35. The use of moxibustion
Chapter contents
Moxa273
Deciding whether to use moxa273
Moxa cones and sticks275
Contraindications276
Moxa
What is moxa?
Moxa is a downy material prepared from the leaves of the herb Artemesia vulgaris latiflora. This is similar to the common mugwort plant that is grown in the UK and USA. To prepare the artemesia, the veins of the leaves are stripped, then ground, aired and dried before it becomes what is commonly called moxa ‘punk’ or ‘wool’.
When is moxa used?
An acupuncturist uses moxa during a treatment in order to warm a patient. Whether to use moxa or not is an important issue. In some cases it can be essential in order for patients to make progress. For example, patients who are cold will not improve, or will take much longer to get better, if they do not have moxa. On the other hand, it can be dangerous to heat a patient who is already too hot.
How is moxa used?
Most commonly a Five Element Constitutional Acupuncturist rolls the moxa into small cones that are then placed on the acupuncture points and lit. Sometimes a moxa stick is used instead of cones, especially if a large area needs to be warmed. Moxa cones can be used alone and have a stimulating effect on a patient’s qi. More often they are used before the needles are inserted and in this case they warm a point and the needles take the heat to the point.
Deciding whether to use moxa
As a result of the diagnosis, the practitioner should be able to decide whether to use moxa. The patient will fall into one of three categories:
• The patient definitely needs moxa and is unlikely to get better or will not get better as quickly without it.
• Moxa may be used to tonify the patient but is not essential. In this case the patient may not be abnormally cold, but the warmth will prepare the point before a needle is inserted.
• Moxa should definitely not be used. It will not help and it may make the patient worse.
A patient may change categories as treatment progresses, and this should be noted during the ongoing process of diagnosis.
Moxa is used more frequently in cold weather and during the winter, or when there is a cold and damp climate.
Keys to deciding if moxa is appropriate
Touch, visual observation, questioning and smelling give the practitioner the relevant information needed in order to decide whether moxa will be of benefit. 1
1The concept of yin and yang is useful here. Yang energy is warming and moving. Yin energy is nourishing and cooling. Yang deficiency requires the use of moxa, Yin deficiency may or may not require moxa and Full Heat definitely indicates that moxa is forbidden. For these distinctions, see a good TCM textbook, such as Maciocia, 2005.
Touch
When palpating the patient during the physical examination, the practitioner may notice that certain areas of the body are cold. For example, one or more of the three jiao may be cold. This indicates that moxa might be beneficial when treating the Organs situated in the cold jiao. Additionally, if the patient’s feet, hands, legs and arms or lower back are cold to the touch, there is also a case for using moxa.
If a patient’s pulse is particularly slow, for example 60 beats per minute, this may indicate a need for warming the qi. Some exceptions to this are if the patient is undergoing strenuous physical training or is taking medications such as beta-blockers, both of which cause the pulse to slow.
Observation
A very pale face (pale and bright even more so) suggests the patient is cold and would benefit from moxa. There may be more obvious signs such as a person wearing a jumper when others are in T-shirts or the person huddling close to heaters and shivering.
Questions
It is important for the practitioner to question several areas when deciding if the patient needs moxa:
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