What's that Moxa smell all about?

Moxibustion, or moxa as it’s commonly know is a herbal therapy used in Chinese medicine, often alongside acupuncture, where the herb is burned to warm acupuncture points.

There are several types of moxa, and two main uses known as direct and indirect Moxa. Although Moxa smells similar to marijuana when it’s burning, there is no similarity in its effects or properties of the herbs! Lots of people have made comment over the years entering our clinic and shopfront that "oh someone is toking up back there" as I'm sure many other TCM practitioners would have been confronted with these comments too.

The most common types of moxa used are the needle-head moxa, Japanese moxa cones (stick-on moxa) and Moxa sticks.

When Moxa is in it’s natural state, it looks like a pile of green herbal fluff – known as “moxa punk”. The punk can be condensed into sticks, cones or the rougher grades of moxa punkare used in baths or externally applied.

Moxa sticks are most commonly used by practitioners – holding them over points, or the sticks can be put into a moxa box and applied to the acupuncture points.  Parts of the sticks can be used on the needles, known as needle-head moxa.

Moxa can be used as the whole or part of the treatment in many conditions. It’s particularly useful when cold has invaded into the body. A common example is cold-obstruction type arthritis. Moxibustion is used routinely in China for knee pain. Several studies on osteoarthritis of the knee have been done, although small sample sizes and other inconsistencies make it hard to draw definitive conclusions using a western medical research model¹.

In my clinic, treatment of knee pain is one of the most common uses of moxa. Usually four points around the knee are used with needle-head moxa. This can expel cold and stimulate local blood flow, and stop pain.

Moxa works by the application of heat to acupuncture points. Actually it causes a very minor burn on the skin (First degree burn, which is simply redness), which stimulates the bodies inflammatory response. This inflammatory response is a complex process where blood vessels change to allow cells to exit into the inflamed area, and increased blood supply in general. While inflammation is normally considered a negative or unwanted thing, it is perhaps the “short burst” /localized activation of this response that is involved in the Moxibustion treatment of pain.

Breech Presentation is another routine use of moxa. The moxa cones or moxa stick is applied to the points at the end of the toes, which can cause the breech baby to turn into the correct position. The point used is BL 67 – it is known as the point which turns Yin into Yang. 

When the yin (Growth, nourishment, sedintary) reaches it’s maximum , it will transform into Yang (activity, birth, moving). In treating breech presentation, this is best applied sooner rather than later, around 34 weeks is good to start. Usually a course of treatment over 10 days is given, the practitioner can instruct the patient how to appy the moxibusion themselves (usually a partner can help do it at home), with 2 or 3 treatments of moxibustion, usually combined with acupuncture given in the clinic over this 10 day period. Increasing numbers of midwives and clinicians in hospital environments are using moxibustion for breech presentation. As recently suggested in letters to the editor of Acupuncture in Medicine Journal of Brittish Medical Acupuncture Society², many hospitals could save money on cesareans and obstetric procedures if moxibustion was used as a protocol.  

Next time you visit your acupuncturist, ask if moxibustion is appropriate for your case.

References:

1. Choi, T, Kim, T, Kang, J, Lee, M, & Ernst, E 2011, 'Moxibustion for rheumatic conditions: a systematic review and meta-analysis', Clinical Rheumatology, 30, 7, pp. 937-945, MEDLINE Complete, EBSCOhost, viewed 19 November 2013.
2. Michael, W 2013, 'Letter to the editor on obstetric acupressure and acupuncture', Acupuncture In Medicine: Journal Of The British Medical Acupuncture Society, 31, 2, pp. 257-258, MEDLINE Complete, EBSCOhost, viewed 19 November 2013.

Stories from China... Inside the Chinese Medicine Hospital

My three months in Hangzhou as an intern at the Hangzhou Shi Zhong Yi Yuan was one of my most memorable life experiences.

As a teacher in TCM, I am constantly urging my students to "go to China". There is no substitute for this experience. I can't even articluate all the reasons eloquently why this is so imperative, but in this post I hope to shed some light on it.

Imagine a room, around 45m2, with about 6 desks in there. About half the size of a standard office desk. Around each desk are 3 or 4 typical Chinese wooden stools - the kind a size 14 westerner could fit half of their butt on!


The outpatients clinic is a room just like this, except it is filled with people. Each doctor has their own desk, alonside them are their intern(s) - the more they have the more popular that doctor probably is.

