---
title: "Case records"
url: "https://acuiq.com/wiki/research/case-records"
updated: 2026-10-17
last_verified: 2026-10-17
license: CC-BY-4.0
license_url: "https://creativecommons.org/licenses/by/4.0/"
section: "research"
basis: "Classical and modern"
audience: "Anyone"
published: "2026-10-17"
reading_minutes: 7
sources: 10
---

# Case records

_What the four acupuncture casebooks in AcuiQ contain, what a single case can and cannot show, and how the reporting checklists for case reports compare._

A case record is the account of one patient treated by one practitioner: the complaint, what the examination found, the diagnosis, the points and how they were needled, how often, and what happened. Chinese medical teaching uses collections of these records to show how general principles are applied to a particular patient, and four such collections, published in English between 1988 and 2013, are indexed in AcuiQ beside the trial literature. This page describes the four books, what a case record can and cannot show, and how AcuiQ files an entry taken from one.

## The four casebooks

| Book | Published | Where the cases come from | How a case is set out |
| --- | --- | --- | --- |
| [Chen Jirui and Nissi Wang (eds), _Acupuncture Case Histories from China_](https://books.google.com/books?vid=ISBN0939616076) | Eastland Press, Seattle, 1988 | Records of practitioners at institutes including the Chinese Academy of Traditional Chinese Medicine and the Chongqing Institute of Traditional Chinese Medicine, grouped by system: internal medicine, neurology, gynaecology and others | History and examination, syndrome differentiation, the points selected with their technique and schedule, a discussion of why each point was chosen, and the result |
| [Zhang Dengbu, _Acupuncture Cases from China: A Digest of Difficult and Complicated Case Histories_](https://books.google.com/books?vid=ISBN044304788X) | Churchill Livingstone, Edinburgh, 1994; first published in Chinese by Shandong Science and Technology Publishing House, 1989 | Cases credited one by one to a named practitioner and hospital, some reprinted from conference proceedings | History, examination, diagnosis, treatment principle, principal points and course, followed by an editor’s note on the reasoning |
| [Zhu Bing and Wang Hongcai (eds), _Case Studies from the Medical Records of Leading Chinese Acupuncture Experts_](https://books.google.com/books?vid=ISBN9781848190467) | Singing Dragon, London, 2011, with People’s Military Medical Press | The China Beijing International Acupuncture Training Center; the foreword counts 176 cases across 76 diseases | Eleven fixed headings: general data, chief complaint, history, present symptoms, tongue and pulse, differentiation and analysis, diagnosis, treating principle, prescription, effect and essentials |
| [Henry C. Lu, _Clinical Cases of Acupuncture_](https://books.google.com/books?vid=ISBN9781481830775) | Self-published through CreateSpace, 2013 | 413 numbered cases compiled from Chinese sources, most closing with their source in brackets; cases 339 to 413 are Lu’s translation of an unpublished manuscript by Zhong-Xu Huang of the Fujian College of Traditional Chinese Medicine | Varies with the source: some are narratives, others a fixed layout of diagnosis, prescription, technique and frequency |

## Which entries in these books are not patients?

Many of Henry Lu’s entries are not patients. They come from Chinese examination materials, tagged in the book as a licensing examination, a learner’s collection of questions or a question bank: a description of a patient followed by the answer an examiner expects. Nobody was treated and no outcome is reported, so AcuiQ takes nothing from them. The same applies to entries in any of the books that give a prescription for a condition with no patient attached.

## What can a case record show?

A case record shows what one practitioner did for one patient and what they saw afterwards. It cannot show that the treatment caused the change. [Nissen and Wynn](https://doi.org/10.1186/1756-0500-7-264), reviewing the arguments for and against the case report in 2014, list what it is good for: detecting something new, generating hypotheses, recording harms, and teaching. They also list what it cannot do: support a generalisation, establish cause and effect, or escape publication bias, since successes are more likely to be written up than failures.

The four books are teaching collections, and they say so. Chen and Wang’s introduction presents the case history as the way a student sees principles applied to a particular patient, and expects similar diagnoses to be treated differently by different contributors. Zhang’s subtitle announces a selection of difficult cases. Almost every case in the four books closes with the patient recorded as improved or recovered. The failures they do record are usually a first prescription that the practitioner then changed, and the record goes on to the second.

## How do they compare with a published case report?

Medical journals now ask for case reports to follow a checklist. The [CARE guidelines](https://doi.org/10.1186/1752-1947-7-223), agreed by 27 clinicians, researchers and editors in 2013, set 13 items, including a timeline, the diagnostic assessment, follow-up with any adverse events, the patient’s own perspective and informed consent; the [2017 explanation](https://doi.org/10.1016/j.jclinepi.2017.04.026) gives an example of each. Two checklists have since adapted it. [CARC](https://doi.org/10.1007/s11655-015-2121-6), for case reports in Chinese medicine, was agreed by 118 participants from China and Korea in 2016 and has 16 items. [CARE for acupuncture](https://doi.org/10.1136/bmjebm-2025-113641), developed through three Delphi rounds with 38 experts and published in 2025, has 30 items covering what an acupuncture report needs to state.

