have you noticed the replica set of nine needles hanging on the wall in the Meridians’ reception? It came from the Shanghai Museum of Traditional Chinese Medicine. It also came with a slightly dodgy translation into English. Here’s a sample.

The Yellow Emperor asked ‘Is there any criterion for the length of needles?’

Qibo said, ‘The first kind of needle is called the saggital needle, (arrow-shaped) which is made following the example of a sewing needle. It becomes suddenly sharp half an inch from the tip and its length is 1.6 cun. It is mainly used for treating pathogenic heat in the head and body.

‘The second kind is called the ovoid-tip needle, with is made following the wadding needle (wadding is a soft layer of fibrous cotton used for padding). The body of the needle is straight and round and the tip is round and sharp like an egg. Its length is 1.6 cun and it is mainly used for treating the pathogens between the muscles.

‘The third kind of needle is called the blunt-tip needle, which is made following the example of the glutinous millet, being round and somewhat sharp. Its length is 3.5 cun and it is mainly used to press the meridians to move Qi to eliminate the pathogens…”

Qibo carries on chatting to the emperor in this vein until he has described all nine needles. Sadly, although we have these written descriptions, we have no images from antiquity. No one really knows what these needles actually looked like! We can only guess…

The illustrations below are from the Chinese book Zhen Jiu Da Cheng, in 1601 and two Japanese sources, the Sugiyama Ryu Sambusho, around 1700 and the Shinkyu Cho Hoki of 1726. It’s no surprise to learn that Chinese and Japanese historians have modeled different needles from this same data.

From Japanese Acupuncture: A Clinical Guide by Stephen Birch and Junko Ida
From Japanese Acupuncture: A Clinical Guide by Stephen Birch and Junko Ida

The needle types go from right to left, Chinese style.

As you can see, from the same written description originating in 100BC, these 17th and 18th century books have come up with quite different visual profiles for each of the needles. The reproductions in the picture frame on the wall at Meridians are from the Zhen Jiu Da Cheng,
The Nine Needles


English Modern name Chinese Japanese
Sagittal or arrow-headed needle Arrowhead needle Chan zhen Zanshin
Ovoid tip needle Roundhead needle Yuan zhen Enshin
Blunt tip needle Blunt needle Shi zhen Teishin
Three-edged needle Three-edged needle Feng zhen Hoshin
Sword-shaped needle Sword-shaped needle Pi zhen Hishin
Horsehead needle Round-sharp needle Yuan li zhen Enrishin
Filiform needle Filiform needle Hao zhen Goshin
Long needle Long needle Chang zhen Choshin
Large needle Large needle Da zhen Taishin



Nine needles in practice

The acupuncture needle most commonly used worldwide is the filiform needle, the goshin. This is your standard acupuncture needle and the one we have all seen on TV which, when inserted in great numbers on the back, makes the patient look like a porcupine.



The needles above on the left are Chinese styled, with a coiled loop handle. The Japanese tend to use  pipe-handled goshin, such as the ones on the right.

The otherthree edge needle needle very commonly used in acupuncture is the three-edged needle, as bloodletting is a well-established therapy in both China and Japan.





What about the others? In addition to the  commonly  goshin for standard needling, we do use other variations of the nine. That rounded copper thing we rent out for you to treat your kids at home is called an enshin. If you’ve seen me treating kids you will also have seen me use a blunt needle called a teishin. And from time to time I’ll use a zanshin for massaging.  In cases of severe pain or blood stagnation, I will break out a hoshin for shiraku or bloodletting, .

So at Meridians we are still using five of the classical nine needles!

What are they all used for?

Needle Insertion Use
Zanshin Shallow Removes evil (disordered) qi at the surface
Enshin No insertion Removes evil (disordered) qi at the borders of the flesh
Teishin No insertion Circulates qi and blood
Hoshin Shallow Bloodletting
Hishin Shallow Removes pus
Enrishin Deeper Removes fulminant qi (sudden or violent movements of energy)
Goshin Deeper Strengthens zheng qi (the True or Correct Qi, the core energy of the body), treats arthritis
Choshin Deeper Removes chronic arthritis or deep problems
Taishin Deeper Removes water qi of the joints


 Ancient forms and contemporary design

In Japan, the teishin, enshin and zanshin have all evolved, from the classical shapes to more modern forms and materials. Tools made from silver, gold, platinum, copper and brass with gold plate are all commonly used.

Here is a reproduction from Japan of the nine needles, another attempt to conjecture about the original form of the nine.

The Japanese extrapolations of shape are very different to the Chinese. We may never know...
The Japanese extrapolations of shape are very different to the Chinese. We may never know…

Here are some contemporary Japanese teishin, the third blunt-tip type of needle. You can see they all have a rounded ball at one end, echoing Qi Bo’s ‘glutinous millet’ and a blunt tip at the other.

The top one is a compound teishin/enshin. At one end is a retractable spring-loaded teishin, with markings that can be used to calibrate downward pressure on acupuncture points. At the other end it is a rounded enshin, used for rubbing and stroking the channels. Compound instruments are quite common in Japan.


Here are some examples of rounded enshin, developed from the original ovoid or roundhead needle, the second type. The top one is stainless steel, the second one is silver. Copper enshin are very common too.



Note that any silver spoon will make a great enshin, so much so that in Malaysia, Shonishin (acupuncture for kids) has been unofficially dubbed Spoon Massage! These lovely silver spoons belonged to my grandmother.


Here is a wonderfully elegant silver zanshin from Japan, known as a conical zanshin because of its shape. It’s based on the first of the needle types, the arrowhead needle and it is used to press on the meridians.

This still has a 'saggital' or arrow-head tip, but it's been made more three-dimensional, like a rolled sheet of paper
This still has a 'saggital' or arrow-head tip, but it's been made more three-dimensional, like a rolled sheet of paper

Also pictured are two wooden needles. The darker one at the bottom is a Chinese gua sha tool and the lighter one above it is Dr. Manaka’s famous ‘wooden needle’ with which he tapped on acupuncture points at specific frequencies of beats per minute. This is the practice that inspired the Ontake Warm Bamboo treatments at Meridians.

Learn more about Ontake Warm Bamboo
wooden needles

By shape, they look like enshin but their function is to circulate Qi and blood, by pressing, rubbing or tapping, so more like teishin or even zanshin. I think the shape is the best clue to their origin so perhaps we could classify them developmentally as enshin.


Acupuncture Evolution

Just like everything else on the planet, acupuncture is in a constant state of development.

The amazing Yanagishita enshin
The amazing Yanagishita enshin

In 2010, the president of the Toyohari association, the late Mr. Torio Yanagishita designed this stunning stainless steel enshin. You can see how the design has changed. Instead of a sphere at the end, it has an ellipse and at the other end, a hexagonal shaft. Finely machined lines on the centre can be used for rubbing.

The design is even more remarkable when we consider that Mr. Yanagishita was blind and had to explain all his ideas without any visual aids and pass judgement on prototypes just by their feel.
Yanagishita Sensei
Sadly, while at the top of his field, in 2011, Mr Yanagishita passed away. His enshin is part of his legacy.


So, although the English word for acupuncture includes the idea of piercing the skin, the reality of acupuncture practice is that piercing the skin is not necessary. This should come as a great relief to anxious patients and children.
You don't need needles to do acupuncture!
Acupuncture could really be renamed meridian therapy, as all we are doing is moving energy in the meridians of the body, using a wide variety of tools and techniques, many of them non-insertive, as described above. In Japan, someone had this idea already and a large proportion of practitioners are members of a style called Keiraku Chiryo, which means, literally, Meridian Therapy.

Many thanks to my teacher Yanagishita Sensei, who inspired so many with his knowledge, skill and not least, his wicked sense of humour.

y teishin

If you'd like detailed and referenced information about this material, please refer to two great books, from which all of the above is taken.
Shonishin: Japanese Paediatric Acupuncture, by Stephen Birch
Japanese Acupuncture: A Clinical Guide, by Stephen Birch and Junko Ida