Moxibustion Elective Mugwort Mugwort and Moxa Floss

Moxibustion Elective

by Lorraine Wilcox L.Ac. Mugwort [email protected]

Mugwort and moxa floss

• Mugwort is the common name for 艾 • Mugwort is a common 葉 Ai Ye (Folium weed. It grows almost Artemisiae argyi). everywhere. • Mugwort floss (艾絨 ai rong) is also known as mugwort wool , mugwort punk , or loose moxa .

What you see here is California Chinese mugwort looks a bit different, but the mugwort (Artemisia douglasiana) local version makes floss just fine.

1 This is Artemisia argyii, the preferred The leaves are green on top but source, but A. vulgaris is also used. have white fur on the bottom.

It has a fragrant odor that is easy The Best Dates for to recognize once you know it. Harvesting Mugwort

• Traditionally, mugwort was picked on the third day of the third lunar month or the fifth day of the fifth lunar month and then dried in the sun.

Third day of Fifth day of Year third lunar month fifth lunar month 2011 April 5 June 6 2012 March 24 June 23 2013 April 12 June 13 2014 April 2 June 2 2015 April 21 June 20 © 2010 Lorraine Wilcox L.Ac. 9 © 2010 Lorraine Wilcox L.Ac. 10

Mugwort in April in Malibu (around Mugwort in June in Malibu (around the 3 rd day of the 3 rd lunar month) the 5th day of the 5th lunar month)

2 Harvesting mugwort

• Besides being the Once mugwort right time to get the starts to make leaves (before the plant starts to flower), flowers or seeds, this is the time of the it is too late to year when yang is increasing or near its pick for floss. peak within the universe. So mugwort picked at this time retains more yang qi.

Traditionally mugwort was picked on the fifth day of the fifth lunar month ( 端午 Making Floss 節 Duan Wu Festival) and hung over the door to protect the house from toxic things such as snakes and scorpions.

By the way, California mugwort is Making floss sometimes called ‘ dream sage .’

• After harvesting • Native Americans used it the mugwort, strip the leaves off the to promote vivid dreams stalks and dry and sometimes even lucid them in the sun, dreaming. The dreams are or hang the stalks usually peaceful. upside down • If you hang the mugwort to while the leaves dry in your bedroom, you dry, probably for a may be pleasantly couple of weeks. surprised!

3 Once dry, remove the leaves from the To make floss, grind the leaves. stems. You can store the leaves for later.

• Use a rough mortar and pestle. • A Mexican molcajete works very well. • It helps to pick out the stems and large veins before grinding.

In the first grinding, the leaves are broken up.

Pick out any stems.

Use a sieve.

• Put the floss in a sieve. Rub it against the sides. • Discard the powder that comes out the bottom. • Pick out any sticks or foreign matter.

4 Look at the fine fibers at the edge of the leaf. That is what we want. The rest needs to be removed.

Repeatedly grind it and sieve it This is a dusty job, so you might until it is the quality you want. want to wear a mask if you do a lot.

You can also use an electric herb Still needs more work grinder to make more faster.

5 Aging the floss Aging the floss

1 year • Floss should be aged old for three years, not sometimes placing it in aged 2 year the sun. old Recently • Floss looks green when made freshly made. • It will turn golden or aged brown as it ages, in depending on the quality. sun

New versus Old Storage

• Floss should be stored inside a dry container. • Periodically, perhaps shortly before it is used, you can dry it in the sun or bake it in the oven at a low temperature. This is especially important if you live where there is high humidity. © 2010 Lorraine Wilcox L.Ac. 33 © 2010 Lorraine Wilcox L.Ac. 34

Note: Why would anyone want to pick mugwort and make floss?

• Not to save money on moxa supplies! • We are so out of touch with nature (heaven and earth). This is a good excuse to get out Quality of Moxa Floss of the city and follow a stream. • This is an activity that doctors have done for thousands of years. It is a way of connecting with our predecessors. • I live in my head way too much and working with my hands takes me back to my heart.

