With the rising trend of health preservation, many people have begun to pay attention to wellness, but how many truly understand the contraindications, indications, sequence, and optimal timing for moxibustion? In fact, just like “needles can kill or revive,” moxibustion has its own intricacies.
The Iron Rules of Moxibustion
1) During moxibustion, or throughout the entire treatment course, it is strictly forbidden to drink cold water or eat cold food, as this is akin to extinguishing the fire of moxibustion, which is detrimental to disease treatment.
2) It is best to drink a cup of warm water, above body temperature, before moxibustion. After moxibustion, replenish with a cup of hot water around 60 degrees Celsius, slightly hot to the mouth.
3) After finishing moxibustion on an acupuncture point, gently pat or massage the point and surrounding area, known as sealing the point! After sealing, cover the moxibustion area with clothing.
4) If you wish to wash your hands immediately after moxibustion, use hot water, above body temperature, around 50 degrees Celsius. Except for rheumatic diseases, cold diseases, and postpartum wind diseases, generally, one can touch normal temperature water 30 minutes after moxibustion, but in principle, do not rush to use cold water.
5) For children, the weak, and those with diminished function: the amount of moxibustion must be small, gradually increasing the duration.
6) For robust individuals, those with dull sensations, and conditions of excess function: appropriately increase the amount of moxibustion.
7) For thick-skinned areas like the lower back, abdomen, and shoulders, where there is much flesh and coldness, strong moxibustion is necessary; it can be large and frequent.
8) For thin-skinned areas like the head, face, chest, and extremities, where there is more muscle and susceptibility to wind-cold, the amount of moxibustion should not be excessive. It should be small and infrequent.
9) Post-moxibustion care mantra: After moxibustion, avoid wind and cold, be cautious with emotions, and avoid raw, cold, and rich foods; a light vegetarian diet is most suitable.
10) Extreme emotions such as great sadness, joy, or anger can diminish the effectiveness of moxibustion. Being angry during moxibustion can obstruct the meridians, making moxibustion ineffective and potentially worsening blood stagnation.
11) If there are corresponding points on both the upper and lower body, moxibustion should first be applied to the Yang meridians, then to the Yin meridians, starting from the upper body and then the lower body, i.e., first the back, then the chest and abdomen, and finally the limbs, in that order. This is to draw Yang to Yin without excess, so the order should not be reversed. If the sequence is not followed, moxibustion on the head and face may lead to residual heat, dry throat, or discomfort. Even if there are no such reactions, moxibustion should still proceed from top to bottom, similar to acupuncture, where the order is important and should not be forgotten. (Note: Moxibustion emphasizes sequence, more details to follow~)
12) It is best not to perform moxibustion at night, as doing so long-term can harm Yin. After 10 PM, the body’s meridians need to rest and enter a state of contraction, while moxibustion promotes expansion, so late-night moxibustion is not advisable. (Note: The best time for moxibustion will also be discussed below~)
13) Many people ask if they can take a shower immediately after moxibustion. Although many texts say it is okay to take a hot shower half an hour after moxibustion, I generally recommend waiting 2 hours before showering, even with hot water, as hot water can introduce dampness into the meridians and acupuncture points.
14) If symptoms of excess heat appear after moxibustion, you can moxibustion on Zusanli (足三里) to guide the heat down, and also drink more warm water. If necessary, stop moxibustion or reduce the frequency, and these symptoms will quickly disappear.
15) Some people eat while moxibusting, which is not advisable. One cannot know the nature of the food being consumed—whether it is cold or warm. Eating while moxibusting can challenge the stomach’s Qi. Those with gastrointestinal diseases should avoid this.
16) Although everyone knows not to use air conditioning or fans during moxibustion, what about afterward? After moxibustion, your pores are still open, so you should avoid cold and wind. You can do this by turning on the air conditioning in another room to gradually lower the temperature of the entire house while moxibusting in a room without direct airflow, thus avoiding excessive heat and cold.
17) After several days of moxibustion, some people may sweat profusely with even slight movement. What should be done? Generally, sweating is a good sign of detoxification. However, if you feel very weak and fatigued, you should pay attention to moxibustion on Zusanli (足三里) to tonify Qi, while also ensuring adequate rest and nourishing Qi and blood with foods like yam, red dates, and millet porridge. If symptoms are severe, a consultation with a TCM practitioner is necessary for diagnosis and treatment.
18) Can women perform moxibustion during menstruation? This depends on individual constitution. Theoretically, moxibustion during menstruation does not harm the body and can sometimes yield good results, as it helps expel cold dampness and blood stasis, especially for women with dysmenorrhea or scanty menstruation. However, for those with heavy menstrual flow, moxibustion may exacerbate bleeding, causing panic and concern. If the flow exceeds normal limits and one does not know how to stop the bleeding, it can indeed harm the body, so moxibustion is not recommended for women with heavy menstrual flow.
The Sequence of Moxibustion
Sun Simiao, known as the “King of Medicine,” clearly recorded in his work “Qianjin Fang” that moxibustion should follow the principles of first Yang then Yin, first left then right, and first upper then lower.
How are the body’s parts divided into Yin and Yang?
In TCM, the back and upper body are considered Yang, while the abdomen and lower body are Yin. The head is Yang, and the feet are Yin; the left side is Yang, and the right side is Yin. Therefore, according to traditional TCM theory, the sequence of moxibustion is generally:
First moxibustion on the upper body, then the lower body
First moxibustion on the back, then the abdomen
First moxibustion on the head and body, then the limbs
First moxibustion on the left side, then the right side
When performing moxibustion for daily health maintenance, following the above methods will yield good results. Of course, TCM emphasizes dialectical treatment, and many methods for adjusting various conditions are not singular; generally, the priority is to alleviate symptoms first, such as moxibustion on Ashi points and other key points.
