Practical Moxibustion Therapy

MIZUTANI JUNJI, R. Ac.

FOREWORD BY STEPHEN BROWN

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FOREWORD
I am pleased to introduce this compilation of Mizutani
Junji s articles, Practical Moxibustion Therapy. With
this first series of articles published in the North American
Journal of Oriental Medicine, he has become famous as
a champion of traditional Japanese medicine, especially
moxibustion. Since Mizutani Junji was led to the practice
of traditional Japanese medicine through a teacher
practicing the Sawada Style, he has a passion for traditional
approaches coupled with a no-nonsense pragmatism that
comes from having been a builder and architect. Direct
moxibustion has a central role in the Sawada Style, and
he has remained close to his roots while absorbing other
approaches including Kampo herbology.
Moxibustion or cauterization of acupuncture points
is one of the oldest and most effective forms of medicine.
Yet today the practice of direct moxibustion has become
something of a rarity outside of Japan. Moxibustion was
introduced to Japan from China more than a thousand years
ago along with acupuncture and herbology. Moxibustion
only became popular several centuries later when Buddhist
monks started practicing moxibustion among the common
people. The best material for moxa, which comes from a
species of mugwort, is found in abundance in Japan. The
widespread availability of this herb and the coupling of
moxibustion with religious practices secured the position of
moxibustion within Japanese culture.
After World War Two the occupation government of the
United States tried to ban all traditional medicine in Japan
in the belief that direct moxibustion was a primitive and
even barbaric practice. The therapeutic value of creating
small burns on the skin had been proven in many scientific
studies in Japan, and this evidence served as ammunition
to defeat the misguided attempt to outlaw traditional
medicine. Even though traditional medicine survived,
the Westernization of Japan since that time has caused a
steady decline in the popularity of moxibustion. These
articles by Mizutani Junji are an attempt to reverse this
trend and to place moxibustion on a solid foundation in the
West. This booklet is an important step in this movement
as well as a powerful motivation for all of us to put these
valuable techniques into practice. It is well known in
Oriental medicine that acupuncture and moxibustion are
a pair. This is evident in the way moxibustion is included
in the Chinese term for acupuncture, Zhenji ( Shinkyu). Although recently acupuncture and other aspects
of Oriental medicine have become popular in Europe and
North America, moxibustion has not been receiving the
attention it deserves. Mizutani Junji is exceptional in his
inclusion of Japanese moxibustion techniques in his practice.
He has diligently applied many types of moxibustion on
his own body as well as his patients. With his personal
experience and knowledge of the powerful effects of direct
moxibustion, Mizutani Junji has established himself as an
authority and proponent of moxibustion in North America.
In these articles Mizutani Junji explains the hows and
whys of moxibustion, and shares the depth and breadth
of his knowledge and experience. His simple and direct

style has won him the praise and respect of practitioners

on both sides of the Pacific. It is his assertion that the
benefits of moxibustion are too many and too valuable
not to apply them as much as possible in the practice of
Oriental medicine. Most importantly, moxibustion therapy
is something that goes beyond the limits of clinical practice
to empower patients and their family in their own healing.
Patients are encouraged to apply moxibustion regularly
at home to increase and extend the effect of treatment.
Patient involvement is the key to healing, and because of
this moxibustion, just as other forms of Oriental medicine,
has stood the test of time.
Stephen Brown L. Ac.

Practical Moxibustion Therapy, 2012

by Mizutani Junji. All rights reserved. No part of

this journal may be reproduced without consent from
the publisher. The ideas and opinions expressed in this
journal are not necessarily those of the publisher or of
the editorial staff.
North American Journal of Oriental Medicine
896 West King Edward Avenue
Vancouver, B.C. V5Z 2E1 Canada
Phone/Fax: (604)874-8537
E-mail Address: najom@shaw.ca

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Practical Moxibustion Therapy (1)
1. Introduction
Eleven years have passed since I began practicing
acupuncture, moxibustion and shiatsu in Canada. Shiatsu was already quite popular in Toronto ten years ago
and acupuncture was also well known. When it came to
moxibustion, however, it was a completely different story.
Moxibustion was practically unheard of back then, and this
hasnt changed much. When I was studying acupuncture
in Japan, I was told that foreigners wouldnt go for anything that would cause a burn or scar, and that it was better
to avoid doing moxibustion on them.
There is a little historical incident behind this belief.
After World War II, when General MacArther was in command of the occupation forces in Japan, moxibustion became a big issue. The Americans regarded both acupuncture and moxibustion as barbaric and primitive practices.
Moxibustion especially must have appeared to be some
strange ritual of primitive people, with smoke curling up
as a herb was burned directly on the skin. The Occupation
Government, overcome by zeal, set out to ban all traditional medical practices. They had no idea how much opposition they would encounter. Traditional practitioners
banded together and mounted a massive campaign, enlisting the help of doctors and scientists who understood the
value of these practices. After a long legal battle, the practitioners prevailed and so these practices survive to this
day.
There is, however, still some doubt left among the general public about the primitive practice of moxibustion,
and its acceptability to Westerners. This is one reason why
I hesitated to use moxibustion in my first few years of practice with them. Another obstacle in my using moxibustion
initially was that my English, it was limited, and I would
have difficulty explaining it to my patients.
The fact is, however, that acupuncture and moxibustion
come as a pair in Oriental medicine. In Chinese and
Japanese they are two characters which make up one
word ( zenjiu or shinkyu). Indeed, acupuncture and
moxibustion complement each other to form one mode
of therapy, much as two strands of fiber intertwine to
form a rope. Most practitioners are well aware that the
therapeutic effect is boosted when both forms of treatment
are used together. Furthermore, moxibustion is supposed
to be beneficial for people living in cold climates, so it
stands to reason that it is good for those of us living in the
sub-arctic or northern temperate zones.
I became braver as time went on, and I began to apply
moxibustion more and more, as much for its obvious benefits as for theoretical reasons. I learned many things about
moxibustion in my transition from a hesitant novice to an
enthusiastic moxibustion practitioner and advocate. The
following were some important realizations:
(1) Non-Japanese do not necessarily dislike moxibustion.
Not only that, but many patients will gladly apply
moxa on themselves at home if I show them how.
(2) Japanese, on the other hand, tend to shy away from
moxibustion. The longstanding image of moxibustion

in Japan seems to somehow work against its popularity.

(3) This may seem like an obvious point, but moxibustion
is very effective for non-Japanese as well. Furthermore,
since Caucasians do not have as much skin pigment, the
moxibustion scars are not as visible.
(4) In the case of dark skinned people, the burn heals over
with lighter colored skin, and the moxa scar is more obvious, so indirect moxibustion is more preferable.
(5) Most Chinese and Koreans do not know about moxibustion. Even those who practice Oriental medicine have
very little awareness of the value of direct moxibustion.
There is no question that moxibustion originated in
China. What then happened? Is direct moxibustion a
lost art on the continent? Moxa sticks and other forms
of indirect moxibustion are common enough, but these
dont compare to the real thing.

2. Moxibustion for Westerners

I want to make it clear, if it isnt already obvious, that I
am writing about Japanese style moxibustion therapy here.
I firmly believe that once the people of North America
learn the simple secrets of direct moxibustion, either as a
professional treatment along with acupuncture or as a selfcare technique at home, they will recognize its tremendous
benefits. There are many benefits to moxibustion. Clinically it increases blood cell counts, especially that of white
blood cells. This is a well established fact in Japan, where
it has been confirmed in numerous scientific studies. I am
convinced that this directly translates into strengthening
ones immunity. In this day and age, when the weakening of our immune system has given rise to a whole host
of health problems, strengthening our immunity is one of
the most urgent needs. The general decline in immunity
among people in North America is evident even without
citing the rise in diseases like cancer and AIDS.
Another feature of direct moxibustion is the unique nature of the heat stimulus. The heat from the burning moxa,
rather than dispersing over the skin surface, penetrates
deeply into underlying tissues. This is especially the case
when many cones of moxa are applied consecutively on
the same point. The concentrated penetration of heat into
the body is phenomenal. No wonder it is known in Japan
as penetrating moxibustion. I think this compares to the
heat stimulus achieved by lasers. Therefore, moxibustion
is very effective in reducing pain and inflammation.
The benefits of moxibustion are many, and I could go
on and on about them, but one of the greatest advantages
is its low cost and that it can be applied at home. Yet moxibustion doesnt enjoy the popularity it deserves, even in
Japan, where young people tend to shy away from it. No
doubt this is because people dont like to endure the burning sensation, and also dont like the ideas of moxa scars.
In Japan, moxibustion is viewed by some as an outdated
practice and it doesnt fit in with young peoples sense of
aesthetics.
When I first began to treat Westerners with moxibustion, I had to overcome all these negative aspects. In time
I learned that there were two ways of getting patients to
warm up to moxibustion. The first is to always demonstrate it on yourself with a new patient so as to put their

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fears to rest. The second is to get results. To show that
moxibustion is really not such a big deal, I burn a small
cone on the back of my hand. The patient watches the
moxa cone burn and sees how quick and simple it is. I
then explain how it is hot for just a split second. At that
point most patients are willing to give it a try because it really doesnt seem that bad after all. I also reassure them, I
ll stop if you find it too painful. Then I apply the smallest
cone I can make. In addition, I use a bamboo tube to press
around the moxa cone, just before the fire reaches the skin,
so they can hardly feel any pain at all. After this, I ask the
patient if its OK to apply more cones. Most always the
patient agrees. Once I get their consent, I have it made,
and I continue to apply tiny moxa cones on other points
as well. After applying several cones, the patient becomes
used to the heat stimulation of moxibustion, so I gradually
increase the size of the cones.
The second way of winning people over to moxibustion
- getting results - is not that difficult. The treatment is a
success if the patient feels relaxed after the treatment. This
is simply a matter of making sure that the patient doesnt
feel too much pain. When moxibustion is performed carefully, many cones can be applied consecutively so that the
heat penetrates deeply. This is what brings results. The
rule of thumb for the number of cones needed for good
results is to apply as many as needed to make the skin
around the point turn red or sweat a little. When this happens, the tenderness or induration at that point is diminished, and this can be confirmed by pressing the point.
If the moxa cones are applied repeatedly on the same
point without having removed the ash of each burned
cone, then there are hardly any burn marks. This is especially true when we apply half rice grain sized cones
(4mm height, 2mm width at base). Even if a tiny burn does
form, it heals completely in about three weeks to become
hardly distinguishable from the surrounding skin. When
applied carefully on the right points, you can be certain of
good results. And thus you have another moxibustion fan.
For the practitioner, however, there may be a problem
with moxibustion for it can be time consuming to apply. In
my case, I spend about half an hour on moxibustion alone.
When combined with acupuncture, I do acupuncture first
and then apply moxa on the tight spots that needles havent relieved. Moxibustion serves wonderfully to soften
these leftover areas, thereby complementing the effect of
acupuncture. Thus they work together like two strands of
fiber in a rope.
One good thing about Westerners I have found is that,
once they find something that is good, they tend to stick
with it. In this respect, I dont have a high regard for most
Japanese. Once they get a little better, Japanese often discontinue treatment. This is similar in a way to how they
like to get a new car as soon as there is a model change.
In the case of Westerners, they tend to hold on to a good
thing. So usually they continue with moxibustion once
they find it works. I think the Japanese could learn from
this.

3. My Moxibustion Technique
There seems to be two things which have disappeared

from Chinese medicine: direct moxibustion and abdominal

diagnosis. When Chinese moxa is purchased and examined, it is found to be coarse and poorer in quality than the
type used in Japan for moxa needling technique (
kyutoshin). If this kind of moxa were to be burned directly
on the skin, even the most insensitive person would find it
intolerable, and would probably never again try moxibustion. People would probably have preferred their back
pain or headache over the extreme pain of direct Chinese
moxibustion produced by very poor quality moxa.
As most people know, moxa is produced from the leaves
of the mugwort plant. The moxa from Japan that is of the
best quality is soft and has a light yellow color. When you
take a small piece in your hand and roll it between your
thumb and index finger, it forms into a long thin strip. It
can even be rolled into strands as thin as string. When a
short piece of this string-like moxa is placed on the skin
vertically, and ignited from the top, the heat sensation can
be mild and even pleasant. One can easily become used
to it and some even learn to like it. Of my patients, some
actually fall asleep as I give them moxibustion treatment.
The trick to this technique is to get the moxa cones to stand
vertically and this I do by first applying a little ointment to
the point. I always use Purple Cloud ointment( Shiunko)1 and then gently place the cone on top of the point.
This ointment is actually very good for burns, and so its
ideal for protecting the skin.
There are about four types of moxa cones commonly
used for direct moxibustion. These are:
(1) thin strands (string-like)
(2) minuscule pieces (sesame
size)
rice grain
(3) small cones (half rice
grain size)
rice grain moxa
(4) medium cones (rice grain
size - 5mm height, 2.5mm
width at base)
1/2 rice grain
The bamboo tube I menmoxa
tioned earlier for reducing
the heat sensation is something I learned about in a
string-like moxa
moxibustion study group
of Irie Seiji, which I had
(actual size)
a chance to attend. It is a
bamboo tube about 12 centimeters in length with an inside
diameter of 1.5 centimeters. One end is closed, being the
joint of the bamboo. When the open end of this tube is
placed over the ignited moxa
diameter
cone and pressed down with
a little force, the patient feels
very little pain. Something
other than bamboo would
serve just as well. One could
use a small glass bottle or jar
with the right sized mouth.
If one doesnt have anything
like this, it is possible to get a
similar effect by simply pressing either side of the burning
cone with two fingers.
There are, however, those who are hypersensitive who

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can not tolerate the heat of direct moxibustion under any
circumstances. Even the indirect moxibustion devices
available from Japan such as sennen kyu or
kamaya mini can be unbearable to some. For
such people, I like to apply the moxa needle technique, if
they are willing to receive acupuncture. When they cannot
tolerate even that, I give them shiatsu and warm them with
an infrared lamp. In regard to sennen kyu and kamaya
mini, the kamaya mini heats the point very well, but its
drawback is that it gives off quite a bit of smoke as it is
made of a lot of coarse moxa material.
For all my concern over making moxibustion as painless as possible, I do sometimes resort to the rather extreme
measure of suppurative moxibustion ( dano kyu)2.
This method is very effective for softening the hardened
muscle fibers from myofacial fibrositis. This method, however, is the grand-daddy of scarring moxibustion, so it cannot be performed without the understanding and consent
of the patient. Some localized inflammation and itching
may occur during the healing process, so this has to be explained to the patient. Suppurative moxibustion is a useful method since fibrositis is on the rise in North America.
Acupuncture can also be effective, so of course it is best
to try acupuncture first before proceeding to suppurative
moxibustion.

4. Point Selection for Moxibustion

When doing a treatment with moxibustion alone, my
point selection is based on the use of standard points of the
Sawada style. These include CV12, GV12, TW5, ST36, KI6,
KI16, LI11, BL18, 20, 23, 32, and 43. I use other points as indicated, based on the meridian imbalance, palpating tender
points associated with those meridians. For example, if I
find a liver meridian imbalance, I look for tender points at
LV3, 8, and 14 as well as GV20. This type of moxibustion
treatment is especially helpful for patients with a deficient
constitution who are very low in energy or who have a
chronic condition.
Since moxibustion is applied on points all over the
body, it does take some time. I keep the stimulation at each
point within reasonable limits and usually apply five small
cones (half rice grain size). For patients suffering severe
pain, I first do a general treatment (whole body adjustment) with acupuncture paying special attention to tender
or indurated points. I use quick insertion and withdrawal
as well as retaining techniques depending on what the patient needs. I feel that retaining needles are especially good
for deficient patients. If I find that there is no change after
removing the needles, or that the tenderness or tension has
not been reduced, I look for the sorest and hardest points
and apply moxa to those points. It is an excellent way to
get results in chronic cases.
Thus, as it is written in some classics, I locate the pain
and make it the point (for treatment). In most traditions
of Japanese acupuncture and moxibustion, precise location
of tender and indurated points is very important. Ahshi
points and tender points are the primary focus in applying
direct moxibustion. The meridians and points are living
phenomena, so changes along the course of the meridian or
active points cannot be captured just by locating a point

accurately according to some textbook. The treatment is

of little value unless the practitioner has the awareness to
seek out the active points.
Along with the localized treatment of tender points, it
is important to know how to include some distal points. In
the case of low back pain, for example, I use LV4 and medial BL55.3 Also I know special indications of certain points
for moxibustion and use these wherever applicable. Some
examples are: LI 2 of the Sawada style4 for styes, ST34 for
abdominal pain and diarrhea, and SP6 and BL67 for fetal
malpresentation. Even when using distal points or special
points, I always look for a reaction such as tenderness.
This is a basic rule which applies to the use of points for
acupuncture as well. The best use of acupuncture points
only becomes possible when knowledge of the meridians
and points is matched by experience and sensitivity in the
fingertips.

5. Precautions in Applying Moxibustion

Communicating with a patient is indispensable where
success is concerned whether it be acupuncture, moxibustion, or any other therapy. Some patients cringe when you
just mention the word acupuncture, and others appear
ready to run for the door when I suggest moxibustion.
So, as stated before, we need to demonstrate the procedure in advance to quiet their fears. As they say, a picture
is worth a thousand words. It is also important to clearly
answer a patients questions. There are some patients who
have unimaginably low pain thresholds. When a patient
seems even a little reluctant , it is best not to force such
treatments on them and to use instead another approach.
To get good results with moxibustion, one must take
time and be patient. This is true not only for treatment
time, but also for the number of treatments. Moxibustion
often shows its effect in chronic cases after the scab formed
on the point falls off a couple of times. Symptoms may
then begin to improve rapidly after this and moxibustion
may even be discontinued for a time. It seems that the effect is limited when no scab forms or there is only a small
blister. A scab is natures bandaging, and it is a part of our
bodys protective system. When a scab comes off by itself,
it is a sign that the tissue underneath it has recovered. This
is particularly true when suppurative moxibustion is applied. Initially puss is exuded but after a time this stops
and new skin grows over the wound and the healing is
complete. When this happens, the reaction at that point
is completely removed and no further treatment is necessary there. It can be said that the sooner a scab forms over
a burn, the stronger the natural healing capacity of that
individual. In addition, moxibustion also draws out ones
innate healing ability.
It is unusual, but it does happen, that a patient will
have an adverse reaction to moxibustion. Their symptoms
may be temporarily aggravated, or there may be some discomfort immediately after the treatment, such as dizziness
or nausea. Usually such symptoms do not last very long,
and the patient soon feels better than when they came in
for the treatment. In any case, it is wise to be cautious and
to keep the dosage of moxibustion small when a patient is
new to moxibustion or is very depleted.

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6. Conclusion
The restorative effect5 of moxibustion is very powerful,
as I already pointed out, so it is an ideal way to boost the
effect of acupuncture as well as shiatsu treatments. What I
have related in this paper is common knowledge for most
Japanese practitioners. There seems to be some reluctance
among practitioners in North America to applying direct
moxibustion. Yet there is great potential for this method,
and this would become evident once it becomes more
widely used. Not only that, it is inexpensive, simple to apply, and serves as a powerful preventative medicine. For
this same reason, I hope that the Japanese public will begin
to reconsider this wonderful method of health preservation.
I would like to discuss the application of direct moxibustion in more detail in future issues using some case studies.
Notes
1. Purple cloud ointment (shiunko) - a red ointment made
of bees wax, lard, dang gui( , and lithosperm
root(
2. Suppurative moxibustion (dano kyu) - application of
large cones of moxa to cause a burn over a specific
point, usually on the back. A special ointment is applied
to the burn to encourage the discharge of pus
3. medial BL55 - about one unit medial to standard location
of BL55
4. LI2 of Sawada style - the radial end of the crease on the
crease of the proximal phalangeal joint when the index
finger is flexed
5. restorative effect - This is one of the primary effects of
acupuncture and moxibustion, which returns the body
to a normal physiological balance. Resistance to disease
is increased, sleep is improved, appetite is restored, and
general well-being is improved by regulating the function of the autonomic nervous system.
(July 1994, Translated by Stephen Brown)

Practical Moxibustion Therapy (2)

1. Direct Moxibustion
In the last issue I said that moxibustion was one of the
things which disappeared from Chinese medicine. I was,
of course, referring to direct moxibustion. Indirect moxibustion with the use of moxa sticks and the like is used frequently in China. You often see moxa sticks being sold in
drug stores in China Town. I would like to discuss the use
of indirect moxibustion in a future issue.
With direct moxibustion, one often feels a burning sensation because the moxa is applied and burned directly on
the skin. There are some in Japan who mistakenly believe
that an intense burning sensation is important for moxibustion to be effective. You can sometimes see people
with huge cones of burning moxa on their shoulders, stoically bracing themselves against the pain by tensing their
shoulders and squeezing their thighs, believing that the
intensity of burning sensation will relieve shoulder tension.
We professionals can get the same results while keeping
the heat sensation to a minimum. Even so, many people
avoid moxibustion altogether under a general perception
that moxibustion is painful and leaves ugly scars. When it
comes to minimizing heat sensation, the bamboo tube used
in the Fukaya style is without equal. Aside from devices,
what is most important for applying direct moxibustion
comfortably, is to master the technique of rolling, forming,
and placing moxa cones. When this technique is perfected,
it feels good to receive moxibustion, and patients become
moxibustion fans. We cant complain, however, if moxibustion is dismissed as a barbaric ritual when poor technique is used.
2. Rolling, Forming, and Placing Moxa Cones
Rolling refers to making thin string-like pieces out of the
moxa material. I use the thumb and index finger of my left
hand to roll out thin cords about 2mm in diameter. When
the quality of moxa material is poor, it doesnt form into a
cord but comes out instead as little balls . Sometimes beginners because of sweaty hands may find that the material
globs and sticks to the fingers. If this tends to happen, it is
a good idea to prepare cords before starting a treatment.
Sweaty hands are rarely a problem, even in the summer,
once a person becomes good at rolling moxa. The way to
form cords of moxa in advance is to use two business cards
and place a small amount of moxa between them. The two
cards are then moved back and forth gently, and this forms
beautiful thin cords. Whether one rolls the moxa between
ones fingers or between cards, very light pressure should
be used to keep the moxa cord soft. Soft moxa cones burn
quickly and thus the heat sensation is tolerable, but tightly
rolled ones burn longer, increasing the heat sensation.
There is easily a 10 centigrade difference in the combustion temperature between the two types of rolling. When
breaking off a piece of moxa to form the cord, it should not
look like it was cut off with a pair of scissors. If the bottom surface of the cord is smooth, the contact with the skin
is greater and more heat is felt. When the bottom surface
of the cone is irregular, the cone stands easily and burns

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quickly. Instead of pinching it off with ones nails, it should
be pulled off gently so that the edge is ragged. This further
loosens the moxa material, yielding a cone that is even softer. Holding the cord between thumb
and forefinger, placing it on the point,
and lightly pressing the cord against
the skin surface creates the cone. This
action might be compared to gently
setting down the lunar landing module on the surface of the moon.
When some Shiunko ointment is applied to the point
beforehand, the moxa cone adheres to the skin and stands
up without any effort. I like to use Shiunko as much as
possible. I was taught how to use Shiunko for direct moxibustion from Mr. Fukushima, my teacher in acupuncture
school, and ever since it has become indispensable. I discussed the use of Shiunko in the last issue, and one of our
members Augusto Romano asked me how to make the
ointment. It is quite easy to make, so I will give the recipe
below:
How to Make Shiunko ( Purple Cloud Ointment)
Ingredients: 1 liter of sesame oil, 100 grams each of Dangkui ( ) and Zigen ( lithospermum), 380 grams of
bees wax, 25 grams of lard.
(1) Heat the sesame oil.
(2) Mix in the bees wax and lard.
(3) Add the Dangkui.
(4) Add the Zigen.(keep 140C)
(5) Remove from heat when the mixture becomes a uniform
dark red color. Strain mixture through cheese cloth and
let it cool.
(6) Mix around and work into a soft and even consistency.
The application of shiunko was developed in Japan by
Seishu Hanaoka, a famous surgeon in the late Edo period.
It is not available in Chinese drug stores. The ointment is
useful for a whole variety of purposes. Shiunko has a fantastic effect especially for burns and bleeding hemorrhoids.
Of course it is also very useful for preventing moxa burns,
and minimizing scars.

3. Number of Cones and Healing Reactions

It is standard practice in Japan to apply an odd number
of cones, but there is no hard and fast rule. In cases where
overuse of the hands such as typing a lot or doing too much
shiatsu causes acute tendinitis, burning just one to three
cones on tender points reduces the pain without fail. On
the other hand, for low back pain, sometimes I apply between twenty and fifty cones repeatedly on the same point
until the heat can no longer be felt. The number of cones
to be applied on each point thus depends on the condition.
The classical adage about the dosage goes, if heat is felt,
apply until the heat cannot be felt; if heat cannot be felt, apply until it can be felt. This really is true. This approach
is very useful for local treatments, but when it comes to
whole body moxibustion treatments as is done in the Sawada style, one must limit the number of cones according to
what the patients body can tolerate. If the moxibustion
stimulation is excessive, a healing reaction can occur. There
are many symptoms associated with healing reactions and
they vary in severity, but the following are common: sense

of fatigue, feeling of heat all over the body, flushing, slight

fever, heaviness of head, loss of appetite, dizziness, nausea,
and diarrhea. Aside from the question of the benefits of
healing reactions, in my experience the healing reaction my
patient had from too much moxibustion was hard to bear,
so I try to avoid such healing reactions.
Quite often, a blister forms as a result of direct moxibustion. It is quite allright to apply moxa cones directly
over the blister. When moxibustion is applied again and
again on the blister without breaking it, a scab forms over
the point and there is no pain. The heat of moxibustion on
this point usually feels good. If this point should somehow
become infected, moxibustion should be discontinued for
a time. Apply shiunko or some other ointment to disinfect
it and allow it to heal. Moxibustion can be resumed once
the skin heals. There is no need to become nervous should
there be a little infection. There is even a practice called
suppurative moxibustion, the aim of which is to cause infection and pus excretion.
My first attempt at moxibustion was on myself in my
first year of acupuncture school. I applied direct moxibustion on ST36 every day for one week. Blisters formed on
both points and I felt light headed and slightly dizzy. Once
when I pressed on these blisters, a white creamy puss came
out. After that, my legs felt stronger and I was able to climb
many flights of stairs with ease. If you havent experienced
direct moxa yet, I recommend that you try it on ST36.

4. Case Report of Direct Moxibustion (fetal malpresentation)

R. H. 30 years old, 38 weeks pregnant, first pregnancy
First Visit: January 19, 1991 (Toronto)
The baby was due in one week, but it was in breech position, and a Caesarean section is scheduled in one week.
The mother did not want an operation and came to me
after hearing about moxibustion from her midwife. The
midwife is a Caucasian born in South Africa, but she had
experienced the effect of moxibustion when she had a baby
in breech position, and also with one of her patients. She
thought, however, that the position of the fetus corrected
the best at around 31 weeks, and this patients pregnancy
was already into the 38th week. Her baby seemed large
and her belly looked enormous. So the midwife told this
woman that there wasnt much hope of moxibustion being
effective since she was so close to her delivery date and it
was her first birth. Nevertheless, this woman insisted on
trying it anyway.
I applied seven cones (half rice grain size) on SP6 and
BL67 on both sides. Since her husband was concerned and
had come along with the patient, I showed him how to apply moxibustion and instructed him to apply it every day
up until the delivery. I got a call from the patient on the
afternoon of January 21, and she told me that she had gone
to the hospital to receive the last manipulation to attempt
to correct the fetal position. When they performed an ultrasound examination on her, the baby was already in the
normal position. Her doctor asked, did you receive some
special treatment? She said she had received moxibustion.
She laughed as she told me that the doctor looked puzzled
as he wrote this down on her chart. She also told me that

NAJOM
she had felt the baby moving during the night, after her
husband had applied moxibustion for the first time. This
was just a day after I had given her a treatment. The birth
of her baby was two weeks later than scheduled, but she
gave birth without any surgery to a healthy girl weighing 8
pounds and 3 ounces.

5. About SP6 and BL67

In the classics the correction of fetal malpresentation is
mentioned in passages such as for breech births and difficult labor, burn three cones on BL67. These references are
just about the same in different texts, and BL67 on the right
side seems to have been used the most in the olden days. I
think it was Dr. Nobuyasu Ishino who first used SP6 for abnormal fetal positions. Probably it was Isaburo Fukaya, the
famous moxibustion practitioner, who first used SP6 and
BL67 together. I follow the Fukaya system and apply three
to seven cones on SP6 and BL67 on both sides. I have treated three cases of fetal malpresentation to date, and in every
case the position corrected in one to three days. According
to Kazuo Hayashida (Correction of Fetal Malpresentation
with Acupuncture and Moxibustion, Journal of All Japan
Acupuncture and Moxibustion Association, Vol. 38, No.
4, 1988, page 1), in his attempt to correct breech births by
acupuncture or moxibustion on BL67 and acupuncture
moxibustion, or moxa needle on SP6, he had an 89.9% success rate. Furthermore, among his successful cases, 52.3%
corrected within 24 hours.
I am a parent of three children and for each child, I had
my wife apply moxibustion on SP6 and BL67 after the fifth
month of pregnancy. As a result the fetus became very active, and my wife complained that she had to endure a lot
of pain because they kicked so hard inside her belly. My
sister gave birth to her son in breech position. She also applied moxibustion on SP6 and BL67 and, even though the
position did not correct, she was able to give birth easily
in six or seven hours with no complications. Things went
well for my wife as well, and the delivery time was reduced with each birth. The first birth took seven hours, but
the second and third birth was completed in around four
hours. One of my patients even had a delivery which took
only an hour and a half.
It seems to me that, moxibustion on SP6 and BL67 is not
only effective for correcting abnormal fetal positions, but
also for increasing fetal movement and facilitating delivery.
Shoji Yoshimoto reports in his book (Rinsho Ikano Tameno
Shinkyu Ryoho - Acupuncture for Medical Practitioners,
page 230) on successful cases using moxa needle, warming moxa, and lasers on SP6. So this is a method which is
useful even for those patients who dont like direct moxibustion. I would like to hear more about the results of this
treatment from other practitioners in North America.
(November 1994, Translated by Stephen Brown)

Practical Moxibustion Therapy (3)

1. Direct Moxibustion and Whole Body Treatment
The objective of Oriental Medicine is to balance the
human body and to adjust the functions of the body to allow maximum performance. Homeostasis is achieved as
a result of the treatment and our body is corrected from an
unsound condition to a sound one. As opposed to Western Medicine, which treats only the head when you have a
headache, or only the stomach when you have a stomach
ache, Oriental Medicine treats the whole body besides the
headache and stomach ache.
With both acupuncture and shiatsu, whole body adjustment is the basic principle. In acupuncture, General
Harmonization (Root Treatment) is developed as a system
to adjust the body, while in shiatsu, a basic treatment sequence is followed.
Although local and symptomatic treatment to remove
pain are considered thoroughly, the final goal of Oriental
Medicine is to activate the whole bodys function to the
stage where vital energy can be achieved to the maximum.
As a result of whole body treatment by moxibustion,
there are quite a few instances where the condition of a
patient improved so remarkably that he/she became like a
different person. The following is a case in point.
2. Case Report
S. Y. (Female) 85 years old
First Treatment: October 10, 1993
Chief Complaint:
She has been suffering from lumbago since 1976 and is not able to walk by herself. Also
she is not able to raise her leg to the
height of the floor of a car when getting into a car. Lately due to the curvature of her lower back, her upper
body leans forward nearly 45.
Diagnosis:
Pulse: flooding, big, rapid
Abdominal Confirmation: Rectus abdominis muscles feel hard like sticks
on both sides of the navel. (Fig. 1)
Others: Right side tibialis anterior
muscle (above and below of ST37) is
Fig. 1
swollen, there are many pressure pain

NAJOM
points on the right side of the lower back and buttock.
Treatment:
(1) abdomen-(R) ST24, (L) ST25,
(L/R) ST26, (L/R) ST28
(2) lower limbs-ST36, GB34, SP9,
SP6, SP6,GB39 (both sides of
each point) (Fig. 2)
(3) lower back-(L/R) BL21, (L)
BL22, (R) BL23, (R) BL25, (R)
Youkon, (R) BL27, (R) BL29, (R)
BL53, (R) Denatsu, (R) 0.5" outside to BL54 (Fig. 3)
Seven half-rice-size moxa cones
are applied to each point. I teach
the daughter who accompanies
her mother how to do moxibustion
and instruct her to apply 3 cones of
moxibustion on each point every day.
Second treatment: October 23, 1993
Diagnosis:
Pulse: full, but flooding and big are not observed; it is much
firmer.
Abdominal confirmation: the hardness of the rectus abdominis muscle is observed to have softened more than
50 %. The pressure pain point on the right buttock has
dissipated but the pressure pain on the left side of the
lower back and buttock is much stronger. Such movement of pain or pressure pain points occurs frequently
after concentrated treatment is given only on one side.
The daughter diligently gave moxibustion treatment to
her mother everyday, however it took about an hour per
session because she was new to moxibustion.
The lower back pain is greatly eased in three weeks and
she is able to walk much easier. Also, as she could notice
the effect of moxibustion and
thought it would be good for her
shoulder pain , she asked her
daughter to do it on GB21 and
LI15.
Treatment:
(1) abdomen-readjustment of
moxibustion point (Moxibustion points move every 2~3
weeks, so adjustment is required.)
(2) lower limbs-in addition to
original points, triangle points
centering around GB33 are
chosen.
(3) lower back-points are readjusted. (Fig. 4)
Third treatment: November 13, 1993
Diagnosis:
Pulse: full
Abdominal confirmation: Lower abdomen is still a little
hard. Although the upper body leaned forward nearly
45, it has been corrected to less than 30. She can get
out of a car by herself and can walk to the treatment
room with a cane. It has been only six weeks since she

started moxibustion, but her legs

feel lighter and she can get in and
out of a car with ease.
Treatment:
(1) abdomen-CV12, (L/R)ST262728,
(L) ST29,
(2) (R) 0.5" front of LI15,
(3) lower limbs-same,
(4) lower back-points are readjusted.
(Fig. 5), pain in the pressure points
is decreased remarkably.
This patient continued with moxibustion and although she complained
of incontinence, frequent urination,
and residual urination during her visit on February 26, 1994
, she was still able to walk and get in and out of a car with
free and unrestricted action. This case shows in part how
moxibustion can draw forth human vitality, activate degenerated tissue and revive body functions which were once in
decline.
This kind of effect is considered to be more an activation
of the human body than a treatment for sickness, and it is
a rejuvenation which is completely different from Western medical treatment that kills viruses and removes sick
organs. This eighty-five year old patient who had been
suffering from lower back pain and restricted mobility for
a long time was able to recover her health almost miraculously, and regain movement.

3. Moxibustion Points for Whole Body Treatment

It is presumed that Master Sawada Ken first systematized whole body moxibustion treatment known as Tai
Kyoku Ryoho ( Tai Chi Treatment). He always
insisted that "any sickness has its origin in the Five Organs
and Six Bowels....When Tai Kyoku, the Five Organs and
Six Bowels, is cured, other diseases are automatically cured
as well. When blood circulation is well-balanced, the body
is in harmony and heals itself." 1 He gave moxibustion
treatment centering around the basic pressure points taught
by the Sawada school and added others according to symptoms as they arose.
Dr. Manaka Yoshio listed the following as basic pressure
points of the Sawada school: CV12, CV6, LI11, TW4, ST36,
KI6, GV20, GV12, BL17, BL18, BL20, BL23, BL52, BL32. He
explained that "these basic points are useful for the maintenance of health and modulatory treatment of chronic disease because this treatment does not aim at a quick cure but
instead corrects abnormal symptoms which gradually leads
to a cure. Depending on the disease, moxibustion points
are changed or added as necessary. It is also effective to do
moxibustion only on the basic points. An advantage of Tai
Kyoku Ryoho is that any disease can be treated with good
results if moxibustion is continued for an extended period
of time."2
These basic points are well-distributed throughout the
whole body. That is to say, all the points on the limbs are
located around the four large joints: the wrist, elbow, ankle
and knee (Four Joints). These joints must maintain a very
high level of activity. Disorders such as arthritis which
occur frequently due to fatigue or overuse of the joints is

NAJOM
caused by the obstruction of Ki (Chi) and Ketsu (Blood).
Therefore, the Four Joints should always be kept in good
condition in order to maintain the primary function of the
human body which is movement. As well, the points on
the abdomen and back are the most important points of our
body and represent the upper, middle and lower (triple)
warmer which stimulate our congenital and acquired Ki
energy. At the same time, the points on the back reinforce
the spine which is the framework of our body.
In addition to the basic points, symptomatic points are
used for individual problems. Interestingly, the heat of
moxa if applied daily, stimulates those points to improve
blood circulation and the body's mobility; stimulation of
the back shu points can activate the function of organs such
as the liver, spleen and kidneys. This style of moxibustion,
if continued over time, can gradually increase the bodys
energy, improve appetite and digestion, all of which helps
the healing process and reduces sickness. This method
strengthens the body and activates our natural healing
power.

4. Method of Whole Body Treatment

My treatment is usually composed of 80% acupuncture
and 20% shiatsu or vice versa. I occasionally treat a patient
with only acupuncture or shiatsu depending on the patient
s preference. When there is no change observed in a patient
after a treatment period of three months or after ten treatments, I change my treatment style from the initial one to a
full-body Moxibustion treatment such as Tai Kyoku Ryoho.
Also in the case of a patient who already has a Kyo (deficiency) condition; is suffering from the symptoms of aging
(skin that hangs loosely or degeneration from over-fatigue),
too much work or stress, a surgical operation, etc., then a
whole-body treatment by moxibustion is applied.
If a family member gives moxibustion to a patient over
an extended period as is the case mentioned above, then
I check moxibustion points about every ten days and reduce or add points as the situation requires. I examine the
original pressure pain points, eliminate those points which
have become painfree and choose new ones which have become tender. Acupuncture points are alive. When you give
moxibustion continuously, the points become active; they
either move or disappear. It is most important to follow the
movement of points. Pressure pain points can move from a
few millimeters to 1~2 centimeters at a time, or to the other
side of the body as in the above case. Generally speaking,
I first apply seven moxa cones (half-rice size) in order to
initiate a moxa mark; two sesame-size cones for patients
with extreme Kyo conditions, and daily thereafter, three to
ten moxa cones. The total number of points for whole body
moxibustion treatment is quite large, because by following
the example of the Sawada school basic points, there are
fourteen acupuncture points (twenty points altogether) and
symptomatic points are used in addition to these. I suggest
that you start moxibustion with a small number of cones
to avoid serious healing reactions. There is a difference in
the usage of moxa cones for whole body moxibustion treatment and local moxibustion treatment. In local moxibustion treatment, 50~100 moxa cones can be applied at one
time to eliminate pain but in whole body treatment heavy

10

doses should be avoided since it could cause a heavy burden on the patient. The aim of whole body treatment is to
strengthen the body gradually over a period of time.
Treatment dose is determined by the condition of the
pulse, the strength of the abdomen (flexibility, thickness
of stomach flesh) and finally, most importantly, intuition
gained through observation .
General treatment order is as follows:
(1) abdomen-back position,
(2) lower limbs-back position,
(3) below BL17, lower back, buttock-prawn position,
(4) shoulder, upper back-sitting or prawn position,
(5) upper limbs
The key to success for Moxibustion whole body treatment is to continue it for an extended period of time; its
beneficial effects can slowly be realized if it is done regularly for a month. The time commitment required for moxibustion treatment discourages modern day use. However,
if one perseveres, good results can be experienced; results
which have often confounded Western medical theory. As
Dr. Manaka mentioned, it may not be an exaggeration to
say that moxibustion is more reliable than acupuncture because moxibustion works for "Ketsu-Blood" in marked contrast to acupuncture which works for "Ki-Chi". This means
moxibustion is applicable to organic problems and is the
reason why it is often recommended for difficult diseases
in ordinary medical practice. In olden times, people were
cured of tuberculosis and, more recently, some victims of
the atomic bomb in Hiroshima have survived by having
moxibustion treatment. Moxibustion can be applied without limits to present-day diseases such as AIDS, tumors,
chronic fatigue syndrome and many degenerative disorders.

Notes
1. Shirota Bunshi, Sawadaryu Monjo Shinkyu Shinzui,
p95,p121, 1978, Ido-No-Nippon Sha
2. Manaka Yoshio, Dr. Manaka Yoshio Kyu To Hari,
p89~p91, 1986, Shufu No Tomo Sha
(March 1995, Translated by Naomi Shikaze)

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Practical Moxibustion Therapy (4)
In moxibustion therapy there are points which have
a specific effect on special diseases or symptoms. These
are known as special effect points (tokko-ketsu). In most
cases, as long as the point location is accurate, these points
have almost miraculous effects. Certain kinds of pain and
inflammation can be alleviated quickly and effectively. So
much so that sometimes even the therapist applying the
moxibustion is amazed. These points work far more quickly in many cases than antibiotics and surgery of Western
medicine.
The general effects of moxibustion are: (1) the thermal
effect (Moxibustion gives off a special wavelength of light,
as I explained in my first article.) and (2) stimulation by
denatured proteins (Histotoxins are released in the serum
and stimulate the production of red and white blood cells.)
Both of these effects bring about a positive change in blood
circulation or constituents.
The effects of the special effect points can be regarded
as the combination of the above general effects with the
unique effects of the acupuncture point. Of course there
is a change in blood constituents in the area around the
point wherever moxibustion is applied. In addition, however, there can be profound effects on certain symptoms
far removed from the point. This phenomenon cannot be
explained without there being some relationship between
the acupuncture point and the disease, or the point and the
affected body part. It is possible that many such relationships between certain diseases and effective points were
discovered before the concept of meridians was finally developed,. The special effect points are some highly effective
moxibustion points which have been passed down to this
day, without special regard to meridians.
The special effect points of moxibustion are unique to
moxibustion, and most of them are not points used for acupuncture. Both acupuncture and moxibustion can be used,
however, on certain special effect points to increase the
effect. Unlike the so called single needle treatment points
of acupuncture, good results are assured with the special
effect points of moxibustion because there is no hit and
miss. As long as the point is located correctly, moxibustion
is effective no matter who does the treatment. The reason
these special effect points are different from other acupuncture points is perhaps because the effect of moxibustion is
based on heat stimulation and changes in blood constituents. Taking this line of reasoning a bit further, it can be
assumed that there are points which are more responsive
to heat stimulation. Whatever the case may be, I will give
some cases to describe the special effect points I have found
valuable in my practice.

Case 1: Appendicitis and CV6 (26 year old female

treated in 1984)
A friend of mine once came to my office and reported
that his wife was bedridden with back pain. I made a
house call and found the patient in bed curled up like a
shrimp. She said her stomach also hurt, so I examined her
abdomen and found that the ileocecal area was hot and

swollen. It was obvious that this was a case of appendicitis

since the ileocecal region was very tender and inflamed. If
we left her like this, the appendix would perforate and take
her life.
I asked them, Why dont you hurry up and go to a
doctor and get an operation? They replied, We dont like
Western medicine. I told them that this was no time to
talk about likes and dislikes, but they simply pleaded, Won
t you please fix it with acupuncture? I asked them over
and over, What are you going to do if it becomes too late
to save her? They insisted that they were willing to accept
the consequences, and that they at least wanted to try acupuncture first.
Finally, I gave up on convincing them otherwise and
started the treatment using 40mm, No. 2 Japanese needles.
I performed simple insertion technique on points in her
arms and legs, a few points on her back, and then on her
abdomen. Her tension seemed to ease somewhat so I explained that I was going to do some moxibustion. The patient said she was afraid, but willing to go along anyway. I
asked her husband to hold her hand and encourage her as I
began applying the moxa. I placed tiny sesame-sized cones
on CV6 and burned them one after another. At first the patient seemed to break out in a cold sweat, but she started to
relax after 20 or 30 cones so I increased the size to half-ricegrain size. I continued applying moxibustion for about an
hour, and after more than 150 cones, a bright red spot about
six centimeters across formed around the point.
By that time the patient had fallen asleep from exhaustion. I said we needed to let her rest. Since the patient was
also extremely constipated, I instructed her husband to boil
some Jiemingzi (cassia seed) and have the patient drink
it when she woke up. I went home after that, but I could
hardly sleep that night over my concern about that patient. I received no word about how the patient was doing
by early evening the next day, so I went to her home once
more. Much to my surprise she was in the kitchen preparing supper as if nothing had happened. She told me that,
after the treatment the night before, she slept soundly until
the morning and then drank the tea as instructed. She had
a bowel movement and the abdominal pain disappeared
completely.
When I examined her abdomen, I found that the heat
and swelling in the ileocecal region were gone without a
trace, and the area was not even tender. Only the moxibustion scar on CV6 was glaringly evident. The signs of appendicitis were completely gone. It seemed like a miracle,
and I breathed a sigh of relief, even though I felt as if something inexplicable had taken place.
I gave the patient an acupuncture treatment for general
balancing that evening as well as the day after. When I saw
her again at my clinic several weeks later, she told me that
the warts on her hands and feet all fell off without a trace. I
had seen more than ten warts on her hands and feet before
but, sure enough, they were all gone. I could only explain
this phenomenon as a side-effect of moxibustion. Whatever
the case may be, CV6 proved itself once and for all as one
of the outstanding special effect points of moxibustion.

11

NAJOM
Case 2: Gastric Spasms and ST34
Gastric spasms are something I have a lot of experience
with. Ive had a chronic problem with stomach cramps
since my youth. I used to get stomach cramps all of a sudden on hot summer evenings. I would vomit or get diarrhea, and my stomach would go into intermittent cramps. I
would break out in a cold sweat and writhe around in bed.
When it was really bad, this cramping would continue for
two or three days, and I couldnt eat or do anything else.
I found the remedy for gastric spasms once I learned
acupuncture and moxibustion. There is a fantastic effect
when twenty cones of rice-grain-sized cones are applied on
ST34. In most cases the cramping stops right away and I
am able to eat and work in moderation. An immediate effect is almost guaranteed when ST34 is treated along with
CV12. My son (7 years old) is like me, and he often gets
belly aches and stomach pain. It seems to be largely psychosomatic, but moxibustion on ST34 also works wonders
for children like him. In the case of children, however, seven to ten sesame-sized cones are enough. Stephen Brown
told me he also treats gastric spasms with moxibustion on
ST34 as well as meridian stretches.
Sometimes I am troubled by stomach pains during a
meeting. When I cant leave my seat for some reason, I
have to endure extreme discomfort. In times like this, I
have been able to reduce the pain considerably by applying
continuous pressure on ST34. Therefore both acupressure
and moxibustion on ST34 are effective for gastric pain. It
would seem that acupuncture would be as effective, but I
have found otherwise. Ive actually caused stomach pains
in myself by needling this point. This is a good example
of how the effects of acupuncture and moxibustion at the
same point differ.
Case 3: Throat Pain and Upper LU5
This case is also my personal experience. When I get a
cold, it usually starts with a sore throat. Sometimes I wake
up in the middle of the night with a sore throat, and at
other times, I wake up in the morning with a sore throat.
In either case, I apply about ten half-rice-grain-size cones
on the tender point one to one-half unit proximal to LU5.
This usually relieves the throat pain at once. This is the so
called upper LU5 which is a variation of LU5. Moxibustion
on this point is most effective when the sore throat is just
beginning, but it is also effective after the sore throat has
become established. In one Chinese book on home moxibustion therapy, it says that one can use a cigarette instead
of stick moxa to warm LU5, and obtain the same results.
The tradition in Japan is direct moxibustion, and I tend to
believe it is more effective.
In the Sawada school LU5 is a frequently used point for
pharyngitis, bronchitis, asthma, and respiratory diseases
in general. When there is throat pain, however, the point
seems to move proximally. In this case, palpating a little
above LU5, one will find a small nodule up to a quarter of
an inch in diameter, which is quite tender. The moxa is applied over this nodule. Occasionally this nodule appears at
the standard location of LU5 and, it is rare, but sometimes
it appears below LU5. It is known as a variation of LU5
just because its location varies so much. Upper LU5 is one

12

of those special effect points that quickly proves its worth.

Below are the moxibustion special effect points which
I have found useful up to now. I generally apply many
cones of moxa (10 to 20) on these points, but some of them
prove effective with just a few cones. One does not have
to concern oneself with the meridians, but can simply use
these points for symptomatic treatment since they are very
useful in bringing quick relief from symptoms.
Sawada LI2 (radial end of the proximal crease in the
joint of the index finger) - styes
LI15 - hives
BL10 - neck & shoulder stiffness
BL17, 18, 19 - indigestion, gastric pain
BL43 - arm pain
BL22 - low back pain
BL67 - fetal malpresentation
GB43 - intestinal pain (iliocecal region)
GV12 - infantile fright and disorder
GV14 - colds
GV23 - sinus infections, rhinnitis
Shitsumin (shimian - center of heel) - insomnia
I have used only a fraction of the moxibustion special
effect points in my own practice. They are described in
great detail in books on Taikyoku Ryoho (great harmony
therapy) of the Sawada school and on the moxibustion
techniques of Isaburo Fukaya. I have no intention of listing
all these points here, but you can study these special effect
points and make them your own. Many of our patient
s complaints can be quickly alleviated this way and its a
great help in building their trust in acupuncture and moxibustion. Of course, these special effect points are squarely
in the realm of symptomatic treatment, yet the patients
confidence gained in this way becomes a catalyst for speeding up the overall process of their therapy. The special effect points serve an important role in facilitating the general
treatment. There may be those who view the general or
root treatment to be the principal purpose of treatment, but
one must bear in mind that symptomatic treatments such
as these special effect points boost the speed of treatment
and shortens the treatment process.
(July 1995, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (5)
Thoughts on indirect moxibustion
Almost all the moxibustion I practice is direct moxibustion. The reason is because direct moxibustion (dm) is so
simple and effective that I only use indirect moxibustion
(im), which takes more time and effort, in special cases.
This is why I only employ indirect moxibustion for those
patients who are in an extremely cold or depleted condition, or otherwise are adverse to having their skin burned.
The numbers of such patients are far fewer than those
patients of mine who receive direct moxibustion, and thus
my methods of indirect moxibustion are limited. In China
today, however, indirect moxibustion is the primary method of moxibustion, and I hear many stories from people
about the good results obtained from indirect moxibustion.
Therefore in this issue I will discuss my approach to im.
The difference between direct and indirect moxibustion
As I have explained in previous issues, the therapeutic
mechanism of direct moxibustion is primarily the two factors of heat stimulation and the special effect of burning
the skin. If heat stimulation were the only effect, moxibustion would be no different than infrared lamps or hot
compresses. But the penetration of heat rays from burning
moxa is far superior to other methods. To demonstrate
this, Sorei Yanagiya is said to have burned 300 cones of
moxa on a watermelon. When he cut the watermelon in
half right at the point burned, the red pulp of the melon
had changed and there was a yellow line reaching all the
way to the other side. When he burned watermelons with
300 cones made of other material such as cotton and wheat
straw, only the surface of the melon was burned and there
was no yellow line going all the way through.
As suggested by this experiment, the heat which comes
from burning moxa is a heat ray of a special wave length.
It is my guess that the source of this special heat ray is
the ash which is left after burning moxa. The ash of good
quality moxa is pure black carbon. When other material
is burned, either gray or white ash is produced. The penetrating heat ray of moxibustion probably comes from reheating the ash or carbon which is left on the point.
Even in the case of indirect moxibustion, as long as
good quality moxa is used, the heat rays penetrate deeply
into the acupuncture point. This increases circulation,
softens hardened tissues, and reduces inflammation. In
the case of direct moxibustion, the effect of burning the
skin (histotoxins) is added so it can be said to have an even
greater effect. Of course, as I have explained before, in addition to these general effects of moxibustion, it goes without saying that there is the special effect which comes from
the acupuncture point stimulated.
Effective indirect moxibustion
The definition or objective of indirect moxibustion is
to apply heat without burning the skin. There are, of
course, countless variations to indirect moxibustion and,
among the methods that use some insulating material,

those using ginger, garlic, miso, or salt are popular. Such

insulating material is most often of a Yang nature, and the
essence of things like ginger and garlic must have some
benefit. Yet, no matter what insulating material is used,
there is no point to doing moxibustion unless the heat of
the burning moxa penetrates deeply into the acupuncture
point.
Recently practitioners have started using ointments
such as mentholatum and shiunko (see Part 1 in NAJOM
#1) as insulating material. Mitsuki Kikkawa of Toronto
has been using metholatum for insulation in applying
moxa since about 1984; Kazunobu Kamiya also of Toronto
has been using shiunko since around 1987. The ointment
is applied thickly on the skin and then moxa cones are
placed on top and burned. The base is ointment so the
cone stands up easily anywhere on the body. The ointment
is also very useful; it is good for protecting the skin and it
serves as insulation for a small number of cones. But when
it comes to burning many cones, the heat builds up and
tends to raise the heat of the oils in the ointment which can
then cause an oil burn. In this respect, no matter what kind
of insulation is used, when it comes to thoroughly heating a point, like burning multiple cones, it will cause a low
temperature burn. So essentially indirect moxibustion and
multiple cone moxibustion are not compatible.
This is just an idea but, as another kind of insulation
material, it might be interesting to gather the ashes from
burned moxa and press it into a round flat piece the size of
a nickel and apply moxa over this base. This would heat
the carbon to produce a heat ray with greater penetrating
power. It would probably have the same effect as applying
multiple cones of dm one after another without removing
the ash of the previous cones. This is merely conjecture at
this point, but I would like to do some experimenting with
this someday.
As for actual practice, the indirect moxibustion I use is
the kamaya mini (weak), which I purchased in Japan. It is
a simple device consisting of a small cardboard tube (9mm
diameter and 12mm length), which is filled with coarse
moxa. One end of the tube has adhesive material which
makes it stick to the skin. A small stick is used to push
the moxa halfway up the tube so that there is a 6 to 7mm
space between the skin and moxa; thus, preventing the
skin from being burned. A considerable amount of heat is
produced because of the relatively large quantity of moxa
material used. There are drawbacks to this method. It is
comparatively expensive and produces a lot of smoke. If
I had my way, I would
have them use better quality moxa
so that it
would provide a better
heat which
would be
more comfortable.
(Fig.1)
Fig. 1

13

NAJOM
Another method I use is salt moxibustion using a paper frame. I make a box out of handmade Japanese paper
(thicker and coarser) about 5cm square and with 1cm sides.
I pile in salt with a spoon. Then I roll a piece of green
coarse moxa about 1.5cm in diameter and place it on the
center and light it. The salt heats up with successive cones
and gets quite hot. The advantage of this method is that,
when the patient begins to feel that it is getting too hot, the
whole contraption can be moved. (Fig. 2)

Fig. 2

Case 1 Kamaya mini for neck and shoulder tension

50 year old woman: stiff neck and shoulders with menopause June - July 1995
This patient had sporadic neck and shoulder pain which
extended down her arms starting about two years earlier.
She is of sturdy build, has a pale complexion who doesn
t get enough exercise. She has a nervous disposition and
constantly complains about personal problems.
Normally I would perform a whole body treatment (retaining needles for 10 minutes each in abdominal and back
points, simple insertion in arm and leg points) and then
apply moxibustion (5 cones of 1/2 rice grain size) to those
points of shoulder tension (kori) which are the worst. If the
tension were still present after this, I would bleed a couple
of points between the shoulder blades. Typically the problem would clear up after three or four treatments and relief
would last for about six months.
On this occasion I provided the same treatment, but the
patient got no relief after two or three treatments. I therefore instructed her to continue applying moxa at home using kamaya mini. She had her husband apply the moxa on
about twenty Ahshi points on her shoulders, interscapular
area, and arms. I also prescribed Kami Shoyo San 1(
Jiawei Xiaoyao San: bupleurum and peony powder).
Her subjective symptoms markedly diminished after two
weeks as did her complaints.
Press Moxibustion
Stick moxa figures prominently in modern Chinese
acupuncture texts. In this method the skin is warmed with
radiant heat, but the heat from stick moxa tends to disperse
over the surface seeming to make it hard to penetrate the
body through a specific acupuncture point. Also the way
in which the body receives the heat from a constant heat
source like stick moxa seems to be different than that from
dm which goes through the stages of ignition, combustion,
and extinguishing. Furthermore, Chinese stick moxa contains poor quality moxa and possibly other herbs as well

14

because the smoke and odor is strong enough to cause a

headache. I make my own stick moxa. I pack in good quality moxa so that there is not very much smoke or odor. It
lasts for about two hours.
I learned my technique for using stick moxa from Fukushima Sensei, my teacher in acupuncture school. It is
called oshi kyu( ), or press moxibustion. In this
technique first a piece of cotton cloth is laid on the skin and
two layers of newspaper are placed over this. Then the lit
end of the moxa stick is pressed down on the newspaper
directly over the acupuncture point. The same point is
pressed three times consecutively. By the third time, however, the heat can become quite intense so the pressure can
be somewhat reduced on the last press. The heat sensation
is pretty sharp, so the pressure should be lighter for those
who are new to this technique. Chinese moxa sticks can
also be used, so I recommend that you give this method a
try. Press down the Bladder meridian on the back from top
to bottom: it warms up the back and feels very good. One
might even call this a heat massage.

Case 2 Press Moxibustion for constipation

65 year old male: constipation for about a month
A friends father who used to be a police officer was
afflicted with Alzheimers disease about three years previously and had been bed ridden ever since. He was unable
to speak and so disabled that he could not sign a check.
Only his appetite was good; he could eat practically anything. My friend told me that his father hadnt had a bowel
movement in two weeks, so I paid them a house call. The
patients overall physical condition was poor. He seemed
like he could reach a critical stage at any moment so I
explained to my friend that he was beyond my help and
that he should consult a doctor. Two weeks later having
completely forgotten about this patient, I got another call
from my friend. He told me that the doctor had prescribed
laxatives and enemas, but that his father still had not had a
bowel movement. He was afraid that his father would really die if this went on, and he asked me if I knew of some
method. He came to pick me up saying, just try anything,
acupuncture or moxibustion, so I was compelled to see
this patient again.
I thought I was really in a bind but, when I examined
the patient again, it occurred to me that his constipation
was caused by an extreme case of cold stagnation from the
decline in his metabolism after having spent so many years
in bed. I decided to dispel this cold pattern with press moxibustion. I was convinced that such a chronic case of cold
stagnation wouldnt budge with any normal amount of
heat stimulation, so I applied press moxibustion on all the
Namikoshi shiatsu points. I pressed from his abdomen to
his arms and legs, and then his back. On his arms and legs,
and Bladder meridian on his back, I enlisted my friends
help and we used two moxa sticks to press down both sides
simultaneously. The treatment took approximately forty
minutes. The heat of the press moxibustion caused his skin
to turn pink all over, and it was clear that his circulation
had picked up.
The following day my friend reported that his father
passed some watery stools. I decided we had a chance so

NAJOM
we repeated the same treatment. The day after the second
treatment my friend reported that for the first time in a
month his father had had a bowel movement and evacuated a large quantity of stools. The press moxibustion all
over his body had gotten his body fluids moving, warmed
up his intestines which were beset with cold, and gotten
them moving again. This was a case where press moxibustion worked decisively to push out the cold. After that
I gave this patient a press moxibustion treatment once a
week for three months, and then discontinued treatments.
His constipation was greatly improved and in the remaining three years of his life he never had a big episode of constipation again.