The CARC group based its checklist on a survey of published reports. [Fu and colleagues](https://doi.org/10.1007/s11655-015-2250-y) read 1,858 case reports describing 3,417 cases in 13 core Chinese medical journals from 2006 to 2010. Over 90% recorded the Chinese medicine signs and the tongue and pulse; fewer than half gave the rest of the medical history or the reasoning behind the diagnosis.

The four casebooks record the complaint, tongue, pulse, pattern, points and schedule in detail, and three of the four predate both checklists. None of them has a heading for harms, consent or the patient’s account of the treatment.

## What the books say about how often to treat

Chen and Wang’s introduction gives the schedules its contributors worked to, as general guidance from a health system where frequent treatment was cheap. Acute conditions were needled once a day, more often if severe, in courses of 5 to 7 days with 1 to 2 days’ rest. Chronic conditions were needled every other day, in courses of 10 to 15 treatments with 3 to 5 days’ rest. A case’s session count and course length are recorded on its AcuiQ entry where the book states them; [Reading a protocol](/wiki/method/reading-a-protocol) explains those fields.

The same introduction lists [`LI04`](/points/li04) (Hegu), [`SP06`](/points/sp06) (Sanyinjiao), [`BL60`](/points/bl60) (Kunlun) and [`BL67`](/points/bl67) (Zhiyin) as points its contributors did not needle in pregnancy, with the lower abdomen and later the lower back also avoided. [Pregnancy and the forbidden points](/wiki/safety/pregnancy-and-the-forbidden-points) sets that list beside the others.

## How does AcuiQ file a case from a casebook?

Each patient becomes one entry, under the evidence kind for a clinical text or case report. Where a case changed its prescription for a later course, each prescription is its own entry with a note saying it is the same patient. The source on every entry is the book rather than the page, so the [conformance register](/wiki/research/conformance), which counts distinct sources rather than entries, reads one book as one source however many cases it holds.

Some parts of a case are left out. A point the catalogue does not hold, such as an [ashi point](/wiki/theory/ashi-points) or a local point named in only one book, is dropped rather than matched to the nearest catalogued point; a prescription the book leaves open, ending in “etc.”, is not recorded at all, since a partial prescription cannot be told apart from a complete one. A drug or tissue extract injected at points is outside the index; [Point injection](/wiki/techniques/point-injection) describes the method. The scans were read by optical character recognition, and each point code was checked against its printed pinyin name, since the scans confuse similar codes and the name settles which point was meant.

## What these records cannot settle

A casebook entry says that a named practitioner chose these points for this patient and recorded improvement. It cannot say how many similar patients were treated the same way without improving, or whether the patient would have improved anyway. Where a condition also has trials, the symptom page lists the casebook entry alongside them, and the trials are the place to look for an answer to whether the points work. For future case reports, CARE for acupuncture sets out what a single case report needs to state for a reader to judge it.

### Sources

1. Chen Jirui, Wang N (eds), Acupuncture Case Histories from China, Eastland Press 1988 — https://books.google.com/books?vid=ISBN0939616076
2. Zhang Dengbu, Acupuncture Cases from China: A Digest of Difficult and Complicated Case Histories, Churchill Livingstone 1994 — https://books.google.com/books?vid=ISBN044304788X
3. Zhu Bing, Wang Hongcai (eds), Case Studies from the Medical Records of Leading Chinese Acupuncture Experts, Singing Dragon 2011 — https://books.google.com/books?vid=ISBN9781848190467
4. Lu HC, Clinical Cases of Acupuncture, CreateSpace 2013 — https://books.google.com/books?vid=ISBN9781481830775
5. Nissen T, Wynn R, The clinical case report: a review of its merits and limitations, BMC Research Notes 2014 — https://doi.org/10.1186/1756-0500-7-264
6. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, The CARE guidelines: consensus-based clinical case reporting guideline development, Journal of Medical Case Reports 2013 — https://doi.org/10.1186/1752-1947-7-223
7. Riley DS, Barber MS, Kienle GS et al., CARE guidelines for case reports: explanation and elaboration document, Journal of Clinical Epidemiology 2017 — https://doi.org/10.1016/j.jclinepi.2017.04.026
8. Fu SF, Cheng CW, Zhang L et al., Consensus-based recommendations for case report in Chinese medicine (CARC), Chinese Journal of Integrative Medicine 2016 — https://doi.org/10.1007/s11655-015-2121-6
9. Duan Y, Xu Z, Zhang Y et al., CARE extension guideline for acupuncture case reports, BMJ Evidence-Based Medicine 2025 — https://doi.org/10.1136/bmjebm-2025-113641
10. Fu SF, Kun W, Zeng XX et al., Urgent need to improve the quality of case report in traditional Chinese medicine: assessment on reporting quality of 3,417 cases, Chinese Journal of Integrative Medicine 2016 — https://doi.org/10.1007/s11655-015-2250-y