Moxibustion’s Optimal Timing
According to the “Neijing: Ling Shu,” the ancients divided the day into four periods corresponding to the four seasons: morning as spring, noon as summer, sunset as autumn, and midnight as winter.
Specifically, the time is divided as follows:
From 3 AM to 9 AM is the spring of the day, called Day Spring
From 9 AM to 3 PM is the summer of the day, called Day Summer
From 3 PM to 9 PM is the autumn of the day, called Day Autumn
From 9 PM to 3 AM is the winter of the day, called Day Winter
In the morning, both nature and the body’s Yang Qi begin to rise, making moxibustion during this time particularly effective, especially for those with Yang deficiency or Qi deficiency, such as those who are cold-sensitive, have cold hands and feet, low immunity, or loose stools.
Of course, depending on different constitutions and conditions, the timing for moxibustion varies. For example, to regulate spleen and stomach function, moxibustion can be performed from 9-11 AM, and for kidney nourishment, from 5-7 PM. Generally, for health maintenance, moxibustion is best done between 10-11 AM and 2-4 PM.
It is said that ancient moxibustion was more effective, so moxibustion must be hot!
What is the benefit of being crispy on the outside and tender on the inside? During moxibustion, warmth is sufficient; the key is to feel the Qi! The sensation of moxibustion is the most important!
Moxibustion: Hot or Warm?
This is an old topic, but I bring it up again because many people have asked about it.
Moxibustion is not barbecuing!
Many people do not understand that moxibustion is not done haphazardly, and it is not the same as barbecuing! The character for “moxibustion” has the “moon” radical, which is commonly associated with “meat,” and the bottom part is “fire,” so its original meaning is to cook meat with fire. Moxibustion uses fire to treat diseases, requiring “duration” and emphasizing “duration” in its application. The combination of fire and duration can achieve the effects of disease prevention and treatment.
Moxibustion emphasizes the penetration of moxa fire and medicinal properties, rather than just heating!
However, some people feel that some acupuncture points are not hot while others are very hot during moxibustion. What is the reason for this?
Not hot: This indicates that there is significant coldness within the body, and the internal coldness counteracts the heat, hence the lack of sensation; it may also be due to recent fatigue and Qi and blood deficiency. In this case, the amount of moxibustion should be increased (i.e., increase the duration and frequency of moxibustion on the same point).
Hot: This indicates that there is stagnation in the meridians, preventing the heat from penetrating.
Hot areas are often problematic: areas that are painful or have nodules upon pressure, or areas that are usually uncomfortable or painful. In this case, more manual massage should be applied to unblock the meridians.
During moxibustion treatment, the patient’s sensations should be prioritized, with skin redness and warmth as the standard, rather than pursuing “heat.” Therefore, moxibustion practitioners should focus on the sensation of moxibustion and not lose sight of the main point.
The essence of acupuncture treatment is “Qi reaches the disease location,” so “obtaining Qi” is very important! When needling or moxibusting a specific acupuncture point or area, the body may experience sensations such as soreness, numbness, heat, swelling, heaviness, coolness, or itching, and this sensation may travel along the meridian pathways. The transmission of sensations can vary in speed and direction. The sensation transmission along the meridians is a sign of meridian opening; if the meridians are open, the treatment effect will be very significant!
A netizen once experienced a cold and moxibusted Dazhui (大椎), Yingxiang (迎香), Taiyang (太阳), and Yintang (印堂). Only Yintang had a sensation of moxibustion, and even when holding the moxa stick very close to Yintang, it did not feel hot. After just a few seconds of moxibustion, she felt a tingling sensation in her face and neck, deep within the muscles, which was uncomfortable and made her want to scratch. As soon as she removed the moxa stick, the tingling sensation disappeared immediately, and upon reapplying, she felt the tingling again. This was a sensation she did not experience with other acupuncture points. After her cold improved, she no longer felt the tingling sensation when moxibusting Yintang.
Research on heat-sensitive moxibustion has found that under disease conditions, certain surface areas of the body exhibit a unique “reaction point” that is highly sensitive to gentle moxibustion, producing many special responses, hence termed “heat-sensitive points,” with an average occurrence rate of about 70%. After recovery from illness, the occurrence rate of heat-sensitive points drops to 10-15%.
Wherever the sensation of moxibustion is felt, the symptoms will subsequently alleviate:
(1) Moxibusting Fengmen (风门) results in a heat sensation radiating to the shoulder, providing immediate relief from chronic shoulder pain;
(2) Moxibusting Yanglingquan (阳陵泉) results in a heat sensation radiating to the lower back, providing immediate relief from chronic lower back heaviness and pain;
(3) Moxibusting Sanyinjiao (三阴交) results in a heat flow to the lower abdomen, significantly improving pelvic effusion after several treatments;
(4) Moxibusting Tianshu (天枢) results in heat penetrating the abdominal cavity, significantly improving long-standing intestinal dysfunction after several treatments.
Some diseases have high incidence areas for heat-sensitive points, such as facial paralysis at Yifeng (翳风), colds at Fengfu (风府) and Yintang (印堂), pelvic diseases at Sanyinjiao (三阴交), and eye diseases at the earlobe area.
As stated in the “Neijing,” “The key to needling is that Qi reaches the location and is effective.” Many TCM practitioners and moxibustion therapists focus more on dialectical point selection, precise point selection, and obtaining Qi during clinical treatment, rather than just heat, emphasizing “warmth is sufficient” and “skin redness is acceptable.” If one wishes to pursue obtaining Qi, it is best to hold the moxa stick for suspended moxibustion or use indirect moxibustion.