First I should reveal a personal bias – I love moxibustion! If forced to choose between needles or moxa I might well go for the smoky option. Needles are nice but moxa is marvellous, it just does so many things so well.
We have seen the publication of quite a few moxa texts in recent times, each one taking a distinctive approach and each one very distinct from the next. This book is quite different in style and content from two other leading contenders; Moxibustion – The Power of Mugwort Fire by Lorraine Wilcox and The Moon Over Mastushima by Merlin Young. Wilcox’s book takes as its reference point the historical literature on moxa and so gives a strong sense of treatment from the perspective of the historical tradition. Young’s book is more like a collection of fascinating and chatty miscellaneous essays on all aspects of moxa – a style and content quite different to the text under review here, which is a bit more normal.
Illustrated Chinese Moxibustion – Techniques and Methods is ‘very Chinese’ – personal shorthand for a mix of positive attributes blended with the cultural idiosyncrasies and artefacts of the translation process that we have come to know and love.
The first 20 pages covers basic moxa theory well; its effects in traditional terms, general indications and application in bu fa and xie fa (strengthening and draining), warming, moving and so on. Discussed too are numerous issues such as contraindications, selection of suitable points, dealing with sores. All this is expressed using the Chinese medicine explanatory model as well as connecting, to some degree, to the realities of biomedicine. For instance: ‘The heat of moxibustion can warm, supplement and support yang qi and treat vacuity qi desertion. From the perspective of modern western medicine it can regulate the body’s stress levels and raise tolerance, regulating various glandular functions and maintaining the organisms physiological functionality.’
Here we see another dimension of the concept ‘very Chinese’. The biomedical notions alluded to seem rather vague and, to the critical, raise more questions than they answer. You have got to admit that it is hard to be much more vague than ‘regulating various glandular functions’. These days it is possible to be more specific and detailed about the effects of moxibustion on physiological function; on the specific alterations in immune responses it can elicit, its effects on nitric oxide, blood flow, and so on. It seems a shame that such a detailed textbook should be so coy about the literature on actual physiological effects.
Following this we have 30 pages of basic data on the traditional points with illustrations and basic indications tabulated – again ‘quite Chinese’, for instance the heavy emphasis on ‘atrophy and paralysis of the legs’. Most leg points are given this attribution but it is not too clear what actual conditions are referred to; stroke? multiple sclerosis? traumatic nerve injury? spinal stenosis? old age? This section is useful if you are a novice but less compelling for experienced readers.
I like the chapter on moxa for yang sheng – health cultivation with its numerous subsections such as ‘foster and supplement original qi and protect against disease’ and ‘perseverance is golden’ and ‘fortify brain, boost intelligence’. The key points and methods used in yang sheng treatment are covered extensively and, again, the pronouncements are couched in the classic Chinese style. On Bl 43 we are informed that: ‘moxa of this point can perfuse and free yang qi, kill worms and calm panting … A common folk custom is for children to moxa this point at 17 or 18 years of age … to raise their ability to resist tuberculosis and common cold.’
These days, part of our new-found maturity as a profession entails applying a little more criticality to the representation of what acumoxa can and cannot do (and equally to what modern biomedicine can and cannot do). It is hard for me to adjudge the effect of moxa on this point on killing worms but I do feel that nowadays our textbooks should themselves include a touch more criticality.
Next we get some very good information on moxa itself; its different forms, the manufacturing processes used, the use of other combustible substances such as juncus grass pith, which is referred to as juncibustion. This is where you take the pith out of the Chinese grass deng xin cao, dip it in oil and then apply burning end to acupoints. There is excellent information on non-heat moxa methods – the use of irritant substances on the skin such as mustard seeds and garlic that are quite commonly used in China. The subsequent chapter, on special moxa methods, is excellent too and describes many ways of using moxa stick including one of my personal favourites – pressing moxa. This involves momentarily pressing a moxa stick into tissues using cloth or paper partitioning. I know from experience, first as a patient and then in my practice, that this produces a deeply penetrating sustained warmth that often provides rapid results. Other partitioning methods include the use of fuzi (aconite) cake, garlic, ginger and moxa of the eyes using walnut shells – another wonderful, if slightly bizarre, method to experience for yourself first.
The rest of the book is a reference formulary that discusses well over 100 conditions, point selection and the most appropriate moxa techniques for each condition. Some of the conditions the authors cover here I have not seen discussed elsewhere in relation to moxa treatment such as psoriasis and chronic fatigue syndrome. As an example, a section on excessive armpit sweating says: ‘… shave the armpit, and then mix starch into a paste with an appropriate amount of water, applying it to the underarm. A needle-like black point will appear on the surface of the starch paste; this is the area of a large sweat gland. Put a small moxa cone on the black point and perform direct moxa, 3-5 cones each time 2-3 times per week.’
This is neat and, as with many of the numerous other interesting clinical tips to be found here, is obviously born out of practical experience.
All in all, this book succeeds in delivering a comprehensive and enlightening Chinese-style presentation on the practice of moxibustion. ‘Very Chinese’ is fine by me and is largely the language-culture issue that we accept or even enjoy. The weak point is the lack of anchoring of the material in efficacy and mechanism research and in meaningful biomedical terminology. Overall, as a student text or for one wishing to develop high-level clinical moxa skills I warmly recommend this book. For those fascinated by scholarship of classic texts get Wilcox’s book and for endlessly engaging bedtime reading seek out Merlin Young’s eclectic text and so help fund his Moxafrica project.
Charlie Buck Charlie Buck has enjoyed three decades in the world of Chinese medicine and was one of the very first to practise Chinese herbal medicine in the UK. As an author and educator he has made significant contributions to the development of Chinese medicine in the UK and Europe. Rooted equally in both classical Chinese medical scholarship and in science, Charlie’s teaching has been described as lucid, engaging and insightful. He is currently chair of the British Acupuncture Council.