6 Here is some homemade floss from California mugwort. You can see sticks and dark spots, so it still needs more work.

Here is a batch of homemade floss, fairly Homemade good quality (but still needs more aging) floss

The lighter color, softer, and cleaner it is, the better the quality. 1 low quality commercial floss 2 high quality commercial floss 3 homemade floss, not yet aged

7 Quality of Moxa Floss

Good quality floss Poor quality floss Yellow, pale Greenish-brown, dark Soft, fine texture Coarse texture No pieces of twigs Has impurities Cones hold together Cannot make small cones Spongy Not springy 500 g of leaves makes 500 g of leaves makes 300- 100-150 g of floss 350 g of floss

Low quality floss on the left, High quality floss is used for high quality on the right direct moxibustion . (both are store-bought)

Why is high grade floss reserved High quality floss for direct moxibustion? • High quality floss holds together as grain-of-rice size cones or smaller. It makes much less smoke and smells pleasant. Its heat is less ‘fierce’ so it will not damage the flesh. • High grade floss is pure fiber without any leaf matter, twigs, or excessive amounts of volatile oils. This makes its fire more mellow.

8 High Quality Floss Lower quality floss is still • Ultra Pure Gold floss useful. It from Japan (on the left) is considered the is used for best. indirect • High quality Korean floss (on the right) is moxibustion almost as good and is or in a third of the price. moxa sticks .

However, I suggest avoiding the lowest quality Low quality floss floss as it is more smoky, smell, and ‘fierce.’

Low quality floss can be Modern commercial production improved of floss

• If you buy low quality floss for indirect • In modern times machines are used to grind the moxibustion, you can leaves and sift off the still improve it some residue. by using the sieve. • We still want to remove all The more dust you stems and leaf matter (the get off it, the less green parts of the leaf) smoke and smell it and retain the fine white will make. fibers from the leaf.

9 Leaves to floss ratio 黃金艾絨 gold moxa floss

• The quality is determined in large • Floss with a 30/1 ratio part by the ratio of dried leaves to is called gold moxa floss obtained from it. floss ( 黃金艾絨). – A 3/1 ratio means three grams of leaves are processed for every gram • High quality mugwort of floss obtained. floss like this – The higher the ratio, the better the quality. undergoes several – Commercial floss may have a 3/1, weeks of being 5/1, 12/1, or 30/1 ratio. ground, cleaned with • Unfortunately, this ratio is not a sieve, and dried in written on the package when you the sun, perhaps a buy floss. few dozen times.

Quality of moxa sticks Aging • Mugwort to be used in herbal • Moxa sticks are also judged by the formulas has different standards quality of floss inside them. There is ordinary grade, grade A, high than mugwort floss. grade, ultimate grade, and so forth. • Ming and Qing dynasty books often • The ordinary grade is basically 1/1 wrote: 煎服宜鮮，灸火宜陳。 (one unit of leaves makes one unit “Fresh is suitable to be decocted of floss – just the broken up for internal use; aged is suitable for mugwort leaf with nothing sifted moxibustion fire.” off). There are twigs and all kinds of coarse materials inside these moxa sticks.

Aging Aging

• Mengzi (Zhou) said: “A • Floss needs to be aged for some time so that excessive volatile oil content can evaporate. As disease of seven years it ages, the floss color changes from green to needs three-year-old gold (high quality floss) or greenish-brown to mugwort.” brown (low quality floss). • Li Shizhen (Ming) said “Moxibustion with fresh mugwort floss damages a person’s flesh and vessels.”

10 Before we talk about moxibustion...

Week 2 • ... we need to begin making 紫雲膏 Zi Yun Zi Yun Gao, Gao because it takes a Clinical Overview long time. • We are making Zi Yun Gao so we can use it in Lorraine Wilcox L.Ac. direct moxibustion. [email protected] • I will tell you the details soon, but let’s start cooking it first.

