Moxibustion is the most common form of cauterization. Cauterization has been used in China since the ancient times. In cauterization the same points are used as in acupuncture. Contrary to acupuncture where instrumental simulation is brought up, in cauterization stimulation is evoked by means of thermal effects. In history cauterization was performed in different ways; by means of iron-chopsticks burnt red hot in fire, with burning tobacco, by means of lighted wick in an iron box, by means of applying squashed garlic to the ailing spot and by means of burning moxa which is the most common method.

Japanese moxibustion set (Ibuki)

Japanese moxibustion set (Ibuki)

The word moxa is derived from the Japanese moe kusa – a burnt plant. In Chinese it is called ai, which denotes Artemisia vulgaris. It is a very common plant which can be found everywhere and purchased throughout China at a very price.

Preparation of the Moxa Powder (airong)

Moxa is picked in the fifth month of the lunar calendar and kept in a dry place for three years. After having been dried, the leaves are ground and sifted and made into a fine powder called airong. It burns slowly and gives a pleasant feeling of warmth. Sometimes other plants or drugs, such as Aquilaria agallocha, Rosa banksiae, Pistacie lentiscus, Artemisia capillaris, dry ginger, ant-eater etc., are mixed with moxa.

Different Methods Used in Moxibustion

Sparrow-peck moxa stick moxibustion

1. Moxa cone, 2. Indirect cauterization, 3. Moxa-stick, 4. Sparrow-peck moxa stick cauterization

There exist two methods in moxibustion: cauterization leaving marks (you-banhen-jiu) which is applied directly and markless cauterization (wu-banhen-jiu) which is directly or indirectly. The following techniques are used in cauterization:

Moxibustion leaving marks

Moxa-cone cauterization (aizhu-jiufa). A moxa-cone aizhu is put on the skin and lighted. The moxa-cone is a pyramid-shaped cone kneaded from moxa-powder. It is of three sizes: that of a grain, a date-stone and that of the thumb. The amount of the moxa-powder which can be contained in one moxa-cone, is called zhuang. It differs according to the patients construction.

Moxibustion cauterization

      1. Moxa-cone cauterization (aizhu-jiufa). This is the method of direct cauterization when a moxa-cone is put on the skin and lighted. It is removed only at the moment when the patient feels too hot. When Cheng Dan’an writes about moxa-cone cauterization, he means this method.
        Other methods are those of the indirect cauterization, when an insulator is put between the skin and the lighted moxa-cone.
      2. Ginger Insulator moxibustion (gejiang-jiufa). A slice of ginger about 1-3 fens thick with little holes pierced through it is put under the moxa-cone. If the pain becomes too violent, the slice of ginger is removed and when the pain is alleviated, it should be put back again and kept there till the patient perspires and the spot becomes red. Sometimes when the intensity of heat is not regulated, a blister may appear.
      3. Garlic Insulator moxibustion (gesuan-jiufa). This method is similar to the previous one only with the difference that when pain is felt it should not be removed. It is suitable for chronic paralysis or for initial stage of the forming of a carbuncle. A piece of wet paper is put on the carbuncle. On the spot where it becomes dry a piece of garlic about 3 fens in thickness is attached and on top of it a moxa-cone is placed and lighted. The piece of garlic should be changed after the application of five moxa-cones. If the carbucle has several tops, squashed garlic should be spread over it before a moxa-cone is applied. If the carbuncle is painful, cauterization should last till the pain disappears; in case it is not painful, the cauterization should last till the pain appears. If the wound does not suppurate, long 1asting cauterization may be applied.
      4. Bean-cake insulator moxibustion (gubing-jiufa). Bean, pepper, ginger, salt, and onions are crushed and made into a cake 3 fens thick which is placed on the respective spot and lighted. In the case the patient feels too hot, the cake may be lifted for a while and again attached. It is kept there until the patient feels hot inside and the skin becomes red. In case of suppuration this method of cauterization should not be used.
Chinese moxibustion instruments

