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Case examples of indirect moxibustion in treating viscera diseases
WorldJournal ofAcupuncture-Moxibustion (WJAM) Vol. 23, No.4, 30th Dec. 2013
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Medical Record
Case examples of indirect moxibustion in treating viscera diseases WANG Yi-zhou (..I..-IWl)\ LIUYu (:*1 ~f, ZHAO Qiang (~ 5li 1. Department of Tuina, Affiliated Hospital of Tianjin Academy ofTCM, Tianjin 300120, China; 2. Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences ( 1. :R$m 9=1 ~~1:i1fJE~ ~M~~fl*f4, :R$ 300120, 9=100; 2. 9=l009=l~f4~~)g(n~~IL'r*Jf4)
ARTICLE INFO
ABSTRACT
First author: WANG Yi-zhou (1988-), male,
Indirect moxibustion is used to treat qi constraint amenorrhea, chest bi due to congealing cold, spleen deficiency diarrhea, cough and panting due to lung deficiency, enuresis with kidney deficiency and other diseaseswith satisfactory treatment effects. It is believed that indirect moxibustion is characterized by simple and effective acupoint selection and broad indications. During the treatments, quantity and duration of moxibustion should be determined according to the practical pathogenetic conditions and state of an illness, and the propagated sensation along meridians is regarded as the better treatment effect for the patients.
resident physician. Research field: studies in clinical practices and mechanisms of orthopedics and Tuina. E-mail: [email protected] Accepted on July 29,2013
KEY WORDS: indirect moxibustion; viscera diseases; medical cases
Moxibustion is one of the external treatment methods in TCM. Dry moxa or other drugs are used for cauterizing and ironing on acupoints, in which heat of moxibustion fire and pharmaceutical actions penetrate muscular layer, propergation through meridians, thus regulate zang-fu organs, warming and unblocking qi and blood circulation, supporting healthy qi to eliminate pathogen, in order to reinforce circulation of qi and blood and prevent diseases. It is documented in Lingshu: Cijie Zhenxie (<<~~ ~J l'J.$» Miraculous Pivot: Acupuncture Principles and Diseases) that "only fire can dispel the blood stagnation in the vessel". Moreover, it is also recorded in Lingshu o Jinfu ( «~m ~~IU Miraculous Pivot: Forbidden medicine) that "the blood cold should be treated by moxibustion." There are many different kinds of moxibustion, among which the treatment effect of indirect moxibustion are more significant than direct moxibustion since its power is mild and it can introduce the dual effects of moxibustion and drugs to the affected positions. Therefore, it is suitable for the treatments on multiple kinds of chronic diseases, and 0
0
some understandings towards the treatments on viscera diseases by indirect moxibustion in clinical practices are summarized and introduced as follows.
Case 1 Amenorrhea due to Qi constraint A patient, female, 28 years old, visited on May 10th, 2010. She was always busy at work and felt high pressure during routine work, and she got angry one day and became gloomy for several days after quarrelling with her family. She came to our hospital for help due to absence of menstruation for three months. The observations in examinations indicated eructation, chest oppression, distending pain in hypochondrium and breasts, bitter taste in mouth, anorexia, dark tongue color, thin and white coating, and fine and string-like pulse. Finally, she was diagnosed as menostasis and the syndrome differentiation was stagnation of qi due to depression of the liver. Therefore, she was subjected to ginger moxibustion once a day at Ganshu (Mf,j BL 18) and Shangliao (J::~ BL 31), CHiao ({j(~ BL 32), Zhongliao (9=1~ BL 33), Xialiao Cf~ BL 34) at
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WorldJournal ofAcupuncture-Moxibustion(WJAM) Vol. 23, No.4, 30th Dec. 2013
night, 15 moxa cones once. After the moxibustion for the first time, the patient felt 1ukewann at lumbosacral region and back, she felt unobstructed functional activities of vital qi at lumbosacral region and back after moxibustion for continuous three days, just like the coherence of fishes swimming freely. The sense of warmth during moxibustion could penetrate into abdomen locally and persisted for 1-2 hours after moxibustion. After moxibustion was carried out the seventh day, the menstruation came, it was dark in color and stasis clots could be detected, and abdominal pains were also concurrent. After menstruation terminated, the moxibustion was continued for another three weeks according to the method as mentioned above, the next menstruation came as expected, it was reddish in color, stasis clots was not detected, and she seldom had uncomfortable feeling in abdomen. Notes: it is documented in Fuqingzhu Nuke (<< f.i Fu Qing-zhu 's Treatise on Gynecology) that "menstruation is derived from kidneys, while liver is the child of kidney, and liver qi depression may lead to kidney qi depression." Therefore, the free flow of qi regulated by liver is essential conditions of "regular menstrual cycle". Regulations on liver and kidneys are particularly important for menostasis cases since most of the cases are concurrent with liver and kidney syndromes for both excessive and deficiency. Therefore, ginger moxibustion was carried out at BL 18 and BL 31, BL 32, BL 33, BL 34, the functions of fresh ginger in promoting blood circulation and dispersing stasis and the lukewarm power of moxibustion can penetrate skin and reach deep position, reinforce the efficacy for soothing liver, relieving qi depression and guiding menstruation, and thus eliminate the menostasis induced by stagnation of qi due to depression of the liver.