Purple Cloud Ointment (紫雲膏 Zi Yun Gao, 紫雲膏 Zi Yun Gao Shiunko in Japanese) Purple Cloud Ointment

• An ointment made • The original recipe was with called Flesh Moistening • sesame oil and Ointment (Run Ji Gao ), beeswax from 陳實功《外科正宗·潤肌膏》 Correct Model of External Medicine by Chen Shigong (Ming dynasty)

紫雲膏 Zi Yun Gao 紫雲膏 Zi Yun Gao (Purple Cloud Ointment) (Purple Cloud Ointment) 1 liter 麻油 Sesame oil 100 grams 紫草 Zi Cao (Zi Gen) ( 紅條紫草 or 紫根) • Heat the oil and wax to 當歸 100 grams Dang Gui (Radix Angelicae Sinensis) 120°C. 300 grams 黃蠟 Beeswax • Simmer the Dang Gui until it floats. • If you make this for yourself, you can make a • Remove it with a half recipe. slotted spoon.

11 紫雲膏 Zi Yun Gao 紫雲膏 Zi Yun Gao (Purple Cloud Ointment) (Purple Cloud Ointment)

• Let the heat rise to 142°C. • When the • When the Zi Cao stops temperature is 142°, foaming (maybe 10 turn off the heat and minutes), remove the big add the Zi Cao. The pieces of Zi Cao and oil will immediately strain it through a cloth. turn quite red.

紫雲膏 Zi Yun Gao Stirring gives you (Purple Cloud Ointment) the proper texture

• As it cools, stir it to make it the • Making this type of proper texture. If not, it becomes ointment is like making hard like a candle. ice cream – you have to stir it if you want the • When it is very thick like honey soft texture. Otherwise or yogurt, pour it into small the ice cream would containers. Let it cool. freeze into a solid block.

紫雲膏 Zi Yun Gao 紫雲膏 Zi Yun Gao (Purple Cloud Ointment) (Purple Cloud Ointment) Functions : moistens the skin, stops itching, Functions : For direct moxibustion, it is used to engenders flesh, kills fungus, reduces inflammation, help stick cones on the point, aid in healing, stops pain, and helps close open sores. and prevent scars. Uses : burns, bleeding hemorrhoids, dry skin, wrinkles, ulcers, eczema, tinea, calluses, corns, acne, cold sores, frostbite, alopecia, external injuries, itchy bug bites, and various skin problems.

12 What is moxibustion?

enduring 久灸 moxibustion Clinical Overview and Safety fire 火灸法 jiu fa moxibustion

針灸 zhen jiu acupuncture-moxibustion

What is moxibustion? What is moxibustion?

• The broader definition : Moxibustion is an external heat • The narrow definition : therapy applied on or over an Moxibustion is the medical acumoxa point or an affected application of burning site. mugwort floss on or over • Mugwort or other combustible materials may be used. an acumoxa point or an Mulberry twigs (Sang Zhi, affected site. Ramulus Mori), peach twigs (Tao Zhi, Ramulus Persicae), Deng Xin Cao (Medulla Junci), and even incense may be burned as moxibustion. © 2010 Lorraine Wilcox 75 © 2010 Lorraine Wilcox 76 [email protected] [email protected]

What is moxibustion? What is moxibustion?

• Some moxibustion doesn ’t Moxibustion Summary even use fire. You can use Burning Burning other The use of other chemically-induced heat to mugwort medicinals medicinals without fire warm the points. • Example : the external application of a warm- natured medicinal such as garlic. This is called heavenly moxibustion or medicinal application moxibustion .

13 Advantages of moxibustion Advantages of moxibustion 5. In some cases, moxibustion is more 1. Cost-effective and fairly convenient to perform. effective than other modalities: 2. Variety of application methods and functions. – Can be used when the patient is too weak for 3. A fully developed system with its own theories, acupuncture or medicinal formulas cannot be scope of practice, methods for supplementation digested. and draining, contraindications, and a long – In acute conditions, moxibustion provides record of clinical experience. quicker results than internally administered formulas. 4. Effectively treats many diseases. Modern research and clinical experience confirm this. – There are also some conditions that respond better to moxibustion than to acupuncture or medicinals.