Chinetsu kyu
In Osaka there is a famous moxibustion technique
known as the health promotion moxa of Sayama. Sukeharu
Fukunishi is the leader of this style of moxibustion. It is
also known as chinetsu kyu (sensing heat moxibustion) and
lies somewhere between direct and indirect moxibustion.
In chinetsu kyu a cone of moxa the size of an azuki bean is
burned on the skin. The moment a patient feels the heat,
he gives a signal, and the burning cone is removed immediately. The patient feels just a brief heat sensation and does
not get a burn. This method is said to be very effective for
pain in the joints such as the knees. The reason I mention
chinetsu kyu here is because, while it is somewhat like indirect moxibustion, it seems to give results like direct moxibustion. I will explain Mr. Fukunishis method of applying
chinetsu kyu below. It seems like this method would be appreciated by patients in North America who cant get used
to the idea of having their skin burned.
1. First locate nine tender points around the affected area
and mark them with a felt tipped pen (* mark in Fig. 3 ).
The point location can be confirmed by using a small but
blunt object like the cap of a pen.
2. Have a bowl of water and a wash cloth ready. Wet three
points in a row and place a moxa cone on each one.
Then light them one after another.
3. Keep your thumb and index finger wet. As soon as the
patient indicates that he feels heat, remove the burning
moxa without a moments delay. The moxa has to be
removed from three points, one right after another, so
your movements must be swift or else the patient will
be burned.
4. After burning three cones in a row in the above manner
on three different lines so that all nine points are treated,
dry your fingers off with
the towel.

5. Repeat the above procedure

again to apply a total of two

rounds. Then do the same

thing for two rounds on the

in between points (+ mark

in Fig. 3).

The moxa is removed after it is about 80% burned, so

there is no burn and no scarring. When this treatment
works, the tenderness diminishes and spontaneous pain is
reduced. If there is still some tenderness left at some points,
the same moxibustion technique can be applied again on
those points. Mr. Fukunishi states that, when tenderness
still remains, the same technique can be applied the following day, moving the point location slightly. Most of the pain
will be alleviated in this way.
The drawback of this method is that many points are
used and a lot of moxa is consumed. It also takes time to
get the hang of removing the burning cones in a timely
manner. Yet I am in favor of such intensive approaches to
moxibustion. It is my belief that moxibustion is not something that works, but something that we make work. I
encourage our readers in North America to try this method.
As for myself, indirect moxibustion still seems a little
like beating around the bush, but of course it is effective.
And when its applied skillfully, it doesnt cause any pain to
the patient and produces no scar. So by all means it should
be used on those patients who cant take direct moxibustion. The key point in applying indirect moxibustion simply boils down to how to get the heat to penetrate.

Note
1. Kami Shoyo San ( Jiawei Xiaoyao San):
3g
2g 1g
(November 1995, Translated by Stephen Brown)

Fig. 3 point location pattern

for chinetsu kyu

15

NAJOM
Practiccal Moxibustion Therapy (6)
Moxibustion and tender points
Selecting tender points and indurations and alleviating
these with acupuncture and moxibustion is in line with one
of the classic principles of treatment, the (point of) pain
is the point (of treatment). If one is a practitioner, it is a
common experience that the outcome of this process (finding and treating reactive points) often affects the outcome
of treatment.
I dont subscribe to a particular treatment style and the
first step of treatment for me is still to palpate the patient
and get a sense of the patient's body with my hands and to
take in information in this way. The things I pick up from
palpation of the patient are (1) heat, (2) cold, (3) edema,
and (4) hard spots or indurations. The points with heat
or edema are most often tender, but patients usually say it
feels good when I press indurated points. I focus on tender
points and use the points that are most tender for treatment. I like to apply moxa at the very center of the tender
points, and in this way I make sure to get the heat from
the moxa to penetrate thoroughly. Thus the tenderness
is always alleviated and many times I have experienced
dramatic improvement in the patient's symptoms. The patient also gets a direct experience of the immediate effect of
moxibustion.
There is a problem when looking for tender points, however, if you find too many. This is especially the case when
there is a musculoskeletal problem like sprains and strains.
It tends to be tender wherever you press. Injury of the tissues causes hypersensitivity and excitation of nerve endings so, even if you ask patients, they are unable to tell you
where it really hurts. In this case, the area that received the
injury is the real tender point, and all other tender points
are just like radiating pain. The secret to successful treatment in this case hinges on finding the real tender point.
Once this real tender point is located, you might even say
that the treatment is half finished. When I treat such cases,
I bring maximum focus to bear on finding this point, and I
feel that the success of the treatment rides on this moment
of concentration.
How to find the real tender points
This moxibustion technique is primarily for the treatment of musculoskeletal and neurologic disorders. A great
many tender points appear with these conditions, but their
source is the site where the tissue has undergone some degenerative change. One has to sift through the many tender points to close in on the site of degeneration.
The first step in treatment is to needle the tender points.
I use a No. 2 or 3 needle of 40 or 50 mm length and retain
these needles for five to ten minutes. When the points are
so sensitive that inserting needles, not to mention retaining
needles, is difficult, I go with thinner needles. I simply insert and withdraw or retain the needles very superficially.
When I check the tender points after removing all the
needles, invariably the number of tender points is reduced.
If I find any new tender points afterwards, I do simple insertion and withdrawal, or a little sparrow pecking on just

16

these points only. Then I check the tender points again to

see if they have diminished. It might seem that using so
many needles in a steam roller strategy like this is an inferior approach, but this is exactly in line with the adage the
pain is the point. This initial needling reduces the radiating pain, and the tender points that do not improve stand
out.
In the second step, the tender points which do not subside at all are treated as the real tender points, and direct
moxibustion is applied. To reduce such tenderness, in most
cases I apply multiple cones (ten to over twenty half rice
grain sized cones). This reduces muscular pain substantially regardless of whether there is damage to the tissue. It
takes more time to get results for neurogenic pain than for
the treatment of muscular pain, but still it can be reduced
considerably. The important thing is to be sure to get the
heat of moxibustion to penetrate into the core of the tender
point. The pain killing effect that results from just this is
quite amazing and far surpasses pain medication.

Case 1
49 year old male
Main Complaint: For the past three years this patient has
strained his back every Spring and Fall. This time he
hurt his back lifting a 25 lb bag of rice in October 1994.
It has been three weeks since then, and he received
treatments alternately from two other acupuncturists,
but when he came to me for treatment on November 14,
he had great difficulty turning over in bed; and standing
up was very difficult after sitting for even brief periods.
Pulse: soft, weak, and deficient
Abdomen: lower abdomen weak - Kidney deficient
Treatment: I retained needles (No. 3, 50mm) for five minutes in the abdomen (KI16, ST25 & 27 on the left) and
then applied five cones of moxa. With the patient prone,
I retained needles for ten minutes in tender points in
his lumbar area ( mark in Fig. 1). After removing the
needles, I found the points marked in Fig. 2 to still be
sensitive. When I pressed them the patient would twist
saying ouch. I applied fifteen cones of half rice grain
sized cones on these points and concluded the treatment. The patient found he could move with greater
ease getting off the table. He also could put on his pants
and socks more easily.
When he came for treatment on November 18, he said

Fig.1

Fig. 2

NAJOM
that movement was easier, but it was still difficult to stand
up after sitting for a long period. The number of tender
points on the hips had decreased, but the left lumbar area
was tense, so I applied moxibustion on a few points on the
left side (Fig. 3). I also treated the following tender points
on the abdomen: CV12, both ST25, and ST24, 26, and 27 on
the left.
When the patient came for his third treatment on November 21, he said the pain had greatly improved. So I
asked him, is it about 60% better? And he replied, even
more than that. The tender points on the abdomen were
located at CV12, CV6, and both ST25. The tender points
and treatment points in the lumbar area are indicated in
Fig. 4. I retained needles for five to ten minutes, and then
applied fifteen cones of moxa on the same points. I judged
this patient to be practically cured, and therefore made this
the last treatment.

Fig. 3

Fig. 4

This patient did not get enough exercise and he lacked

muscle tone. He gets low back pain whenever he becomes
fatigued. Aside from being middle aged and a little worn
out, he seemed to have no problems in his meridians and
organs, so I gave him a thorough tender point treatment.
This proved very effective, and his complaint was quickly
alleviated. It was a case where pain was removed by the
two-stage treatment of tender points with acupuncture and
moxibustion.

Moxibustion and indurations

One can almost say that the technique for moxibustion
for indurations and that for tender points which originate
in muscle tissue is exactly opposite. Both indurations and
tender points are unnecessary to the body, and yet they
occur for entirely different reasons. The moxibustion treatments for these points therefore also differ. The difference
is that tender points which originate in muscle tissue can
be effectively treated in a short period by the application of
multiple cones, while indurations are hard knotted areas
which require fewer cones (3 to 5) over a long period (3 to
6 months or more). This is what makes moxibustion interesting and, even if the induration is also a tender point, it
takes a long time to normalize indurations even with moxibustion.
This occurs because indurations have been created

over a long period of time and result from daily repetitive

movements, and are associated with degenerative changes
in muscle tissue. Let me explain my view on indurations.
The process by which indurations come about can be divided into several stages. First they appear as a condition
of muscle fatigue from simple overuse accompanied by
slight edema and/or pain with movement. For example, if
people who are out of shape suddenly do a lot of exercise
or go on a long hike, their muscles become sore the next
day. This condition is temporary and they recover quickly
with a little rest. The next stage is muscular fatigue associated with repetitive strain. This occurs with excessive
exercise or repeated use in work or sports, and manifests
as hardness in the muscles. On top of this muscle fatigue,
conditions such as stress, jet-lag, disease, degeneration by
aging, lack of exercise, or injury from sports, or auto accidents are added. Prolonged exposure to such conditions
make the muscle tissue irreversibly hard. In this way, the
elasticity of the muscle fibers is drastically reduced. The
muscle is no longer able to contract or expand, and it forms
hardened nodules. Metabolic wastes (e.g. lactic acid, uric
acid, excess minerals, etc.) begin to accumulate between the
muscle fibers and it starts to hurt.
The indurations I am referring to here are such chronically hardened muscle tissue. When the condition of muscle tissue deteriorates to this point, a host of other problems
occur. These include numbness, insomnia, and high blood
pressure. Furthermore, indurations are considered to be
an exciting cause for myofibrosis and fibromyositis, and
is even thought to reduce the immune function and provoke allergic reactions. Unfortunately, modern medicine
is practically powerless in helping restore muscle tissue in
this condition. With long term application of moxibustion,
however, it is possible to revitalize tissue that has had almost irreversible damage. It is no overstatement to claim
that this is one of the major advantages of moxibustion
therapy.
The indurations or hardened nodules range in size from
1cm to almost 10cm across. Sometimes there is no pain
when they are small, but usually indurations are accompanied by discomfort or pain with movement. In some cases
they become inflamed and cause great pain during the
night. Moxibustion treatment for such obvious indurations
is a simple matter. Simply press and locate the center of
the hard spot with your fingertips, and apply three to five
cones of either sesame or half rice grain sized moxa cones
where the sensation is the strongest. The number of moxibustion points treated in this way may be quite a few, but
this is just another application of the principle, the pain
is the point. Once the indurated areas begin to improve,
the number of points treated decreases steadily. Also the
moxibustion points tend to move around somewhat, and
their movement must be followed. One or two treatments
a week bring about a clear change, and this seems to be the
ideal frequency. It is a very simple approach that requires
patience, but when this treatment is repeated over a long
period, the pain goes away for even serious cases of myofibrosis. The gradual normalization of the underlying tissues
can be observed, so this can be called a kind of rejuvenating moxibustion technique.

17

NAJOM
Case 2
34 year old female
Main Complaint: Pain in her back, neck, shoulders, and
headaches.
History: Since being injured in an auto accident, she has
had pain in the low back, neck, and shoulders, as well
as headaches and numbness in her arms along with an
extreme sense of fatigue. She has headaches everyday
and she becomes exhausted and takes to bed about four
oclock in the afternoon. She has bad menstrual cramping. She is a single mother raising a teenage boy and
has been working with computers for many years. Her
arms and legs start to shake after three or four hours of
work, and she also suddenly goes into states of shock.
Palpation: There are many abnormal and indurated points
around the superior angle of the scapula (GB21, TW15,
SI14), the medial border of the scapula (BL41, 42, & 43),
and in the lumbar area (BL21, 51, 52, and iliac points).
Also there is hardening in the muscles between the
gluteal reactive point and GB30 on the left side. The
muscle tone in her body overall, however, is completely
lacking, and her skin is soft and mushy and feels like a
water filled balloon.
Pulse: The pulse width is normal but it is soft and weak.
Clearly a deficient pulse.
Abdomen: There is a hard spot above and below ST27 on
the left side, indicating the presence of Blood Stasis.
Observations: When she first came for treatment, this patient was in bad shape all over, and she appeared completely exhausted. I guessed that this came about by the
shock of the accident on top of the cumulative stress of
many years of overwork. Not only the condition of her
muscles, but the functioning of her nervous system was
in complete disarray.
Treatment: First treatment July 14/94: I used mainly 40mm
No. 3 needles and performed simple insertion on abdominal points and retained needles in indurated points
of her neck and shoulders. She had a reaction to this
treatment (fatigue and pain) possibly due to excess needle stimulation so, as we continued with weekly treatments, I began to do light shiatsu for starters, and then
performed simple insertion with 40mm No.1 needles in
only the worst indurations on her neck, shoulders, and
back.
Her fatigue began to decrease a little in the last half
of October, but her muscle tone was not much better. In
December, it seemed like the indurations softened a bit.
In February, 1996 she started an exercise program for
nine hours a week on the advice of a physio therapist. I
was concerned that this was too much exercise, and sure
enough, in March she reverted to a condition of extreme
fatigue. We continued treatments, and time passed without
significant change. In June she took time off from work to
take a two and a half week trip to Europe. After this trip
the indurations in her neck and shoulder area softened up
considerably. Indurations appeared, however, on the left
side of her low back (BL51 and 52), and soon the right side
began to hurt.
On July 20, her back pain got so bad that I applied
moxibustion on her low back for the first time (5 cones each

18

on the indurated points). The pain was greatly reduced,

much to the surprise of the patient, and she was motivated
to come in for more moxibustion treatments targeting the
indurations on her neck and shoulders. By the latter half
of August the muscles in her low back became almost surprisingly soft, but she still continued to have low back pain
during her menstrual period. Her fatigue, however, had
greatly improved, and she no longer took to bed late in the
afternoon. In September some indurations appeared in her
cervical region, and in November a tender point appeared
between TW4 and 5 with some spontaneous pain in the
wrists on both sides. In each case, moxibustion on these
points alleviated the pain.
The patients condition has stabilized in December, and
she is relaxed. Since she has been receiving moxibustion
treatments, her body has less pain and feels lighter. She
also has more energy and her fatigue has been reduced so
that she is able to go swimming. This is a case where a one
year course of treatment combining shiatsu and acupuncture did not really have much of an effect on indurations.
After I started giving her treatments combining shiatsu and
moxibustion however, there has been progressive change
and softening in the indurations and the results improved
dramatically.
The treatments of tender points and indurations with
moxibustion may not seem like a very sophisticated strategy when compared to treatments applying more subtle
stimulation, such as Meridian Therapy. Be that as it may,
when it comes to organic or structural pathology which
only responds to heavy handed approaches, the decision
to launch a frontal assault like this depends on the level of
trust between the patient and practitioner.
(March 1996, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (7)
Whole body treatment
The first thing that comes to mind when you say whole
body treatment for moxibustion is the Taikyoku Therapy of
the Sawada style.1 This is the method using a combination
of 11 to 15 standard points and special effect points based
on the unique Sawada approach. In this approach moxa is
applied on the abdomen and lumbar area and then on the
upper back and the upper limbs and finally on the lower
limbs.2 This approach treats all the major joints and major
points adjacent to the spine, and covers the whole body in a
balanced way. (Fig. 1)
GV20

GV12
Bl17
Bl18
Bl20
Bl23
Bl52
Bl32

CV12

LI11

CV6

TW4

St36

Fig. 1

Ki6

When moxibustion is applied to points located over the

whole body in this way, blood circulation over the whole
body is rapidly improved, the blood becomes more alkaline, and the innate healing power of the body is increased.
Thus, even chronic and intractable conditions that medical
doctors have given up on, gradually improve and health is
restored amazingly quickly.
This kind of treatment, just as the term whole body
treatment implies, uses points all over the body. There is
very little hit or miss, and good results are almost certain,
no matter who performs the treatment. This is why, in my
practice, I often use the Sawada style treatment as a last
ditch strategy for acupuncture and shiatsu patients who
show no improvement after many treatments, or patients
whose innate healing power is very weak due to extreme
depletion.

Hara Moxibustion System

In contrast to the Sawada style point selection and treatment over the whole body, Shimetaro Hara M.D.3 maintained that it is possible to treat the whole body with a total
of just ten points. He asserted that all diseases could be
treated with his regimen of ST36 and eight points on the
back.4

In general, I think the effects of moxibustion can be explained in three ways as follows:
1. Changes in the blood chemistry after direct moxibustion
2. Physical effects of the heat
3. The effects of acupuncture points
Be that as it may, Dr. Hara only highlights the changes
in the blood chemistry after direct moxibustion. The reason
he reduced his treatment points to ST36 and eight points on
the back was quite simple. He confirmed through personal
experience that the traditional practice of moxibustion on
ST36 actually was effective for longevity. In fact, as a result,
Dr. Hara lived to the age of 108. As for his choice of back
points, Dr. Hara gave the following simple reasons:
1. They are excellent points in terms of anatomy, and are in
a suitable location for long term application of moxibustion.
2. Ugly moxa scars are hidden by underwear, so that people
wont notice (the appearance issue).
3. Moxibustion on the low back leaves one with a pleasurable sensation.
Even though his approach may have been somewhat
limited and his research was done in the 1920s, Dr. Hara
s research on changes in the blood chemistry with direct
moxibustion was a valuable contribution still applicable
today. His conclusive findings are part of the explanation of
the therapeutic effects of moxibustion, and they are as follows:
1. There is an increase in white blood cells. The white blood
cell count begins to increase immediately after moxibustion, and reaches a peak eight hours later. This peak is
maintained for 24 hours. The number declines somewhat after three days, but it remains elevated for four to
five days after moxibustion. The white blood cell count
almost doubles with moxibustion, but when applied
continuously for six weeks, the increase is sustained for
up to 13 weeks after moxibustion is discontinued.
2. The phagocytic activity of the white blood cells increases.
For example, with typhoid bacilli the phagocytic activity
increases just 15 minutes after moxibustion. This activity reaches a peak in two to three days, and gradually
declines after that. Phagocytic activity is greater than
normal for about a week after moxibustion but, when
moxibustion is applied continuously, the increase in this
activity continues for a longer period.
3. There is an increase in red blood cells and hemoglobin.
For subjects who had an average hemoglobin ratio of
78% just before moxibustion, the ratio increased steadily
to reach a peak of 90% in eight weeks. Applying moxibustion continuously for 15 weeks, it takes 22 weeks for
the red blood cell count to return to what it was before
moxibustion.
4. The sedimentation rate of red blood cells increases.
5. Platelet count increases.
6. The speed of blood coagulation increases.
7. Blood glucose count increases.
8. Blood calcium increases.
9. Serum complements increase.
10. The capacity to produce antibodies increases.
Dr. Hara claimed that these experimental results were
produced by minute amounts of histotoxin (denatured

19

NAJOM
proteins), which stimulated an increase in blood constituents and their activity. Furthermore, he enlisted the concept of homeopathy to explain that, while large amounts
of histotoxin from big burns are harmful to the body,
minute amounts of this substance from the continuous application of moxibustion was actually beneficial and useful
for maintaining health.

Moxibustion of ST36
Moxibustion on ST36 has been famous in Japan since
the olden days as a regimen for health and longevity. In
the Edo period (1596-1868) a farmer by the name of Manpei
in the district of Mikawa is said to have lived to the age of
300 by applying moxibustion on ST36 religiously. Manpei
was summoned at the age of 196 to be questioned by officials on his secret to longevity. When he was 242 he was
invited to the opening of the Eitai Bridge in Edo. In addition to Manpeis extraordinary longevity, many members of
his family lived to an extremely old age. In Japan there is
an old saying, Dont go on a trip with anyone who doesn
t moxa ST36. (This came from a time when most travel
was by foot.) Dr. Hara is reputed to have said that regular
moxibustion on ST36 would destroy doctors. His approach involves burning seven rice grain sized cones (about
2.5 mm at the base and 5 mm high) on adults and one to
three on little children. If done everyday, this would mean
burning more than 5110 cones on both legs in a year. The
generation of small amounts of histotoxin in this way
enhances hematological functions to its highest possible
level, and is thus effective in promoting health. The reason Dr. Hara suggests rice grain sized cones is because the
combustion temperature of these cones is between 70 and
80 degrees Centigrade, which he considers to be the most
effective temperature for the production of histotoxin.
Furthermore, Dr. Hara stated that this practice of moxibustion on ST36 could be continued even after a person had
a stroke, hematemesis, or hemorrhaging in the intestinal
tract.
Moxibustion on Eight Points of the Back
Once a person has become used to direct moxibustion
with regular application on ST36 and masters the technique, Dr. Hara recommended starting moxibustion on the
eight points of the back. He described the location of the
eight points of the back as follows: four points (horizontally) in line with the fifth lumbar vertebra and four points on
two parallel lines roughly corresponding to the second and
fourth sacral foramina. (Fig. 2) In practice, he drew an
inverted triangle with the Jacoby line (connecting both iliac
crests) and two lines from the tip of the coccyx going to the
lateral ends of the Jacoby line. The first four points are on
the two ends and the trisected points of the Jacoby line (A,
a, b, B). Another two points are points of intersection (c, d)
on the lines AC and BC when two vertical lines are drawn
down from points a and b. The last two points (e, f) are the
midpoints on the vertical lines ac and bd.
Dr. Haras approach to using these eight points for people new to moxibustion was to start out with fewer cones
to prevent over treatment. He recommended three methods. The first method was to do only one to three cones

20

per point on the very

first treatment. On the
second day seven cones
are applied on just the
upper points (A, a, b, B).
On the third day seven
cones are applied on just
the four lower points (c,
d, e, f). So seven cones
are applied on each point
for one week, alternating each day between the
upper and lower points.
On the second week
seven cones are applied
to the upper points every day while the same is applied to
the lower points on every other day. On the third week all
eight points are treated with seven cones every day. Dr.
Hara stated that the above one week period could be increased to ten days or shortened according to the patients
condition. The duration of treatment is a minimum of one
month and up to several years for chronic diseases like tuberculosis.
His second method is especially for children, depleted
patients, or those in a weakened state due to prolonged
illness. In this method, seven cones each are applied on
the points, alternating every week between the four upper
points and the four lower points. The duration of treatment
is from several weeks to one year. In the third method, the
eight points on the back are treated six to eight weeks in
the Spring and Fall, and they are not treated in Summer
and Winter. Moxibustion on ST36, however, is continued
throughout the year. This way the effect of moxibustion is
maintained all through the year.
For children Dr. Hara stated that moxibustion on ST36
was sufficient, and if points on the back were to be added,
it should be limited to the a and b points or the a, b, e, and
f points at the very most. The number of cones for children
is one to two cones for those one to two years old, three to
four cones for those three to four years old, five to six cones
for those five to six years old, and seven cones for those
seven years and older.
Dr. Hara stated that, for adults, treatment of the ten
points (ST36 and eight points on the back) was harmless
and beneficial regardless of how many years it was continued. Dr. Hara maintained that just the above ten points
were sufficient to deal with almost all diseases including
pulmonary tuberculosis, diabetes, high blood pressure,
neurological disorders, heart disease, gynecological disease, arthritis, neuralgia, goiter, venereal disease, and even
typhoid fever. The only disease he considered untreatable
was cancer.
Fig. 2

Features of the Hara moxibustion system

The features that distinguish the Hara moxibustion system from other approaches are as follows:
1. The amount of treatment (number of points) is less than
that in the Sawada style.
2. The intention from the beginning is long term application
of moxibustion.

NAJOM
3. The use of acupuncture points is viewed as something
to be studied later, when moxibustion on ST36 and the
eight points on the back are not effective.
I believe that these features of the Hara system, which
make it a very simple approach, are the reasons it has endured so long among the common people of Japan. From
time to time I have a patient who tells me I did moxibustion for one or two years and cured such and such. I
am often surprised when I inspect the moxibustion scars
on these people because the scars are often in places that
couldnt possibly be an acupuncture point. Yet it still
worked, so it is an undeniable fact that direct moxibustion
has an effect no matter where you apply it. This can be explained by the same logic as the generalized effect of foods
and medications. It is a result of the effect of direct moxibustion (the influence of denatured proteins) extending to
the whole body. This effect prompted Dr. Hara to state, In
direct moxibustion there are no acupoints which exist without the special effect of proteins.5 This, of course, refers to
the chemical effect of moxibustion on the body, and does
not take into account the localized physical change at the
sight of stimulation or the acupuncture point. Nevertheless, the systemic effect of moxibustion, which works no
matter where you burn, is quite impressive and not to be
overlooked. This effect makes moxibustion ideal for home
therapy and this global effect accounts for its popularity
among the common people. And I myself make a practice of
applying moxibustion on ST36 everyday along with my wife
in the hopes that maybe I can be like Manpei the farmer.

Notes
1. Edward Obaidey, Taikyoku Therapy: Sawada Style
Treatment Strategy, NAJOM, March 1996, p. 12.
2. Shirota, Bunshi, Shinkyu Shinzui (The True Essence of
Acupuncture and Moxibustion), Ido-no-Nippon Sha,
1976, p. 18.
3. Shimetaro Hara, M.D. was born in 1883. He entered the
Kyoto Prefecture Medical Specialty School in 1901 and
became a doctor. He began doing research around 1924
at the Public Health Section of the Kyushu University
Medical School. Starting with his study of hematological effects after the injection of oxygen, he went on to
conduct moxibustion research including, the hematological effects of moxibustion. After that, he became a
lifelong advocate of moxibustion on ST36 as a method
of health promotion and freedom from disease. He
practiced this method himself and proved its remarkable effects by living to the age of 108. When he passed
away on June 18, 1991, he had been the oldest living
Japanese man for two months. (The Japanese have the
longest life expectancy in the world.)
4. Hara, Shimetaro, Manbyo-ni-Kiku Okyu Ryoho (Moxibustion Therapy Effective for All Diseases), Jistugyo-noNippon Sha, 1933, p. 133.
5. Ibid, p. 144.
(July 1996, Translated by Stephen Brown)

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21

NAJOM
Practical Moxibustion Therapy (8)
I have tried Dano-kyu (suppurative moxibustion) on
about five patients over the past year, and in each case I obtained results far exceeding that of acupuncture or regular
moxibustion. Therefore I will present some of these cases
together with a general explanation of Dano-kyu, and also
discuss the problem with skin allergies in the use of Danokyu which I recently discovered.

1. What is Dano-kyu?
I first encountered Dano-kyu around 1984 as an observer at the clinic of the late Dr. Yoshio Manaka in Odawara.
I recall that the point Dr. Manaka used was either BL17 or
18. The patients were elderly, and I remember him using
Dano-kyu on two or three occasions. After burning the
points, Dr. Manaka gave the patients a special ointment (that
causes suppuration) to apply to the points. He told them
to switch to Shiunko ointment after approximately two
weeks in order to heal the burn. This perked my interest so
I ordered the special ointment thinking that I would try it
myself.
Dano-kyu is explained as follows in Shinkyu no Kagaku
- Jitsugi hen (The Science of Acupuncture - Techniques Volume) by Sorei Yanagiya1: Dano-kyu is moxibustion that
is applied with the aim of causing an infection at the burn
(usually Sumouko ointment is applied for this purpose) to
induce the excretion of pus (this is the meaning of dano).
Causing the excretion not only of pus, but also of serous
fluids in this way is called Dano-kyu.
This text gives slightly more than a page of explanation
of Dano-kyu along with instructions on how to form the
cones and several possible point combinations. There is
no mention of the therapeutic mechanism or its scientific
basis. Thus one just gets the general idea that this form of
therapy exists and most acupuncturists never give it another thought. I also learned about Dano-kyu when I was a
student but, as I recall, our instructor explained it in a half
joking manner. I assumed that it was some sort of old fashioned and barbaric folk remedy, and left it at that. I became
interested in Dano-kyu only because I saw Dr. Manaka using it.
2. My approach to Dano-kyu
When I was a student, I was taught that moxa cones as
large as a horses eyeball were applied in Dano-kyu, and
that the burns were allowed to become infected. Actually,
there are several temples in Japan where something similar to this is still practised. Moxibustion using such huge
cones is applied on believers. Some of them are so fanatical
as to believe that the hotter it is, the better it works. Believe
it or not, these establishments still do a good business.
When I do Dano-kyu, however, I like to keep the burn
sensation to a minimum since the aim is only to create a
burn. I apply many cones in succession and use a bamboo
tube2 to reduce the pain. I generally apply ten to twenty
cones. In cases where this is not sufficient to cause a burn,
I repeat this procedure the next day, and the next if necessary. Once there is a good burn, a suppurative ointment is

22

applied once or twice a day to cause suppuration and the

excretion of pus.
The ointment that I use is Kuro Kouyaku (black ointment) previously manufactured by Nakagawa Pharmaceutical Company. It is also called Hiru-no-Suidashi (leeches
suction). Unfortunately, I recently learned that this company went out of business in August, 1995. If any of our
readers are aware of another company that makes a suppurative ointment, please let me know. The explanation of
the effects of Koro Kouyaku states, effective for leeching
out warts, carbuncles, furuncles, boils, and other swelling.
The constituents are listed as follows: vegetable oil 50g,
pine oil 12.5g, red lead 25g, Japan tallow (vegetable wax)
12.5g, ohbaku ( ) 5g. This ointment comes in a plaster
form layered between two sheets of paper. This ointment
becomes runny as soon as it is warmed, so one sheet is removed and the ointment is then pressed onto the burn as
soon as it softens. There is a sharp burning sensation the
moment it touches the skin, and those who experience it for
the first time tend to jump. Nevertheless, once the patient
gets used to it, this burning sensation is not a problem and
some people even get to like it.
As I said, the ointment is applied once or twice a day.
Once the burn blister breaks and the ointment begins to
penetrate into the subcutaneous tissue, the pus starts to
come out. Sometimes the pus is thick and creamy, while
at other times it may be mixed with serous fluid. The pus
excretion lasts from two to three weeks. During this period
those who have sensitive skin get a rash around the moxa
burn where the ointment comes into contact with the skin.
This area may also begin to itch. However, there is nothing
to worry about because such redness and itching comes to
an end as soon as the application of the suppurative ointment is stopped.
These burns which have become infected with large
amounts of pus being released are not a pretty sight. One
may even begin to wonder if the infection might spread.
Yet the pus eventually diminishes and a layer of new skin
forms over the burn. This happens because the tissue has
been revitalized and has returned to normal. The formation and excretion of pus stops even when suppurative
ointment continues to be applied. This regeneration is a
characteristic feature of direct moxibustion treatment. No
matter how big of a burn direct moxibustion causes, when
the cells and tissue are revitalized after continued moxibustion, new skin forms naturally from underneath and
the scab falls off. Thus the skin underneath is completely
renewed. This regeneration of skin can even be considered
as a barometer of healing.

3. The aim and results of Dano-kyu

The aim of Dano-kyu, as the name implies, is to cause
the excretion of pus. In my experience those moxibustion
points which yield the most pus are places that have the
most kori or indurations. When the process of Dano-kyu
is complete, the hardness and indurations go away and
the tissue becomes normal. In addition, pressure pain and
spontaneous pain also disappear. Even induration and
accumulated hardness over the years, which no amount
of shiatsu or acupuncture can remove, softens and the tis-

NAJOM
sue becomes normal in just two to three weeks. The patient feels like a new person because stubborn indurations
caused by firbrositis and the chronic inflammation of the
connective tissue disappears in a few short weeks.
The excretion of pus is actually the elimination of accumulated metabolic waste and toxins lodged in the tissues
so the tissues are, in fact, revitalized. A similar effect can
be obtained by applying direct moxibustion every day for a
period of six weeks or more, but the effect is not as powerful as Dano-kyu. In my experience, I have never been able
to obtain such profound and lasting effects from shiatsu or
acupuncture. Dano-kyu draws out toxins and waste products through the skin, and this effect impacts the function
of the organs. As a result, the entire body is revitalized and
this leads to recovery from disease. This approach to treating illness in many ways resembles that of blood letting. It
is a simple and even primitive concept of drawing out accumulated toxic substances in the body through the skin.
Yet this seemingly extreme measure has such a dramatic
effect that some people enthusiastically continue to use this
method. A person can see the pus excreted and also feel the
stubborn hardness and tension diminish day by day. This
is why after patients receive this baptism by fire, they become believers.

4. Case studies of Dano-kyu

(1) 61 year old male (1-30-96)
Chief Complaint: Pain in the right shoulder and inability
to raise his right arm. Headaches almost every day for
the past eight or nine years.
Examination: Muscular and well built. Muscles in the right
interscapular region, right side of neck, and anterior aspect of the right shoulder and upper arm are contracted
and extremely hard. There is contracture, pain with
movement, and restriction in movement from many
years of physical labor. Tender points shown on Fig. 1.
Treatment: Simple insertion in the abdomen and at reactive
points on the Bladder meridian of the back with 40mm
No. 2 silver needle. Also simple insertion in tender
points in Fig. 2 with the patient in the side position, five
cones of direct moxibustion (half rice grain size) were
applied to the same points. Treatment concluded with
ten minutes of shiatsu on the Bladder meridian with the
patient in the prone position.
Progress: Treatments similar to the above were administered every ten days for four sessions, but his muscles
did not soften up at all. On March 23 I applied Dano-

kyu to three points (Fig. 3).

The burn was not sufficient, so I repeated the procedure
on March 25, and instructed him to apply the suppurative
ointment every day until the next treatment. When he returned on April 13, the hardness which had bothered him
for many years had disappeared without a trace and his
other symptoms were almost completely relieved. He was
very happy with the results and insisted that I work on the
remaining hard areas with Dano-kyu, so once again I applied Dano-kyu to the points shown in Fig. 4.
Fig. 3

Fig. 4

When he returned again on April 27, however, the burns

where I had applied Dano-kyu were very soggy and almost
festered. I had him stop the application of the suppurative
ointment, and had him apply Shiunko instead to facilitate
the healing. Even so, a dark scar about 5mm across remained for a few months afterward. The hardness under
the scar, however, was reduced considerably. Seven more
treatments similar to the initial one were given up to midJuly at which time the treatment was concluded.
(2) 53 year old female (1-31-96)
Chief Complaint: Pain due to rheumatoid arthritis (occipital area, left elbow, right wrist, right fingers, knees, and
left foot) which started 16 years ago after having a baby.
Problems in using her right hand, unable to bend her
right index finger, cannot drive, and has difficulty walking.
Examination: Bogginess in occiput and back of neck (fluid
retention). Alopecia (W 8cm X H 4cm) in the occipital
area. Hardening in the muscles of the shoulders and
interscapular area. The skin of her upper back is rough,
dry, and blackish in color. Pulse is floating and large (a
wide pulse).
Treatment: After giving shiatsu in the side and prone positions, I performed simple insertion at reactive points
on the Bladder meridian of the upper back using 40mm
No. 2 stainless steel needles. I also applied Dano-kyu to
five points (Fig. 5).
Progress: She came for her second treatment on February
15. Since there was not much excretion of pus from the
burns I applied multiple cones on the same points to
make a deeper burn. When she came for her third treatment on February 28, large rashes had formed around
the burns and the wounds were very soggy. Concerned
that the infection might spread, I told her to stop using
the suppurative ointment and to apply Shiunko instead.
This woman seemed to have exudative diathesis (a

23

NAJOM
constitution with a tendency to exude fluids from skin)
and the wounds took forever to
heal. It took about two months Fig. 5
for the wounds to become dry.
This patient, however, had
seen how Dano-kyu worked
wonders for her own mother
and therefore did not complain
even when the wounds were
festering, and she also put up
with the itching. By the time
the wounds did heal, the movement in her neck was improved and restrictions in her
arm and hand movement were reduced so that she
could drive once again.

5. Observations
Dano-kyu is an excellent method which expels metabolic wastes and toxins in the tissues in a short period of
time. As a result the tissue is revitalized and this facilitates
recovery from illness. The speed of this process seems to
be much faster than any other method of treatment. It is
not an overstatement to say that there is no other method
with such a powerful therapeutic effect. In general there
are no side-effects. Those who have allergies or are sensitive, however, often develop a big rash (probably allergic
dermatitis) when this treatment is continued over a period
of time. This dermatitis is accompanied by the copious
excretion of serous fluids and itching. The wound is very
unsightly and also leaves a scar, but the infection does not
seem to spread. When I applied Dano-kyu twice in succession as I did in Case 1, even if there is no problem the first
time, severe rashes are produced the second time perhaps
because antibodies are formed. I have seen this pattern
in many cases. In cases such as this, I discontinue this
treatment and do not do Dano-kyu again for at least three
months. Performing Dano-kyu after this period does not
cause dermatitis.
Sometimes I take the meridians into consideration for
point location, but generally I select the points that are the
hardest or most indurated. I feel the aim of Dano-kyu is
fulfilled by removing the indurations. However, I have my
doubts as to whether this method, which can be considered a form of sedation on a grand scale, will ever be used
in North America. My intention was only to inform our
readers that such a method not only exists but in fact really
works.
Notes
1. Yanagiya Sorei, Shinkyu no Kagaku - Jitsugi hen (The
Science of Acupuncture - Techniques Volume), Ishiyaku
Shuppan Co.,1959.
2. Mizutani Junji, Practical Moxibustion Therapy, (on the
use of bamboo tube to reduce pain in moxibustion), NAJOM Vol. 1, No. 1, 1994.
(November 1996, Translated by Sthephen Brown)

Practical Moxibustion Therapy (9)

Case Studies of Direct Moxibustion

1. A Case of Stubborn Constipation

79 year old male
First Treatment: September 4, 1996
Chief Complaint: Constipation began following a stomach
operation 10 years earlier. It became much worse three
years ago and since then he has had at best only one
bowel movement every three days. He has difficulty
passing stools which he describes as small and hard like
rabbit feces. Recently, it has became even worse and
bowel movements barely come once a week. In August
he went to a physician for examination but was found
to have no abnormalities.
History: He had a minor stroke in February 1996. As an
aftereffect, he feels a stiffness in his left foot as well as
stiffness in his left shoulder and radiating down the left
arm. Recently he contracted herpes and there is residual
pain under his left scapula and flank region.
Pulse: rapid, large, and strong (flooding)
Abdomen: It is a deficient abdomen. There is lack of
muscle tone and the abdominal wall seems to be thin,
yet the muscles are tense and peristaltic movements of
the intestines are visible. A strong pulsation can be felt
along the Stomach meridian on the right.
Movement: Due to the stroke, his movements are uncoordinated and he walks falteringly in small steps. His
speech is very slow and he seems to be tongue-tied.
Questioning: He loves sweet things and eats a lot of jelly
and raw vegetables. He doesnt eat meat, but he eats
fish.
Analysis: In terms of TCM this is a case of Yin Deficiency
Fire Blazing. Fluids have dried up to produce Deficient
Heat and this has caused the stools to harden. In terms
of Japanese acupuncture it is a Deficient Cold Pattern of
the Spleen and Stomach. Cold has lodged in the body
and has reduced his metabolism and slowed down
blood circulation. This has caused chills and hardening
of the stools. The overconsumption of raw vegetables
and sweets has also caused chilling, and loss of tone and
contractile strength in the smooth muscles of the intestines so that there is loss of strength to eliminate stools.
Treatment: Ten cones of half rice grain sized direct moxibustion was applied to points on the abdomen (CV4
and 12, ST23 on right, ST25, and 27, and SP5) and lumbar area (BL23, 25, and 50, Bentsu or bowel movement
point, and gluteal tender points). The treatment was
concluded with seven cones of direct moxa on ST36 and
ten to fifteen minutes of abdominal massage. (Fig. 1)

Fig. 1

24

NAJOM
I advised him to stop eating sweets or cold foods and
everyday to eat vegetables that had been cooked or fried.
(Second) Sept. 9: The day after treatment he had a large
bowel movement, passing stool the size of a banana. The
pulsation in his abdomen was gone with the abdomen feeling a little softer. The same moxibustion treatment was applied with the addition of SP13.
(Third) Sept. 17: He had two
bowel movements following the
last treatment. He complained of
numbness from his left shoulder to
his arm so I applied seven cones of
direct moxa on the medial border
of the scapula (Fig. 2) as well as on
LI10 and 11 on the left. The points
treated on the abdomen and lumFig. 2
bar area were the same as before.
(Fourth) Oct. 2: He had four bowel movements following the last treatment. Since the numbness in his left shoulder and arm continued, I applied seven cones of moxibustion on LU2 and LI11. To treat his constipation I added
BL32 and 35.
(Fifth) Oct. 15: He has had bowel movements every
three days. Numbness in his shoulder and arm was improving. I repeated the same treatment as before.
(Sixth) Oct. 31: He has had bowel movements every
other day, for a total of seven times. His appetite was improving. I applied the same treatment as before. I decided
to conclude this series of treatments since he said he was
getting too busy with dental appointments, but told him to
come in once a month for moxibustion.
Observations: This patient had low vitality and presented a Deficient Cold Pattern. The success of these treatments was due to the use of only moxibustion without
acupuncture in order to thoroughly tonify and warm. It
was also helpful that I used smaller cones (half rice grain
size) and took my time in applying them so that the heat
stimulation would not be too much for him to bear. Laxatives are ineffective for cases of constipation in elderly and
deficient patients like this, and in some instances may even
make it worse. It is best to make the heat of moxibustion
penetrate gradually to improve circulation, improve tone
in flaccid muscles, and to wait for the natural elimination
of stools. Moxibustion is excellent for improving appetite
and increasing vitality. It is also important to inquire about
the patients diet. Patients like this should strictly avoid
Yin foods like raw vegetables, fruit, and refined sugar. On
December 2, the patient came for treatment. He reported
having good bowel movements every other day, and, in
general, that he was doing very well.

2. Stomatitis (Canker Sores)

Fifty year old male
First Visit: May 1996
Chief Complaint: Since getting gastritis one year earlier,
the patient has had an outbreak of stomatitis every
month or two. It takes ten days to two weeks for the
sores to disappear. When canker sores are present, he
is unable to eat much because a sharp pain arises every
time food comes into contact with a sore.

History: He has had gastric hyperacidity for the last ten

years. His complexion became poor between the age of
24 and 25, and the whites of his eyes are yellowish so
that liver disease was suspected, but tests show no abnormality. He had migraine headaches once or twice a
week eight years ago before he quit smoking. Sleeping
used to get rid of the headache.
Visual Inspection: Bluish black complexion. He appears
fatigued.
Pulse: even pulse
Questioning: He drinks one or two small bottles of beer a
day. If he drinks any more than that, he has a bad hangover. He does not exercise.
Analysis: He has a very sturdy build and has an excess
constitution. It would appear that stress and overwork
has caused Stomach excess and the autonomic nervous
system has been affected to cause inflammation of the
oral mucosa.
Treatment: When he came for treatment in May 1996, I decided to try herbal remedies and prescribed the minor
cinnamon and peony formula1 for two weeks and the
coptis and rhubarb formula2 for another two weeks, but
the stomatitis did not improve. I therefore decided to
try home moxibustion therapy. The points I selected
were CV12, LU7, GB34, and Ino-mutsu-kyu (six points
for stomach disease) or BL17, 18, and 20. I applied seven half rice grain sized cones on each point. As for the
home therapy, I had him apply five cones each on CV12,
LU7, and GB34, since these were points he could treat
himself every day. I also had his daughter apply five
cones on the Ino-mutsu-kyu points whenever she was
able. He continued home moxibustion therapy for the
two months of June and July. The stomatitis was cured
so I told him he could stop the moxibustion treatments.
I heard from him in late November and he said that he
was doing fine.
Observations: His daughter was quite busy so she treated the Ino-mutsu-kyu points only occasionally. Thus the
treatment points were actually just the five points of CV12,
LU7, and GB34. Yet this improved the condition of his
stomach and cured the stomatitis. The moxibustion master
Isaburo Fukaya writes that, in cases of stomatitis, pressure
pain can always be found at LI4, 10, and 11, and at LU7.
He selects the points that are the most sensitive and applies
multiple cones of direct moxibustion. In the case of this
patient, LU7 was tender so I included it in the treatment.
The mouth is ruled in part by the Large Intestine, and LU7
is connected to the Large Intestine as the connecting point
of the Lung meridian. GB34 and the Ino-mutsu-kyu points
are famous moxibustion points for alleviating gastric hyperacidity.
This is an aside but, when points on the back are to be
treated bilaterally, such as with the Ino-mutsu-kyu points,
there is a traditional method called the suji-kae moxibustion technique (Fig. 3). This has to do with the order in
which the cones are applied, and it is one of crisscrossing
back and forth. Thus if one were to start at BL17 on the
left, the next cone would be applied on BL18 on the right,
then BL20 on the left, then BL17 on the right, then BL18 on
the left, and finally BL20 on the right to complete one cycle.

25

NAJOM
Fukaya states that this is a
very effective way of applying
heat stimulation, and I agree.

Fig. 3

3. Osteoarthritis of the knee

joint
First Visit: November 14, 1996
BL17
Chief Complaint: Pain in the
BL18
right knee became intense
a ro u n d A p r i l 1 9 9 6 a n d
BL19
walking became difficult
with pain becoming so bad
after about ten minutes of walking that she could no
longer continue. It hurt especially when she would go
down a flight of stairs. At night she was unable to lie
on her side because of pain and would find it difficult to
turn over.
History: Her right knee had begun to hurt about four years
earlier. At that time there was pain during the night,
but it didnt hurt during the day so that she was able
to walk. The pain would come and go in about a twoweek cycle. She took steroids about three months ago,
and the pain went away for two or three days, but a
week later it came back so she stopped taking them.
Visual Inspection: She has a pale complexion and is slightly overweight. It seems like her extra weight is from
water, or fluid retention under her skin.
Palpation: Fluid has collected around the right knee and it
is slightly swollen. There are cord-like strands of tension in the popliteal fossa, and the lumbar muscles (psoas
major) are extremely tense.
Analysis: There is no deformity in the knee, and water retention under the skin is just at a medium level. This
type of osteoarthritis is thought to occur from the loosening in the support structure around the knee and
fluid accumulation. Thus the cartilage becomes soft
and the joint is not well supported during movement so
that inflammation occurs. If however the support structure around the joint is strengthened and elasticity is
restored in the tissues, then inflammation will subside.
This patient has better than average vitality, so I decided
this could be treated just with moxibustion on tender
points around the affected knee.
Treatment: This patient had never seen moxibustion, and
seemed apprehensive, but I convinced her
that this would be effective as a treatment
and applied small cones. I took my time
and taught her how to apply moxibustion
herself. I asked her to bear with it and apply moxibustion every day for three weeks.
The treatment points are shown on Fig. 4.
Three cones each were applied to points on
the anterior knee, and five cones were applied to those in the popliteal fossa.
When she returned for treatment on December 3, she reported that she had been surprised on her way home following her first
treatment saying that her legs had felt light
and that she was able to walk all the way home
without stopping. She further reported that
Fig. 4

26

she had had her husband apply moxibustion without fail

on a daily basis, that the pain at night had disappeared and
that she was now able to turn over in bed. Just two days
earlier, an escalator at a train station was out of order and
had descended a long flight of stairs with some trepidation,
but she was encouraged because she felt no pain. Examining her knee, the swelling was almost gone. I palpated a
few hard nodules around the patella which were tender. I
looked for tender points and located new treatment points.
I asked her to continue her daily moxa regimen for three
more weeks.
Observations: Moxibustion is very effective for this
type of arthritis and tendonitis. For tendonitis of a small
joint like the wrist, applying small cones on tender points
for three to five days is sufficient to alleviate most pain.
For arthritis of the knee joint which is quite advanced,
however, six weeks to two months of daily moxibustion
treatments is necessary. In this case, the treatment points
must be reexamined every two to three weeks so as to stop
treatment on those points which are no longer tender and
to add new points which are. When moxibustion is done
on a daily basis a scab forms over the burn, and eventually it becomes hard and peels off by itself. By that time
the tenderness is gone and the tissue around the point has
returned to normal. As this process is repeated, the pain
gradually disappears, and the patient should no longer
have problems walking. This is true also for cases of pain
caused by osteoporosis. The elasticity of the supportive
structures around the joint is restored with moxibustion.
Once the joint becomes supported and protected, the pain
is greatly alleviated and movement becomes easier. In this
way, moxibustion can to some extent reverse degenerative
changes in tissue, an effect that is unique to moxibustion.

4. Conclusion
The advantage of moxibustion is that even novices can
do it at home. Good results can be obtained as long as the
treatment points are located correctly. There is nothing like
direct moxibustion for helping chronic diseases, problems
of unknown origin, and stubborn conditions which doctors give up on. Furthermore, moxibustion is inexpensive,
safe, and can be used to complement other therapies. The
resolution of difficult conditions on one's own by selfapplication of moxibustion, such as in cases 2 and 3, is the
essence of moxibustion. We acupuncturists merely support
this process of self-care and healing.
Notes
1. Minor cinnamon and peony formula ( Xiao
Jian Zhong Tang) cinnamon ( ) 4g, ginger ( )
4g, peony ( ) 6g, jujube ( )4g, licorice ( )
2g, maltose ( ) 20g
2. Coptis and Rhubarb formula ( San Huang
Xie Xin Tang) rhubarb ( ) 1g, scute ( ) 1g, coptis ( ) 1g
(March 1997, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (10)
1. Healing Reactions
The commonly used expression kyu-atari (moxa reaction) is used to describe an increase in pain after treatment,
or otherwise, the occurrence of fever, lassitude, heaviness
in the head, loss of appetite, nausea, or increased stiffness
in the neck and shoulders. This phenomena of temporary
exacerbation of symptoms followed by rapid recovery is
known as menken (healing reaction). These symptoms are
a physical reaction to excessive moxibustion (heat) stimulation, but they usually go away by themselves in one or two
days. Therefore, when the patient is reassured and gets
some rest, the symptoms disappear as if by magic, and their
physical condition improves all at once. In cases like this,
there is no harm in continuing the moxibustion therapy.
If, on the other hand, such symptoms persist for three
to four days, we have to consider it to be a change in the
course of the disease, or a reaction to inappropriate treatment. If the symptoms occur right after a treatment, it is
very hard to judge whether they are due to a healing reaction, or a change in the disease, or inappropriate treatment.
If the symptoms persist for more than three days, we must
assume that a change has taken place in the disease and
reconsider our treatment strategy. In this article I will present one case which showed unmistakable signs of a healing
reaction, and another case in which there was a reaction to
inappropriate treatment.
2. Case 1: Sciatica
42 year old female
First Visit: Feb. 27, 1997
Signs and symptoms: One of my patients asked me to
do a housecall for a friend who had severe low back pain
and was barely able to move. When I arrived at her house,
she was bed ridden. The pain was very bad, already a
week had passed with her being unable to do anything.
Getting to the bathroom was difficult and it took her up to
half an hour. Her physique was normal and she was not
weak. Her voice as well as her manner were steady and
she had a strong spirit. It was the first time that she had
experienced such strong pain, however, and
being unaccustomed to pain, she seemed hypersensitive.
Abdomen: Hard and tender point around
ST27 on the left. (Sign of blood stagnation).
Lasegues Sign very positive.
Pulse: A little tense but fairly normal.
Treatment: From the questioning exam
and her physical state it seemed to be only
a case of sciatica, but because she seemed
sensitive to pain, I kept the treatment as
light as possible. First I retained needles for
ten minutes in abdominal points (CV12 and
left ST27) and both LV4. I used No. 2 gauge
50mm needles. While the needles were in
place, I engaged in a casual conversation so
that she would get used to the needle sensation. After removing the needles, I got the
Fig. 1

patient to roll over onto her stomach with some difficulty.

The tender points I found are shown in Fig. 1.
I retained needles in these tender points for 15 minutes.
Then I applied a total of 30 cones of half rice grain sized
cones on points on her lumbar and gluteal area. Generally,
with this kind of treatment, a normal case of acute low back
pain shows some improvement in terms of the patient feeling some relief. It isnt so simple, however, in serious cases
of sciatica. You are lucky if there is no change, and sometimes the pain gets worse. This is what I was afraid of, so
I left promising to return the next day to give her another
treatment.
Feb. 28: The pain did not get worse, but it didnt get any
better. I gave the same treatment as the day before. I left
the patient Guizhi Fuling Wan (
cinnamon-hoelen formula) and instructed her to drink the decoction.
March 2: The pain did not get any
worse. The patient said it was easier getting to the bathroom. As in the previous
treatments, I retained needles in tender
points. I moved the moxibustion points a
little to treat those places that were most
tender (Fig. 2).
It seemed to me that her condition had
Fig. 2
improved somewhat, so I increased the
amount of stimulation for both acupuncture and moxibustion. I thought that this would give her more relief.
The next day, on March 3, I got a call from the patient.
She told me that the pain got worse and worse after the last
treatment. Finally it reached a point where she could no
longer stand it, so she called an ambulance to go to a hospital emergency room. She received various examinations
in the hospital but, since it was a primary case of sciatica,
they had no solution except to give her pain killers. So
she went home by ambulance. She told me that she was
afraid of my treatment because the pain got worse than
before. She wanted to discontinue treatment and see how
she did on just the pain medication. The patient was obviously worked up, so rather than try to explain things to her,
I simply agreed and asked her to call me if there was any
change. At that point, I could not tell whether this incident
was due to a healing reaction or inappropriate treatment. I
was concerned, but I had no choice but to anxiously await a
further report.
March 9: I got a call from the patient about 1 p.m. She
said that the pain began to dramatically decrease about
three days earlier. It feels like I was under some kind of
spell, she exclaimed. I think Im OK now, she added.
March 20: The patients son had driven her to my clinic
for treatment. She was able to walk without any difficulty.
Her main complaints were that the side of her right leg felt
heavy at night while in bed, and stiffness in the neck and
shoulders on the right. As for the sciatic pain which had
been so excruciating, other than some localized tenderness,
the spontaneous pain was gone. There was some curvature
between L2 and L5, and BL26 was tender on the right side.
I limited the treatment to shiatsu with a focus on the Bladder meridian in the lumbar area and her neck and shoulder
on the right side.

27

NAJOM
April 3: The patient experienced a slight back strain
after the last treatment, but it cleared up by itself. There
was still quite a bit of tenderness on the back of the thigh
between BL36 and 37, but there was no more spontaneous
pain. The patients main complaint was stiffness in her
neck and shoulders. I gave her shiatsu only, as in the last
treatment, considering that the sciatica was cured for the
time being.
Discussion: I have had experience with many cases of
nasty sciatica like this which gets worse after treatment, but
improves miraculously in three or four days. In the above
case, I applied multiple cones of direct moxibustion as the
primary treatment. I have had similar outcomes, however,
with two cases in which I primarily used electroacupuncture. (For sciatica I apply a low frequency current between
a tender point on the hip and BL40.) In any case, the pain
was exacerbated and both the patient and I felt terrible.
Nevertheless, the pain subsides quickly after a few days to
disappear completely as if she had been under a bad spell.
It seems that the stimulation I applied was excessive, and
her body couldnt handle the sudden change. So the pain
got worse before it got better. I feel that cases where I get
results like this (healing reactions) I must have been trying
too hard and fallen into the more is better mindset.

3. Case 2: Stomach Pain (Deficiency Syndrome)

75 year old female
First Visit: Nov. 11, 1988
Complaints: This patient had had stomach pains since
January of that year. When she has stomach pain, the soles
of her feet feel funny. She thinks that maybe her circulation
is poor. She tires easily, and has a stiff neck, dizziness, and
tinnitis.
Signs and symptoms: She has had high blood pressure
for the last four years (left 150/100, right 160/75). Her
complexion is ashen and she looks thin and weak. She
tends to be cold. She had a kidney operation when she was
55. She injured her left foot five years ago in an auto accident. She had an operation in her left eye five months ago.
She lacks both mental and physical stamina, and it seems
like the term Kidney Deficiency was created for people like
her. Her digestion is weak and the Spleen and Stomach
have Deficiency Cold. She tends to be nervous and worries
a lot.
Pulse: large and floating
Abdomen: Sunken like the hull of a
boat. The abdominal wall is thin.
Treatment: Deficient patients like
this require long-term therapy with
Sawada Style moxibustion treatments.
For acupuncture, I retained needles
shallowly and then marked points for
moxibustion for home treatment. The
needles used were 40 mm, No. 2 and
they were retained in the points marked
with an x in Fig. 3. Then I applied direct moxibustion on the points marked
with an o, and instructed the patient
Fig. 3
to apply moxa to these points at home
and also to drink decoctions of Bawei

28

Dihuang Wan ( Rehmannia Eight Formula).

Nov. 30: Her blood pressure was left 138/88, right
130/60. Both her complexion and skin lost their darkness,
and her weight had increased slightly. I checked the moxibustion points and added two new ones, and told her to
continue the home moxibustion treatment.
Jan 31, 1989: Her blood pressure had stabilized and was
left 140/78, right 124/56. Her pulse was large and strong.
She said she felt stronger. She still has tinnitis and feels unsteady on her feet. She had congestion in her occipital area
and her shoulders were stiff, so I did some blood letting at
BL10 and GB21. I also did some shiatsu and instructed her
to continue the moxibustion at home.
Feb 27 & March 22: Her blood pressure was stable at
left 132/82, right 128/52. Her neck and shoulder tension
persists along with the tinnitis. I found marked stiffness
along the Bladder meridian on the right side. I bled Bl10
and GB12 a few drops, and also bled GB21 a little more. I
concluded the treatment with some shiatsu and instructed
her to continue the moxibustion.
April 12: Her pulse was floating, large, and hollow. The
tinnitis had gotten worse and she also had nose bleeds, so
she had gone to see a doctor. She appeared to be stronger
than before. After retaining needles in the abdomen, I did
blood letting and shiatsu as described above. The patient
appeared to be very tired after this treatment.
April 13: The patient called the next day to tell me that
she had been nauseous and without any appetite all day
after the treatment and had stayed in bed. Her voice over
the phone was very weak, and I felt like I was talking to a
ghost. It had occurred to me that I might have over done
the stimulation a bit, but in this moment I realized that I
had indeed. The last treatment had pushed her over the
edge. I had given her a strong treatment, believing that she
had more strength and could handle it. It turned out that I
had stripped her of the vitality she had regained.
By April 14, the next day, she had recovered to a point
where she was able to eat a little rice gruel. Be that as it
may, she was bed ridden for over a month and did not regain her vitality until she came for another treatment on
May 17. I knew that this wasnt a healing reaction the instant I heard the patients report.
Discussion: The patient suffered for over a month because I applied excessive stimulation when she was in a
deficient state. She had come in with a lot of complaints
to begin with. Being weak and hypersensitive, she was
unable to tolerate the strong stimulation, and her physical condition deteriorated all at once. It is hard to imagine
what it might feel like to hit the bottom physically and
mentally in this way.
After this incident, I saw this patient again on May 17,
July 13, August 3, and August 28. When she came in July
and August, I palpated strong pulsations in her abdomen
as well as rigidity in the rectus abdominous muscles. I gave
her four treatments in 1990, and one more in March 1991.
I moved my practice in July 1991, and my colleague took
over the clinic and continued giving her treatments once or
twice a month. Her condition went back and forth between
slight improvement and exacerbation. In March 1992 the
patient had an operation for arteriosclerosis and she passed

NAJOM
away later the same year. Anyway, the incident with this
patient burned into my memory, and I still remember this
patient clearly to this day.

4. Final Thoughts on Healing Reactions

The term healing reaction (menken) appears often in
the works of Kampo herbologists of the Koho School (18th
century Japan). Todo Yoshimasu,1 the leader of the Koho
School, stated as follows:
All diseases are caused by one poison. In other words,
this poison moves (inside the body) to produce symptoms.
Poisons are generated by impure Qi from food and drink.
Therefore, by attacking this with another poison (strong
drugs), the poison is expelled from the body and disease is
cured." 2
Thus herbalists of the Koho School were known for very
aggressive treatments. Even when a strong reaction occurred that was almost life threatening, it is said that they
welcomed it as a healing reaction. Sometimes, as one
of the therapeutic mechanisms of herbal therapy, there is
a strong reaction and a symptom gets temporarily worse
or a completely different symptom appears. The disease
process takes an unexpected turn and then recovery comes
unexpectedly.
A similar phenomenon occurs in acupuncture and
moxibustion treatments. The late Dr. Manaka spoke about
one of the therapeutic mechanisms of acupuncture and
moxibustion as an eye for an eye, more stress for stress,
or putting a warp (bias) on the body. This is similar to
the idea in the Koho School of controlling poison with
poison. It is not going too far to say that one aspect of
acupuncture and moxibustion is to shake up the body with
counter-stress or biasing and thus greatly excite the therapeutic potential of the body and resolve illnesses rapidly in
a way that is unbelievable in terms of modern medicine.
Notes
1. Yoshimasu Todo(1702-1773), Manbyo Ichidoku Ron (Theory of All Diseases as Being Caused by One Poison)
2. Nagahama Yoshio, Toyo Igaku Gaisetsu (Outline of Oriental Medicine) Sogen-sha, Tokyo, 1961, p55-56.
(July 1997, Translated by Stephen Brown)

Letter to the Editor

I have a comment to make after reading Mr. Mizutaini
s article, Practical Moxibustion Therapy (10). Since the
pathological condition of the sciatica in Case 1 was not
made clear, I think its hard to say whether this case was a
healing reaction, just the disease process, or some idiosyncratic phenomenon. He stated that the patient showed a
very positive Lasegues sign, but what about other signs
like numbness in the leg, the Achilles tendon reflex, or sensitivity to pressure? Also were there any signs of problems
in the piriformis muscle?
When lumbar pain becomes chronic, tender points appear in the lower abdomen and flank region because of the
hypertonus in the abdominal muscles. Also the anxiety in

the patient leads to a variety of autonomic symptoms and

psychological symptoms. What bothered me about Case 2
was that there was a 20 point difference between the diastolic blood pressure on the right and left sides. From this
alone, I would speculate that this patient had a serious disease. In regards to this case, near the end of the case study
it says, In March 1992 the patient had an operation for
arteriosclerosis and she passed away later the same year. I
was most concerned about the cause and effect relationship
between this outcome and the underlying pathology, which
was never clarified.
Matsumoto Hiromi(Yokohama, Japan)
I read the article Practical Moxibustion Therapy (10)
with great interest. I am especially impressed with the
honesty of Mr. Mizutani and his way of life as a clinician
that he would expose his own mistake (?) in Case 2. I discuss the subject of healing reactions with my friends and
colleagues, but generally they have the same opinion as Mr.
Mizutani. They say they cant tell if it is a case of a healing
reaction, wrong treatment, or an exacerbation of the condition until they observe the progress of the disease for at
least a few days. I feel that healing reactions are transitory
phenomena. This transitory phenomena is one of the
healing mechanisms of the body, and it involves a temporary exacerbation of subjective symptoms.
Indurations which are located in deeper parts of the
body are softened up with (acupuncture) treatment, and
part of this induration floats up to the skin surface. On the
other hand, when incorrect treatment has been applied, or
the pathological condition becomes worse, the skin surface
lacks tone and indurations become harder than they were
before treatment. Gas can be detected in some parts of the
abdomen, but not others, and percussive sounds indicate
a localized increase in surface tension. Because of these
changes, one can tell the difference between a healing reaction and wrong treatment by carefully examining the body
before and after the treatment.
If I may be allowed to speculate what the body surface
of the patient in Case 2 was like on April 12 after treatment,
probably the skin surface was slack and without tone. Furthermore, probably there was an accumulation of gas in the
epigastric region and the pulsation of the abdominal artery
was palpable around the navel. In this situation, the radial pulse must have become more submerged than before
treatment, as well as slightly thinner and harder.
It seems that bleeding BL10, GB12, and GB21 was not
appropriate in this case where there was a large difference
in the level of tension between the skin surface and the underlying indurations in this area. I interpret gas (accumulation) in the stomach (epigastric region) as a manifestation
of a diaphragmatic reflex. The way to deal with this is to
retain needles in ST36 or GB34. When the gas in the stomach moves downward by retaining needles in the leg, this
serves to reduce congestion and stiffness in the neck and
shoulders. The thing about blood letting is that it can alleviate subjective symptoms considerably. Often, however,
there is a problem later on. I myself have made many mistakes blood letting. I have caused cerebral anemia (fainting)
by bleeding GB21, and have caused dizziness by bleeding a
point on the midline below the spinous process of C-5. One
must be careful.
Tanioka Masanori (Osaka, Japan)
(November 1997, Translated by Stephen Brown)

29

NAJOM
Practical Moxibustion Therapy (11)
Special Effect Points
In moxibustion therapy there are the so called special
effect points, or renowned moxibustion points. The aim
of this article is to pickup these special effect points and
explain them in detail. Before doing this, however, I would
like to briefly discuss the nature of special effect points.
The prominent features of special effect points is that
they are located at a distal point from the conditions they
treat, and that they are always effective for specific symptoms. Perhaps because of this they tend to be looked down
upon by some practitioners as folk remedies applied simply
like, for such and such disease, apply moxa to such and
such a point.
Among my patients (many of whom are Japanese),
there are a few moxa fans who know about special moxibustion points such as those for hemorrhoids, stomach
pain, or asthma. This is because the results of moxibustion
on special effect points are fast and reliable, and it works
no matter who does it. Thus knowledge of these points
have become widespread among the Japanese people. Yet
special effect points are highly useful in the clinic as sure
fire treatment points. This sure fire effect, however, is
simply a consequence. The original significance of special
effect points lies in their relationship to meridians and acupuncture points. Distal points can be utilized to eliminate
specific symptoms in certain parts of the body only because
meridians exist. I think that the only reason special effect
points work so quickly is because the vibration (hibiki) of
the moxa on the point connects it through a meridian to effect all the meridians in the body. Thus it becomes a whole
body treatment. To put this in another way, special effect
points can be considered to be acupuncture points that
came about from a very powerful pathological manifestation in a certain part through the meridians. In this sense,
special effect points are not symptomatic treatment points,
and neither are they exclusively for local treatment. They
can be considered to be acupuncture points which are most
closely linked to the meridian network.
In clinical practice, however, they are convenient acupuncture points which can be used more casually to treat
certain symptoms without the need for complicated rules
or procedures of diagnosis and treatment as in Meridian
Therapy.
Special effect points are interesting because a point on
the hand can be used to treat symptoms on the face, a point
on the leg can treat pain in the abdomen, and a point on the
hip can treat leg pain. The neat thing about the meridians
and acupuncture points is that points in seemingly unrelated places can be used to resolve symptoms. This is what
makes acupuncture and moxibustion so fascinating.
The following are some of the special effect points that I
use often.
HEAD
1. GV23 - emphysema and nasal congestion
This point is indispensable for nasal problems. GV23 is
located one unit above the hairline. Press this point and, if

30

there is no penetrating sensation to the nose, move up toward GV22 (two units above the hairline) until you find the
point with the strong sensation. Isaburo Fukaya explains,
If this point feels hot when moxa is applied, apply seven
cones; if it doesnt feel hot, apply 15 to 30 cones. Sometimes there is a temporary reaction and copious puss is
discharged, but eventually the discharge stops and the nasal congestion clears up. Then the nasal passages are open
and the head also feels clear so the healing is evident. 1
I myself have had the same experience many times. In
general moxibustion on the scalp does not feel as hot as
one may think, and when done right it even feels good. A
small spot of hair is lost where the moxa is applied but,
once the moxibustion is discontinued, it grows back thicker
and darker than before. A scab may form over the point
when moxa is applied repeatedly, but in my experience
there is no concern about infection.
2. GV20 - anal prolapse
When the anal sphincter muscles become weak, the
lower section of the rectum can herniate during defecation.
It is surprising that GV20, on the top of the head, is effective for the weakening of muscles in the pelvic floor. GV20
is also known as the Three Yang Five Meeting Point, and
is the confluence of five meridians (GV, BL, SI, LV & GB).
Since GV20 has the strongest Yang Qi among all the points,
it corrects weakness of Yang Qi, and it causes Yang Qi to
draw up and cure anal prolapse. Anywhere from seven to
35 cones are applied.
3. GV15 - aphasia
According to Bunshi Shirota, this is a special effect
point that cures aphasia due to strokes or arteriosclerosis,
and otherwise, when there is impairment in tongue movement.2
The classics list GV15 as a point forbidden for moxibustion. Ken Sawada is said to have broken this taboo
and obtained good results. However Shirota warns that,
moxibustion on this should be limited to those who have
problems in (movement) of the tongue. It is best not to apply moxa here for those who do not have this problem. 3
Fukaya states as follows concerning moxibustion for
patients who have had a stroke: In applying moxa to patients who have had cerbro-vascular accidents, one must
not do it right after the accident. It is safest to wait at least
a month after the stroke, and even then it is best not to start
with methods like the Seven Points for Strokes (GV20, GB7,
GB31, GB39, LI15, LI11, & ST36).4
I agree that one needs to be careful. I feel that not more
than three cones of half rice grain size cones should be applied to CV15 for stroke patients. It needs to be treated
over a long period along with whole body treatments.

ARMS
4. Sawada style LI2- sty
This point is located on
the radial end of the crease
in the joint of the distal and
middle phalanges of the
index finger. (Fig. 1) According to Fukaya, LI2 has
a miraculous effect, and he

Fig. 1

NAJOM
writes, First apply five half rice grain size cones. Then the
pain disappears almost completely. If there is still some
pain, apply five more cones. Then even the eyelids seem to
become lighter.5
My father-in-law got a sty this summer. My wife who
was visiting him in Japan at the time did moxibustion for
him on Sawada style LI2. Later my father-in-law went to
see a doctor and received antibiotics and eye drops, but
these had no effect at all. The swelling continued to grow
and three days later the whole eyelid became red and swollen; so much so that the swollen upper eyelid swelled shut
so that he could no longer see out of that eye.
My father-in-law had gotten a sty before, and that time
he had to have it surgically removed. When he went to the
doctor for the second time, the doctor said he had never
seen such a big sty and prescribed an even stronger antibiotic. He said they would see how things went and do surgery if it got worse. The strong antibiotics upset my fathers
stomach terribly, so he stopped taking them. My wife did
her part and kept applying moxa on him everyday. That
night the sty broke open by itself and puss was excreted.
The next morning the swelling had shrunk down to about
half the size. The speed with which the infection developed and the rapid healing once the puss was discharged
naturally was amazing, and the doctor was perplexed. My
father-in-law is convinced that the sty healed naturally and
that he avoided surgery because of the moxibustion.
5. LI4 - facial furuncle
A furuncle is a focal infection and inflammation of the
skin and subcutaneous tissues. About facial furuncles
Fukaya writes, apply multiple cones of 100 to 200. After
about 50 cones the throbbing pain in the furuncle stops.
The pain will return if the moxibustion is stopped at this
point, so continue. After a while the pain will go away
completely and the furuncle will open by itself to discharge
puss.6
Shirota states,LI4 is renowned as the (moxibustion)
point for furuncles. Often the point on the same side as the
furuncle is treated. Amazing results can be obtained when
moxibustion is applied repeatedly day and night. Also, applying strong stimulation on this point when a person has
a bad toothache or a strong headache will immediately cut
the pain in half. Therefore this point is used as the induction point for (drawing away) congestion in the head.7
There is the famous Sakuraido Moxibustion in Shizuoka (east-central) Japan, which is known as being especially effective for facial furuncles. Patients from all over
Japan flocked to Sakuraido because it was so famous, and
there is even a story about how the nearest Kusanagi train
station on the Tokaido Line was specially constructed because of this. It is said that 500 patients a day used to go
there for moxibustion. It is obvious that treatments like
this were highly valued in the era before antibiotics, when
minor infections like furuncles could lead to complications
like meningitis and septicemia and even cause death.
6. LI11 - pain and fatigue in the thumb
After giving shiatsu for many hours, sometimes the
thumb joint and the surrounding muscles become swollen and painful. When this happens, I apply five half rice
grain size cones on LI11. My fingers feel lighter and I can

continue giving shiatsu. LI11 is located on the radial end of

the cubital crease when the elbow is fully flexed, but look
for the point with the greatest sensitivity to pressure. Applying moxa on this tender point will make the heat sensation radiate toward LI10, and it feels great.
In Sawada style treatment LI11 is one of the standard
treatment points and almost every patient gets treated on
this point because it is an indispensable point for whole
body regulation. According to Shiroda, LI11 is effective
for neuralgia, paralysis, rheumatism, stroke recovery, hemiplegia, headaches, stiffness in the neck and shoulders, as
well as being particularly useful for eye diseases.8 Fukaya
includes LI11 among the special points for chilblains and
states, applying seven half rice grain size cones on LI11,
LI10, and TW9 will cause even very broken up skin to begin to heal.9
It is undeniable that using LI11 has a reflexive effect of
improving circulation in the forearm, and it also acts as
an induction point for drawing Qi down from above the
shoulders. This makes LI11 invaluable for regulating the
whole body. For this reason I call LI11 the closing moxa
point. What I mean by this is that it is a point for bringing
the treatment to a close. It serves to draw away any uncomfortable sensations which may linger in the upper body
at the end of treatment, and it smooths the flow of Qi and
Blood. By my finishing with this closing moxa point, the
patient is able to feel refreshed after the treatment.
(More special effect points will be presented in the next
issue.)

Notes
1. Fukaya Isaburo, Meikyuketsu-no-Kenkyu (Study of Renowned Moxibustion Points), Kankando Press, 1983, p.
131.
2. Shirota Bunshi, Shinkyu Chiryo Kisogaku (Basic Study
of Acupuncture and Moxibustion Therapy), Ido-noNippon Sha, 1979, p. 281.
3. Ibid., p. 282
4. Fukaya Isaburo, Meikyuketsu-no-Kenkyu (Study of Renowned Moxibustion Points), Kankando Press, 1983, p.
142.
5. Ibid., p. 118.
6. Fukaya Isaburo, Kadenkyu Monogatari (Stories of Family Moxibustion Secrets), Sankei Press, 1982, p. 220.
7. Shirota, Bunshi, Shinkyu Chiryo Kisogaku (Basic Study
of Acupuncture and Moxibustion Therapy), Ido-noNippon Sha, 1979, p. 80.
8. Ibid., p. 85.
9. Fukaya Isaburo, Meikyuketsu-no-Kenkyu (Study of Renowned Moxibustion Points), Kankando Press, 1983, p.
114.
(November 1997, Translated by Stephen Brown)

31

NAJOM
Practical Moxibustion Therapy (12)

Special Effect Points - No. 2

Legs
1. Uranaitei (Ventral ST-44)
This is an extra-point on the plantar surface
of the foot, at the base of the second toe. To
locate it, an ink mark is placed in the middle of
the pad of the second toe, and transferred to the
bottom of the foot by fully flexing and doubling
the toe over. (Fig. 1)
In the Sawada School it is said: When
moxibustion is applied on this point and no heat
is felt, the patient has food poisoning. Normally the sole of the foot is very sensitive and direct
moxibustion feels extremely hot. Yet, for some
reason, when one has stomach pains or diarrhea, it doesnt feel hot. When successive cones
of direct moxa is applied to this point until heat
is felt, the stomach pain or diarrhea stops right
then, and any food poisoning is alleviated. In
cases like acute enteritis with severe diarrhea, it
Fig. 1
is good to also moxa ST34; for tenesmus (urgency
with difficulty in elimination) also use BL60. Apply at least
10 cones on these additional points.
I have heard that Uranaitei is also used for auto intoxication such as food allergies. I dont have any experience
with this, but I would like to hear from readers who have.
2. ST36 (Ashi Sanli)
Moxibustion of ST36 has been famous in Japan for centuries as a practice for longevity. Traditionally it was called
eight day moxibustion, and people applied moxa on
ST36 for the first eight days of every month. In the Sawada
School, ST36 is used for almost all patients as a standard
point since it is held to be effective for all chronic diseases
as well as digestive, nervous, and nasal diseases. Ken
Sawada borrowed the theory of Kinjiro Kimura, a famous
blind acupuncturist, and stated: Sanli is effective for Stomach, Spleen, and Kidney. Thus it is known as Sanli (three
places). Li of Sanli means principle. Thus it is Sanli (three
principles). When Sanli is needled, induration at BL40 goes
away and bladder function improves. Thus Sanli nurtures
both prenatal and post-natal Ki. This is why vitality does
not diminish and it is known as the moxa point for longevity.1 It is interesting, however, that Sawada also stated:
Sanli does not work for hyperacidity. Use BL43 for gastric
hyperacidity. When both Sanli and BL43 are treated, it will
actually cause stomach disease.2 Isaburo Fukaya explained
ST36 as follows: This point has been treasured from the
olden days as a moxa point for stroke prevention, and also
has been one of the treatment points for strokes. In addition, its effect in calming the nerves for neurasthenia and
hysterical disorders almost surpasses tranquilizers. 3
The simple way to locate the ST36 moxibustion point is
to flex the knee at a 90 degree angle and wrap the web between the thumb and index finger over the upper edge of
the patella. The point is where the tip of the middle finger
touches the lower leg. (Fig. 2)
Apply five to seven half rice grain size cones on this

32

point for adults and one to three sesame seed

sized cones on children. When moxa is applied on this point regularly, the legs become
light, they do not fatigue even when walking
a long way, and climbing stairs becomes a
breeze. Since I have made a practice of moxibustion on ST36, I climb stairs two steps at a
time. Your legs really do become nimble. So
you will understand the Japanese saying, from
a time when most travel was by foot, Do not
Fig. 2
go on a trip with anyone who doesnt do moxa
on Sanli. Also, it is quite miraculous how
the nose begins to clear after regular moxibustion on ST36.
This is why ST36 is also known as a special effect moxibustion point for sinusitis. The Stomach meridian begins at the
inferior border of the orbit, or next to the bridge of the nose.
That nasal problems are resolved by treatment of ST36, the
He Sea point of the Stomach meridian, is the uncanny effect
of meridians. It is stated that He Sea points draw down
the inversion of Qi. In this regard, it is written in Shinkyu
Chohoki (Treasured Record of Acupuncture and Moxibustion) 4 as follows:
In general, when moxibustion on ST36 is not applied
on persons over 30, Ki ascends and strikes the eyes.5 Also,
when applying moxa on points like the Four Flowers, 6
BL43, and GV20, follow this up with moxa on Sanli to pull
down the heat above.
This passage is very instructive for moxibustion therapy
in general.

3. Shitsu-min (Sleep Loss)

This is an extra-point in the middle of the plantar aspect of the heel. (Fig. 3)
It is effective in resolving edema in the feet
as well as generalized edema that comes with
diseases like nephrosis. When the quantity of
urine becomes as little as 500cc (half a liter) a day
with nephrosis, there is no heat sensation when
moxibustion is applied on Shitsu-min of both feet.
Usually, for people in good health, the heat is felt Fig. 3
very keenly with just one cone. Edema will be
resolved quite effectively when more than fifty cones are
applied. Also, as the name suggests, Shitsu-min is very effective for problems with sleep. Some mornings, when I
want to take it easy and sleep in, I apply moxibustion on
this point myself.
Back
4. GV14
This point is located between the spinous processes
of the seventh cervical and first thoracic vertebra. When
the neck is bent forward, one spine near the collar sticks
out, and this is the seventh cervical vertebra. So GV14 is
in the depression just under this. Applying 20 to 30 cones
here successively when you feel chills coming on in the
early stages of a cold warms up the back muscles, stops
nasal discharge, and you start to breathe easier. Also GV14
serves to reduce fever, so you can apply moxibustion without reservation on this one point even when a patient has
a fever. Thus GV14 is very effective for colds, but the same

NAJOM
approach (20 to 30 cones of direct moxibustion) is also effective for allergic rhinnitis. The rhinnitis will clear up before long with daily moxibustion on GV14.
GV14 is known as a confluence point where all the Yang
meridians converge, and Yang Qi is the strongest here, so
no doubt repeated moxibustion disperses EPIs like Wind,
Cold, and Damp. GV14 is also a special effect point for tonsillitis and headaches, as well as kata-kori (stiffness in neck
and shoulders). So one might call this a point with endless
applications.

5. GV12
This point is located in the depression under the third
thoracic vertebra. It can also be located by finding the intersection of the spine and a line drawn between the medial
angles of the scapulae. GV12 is used to treat various nervous
disorders. This includes neurosis, hysteria, tics, epilepsy,
and mental diseases. Since the olden days GV12 has been
called chirike in Japan, it and has been famous as a special effect moxa point for infantile disorders. This includes
night crying, vomiting milk, hypersensitivity, constipation,
diarrhea, or greenish stools. Infantile disorders, popularly
known as kan-no-mushi, refers to any problem which
makes a baby hard to care for. Moxibustion on GV12 is incredibly effective for this problem. Fukaya writes: Infants
often get nasal congestion, and this makes it difficult for
them to suckle. In cases like this, applying five very small
string-like cones of moxa on GV12 will clear the nose immediately. And the nose will not become congested again
later. 7 When children make a big fuss and dont stop
crying, applying moxibustion in the way described above
will make them calm down and stop crying. Also, regular
moxibustion on GV12 benefits children because they catch
fewer colds, they become tougher because their development is aided, and they become more calm and composed.
Thus GV12 is an indispensable point for children. I started
applying moxibustion on this point on my first son since he
was two weeks old and continued it for over three months.
Ever since then, I have applied this moxa treatment on him
whenever it seemed necessary. Thus, today at the age of
nine, he has yet to take any drugs or antibiotics prescribed
by a doctor. I attribute this to the effect of chirike.
6. BL43 (Gaohuang in Chinese)
This point is three and a half
units lateral to the midline and is in
the fourth intercostal space. A good
way to locate it is to have the patient
sit with their knees and hips fully
flexed and hug the knees. This way
the scapulae move apart and points
on the medial border of the scapulae
become easy to locate. (Fig. 4)
When locating this point on
yourself, assume the posture shown
in Fig. 5 and palpate it with your
fingertips. The third line of the
Bladder meridian is three units from
the midline (the first line being the
Huato Jia Ji points), but BL43 is

Fig. 4

more lateral than this, and

quite often these points are
hidden under the scapulae.
This is why it is best located
in the seated position with
the scapulae spread apart
all the way. It may also be
located with the patient lying face down with the arms
hanging down the sides of
the table, as with narrow
chiropractic tables. It is,
however, difficult to locate
with the patient the usual
prone position. Another
Fig. 5
method that works (if you
want to treat one side) is to have the patient in the sidelying position with their top arm in front so the scapula
moves forward.
Pressing BL43, one often has the impression that it is an
induration that is stuck to the ribs just under the margin
the scapula. Further, the sensation of soreness radiates up
to the neck and toward the ear. Also pressing this point
can cause a strong heat sensation to travel from the scapula
to the posterior aspect of the shoulder and arm and reach
down to the elbow. This heat sensation is felt most keenly
when direct moxibustion is applied the point. Based on
these observations, I use BL43 for facial pain such as trigeminal neuralgia, and any pain in the shoulder or arm.
Also from its location in relation to the spine, it is an indispensable point for cardiac or respiratory diseases. In addition, a strong reaction often manifests at BL43 in patients
with chronic digestive problems.
When a human being is compare to a bird or an air
plane, the arms are the wings. The medial borders of the
scapulae are connecting points of these wings to the
body, and thus this is an area of the body that is under great
stress. Since the whole body is attached to and supported
by the arms in this way, it seems that all disorders in the
body manifest at these points. Accordingly, BL43 can be
called one of the most vital, or Yang, parts of the body.
It is written in China that, between 590 and 570 B.C.,
when Jinggong, the king of the kingdom of Jin, became
very ill, the renowned physician Huan was called from
the kingdom of Qin. Before Huan arrived, however, Jinggong had a dream in which his disease appeared in the
form of two children who were discussing how to evade
the renowned physician Huan. The children said, If we
hide above the Gao and below the Huang, 8 not even the
best physician can get to us. Later when Huan arrived
and examined the king, he stated, The disease has gone
above the Gao and below the Huang. There is no cure. It
cannot be reached with a needle, and medicines cant get
to it either. I cannot treat it. Upon hearing this Jinggong
said, You are an incredible doctor, and sent Huan back
to the kingdom of Qin with the greatest honors. From this
story came the saying the disease has entered Gaohuang,
which means the disease in incurable.
In the classics it says that applying moxibustion on BL43
raises the Yang Qi so much that moxibustion should also

33

NAJOM
be applied on points like CV6 and ST36 to disperse the fire
and draw the excess downward. In this way, balancing the
top and bottom is encouraged, and this is a principle worth
bearing in mind for all moxibustion treatments.
(March 1998, Translated by Stephen Brown)

References and Notes

1. Shirota Bunshi, Sawada-ryu Monjo - Shikyu Shinzui
(Sawada Style Oral Teachings - The True Essence of
Acupuncture and Moxibustion Therapy), Ido-no-Nippon Co., 1978, p 266.
2. Ibid, p. 251.
3. Fukaya Isaburo, Kadenkyu Monogatari (Stories of
Family Moxibustion Secrets), Sankei Press, 1982, p 51.
4. Hongo Masatoyo, Shinkyu Chohoki (Treasured Record of Acupuncture and Moxibustion), originally published in 1718, reprinted by Ido-no-Nippon Co., 1959,
p 128.
5. Ki ascends and strikes the eyes .
The character for strike is Chong
of the Chong Vessel. Thus it
means there is an inversion of
Yang Qi which rises up to the
eyes.
6. Four Flowers - These are traditional moxibustion points said
to be effective for all respiratory
diseases. They are generally
treated together with the Kanmon points to treat a total of six
Fig. 6
points (Fig. 6).
7. F u k a y a I s a b u ro , K a d e n k y u
Monogatari (Story of Family Moxibustion Secrets),
Sankei Press, 1982, p 19.
8. Gaohuang - Pronounced Koh Koh in Japanese. Above
Gao means above the diaphragm, and below
Huang means below the Heart.

34

Practical Moxibustion Therapy (13)

Mini-cautery Moxibustion: how to minimize burning
and scarring
My moxibustion treatments often consist primarily of
multiple cones of direct moxibustion. One major reason
for this is that the chief complaint of many of the patients
I see is muskulo-skeletal problems or pain. The benefits of
multiple cone direct moxibustion is that it promptly reduces the pain, and its effect is such that sometimes both the
patient and I am surprised. It is extremely satisfying and
validating as a practitioner when a patient comes in with so
much pain they can barely move, and then they head home
in smiles after getting relief with multiple cone moxibustion. Repeated successes with multiple cone moxibustion
have given me great confidence in moxibustion therapy
and has further increased my interest in it. Thus multiple
cone moxibustion has become an indispensable tool for
acute pain. I use it without fail and get great results.
Even though I apply multiple cones of direct moxibustion, I use a bamboo tube developed by Fukaya for reducing the heat sensation so the patient doesnt feel much heat.
Recently I modified this bamboo tube so that the heat sensation is reduced even more. In this way I devised a way to
prevent burns, and this has become my favorite method. In
the past I used methods such as the 80% technique where
the cone is removed after it is 80% consumed - as soon as
the patient feels the heat. Also I tried applying very small
cones and pinching it out as soon as the patient felt the
heat. Even if the heat sensation was minimal with these
methods, a stinging sensation seemed to remain for a long
time afterward and I never really liked this approach. Instead it seemed that the strong heat sensation of rice grain
sized direct moxibustion - which seems to penetrate right
through the skin - was preferable because one could feel the
refreshing after-effects of the body warming up and becoming lighter. I actually have a few macho patients who go to
sleep and start snoring even as I apply this type of direct
moxibustion. The first experience of cautery moxibustion
can, of course, be quite painful and can make you jump.
Once you become used to the heat, however, it can actually
become a pleasant sensation. This is the mystery of moxibustion. The primitive stimulation of heat on some level is
very compatible with the body. This is why a person can
learn to endure this primitive and simple stimulation even
when the temperature is extremely hot.
The point I am trying to make is that, a wishy-washy
heat sensation can be most irritating and can leave a bad
aftertaste. Be that as it may, those who are new to moxibustion tend to be afraid of it. Large cones produce a stronger
heat sensation, so cautery moxibustion using rice grain
sized cones is not a good idea. Acupuncture and moxibustion must be painless and comfortable especially for children and patients who are receiving these treatments for
the first time. Simply speaking, comfortable stimulation is
the key for getting the sick body to change direction toward
health.
I apply moxibustion on my own children, but no matter how small I make the cones, they dont like the ones

NAJOM
that cause a sharp burning sensation. One can use the 80%
technique in which the cone is pinched out before it burns
completely. However, the timing is difficult because the
burning cone must be extinguished the instant heat is felt.
Heat stimulation is rarely uniform and therefore it is hard
to assure a comfortable heat sensation each time. It takes a
lot of practice to perfect this technique.
In order to consistently apply a more uniform and lower
level of heat stimulation, I came up with the idea of shortening Fukayas bamboo tube for reducing heat sensation.
In the past Isaburou Fukaya used a bamboo tube 4cm long
with an inside diameter of 15 - 16mm as the A type tube for
light pressure which he used for points on the arms and
legs. He also used the
B type tube for strong
pressure, which I had
been using. It is 12cm
long with the same
inside diameter, but
one end is closed (by
the joint of the bamboo). My improved
tube is a combination
of these two types.
T h e l e n g t h i s 11 12cm and about 2.5cm
from one end there
is a joint that closes
the tube off (Fig. 1).
Either end can be
used to press over the
improved
type A
type B
burning cone of moxa
tube
t o re d u c e t h e h e a t Fig. 1 bamboo tubes for reducing heat
sensation.

sensation
When the short
end of this improved tube is used to press over the burning cone, moxibustion can be applied with very little heat
sensation, and burns are kept to a minimum. When the
conventional half rice grain sized cones are applied this
way, just three cones produces a burn no more severe than
a sunburn with no blister forming. Occasionally there
are people with very fine skin who do get a blister. These
people are the exception, and there is no problem when doing direct moxibustion like this if you explain to them in
advance: You may get a small burn like a sunburn, and a
small blister may form but dont worry because it will heal
quickly.
The trick to using the short end of the improved tube
is simply to press firmly over the moxa cone after it burns
halfway. The volume of air in the short end of the tube is
small that the cone of moxa quickly goes out. The moxa
material next to the skin remains unburned, and this can be
visually confirmed. The rapid extinguishing of the moxa
cone keeps the heat sensation to a minimum and, since the
cone is not removed or pinched out, a very small burn is
created without discomfort. This is what is different about
using a tube compared to the conventional 80% technique
or chinetsu kyu (heat sensing moxibustion: The size of the
cone varies but in this paper chinetsu kyu refers to direct
moxibustion where the cone is removed as soon as the pa-

tient feels heat.)

In addition to the improved tube, I have devised a convenient moxa
rolling method. I use
two small pieces of wood
10 - 11cm long, 7 - 8cm
wide, and 0.8 - 1cm thick.
I place a piece of moxa
the size of a small bean
or larger between these
pieces of wood and roll Fig. 2 - moxa rolling method
the moxa by moving the
pieces of wood back and forth. This produces thin stringlike strips of moxa material (Fig. 2). These strips of moxa
can be rolled to any thickness desired, and it is far more
even and softer than rolling moxa between the thumb and
index finger. Breaking small pieces off these thin strips of
moxa makes it possible to fine tune the level of heat stimulation.
I originally devised the improved bamboo tube to use
the short end on my own children. I thought it would take
the place of chinetsu kyu, but I found that using the short
end of this tube was far superior to the 80% technique or
chinetsu kyu. The first advantage is that there is no sharp
burning sensation. The second advantage is that it produces a small burn (first degree burn). Thus the effect of
cautery moxibustion can be obtained to some extent. This
is why I have named this technique mini-cautery moxibustion. Below, I will present three case studies in which I
used mini-cautery moxibustion.

1. Childrens cold
My own children - two boys 9 and 6 years old
This spring both my boys caught a cold and they began
to cough a lot. My nine year old caught the cold first and 4
or 5 days later my six year old caught it.
Treatment: Three cones of mini-cautery moxibustion
on CV12, LU5, GV12, BL13, and ST36 for three consecutive
days. Both boys got over their colds after three days.
Comments: Generally it is difficult to do direct moxibustion on children. They become afraid and wont listen even
if you try to explain it to them. My children dont have this
fear because, from a very young age, they have seen me applying moxibustion on my patients and I use moxibustion
on my family every time I have a chance. Once children
are around ten years old, they will let you try moxibustion
on them once or twice if you carefully explain to them and
demonstrate on yourself first. Mini-cautery moxibustion is
very useful on such occasions.
2. Neuralgia in the right arm
49 year old female
When returning to Canada from Japan on January 29,
1988, she carried a heavy suitcase for a long distance developing a pain between her right shoulder and elbow. For the
previous two days, her arm hurt so badly that she couldn
t even turn a door knob. There was pain during the night.
The previous winter she suffered with similar symptoms in
her left arm. She always feels a stiffness in her shoulders.

35

NAJOM
First Treatment - Feb. 9: The painful areas are shown
in Fig. 3. It was swollen above and below the elbow joint.
Using 40mm, No. 3 stainless steel needles, I needled tender
points to a depth between 0.5 and 0.8cm and retained the
needles with the patient seated. Then I applied between
four and seven cones of half rice grain size mini-cautery
moxibustion on the remaining tender points shown as dots
on the figure. I then gave shiatsu around the right shoulder
with the patient lying on her left side. I finished up with
shiatsu in the prone position pressing along the spine on
the Bladder meridian and
down to her feet.
Second Treatment - Feb.
18: No more pain at night
following the treatment. I
repeated the same treatment. The treatment points
were the most tender points
in the areas shown in Fig. 3.
These were not the same as
the first time. I only applied Fig. 3
three c o n e s e a c h for the
Painful areas in right arm
mini-cautery moxibustion.
Third Treatment - Feb. 25: Her arm
was not painful if not used. When she
did use her arm, the forearm would
begin to hurt after a while. In addition
to the same areas as the previous treatment, I retained needles and then applied mini-cautery moxibustion on the
anterior shoulder (Fig. 4).
Fourth Treatment - March 6: Strong
neuralgia-like pain in the right elbow.
Same treatment.
Fifth Treatment - March 10: Many
tender points appeared from the right
interscapular area to the posterior side
of the forearm. Swelling above and
below the elbow. Same treatment as before. Needles retained and then minicautery moxibustion applied at the tender points.
Sixth Treatment - March 17: The pain has eased since
the last treatment.
Seventh Treatment - March 25: She is able to turn door
knobs.
Eighth Treatment - March 30: She felt more spontaneous pain, but pain would sometimes arise when she carried
something, and if she strained her arm there would be a
sharp pain.
Ninth Treatment - April 15: Almost no pain. Sometimes
she feels rigidity when sleeping.
Tenth Treatment - May 21: No pain since the last treatment. Stiffness in the shoulders has gone and there are no
tender points. I decided to conclude this series of treatments.
Comments: Pain at night went away after the first treatment. The painful area moved around a lot in the anterior
shoulder, right elbow, right interscapular region, posterior
side of forearm, and above and below the elbow. I focused

36

on the area of pain each time and selected the most tender
points and retained needles shallowly and would follow
this up with three cones of mini-cautery moxibustion. So
these treatments were thorough tender point treatments
from beginning to end. The number of points treated were
numerous because I covered all the painful areas, but minicautery moxibustion rarely causes a burn so it was possible
to use moxibustion on different points each time.

3. Osteoporosis
84 year old female
On March 10 of this year she had a sudden attack of
pain on the right back at the level of T10 and T11 and the
right ribs and flank region, and was unable to move. The
pain was so severe she had difficulty sleeping at night. I
paid her a house call on March 11
and attempted to give her acupuncture and moxibustion, but the pain
was so bad she seemed beyond my
capacity to help so I told her to seek
care in an emergency room. She
was under the care of a doctor for a
month after that, but her pain was
not relieved. The diagnosis was osteoporosis.
I began giving her treatments
from April 10, applying only minicautery moxibustion on the tender
points. With the patient seated
I applied sesame sized cones on
the tender points as shown in Fig.
5. These moxibustion treatments Fig. 5 Moxibustion
lasted a little less than twenty min- on tender points on
utes. She was hopeful because she the back
got relief after treatment to the time
she went to bed. I gave her a
total of 27 treatments between
April 10 to May 23. On April 16
she reported that getting up in
the morning was much easier.
On April 18, however, she had
an attack of neuralgia-like pain
reaching to the right flank region. This pain disappeared after
four moxibustion treatments of
tender points. She was thus able
to sleep through to the morning,
but no sooner than she would
get some relief, the neuralgialike pain would reappear on her
left flank region. I treated the
tender points shown in Fig. 6,
and gave her treatments for three
consecutive days, and this pain too was alleviated.
In this period, however, another pain appeared in her
left shoulder region, on the rotator cuff along the Triple
Warmer meridian on the posterior aspect and along the
Lung meridian on the anterior aspect. I applied the same
tender point treatment for this shoulder pain and after
three successive days of treatment, this pain also subsided.

NAJOM
By May 4 sleeping
was no longer a
problem, and even
when her back or
shoulder started to
hurt, it would go
away immediately
with some rest. In
t h i s w a y, b y m i d
May, she was able to
take care of herself
living alone, and she
had enough energy
to go visit friends in
rest homes.
The photograph
was taken on May
19, but we are controlling the pain
from osteoporosis by
continuing regular
mini-cautery moxibustion treatments.

4. Conclusion
This approach of finding Ahshi points wherever there
is pain or stiffness and applying mini-cautery moxibustion
on as many points as necessary may seem rather excessive.
When such treatments are continued, however, not only are
the symptoms relieved, but the root of the pain can be located and treated as the symptoms shift around. Thus the
whole area of pain can be guided toward normalization.
As I have said before, conventional direct moxibustion is
very effective for structural abnormalities and degenerative changes which do not respond to any other treatment.
Mini-cautery moxibustion, in addition, does not leave ugly
scars and the minimal heat stimulation makes it ideal for
sensitive or weak people such as some women, children,
and old people. The primitive heat stimulation of moxibustion seems to be perfectly matched to the natural healing
mechanism of the human body.
(July 1998, Translated by Stephen Brown)

Practical Moxibustion Therapy (14)

Aging Patients and Moxibustion Therapy
Introduction
It has already been six years since I moved from Toronto
to Vancouver and opened my clinic. In these six years the
age group of my patients has shifted dramatically. For example, among the 164 patients I treated in August 1998, 77
were over 65 (senior citizens) or 47% of the total number
of patients I treated. Among these 77 elderly patients, 18 or
11% were over 80 years old.
In this way my practice is being washed by the waves
of an aging society. This may be due in part to the large
numbers of senior citizens living in Vancouver, a city that
is known for its mild weather. It also shows how acupuncture and moxibustion have grown in popularity. This is a
welcome development for a practitioner like myself. When
a patient population becomes elderly, however, those of us
who treat them must adjust our treatments accordingly. So
in this article, I will first comment on observations I have
made in treating elderly patients, and then give a few case
histories.
Treatment of Elderly Patients
The first point in treating elderly patients is to try to
match the treatment to their physical capacity. Even if
symptoms may indicate excess and a patient is plump and
has a lot of muscle tension, physical strength does generally decline as one gets older. I do quite a bit of acupuncture
on elderly patients and naturally I increase the amount of
moxibustion to strengthen their bodies. If the symptoms
indicate deficiency, or a patient is recovering from an illness or has a weak constitution and a tendency to become
chilled, I inevitably lean toward moxibustion. Of the abovementioned 77 patients, I gave treatments of moxibustion
or a combination of moxibustion and other therapies to 76.
One patient received only shiatsu.
In a nutshell, the advantage of moxibustion as I have
said before is that it improves the circulation and the functional capacity of blood and thereby greatly aids the regeneration of tissue. Degenerating tissue and malfunctioning systems are thus restored. This means that it has the
remarkable effect of restoring youthfulness. There is no
medicine anywhere which has an effect like this, and that is
why moxibustion is ideal for elderly patients.
The tissues and functional capacity of the human body
generally begins to decline from around the age of 35. The
vitality of a person who is 35 is substantially different from
someone who is 65. If they were to get the same disease, the
younger and stoutly built person should recover quickly,
and the older and frailer person could require a long time
to recover. For young people, often it is just a matter of using an antibiotic to kill the germs and the body takes care of
the rest and recovers quickly. It is not so simple for elderly
people. Even if the germs are destroyed, it may take a long
time to recover because the body may not have a reserve
strength. On top of this, antibiotics tend to diminish the
bodys natural healing ability. This is why it is important
in the treatment of elderly patients to increase their vital-

37

NAJOM
ity. This is where the effect of restoring youthfulness of
moxibustion comes into play.
I have been talking in generalities, but speaking more to
the point, for those of my elderly patients who are robust,
I give moxibustion treatments combined with acupuncture
or shiatsu. For those who lack vitality, I give only moxibustion. Moxibustion can even be applied when a patient has
a slight fever. I apply moxibustion on points like ST36 and
GV14 for patients with temperatures of up to 38oC. There
is no danger in moxibustion as long as you pay attention
to the physical capacity of patients and give them only as
much stimulation as they can handle. Furthermore, there is
no danger in giving moxibustion to patients while they are
on medications.
It is difficult, however, to gauge the level of vitality and
the appropriate level of stimulation in the first treatment
so, for elderly patients especially, I start off by reducing the
stimulation at about 50%. This is to avoid healing reactions
as much as possible. Even when a healing reaction does
occur, young patients recover in less than three days. In the
case of elderly patients, however, recovery is prolonged
and sometimes may take up to a month. Such a long setback is more than a healing reaction; it can be considered a
consequence of incorrect treatment.
Although at first, less is better, in the case of elderly
patients, the more often they receive treatments the better.
As a rule, I have them receive moxibustion once a day for
a month and a half. This first course is for the purpose of
relieving the symptoms, but treatments must be continued
for 3 to 6 months to increase vitality and improve their
functional ability. Sometimes, when pain is severe, I have
them receive moxibustion twice a day. As for the size and
number of cones, I generally apply 3 to 5 half rice grain
sized cones using the mini-cautery method I discussed in
the last issue, and otherwise I consider 3 cones of the half
rice grain sized cones to be appropriate stimulation. The
number of points for local treatment varies from 3 to 10,
but for patients who need overall strengthening, I do these
local points in addition to the standard Sawada Style points
(see NAJOM Vol. 5 No. 2, November 1995; pp7-8).
My moxibustion treatments need to be applied frequently, so they end up becoming principally home treatments. I
have the patient come in once every week or two to check
the points and suggest changes in the number of cones. For
home treatments of points on the back, the cooperation of
family members becomes necessary. Therefore I convince
the patient and their families of the importance of moxibustion, and teach them the mini-cautery method, and have
them actually practice it themselves in my clinic. I get a
family member to observe the first treatment, and I explain
what I am doing as I treat the patient. In subsequent treatments, I have them help me apply the moxibustion so they
get the hang of it. After this they start home treatments, but
I always warn them of one thing. That is, When I apply
moxibustion the heat is mild and it feels good but, when
beginners first apply moxibustion, it is very hot. Unless
I impress this on them, a family squabble is liable to occur,
and they will not continue the moxibustion treatments and
all efforts will come to nothing.

38

Case History 1
69 year old female
I had been giving this woman shiatsu since May of 1995
for her low back pain. She had a great deal of stamina
and did a lot of cooking as a volunteer. Her back pain was
almost gone after regular shiatsu treatments every other
week, but she enjoyed the treatments so she continued
coming. In January of 1997 she complained of pain above
and below her right knee. The pain occurred whenever she
sat down or stood up from a chair. One week later, after she
returned from a trip, her knee was quite swollen and felt
warm to the touch. It was not so painful
that she couldnt walk, but it seemed like
the early stages of osteoarthritis. Even so,
when she came for treatment on February
3, I only gave her a shiatsu treatment because she didnt like the idea of moxibustion.
Feb. 14: The pain in her knee got so
bad she had difficulty walking, so I convinced her to do home moxibustion treatments. I located points and applied moxa
and taught her the technique. I applied
seven cones each on seven points (Fig. 1).
Feb. 21: Her pain was greatly relieved.
Feb. 28: She is able to go down stairs. The swelling is
down 70 to 75%.
March 7: Only 15% left to go on the swelling.
March 17: Both pain and swelling are gone. I told her to
discontinue home moxibustion treatments.
Subsequently the knee pain recurred occasionally, and
each time she came in for moxibustion (five or six times). It
almost completely healed after that and she enjoys an active life. About a year later, she complained about a corn
on the little toe of her right foot, which was very painful
when she golfed. I had her apply five rice grain sized cones
directly on the corn everyday at home. When she returned
for her biweekly treatment, the corn had hardened so I
shaved it off with a knife after the shiatsu treatment. I did
this about four times, and the corn all but disappeared by
the end of June.

Case History 2
88 year old female
First Treatment - Sept. 25, 1997: Her main complaint
was pain and numbness in the right hand since around
September 1996. She could not flex her fingers. Also, there
was pain with movement in the right shoulder, numbness
in the right leg and pain in the right ankle, which made
walking very difficult. It took her about 30 seconds to
hobble just five meters. Putting cloths on and taking them
off was also difficult. She was hard of hearing and it was
difficult to talk with her, but her mind was sharp. At first
sight, she looked very frail and it seemed that if she caught
a cold it could turn into pneumonia and she might die. I
was a little worried about taking her on as a patient, but I
got a favorable impression from her speech which was very
clear. So I got her to promise that she would give herself
regular home moxa treatments, and I agreed to go for a

NAJOM
long balloon. Even so, she was able to flex her right elbow
a little. Yet she still wanted to continue with her moxibustion treatments, so I located points around the shoulder and
the elbow, which was swollen, and burned one cone each
and repeated this for three rounds. When I went to see
her on September 23, the swelling was 50% better and she
could move her upper arm about 20 degrees. The patient is
very hopeful, saying it is just a matter of a few more weeks
before she is healed.

Fig 2

housecall once a week. The points I selected were several

Ahshi points in addition to standard Sawada Style points
(Fig. 2).
The dosage was three cones of sesame sized cones, but
I increased the number of cones to five after about three
weeks. With this it took a little less than an hour for her to
do the moxibustion treatment.
I only saw her once a week so I didnt have any idea
how long it would take her to get relief, but as long as she
didnt give up, I decided to look after her to her deathbed
if need be. This patient had lost her husband and had
no children and was living alone on the second floor of a
house owned by a distant relative. She had firmly resolved
not to become dependent on anyone as long as she was able
to move her body even a little, and I wanted to help her in
any way I could.
In late March, at the time I gave the 25th treatment, I
measured how long it took for her to climb from the first to
the second floor. Before it took her more than two minutes
to drag herself up one step at a time. This time it only took
her about one minute. Her walking pace was also twice as
fast as before.
In May, I was surprised to learn that she had started to
go shopping to the corner store which was about 70 meters
away. By this time she complained less about pain and
numbness. In June, she had enough strength and resolve to
go to the ophthalmologist, and in July she went to the dentist on her own. In August she could bend the fingers in
her right hand completely, and was able to cut her toe nails
herself.
I had been seeing her for almost a year, and I was beginning to feel confident that she would be able to continue
living alone free of pain and numbness, even with some difficulty. On September 9, however, she lost her balance and
fell when she was reaching for something, and she cracked
her right scapula. The pain was so bad she could not make
any movements involving her right shoulder. Also her
right arm from the shoulder to the wrist was swollen like a

Case History 3
94 year old male
July 30, 1998: This patient almost fainted and fell down
with something like cerebral anemia, and he hit his right
hip very hard. The pain was so bad after that he had to
remain in bed. He came to my clinic with the assistance of
family members. The pain was so intense he couldnt even
move enough to have x-rays taken. He hadnt had a bowel
movement recently, which he used to zhave every day. His
family member explained that he was dispairing that he
was going to die.
His pulse was flooding and large, and his abdomen
was rigid like a board. His hearing was very poor, but he
was mentally alert. For treatment I retained No. 3, 50mm
needles shallowly with the patient prone (Fig. 3). The
needles were retained for ten minutes. After that I applied
20 half rice grain sized cones of moxa on the circled points.
His pain had diminished, so I had him lie face-up and concluded by treating the abdomen with some acupuncture
and moxibustion (ten half rice grain sized cones: Fig. 4).
To relieve his constipation, I had him take home a two day
supply of guizhi jia shaoyao dahuang tang.1 After the treatment, the pain had become much better, and the patient
began walking nimbly, so the family members were greatly
relieved as they accompanied him home. Since the pain
was gone all day, the patient spent the afternoon tidying up
his room. The next day the pain came back again and he
was laid up in bed.

Fig 3

Fig 4

39

NAJOM
August 1 to 3: He came for treatments three days in a
row, but there was no change in the pain. He also had no
appetite and sitting brought the pain out so he remained
in bed. On August 3, however, he had used a suppository
which relieved his constipation, so he was feeling a little
better. I had him start taking xiao jianzhong tang with 3
grams of renshen (ginseng) added.2
August 5: His pulse was flooding, large, and tight. I
treated him using more moxibustion. I had his family
members start giving him home moxibustion treatments.
The points used are shown in Figure 5.

Fig 5

August 7: The flooding pulse was softer and also his

abdomen had more resiliency. After this treatment, he had
natural bowel movements four days in a row, and he was
pleased about that. His appetite returned and he started
eating brown rice.
August 10: Tender points showed up along the sciatic
nerve on the right side. He still could not sit up without
pain, so he ate in bed. I added the four moxibustion points
BL30 and 35 as well as Jousen.3
August 13: He still had a lot of pain when standing up.
There was also strong pain with movement. I added moxa
points on the Huato Jia Ji at the level of BL22 and 23.
August 18: There were less tender points. He said the
pain was better.
August 28: His walking pace became surprisingly faster.
I add moxa points at GB33 and SP6.
September 12: The patient said he can walk for about
two hours if he uses analgesic suppository Fig 6and a walker. There were no tender points in the low back, but he said
the lumbar area felt stiff. I retained some needles shallowly
and applied moxibustion. Treatment points were palpated
evenly on both sides of the lumbar region. (Fig. 6)
September 19: Patient could walk for two hours without a suppository.

40

September 24: Patient was able

to walk for two hours with only a
cane. He complained of numbness
in the right little toe and discharge
of excessive phlegm from his throat
and sinus, but the low back pain was
gone and he could sit and eat with
his family. His condition was stable
with regular bowel movements everyday.

Conclusion
The first case history is about a
patient who applied moxa on herself
to heal arthritis in the knee and help
remove a corn. This case shows how,
if there are no internal diseases and
only muskulo-skeletal problems in
the arm or leg, using only moxibustion it can almost be taken care of by
oneself. The second case is an example of a very old patient, 88 years old
Fig 6
and in poor physical condition, who
recovered to a point of being able to
take care of her own daily needs after weekly moxibustion
treatments over a long period. The third case is an example
of how daily moxibustion treatments by family members
got an extremely aged patient who was bedridden to return
to a normal life. In this last case, every member of the family took turns giving the patient moxibustion treatments.
Each case is evidence that when moxibustion treatments
patiently applied over a long period it has an effect far beyond Western drugs. In the last two cases especially,
patients recovered in a relatively short period which
seems impossible in terms of Western medicine. Moxibustion unlike Western drugs takes time, but it does not create
a drug dependent patient. In addition, it can be applied at
home safely and inexpensively. Furthermore, moxibustion
not only is effective as therapy, but serves to prevent senility. Therefore I am convinced that it is the ticket for home
care which is on the increase with our aging society.
Notes
1. Guizhi jia shaoyao dahuang tang - 4g. guizhi, 4g. dazao,
6g. shaoyao, 2g. gancao, 1g. ganjiang, 1g. dahuang
2. Xiao jianzhong tang jia renshen - 4g. guizhi, 4g. dazao,
6g. shaoyao, 2g. gancao, 1g. ganjiang, 3g. renshen, 20g.
jiaoyi
3. Jousen - same as the extra point Shiqizhuixia (M-BW25)
between the fifth lumbar vertebra and the sacrum
(November 1998, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (15)
Since the beginning of NAJOM until now, I have written
a series of fourteen articles on moxibustion therapy. These
were written one by one based on my impressions from
my limited clinical experience and what I had learned from
my patients. There is probably nothing like this record of
experiences with moxibustion published in English before.
Many readers found these articles interesting, but some
readers may have been confused by the articles because
I wrote them in a empirical and unsystematic way. Perhaps as a sign of this, recently I have been getting inquiries
from readers. Some of the questions have already been
answered in the last fourteen articles, but there are other
questions which had never occurred to me. I am amazed
that there are so many different ways of looking at this subject, and have been seeking answers with some curiosity. I
will write this article as an answer to some of the inquiries I
have received.

Question 1
From the inquiries I receive, it is apparent that many
of our readers are avoiding direct moxibustion. The first
reason is that patients do not like it, and the second reason
is that many practitioners are not confident about direct
moxibustion. In the latter case, people seem to be giving
moxibustion treatments by applying chinetsu-kyu (sensing
heat moxibustion) 1 and string-like moxibustion.
The inquiry I received was, without the scarring, does
the effect on the blood, especially (raising) white blood cell
count still occur?
You may think that chinetsu-kyu and string-like moxibustion do not cause burns or scarring, but this is not true.
It may not show up as much because the amount of heat
is small, but the skin is burned, although ever so slightly.
It is probably less than whats called a first degree burn in
Western medicine, but when two cones of chinetsu-kyu
are burned more than 80%, a brown coloration appears the
next day. This burn is no more than a mild sunburn so that
it quickly fades away and there is no problem but, if moxibustion is applied on the same point repeatedly over a long
period, a scar will eventually form.
That is why even in non-scarring moxi-bustion there is
an effect on the blood, but the amount of heat stimulation
is low so the effect is small. Therefore, non-scarring moxibustion has to be applied over a long period to have this
effect. No matter how small the amount of stimulation, the
effect depends on the number of cones and the duration of
treatment, and the size of the cone will also have an influence. Further, the size of the cones applied depends on the
size of the patient as well as whether they are excess or deficient. In giving moxibustion treatments, therefore, these
factors have to be taken into account to decide the size and
number of cones as well as the duration of treatment.
It is natural that people dont want to burn the skin and
want to keep scarring to a minimum. For this purpose I
recommend using mini-cautery moxibustion 2 and shiunko3
(Purple Cloud Ointment) as much as possible. Indirect
moxibustion, of course, does not produce scars but it has its

own effects which are completely different than direct moxibustion, so it does not serve as a substitute. I have used
indirect moxibustion such as salt moxibustion and press
moxibustion quite a bit, and for more information on these
techniques I would have you refer to my article in the, November 1995 (Vol. 2, No. 5) issue of this journal.

Question 2
Another inquiry I received asked, Ive noticed that doing direct moxa on ST36 seems to either cause constipation
or sluggish bowels. Is this a common reaction?
This could be possible. ST-34, which is two units above
the top of the patella, according to Bunshi Shirota4 requires
particular caution because it is a famous point for stopping
diarrhea, so continued moxibustion is likely to cause constipation. Once the diarrhea has stopped, it is better to discontinue moxibustion (on this point). If (the patient) gets
constipation, apply moxa on HT7 of the Heart meridian
because HT7 is a famous point for curing constipation. 4
ST36 is quite close to ST34 so they could have a similar
effect. I have not had any experience of causing constipation with moxibustion on ST36, so I think it is a rare phenomenon. The reader who asked this question has been
applying direct moxi-bustion on ST36 for almost seven
years. And he said that the heat no longer feels so strong.
The sensation of heat is different from ordinary pain, and
it is a sensation that is easy to get used to. It is funny how
the heat feels painful almost because people think that it
s going to be painful. In practice, however, even when the
amount of heat is considerable, people tend to get accustomed to it. It is curious how the heat sensation actually
feels good when you become used to direct moxibustion.
Some of my patients prefer the strong heat sensation, and
even fall asleep and snore in the middle of treatment.
This is paradoxical, but very much in line with Oriental
medicine, that the burning sensation actually relaxes the
patient. This response of the body should be construed
as a normal response. Patients who experience great
pain even with small pieces of string-like moxa are either
hypersensitive or their nerves are over excited. On the
other hand, just because a patient doesnt feel much heat,
it doesnt mean the moxibustion treatment is ineffective.
It could simply mean the body has become accustomed to
the heat, so there is no need to indiscriminately increase the
size of the cones.
Question 3
The questions from another reader were, Can you use
this (mini-cautery moxi-bustion) as a muscular skeletal
treatment on people that have internal heat or Yin Deficiency? And, Do you use this mini-cautery moxibustion on
points that are on the inner arm (e.g. PC6)? And further,
Is this (mini-cautery moxibustion) the treatment of choice
when you have pain that is described as burning, or is it
only appropriate when the pain is aching, numbness, or
feelings of cold?
This reader said she had been taught that moxibustion
was contraindicated for internal heat or Yin Deficiency and
localized pain accompanied by a heat or a burning sensation. This concept probably came from Traditional Chinese

41

NAJOM
Medicine, but the heat of direct moxibustion cannot be understood merely in terms of the simple treatment principle
of when there is heat, reduce the heat, and warm when
cold. Furthermore, it cannot be said that, since moxibustion is heat stimulation, it can only be used for tonification.
The condition of Yin Deficiency is one where Yin Fluids
are lacking, so actually it is a condition of nutritional deficiency, or otherwise a lack of vitality in the function of Yin
or internal organs. In cases like this there are signs such as
a sensation of heat in the chest, palm, and soles, and tidal
fever in the afternoon. In such cases the muskulo-skeletal
system is also deficient. That is, pain tends to appear. On
patients like this I typically give a whole body moxibustion treatment (Taiji Therapy 5) without hesitation. Taiji
Therapy vitalizes the Zangfu, improves digestion, and
increases physical strength so that the Yin Deficiency goes
away. There is no medicine which works this way in Western medicine, and moxibustion is the most appropriate for
patients in this condition. A simple case of Yin Deficiency
can be treated adequately by novices at home as long as
they know a little about Taiji Therapy.
As to the question about moxibustion on PC6, the
moxibustion master Isaburo Fukaya applied what he
called pierce through moxibustion on patients with joint
inflammation like rheumatism. 6 This is because when
moxibustion is applied to the local area on patients with inflammation, rather than reducing the pain it is exacerbated.
Fukaya said that the secret in such cases was to apply pierce
through moxibustion or to treat distal points which are
on opposite sides of the limb. Some examples of pairs of
points for pierce through moxibustion are St34 and Sp10,
Sp9 and GB34, Li9 and GB32, Li6 and GB35 for inflammation in the knee; GB39 and Sp6 for inflammation in the
ankle; PC6 and TW5 for inflammation in the wrist. (Fig. 1)
It should be clear from this that there is no problem in

GB39

Li9

Sp10

Sp10

GB32

St34

St34

Sp9

GB34

Li6

GB35

SP6

PC6

Fig. 1

42

TW5

applying direct moxibustion on PC6, and as long as you

use common sense in selecting the points, there are very
few points contraindicated for moxibustion.
In cases of inflammation where there are areas with
swelling and or heat, distal treatments like pierce through
moxibustion must be applied. Another approach is to
apply one tiny cone of string-like moxa about every centimeter around the perimeter of the inflamed area. As the
inflamed area shrinks, repeat the same treatment by applying one cone of string-like moxa every centimeter around
the smaller inflamed area. As you repeat this treatment, the
inflamed area will become smaller and smaller. This approach is effective for redness and swelling from sprains as
well as for arthritis with a lot of swelling.
This string-like moxa around the perimeter of the inflamed area is even more effective when adjacent tender
points are treated. Anyway, it cannot be said that direct
moxibustion is contraindicated for localized pain that feels
hot or is described as burning. Instead, the skilful use of
moxibustion immediately improves the circulation to facilitate absorption and reduce the inflammation.
Also, even when there is a fever, if the temperature is
under 38 oC, moxibustion is not harmful as long as the patient is not in a weakened state. Applying twenty to thirty
cones on GV14 for multiple cone moxi-bustion, is good
for the early stages of a cold; the body warms up and the
cold often goes away immediately. Even when there is a
fever, moxibustion on GV14 is very useful for drawing the
heat down. So direct moxibustion can be applied on GV14
even for high fevers. I also apply moxa on ST36 when there
is a fever; it almost seems necessary for raising the energy.
Moxibustion originally came from China, but it seems
that in Traditional Chinese Medicine, it is considered to be
little more than simple heat therapy. Very little direct moxibustion is practiced in China anymore and, even if you look
for it in Chinatown, you cant find high grade moxa for
direct moxibustion. In Japan, when people say moxibustion, the first thing you think of is direct moxibustion. It is
my impression that the original moxibustion methods have
been preserved in Japan, while in China moxibustion remains little more than a name or a minor category of treatment.

Notes
1. Chinetsu-kyu: NAJOM Vol. 2, No. 5, November 1995, p.
32.
2. Mini-cautery Moxibustion: NAJOM Vol. 5, No. 13, July
1998, p. 23.
3. Shiunko (Purple Cloud Ointment): NAJOM Vol. 1, No. 2,
November 1994, p. 22.
4. Shirota Bunshi, Shinkyu Chiryo Kisogaku (Essential
Study of Acupuncture and Moxibustion), Ido-no-Nippon, 1941.
5. Taiji Therapy: NAJOM Vol. 5, No. 13, July 1998, p. 7-8.
6. Pierce Through Moxibustion: Fukaya Isaburo, Okyu
Ryoho no Jissai (The Actual Practice of Moxibustion
Therapy), Midori Shobo, 1977, p. 157.
(March 1999, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (16)
Examples of Point Selection

There is no set pattern to my treatments. I also think it

would be hard to formulate my treatments. If I had to explain the approach I use, I primarily use Taikyoku Therapy1
for chronic and difficult cases, and for acute cases I give
treatments combining Ahshi points and reactive points on
related meridians. I decide which points to use when the
points that come to mind and the points that I find by palpation match up. Otherwise, for certain conditions I use
special effect points from the start.
The basic points I use for Taikyoku Therapy are the
standard points of the Sawada Style including CV6 and
12, GV12 and 20, LI11, ST36, KI6, BL17, 18, 23 and 52. Of
course I do pulse and abdominal diagnosis, but these are
for judging the physical strength of the patient, and for
deciding the amount of stimulation, and also to find out
whether the patients strength has increased as a result of
treatment.
Since my treatment principles are so simple, sometimes
I refer to the point selections of respected teachers and use
them. I sometimes find myself nodding my head at their
point selection, because they seem so typical of moxibustion therapy and it feels like they would indeed be effective.
I find these point selections very useful, so in this article I
will give some examples of point selections from Bunshi
Shirota and Isaburo Fukaya drawn from their books.

Common Cold
a. symptoms in early stage (headache, chilling, nasal discharge, sore throat, sneezing, etc.)
Shirotas Point Selection (hereunder simply Shirota): 15 to
20 cones on GV14 & 12, and BL12. Often this cures the cold.
Fukayas Point Selection (hereunder simply Fukaya): 20 to
30 cones on GV14. After this treatment the muscles of the
back feel warmed up, nasal discharge stops, and breathing
becomes easy.
b. high fever
Shirota: 20 cones on SI3.
Fukaya: Multiple cones on GV14.
c. coughing
Shirota: KI27, LU5, GV12, BL12 & 11, GV10, KI6 & 26.
Fukaya: 5 to 7 cones on GV14, BL11, 12 & 13. 5 cones on
ST13, LU1 and LI10.
d. bronchial asthma
Shirota: KI27, LU1, GV14, CV12, GV12, BL12, GV10, BL50,
LU5 and KI6.
Fukaya: 10 to 15 cones on BL17.
e. lassitude
Shirota: 10 cones on GV12, BL12, GV10, and LU5.
Fukaya: 3 to 7 cones on GB21, LI10, and ST36.
Headaches
a. early stage of a cold or fever
Shirota: GV20, Upper BL10, BL10, and GB20.
Fukaya: 7 cones on GV20. When this doesnt bring relief,
treat GV23 until heat is felt on the point. Also 5 cones on
GV15.
b. chronic headache

Shirota: GV20, Upper BL10, BL10, GB20, GV12, BL12, LI11,

GB34 and (for neurasthenia) HT7.
Fukaya: 5 to 10 cones on GV20. Also GV23, 22 & 15.
c. migraines
Shirota: Same treatment as chronic headaches, but when a
migraine attack is about to occur, 10 to 15 cones on BL7 is
effective.
Fukaya: 7 cones on GB20 & 21.

Gastrointestinal Problems
a. gastric spasm
Shirota: 10 cones on ST34 on both sides. When this is not
effective, treat BL50 and apply 30 cones on CV12. For prevention and general treatment use CV12 & 14, LR13, BL50
& 20, GV12, BL17, LI11, and GB34.
Fukaya: 7 cones on ST34 on both sides
b. gastritis (acute)
Shirota: Uranaitei2 - Moxibustion on this point when a person has food poisoning does not feel hot. Sometimes heat
is felt after applying more than 20 cones. For general treatment use the same points as for gastric spasm.
Fukaya: Multiple cones on Uranaitei. Sometimes heat is
felt only after more than 100 cones have been applied.
c. gastritis (chronic)
Shirota: CV14 & 12, ST19, LR13, BL20, 50, & 17, GV12, LI11,
and ST36.
Fukaya: 7 cones on the Six Points for the Stomach (BL17,
18, & 20). In the upper back tenderness and indurations
can be found at BL14 or 15 (hyperacidity), and in the lower
back reactions can be found at BL21 and 22 (gastric ulcer).
Multiple cones on these reactive points will stop the spontaneous pain, and applying just a few cones on each point
invigorates the digestive function. Also treat GB21 and
BL43 when there is stiffness in the neck and shoulders.
d. colitis (diarrhea)
Shirota: 10 to 20 cones on ST34, CV9 & 6, and ST 27. Treat
BL60 for early morning diarrhea. 20 cones on BL33 for tenesmus (urge to go after just having gone).
Fukaya: 7 cones on ST34. 10 to 15 cones on points around
navel (CV9 & 7, and points one unit lateral to navel).
e. chronic colitis
Shirota: CV12, 9 & 6, ST27, BL20, 23, 52 & 33, ST34 & 37,
LI10, BL25, SP6 & 4.
Fukaya: BL25 & 27, CV12, ST25, CV6 & 5, and SP6.
f. appendicitis
Shirota: 20 cones each on ST34 and LR8 on the right side for
acute cases. Next apply 20 to 30 cones on CV6 and then 20
more cones on a tender point about one centimeter lateral
to BL25 on the right side. For chronic appendicitis, treat
CV12 & 6, ST27, BL23, 25 & 20, GB34, ST36, KI6, and LI10.
(The author uses these points for Crohns disease as well.)
Fukaya: Multiple cones on CV6, and 10 cones on CV12 and
ST25 if the points are tender. An egg-sized induration, the
McBurney point, appears in inflammatory appendicitis.
This point can be treated with moxibustion as well. There
is no induration like this with gangrenous appendicitis, and
in these cases moxibustion is not indicated.
g. nausea
Shirota: In cases of food poisoning, apply 20 or 30 cones on
Uranaitei until the heat is felt. It is said that, with this treatment, those who need to vomit will vomit, and those who

43

NAJOM
need to have diarrhea will have diarrhea. Sometimes a patient does both, and sometimes they do neither.
For nervous nausea treat GV20 & 12, BL17 & 20, CV12 &
14, LI11 and GB34. For morning sickness treat CV12 & 14,
LR14, GV22 & 12, BL17, 20, 50 & 32, LI11, ST36 & 34 and
LR4.
Fukaya: For morning sickness apply 10 cones on CV18
and GV11 or CV17 and GV10 for pierce through moxibustion.3 There is a penetrating sensation of heat when 8
to 9 cones of loosely rolled half rice grain sized cones are
applied successively without removing the ash on these
points opposite from each other. If there is no sensation of
penetrating heat after applying ten cones, continue applying more cones. It is good if this treatment leaves a small
burn on the skin when the ash is removed.

High Blood Pressure

Shirota: For serious cases (systolic over 200, diastolic over
100) apply 3 small cones on CV9, 4 & 6, GV12, TW15, BL32,
HT3, KI2 or KI9, and GV20.
For moderate cases (systolic between 170 and 200) treat
GV9 or GV10, BL15, & 14, LI11 and GB34. For mild cases
(systolic between 150 and 170) treat the same points as
above, except add upper LR14 on the right side for those
with liver symptoms, add KI23 on the left side or CV17
for those with heart symptoms, and add BL23 and CV3 for
those with kidney symptoms. Use BL25 instead of BL32 for
those with constipation.
Fukaya: Three small cones on GB20 & 21, BL43, LI11 & 10,
and ST 36 everyday for one week. Then take a one week
break. Otherwise treat the above points every other day for
as long as possible. Also apply three cones on the bottom
of the big toe, in the middle of the crease where it connects
to the foot. If no heat is felt, apply more cones until the
heat is felt. This last point is effective for lowering the diastolic blood pressure. It is also effective for inflammation
and pain in the tonsils.
Trigeminal Neuralgia
Shirota: For neuralgia of the first branch, treat GB16, TW20,
GB5, TW22, GB12, TW17, and LI5. For neuralgia of the
second branch, treat GB20 & 12, TW22, GB5, and LI5. For
neuralgia of the third branch, treat GB12, TW17, SI19, and
LI5. Treat points on the face with acupuncture. For overall
balancing, apply moxibustion on CV12, BL23, GV12, TW15,
LI11, and ST36.
GV14
Fukaya: Do not treat tender points
on the face. Direct moxibustion on
the face can make matters worse.
Apply 7 cones each in a triangular pattern (Fig. 1) using GV14
and BL12 or GV13 and BL13. The
triangular pattern technique is
explained in detail on page 20 of
the Illustrated Guide to Fukaya
GV14
s Moxibustion Techniques by Seiji
Irie. To put it simply, it is a techBL12
nique of treating tender points on
GV13
three corners of a triangle. Tender
points appear in this pattern, not Fig. 1
BL13

44

only over the Governor and Conception Vessels, but also

on the arms and legs. Pain can be relieved almost instantly
by using this method. Lesser tender points tend to appear
in the periphery of the most tender or painful point, and
using the triangle pattern focuses the treatment area. This
method is used often in the Fukaya style for neuralgia and
joint pain.

Insomnia
Shirota: 7 to 10 cones on GV20 & 22, BL10, GV12, BL18,
HT7, ST36, and KI2. Points on the head should be treated
before going to bed.
Fukaya: Reactions appear at BL17 and GV9. Apply 20
cones on indurated or tender points. If this doesnt work,
apply five cones on GV12, 11, 10, 9 & 8. Also apply three
cones on GB20 or BL10; GB21, BL43, 15, & 17, LU4, LI11 &
10, and ST36.
Diabetes
Shirota: Always apply cones that are
smaller than rice grain size on CV12,
KI16, BL20, 21, & 23, ST36, SP8,
GV12, and LI11. Diabetic patients
are prone to get infections, so do not
use points where there is hair.
Fukaya: 7 cones each every other
day or every third day on GV7 & 6,
or on reactive points with a penetrating sensation just next to the spinous
process of the tenth and eleventh
thoracic vertebrae. GV7 & 6 should
be located as shown in Fig. 2.

Fig. 2

Conclusion
I have presented some examples of point selections from
the text books of Shirota and Fukaya styles, which I thought
might be useful. The point selection I have introduced
here is just a small portion of these texts, and it shows the
common denominator in these styles. It should therefore
be regarded as just a sampling from these styles. These
approaches are more thoroughly digested and adapted in
the actual practice of moxibustion therapy. Therefore my
treatments end up being quite different from what has been
written here. Also, since I do acupuncture, shiatsu, and
herbs in addition to moxibustion, it is not realistic to emphasize just this aspect. Nevertheless, moxibustion therapy
often serves as the trump card in the treatment of chronic
and recalcitrant cases, so it would be worthwhile if readers
could get some idea of the approach in the Shirota (Sawada)
and Fukaya styles.
The special feature of the Sawada style is the use of
points all over the body to balance the body (harmonize
the zangfu) in addition to the selection of two or three
points on related meridians to deal with the symptoms.
Many points end up being treated this way, but just this
moxibustion treatment alone is a foolproof way of gradually strengthening the body, slowing the momentum of the
disease, and eventually conquering it. It is the unique heat
stimulation of direct moxibustion which makes this possible, and I feel that the Sawada style would not exist with-

NAJOM
out moxibustion.
The Fukaya style, on the other hand, is based on the distillation of experience, and treatments for various diseases
were developed by testing the methods in the Classics.
Isaburo Fukaya took the most effective points from the
Classics as well as modern approaches such as the Sawada
style, and made them his own. He therefore uses fewer
points, but his simple approach has astonishingly wide applications, and he is truly worthy of the title of moxibustion
master.
In conclusion, I would like to quote a few sayings from
the Ten Tenets of Fukaya Style Moxibustion.
Points do not work. You make them work.
Points move around.
Points that show no reaction do not work.
Locate points efficiently.

References
1. Taikyoku Therapy: see NAJOM Vol.5, No. 13, p.7-8
2. Uranaitei: see NAJOM Vol.5, No. 12, p.28
3. Pierce through moxibustion: This is a direct moxibustion
technique where points on the opposite side (right/left,
anterior/posterior) are treated to make the heat penetrate through that part. Some examples are ST34 and
SP10, or SP9 and GB34, around the knee joint, SP6 and
GB39 above the ankle, and CV12 and GV8 on the torso.
(July 1999, Translated by Stephen Brown)

Practical Moxibustion Therapy (17)

Introduction
It has been seven years since I moved to Vancouver, BC.
The temperature here does not vary much throughout the
year, and all during the Winter it either rains steadily or
there are low clouds which make it dark and cold even during the day.
Since I moved to Vancouver, I have been treating more
and more patients with musculo-skeletal complaints, especially muscle or nerve pain. These include frozen shoulder,
neuralgia, the after effects of automobile accidents, and
sports injuries. Most of these patients have the chief complaint of pain with movement and restriction in movement.
What I find in common in all these cases is shortening,
contracture, and impaired circulation in the muscles and
tendons. The symptoms are quite severe in many cases.
Before I moved to Vancouver, I lived in Toronto for nine
years. Vancouver and Toronto have completely different
climates. As I said, Vancouver is cool all year and the temperature doesnt vary much. It rains constantly in the Winter so it is very wet. In Toronto, on the other hand, there is
a big difference in temperature between summer and winter. Even though it snows in the Winter, the air is dry. The
climates in these two cities in the East and West are almost
complete opposites. This is why the diseases people suffer from are so different. In my practice in Toronto, I rarely
saw patients with frozen shoulders or neuralgia, and when

I did treat these conditions they were easy to cure because

they were not that serious.
It is my belief that in climates which vary little, as in
Vancouver, the body does not have to adjust to the climate
that much. This reduces the bodys adaptability to external
stimulus. As a result the functional state of the circulatory
and musculo-skeletal systems remains stuck at a low level,
and this increases the incidence of diseases of the musculoskeletal system.
The constant rain in Vancouver is nothing other than an
external pathogenic influence called tidal dampness in
Chinese medicine. Tidal dampness is characterized by (the
pain being) fixed, heaviness in the body or limbs, heaviness in the head as if one were wearing a hat, a constricting
pain, or a pain that is dull and fixed which makes the joints
heavy and hard to move. Furthermore, conditions caused
by dampness have a long duration and take time to resolve.1 Exposure to the pathogenic influence of dampness
happens by living in a damp climate or in swampy areas
for a long time, receiving the influence of dew or mist,
walking in water, getting soaked in rain, or working for
long periods in water.2
Working in Vancouvers damp conditions, I have discovered another aspect of acupuncture and moxibustion
therapy which I would like to discuss in this issue.

Meridians and moxibustion

The meridians are not addressed in much detail in Japanese moxibustion therapy, whether in the Sawada style or
the Fukaya style. Specific imbalances in the meridians are
not discussed in the Sawada style, and instead all fourteen
meridians are treated together as Taikyoku Therapy. One
way to visualize this is to place the meridians between the
stations in a loop line so that all meridians are within one
big circle. A diagram something like this by Ken Sawada is
featured on the cover of the 15th issue of this journal. Anyway, the five phasic points used by the meridian therapists
are not tonified or sedated in the Sawada style. Instead a
combination of eleven standard points are used along with
Source, Accumulating (Mu), Associated (Shu) points and
special effect points.
In the Fukaya style, as I have discussed in previous articles, points (tsubo) which have been gleaned from the
classics and the experience of practitioners of earlier times
are used. Thus it seem s to be more of a symptomatic
tsubo (active point) therapy. In this way Japanese moxibustion therapy seem quite different from approaches
like meridian therapy practiced by traditional Japanese
acupuncturists who treat specific meridians and points according to the Pattern. Be that as it may, similar points are
used by both types of practitioners even though the moxibustion practitioners tend to use more tsubo and special
effect points. All these practitioners stimulate points on
the body surface. As long as points are stimulated, they
can be understood as being acupuncture points which are
effective for treatment because of the reflex effect of the
meridians. Tsubos (active points) have always been utilized in Japanese acupuncture and moxibustion therapy.
All these approaches can therefore be called treatments
using point combinations. To a greater or lesser extent,

45

NAJOM
they all use the meridians by treating points on them. In
the final analysis, therefore, it can be said that the mysterious effect of meridians are also utilized in moxibustion
therapy.
As I mentioned before, while treating many musculoskeletal problems, I came to the realization that myofascial pain caused by climatic factors such as the external
pathogenic influence of dampness does not manifest only
on points and along meridian lines. Instead, such pain
occurs over a broad area like a piece of cloth covering the
skin. Thus the site of pain has a certain breadth and covers an entire area. This manifestation of pain is also seen in
musculo-skeletal conditions due to aging and from accumulated fatigue from excessive strain on certain parts (RSI).
This is also the case with the after effects of auto accidents,
surgery, and injuries.
In cases like these there are a large number of tender
points since the area of pain is large. It seems sore no matter where you press in the affected area. This does not
mean it is referred pain or a reflexive pain. Rather it is a
manifestation of a decline in the vitality of the soft tissues
of that area due to reduced circulation and functional state
of the muscles.
To treat conditions like this, in the case of frozen shoulders, I used to use standard points like TW15, SI10, LI15,
anterior LI15 (Jianqian), LU1, BL10 and 43. Over time,
however, I came to treat all the tender points in the area. My
aim was to relieve or eliminate these tender points. This
approach is similar to thermal therapy or infrared treatment. A more extreme comparison would be hydrotherapy
or hot springs treatment, where part or all of the body is
immersed in hot water to raise the temperature of the body
surface, stimulate capillary action, and boost natural healing power. Therefore, my approach is like more simple
and primitive approaches. This may seem like an approach
with low strategic value from the perspective of traditional
acupuncture and moxi-bustion therapy, which employs the
reflexive effect of the meridians and acupuncture points.
Nevertheless, such a primitive approach to treatment goes
beyond complex techniques and methodologies to capture
an essential element of therapy. That is, it creates conditions
for the body to recover naturally from symptoms which
arise from a decline in function or physiological activity.
This approach does not make use of the meridians per se,
but the end result is that energy is moved through the meridians to effect healing. In my more recent experience, this
approach of treating the entire area of pain works very well
for musculo-skeletal conditions mentioned earlier. Below is
a case history which demonstrates this.

Case Study
59 year old female
First Visit: March 29, 1999
Chief Complaint: Spasm and pain in muscles of the
left upper thigh. She has pain along the scar of an incision
from a hip replacement surgery on the left side. Her left leg
goes into spasm when she walks more than 30 steps. Also
she has sciatica in her left leg.
History: She broke her left ankle in February 1992, and
her sciatica developed after that. In 1998 she was diag-

46

nosed with arthritis in her hips and received hip replacement surgery on the left side in March. Subsequently she
dislocated this artificial joint, once in October 1998 and once
again in January 1999.
Other: She used to love to go bicycle riding and played
all kinds of sports. Now, however, she has difficulty just
walking. Her leg pain doesnt go away even while she is
sitting at work. She awakes with a burning pain along the
sciatic nerve about 3 a.m. and cant get back to sleep. There
is a prickling sensation in the left leg which runs all the
way down to the sole.
Examination: There is a surgical scar below the left inguinal area, just in front of the greater trochanter. There is a
long induration in the muscle (2.5cm wide and 6.5cm long)
medial to this scar, just below the inguinal crease. There are
rope-like indurations in the tibialis anterior of the left leg
(from ST36 to about 8 inches below). There are numerous
tender points in the left hip (gluteus maximus, medius, and
minimus, as well as the tensor fascia latae). She is unable to
flex her left hip joint due to the pain. Her pulse is stronger
than average and her abdomen is softer than average. She
has a large build and looks solid.
Treatment: With the patient in the supine position, I
palpated tender points below the inguinal crease and medial to the scar. Then I inserted 50mm, No. 3 stainless steel
needles about 10 mm in these points and retained them. I
also placed needles in tight and tender points in the tibialis anterior at a depth of 5 to 10mm. These needles were
retained about five minutes, and after removing the needles
I checked these points again to see if they had improved. I
then applied three half rice grain sized cones each (minicautery moxibustion) on these points (Fig. 1) .
Fig. 1

With the patient in the prone position, I retained needles in tender points
on the left low back, hip, and posterior
thigh at a depth of 30 to 50mm. After removing these needles I checked
the points again to see if they had
improved. I then applied three half
rice grain sized cones on each of these
points. I gave treatments like this once
a week for 18 sessions up until August 8
(Fig. 2).
Progress: At the third treatment, I
could feel that the muscles around the
left hip joint had softened. The symptoms, however, remained unchanged.
If anything, the sciatica was aggravated
and the pain was sharper. From the
fourth treatment I prescribed Shu Jing
Fig. 2
Huo Xue Tang (Clear Channel Activate
Blood Formula)3 and had the patient take it for ten weeks.
After the fifth treatment, her sleep improved to the point

NAJOM
where she would wake up once, but could get right back
to sleep. At the seventh treatment, the patient reported that
the burning pain in her leg was greatly reduced. At the
eighth treatment, she was able to walk a little further. At
the ninth treatment, the patient drove herself in a car with
a stick shift, without any pain. At the tenth treatment, the
patient said that she could swim for twenty minutes and
could drive without any problem. On the eleventh treatment, she came in with stomach cramps. So I applied 5
cones each at CV10, BL18 & 20, and ST24 & 25 on the left
side, in addition to the regular treatment. Also I had her
stop taking the herbs. At the twelfth treatment, the patient
said she could now sleep through the night. Even so, now
she was having pain in her right low back and hip. I decided that this was probably a temporary phenomenon which
resulted from the shifting balance in her lower limbs. In
addition to retaining needles and applying three cones each
on tender points in the low back and hip, I did some auricular acupuncture (Shenmen and hunger point on the left).
At the thirteenth treatment, the patient said her stomach
still gave her trouble. She often felt nauseous. I applied
three cones each at CV9 & 10, as well as on the Six Points
for the Stomach (BL17, 18, & 19). At the fifteenth treatment,
the patient reported that the condition of her stomach had
improved. Muscles in her left thigh would become stiff after walking thirty or forty steps, but there was no pain. She
still felt some stiffness along the sciatic nerve on the left,
but it no longer hurt. Also she lost four pounds. At the
eighteenth treatment, I had been continuing the auricular
acupuncture at Shenmen and the stomach point on the left,
in addition to moxibustion on abdominal points and the Six
Points for the Stomach. The stomach pain was gone, and
the patient could now walk for up to two hours. Also she
no longer had pain while sitting at work. After this I gave
two treatments three weeks apart, and her condition remained stable. The long induration medial to the scar, just
below the inguinal crease, and the rope-like indurations in
the tibialis anterior of the left leg were greatly diminished.
Observations: This patients sciatica was caused by the
external pathogenic influence of dampness. Even though
she had leg pain, this patient came for treatment wearing
only shorts. By dressing so lightly and exposing her lower
extremities to cold and dampness, the patient developed
contracture in the muscles in her hips. In addition, her hip
replacement surgery created a large scar in her left anterior
thigh. She also dislocated this joint twice and movement
became impaired because of the pain. My treatment strategy was to treat every place below her waist with pain or
tenderness as well as all tissue with contracture. Thus, in a
sense, the treatment was like cleaning up a large area. Her
pain and restrictions in movement resolved with about four
months of weekly treatments. For the first month of treatment, the area of pain moved around, and her condition
was unstable. After that, however, her symptoms began
to improve week by week. Thus the patient gained hope
and persisted with the treatments to obtain complete relief. From now on, I plan to continue treating this patient
once every three weeks and ask her to steadily increase the
amount of exercise to strengthen her muscles.

Conclusion
I presented only one case study due to space limitations,
but I treat many patients in Vancouver like this who have
large areas of contracture in their soft tissue. This is due to
exposure to dampness or to adhesions from surgeries, and
often there is impairment in movement and activities of
daily living.
Invasion by the external pathogenic influence of dampness can be likened to a landslide which covers a mountain
road with wet dirt after a long rain. This wet dirt needs to
be dug up and moved away by someone. Otherwise the
road will not become passable. In the same way, in giving
treatments to relieve myofascial contracture, the soft tissue must be patiently worked and softened up to restore
its elasticity. This type of treatment has been the arena of
massage of physical therapy, but when we compare these
to acupuncture and moxibustion in terms of the effect of
softening indurations in muscles, relieving contracture, and
improving mobility, acupuncture and moxi-bustion seem to
be far more powerful. This is because of the physical stimulation of the needles which penetrates indurations and
the moxibustion which cauterizes the skin. This maximizes
capillary action and revitalizes the tissue. Herein lies the
value of acupuncture and moxibustion as physical therapy.
The most important thing in this kind of treatment is to
adjust the dosage to suit the patients strength. Going back
to the earlier analogy of a landslide, this might be like the
difference between using shovels and moving dirt off the
road by hand and moving the earth by using a bulldozer.
When the road is a small one, heavy equipment will destroy the road. Doing it by hand is labor intensive, and it
takes time and effort. What is important, whether the process is gradual or quick, is that the dirt is moved to clear off
the road and restore its function.
From my experience treating many cases of sciatica
related to dampness as well as contracture and impaired
mobility due to aging, I have learned that treatments
which cover a broad area using a large number of points
quickly restores vitality in the tissue with contracture. As
long as you dont mind the labor intensiveness of this kind
of treatment and are persistent, you can consistently bring
improvement for very serious cases, even for people over
90 years old.
Notes
1. Chu-igaku Nyumon (Introduction to Traditional Chinese Medicine), compiled by the Kobe TCM Research
Group, Ishiyaku Publishing Co., 1981, p. 40.
2. Chugoku Kanpou Igo Jiten (Chinese Herbology and
Medical Terminology Dictionary), compiled by the
Japanese Translation Committe for Basic Terminology
of Traditional Chinese Medicine, Chugoku Kanpou Co.,
1980, p. 77.
3. Shu Jing Huo Xue Tang (Clear Channel Activate Blood
Formula): 2.5g shaoyao; 2g each danggui, chuangxiong, dihuang, baizhu, taoran, and fuling; 1.5g each
nuixi, weilingxian, fangji, qianghuo, fangfeng, longdan,
baizhi, and chenpi; 1g each gancao and ganjiang.
(November 1999, Translated by Stephen Brown)

47

NAJOM
Practical Moxibustion Therapy (18)
Treatment of Difficult Cases
Juvenile Diabetes
Patient: 5 years 9 months old girl
Background: Her mother is Japanese and her father is
American; she has a sister two years older. When she was
in Japan this year, her grandfather and grandmother noticed that she ate voraciously but yet did not gain weight,
and instead was thin as a rail. She received a medical
checkup, was diagnosed with diabetes, and started taking
insulin. Her mother thought somehow moxi-bustion might
help her and brought her in for treatment.
First Visit: April 1, 1999. This child was frightened of
moxibustion and cried and screamed, and I could not begin
to treat her. Still I managed to calm her down enough to
examine her. Observing her abdomen in the supine position, the costal arch on the left side protruded abnormally.
It looked about 2 cm higher than the right side. The tender
points on the abdomen
are as shown in Fig. 1. Examining her spine in the
prone position, T12 was
sunken in, and BL21 on
Fig. 1
either side were hard and
indurated (Fig. 2). I was
unable to give a treatment
this day, but I managed
to apply just one cone of
threadlike moxa on ST36
as I was explaining how to
apply moxibustion to her
mother.
Second Visit: May 1.
After the first visit her
mother applied moxibustion on ST36 several times.
The girl cried when anyone other than her mother
attempted to apply moxibustion, so I had difficulty.
Nevertheless I used the
small cup of the bamboo
tube1 to apply three sesame
Fig. 2
sized cones on ST36, CV12,
GV6, and BL20. I instructed the mother to apply
moxa on these points at
home.
Third Visit: June 19.
She has gained weight
and had more flesh. The
abnormal protrusion of the
costal arch on the left side
was almost unnoticeable.
Also the depression at T12
improved to appear al-

48

most normal. Furthermore, her insulin intake was reduced

two units to 11. (She had been taking 13 units and still
had hyperglycemia once.) Her blood sugar count had also
stabilized between 0.035 and 0.07%. I applied moxibustion
in the same manner as the second visit to CV12, left LR14,
BL19, 20, and 21 as well as ST36, and instructed her mother
to continue applying moxa to these points at home.
Observations: Diabetes is treatable with moxibustion.
But I dont have that much experience treating diabetes,
and had treated only two cases before. The first patient had
retinitis, and vision had deteriorated considerably, but acupuncture and moxibustion brought recovery. In the second
case, I gave two or three shiatsu treatments, but the second
patient stopped coming for treatments, so the results could
not be determined. Of course I had never before treated
juvenile diabetes, and such a serious case, so I was not
confident about treatment. I undertook these treatments
because the mother was so enthusiastic and hopeful about
moxibustion.
There was a dramatic change in the fifty days of home
moxibustion treatments between the second and third visit.
Of course the patient was also receiving Western medical
treatments and the mother independently administered
Eleotin, which is said to be effective for diabetes. Yet the
change in this short period was not limited to a decrease
in the amount of insulin taken and an increase in weight.
There were major structural changes including the normalization of the spine and the costal arch. After the third
visit, the patient moved to America. I heard from someone
else in December 1999 that since moving to America, they
stopped doing moxibustion treatments and the patient has
not improved any more. In this case I gave only three treatments and most of the treatment was done at home by a
novice, and it is incomplete in that I could not follow up on
the outcome. It does suggest, however, that home moxibustion treatment of children can have a powerful effect. It
is an unforgettable case.

