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Practical Considerations for Modern Use of an Ancient Techni

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One of the main sources used for this literature review was the Journal of Traditional Chinese Medicine, published in English since 1982 and revised in 2003. This magazine has many articles on various forms of the practice of traditional Chinese medicine, including a variety of techniques of acupuncture, moxibustion, cupping, bloodshed, massage therapy and internal medicine (herbal prescriptions ) and topical applications of herbs. The journal includes articles that examine the techniques in general, as well as articles on the treatment of specific diseases, or use of acupuncture points or herbs. A limitation of this review is the dependence on publications in English (translation from Chinese), but one advantage is that readers will be able to review most of the reference texts and articles.

Practitioners of Chinese medicine usually receive limited training in moxibustion therapy. The training consists mainly of the presentation of some basic techniques and moxa lists some indications for the use of moxibustion (for example, to treat cold syndromes) and against (for example, in the syndromes of heat ). The experience of using moxibustion is often unclear. Practitioners, patients and others concerned about the smoke from the moxa in terms of safety and other impacts. Practitioners are not without much education, how to implement moxa intensively to get the desired results. Sometimes they are responsible for using moxa slightly with short and little administration, contrary to its actual use in China, and there remain questions about its mechanism of action and its effectiveness. This article reports an exploration of the literature on moxibustion to help clarify some of these issues. It is an extension on a section of a previous article by START 1998, Borneol, Artemisia, and Moxa. This article refers to the herbal material used for moxa (artemisia, also known as wormwood) and one of its active components, Borneol, which is isolated (provided in the form of crystals, called bingpian) and commonly used in therapy topical for its antiseptic and analgesic effects.

Relative position of Acu-Moxibustion In moxibustion
The term of Chinese origin of what we call today acupuncture is widely zhenjiu, which means both needling (zhen) and moxibustion (ICC), two techniques to be heard essential parts of a basic approach for the treatment of disease and maintaining health. However, compared with acupuncture, moxibustion is generally considered a secondary practice. In the Niejing Huangdi (comprised of Suwen and Lingshu), the basis of ancient texts and modern concepts of acupuncture and moxibustion treatment, only a few sentences are devoted to moxibustion. Paul Unschuld, in his translation and detailed analysis of the Neijing Suwen (1), four pages devoted to the consideration of its application in a section on heat treatment. The start and the application of key moxibustion is described in the Suwen as follows:

The North is the region where the sky and the earth safe and store. Its territory is situated at a high altitude, its population lives in the mounds of earth. The wind and cold chills and dominate his people find the joy of living in the desert and drinking milk. Their deposits are cold and generate diseases of fullness. For their treatment, the burning moxa is appropriate. Therefore, moxa burning home in the North.

The reference is here in north China, especially the tribes of the Mongols, who drank mare's milk and lived at high altitude (the average altitude of Mongolia is about 1580 meters and 5000 feet to the point lowest is 552 meters. Huttes mud were the standard Mongolian housing in ancient times and are still in place in small villages. The Mongolian winters are fiercely cold and windy and the climate is so difficult that only about 2.5 million Mongolians live in its vast territory today. It is clear that the purpose of moxa, a heating treatment is to deal with the cold. His role, as described in Unschuld the discussion is to yang qi of the body. The characteristic of these diseases among people living in Mongolia in the cold north are classified as in this passage of fullness. This description is partly a reference to the notion that the North is dedicated to the security and storage . For example, Mongolians gathered food plants and animals during the short summer, and then store the equipment for use throughout the year. People even be stored until to foods in their bodies by eating warm when food is plentiful and relying, whenever possible, on the rich, fatty foods, and milk, which is intended to be used with caution in the spleen yang deficiency and phlegm or fluid retention (33). The cold could contribute to the stagnation of the surplus of food species, causing a disease of fullness (eg, an excess of yin). Often, these diseases would be d first to produce abdominal pain with stomach and intestinal spasms, if advanced disease, it could cause swelling under the skin and the formation of bodies of others. It is also mentioned in the Suwen that:

In case of damage caused by diet, use moxa. If the disease does not come to an end, it is essential to monitor the ducts overflow yang qi: pierce carriers frequently and herbs.

The situation where moxa fails, as described here, reveals some of the thinking about its effects. The damage caused by food is an accumulation, which must be dispersed by the heat of moxa. The yang qi that gives moxa treatment is the basis of the effect of dispersion. However, if the moxa fails to disperse stagnation, he simply added a new overrun, the yang qi in the former than yin. Therefore, the answer must be to drain the channels through bloodshed in order to get rid of all excesses.

