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====Establishment and growth==== In the first half of the 1st century AD, acupuncturists began promoting the belief that acupuncture's effectiveness was influenced by the time of day or night, the lunar cycle, and the season.<ref name="abc"/>{{RP|140–41}} The 'science of the yin-yang cycles' ({{lang|zh|運氣學}} {{transliteration|zh|yùn qì xué}}{{efn|A reference to the five movements and six ''qi'' ({{lang|zh|五運六氣}} {{transliteration|zh|wǔ yùn liù qì}}).}}) was a set of beliefs that curing diseases relied on the alignment of both heavenly ({{Lang|zh-latn|tian}}) and earthly ({{Lang|zh-latn|di}}) forces that were attuned to cycles like that of the sun and moon.<ref name="abc"/>{{RP|140–41}} There were several different belief systems that relied on a number of celestial and earthly bodies or elements that rotated and only became aligned at certain times.<ref name="abc"/>{{RP|140–41}} According to Needham and Lu, these "arbitrary predictions" were depicted by acupuncturists in complex charts and through a set of special terminology.<ref name="abc"/> Acupuncture needles during this period were much thicker than most modern ones and often resulted in infection. Infection is caused by a lack of sterilization, but at that time it was believed to be caused by use of the wrong needle, or needling in the wrong place, or at the wrong time.<ref name="abc"/>{{RP|102–03}} Later, many needles were heated in boiling water, or in a flame. Sometimes needles were used while they were still hot, creating a [[cauterizing]] effect at the injection site.<ref name="abc"/>{{RP|104}} Nine needles were recommended in the ''Great Compendium of Acupuncture and Moxibustion''{{efn|{{lang-zh|t=針灸大成|s=针灸大成|p=Zhēn jiǔ dà chéng|w=Chen Chiu Ta Chʻeng}}.}} from 1601, which may have been because of an ancient Chinese belief that nine was a magic number.<ref name="abc"/>{{RP|102–03}} Other belief systems were based on the idea that the human body operated on a rhythm and acupuncture had to be applied at the right point in the rhythm to be effective.<ref name="abc"/>{{RP|140–41}} In some cases a lack of balance between Yin and Yang were believed to be the cause of disease.<ref name="abc"/>{{RP|140–41}} In the 1st century AD, many of the first books about acupuncture were published and recognized acupuncturist experts began to emerge. The ''Zhen Jiu Jia Yi Jing'',{{efn|{{lang-zh|t=針灸甲乙經|s=针灸甲乙经|p=Zhēn jiǔ jiǎ yǐ jīng}}.}} which was published in the mid-3rd century, became the oldest acupuncture book that is still in existence in the modern era.<ref name="abc"/> Other books like the ''Yu Gui Zhen Jing'',{{efn|{{lang-zh|t=玉匱鍼經|s=玉匮针经|p=Yù guì zhēn jīng|w=Yü Kuei Chen Ching}}.}} written by the Director of Medical Services for China, were also influential during this period, but were not preserved.<ref name="abc"/> In the mid 7th century, [[Sun Simiao]] published acupuncture-related diagrams and charts that established standardized methods for finding acupuncture sites on people of different sizes and categorized acupuncture sites in a set of modules.<ref name="abc"/> Acupuncture became more established in China as improvements in paper led to the publication of more acupuncture books.<ref>{{Cite web |date=2022-10-20 |title=Some Sepsis Stuff {{!}} Science-Based Medicine |url=https://sciencebasedmedicine.org/some-sepsis-stuff/ |access-date=2022-11-04 |website=sciencebasedmedicine.org |language=en-US |archive-date=4 November 2022 |archive-url=https://web.archive.org/web/20221104115738/https://sciencebasedmedicine.org/some-sepsis-stuff/ |url-status=live }}</ref> The Imperial Medical Service and the Imperial Medical College, which both supported acupuncture, became more established and created medical colleges in every province.<ref name="abc"/>{{rp|129}} The public was also exposed to stories about royal figures being cured of their diseases by prominent acupuncturists.<ref name="abc"/>{{rp|129–35}} By time the ''Great Compendium of Acupuncture and Moxibustion'' was published during the [[Ming dynasty]] (1368–1644 AD), most of the acupuncture practices used in the modern era had been established.<ref name=White-Ernst/>
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