Disadvantages of moxibustion Functions of Moxibustion

1. Time-consuming and requires stocking various Warms whatever is cold Moxibustion is yang so it substances. Transforms dampness counters yin evils 2. Smoke and ash: smoke alarms, odor, messy, etc. Warms the channels and frees the 3. Risk of fire and burns. Some malpractice network vessels Moxibustion is yang so it insurance policies do not allow direct Moves qi, quickens the blood, stops moves qi and blood. moxibustion. pain 4. Possible the toxicity of the fumes when certain This also stops pain. powdered medicinals are burned. Example: 雄黃 Disperses blood stasis, resolves qi Xiong Huang (Realgar). depression

Functions of Moxibustion Functions of Moxibustion

Regulates and contains the Supplements the center, boosts post-heaven qi Commonly used for thoroughfare ( chong ) and gynecology because of its Supplements qi, nourishes blood conception ( ren ) vessels functions (moving blood, Warms yang, supplements qi and yang Moxibustion nourishing blood, dispersing Returns yang, stems desertion supplements qi, Repositions the fetus cold, etc.) Upbears yang, lifts the fallen blood, and yang. Prevents disease, safeguards health, strengthens the body, boosts longevity

14 Functions of Moxibustion Functions of Moxibustion

Nourishes yin If the right points and Hand technique Downbears counterflow, techniques are chosen, can be descends qi used to descend qi and nourish plus Levels (or calms) the liver, yin... but these functions are point selection somewhat controversial. subdues yang, extinguishes wind defines Expels evils from the body Can be used to radiate evils Clears heat, resolves toxins outward, including heat evils. which function is activated.

Direct (left) and Indirect (right) Overview of techniques Moxibustion Mugwort Moxibustion Direct Non-marking or Mugwort moxibustion marking moxibustion cone Using various Indirect moxibustion substances to isolate moxibustion the cones

Pressing (left) and Mugwort Moxibustion Suspended (right) Moxibustion

Pure Suspended moxibustion: techniques such as mugwort wandering, sparrow- Mugwort stick pecking, circling, gentle moxibustion Both stick moxibustion, etc. have moxibustion Moxa sticks Pressing moxibustion with other medicinals Isolating substance added moxibustion

15 Mugwort Moxibustion Mugwort Moxibustion

Warm-needle Using moxa floss, slices of Mugwort cake Using ironing, sunlight, hot- Moxibustion moxa roll, moxa caps, etc. moxibustion water bottles, or heat lamps

Mugwort Moxibustion Mugwort Moxibustion

Mugwort-fuming and Using smoke or steam Warming device Using a warming cylinder, steaming moxibustion to treat an area moxibustion moxa box, etc.

Mugwort Moxibustion Non-mugwort Moxibustion

Liquid moxa, self-heating Moxibustion by Peach or mulberry stick, Deng Xin Modern methods cones, point plasters, and burning Cao (Medulla Junci) moxibustion, other modern innovations medicinals and other types

16 Non-mugwort Moxibustion Non-mugwort Moxibustion

Electrical heat moxibustion Heavenly Electrical moxibustion Electrical warm-needle moxibustion moxibustion Moxibustion (blistering) without burning Medicinal medicinals application moxibustion (non-blistering)

Related External Heat Therapies Clinical overview

Ironing Placing medicinals on the body and using a hot iron to press them. • The treatment room Fuming Burning mugwort or other medicinals and holding the affected should have good part in the smoke. ventilation but not be Medicinals, often mugwort, are boiled in a liquid. The affected drafty or cold. Steaming region is held in the steam. All of these methods begin with a decoction. • Have the equipment Washes, • Wash : the decoction is applied to the affected region with a ready: moxa supplies, soaks, cloth or the liquid is poured over the site. lighter, ash tray; but also • The affected part is immersed in a soak . fire extinguisher, first aid or • The whole body is immersed in a bath . baths Often a steaming liquid is used as a wash, soak, or bath when it is kit, etc. cool enough. • Position the patient Roasting Medicinals are applied to a site, then heated near a heat source. comfortably. © 2010 Lorraine Wilcox 99 © 2010 Lorraine Wilcox L.Ac. 100 [email protected]

Apply Moxibustion to Yang First Clinical overview and Yin Second • How will you put out the Yang First Yin Second fire? Be prepared. • Be ready to remove the Upper body Lower Body moxa from patient. Don’t Head and trunk Limbs leave patient alone. Do you need tweezers, moxa Yang channels Yin channels scoop, etc.? Back Front • Moxa ash can cause burns and is messy if not Left side Right Side properly managed. • Avoid burns on the patient, Also yourself, counters, and First less Later more treatment tables. © 2010 Lorraine Wilcox L.Ac. 101 © 2010 Lorraine Wilcox L.Ac. 102

17 Dosage Dosage

• Moxibustion must be strong Appropriate Dosage enough to be effective. Dosage is Determined By Moxibustion is generally given in is based on weaker doses in the west than in Condition of the patient China: it is given less frequently Number of cones and with less intensity. Constitution of the patient • A treatment with moxibustion uses Size of the cones fewer points than an acupuncture Age of the patient treatment. It is better to give Duration (course) of treatment adequate treatment to a few points Site or point to be treated than to give inadequate treatment Frequency of treatment to many points. Philosophy of the doctor

Low dose for yang areas; Dosage Dosage high dose for yin areas of the body.

Half the dose Double the dose Range Location Exceptions Very old or very Low Head, face More on Bai Hui (Du 20) Standard dose Strong patient or dose young patient, Arms - serious disease Chest, upper emaciated, weak Less on Ju Que (Ren 14) and Jiu Wei (Ren 15) abdomen • Moxibustion for 養生 nourishing life usually uses a lower Less on Xin Shu (UB 15) dose per session with frequent sessions over a long Upper back period of time. More on Gao Huang (UB 43) • Moxibustion to treat disease usually uses a higher dose Bony areas - per session and treatment should be ceased as soon as Fleshy areas - the patient recovers. Legs More on Zu San Li (ST 36) • More moxibustion is given in the autumn and winter than More on Shen Que (Ren 8), Qi Hai (Ren 6), in the spring and summer: as yang increases in the Lower abdomen universe, less yang is needed in treatment. High and Guan Yuan (Ren 4)

Number of Cones Number of Cones

• Generally, when • The effect of moxibustion treatment is cumulative, so cones are used, the treatment may be spread out into ancient books sessions. would specify an • If a low number of cones is odd (yang) number suggested, such as 3, 5, or 7 if the count was less cones, this probably means to give than 10, such as 1, this treatment every day until the 3, 5, or 7 cones. patient is better. • When a formula says 100 or 300 cones, do it all in one day or spread it out over a few consecutive days. © 2010 Lorraine Wilcox L.Ac. 107 © 2010 Lorraine Wilcox L.Ac. 108

18 Moxa Sensation After Treatment

• Wipe ash, moxa tar, and/or • Like needling sensation or de qi (得氣) with ointment off the point. acupuncture, there is also “moxa sensation. ” • Moxa tar sometimes appears as a yellowish- brown oily film around the In an effective treatment, the patient experiences a reaction point. Since studies show moxa tar has beneficial (one or more of these): qualities, don ’t be in a Hot qi moving through the channel hurry to clean it off. • Do not use alcohol as this Hands and feet feel warm is cold and will counteract Feeling of heat throughout the body the treatment. Tip of the nose sweats • If you want to clean it further, use warm water. Lips turn red © 2010 Lorraine Wilcox L.Ac. 109 © 2010 Lorraine Wilcox L.Ac. 110

After Treatment Self-care after moxibustion

• You may choose to apply an ointment Do Don’t afterwards. Immediately rest for a while Engage in sex for 24 hours without eating or drinking • Keep the area that received treatment (besides water) Get stressed or upset for 24 hours covered up so the mugwort qi and warmth Eat a simple bland diet for Participate in sports or intense do not escape. some days activity Eat cold or damp foods This table assumes a high Overeat or get too hungry dose of moxibustion. Allow exposure to wind

Moxa Sores Moxa Sores

• According to past masters, moxa sores are necessary for effective treatment. This is when moxibustion causes a blister followed by a sore. • Since a moxa sore takes a while to heal, one treatment gives continuous stimulation for an extended period of time. • Compared to a patient that gets a weekly treatment which only results in redness and warmth, there is obviously a big difference in the dosage.