fIr.± :9:*4»
Case 2 Chest-hi due to congealing cold A patient, female, 58 years old, visited on October 19th, 2010. She suffered coronary heart disease for 20 years, and she had been subjected to drug medication with vascardin, xinbao and other drugs, but the treatment effect was not satisfactory. The symptoms were as followed: paroxysmal pains in precordial region and behind breast bones, extension to her back at the left side, she also suffered irregular heart beat and dyspnea, short breath, lack of power, hyperarousal, dizziness, dark tongue color, thin and white coating, knotted pulse. Holter indicated: myocardial strain at left ventricle, atrial premature beats occured in pairs sometimes, and ventricular premature beat was occasionally detected. She was diagnosed with chest-hi due to congealing cold in
• 61 • heart meridian. Therefore, ginger moxibustion was carried out once a day at Xinshu (lc.,1'tr BL 15) and Geshu (M1'tr BL 17) in the morning. All of the drugs were withdrawn during the treatments, and the back pain disappeared after moxibustion for five times. The clinical symptoms completely disappeared after treatments for two weeks. The results in the reexamination showed that atrial premature beats and ventricular premature beats disappeared, the VS-V6 T wave became erected and no longer maintained low and flat, indicating normal electrocardiogram. Notes: the major causes of chest-hi should be attributed to consumptive diseases in heart, kidneys and spleen, intemperance of taking foods, internal injuries caused by seven emotions, invasion of pathogen cold, subsequent stagnation of phlegm, qi stagnation, cold accumulation, blood stasis and other lesions, which may lead to thoracic yang stuffiness, stagnation of vital qi and blood stasis. Therefore, the crucial point for treating chest-hi is to warm and dredge heart meridian, promote qi and blood circulation, and the pains can be eliminated after the heart is supported. The back-shu points can be used to treat diseases in zang-fu organs and other systems related to zang-fu. Ginger moxibustion can warm and dredge collaterals, promote qi to activate blood, subside swelling and dissipate masses. The combination of them can boost qi and invigorate blood, unblock the meridians and collaterals to stop pain, improve oxygen supply in cardiac muscles, and thus treat chest-hi.
Case 3 Diarrhea due to spleen deficiency A patient, female, 50 years old, visited on July 8th, 2011. She mainly complained about diarrhea for almost two years, 3--4 times a day, the purgation was watery stool, and she was diagnosed with ulcerative colitis according to the western medicine. The patient had been administered with antibiotics, fluid replacement and other treatment, but the effects were not satisfactory. The observations during the examinations were as follows: lusterless facial complexion, anorexia, lack of power, haggard and cavernous eyes, thin and white coating, thin and weak pulse. The syndrome of diarrhea belongs to diarrhea induced by spleen and kidney deficiency. Moxibustion on Typhonium Rhizome cake was carried out twice a day on Pishu (H$1'tr BL 20), Shenshu ('!f1'tr BL 23), Shenque (flfi w;] cv 8) and Tianshfi (:~m ST 25) for 20 min and one week later, the symptoms were alleviated, the frequency of stools decreased to twice a day and became normal after moxibustion for another three
WorldJournal ofAcupuncture-Moxibustion(WJAM) Vol. 23, No.4, 30th Dec. 2013
·62· weeks. The clinical symptoms completely disappeared and did not recur during the two-year follow-up.
Notes: it is believed in TCM that the major reasons for the incidence of ulcerative colitis should be attributed to deficiency in native endowment and postnatal disorder in spleen-stomach transportationmetabolism. With a long disease course and different seriousness, it occurs repeatedly, lingering and refractory. Moxibustion on Typhonium Rhizome cake was carried out on the acupoints to regulate qi and blood circulation all over the body by the pharmaceutical action of moxa cone and Typhonium Rhizome, and thus recover yang of human body. Bladder Meridian of foot-taiyang starts from head to feet, runs at the back of human body, kidney and bladder are exterior-interior related, primordial yang is reserved in kidney of human body, fire is generated, negative haze is dispersed, kidney yang is recovered and capable of warm spleen, stimulate spleen yang and control transport and transformation, intaken foods are digested, refined nutritious substances are transported, yin and yang are harmonized, and thus diarrhea is healed; kidney yang is strengthened and thus spleen yang is recovered, the symptoms disappeared and the diseases are healed; Typhonium Rhizome are stimulated by the persistent lukewarm at the reaction site, thus the treatment effects directly reach the diseased position, meridians are unobstructed, qi and blood circulation are regulated, pathogen dampness in intestinal tract is eliminated, stagnated blood is removed and new blood is generated, warming yang runs in meridians and the ulcerative surface is healed.
Case 4 Cough and asthema due to lung deficiency A patient, male, 70 years old, visited on December 10th, 2011. He had been subject to persistent cough and dyspnea for four years, the disease recurred one month ago due to affection of exogenous cold, and the patient turned to our hospital for help since the treatment effects were not satisfactory after taking medicines. The observations in the examinations were as follows: cough, back chills, cough with white phlegm, short and discontinued breath, the symptoms of serious cough after exercises, soreness and weakness of waist and knees, deep and feeble pulse, light tongue proper with thin and white coating, and slightly greasy root. The patient was diagnosed with cough due to lung and kidney deficiency, and treatments for tonifying kidney and reinforcing lung were suitable. Therefore, Feishu (HiP1'tr BL 13), Gaohuang (.-rf BL 43), Taiyuan (*t1JI![ LV 9), Danzhong OIl CV 17) were selected, ginger
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moxibustion was carried out at BL 13 and BL 43, warming moxibustion was carried out at LV 9 and CV 17 for 20 min, once for every two days. The back chills were eliminated after moxibustion for three times, the coughing was significantly alleviated, the patient could keep peaceful prostration and sleep, the symptoms were all eliminated after treatments for seven times, and did not recur during the two-year follow-up. Notes: BL 13 belongs to Bladder Meridian of foot-taiyang, it can disperse the meridian qi in taiyang Meridian, dispel exogenous pathogen; it is also the back-shu point of lung, it can replenish and restore lung qi, direct counterflow downward and relieve asthema, purify lungs and eliminate sputum; CV 17 is an qi influential points, moxibustion can loosen chest and regulate qi, spread out functional activities of vital qi; it is documented in Qianjin Yaofang ( «T~ !J11f» Important Formulas Worth a Thousand Gold Pieces) that "BL 43 can be used to treat many diseases, excessive deficiency, nocturnal emission, cough with dyspnea, psychosis and madness." It can regulate lung and tonify asthenia. LV 9 is the yuan-source point of lung meridian, which is capable of relieving cough and reducing sputum, dredging and regulating blood vessels, dispersing dampness in the deepest layer of lung, transporting lung qi to the upper layer.
Case 5 Enuresis with kidney deficiency A patient, male, 7 years old, visited on June 6th, 2012. He always wet the bed unconsciously during fast sleep at night, and was not improved after acupuncture and drug medication. The observations in the examinations were as followed: his face was slightly dark, deficient breath and few words, depression, dizziness, distress in the loins, cold limbs, frequent urine in day time, pale tongue and white coating, deep and feeble pulse. Ginger moxibustion was carried out once a day at Shenque (flj:! ~ CV 8) and Sanymjiao (.:=: 1m 3t SP 6) on both sides at night, a half of moxa stick was used once, and the patient was advised not to take too much water foods at night. The frequency of urine became normal in day time after moxibustion for three times, he still wet the bed at night occasionally after one week, but the urinary volume decreased. After two weeks, the patient no longer suffered bed-wetting and the disease did not recur during the two-year followup. Notes: infantile enuresis belongs to "enuresis" in children's miscellaneous diseases in TCM. It is believed in TCM that the causes for this disease should be attributed to insufficient native endowment
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World Journal ofAcupuncture-Moxibustion (WJAM) Vol. 23, No.4, 30th Dec. 2013
and cold lower energizer. Kidney deficiency always leads to insufficient kidney yang, the patients may be subject to general lassitude, pale face, cold limbs and fear of cold; waist is the house of kidney, the kidney being in charge of bone, and thus the patient suffered soreness and weakness of waist and knees; kidney produce marrow, kidney deficiency always leads to deficiency in brain and spinal cord, and thus the patients always suffered poor intelligence; lower origin cold syndrome always lead to clear and long urine. It is documented in Volume 8 of Leijing Tuyi ( «~~OO if.» Pictorial Appendices to 'The Classified Classic ') that "moxibustion with 300-500 moxa cones cannot only heal diseases but also prolong longevity." Saltseparated moxibustion on CV 8 can warm and tonify the lower energizer, warm and dredge meridians, regulate qi and blood circulation, and warm yang and tonify kidney, arrest polyuria and stop enuresis. SP 6 is the converging acupoint of the three yin meridians of foot, and thus it can invigorate kidney and tonify spleen, arrest polyuria and regulate sphincter muscle of urinary bladder, thus achieve the treatment effects.