The case of treatment associated with the accumulation of food cold and stagnation is one of the few cases in ancient literature where moxa is recommended that the first therapy to be tested, in most cases it is the locality should acupuncture fail. This fact is mentioned in the book Chinese Acupuncture and Moxibustion (2), in reference to the Neijing Lingshu and a side of the text:

Chapter 73 of the Lingshu states: "A disease that must not be treated in May [are not successfully treated] by acupuncture May be treated by moxibustion." In Introduction to Medicine [1575 AD], it is said: " When the disease does not respond to herbs and acupuncture, moxibustion is suggested. "

In search of commentary on the history of moxibustion Neijing since few rounds, apparently, the subject has not attracted much interest, despite its use as therapy. In the famous text Zhenjiu Jiayi Jing Huangdi (Yellow Emperor's Classic of Acupuncture) by Huangfu Mi (214-282 AD), moxibustion is silence, even in the chapters on diseases of cold (10). A monograph on the herb used to moxibustion, wormwood (Aiyê Chuan), published around 1500 AD by Li Yenwen was lost. Its title is registered, but nothing is mentioned, not even in the Bencao Gangmu published later this century by the son of Li Li Shizhen, who have other quotes from his book on ginseng (3).

After the Chinese revolution in 1949, a major reorganization of traditional Chinese medicine was undertaken. One of the first steps was to examine and evaluate traditional methods of acupuncture and moxibustion therapy. The results of these studies have been published in a series of reports in the English language Journal of Traditional Chinese Medicine in 1984. In the first article of the series (4), dedicated to the history of the practice, only the following was noted in particular the moxibustion:

Fifty types of moxibustion methods were summarized by means of research on ancient literature of moxibustion. In these [documents] have been examined from different materials for moxibustion, various forms of wormwood cone or roll material to be placed between the point on the skin and the burning moxa, and different temperatures and handling of moxibustion.

The second part of the series on acupuncture and moxibustion (5) is devoted to the diversity of techniques currently used (eg, scalp acupuncture, wrist / ankle acupuncture, ear acupuncture , etc.). This article proposes the following text on moxibustion, with emphasis on clinical effectiveness scarring moxibustion and attempts to introduce greater use of other non-healing:

Some units have modified their equipment moxibustion for easy handling. Among the various methods of moxibustion, those commonly used today are those using moxa cone, moxa stick moxibustion hot, hot cylinder, and in some cases, combustion [skin] with moxa. It was stressed that the moxibustion therapy is particularly effective for the treatment of deficiency disease-cold, then it is against the disease and beyond fever due to yin deficiency. However, some workers have presented clinical cases of febrile illnesses successfully treated by moxibustion therapy. Ancient medical records support this assertion. These workers have studied the issue and declare the prohibition of moxibustion therapy in febrile illness to be unfounded. Yet both views coexist and are discussed.

Moxibustion treatment is simple and effective for childhood diarrhea, gastroenteritis, chronic peptic ulcer, bronchial asthma, rheumatism of muscles and joints, neurasthenia, hypertension, menstrual disorders, chronic pelvic inflammation syndrome and climacteric [menopausal] . Definite effect was obtained in the treatment of pulmonary tuberculosis, and thromboangitis obliterans. A report of 182 cases of asthma treated with scarring moxibustion at acupoints selected on the basis of the differential diagnosis leads to a shot-term effective rate of 76.9%, with 70% long-term rates effective monitoring for the examination of three years. Other reports claim that scarring moxibustion May significantly reduce blood pressure, reduce blood viscosity, and the vessels dilate.

These reports indicate that scarring moxibustion decreases the incidence of fulminant apoplexy by lowering blood pressure. The observation of more than 17 years of 54 cases of high blood pressure showed that only 5 suffered from fulminant apoplexy after scarring moxibustion, while 4 of 12 in the control group did. These results of therapy are obvious. Experimental and clinical studies have done on other health benefits of scarring moxibustion. For example, 299 cases of asthma treated with purulent moxibustion which 70.6% were effective and 29.1% markedly effective. Abnormal WBC count in 20 cases were corrected before treatment in 19 cases? Animal experiments have shown moxibustion to significantly enhance the immunity of the body.

Finally, it should be noted that although moxibustion has been widely used clinically, it has received far less attention than acupuncture, a point that merits reflection.

One can note the change in the therapeutic indications for the accumulation of moxibustion (a type of excess), with the cold from the lack of cold, where moxibustion is seen as a way to tonify the deficiency. May this change reflect a change in the use of moxibustion as a processing time for the use of the dispersion in the treatment repeated daily for toning deficiency often requires extended. Scarring moxa, moxa also called purulent, where severe blisters and ulcers of the site occurs (sometimes with unintended wound infection), resulting in the formation of a scar. This method reflects the dominant form of moxibustion, until very recently, for this reason, many writers translate moxibustion as cautery. Instructions for applying moxa in Chinese literature would typically be repeated many burning small cones of moxa directly on the skin, causing blisters or further damage. This type of moxa therapy is not discussed in detail as part of the West acupuncture training, as it is not permissible in Western practice.

The production of rolls of moxa useful for indirect heating is a modern technological development, compared to the simple practice of training in small moxa cones wool by hand. Moxa rolls for treatment have been introduced at the end of the Ming dynasty, but did not become commonplace until 1950, when factories were established which could turn thousands of them every day . Yet, traditional medicines have been used for use of the standard for direct moxa cones and many of them do not easily make the transition to this alternative method.

In a report on scarring moxibustion presented at a conference in Beijing in 2000, Wang Kenliang (21) stresses that:

Moxibustion lot of dough should be applied immediately after moxibustion to protect injured skin and promote non-bacterial suppuration. In one week after the moxibustion treatment, the exudate becomes increasingly wound will gradually suppurate卆nearly over a month, the pus will disappear and the new chair will grow, the injured skin will be recovered with a slight scar remains. The patient must rest after suppurative moxibustion treatment and to avoid strong emotions at work and anomalies such as sadness and anger, the patient should also take food, limited sex life, and prevent exposure to pathogenic cold or heat. More nutritious food should be taken, such as fresh meat, beans and vegetables, these foods help the recovery of moxibustion painful and remove pathogenic factors? This treatment can treat tuberculosis, bronchial asthma, arthritis, hiccups, facial paralysis, and tuberculosis of neck lymph nodes.

The author of the Journal of Traditional Chinese Medicine review article highlights the point moxa which is widely used in clinics in China, but receives far less attention than acupuncture. This comment refers to doubt limited reports of its use as primary therapy and one can see from the description that Wang moxa treatment can sometimes be quite severe test, which limits its use in major hospitals in most medical reports are generated. One can speculate on other reasons for talking about its rare in the literature. Most articles on the therapy of acupuncture treatment on the complex involving many models of acupuncture points. The needles can be inserted one by one, then the doctor may perform manipulations on each of them, leaving them in place for 20-30 minutes. Moxibustion is usually on one or two points in a complex pattern of treatment, including acupuncture. Accordingly, the main part of the therapy is needling, moxa with a small part of the treatment. It is difficult for the authors of the reports on these treatments to the proclamation that the therapy is based on moxibustion or that the outcome depended on the part of the moxibustion treatment.

Relatively few diseases are treated by moxa alone or with her as the primary therapy. Thus, little attention is paid to this technique, in part, because it accompanies acupuncture when it is used with the most points and more specific manipulation. Articles on moxibustion as the main technique tend to be brief, and little is said about the point or the selection method of the application of moxa. In an article to describe the disease effectively treated by moxibustion (44), three cases were selected and one of them (the treatment of pterygium) involved moxa alone, others (carpal tunnel syndrome and the neuralgias throat) are more moxa acupuncture.

In fact, a search for clinical research on moxibustion in the Journal of Traditional Chinese Medicine (in the publication of more than 20 years) revealed a few articles on moxibustion, and the majority of articles mentioning the use of this technique is that it is apparently a minor adjunct to acupuncture therapy. Articles mentioning acupuncture and moxibustion in the title, often, are only giving the translation of zhenjiu while treatments involve needling only.

In Part 3 of the series to consider acupuncture and moxibustion (6), focusing on the troubles the different techniques are considered useful in the treatment, moxibustion is specifically mentioned as a success for the application for correction of abnormal fetal position:

The success rate of moxibustion on zhiyin (BL-67) for the control of abnormal fetal position well above the figure for the manual restore abroad. Two to 4 sessions are sufficient, even if very loose or very tense abdominal wall, with fixation of the head of the fetus subcostal below the region, and partly by the descent of the fetus in the pelvic cavity were less successful or even ineffective.

Other reports summarized in this study only relate to either acupuncture or acu-moxibustion, referring to the use of acupuncture and moxibustion for possible inclusion in at least some of the treatments (without mentioning moxibustion techniques). A rare example of a report in which non-scarring moxibustion has been used as primary therapy for a chronic disease was published in 1992. They were 183 patients with coronary artery disease. Here is the description of the technique, using moxa rolls:

The acupoints selected neiguan (PC-6, bilaterally), shenzhong (CV-17), and xinshu (BL-15 bilaterally). During treatment, the patient is in supine position with the exposure of the acupoints. The end of the ignited moxa roll is directed to neiguan (one side), with the end of 0.5-1.0 cun burning of the skin for 5 minutes until the patient had a warm welcome, but not burning sensation and skin color became slightly red. Then, the same method was applied to neiguan on the other hand, Shanzhong and xinshu (both sides) for every 5 minutes. Treatment was given once daily, 6 times as a treatment. There was a rest day before the second treatment cycle began. The acupoints used for the control group are the same as for the moxibustion group, only acupuncture was used instead of moxibustion? Typically, patients in both the moxibustion and control groups were 5-10 during treatment, lasting 1 - 2 months.

In their abstract, authors, echoing the remark that moxibustion does not receive much attention, said: In recent years, most clinical and experimental studies have shown that acupuncture neiguan with that item is the main therapeutic effect in treating coronary artery disease, however, few reports of moxibustion in the treatment of this disease were observed. They also noted that there was no significant difference between the acupuncture and moxibustion in effect. Unfortunately, in the absence of a placebo control, it is unclear to what extent the effects were due to stimulation of points and how many were due to other factors not specifically related to treatment (such as responses usually attributed to placebo effects). The claimed benefits included relief of symptoms, improvement of the ECG, and lowering blood pressure and blood lipids. In this case, the authors suggested that the indirect moxibustion was preferred by patients over acupuncture because of the absence of pain and discomfort (in Chinese clinical needling is much stronger than in the clinical West). This is in contrast with the situation in direct moxibustion, which can be more painful than acupuncture, the painful nature of the usual direct moxibustion are mentioned in several texts.

The intensity of moxibustion clinics described in this report, where the rollers were used moxa contrast with common practice in Western clinics. Moxibustion was given for 5 minutes each, with five points covered, for a total of 25 minutes and moxibustion treatment was given per day for 30-60 consecutive days. Heating was done until there was an obvious reddening of the skin. In Acupuncture: a complete text (27), the importance of heating means is mentioned: A text of the Qing Dynasty, The Golden Mirror of Medicine, explains: "When the treatment of moxibustion, for there has any effect, the heat must be sufficient to get the Qi. "

In another case of treating a chronic disease, herbs interposed moxibustion was administered for the treatment of Hashimoto thyroiditis (28). Two groups of points were selected for the two days of treatment: dazhui (GV-14), shenshu (BL-23), and Mingmen (GV-4), has established one; Shanzhong (CV-17), zhongwan (CV-12), and Guanyuan (CV-4) were in the second set. Each time, five moxa cones, 2 grams each, were burnt continuously on each point of the whole. Patients were treated every day, patients were treated daily with a total of 50 treatments for a course of therapy. Many patients said they had benefited in terms of symptoms and results in blood tests with regard to thyroid hormones and antithyroid antibodies.

References to the use of moxibustion decreased in recent issues of the Journal. Two very brief articles in recent issues of how to use moxibustion, both through grass interposés method, the one with the ginger, the other with garlic:

Gastroptosis (7): First, moxa was applied to a slice of fresh ginger on Baihui (GV-20), while the patient is sitting still and relaxing. When the treatment is completed, the patient lies down, and applied to moxa zhongwan (CV-12) and qihai (CV-6). Processing time is only 15 minutes (5 minutes per item), and treatment was given once or twice a day. Patients were also given exercises to do every day to improve the strength of the muscles of the abdomen. After 15 days of treatment, it was said that 30 of the 50 cases were cured and all the other cases showed some degree of improvement. The authors stated that: Baihui is a point of authority in the chain, which dominates the yang of the whole body. Moxibustion can tonify qi qi ascending and promote in the middle jiao. zhongwan and qihai of ship design is chosen as the key local. Moxibustion on these two hot spots in May until mid-jiao, replenish qi, promote more yang qi, to relieve the prolapse.
Acute lymphagnitis (also called thread boil; 8): Three hours of needle tip is used to exit the blood on both sides of the boil. Thin slices of garlic are placed on these two points to leave the blood, then moxa is applied. The therapy in question 1 to 3 treatments, with demand for treatment in all cases, most of them requiring treatment 2.
The second report concerns the moxibustion to a skin lesion. This method seems common practice in the treatment of skin diseases, as relayed in the book of outpatient treatment of acupuncture and moxibustion (15), where the role of the element introduced by moxibustion the authors.