19 Practical considerations when Moxa Sores making moxa sores • 楊繼洲《針灸大成》 Zhen Jiu Da Cheng (Ming): • Proper written informed consent . “If the moxa sore-opening closes easily, the disease qi is unable to exit. ” • Be sure your malpractice insurance • For repletion evils, moxa sores create an opening through which the evil qi can be covers it. expelled. This is like opening the pores to expel wind evils from the exterior. Sweating affects the • Others could incorrectly attribute most superficial layers, but moxa sores open moxa sores to abuse , so educate the into the channel system. So this method can expel evils from deeper in the body. family. • Moxibustion is also used on an affected site such as an abscess. In that case, it directly lets the evil qi exit. © 2010 Lorraine Wilcox L.Ac. 115 © 2010 Lorraine Wilcox L.Ac. 116

Practical considerations when Practical considerations when making moxa sores making moxa sores

Do not make moxa sores on • If you are new to this, first practice on yourself . – Try Zu San Li (ST 36), Qi Hai (Ren 6), or Guan Yuan (Ren 4). • people with compromised immune systems – This builds technical skills • diabetics – This helps you understand what the patient experiences. – You receive immediate feedback, helping refine your technique. • people who cannot keep the region clean • Moxa sores often show up some hours after treatment. If • people who form keloid scars you try to make them appear during treatment, you will over-do it. • the face or areas that would disfigure the • Use more small cones, not few large cones. The clinical patient results will be the same but the patient will suffer less. • the soles of the feet: walking would be painful. © 2010 Lorraine Wilcox L.Ac. 117 © 2010 Lorraine Wilcox L.Ac. 118

Practical considerations when Practical considerations when making moxa sores making moxa sores • You can give one treatment using many small • Gradually increase the intensity of treatment to cones, or use a somewhat milder treatment for help the patient tolerate it more easily. Burn the 2-3 days in a row. The latter will be less painful first cone half way and the second cone two- for the patient but can still make moxa sores. thirds of the way down. Then the third cone can • With moxa sores, the dosage is already fairly burn all the way down with less discomfort (if it is high so use only 1-2 points (bilaterally). This is a not too big). This is based on “first use less and potent treatment and will not need repeating more than approximately once per month (you later use more moxibustion.” could use acupuncture or herbs in between). • Generally, blisters do not need bandaging Once a blister has formed, no more moxibustion unless they are in an area that will easily get is needed until the site has healed. dirty or will be rubbed by clothing.

20 Practical considerations when Moxibustion & safety making moxa sores 1. Burns - Unintentional burns should never happen. • Inform the patient about proper after-care. Perhaps give written instructions. The patient Be especially careful or avoid moxibustion on: must keep the area clean and should not break the blisters. Leave them to heal naturally unless • People who cannot report what they feel: comas, dementia, or they are extremely large. If large, you can open otherwise impaired consciousness, small children, people with them with a sterile needle. Then apply antiseptic reduced sensitivity (numbness or neuropathy). and bandage them. • People with immune disorders that make the healing of sores • Follow up on the patient to be sure that infection difficult: immunosuppressant drugs, advanced HIV disease. does not develop. If the sore begins to look infected (more redness, swelling, and pus), • People with certain bleeding disorders (occasionally a burn or apply an antibiotic ointment and bandage it. sore may bleed).

Burns Burns

Do not use moxibustion on the extremities of patients with Don’t let hot ash drop on the patient. Frequently remove ash from diabetes as they may have less sensation due to neuropathy moxa sticks or incense. For warm-needle, place a skin shield at and also have a harder time recovering from infections. the base. Be sure the patient knows to report their sensations during Always have a plan for extinguishing the moxa before it is lit and treatment. Frequently glance at the patent’s face or notice if have the proper equipment nearby. their body is tense. Make sure all materials are completely extinguished before you Often touch and look at the skin around the site to monitor skin leave the treatment room. Be careful that nothing burning is temperature. thrown in the trash. One ember can burn down a clinic. Remember, blisters often do not show up for some hours after treatment. • First Aid : standard for burns or infection.