EXPERIENCES
Simple and effective acupoint selection, treatments on many diseases through moxibustion Indirect moxibustion only select a few but essential acupoints, which are selected in general, according to syndrome differentiation along meridians, normally 1-2 specific acupoints or experiential acupoints are selected. It is documented in Bencao Zheng The Orthodox Materia Medica) that argy wormwood leaf can dredge twelve meridians and is particularly suitable as drugs for liver, spleen and kidney, it can warm spleen-stomach, dispel cold and eliminate dampness, promote qi in blood and stagnation in qi ... it can be used by grinding the raw materials into juice, decocting, moxibustion for many diseases, or frying hot, then ironing and administrate for dredging meridians, or wrapped in bags to warm umbilicus and knees, exterior and interior, raw and cooked leaves are suitable for different syndromes." The "warm characteristics for raw materials and hot characteristics for cooked materials", "recovery of dying primordial yang" and "pure yang characteristics" all confirmed its lukewarm efficacy, while "dredging the twelve meridians", "promoting qi in blood circulation and stagnation in qi", "permeate the meridians" all documented its efficacy in dredging meridians. It is reported in Bencao Congxin ( «*1it~~» Thoroughly Revised Materia Medica) that "argy wormwood leaf is bitter,
(<<*1itiE»
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raw leaves are warm and cooked leaves are hot, its pure yang characteristics can restore yang-exhaustion, dredge the twelve regular meridians, promote the three yin, regulate vital qi and blood circulation, dispel cold dampness, warm womb, stop hemorrhage, warm spleen-stomach, expel stagnation, regulate menstruation and prevent miscarriage···moxibustion with it can permeate meridians and eliminate many diseases." It is documented in Bencao Gangmu ( 1it~ The Grand Compendium ofMateria Medica) that "Raw argy wormwood leaf is slightly bitter but too acrid, cooked argy wormwood leaf is slightly acrid but too bitter, raw leaf is warm while cooked leaf is hot, pure yang. It can produce primordial fire and recover dying primordial yang·· .moxibustion with it can permeate meridians and treat many pathogenic factors, its treatment effects are significant since patients suffering furuncle can be healed." Therefore, the effects of argy wormwood leaf are extensive, and thus indirect moxibustion can be used in treating many diseases.
§»
«*
Quantity and duration for moxibustion determined according to practical pathogenetic conditions and characteristics If the disease being located in the exterior, the quantity of moxibustion should be small; the moxacone should not be too big; if the lesion located deep, bigger moxa cones should be used for moxibustion. As documented in Zhenjiu Dacheng ( «tr~*fflG» The Great Compendium ofAcupuncture and Moxibustion), "if the abnormal pulse is thin, moxibustion should be carried out on meridians, the moxa-cone in sparrow stool size can also heal diseases; bigger moxa cones should be used for abdominal distention, hernia, conglomerations and renal mass disease." It is documented in Beiji Qianjin Yaofang ( «~EtT~ !Jf:1f» Important Formulas Worth a Thousand Gold Piecesfor Emergency) in terms of the number of moxa cones, it can be increased by several times for the prescription if the patients are strong and the root cause is refractory." Bianque Xinshu (<
World Journal ofAcupuncture-Moxibustion (WJAM)
Vol. 23, No.4, 30th Dec. 2013 terms of the number of moxa cones, it can be increased by several times for the prescription if the patients are strong and the root cause is refractory", "in terms of upbearing qi generated in stomach and roared, hiccup and aphagia, moxibustion should be carried out on Taichong c;titP LR 3) with unlimited moxa cones. It starts from pain to painlessness, or from painlessness to elimination of pain", "moxibustion should be carried out at the position one inch below both breasts until recovery takes place from disease." The health preserving moxibustion should be carried out in small quantity but be persistented for a long term.
Propagated sensation along meridians accompanying moxibustion
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permeate, heat transmission, no (mild) heat on surface but heat in deep position, no (mild) heat at local position but heat at distal position, formication and other special senses. Just as "qi arriving" "deqi" and other meridian qi activities produced by acupuncture, indirect moxibustion can also activate and promote meridian qi in human body, which is the symbol for the activation of endogenous regulatory functions in human body, therefore, the produced moxibustion senses can significantly improve the treatment effects of moxibustion. In summary, the results reported as above only showed the outline, so differences among individuals should be carefully handled based on syndrome differentiation.
Moxibustion senses refer to heat expansion, heat
(Editor: HAN Yan-jing Translator: ZHOU Dong-sheng)
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·60·
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Medical Record
Case examples of indirect moxibustion in treating viscera diseases WANG Yi-zhou (..I..-IWl)\ LIUYu (:*1 ~f, ZHAO Qiang (~ 5li 1. Department of Tuina, Affiliated Hospital of Tianjin Academy ofTCM, Tianjin 300120, China; 2. Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences ( 1. :R$m 9=1 ~~1:i1fJE~ ~M~~fl*f4, :R$ 300120, 9=100; 2. 9=l009=l~f4~~)g(n~~IL'r*Jf4)
ARTICLE INFO
ABSTRACT
First author: WANG Yi-zhou (1988-), male,
Indirect moxibustion is used to treat qi constraint amenorrhea, chest bi due to congealing cold, spleen deficiency diarrhea, cough and panting due to lung deficiency, enuresis with kidney deficiency and other diseaseswith satisfactory treatment effects. It is believed that indirect moxibustion is characterized by simple and effective acupoint selection and broad indications. During the treatments, quantity and duration of moxibustion should be determined according to the practical pathogenetic conditions and state of an illness, and the propagated sensation along meridians is regarded as the better treatment effect for the patients.
resident physician. Research field: studies in clinical practices and mechanisms of orthopedics and Tuina. E-mail: [email protected] Accepted on July 29,2013
KEY WORDS: indirect moxibustion; viscera diseases; medical cases
Moxibustion is one of the external treatment methods in TCM. Dry moxa or other drugs are used for cauterizing and ironing on acupoints, in which heat of moxibustion fire and pharmaceutical actions penetrate muscular layer, propergation through meridians, thus regulate zang-fu organs, warming and unblocking qi and blood circulation, supporting healthy qi to eliminate pathogen, in order to reinforce circulation of qi and blood and prevent diseases. It is documented in Lingshu: Cijie Zhenxie (<<~~ ~J l'J.$» Miraculous Pivot: Acupuncture Principles and Diseases) that "only fire can dispel the blood stagnation in the vessel". Moreover, it is also recorded in Lingshu o Jinfu ( «~m ~~IU Miraculous Pivot: Forbidden medicine) that "the blood cold should be treated by moxibustion." There are many different kinds of moxibustion, among which the treatment effect of indirect moxibustion are more significant than direct moxibustion since its power is mild and it can introduce the dual effects of moxibustion and drugs to the affected positions. Therefore, it is suitable for the treatments on multiple kinds of chronic diseases, and 0
0
some understandings towards the treatments on viscera diseases by indirect moxibustion in clinical practices are summarized and introduced as follows.
Case 1 Amenorrhea due to Qi constraint A patient, female, 28 years old, visited on May 10th, 2010. She was always busy at work and felt high pressure during routine work, and she got angry one day and became gloomy for several days after quarrelling with her family. She came to our hospital for help due to absence of menstruation for three months. The observations in examinations indicated eructation, chest oppression, distending pain in hypochondrium and breasts, bitter taste in mouth, anorexia, dark tongue color, thin and white coating, and fine and string-like pulse. Finally, she was diagnosed as menostasis and the syndrome differentiation was stagnation of qi due to depression of the liver. Therefore, she was subjected to ginger moxibustion once a day at Ganshu (Mf,j BL 18) and Shangliao (J::~ BL 31), CHiao ({j(~ BL 32), Zhongliao (9=1~ BL 33), Xialiao Cf~ BL 34) at
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WorldJournal ofAcupuncture-Moxibustion(WJAM) Vol. 23, No.4, 30th Dec. 2013
night, 15 moxa cones once. After the moxibustion for the first time, the patient felt 1ukewann at lumbosacral region and back, she felt unobstructed functional activities of vital qi at lumbosacral region and back after moxibustion for continuous three days, just like the coherence of fishes swimming freely. The sense of warmth during moxibustion could penetrate into abdomen locally and persisted for 1-2 hours after moxibustion. After moxibustion was carried out the seventh day, the menstruation came, it was dark in color and stasis clots could be detected, and abdominal pains were also concurrent. After menstruation terminated, the moxibustion was continued for another three weeks according to the method as mentioned above, the next menstruation came as expected, it was reddish in color, stasis clots was not detected, and she seldom had uncomfortable feeling in abdomen. Notes: it is documented in Fuqingzhu Nuke (<< f.i Fu Qing-zhu 's Treatise on Gynecology) that "menstruation is derived from kidneys, while liver is the child of kidney, and liver qi depression may lead to kidney qi depression." Therefore, the free flow of qi regulated by liver is essential conditions of "regular menstrual cycle". Regulations on liver and kidneys are particularly important for menostasis cases since most of the cases are concurrent with liver and kidney syndromes for both excessive and deficiency. Therefore, ginger moxibustion was carried out at BL 18 and BL 31, BL 32, BL 33, BL 34, the functions of fresh ginger in promoting blood circulation and dispersing stasis and the lukewarm power of moxibustion can penetrate skin and reach deep position, reinforce the efficacy for soothing liver, relieving qi depression and guiding menstruation, and thus eliminate the menostasis induced by stagnation of qi due to depression of the liver.