Chinese moxibustion instruments: 1. Moxa instruments used in Norther Sichuan, 1a. Place of ignition, 1b. Moxa, 2. Chinese moxa instrument in cross-section (place for moxa powder), 3. Moxibustion instruments made at the Research Institute of Acupuncture and Moxibustion, 3a. Outer appearance, 3b. Cross-section, 3c. Mobile screw, 3d. Inner air holes, 3e. Moxa-powder, 3f. Outer air holes, 3g. Handle

    1. Monk’s hood moxibustion (fuzi-jiufa). Monk’s hood is ground into powder and mixed with the powder of Bletilla hyacinthina and water to form a cake 3 fens thick. It is put on the sore with a lighted moxa-cone on top of it. When the cake becomes dry, it is substituted by another one until the patient feels hot inside.
    2. Salt insulator moxibustion (geyan-jiufa). This method only mentioned by Cheng Dan’an is described in greater details by Ji Shouyan and Zhu Rugong. The navel is filled with white salt and on top of it a moxa-cone is applied. This method is suitable for abdominal pain and diarrhea. It is said to be very effective.
    3. Clay insulator moxibustion (huangtu-jiufa). This method is also only mentioned by Cheng Dan’an but is described in greater details by Ji Shouyan and Zhu Rugong. A cake from clay is prepared and a moxa-cone is put over it and lighted. It is used for curing eczemes and is said to be very efficacious for skin diseases caused by humidity altogether. The cauterization lasts until the patient feels hot inside.
    4. Lightning moxibustion (leihuo-zhenjiufa). A mixture of Aquilaria agallocha, Rosa banksiae, Pistacia lentiscus, Artemisia capillaris, dry ginger and ant-eater (three qians of each) is prepared with a bit of musk and two liangs of moxapowder added to it. The mixture is wrapped up into two sheet of paper, one thin and one thick. Then it is rolled up tightly and smeared with a white of egg to prevent it from unrolling before it is lighted at one end. Meanwhile a piece of coarse cloth (one chi – 30 cm) is folded seven or eight times and put on the respective spot. Then the lighted roll is held now closer and now further from the spot so that the hot air penetrates through the holes of the cloth into the skin but does not burn it. The treatment lasts until the patient feels inside hot. This is especially for curing the muscle and bone diseases.
    5. T.Y. moxibustion (taiyishen-jiufa). This is practically the same method as the preceeding one, the difference is only in combination of the drugs: Moxa powder (three qians), sulphur (two qians), musk (one qian), Pistacia lentiscus (one qian), myrrh (one qian), Jambosa caryophyllus (one qian), Santalum album (one qian), a branch of Cinnamon cassia (one qian), Angelica anomala (one qian), Eucommia ulmoides (one qian), orange peel (one qian), Gleditschia horrida (one qian), Angelica grosserrata (one qian), Asarum sieboldi (one qian), ant-eater (one qian). According to Ji Shouyan and Zhu Rugong one qian of Conioselinum unvittatum and a whole dried scorpion is added to the mixture.
    6. Warm acu-moxibustion (wanzhen-jiufa). This is a combination of two methods. The needle is inserted into the skin so that not more than 1,5 – 1 fen of its stem is to be seen. The physician takes a piece of thin paper about the size of 1 cun, perforates a hole in the middle of it, passes the top of the needle through the hole and puts the piece of paper on the skin. Then the covers the top of the needle with a ball of moxa (about the size of a date-stone), so that it is about 2-3 fens away from the skin and lights it. Several moxa-cones are used this way, but the later one can be smaller. When the patient feels inside hot, the cone is removed. But if after the fifth or sixth cone the skin is hot, but no feeling of inner heat occurs, the needle must be turned and pulled up and down several times in order to increase the stimulation. If the moxibustion lasts too long, the needle cannot be extracted easily.
Japanese moxibustion instruments

Japanese moxibustion instruments: 1. Place where alcohol is poured in, 2. Wick, 3. Place of ignition, 4. Moxa instrument, 4a. Cross-section and place for moxa-powder

  1. Warm moxibustion (wen jiufa). This is an invention of the Japanese. A metal instrument is used, in which moxa and other plants are burnt. It has a handle, so that the physician can change the direction easily. Cheng Dan’an is of the opinion that this instrument is rather expensive and not very much effective.
  2. Moxa-stick cauterization (aitiaojiu or aijuanjiu). This method was invented by Zhu Lian. Moxa powder is rolled tightly in apiece of thin paper like a cigarette. The moxa-stick is 6 cuns (20 cm) long and 3,5 fens (1,2 cm) thick. Each cun burns 10-12 minutes. If the moxa is three years old and the powder is rolled up tightly, it gives a slight, pleasant warmth and burns slowly.