The Wool Moxa is important?
While it is obvious to most presentations on moxibustion heat therapy is used during processing is a key element in the cold treatment and stagnation, the question arises as to what should be used to produce the heat. An explanation for the use of wool moxa (artemisia shredded) that is increasing worldwide, so it is cheap and readily available, it takes easily in the form of cones, and its burning characteristics are ideal: it burns slowly, lights, produces a heating and a pleasant scent (27). But entry moxa ingredients in the body does not seem to be essential. In Tibet, moxibustion is applied with a hot rod, rather than burning moxa, and China, it is not unusual to put something between the moxa and the skin (as in the case above, or ginger garlic), so that the elements of the moxa smoke is not likely to enter the skin. In almost all Western practices and several of the modern Chinese practice, the elements of the burning moxa especially going into the air, is very little to the skin. Thus, one would expect that the heat is the aspect of moxa invoked.

However, some authors describe the value of moxa in relation to its herbal nature. Here's what the authors of the Chinese Acupuncture and Moxibustion (2) have to say:

Artemisia vulgaris produced in Qizhou is known as the best type of moxa, the climate and the soil is good for growth. The leaves of Artemisia Qizhou are much more thick wool [soft fibers]. Moxa cones and rods of this type of artemisia are thought to be the highest quality used in moxibustion. In a new edition of Materia Medica appears the following description: "The moxa leaf is bitter and acrid, producing warmth when used in small quantities and high heat when used in large quantities. It is pure yang nature, having the ability to restore the primary yang collapse. It can open the 12 regular meridians, traveling through the three yin meridians to regulate qi and blood to expel cold and dampness, heat from the uterus, stop bleeding, warm the spleen and stomach to remove stagnation, regulate menstruation, the fetus and ease .. .. When burned, it penetrates all the meridians of the elimination of hundreds of diseases. "Yang can be activated by the Artemisia leaves because it is warm. The acrid odor [aroma of spices, volatile oil] of the leaf can travel through the meridians, regulate qi and blood, cold and to expel the meridians, and its bitter solves moisture. Accordingly, it is used as hardware for the treatment of moxibustion.

It seems that the authors confuse the Materia Medica description of the wormwood used as a remedy for use in moxibustion. A contribution of the plant are also mentioned by the authors of the recently published text of Dermatology in Chinese Medicine (9):

Moxibustion is an important and perhaps under-treatment in traditional Chinese medicine. It May be used alone or in combination with other modalities such as acupuncture .... This method involves the burning of moxa on or above the skin at the location of certain acupoints, or on or near the injury [to deal] himself. The heat of the cautery, and the properties of the moxa itself, serve to warm the qi and blood in the canals, to expel cold and damp, to restore the yang, and in general contribute bodies to regulate and restore health.

A moins que la représentation de la plante à travers les méridiens de pénétrer dans l'application de moxa est entendu à faire participer un esprit-essence qui se déplace de l'armoise dans le corps et a un effet plus fort que de l'herbe lorsqu'elle est utilisée en décoction, il faut comprendre que importante des vapeurs d'armoise et de la fumée pénètre dans l'organisme, soit à travers la peau où le moxa est brûlé ou par la respiration de vapeurs, ou les deux. Une question se pose, cependant, de savoir si oui ou non il serait préférable de consommer de moxa oralement (par exemple, au moyen d'artemisia en décoction ou d'un ingrédient dans une formule complexe dans la forme de décoctions ou pilules) que de compter sur les très petites quantités de pénétrer le peau pendant le traitement ou des montants plus importants que la fumée inhalée.

Cette question est importante si le praticien est de sélectionner des matériaux de moxa et des techniques spécifiques. Par exemple, lorsque moxa cônes sont brûlés à l'extrémité des aiguilles d'acupuncture (en Chine, ce qui se fait habituellement de 15 minutes après aiguilletage pour obtenir le deqi de réaction), les constituants de l'moxa ne pas interagir avec la peau et les effets limitée à transférer la chaleur à travers l'aiguille de la acupoints (on l'appelle aiguilletage chaud). Smokeless moxa de la chaleur, mais très peu de la vapeur, la manière dont il est établi âcre élimine ces éléments mentionnés ci-dessus qui sont censés réchauffer la circulation par l'entrée des méridiens. De même, si l'on utilise une substance interposition, le moxa ingrédients ne vont pas pénétrer dans la peau (même si une très petite quantité de la substance de la matière pourrait interposition). La plupart des cliniques sont conçus pour évacuer la fumée moxa ou d'utiliser des purificateurs d'air pour éliminer autant que possible, cette approche élimine donc une grande partie de l'inhalation de fumée moxa avec des ingrédients qui pourraient servir une fonction thérapeutique. En outre, à base de plantes moxibustion est parfois remplacé par des lampes chauffantes ou d'autres techniques que l'artemisia éliminer totalement; une lotion d'extraits végétaux (qui mai mai ou de ne pas inclure l'ambroisie) peut être appliquée à la peau avec de la chaleur émis par le biais de ces feux, dans un effort à fournir tant de chaleur et de la pénétration de certains locaux herbe électeurs.

En Chine, un autre impact de la moxibustion est d'aider les stériliser à l'atmosphère de la chambre dans laquelle il a été utilisé; jusqu'à récemment, les Chinois ne sont pas propres hôpitaux, et il était facile pour les patients de transmettre des infections. Les visiteurs de la Chine a noté que les aiguilles d'acupuncture ne sont pas stérilisées, mais simplement trempé dans une solution d'alcool, et le manque d'hygiène de rigueur étendu à d'autres aspects de l'hôpital. Ce rôle est devenu de moxa reconnus et certains hôpitaux ont décidé d'utiliser l'approche systématique, même dans les pièces où moxa de traitement n'a pas été donné. Ainsi, un encens fait de l'armoise et Atractylodes (cangzhu) serait utilisée pour réduire les bactéries dans l'air, elle aussi apparemment empêché les virus (13). Selon les évaluations de chinois, il pourrait être utilisé dans les jardins et les pépinières afin de réduire la transmission de maladies, dont la varicelle, les oreillons, la scarlatine, rhume et la bronchite. Ainsi, lorsqu'il est utilisé dans une clinique de l'acupuncture, la fumée de moxibustion peut aider à prévenir la transmission de la maladie d'un patient à l'autre, ce qui est particulièrement important lorsqu'il s'agit de patients immuno-compromis. Cependant, avec des cliniques occidentales modernes, les chambres ont tendance à être propre et de la fumée de l'encens moxa ou dans n'importe quelle grande quantité est peu appréciée.

Indications et applications Pour Moxibustion
Détailler les fonctions de la moxibustion, les auteurs chinois de l'acupuncture et la moxibustion (2) dit qu'il est utilisé aux fins suivantes:

Pour chauffer les méridiens et les expulser froid. Abnormal circulation du qi et du sang se traduit généralement par du froid et de chaleur. Froide provoque l'obstruction de flux, ou même une stagnation de qi, de chaleur et des résultats rapides en flux de qi. Normal la chaleur active la circulation sanguine et le froid empêche son bon déroulement. Depuis la stagnation du qi et du sang est souvent relevé par le réchauffement de la qi, moxibustion est la meilleure façon de générer de la bonne circulation du qi, avec l'aide de la laine moxa enflammé. Dans le chapitre 75 de la Lingshu il dit: «Si la stagnation du sang dans les vaisseaux ne peuvent pas être traitées par le réchauffement à la moxibustion, il ne peut pas être traitée par l'acupuncture." Dans le chapitre 48 de la Lingshu il, «Depressed symptômes doivent être traités par la moxibustion seul, parce que la dépression est due à la stagnation du sang provoqué par le froid, qui devrait être dispersée par la moxibustion."
Pour inciter à la fluidité du Qi et du sang. Une autre fonction de la moxibustion est d'inciter le qi et le sang de couler vers le haut ou vers le bas. For example, moxibustion is given to yongquan (KI-1) to treat the disorders caused by excess in the upper part and deficiency in the lower part of the body and liver yang symptoms due to upward flowing yang qi so as to lead the qi and blood to go downward....If the disorder is due to deficiency in the upper portion and excess in the lower portion of the body and due to sinking of qi caused by deficiency, such as prolapse of the anus, prolapse of the uterus, prolonged diarrhea, etc., moxibustion to baihui (GV-20) may lead yang qi to flow upward.
To strengthen yang from collapse. Yang qi is the foundation of the human body. If it is in a sufficient condition, a man lives a long life; if it is lost, death occurs. Yang disorder is due to excess of yin, leading to cold, deficiency, and exhaustion of the primary qi, characterized by a fatal pulse. At this moment, moxibustion applied can reinforce yang qi and prevent collapse. In Chapter 73 of the Lingshu it says, 'Deficiency of both yin and yang should be treated by moxibustion.'
To prevent diseases and maintain health. In Thousand Pieces of Gold it states: Anyone who travels in the southwest part of China, such as Yunnan and Sichuan Provinces, should have moxibustion at two or three points to prevent sores or boils and to avoid pernicious malaria, epidemic diseases, and pestilence. It is often said, If one wants to be healthy, you should often have moxibustion over the point zusanli (ST-36). In Notes on Bian Que's Moxibustion, it says, When a healthy man often has moxibustion to the points guanyuan (CV-4), qihai (CV-6), mingmen (GV-4), and zhongwan (CV-12), he would live a very long life, at least one hundred years.
These treatments might include scarring moxibustion depending on the particular case. The different styles of moxa application and the method of keeping-fit moxibustion (the fourth application listed above) were elaborated by Yuan Liren and Liu Xiaoming (11), though with reliance on different points, namely shenque (CV-8), zhongwan (CV-12), yongquan (KI-1), and zusanli (ST-36), the latter point was mentioned above and is a standard for many acupuncture and moxibustion treatments. According to the authors, these points are selected and treated as follows:

