Study of the Mechanism behind Moxibustion

Section 1 Study of the Dosages for Moxibustion (Moxa Until the Lips Get Red)

In traditional moxibustion therapy, the sign of adequate moxibustion is the patient’s lips turning red. In this research, an observation was made with fifty-eight patients before and after moxibustion with teardrop erythrocytes (new red blood cells or neoerythrocytes) visible in the peripheral blood being the objective index. The results were as follows: among thirty-seven cases of over moxibustion, no teardrop erythrocytes were found before moxibustion. After moxibustion, twenty-five cases observed teardrop erythrocytes but twelve cases did not. Among twenty-one cases of direct moxibustion, no teardrop erythrocytes could be found before moxibustion. After moxibustion, it could be seen in fifteen of them and still six of them (P<0.05) had no positive finding. Whether by over moxibustion or burning moxibustion, as long as the patient’s lips turned red, there was a significant change in the number of visible teardrop erythrocytes. Therefore, the patient’s lips’ turning red and the appearance of teardrop erythrocytes can be taken as the objective index to the dosage of moxibustion.

What is the criterion for the dosages of moxibustion, in regards to over moxibustion and burning moxibustion? Most books on traditional acupuncture and moxibustion say that the over moxibustion is applied for 5-15 minutes until the patient’s lips get red. We conclude from our clinical practice that both over moxibustion and burning moxibustion shall be applied until the lips become red, regardless of the time of over moxibustion and the number of cones of moxibustion been burned. According to the theory that “spleen controls the blood circulation and mouth is the mirror of the spleen”, we observed the shapes of red cells around the acupoints before and after moxibustion. The experimental
report is as follows:

1. Clinical Data (Fig. 1-3, Fig. 1-8)

58 patients, 28 females and 30 males. They were diagnosed with cold-syndromes or Yang-deficiency and most of them had refractory diseases. They were randomly divided into a group of over moxibustion with thirty-seven patients and the group of burning moxibustion with twenty-one patients.

2. Materials and Methods

Material for moxibustion

Two moxa cones, moxibustion sticks manufactured by Chengdu Binjiang Medical Moxibustion Material Factory. (prescription provided by the lateorthopaedics expert Luo Yu-tian from Chengdu University of Traditional Chinese Medicine)The material of moxa cones were dissolved by 75% alcohol, and then mixed together and put in a hermetically sealed container. (Fig. 1-6)

Acupoints for moxibustion

Zusanli (ST 36), Feishu (BL 13), Zhongwan (V 12)

Criteria of moxibustion

The over moxibustion was applied until the patient’s lips got redder than that

before application, regardless of the time. Burning moxibustion was also applied until the patient’s lips got red, regardless of the number of cones.

Methods of moxibustion

Technique for over moxibustion

Ignite two moxa sticks, hold them above the acupoint at a distance of 3-4 cun (6-8cm) with the right hand. Push the skin around the acupoint with two fingers of the left hand. Do not move the ignited moxa stick around, keep the patient feeling warm and comfortable.

Technique of burning moxibustion

One gram of refined moxa wool was made into 35-40 cones. Keep the cone
burning on the local skin until the cone was burned up.

The methods of routine examination of blood

Stab the skin of the fingertip with a disposable needle after the routine sterilization of fingers and extract two drops of blood, drip the blood on glass slides. After the blood smear dries, draw lines at the both ends with a wax pencil to prevent the staining solution from flowing off the slide. Use 3-4 drops of Wright’s solution to cover the blood, and then add 3-4 drops of buffer after 30-60 seconds. Four or five minutes later, blow on the fluid in order to mix all substances together. Finally, rinse off the fluid with water to wash the staining solution away. Then measure the diameter of red blood cells with an eyepiece and carefully observe the pigment of red cells.

3. Results

In thirty-seven cases in the over moxibustion group, prior to moxibustion, mature RBCs are six to seven micrometers and the color does not expand. After moxibustion, mature RBCs are six to eight micrometers or seven to eight micrometers and the color expands (or the color is full). No “teardrop erythrocytes” are found in thirty-seven cases prior to moxibustion. After moxibustion, “teardrop erythrocytes” are found in twenty-five cases and no “teardrop erythrocytes” are found in the other twelve cases.

Twenty-one cases of the burning moxibustion group prior to burning moxibustion, the mature RBCs are six to seven micrometers; the color region does not expand and no “teardrop erythrocytes” are found in any case. After burning moxibustion, “teardrop erythrocytes” are found in fifteen cases (71.43% of all cases) and no “teardrop erythrocytes” are found in the remaining six cases (8.56% of all cases) (x²>3.11<384 (p>0.05)). No matter we use over moxibustion or burning moxibustion, the “teardrop erythrocytes” have no obvious differences when the lips become red. The result shows that the effects of over moxibustion using medical moxibustion sticks are same as that of burning moxibustion of the ancient times. Medical moxibustion sticks are easy to use because it is safe and convenient
to use and it has no toxicity or side effects. (Fig. 1-10)

For those cases in which “teardrop erythrocytes” appear after moxibustion, the clinical symptoms obviously improve and the curative effects are remarkable. While for those without “teardrop erythrocyte”, the curative effects are not as good.

4. Discussions

The “red lips” criterion of moxibustion is associated with the time and number of pieces of moxibustion

According to the principles of “illness of a deficiency type should be treated by reinforcing method”, “treat the cold-syndrome with hot-natured drugs” and “treat the inward sinking by moxibustion” in NeiJing, we use over moxibustion or burning moxibustion to treat those patients with Yang deficiency caused by cold-dampness or cold deficiency. It is recorded in this work that over moxibustion is based on the criterion of “red lips” or “reddening skin around points”. Burning moxibustion, however, is based on the criterion of cones from ancient times. Our observation shows that as long as we apply moxibustion therapy unti1 the lips turn red, the clinical symptoms will be obviously improve no matter we adopt over moxibustion or burning moxibustion. In over moxibustion, some patients’ lips turn red after ten to fifteen minutes; some after fifteen to thirty minutes; some even after 120 minutes. In burning moxibustion, most patients’ lips turn red after ten to fifteen minutes; some ten to fifteen minutes, while the lips of a few patients with complicated diseases do not turn red at all. The clinical observation tells us that the “red lips” criterion is associated with the time and number cones of moxibustion.

Factors affecting “teardrop erythrocytes”

“Teardrop erythrocytes” are also called “newborn RBCs”. “Red blood cell of irregular shape” or “shape-changing RBC” is usually seen on the marrow smear and seldom seen in peripheral blood. Factors affecting “teardrop erythrocytes” are analyzed on the basis of our observation. First, regarding the aging of marrow,
“teardrop erythrocytes” have appeared in patients whose ages range from seven months old to ninety-six years old. So “teardrop erythrocyte” may have nothing to do with the aging of marrow. Second, regarding the technique and method of creating a slide smear: The person mounting the smear specializes in this technique. In addition, even if “teardrop erythrocyte” is caused by the incorrect operation during pushing the smear, the direction of “teardrop erythrocytes” should be the same. However, we observed through a microscope and found them it appeared in different directions. Third, teardrop erythrocytes are caused by the rapid appearance of marrow. Yang Qi recovers due to the heat energy of moxibustion and the effect of the medicine. Therefore, the formation of erythrocytes in the marrow is rapidly strengthened and many “newborn RBCs” are produced, which pour out of the marrow and flow into peripheral blood. So we can detect “teardrop erythrocytes” in peripheral blood. About Qi and blood, there are many accounts in traditional Chinese medicine, such as “Qi is the commander of blood”, “blood being the mother of Qi” and “the spleen governs the blood”. RBCs in blood are obviously changed after traditional moxibustion. The stain of the mature RBC’s nucleu expands when observed under a microscope; the external form is full; volume increases by 1-2 micrometers or so and we can find many newly born “teardrop erythrocytes”. However, the newly produced erythrocytes are mainly produced by marrow. Therefore, we can draw a conclusion that moxibustion can strengthen kidney Yang and strengthen the formation of erythrocytes in the marrow. Our findings of this research index are a remarkable breakthrough for further research on the mechanism of acupuncture and moxibustion. But we still must do further researches in the direction of genetic engineering.

Section 2 The Effect of Over Moxibustion on Autonomic Nervous System Function

We all know that man’s viscera, organs and emotions have a close relationship with the autonomic nervous system. The author measured the status of autonomic nerve function before moxibustion and after moxibustion at two acupoints with an instrument, the Nerve Express, that operates automatically by computer, and compared the results of the two acupoints.

The Nerve Express is a kind of computer program which evaluates the status of the autonomic nervous system quantitatively. We analyze the Heart Rate Variability (HRV) mathematically, and get two cingulums of frequency from the changes of the wave frequency of the heart rate, and then know the state of the autonomic nervous system through the Nerve Express. We get eight waves of the heart rate corresponding to the eight regimentations of the status of the autonomic nervous system. Through the interface of the sympathetic nerve and parasympathetic nerve listed by the coordinate, we can evaluate the functional status between the sympathetic nerve and the parasympathetic nerve of the patient.

1. The Method of Operation

Measure the status of the sympathetic nerve and the parasympathetic nerve of the patient (fourteen patients, divided into two groups) according to the type of operation.

Apply over-moxibustion to Zusanli (ST 36) and the Voll point of the autonomic nervous system for thirty minutes.

Immediately after moxibustion, measure the status of the sympathetic
nerve and the parasympathetic nerve of the patient (fourteen patients, divided into two groups at random) according to the type of operation.

Note: the Voll point lies in the middle of the index finger.

2. Result

The average value of the group of the Zusanli: sympathetic nerve: before moxibustion 1.79, after moxibustion 1.21; the parasympathetic nerve: before moxibustion -1.92, after moxibustion -1.21.

The average value of the group of the Voll point: sympathetic nerve: before moxibustion 0.92 after moxibustion 0.57; the parasympathetic nerve: before moxibustion -0.42, after moxibustion -0.71.

The experiment shows that there is difference in the group of Zusanli after moxibustion (it is much nearer to the zero point), which indicates effectiveness. It regulates the function of the sympathetic nerve more normally, while there is much more decline in the function of the parasympathetic nerve in the group of the Voll point. Basically, over moxibustion can regulate the function of the autonomic nervous system, and there is much more effect in the group of the Voll point than the group of the Zusanli.

Section 3 Multi-media Cytological Diagnosis of Blister

In traditional Chinese moxibustion, a blister caused by moxibustion is normal and is called “a sore of moxibustion”. There is no particular works to show
how to deal with those sores, but some simple methods are available. In clinical treatment, we observed that the color and concentration as well as the quantity of the secretion from the blisters have a close relationship with the effect. So we had a pathological diagnosis for the blisters. We sent the succus of a healthy person for pathological examination. Details are as follows:

1. The conclusion of cytology

The type of blister: the fluid of blister is clear and some cells of inflammation or neutrophil cells are visible, mostly observed in healthy people.

The type of blood blister: the fluid of blister is secretion of blood or pus and blood, many neutrophil cells or massive cells of inflammation, or a little of squamous epithelial cells, or necro-matter are found.

The type of blended blister: massive cells of inflammation and lymphocyte.

The type of none secretion: The section is very little and some necro-tissue can be found.

2. Rudimentary observation of the clinical effect

The neutrophil (neutral WBC) have a close relationship with the clinical effects. The secretion is light-yellow dense fluid, a little of neutrophil cells and hyperplasia squamous epithelial cells are often found in healthy people. If a few neutrophil (neutral WBC) are found in a patient (Fig. 2-1), he or she will recover much faster, compared to someone who has fewer cells of inflammation (Fig. 2-2). If massive neutrophil (neutral WBC) or necro-matters are found in a patient (Fig. 2-3), his recovery will be slower than the above two. If only a little necro-matter is found, the effect is very bad.

Fig. 2-1 Fewer Cells of Inflammation

Fig. 2-2 A Few Cells of Inflammation

Fig. 2-3 Massive Cells of Inflammation or Necro-matter

Section 4 The More Moxa cones, the Better Therapeutic Effects

In traditional Chinese moxibustion, the number of moxa cones varies a lot depending on individuals. Different books have different records. For example, the Thousand Golden Prescriptions for Emergency mentions moxibustion time after time. When it comes to the number of moxa- cones, it says that at least one needs two to three moxa cones, at most one need a hundred, even several hundred. By this token, the number of moxa cones varies with the patient and his illness. In our clinical practice, the number of moxa cones is fewer at first, but in the treatment of Henter’s facial paralysis, we found that the number of the moxa cone directly affected the effect. Especially in the treatment of facial paralysis, the more moxa cones we use, the better effect we can get. Examples are as follows:

Wan, 62, admitted to our hospital for facial paralysis in the left face four months ago. The therapeutic effects were not very good when he was in the department of internal medicine and neurology successively. Then our department of traditional Chinese medicine treated him with physical therapy, acupuncture and direct moxibustion at the points of Zusanli (ST 36), Yanglingquan (GB 34), and Xuehai (SP 10) with two moxa cones each time, once a day. But his illness did not improve. One day, it happened that twelve trainees treated the patient with direct moxibustion of with 2-3 moxa cones in turn, which added up to at least THIRTY moxa cones! In the end, his lips became ruddy and he also felt comfortable. The next day, his illness improved completely and unexpectedly, which amazed both doctors and patients. After we continued using moxibustion on him for a week, he completely recovered from his illness and remained very healthy for the following three years.

We have cured eighty patients with complete facial paralysis. Among them the longest course of the disease was thirty-eight years, the shortest was one year. The least number of moxa cones we used is ten, the most eighty. All the patients have had a good recovery.

In clinical practice, there are dramatic results when we multiply the number of moxa cones to the difficult clinical problems. The number of moxa cones varies with the patient and his illness. In the meantime, we have to consider the indications and contraindications of direct moxibustion. Keep in mind that never add moxa cones indiscriminately.

Section 5 Large Blisters Cure Obstinate Illnesses

Whatever the application of moxibustion is, it is a common thing that blisters
occur in the process of moxibustion. We found in our clinical observation that unexpected results come with large blisters. Some people may worry about infection, but if you take care of the blister and keep the blister area dry, infection can be avoided. So in the whole process of moxibustion, we should not be over concerned by large blisters. Treated properly, they will not lead to a negative outcome. Regarding the blister following moxibustion and the outstanding effect produced by large blisters, we found a lot of cases proving that large blisters cure obstinate illnesses in our clinical practice. Take some typical cases for instance:

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