fIr.± :9:*4»
Case 2 Chest-hi due to congealing cold A patient, female, 58 years old, visited on October 19th, 2010. She suffered coronary heart disease for 20 years, and she had been subjected to drug medication with vascardin, xinbao and other drugs, but the treatment effect was not satisfactory. The symptoms were as followed: paroxysmal pains in precordial region and behind breast bones, extension to her back at the left side, she also suffered irregular heart beat and dyspnea, short breath, lack of power, hyperarousal, dizziness, dark tongue color, thin and white coating, knotted pulse. Holter indicated: myocardial strain at left ventricle, atrial premature beats occured in pairs sometimes, and ventricular premature beat was occasionally detected. She was diagnosed with chest-hi due to congealing cold in
• 61 • heart meridian. Therefore, ginger moxibustion was carried out once a day at Xinshu (lc.,1'tr BL 15) and Geshu (M1'tr BL 17) in the morning. All of the drugs were withdrawn during the treatments, and the back pain disappeared after moxibustion for five times. The clinical symptoms completely disappeared after treatments for two weeks. The results in the reexamination showed that atrial premature beats and ventricular premature beats disappeared, the VS-V6 T wave became erected and no longer maintained low and flat, indicating normal electrocardiogram. Notes: the major causes of chest-hi should be attributed to consumptive diseases in heart, kidneys and spleen, intemperance of taking foods, internal injuries caused by seven emotions, invasion of pathogen cold, subsequent stagnation of phlegm, qi stagnation, cold accumulation, blood stasis and other lesions, which may lead to thoracic yang stuffiness, stagnation of vital qi and blood stasis. Therefore, the crucial point for treating chest-hi is to warm and dredge heart meridian, promote qi and blood circulation, and the pains can be eliminated after the heart is supported. The back-shu points can be used to treat diseases in zang-fu organs and other systems related to zang-fu. Ginger moxibustion can warm and dredge collaterals, promote qi to activate blood, subside swelling and dissipate masses. The combination of them can boost qi and invigorate blood, unblock the meridians and collaterals to stop pain, improve oxygen supply in cardiac muscles, and thus treat chest-hi.
Case 3 Diarrhea due to spleen deficiency A patient, female, 50 years old, visited on July 8th, 2011. She mainly complained about diarrhea for almost two years, 3--4 times a day, the purgation was watery stool, and she was diagnosed with ulcerative colitis according to the western medicine. The patient had been administered with antibiotics, fluid replacement and other treatment, but the effects were not satisfactory. The observations during the examinations were as follows: lusterless facial complexion, anorexia, lack of power, haggard and cavernous eyes, thin and white coating, thin and weak pulse. The syndrome of diarrhea belongs to diarrhea induced by spleen and kidney deficiency. Moxibustion on Typhonium Rhizome cake was carried out twice a day on Pishu (H$1'tr BL 20), Shenshu ('!f1'tr BL 23), Shenque (flfi w;] cv 8) and Tianshfi (:~m ST 25) for 20 min and one week later, the symptoms were alleviated, the frequency of stools decreased to twice a day and became normal after moxibustion for another three
WorldJournal ofAcupuncture-Moxibustion(WJAM) Vol. 23, No.4, 30th Dec. 2013
·62· weeks. The clinical symptoms completely disappeared and did not recur during the two-year follow-up.
Notes: it is believed in TCM that the major reasons for the incidence of ulcerative colitis should be attributed to deficiency in native endowment and postnatal disorder in spleen-stomach transportationmetabolism. With a long disease course and different seriousness, it occurs repeatedly, lingering and refractory. Moxibustion on Typhonium Rhizome cake was carried out on the acupoints to regulate qi and blood circulation all over the body by the pharmaceutical action of moxa cone and Typhonium Rhizome, and thus recover yang of human body. Bladder Meridian of foot-taiyang starts from head to feet, runs at the back of human body, kidney and bladder are exterior-interior related, primordial yang is reserved in kidney of human body, fire is generated, negative haze is dispersed, kidney yang is recovered and capable of warm spleen, stimulate spleen yang and control transport and transformation, intaken foods are digested, refined nutritious substances are transported, yin and yang are harmonized, and thus diarrhea is healed; kidney yang is strengthened and thus spleen yang is recovered, the symptoms disappeared and the diseases are healed; Typhonium Rhizome are stimulated by the persistent lukewarm at the reaction site, thus the treatment effects directly reach the diseased position, meridians are unobstructed, qi and blood circulation are regulated, pathogen dampness in intestinal tract is eliminated, stagnated blood is removed and new blood is generated, warming yang runs in meridians and the ulcerative surface is healed.
Case 4 Cough and asthema due to lung deficiency A patient, male, 70 years old, visited on December 10th, 2011. He had been subject to persistent cough and dyspnea for four years, the disease recurred one month ago due to affection of exogenous cold, and the patient turned to our hospital for help since the treatment effects were not satisfactory after taking medicines. The observations in the examinations were as follows: cough, back chills, cough with white phlegm, short and discontinued breath, the symptoms of serious cough after exercises, soreness and weakness of waist and knees, deep and feeble pulse, light tongue proper with thin and white coating, and slightly greasy root. The patient was diagnosed with cough due to lung and kidney deficiency, and treatments for tonifying kidney and reinforcing lung were suitable. Therefore, Feishu (HiP1'tr BL 13), Gaohuang (.-rf BL 43), Taiyuan (*t1JI![ LV 9), Danzhong OIl CV 17) were selected, ginger
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moxibustion was carried out at BL 13 and BL 43, warming moxibustion was carried out at LV 9 and CV 17 for 20 min, once for every two days. The back chills were eliminated after moxibustion for three times, the coughing was significantly alleviated, the patient could keep peaceful prostration and sleep, the symptoms were all eliminated after treatments for seven times, and did not recur during the two-year follow-up. Notes: BL 13 belongs to Bladder Meridian of foot-taiyang, it can disperse the meridian qi in taiyang Meridian, dispel exogenous pathogen; it is also the back-shu point of lung, it can replenish and restore lung qi, direct counterflow downward and relieve asthema, purify lungs and eliminate sputum; CV 17 is an qi influential points, moxibustion can loosen chest and regulate qi, spread out functional activities of vital qi; it is documented in Qianjin Yaofang ( «T~ !J11f» Important Formulas Worth a Thousand Gold Pieces) that "BL 43 can be used to treat many diseases, excessive deficiency, nocturnal emission, cough with dyspnea, psychosis and madness." It can regulate lung and tonify asthenia. LV 9 is the yuan-source point of lung meridian, which is capable of relieving cough and reducing sputum, dredging and regulating blood vessels, dispersing dampness in the deepest layer of lung, transporting lung qi to the upper layer.
Case 5 Enuresis with kidney deficiency A patient, male, 7 years old, visited on June 6th, 2012. He always wet the bed unconsciously during fast sleep at night, and was not improved after acupuncture and drug medication. The observations in the examinations were as followed: his face was slightly dark, deficient breath and few words, depression, dizziness, distress in the loins, cold limbs, frequent urine in day time, pale tongue and white coating, deep and feeble pulse. Ginger moxibustion was carried out once a day at Shenque (flj:! ~ CV 8) and Sanymjiao (.:=: 1m 3t SP 6) on both sides at night, a half of moxa stick was used once, and the patient was advised not to take too much water foods at night. The frequency of urine became normal in day time after moxibustion for three times, he still wet the bed at night occasionally after one week, but the urinary volume decreased. After two weeks, the patient no longer suffered bed-wetting and the disease did not recur during the two-year followup. Notes: infantile enuresis belongs to "enuresis" in children's miscellaneous diseases in TCM. It is believed in TCM that the causes for this disease should be attributed to insufficient native endowment
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World Journal ofAcupuncture-Moxibustion (WJAM) Vol. 23, No.4, 30th Dec. 2013
and cold lower energizer. Kidney deficiency always leads to insufficient kidney yang, the patients may be subject to general lassitude, pale face, cold limbs and fear of cold; waist is the house of kidney, the kidney being in charge of bone, and thus the patient suffered soreness and weakness of waist and knees; kidney produce marrow, kidney deficiency always leads to deficiency in brain and spinal cord, and thus the patients always suffered poor intelligence; lower origin cold syndrome always lead to clear and long urine. It is documented in Volume 8 of Leijing Tuyi ( «~~OO if.» Pictorial Appendices to 'The Classified Classic ') that "moxibustion with 300-500 moxa cones cannot only heal diseases but also prolong longevity." Saltseparated moxibustion on CV 8 can warm and tonify the lower energizer, warm and dredge meridians, regulate qi and blood circulation, and warm yang and tonify kidney, arrest polyuria and stop enuresis. SP 6 is the converging acupoint of the three yin meridians of foot, and thus it can invigorate kidney and tonify spleen, arrest polyuria and regulate sphincter muscle of urinary bladder, thus achieve the treatment effects.
