Fire Medicine: Moxa Explained

In Japanese, the characters 鍼灸 that we commonly translate as "acupuncture" actually refer to both "needles" and "moxa." Many Westerners have never heard of moxa, even if they have received acupuncture, since modern clinics often forgo it due to the inconvenience. But you will notice the moxa aroma right away upon stepping into Bridge Acupuncture. Why do we love fire medicine?  

In chemistry, a catalyst is an agent that is needed for a chemical reaction to take place. The right elements might be present for the reaction, but due to a lack of energy they will just keep hovering near each other indefinitely, satisfied with their current stable arrangement... until a catalyst shows up and "pow!" gets the action started. Moxa is like a catalyst in the context of acupuncture treatment, adding that energetic momentum needed for things to start changing in the body.

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​There might be needles in all the right points but the Qi is not going to reach that "pow!" moment of activation and change, until that catalyst shows up. For those who can't have moxa not to worry, we use other catalysts--magnetic and micro-electrical techniques, manual needle stimulation methods, infrared heaters, visualization, movement and breathing methods-- but moxa is a reliable favorite. 

The effects of moxibustion are very clear when I check my patients' bodies for before-and-after comparisons. Though I love the smell it's really the day-in, day-out proof on my treatment table of moxa's impact that compels me to use it. Certain points in particular seem to have a strong affinity for it-- they just won't work as well with just needles, and with moxa, they work like magic.

Moxa basics
Moxa is composed of dried, aged and milled fibers from the leaf of mugwort, Artemisia vulgaris, a common weed that is a relative of sage. Mugwort is so common there's probably some in your back yard, but our source grows on mountainsides in Japan, where it develops a lot of the thick leaf fuzz that makes for good moxa.

Dried mugwort punk (fiber) was thought to be carried around by nomadic tribes of mainland Asia thousands of years ago as a convenient form of tinder. It began to be used for cauterization, and evolved into acu-cauterization (intentionally cauterizing certain points because of their specific therapeutic effects). This was all before the technology for needles existed, a form of proto-acupuncture.

Moxibustion later evolved into more gentle and indirect techniques that didn't require burning the skin. In one of the Japanese methods we use, for example, a half-rice grain size cone is burned atop some herbal ointment (shiunko) on the skin. It's subtle, much as Japanese style acupuncture needling is extremely subtle compared to methods in China. Gentle, comfortable moxa technique can be surprisingly powerful.

Even tiny, indirect Japanese moxibustion elicits a number of physiological reactions. Its particular wavelength of infrared is known to penetrate more deeply into the body than that of other herbs when burned on the skin. When several cones are burned in a row, layers of jet-black ash form that further enhance the energy of the moxa ember. The heat causes proteins to denature and provokes not only a stimulus to the central nervous system, but to the immune, lymphatic and vascular systems as well.

As a general effect, moxibustion has been shown to increase leukocyte (white blood cell) counts in the body, but I think of it as more regulatory to the immune system since it doesn't demonstrate the ability to cause an immune response or inflammation where it is not needed. The particular herbal constituents and volatile oils of moxa may also have special antimicrobial and immune-stimulatory effects.

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Common moxa techniques we love to use:

O'kyu: Tiny half-rice grain size cones of gold moxa, lit by incense. Usually several are burned in succession using shiunko cream as a barrier to protect the skin.

Kyu-to-shin: "Fire needle" method, where balls of greener, semi-pure moxa are burned on the handle of the needle, warming the needle and the general area of the point. Since the moxa used is less refined than that of Okyu moxa, it smells more pungent and burns hotter.

Tiger warmer: A stick of moxa incense is burned inside of a stainless steel instrument that is used to massage the skin. Great on kids or sensitive areas. 

Moxa box: A ball of semi-pure moxa is burned inside of a small wooden box with a protective screen. This can warm the abdomen or a region of the back and is very comfortable.

Moxa drum: A ball of semi-pure moxa is burned on a screen separated from the body with a segment of bamboo.

Barrier moxa: A larger cone of moxa is burned atop a barrier substance such as salt, ginger or garlic. 

Ibuki (stick-on) moxa: A convenient way to self-apply moxa, found widely including in Japanese drugstores. Often comes sold with diagrams of self-care acupoints. 

Conditions we commonly see that respond well to moxa:
Weak immunity
Anemia
Chronic or recurring infection
Skin disorders (eczema, psoriasis, hives, warts, dermatitis)
Tendinopathy ("tendinitis") - tennis elbow, golfer's elbow, rotator cuff issues, achilles issues, etc
Plantar fasciosis ("plantar fascitis")
Sprained joints
Arthritis
Chronic fatigue
Acute colds, flu, sinusitis, gastroenteritis
Menstrual cramping
Carpal tunnel
​Allergies
Thyroid imbalance

By Grace Rollins, MS, LAc

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