zusanli (ST-36): Frequent moxibustion on zusanli can invigorate the spleen and stomach, assist in digestion, hence, strengthening the body and slowing down the process of aging. Some ancient experts advocated the use of scarring moxibustion, placing moxa wool directly on the skin over the point so that a scar is formed after the local skin has developed a boil with pus. Constant application of scarring moxibustion will maintain the moxibustion boil, and this will help to strengthen the body and prolong life. Another similar method, known as hanging moxibustion, is composed of hanging an ignited moxa stick 3-7 centimeters over the point without touching the skin for 5-10 minutes.

Shenque (CV-8): Frequent moxibustion on this point can replenish qi and strengthen the body; it is especially suitable for the middle-aged and elderly. The particular procedure of this kind of moxibustion is as follows: put some salt on the navel, knead some moxa wool into the shape of a cone to be ignited and placed on the salt for moxibustion. The size of the moxa cone should vary with the individual conditions. For people of strong constitution, use big cones in the size of a broad bean and for those of weak constitution, use the middle-sized cones as big as a soybean or use small cones in the size of a wheat grain. The burning up of one moxa cone is referred to as one zhuang. Moxibustion on shenque point requires 7-15 zhuang.

zhongwan (CV-12): This point is an important point for reinforcement, capable of strengthening the spleen and stomach. Both moxa stick and moxa cone are advisable for moxibustion on this point, the duration of which may last 5-10 minutes.

yongquan (KI-1): Frequent moxibustion at this point can strengthen the body and contribute to longevity, for it replenishes the kidney and invigorates yang. When using moxa sticks for moxibustion, it should last 3-5 minutes, and in the case of using moxa cones, 3-7 cones are usually needed each time.

The authors state that the duration of moxibustion should be at least 3-5 minutes, but not more than 10-15 minutes. A relatively longer duration of treatment is indicated for recovery from a serious disease or injury to recapture good health, in autumn and winter, on points of the abdomen (i.e., CV-8 and CV-12), and when treating young and middle-aged adults. Relatively shorter duration of treatment is indicated for simple health maintenance and longevity promotion, for spring and summer treatments, when applying moxibustion to the limbs (i.e., KI-1 and ST-36), for the aged and for children. They caution that:

The aim of strengthening the body and achieving longevity cannot be attained by just applying moxibustion once or twice, it requires persistence for a long time. This does not mean that one should receive moxibustion every day. For the purpose of convalescence for the weak and sick, the moxibustion may be applied once every 2-3 days in the early stage; yet for reinforcement of the body or longevity, it should be once a week in the early stage. And when it has shown some effect, the frequency can be reduced to once a month, and later, once or twice every three months, or even once or twice a year. So long as the practice is persisted in, good effect is sure to ensue.

Another description of life-prolonging moxibustion was offered by Liu Zhengcai (17), with primary focus on zusanli (ST-36), qihai (CV-6), guanyuan (CV-4), and zhongwan (CV-12). The technique was intensive moxibustion. For example, the experience of Wang Chao is mentioned: he said that he never failed to burn 1,000 cones of moxa at guanyuan between summer and fall; or the experience of Liu Jiesheng, who used moxa once a day for five days at beginning of Spring and again at the beginning of Autumn, using large cones on sliced ginger, a total of 30 cones each day of treatment.