Walking in at 8am when the hospital is just opening, it's buzzing full of people. The doctors havent even arrived but there are people everywhere. Down the hallways and crowding around the desks. Each patient is often are accompanied by an entourage - family support for their sick mother, father or even grown up child. Often the patients would have several relatives or close friends with them.
It's apparent that when a person is sick their community is mobilised.

The system in the hospitals at that time (ten years ago) - and still is the way in many hospitals- is a no appointment, first come, first served basis. The patients would register at the administration of the hospital, recieve a ticket then go and wait at the doctors desk to be seen. They place their patient record book on the table and before long a queue of patient record books piles up. When the doctor walks in and sees the normal 15 or so books lined up on their desk they can see today is just another ordinary, incredibly busy day.


The self-ownership of the health care record was the first amazing, unique thing that stood out to me in my first weeks of studying in China. This system seemed so simple and sensical that I wondered why we don't do it in Australia? The answer to that one probably lies in the bureaucratic and popous traditions of western medicine (which developed in ways that take the power away from the patient and make the doctor look important and all-knowing)...but perhaps also in the underlying ownership of health that native Chinese inheritently have. This is a deep part of Chinese Medicine and it seemed that the Chinese have taken this into their management of their health care system at the root of it.

Basically each person is issued with a booklet, which added to that a swipe card around the mid 2000's. The card and the booklet contain all their records with doctors - both western and TCM, the card could be swiped at the computer station or doctors desk and all their MRI's, CT's etc would come up on the screen.

This is an amazing system when you consider "doctor shopping" - one doctor can see what the others have done thus far. It almost creates a bit of professional accountablity amoung herbalists - they can see what herbs and drugs have been prescribed, tests ordered and anything else inbetween.

Marie and Dermatology Doctor Luo Wei Dan

I digress from the main point but I really want to paint the picture that China is such an amazingly different place to any western country and it's health care system is definatley a unique one. I can't think of one western country that dosen't have issues with it's government issued medical services (the NHS in the UK, HMO's in the USA and Medicare etc in Australia).
Waiting lists for routine procedures, possibly unecessary health complications created by the waiting time to simply recieve a diagnosis (not even treatment), and the cost burden to patients are all common complaints.

I'm not saying that China is perfect by any means, but it was common to see a patient present with a health problem for the first time at 8am, see the doctor, have tests ordered and completed and return with MRI or CT test results by the afternoon of that same day. These weren't rich people - just normal everyday people. And this is with the enormous population (1.351 billion at last count - by the way there are 0.3 billion in the USA).

In China, low wages paid to health care workers certainly plays a part. But shouldn't health care be our greatest service to people? High population always lowers costs - supply and demand.

When you go to China as a TCM intern you have the privillage to observe so much. It's not just the hundreds of Chinese medicine (herbal), acupuncture or Tuina cases you see. I found I observed much more because of the language barrier. Your senses are awakened to what you see and feel more than what you can hear and understand in terms of language.

This amazing health care system was a massive stand out to me on my first visit to China as an intern. It's just something different. It has it's faults and flaws just as any other system but it's totally different to what we experience as "hospital medicine" in Australia.

Discover the peace zone...

Where is your peace zone? 

Where is the place where everything shuts off, where your mind can focus on a singular thing? 

Just breathe - no emails, no ideas or problems, no bills, no to do list or things to organize.

 ...just breathe in and out. Feel that life giving breath as your chest expands and oxygen fills your body. 

You can't hear or think anything else just the rhythmical breath and maybe the feeling of your heart beat. 

Five minutes in the peace zone can change your perspective, which can alter all the rest of the days decisions. 

You don't need to go to a course or do anything strange to get into the peace zone. It might seem hard in everyday life to go there but it dosen't mean it can't be done. 

If it seems impossible to find your peace zone in your world now, then go somewhere else - the beach, the forrest, a park, even get inside a wardrobe for 5 mins!

I find a simple change of position leads to a change of mental perspective that will amaze you.

Today I was going somewhere and happened to pass by an empty, silent chapel and went in. No phone on or ipad to check emails. Just sitting and allowing the silence to silence me. 

Before long 5 mins had gone by and I felt new ideas were already coming to me. The stress of the former part of the day was already passing. 

As an acupuncturist I often hear patients say they love coming in for acupuncture because it's the only time they can relax.

While it's great that acupuncture helps you to shut off your mind...and you can't exactly run off and do something when your pinned down to the bed, it's such a sad reality of our society that we don't relax well. 

Demands are always there, life will probably get more complicated and even after you die bills will still be coming in. I think we can benefit from all stealing 5 minutes in the peace zone!

If you liked this blog post, why not share the ways you relax in your peace zone below: