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The Diverse World of Acupuncture in America

Updated: Oct 16, 2019

By: Dr. Halina O'Neill

Chinese medicine, with Acupuncture as its central tenant, is the oldest continuously practiced medical system in the world. The system has been created by some of the brightest and most educated scholars in Chinese history. The fundamentals of Chinese medicine were compiled in the Classics of Chinese Medicine. Some of these include: The Yellow Emperor’s Classic of Internal Medicine by Nei Jing, The Classic of Difficulties by Nan Jing, and The Systematic Classic of Acupuncture and Moxibustion by Zhen Jia Yi Ying, written as far back as 2,500 years ago.

A book about Acupuncture and Acupuncture Pressure Points in Chinese.

Over the years, the practice of Chinese medicine expanded to Japan, Korea and Taiwan, among others. Each culture since has developed their own form of acupuncture based on the Classics of Chinese Medicine.

With such a vast amount of knowledge and adaptation of Chinese medicine by many different Asian cultures, it is inevitable to have a wide variety of specialties and styles of acupuncture. This can cause much confusion for people, adding to the complexity of this practice.

Styles of Acupuncture

Traditional Chinese Medicine (TCM): The TCM style of acupuncture is fairly new. Established in 1950, it is the true and official state-sponsored standardization of Chinese Medicine that is part of the healthcare system of the People’s Republic of China. TCM is based on the Classics of Chinese Medicine but also emphasizes the physical and material aspects of diseases, as provided in the TCM diagnostic system. This accommodates its integration into Western medical ideology and the practice of medicine in China. Integration of Chinese Medicine into the medical healthcare system in China was very successful and became a model for other countries demonstrating how to integrate natural medicine into Western medicine-based healthcare systems.

TCM acupuncture is by far the most common system of acupuncture taught and practiced in North America today. All acupuncture certification examinations in the US are based on this system. The diagnostic system used in TCM is called differential diagnosis. A TCM acupuncture practitioner differs from other acupuncture practitioners by using ticker needles, including a greater depth of insertion and a vigorous manipulation of the needle. A TCM practitioner usually treats more than one patient at the same time, structuring their practice in likeness with western medical models, providing limited individual attention.

A Five Elements Acupuncture Diagram.

Five Element Acupuncture: Also called Classical Acupuncture, Five Element Acupuncture is based on the Classics of Chinese medicine. It has been brought to America by British Acupuncturist, Professor J.R. Worsley. Five Element Acupuncture practitioners are focused on the diagnosis of a Causative Factor - the weakest element in the system, using Five Element diagnostic (CSOE), to get to the root of the illness.

In diagnostic processes, special attention is given to mental/emotional and spiritual levels, as a source of illness. They use gentler needling techniques and thinner needles. Five Element Acupuncture practitioners treat one patient at a time and they tend to have more interaction with patients during the treatment. Treatments are highly individualized due to unique elemental diagnosis.

Japanese Acupuncture. Based on the ancient Classics of Chinese medicine, Japanese Acupuncture’s unique style was developed by Toyo Hari in the 17th century to accommodate blind practitioners of acupuncture. The style of Japanese Acupuncture is very hands on. The diagnostic system centers on the palpation of the abdomen, the back and the meridians, with attention on an underlying cause of dis-ease. Japanese Acupuncture uses very fine needles and the insertion of the needles are very gentle and superficial. Japanese Acupuncture practitioners stay with the patient through the whole course of the treatment and a great amount of attention is provided to the patients. This style of acupuncture is very suitable for highly sensitive people.

Family Style or Generational Acupuncture. This style of acupuncture refers to lineage-based Chinese styles that are typically handed down through apprenticeship training. Examples include the Cheng Tan An style.

Barefoot Doctor Acupuncture. Barefoot Doctor Acupuncture is an abbreviated First Aid approach to public health and was developed in China in the 1950’s. It focuses on basic hygiene, wound dressing, vaccination and family planning. It includes acupuncture, moxibustion and herbal medicine in a very simplified way.

Medical Acupuncture These are usually healthcare practitioners who use acupuncture as an adjunct to support their main therapy. These include many physicians, physiotherapists, and chiropractors. Their application of acupuncture is tailored to conform to their systems of understanding the body and their acupuncture training is often days to weeks to, at most, months in duration. They generally do not rely on the traditional diagnostic systems of the other styles discussed above. They tend to use specific elements of Acupuncture as a technique. They generally characterize their approach as musculoskeletal or neurological. This form of acupuncture doesn’t follow the Classics of Chinese medicine and is a form of analgesic techniques of acupuncture.

Other Systems There are various micro-systems that are typically applied on a purely symptomatic basis. They are widely used by acupuncturists to support and enhance their treatment. The most used are: Auriculotherapy, Sooji Chim Korean Hand system, Chinese Scalp Acupuncture, the Japanese Scalp system of Yamamoto, and Chinese Wrist and Ankle Acupuncture.


All practitioners of Chinese Medicine in America are trained in TCM Acupuncture and use TCM in addition to their own unique style. They are also trained in one or more of the acupuncture microsystems and routinely use them to provide a symptomatic complement to the overall treatment of the patient.

There are many gifted and compassionate practitioners of acupuncture using diverse ways to help you on the journey to healing. You’re encouraged to try different styles of acupuncture until you feel that you have found the right one for you and your unique healthcare needs.



Birch, S., Ida J. (1998). Japanese Acupuncture: A Clinical Guide. Taos, NM: Paradigm Publication

Hsu, Elisabeth. (2008). The History of Chinese Medicine in the People's Republic of China and Its Globalization. East Asian Science, Technology and Society: An International Journal. 2(4): 465-484.

Maciocia, Giovani. (1989). The Foundations of Chinese Medicine. London, UK: CHURCHILL LIVINGSTONE ELSEVIER

Worsley, Professor J.R. (1998). Classical Five Element Acupuncture, Volume III, The Five Elements and The Officials. Published by J.R. & J.B.Worsley

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