Wang Leting, a famous physician in Beijing who practiced from 1929-1979, also commented on using moxa for prolonging life, as described by Dr. Wang's students (22):

The Bian Que Xin Shu (Bian Que's Book of Heart Teachings) says: 'A person without disease should moxa himself for a long time [i.e., regularly]?Although one cannot obtain long life [is not destined to have a long life span], one can achieve longevity of more than 100 years.' Because moxibustion has a warming action and it supports yang, it can be used to course and free the flow of the channels and network vessels, move the qi and quicken the blood, dispel dampness and cold, disperse swelling, and scatter nodulation, secure yang and stem counterflow. For instance, constantly moxaing zusanli (ST-36) is able to regulate and rectify the spleen and stomach function, increase and strengthen the bodily constitution. Constantly moxaing feishu (BL-13), it is not easy to catch an external affliction. Dr. Wang Leting was 88 years old, with the exception of being a little bit hard of hearing, he was still very healthy, his thinking was very keen, and he was still reading and writing books. His secret was mainly doing moxibustion on himself among other methods of protecting his health. He held that after age 40, one's kidney qi declines day by day. Hence, between Summer and Fall every year, when yang qi declines day by day, he began to do moxibustion at qihai (CV-6) and guanyuan (CV-4) with moxa cones. At first, he used 7 moxa cones per day. Then, he gradually used 10 per day and up to a total of 500 for the season. This method greatly strengthened his bodily constitution. He persisted in doing moxibustion for decades and obtained great benefit from it.

The basis for using moxa in the late summer and early fall can be understood by comments in the classics, including the teaching of Li Dongyuan in his Pi Wei Lun (Treatise on Stomach and Spleen). Although Li was an herb specialist and didn't describe use of moxa in this text, he noted that it was traditionally said that diseases of the spleen would heal in the Autumn and that Blood must be nurtured by all means and the defensive must be warmed by all means. With blood warm and the defensive in harmony, one will live out one's heaven-decreed life span (36). Moxa provides a warming therapy at this time of year to invigorate the circulation and activity of defensive qi (weiqi) and protect the spleen from the declining yang qi that is occurring as part of the annual cycle, and the blood can be nourished by eating healthy foods, which are digested, and the resulting essence is transported, by the strong spleen function. Failure to take care of this would lead to repeated illness during the cold months, and overall weakening of the body. The important role of the stomach and spleen in generating ying and wei qi helps explain the emphasis on moxibustion at ST-36.

Aside from these uses of moxa for preventive health care, moxa is often applied for alleviating acute symptoms. In an attempt to relieve herpes zoster outbreaks, moxibustion was applied to dazhui (GV-14). According to the report of this application (23), the technique to be used would depend on the patient: for the elderly and weak, warming moxibustion (using a moxa roll) was administered, but for the strong and robust, direct moxa (9 cones, but non-blistering) was done. Treatment was given once per day, with pain alleviation and change of the zoster lesions to scabs occurring in 3-7 days of treatment. A report on moxibustion for gastric spasm by Song and Zhu (12) in the Journal of Traditional Chinese Medicine involved 97 patients with either gastric spasms or intestinal spasms who were treated primarily on the abdomen points CV-8 (along with ST-37 for intestinal spasm) and CV-12 (along with ST-34 for gastric spasm). The authors report that nearly all the patients had their abdominal pain alleviated with one moxa treatment. The technique used was:

The moxa roll was ignited and placed over the selected points to produce a comfortable warm feeling. When the heat became excessive, the moxa roll was moved around the points or a little higher to avoid burns. A piece of gauze could be laid over the point to protect the skin from accidental injury. 30 minutes constituted one session of treatment.

Unlike the concern expressed here to keep the patient comfortable and uninjured, many traditional moxa specialists (such as Wang Kenliang, quoted previously) believed that blistering of the skin was essential to the success of moxibustion when treating serious ailments, much the way that getting the qi reaction and propagated sensation in response to needling was deemed essential to successful acupuncture therapy. This blistering and scarring method is even mentioned in relation to Keeping-fit Moxibustion, which is for preventive health care. Such intensive moxibustion is avoided in the Western practice, which follows more closely the method used for the gastric and intestinal spasm

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