Moxibustion & safety Moxibustion & safety 2. Smoke : Inhaling any kind of smoke, including moxa smoke, 3. Preventing fire is harmful. • Always have a fire • Moxa rolls containing other extinguisher nearby. medicinals such as 雄黃 Xiong • Smoke alarms should Huang (Realgar) are especially never be disconnected. harmful. Xiong Huang contains • Do not leave a patient arsenic sulphide. Other who is receiving medicinals may also be unsafe. moxibustion unattended. • Have adequate ventilation. Maybe use an air purifier or a smoke-eater. →

21 Moxibustion & safety Moxibustion & safety

4. Side effects of an unbalanced or improper treatment • Have on hand the proper and other prohibitions equipment for extinguishing • Too much moxibustion, especially on the upper body can the moxa. Always have a cause agitation and restlessness: heat agitates the spirit plan for extinguishing the which resides in the heart. moxa before it is lit. • If a patient has heat, dryness, or yin vacuity, improper • Make sure all materials are use of moxibustion can make it worse. That is why some completely extinguished doctors prohibit moxibustion in these cases. before you leave the room. – However, other doctors believe that, when the proper techniques are used, these prohibitions are unnecessary. If care is taken to descend and circulate heat or to radiate it out of the body, moxibustion will not cause harm. Combined with a diet that provides the raw materials to increase yin, moxibustion can help the body nourish yin.

Side effects of an unbalanced or improper Side effects of an unbalanced or improper treatment and other prohibitions treatment and other prohibitions

• Some patients are thirsty after receiving Formula to engender fluids after excessive moxibustion. Let them drink. moxibustion • If the patient has heat (dry mouth, thirst, feels Decoct 15 grams each of: feverish, dark urine, constipation, etc.) after moxibustion, give them a decoction to engender 生地黃 Sheng Di Huang (uncooked Radix Rehmanniae) fluids (see below). 麥門冬 Mai Men Dong (Tuber Ophiopogonis) • Next time, use less moxibustion, focus more on the lower body, and make sure there is enough 玄參 Xuan Shen (Radix Scrophulariae) time between treatments. 肉蓯蓉 Rou Cong Rong (Herba Cistanches)

Formula to engender fluids after Side effects of an unbalanced or improper excessive moxibustion treatment and other prohibitions • If the patient is fearful or the treatment strong, explain the procedure and obtain consent. If the patient is overly frightened, moxibustion may not be the best modality. • If the patient is extremely weak, acupuncture is forbidden but moxibustion may be applied to the dan tian region or Zu San Li (ST 36). • A woman with profuse menstrual bleeding should not be given moxibustion except to stop bleeding. • Be extremely careful when using moxibustion on pregnant women.

22 Side effects of an unbalanced or improper Side effects of an unbalanced or improper treatment and other prohibitions treatment and other prohibitions

Fainting can be caused by an excessive fear or a Fainting treatment that is too strong. • If a patient starts to faint, the procedures are the same • Other causes include extreme hunger or as for fainting during acupuncture. weakness. • Stop the treatment immediately. Make sure the patient • If the patient is weak, the cones should be small. does not fall. Help him or her lie down and elevate the • Do not use too many points; 2-5 bilaterally is feet, placing the head in a lower position. usually enough. • You can apply pressure to Ren Zhong (Du 26) if the patient does not revive immediately. • Symptoms of fainting include dizziness, blurred vision, nausea, pale face, thin pulse, cold hands, • When the patient comes to, he or she can sip warm tea. low blood pressure, difficulty speaking, • If fainting is due to weakness or hunger, apply gentle palpitations, sweating, and impaired moxibustion to Zu San Li (ST36), but do not do this if the consciousness. cause was fear or an overly strong treatment. © 2010 Lorraine Wilcox L.Ac. 133 © 2010 Lorraine Wilcox L.Ac. 134

Moxibustion & safety www.bluepoppy.com

5. Legal liability • Check your malpractice insurance. • Make sure your consent form covers your use of moxibustion.

My Books and Facebook Page Suppliers

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23 Suppliers Good Works

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