EXPERIENCES
Simple and effective acupoint selection, treatments on many diseases through moxibustion Indirect moxibustion only select a few but essential acupoints, which are selected in general, according to syndrome differentiation along meridians, normally 1-2 specific acupoints or experiential acupoints are selected. It is documented in Bencao Zheng The Orthodox Materia Medica) that argy wormwood leaf can dredge twelve meridians and is particularly suitable as drugs for liver, spleen and kidney, it can warm spleen-stomach, dispel cold and eliminate dampness, promote qi in blood and stagnation in qi ... it can be used by grinding the raw materials into juice, decocting, moxibustion for many diseases, or frying hot, then ironing and administrate for dredging meridians, or wrapped in bags to warm umbilicus and knees, exterior and interior, raw and cooked leaves are suitable for different syndromes." The "warm characteristics for raw materials and hot characteristics for cooked materials", "recovery of dying primordial yang" and "pure yang characteristics" all confirmed its lukewarm efficacy, while "dredging the twelve meridians", "promoting qi in blood circulation and stagnation in qi", "permeate the meridians" all documented its efficacy in dredging meridians. It is reported in Bencao Congxin ( «*1it~~» Thoroughly Revised Materia Medica) that "argy wormwood leaf is bitter,
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raw leaves are warm and cooked leaves are hot, its pure yang characteristics can restore yang-exhaustion, dredge the twelve regular meridians, promote the three yin, regulate vital qi and blood circulation, dispel cold dampness, warm womb, stop hemorrhage, warm spleen-stomach, expel stagnation, regulate menstruation and prevent miscarriage···moxibustion with it can permeate meridians and eliminate many diseases." It is documented in Bencao Gangmu ( 1it~ The Grand Compendium ofMateria Medica) that "Raw argy wormwood leaf is slightly bitter but too acrid, cooked argy wormwood leaf is slightly acrid but too bitter, raw leaf is warm while cooked leaf is hot, pure yang. It can produce primordial fire and recover dying primordial yang·· .moxibustion with it can permeate meridians and treat many pathogenic factors, its treatment effects are significant since patients suffering furuncle can be healed." Therefore, the effects of argy wormwood leaf are extensive, and thus indirect moxibustion can be used in treating many diseases.
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Quantity and duration for moxibustion determined according to practical pathogenetic conditions and characteristics If the disease being located in the exterior, the quantity of moxibustion should be small; the moxacone should not be too big; if the lesion located deep, bigger moxa cones should be used for moxibustion. As documented in Zhenjiu Dacheng ( «tr~*fflG» The Great Compendium ofAcupuncture and Moxibustion), "if the abnormal pulse is thin, moxibustion should be carried out on meridians, the moxa-cone in sparrow stool size can also heal diseases; bigger moxa cones should be used for abdominal distention, hernia, conglomerations and renal mass disease." It is documented in Beiji Qianjin Yaofang ( «~EtT~ !Jf:1f» Important Formulas Worth a Thousand Gold Piecesfor Emergency) in terms of the number of moxa cones, it can be increased by several times for the prescription if the patients are strong and the root cause is refractory." Bianque Xinshu (<
World Journal ofAcupuncture-Moxibustion (WJAM)
Vol. 23, No.4, 30th Dec. 2013 terms of the number of moxa cones, it can be increased by several times for the prescription if the patients are strong and the root cause is refractory", "in terms of upbearing qi generated in stomach and roared, hiccup and aphagia, moxibustion should be carried out on Taichong c;titP LR 3) with unlimited moxa cones. It starts from pain to painlessness, or from painlessness to elimination of pain", "moxibustion should be carried out at the position one inch below both breasts until recovery takes place from disease." The health preserving moxibustion should be carried out in small quantity but be persistented for a long term.
Propagated sensation along meridians accompanying moxibustion
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permeate, heat transmission, no (mild) heat on surface but heat in deep position, no (mild) heat at local position but heat at distal position, formication and other special senses. Just as "qi arriving" "deqi" and other meridian qi activities produced by acupuncture, indirect moxibustion can also activate and promote meridian qi in human body, which is the symbol for the activation of endogenous regulatory functions in human body, therefore, the produced moxibustion senses can significantly improve the treatment effects of moxibustion. In summary, the results reported as above only showed the outline, so differences among individuals should be carefully handled based on syndrome differentiation.
Moxibustion senses refer to heat expansion, heat
(Editor: HAN Yan-jing Translator: ZHOU Dong-sheng)
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