There are two techniques in the moxa-stick cauterization:

  • Warm moxibustion (wenhe jiufa). The moxa-stick is lighted at one end and the burning point gradually comes near to the patient’s skin (usually slightly more than half a cun from the skin) and burns 5-10 or even more minutes. The patient feels a pleasant warmth. This method is most suitable for sedation.
  • Sparrowpeck moxibustion (quezhuo-jiufa). The moxa-stick is lighted at one end and alternately brought near to and removed from the skin, so that the patient feels just a pleasant warmth. It is suitable mostly for tonification. The time is shorter than required for warm cauterization, usually two to five minutes. It is also recommended for children.

Application of the Moxibustion

Cauterization is little known in Europe, but widely applied in China, Korea and Japan even today. In China it is mainly used for chronic diseases, with old people or those who are afraid of acupuncture, in cases where acupuncture is not effective or to increase the effects of the acupuncture treatment. Comparing it with acupuncture it has certain advantages. There is no danger of breaking the needle and if during the treatment the patient does not feel comfortable, he may change his position much more easily than during the acupuncture treatment. Moreover cauterization proves to be very useful in clinical treatment. According to the direction of the physician the patients can administer it themselves, for example in nervous collapse, pain due to peptic ulcer etc.

Set for moxibustion

Set for moxibustion

When Moxibustion Is Forbidden?

In old literature the application of cauterization was forbidden to the following points: yamen Gv.15, fengfu Gv 16, tianzhu B 10, chengguang B 6, touwei S 8, zanzhu B 2, jingming B 1, suliao Gv 25, heliao Li 19, yingxiang Li 20, quanliao Si 18, xianguan S 7, renying S 9, tianyou T 16, tianfu L 3, zhourong Sp 20, ruzhong S 17, jiuwei Cv 15, fu’ai Sp 16, jianzhen Si 9, yangchi T 4, shaoshang L 11, yuji L 10, jingqu Lu 8, yangguan Gv 3, jizhong Gv 6, yinbai Sp 1, lougu Sp 7, tiaokou S 38, dubi S 35, yinshi S 33, futu Li 18, biguan S 31, shenmai T 18, ermen T 21, shimen Cv 5, naohu Gv 17, sizhukong T 23, diwuhui G 42, baihuanshu B 50.

According to modern opinions cauterization should not be applied in the environment of the eyes, on the spot of great arteries and veins and in hairy regions.

Cupping Vessels

Cupping vessels for moxibustion

Cupping vessels for moxibustion

The last method of stimulation to be described here is the cupping vessel (bahuoguan or xitong).

First of all the air is sucked out from the cupping vessel which is attached to the respective spot and thus hyperemia is brought up.

The cupping vessels are made of various materials, such as bamboo, earthen-ware, copper, iron or glass. This method was already known during the Jin dynasty (265-419 A.D.) and was called jiaofa. Different methods are used for sucking out the air. A piece of paper or cotton is lighted and either left inside (touhuofa) or taken out by means of pincers (shanhuofa), or a piece of cotton soaked with alcohol is attached to the middle of the inner wall and lighted from above (tiemianfa) or the cupping vessel is boilt in hot water, so that there is little air inside and then attached to the skin (zhufufa).

The cupping vessel is applied to stout patients, on hairless spots, on the back, shoulders, abdomen and thighs. It is often applied after the acupuncture treatment. The cupping vessel treatrnent is effective for lumbago-shenshu B 23, zhishi B 47; abdominal pain – zhongwan Cv 12, tianshu S 25, asthma – feishu B 13; humeroscapular neuralgia – spots on the shoulder; headache – bilateral taiyang EP 1, gonitis – bilateral dubi 35. It can be applied in rheumatism as well.

The vessels should be left on the spot for 10-15 minutes, and can be removed by pressing the immediate surrounding area with the fingers so that air might penetrate inside.