2. Arthritis
Patient: female (age unclear, but around 60)
Background: This patient first came to a class staying
healthy with moxibustion, which I hold for novices once
a month. She had pain and swelling in her right knee, and
I assumed it was osteoarthritis. So I marked a few points
around her knee and taught her how to treat herself with
moxibustion at home.
First Visit: October 29, 1999. She said she was not getting any better after three weeks of home moxibustion
treatments. I figured there was something wrong, and
upon questioning her I learned that she had been diagnosed with rheumatoid arthritis. Laymen dont know the
difference between osteo-arthritis and rheumatoid arthritis,
and she must have thought moxibustion could cure anything. She had started to experience pain in her joints from
that Spring, especially from the top of her right foot to the
knee. She was given a diagnosis of a condition resembling
rheumatoid arthritis, and received some steroid drug.
They symptoms were relieved by the middle of August and
she stopped taking the drug. Then she had a relapse of the
pain after she started playing some golf. Her body hurt

NAJOM
all over, especially her right knee. She had seen an arthritis
specialist on Sept. 22.
Physical examination revealed strong tender points
around ST27 on the left (a sign of blood stagnation). Her
subcutaneous fat layer was very thick, and her skin was
dark and dingy. The right knee was swollen and felt very
hot. Her right arm was not swollen but she complained of
neuralgia-like pain in her upper arm.
Treatment: I palpated tender points on the abdomen,
knee, back, and shoulders and arms and applied five rice
sized cones using a bamboo tube to each of these points (Fig.
3). We decided to have her husband treat these same points
every day, and have her come back every other week to adjust the treatment points.

Fig. 3

Second Visit: Second week. The swelling in the right

knee is greatly reduced. The patient said she applied a cold
compress twice a day. There is pain in the right arm from
the elbow down. I added SI14, BL42, 43, 44 & 45 on the
right, and BL45 on the left.
Third Visit: Fourth week. The pain in the leg was gone.
There was some warmth and edema-like swelling in the
medial knee. Night-time pain in the right arm was gone,
but it hurt when she changed positions while sleeping. I
added ST36 and BL40 on the right and an Ahshi point next
to it.
Fourth Visit: Sixth week. I relocated all the points, except those on the abdomen (Fig. 4).

Fig. 4

Fifth Visit: Eighth week. The swelling in the right knee

is 75% better, and almost no heat can be palpated. The
right arm still hurt when she woke up at night. She said
her rheumatoid index had come down to 21 ( 1 to 20 is the
normal range).
Sixth Visit: Eleventh week. There is just a little warmth
in the right knee, but she can walk easier. The right leg
hurts just a little when walking. The pain in the right arm
is gone except for a little pain in the wrist. Tenderness in
the back and shoulders is less, so I reduce the number of
points for treatment.
Seventh Visit: Thirteenth week. Eighth Visit: Fourteenth week. Similar treatment and points. The patient
went to Japan from February 6, 1998 to the middle of April,
so she did not receive moxibustion for about eleven weeks.
When she came for treatment on April 23, however, there
was no sign of her getting worse and she had no problems
in her daily activities, except for a little pain in the right
knee when going down stairs.
After that she resumed home moxibustion treatments,
and came once a month up until February 1999 to have me
check the treatment points. After that she went to Japan
again and discontinued the moxibustion treatment, but
since July 1999 she has come once a month for treatment.
In this period, she did have a dizzy spell and some low
back pain, but the rheumatic joint pain had subsided almost completely. Her fingers and knee improved to a point
where it was difficult to tell any difference from those of
healthy people. Also she lost abnormal fat deposits to become more trim, and she was able to enjoy golf in the summer of 1999.
Observations: Moxibustion treatments on the whole
body for two years completely cured this patients rheumatic joint pain. The heat stimulation of direct moxibustion corrected the abnormal antigen-antibody reaction of an
autoimmune disease, and not only stopped the destruction
of tissue, but helped to repair the tissue that had been damaged. From cases like this, it is clear that direct moxibustion is very effective for correcting immunity disorders, and
it can be expected to benefit immunological problems of
not only rheumatism, but diffuse collagen disease, allergic
conditions and even AIDS. In this case, the patient and her
husband were an old Japanese couple, so they understood
the necessity of long term moxibustion treatments, and the
efforts of the husband enabled the patient to overcome a
difficult disease. This is a great example of how home moxibustion treatments can serve to avoid unnecessary surgery
and the side-effects of strong drugs.

Dermatitis
Patient: 50 year old female
Background: This patient burned her right hand eight
years ago. She received a prescription of cortisone cream,
but the skin on the back of her hand and fingers had turned
red and festered. There were cracks in her skin, and the
pain was so bad she couldnt make a fist or open her hand
completely (Photo 1). Also there was an area of dermatitis
about 6 cm across at the base of the second toe on the back
of her left foot (Photo 2). Her dermatitis was a side-effect
of using cortisone cream, but it must have spread to her left

49

NAJOM
treated by simple insertion and scatter needling. Then I
applied three half rice grain sized cones each on the points
in Fig. 5, as well as ST36, SP9, SP6, BL11, BL14, BL16, SI15,
SI14 and GB21. Then I applied threadlike moxibustion at 1
cm intervals around the area of dermatitis on the left hand
and foot. I instructed the patient to apply Shuinkou2 on
these areas at home.
Second Visit: September 1. After the first treatment, the
patient went to Japan for two weeks, but she said her condition had improved dramatically. The dryness and roughness in the skin of her forearms was completely gone.
Treatment: Only moxibustion was done applying three
cones each at the points in Fig. 6 as well as LI11, SP6, LR8,
and LR3 on the right. Treatment was concluded with ten
minutes of shiatsu on the back with the patient lying face
down.

Photo 1

Photo 2

hand and left foot. The dermatitis got worse every time
she got water on it. She had used many types of creams on
these areas, but each time it would improve a little just to
get worse later. She told me that her skin must be sensitive
to the oils in the creams. The condition of her skin has been
bad especially for the last five years, and nothing seemed to
help so the patient had decided to try moxibustion as a last
resort.
First Visit: August 14, 1999. Her pulse was thin and
weak, but tight. Her abdomen was extremely tense on
the left side of the navel, indicating blood stagnation. The
skin on her upper arm and forearm was dry and blackish,
and was rough and full of wrinkles like that of a very old
person. She had an operation to remove uterine fibroids 13
years ago. She went through menopause 3 years ago.
Treatment: 40 mm No. 1 disposable needles were retained in the abdomen and low back for five to ten minutes
(Fig. 5). The arms, legs, shoulders, and upper back were

Fig. 6

Third Visit: September 9. The condition of her skin was

further improved. She said this problem which she had
been suffering with for the past five years had dramatically
improved with the last two treatments (Photo 3). She was
having some low back pain that day.

Photo 3

Fig. 5

50

Treatment: Moxibustion was applied in the same way

as the previous treatment and SP10 and LI15 were added.
This patient had eight more treatments after this, up
until December 14. The lesion on her foot improved gradually, and became almost normal. She could form a fist with
her right hand, and the skin on her fingertip became normal
as well. Nevertheless, she had strong itching sensations

NAJOM
in her palm which caused her to scratch it, and this caused
the skin there to crack. Each time we tried Shiunkou and
other creams, but the cracks would clear up and come back
repeatedly. The ointments seemed to help temporarily, but
when she didnt use any ointment the itching would start
again in about a week and skin would crack again. Even
so, the patient says it is much better than it was before, and
that it would be completely better, if only there wasnt any
itchiness.
Observations: The blood stasis was bad at first and the
patient was depleted and weak. As we continued whole
body moxibustion treatments, however, she became progressively stronger. Also the skin lesion on her foot healed
almost completely. The lesion on the hand is better than
at the first visit, but perhaps just 50% better. Just when we
think it has cleared up, it gets worse again. It is probable
that there is a significant circulation problem in addition to
an autonomic or endocrine dysfunction. Since the lesion on
the foot is so much better, it is likely that the lesion on the
hand will gradually improve by continuing treatments over
a longer period and increasing her vitality. This case shows
how whole body moxibustion treatments are effective for
dermatitis resulting from drug side-effects.

Lymphoma
Patient: 52 year old female
Background: This patient had two lymphomas removed
from her right chest on June 30, 1999. She is undergoing
chemotherapy. She has had insomnia ever since she got jetlag on her trip back from Japan in November 1998, and has
been using sleeping pills. She came for treatment in hopes
that moxibustion would increase her vitality.
First Visit: September 13, 1999. The pulse is complicated: it was wide and mushy on the surface, but a thin stringlike portion could be felt with deeper palpation. The abdomen was deficient, soft, and lacking tone. She has lost all
hair on her head, since she has already had three rounds
of chemotherapy. There was motor pain in the teres major
muscle (medial rotation) on the right. There were abnormal
formations on the skin, especially the upper chest, which
looked like brown moss. The proximal and medial phalangeal joints of the right middle finger were swollen and arthritic. There was extreme tension in the interscapular area,
especially on the right side, and it felt like pressing on slate.
Her feet were very cold, and she tended to be constipated.
Treatment: I used the small cup of the bamboo tube to
apply three to five cones on points over the whole body. I
started with the abdomen (CV13, left ST24, left ST25, left
ST27, and CV6), then treated the legs (LR8 and SP6),
low back (BL24, 25 & 27,
Yaoyan, and gluteal point),
upper back and shoulders
(Fig. 7), and arms (LI11). I
concluded the treatment
with about ten minutes of
shiatsu on the back. I instructed the patient to apply moxibustion every day
at home on LR8 and SP6.
Fig. 7

In addition, I asked her to do the basic sotai exercises and

No Shiatsu3 everyday. Using this basic approach, I continued giving treatments about once a week until Christmas.
Observations: By early October the patient started to
feel better than she had ever felt before, and began to take
a Yoga class. In the last half of October, however, she underwent a round of powerful chemotherapy sessions and
became very exhausted and her interscapular area became
tighter than ever. The chilling of her legs also became
worse. In mid-November she had low back pain with some
sciatica, but this improved with acupuncture. She started
radiation therapy in the last half of November, and she became very exhausted and a neuralgic pain started on the
medial aspects of both elbows which disturbed her sleep a
great deal.
As she underwent chemotherapy and radiation the
symptoms of fatigue, muscular tension, arthritis, neuralgia, and insomnia became decidedly worse. Once she
completed radiation therapy on December 18, her strength
gradually returned and her pulse and abdomen became
more normal. Also her constipation, cold feet, fatigue, and
muscle tension improved. Her skin also cleared up and she
could walk for about two hours, but her insomnia alone did
not improve. She managed her daily life through a strict
regimen of home therapies, and was able to live without
major difficulty. The patient is pleased with the results and
says she plans to continue moxibustion therapy.

Conclusion
Despite the advances of medicine in recent years, difficult diseases like diabetes, cancer, arthritis, and allergic
conditions are on the rise. And many such conditions do
not respond to medical treatments. The cases presented
here were treated jointly by moxibustion therapy and Western medicine. By adding moxibustion, the basic vitality of
the body is increased, and the negative aspects of Western
medicine such as drug side-effects are reduced. Thus Western medical treatments are actually assisted and the healing
process is facilitated.
The above four cases were mostly treated by Sawadas
Taikyoku Therapy.4 Whole body treatment with moxibustion does require many points and is labour intensive, but
the advantage is that the patient can continue the treatment
at home. It is important to apply moxibustion continuously
and consistently, even if the cones are small. This is what
gives the wonderful effect of raising basic vitality (i.e. increasing natural healing power). Thus it makes sense that
the character for moxibustion literally means long (term)
burning.
Notes
1. Refer to NAJOM Vol. 5, No. 13, p. 23.
2. Refer to NAJOM Vol. 1, No. 2, p. 22.
3. Refer to NAJOM Vol. 5, No. 12, p. 31.
4. Refer to NAJOM Vol. 3, No. 7, p. 25.

(March 2000, Translated by Stephen Brown)

51

NAJOM
Practical Moxibustion Therapy (19)
Thoughts on Deficiency and Excess

Constitutional deficiency and excess

All organisms have the capacity to maintain homeostasis. This can also be called natural healing capacity. This, in
other words, is the capability to return to a state of health
from a state of disease. Those whose capacity to return to
health is strong have an excess constitution, while those
whose capacity to return to health is weak have a deficient constitution. The fundamental components of one
s constitution, as stated in the classics, are prenatal Qi and
postnatal Qi. Modern terminology for these aspects would
be inherited factors and nutritional state, or level of physiological activity and mental state.
A person who has an excess constitution maintains the
following conditions with the proper balance.
1. good appetite - Isn't particular about food, and enjoys
eating a variety of foods.
2. good sleep - Sleeps well and feels rested.
3. good elimination - No problem in elimination, with easy
bowel movement every day.
4. good movement - No pain with movement, and no fatigue after some exercise.
The state called health fulfills the above four conditions.
When a person has a deficient constitution, one or more
of these four conditions are lacking or compromised. The
cause is a deficiency of prenatal Qi or postnatal Qi. With a
deficient constitution, ones natural healing capacity either
is not active, or if it is active, it is weakened so that the healing response is slow, and the disease either does not heal or
it takes a long time.
Visual examination of a person with an excess constitution gives evidence of vitality and a strong spirit. Such
individuals have good nutrition and good physique. Those
with deficient constitution, on the other hand, have poor
nutrition and appear weak. They tend to be thin and frail,
and dont have much presence. This doesnt necessarily
mean that people with excess constitutions live longer. In
Japan there is an interesting expression, surviving with
one disease.
This implies that one is more conscientious about health
and might live longer with a physical problem.
The purpose of acupuncture and moxibustion is to use
external stimulation to secure and strengthen the above
four conditions, increase vitality, and to activate the natural
healing capacity when ill. In general, strong stimulation is
used in the treatment of those with excess constitutions,
but it is entirely another matter whether strong stimulation
is always appropriate for people with excess constitutions.
For example, even people with excess constitutions are
sometimes hypersensitive. In cases like this, the amount
of stimulation must be moderated. For patients with a deficient constitution, gentle stimulation is usually the best.
Again, this rule does not always apply. I am sometimes
surprised at patients who prefer strong stimulation even
though they seem to have a deficient constitution. So there

52

is no simple correlation between excess and deficient constitutions and the amount of stimulation they need. I think
that optimal stimulation should be decided by how it feels
to the patient. The quality and amount which feels best
to the patient is the optimal stimulation, and this is what
activates natural healing capacity. To put this even more
simply, optimal stimulation feels comfortable and relaxing
to the patient. I think that any stimulation which feels bad
or makes a patient wince does not activate natural healing
capacity. A good treatment is one which provides a quality and quantity of stimulation that makes the patient say,
Oh that feels good. I feel like Im better already. In other
words, we have to optimize the treatment for each patient.

Deficiency and excess of pathology

An excess of pathology refers to a condition of vigorous
fighting between the natural healing capacity and the cause
of the disease (Three Etiologies: Qi, Blood, and Fluids).
Heat conditions predominate since the pathological process
is vigorous, but patients dont give in, and their strength
holds out. Many patients with this condition have excess
constitutions. A deficiency of pathology refers to mild condition, but patients tend to be weak, and the illness goes
on and on, so it takes a long time to resolve. A deficiency of
pathology occurs when patients have a deficient constitution, external pathogenic influences invade, or there is an
accumulation of internal or non-internal and non-external
factors. The natural healing capacity is weak, the recovery
is protracted, and there is a tendency toward chilling, or
cold conditions. The treatment for excess pathological condition is to reduce the vigorous force of the disease process
(dispersion: strong stimulation such as purgation, releasing
the exterior, or reducing inflammation). In general shallow scatter needling, quick insertion and withdrawal, and
blood letting are appropriate. The patient still has strength,
and has plenty of reserve to fight off the pathogenic influence, so decisive and strong treatments are possible. When
the treatment is appropriate (optimized) the patient feels
better right away, and the illness does not take long to resolve. The aim in the treatment for deficient pathological
condition is to strengthen the natural healing capacity. Also,
physical strength must be increased to fortify the body for a
protracted battle. We must prevent the deficient pathological condition, or chronic condition from getting progressively worse. The most effective approach for this purpose
is the whole body treatment of Taikyoku Therapy or the
root treatment of Meridian Therapy, which unblocks the
meridians and improves the circulation of Qi and Blood.
Increasing physical strength also means to improve digestion, so it is necessary to tonify the Spleen and Stomach.
Taikyoku Therapy increases Blood, so it greatly augments
the material basis of the body. The root treatment of Meridian Therapy emphasizes treating Qi, so it balances the
functional state of the body and aids the spirit. Of course,
whether one uses an approach to increase Blood and thus
build Qi, or vice versa, the point is to use a whole body approach to activate the patients natural healing capacity and
change the balance of power between physical strength and
the pathogenic influence. So either way, the aim of leading
the body toward health is the same.

NAJOM
Deficiency and excess of Qi and Blood
The Qi and Blood discussed here are not the
same as the energies of prenatal and postnatal Qi
which the body is endowed with. Qi refers to the
functional capacity of the body and includes the
psychological aspect. Blood refers to the physical
component of the body. To put it in more simple terms, Qi
includes the meridian system, the nervous system, the endocrine system, ones psychology, ideology, and spirit. Blood
encompasses blood, body fluids, soft tissue, bones, blood
vessels, nerve fibers, and skin. The factors which make
these two aspects of the body excess or deficient, of course,
has to do with prenatal and postnatal Qi. Qi and Blood always work together, so if both Qi and Blood are excess, one
basically has an excess constitution. People like this rarely
get sick, and if they do, they recover by themselves. When
one is excess and the other deficient, for example when
Qi is deficient and Blood is excessive, functional disorders
tend to occur. Conversely, when Qi is excessive and Blood
is deficient, structural or organic problems tend to arise. In
these cases, however, either the Qi or the Blood, whichever
is excessive, tends to cover for the deficiency of the other, so
they are relatively easy to treat and patients recover quickly.
When both Qi and Blood are deficient, however, there is a
problem in both function and structure, so treatment takes
time, and the prognosis is not good.
The excess and deficiency I am talking about here is not
a comparative measure (Qi to Blood). They simply mean
ample or lacking. In general, if one is young (ample Blood),
the living environment is good (ample Qi and Blood), and
the educational and ideological foundation is good (ample
Qi), then a person tends to have an excess constitution.
When any of these aspects are lacking, a person tends to
have a deficient constitution. Therefore, these basic aspects
must be taken into account when making a treatment plan.
The concept of Qi and Blood can be interchanged with that
of mind and body, spirit and matter, software and hardware, or control system and structural system. The ideology
of Oriental medicine is that these aspects work together to
make up a human being.
Deficiency and excess of pathogenic Qi and normal Qi
The 28th Chapter of the Suwen states: Repletion of
pathogenic Qi is excess; loss of Jing Qi is deficiency. So,
when one fills up with pathogenic Qi, or otherwise one
loses Jing Qi, it is called excess. Diseases can therefore occur when the body becomes excess or deficient, and it can
also occur when it is both excess and deficient. In the above
case, pathogenic Qi refers to the Three Etiologies (Qi, Blood,
and Fluids), and Jing Qi (normal Qi) refers to the resistance
or natural healing capacity of the body. Viewing disease as
a state of war between pathogenic Qi and normal Qi, when
normal Qi is strong, a person rarely becomes sick, and if
they do, they recover quickly. The most important thing,
therefore, is that normal Qi be kept excess (strong resistance
or natural healing capacity). As long as normal Qi is excess,
the illness will eventually resolve regardless of the amount
of pathogenic Qi. For this reason, the primary aim of my
acupuncture and moxibustion treatments is to secure normal Qi. (Fig. 1)

Of course, it is best if one could avoid pathogenic Qi

or not create pathogenic influences in ones life. In order
to avoid the accumulation of excess pathogenic Qi, it goes
without saying that we need to practice moderation and exercise to stay in shape. These are stressful times, however,
with a tendency of over-work, over-stimulation, drug sideeffects, pollution, overeating and drinking, jet-lag, lack of
exercise. Unfortunately, given these conditions, the number
of people with excess pathogenic Qi and deficient normal
Qi are on the rise.
We need to be careful here that the two opposite aspects
of pathogenic Qi and normal Qi seem to be joined together
by the concept of excess and deficiency. The concept of
excess and deficiency should really be applied to one category, not two different aspects. Actually, if we are discussing pathogenic Qi and normal Qi, which are opposite
aspects, we need to speak in terms of excess and deficiency
of pathogenic Qi and excess and deficiency of normal Qi.
But there is no such thing as deficiency of pathogenic Qi.
As I have stated before, however, there is both excess and
deficiency of normal Qi.

Conclusion
As I have explained, there are many nuances in the
terms excess and deficiency. Clinically they are simply
used to identify conditions of excess and deficiency. The
Chinese characters of either excess or deficiency is used as
a label after putting together various aspects and findings.
In Western medicine, everything is reduced to the smallest
possible unit, and various parameters are evaluated numerically. In contrast to this, in Oriental medicine, various
elements are combined and identified by compressing the
condition into one of two categories (one character). This
method is very convenient for viewing a human being from
all different angles, and assessing a person as a whole. It
is, nevertheless, an intuitive or subjective approach which
is vague in some respects. That is to say, the determination of whether a patient is excess or deficient is left up to
the practitioner, and there are no standards that say excess
starts here and ends here or that deficiency starts here and
ends here. Although there may be expressions like between
excess and deficiency, there is no such thing as an average
value for excess or deficiency. Even if we create a scale from
a to j and arbitrarily divide it into a to c, d to g, and h to j,
there is no definitive measure of excess and deficiency, so it
remains unclear what it means.( Fig. 2)

Deficiency

between Excess and Deficiency

Fig. 2 constitutional deficiency and excess

Excess

So excess and deficiency are hypothetical measures.

Nevertheless, in the clinic, the excess or deficient state of a

53

NAJOM
patient becomes very evident when we palpate the pulse,
abdomen, and skin. And these indications improve with
appropriate treatment. We can feel these things becoming
more normal. This is also reflected in how the patient feels
- their subjective sense of health and well-being improves.
The amount of this improvement cannot be described in
numbers as done in Western medicine. It is picked up by
the practitioners felt sense of excess and deficiency. Accurately assessing the condition of excess or deficiency is
important and this is the key to a successful practice of
acupuncture, moxibustion, and Oriental medicine. We need
to continually hone our palpation skills and develop our
intuition so that we can accurately assess the condition of
excess or deficiency.
(July 2000, Translated by Stephen Brown)

Practical Moxibustion Therapy (20)

In Vancouver, where I live, we had poor weather this
year from Spring through Summer. The temperatures were
lower and the rainfall was greater than in years past. After
weather like this sets in, I have an increase in patients who
complain of neuralgia, muscle aches, and arthritis. From
June through July I had a lot of patients with pain and
numbness in the shoulder accompanied by a loss in range
of motion. There especially seemed to be an unusually large
number of female patients who had the complaint of pain
and numbness in the left shoulder. The symptoms were
quite severe in many of these cases, and the pain and restriction of motion were substantial. I was quite successful
in treating these cases since I added some blood letting to
my usual regimen of acupuncture and moxibustion. In this
issue I will discuss these cases.

Case 1:
T.K. 76 year old female
Occupation: making artificial flowers
First Visit: May 11, 2000 Main Complaints: Strong pain
in the left interscapular region. Strong pain from the lateral
upper left arm down to the lower arm. Numbness in the
left middle, ring, and little fingers. Weak stomach with a
tendency toward ulcers, and stomach pain after even a little
eating.
History: The area around BL43 on the left started to hurt
about three months ago. Then her left middle, ring, and little fingers started going numb. She has had intense pain on
the medial border of her left scapula since three weeks ago,
and has difficulty sleeping. A week ago she went to another
acupuncturist, who bled a point on her little finger, and she
is able to sleep a little better now. There is still pain with the
slightest movement. Examination: Strong tension on top
of the left shoulder, and BL12, 13, 42, and 43 on the left are
sensitive and very tender. Around SI9, there is a hard and
swollen area about 10cm across, which feels warm to the
touch. This area is more than medium level inflammation.
There is another swollen area about 10cm above and below

54

LI11 on the left arm, which feels very warm to the touch.
This is also more than medium level inflammation. Her
skin seems to be in good condition considering she is 76
years old and has stomach trouble. Her complexion is good
and her speech is clear.
Treatment: Simple insertion
was performed for light stimulation in the seated position with
40mm No.1 needles in the following points: SI14, SI15, BL12, BL13,
BL42, BL43, and SI9 all on the left
as well as three points on the posterior upper left arm. (Fig. 1)
After that, small cones (sesame
size) were applied to the same
points. Then simple insertion was
performed on six points on the
left arm between LI10 and TB9.
This was followed by one cone of
thread-like moxa on each of these
Fig. 1
points. The treatment was concluded with five half rice grain sized
cones of moxibustion on CV12
and 10. Second Visit: May 17
They did not radiate to her back
for two days so she took walks on
a golf course. She feels chilled and
numb in the left ring and little fingers. The left elbow and posterior
shoulder were still swollen and
very tender. I repeated a similar
treatment to the first, adding some
points for moxibustion as shown
in Fig. 2.
After applying seven small
cones on the back and five small
cones in the left interscapular area,
I used a lancet and bled a few
drops from about ten points. I also
Fig. 2
applied one cone of thread-like
moxibustion on points of the left elbow and five half rice
grain sized cones on CV12 and 10, and on LR14 and 13 on
the right.
Third Visit: May 24The numbness in her fingers was
50% better. I repeated the same treatment as the second
visit and applied suction cups on SI9 and BL15 to increase
the amount of bleeding. (Photo 1)

Photo 1

NAJOM
Fourth Visit: June 2There is still some numbness in
her fingers, but the pain in her arm is gradually improving.
She started an exercise program three days ago, but the
pain got worse for two days. I repeated the same treatment
as above and also bled the Jing Well points on the ring and
little fingers of the left hand.
Fifth to Tenth Visits: June 14 to July 19Subsequent
treatments were essentially the same as the third visit and
the patient came for treatment every week. By the sixth
visit the numbness in her fingers was almost unnoticeable and the swelling in her elbow was gone. By the tenth
treatment the patient was able to golf for three hours. Also
there was no more pain even when she slept on her side, so
I concluded the series of treatments. In September this patient called to report that her arm was completely healed.
Observations: The cause of the numbness in the third and
fourth digits and the swelling around LI11 on the left arm
was probably the inflammation around SI9 on the left,
which affected the axillary nerve, especially the ulnar and
radial nerves. And the source of the inflammation around
SI9 was the indurations on the Bladder meridian on the
left at BL15, 16, and 17. These indurations then spread to
the medial and lateral border of the scapula to create a
wide area of kori (stiffness). Despite being 76 years old,
this patient continues to work at her job of making artificial
flowers. Therefore, I assume the inflammation started with
the hardening of the muscle tissue from the way she used
her hands for many years. I considered the possibility of
lesions in her vertebrae or intervertebral disks between C6
and T1, but there was only moderate tension in this area,
and there was no pain or restriction in movement. Be that
as it may, there was severe inflammation and pain in the
shoulder and arm, so I was concerned that this condition
could be like bursitis and become chronic. Therefore I was
cautious in the first treatment and kept the level of stimulation mild. In the second treatment, however, I decided
to take a chance and did some bloodletting after applying
moxibustion. I decided to do this because the acupuncturist who treated this patient before did some bloodletting
at the Jing Well points and the patient seemed to be favorably disposed toward it. In addition, she was in satisfactory physical condition and she responded well to the first
treatment. It had never occurred to me before to do blood
letting on the same area right after applying moxibustion.
When I actually tried it, the patients response was better
than expected. From the patients reports, I was able to
confirm that she was getting better and better with each
treatment. And as a result, by the sixth visit (a month and a
half) the symptoms were largely alleviated. After the tenth
treatment, which was in less than two and a half months
later, I was able to conclude this series of treatments. In
my experience, complete recovery from symptoms of this
magnitude in two and a half months is quite fast. Therefore
I was encouraged to try this combination of moxibustion
and blood letting on two more patients.

Case 2:
T.F. 51 year old female
Occupation: cook
First Visit: June 7, 2000 Main Complaints: Strong ten-

sion in the left neck and shoulder. The left shoulder has
been so painful for the last two months, she cannot raise
her arm. Now the pain is so severe, she cannot work. There
is also numbness in the left index and middle fingers.
First & Second Treatments: June 7 & 26Light simple
insertion was performed with 40mm No. 1 needles in tender points on the anterior and posterior left shoulder. This
was followed with five cones of direct moxibustion. The
forearm was treated in the same manner. (Fig. 3)

Fig. 3

Third Treatment: July 6The muscles in the left shoulder were extremely hard on the anterior and posterior
aspects, so I retained 40mm No.2 needles in the tightest
points and applied three cones of moxibustion after removing the needles.
As a result, on July 7, the next day, the pain intensified
and the patient could not move her arm at all. The pain
at night was especially bad, and the numbness in her left
hand was so bad she could barely hold a teacup. I had concluded the treatment with some shiatsu around the teres
major muscle, and this could have caused an over-reaction.
The patient went to a doctor and received an injection because the pain was so intense, and the pain went away like
magic. I have experienced such aggravation and sudden
disappearance of pain many times when the stimulation
has been excessive. The pain is aggravated greatly, and you
really get upset along with the patient, and wonder what
you should do, but the pain dissipates in two or three days
as if it were never there. This is just a reaction which occurs
after over zealous treatments, and some practitioners even
call it a healing reaction because the symptoms eventually
go away. Actually, the prognosis is good when there is such
a strong reaction to treatment. It is distressing, however, for
the patient who has to cope with more pain than before, so
it cannot really be considered desirable. In the above case,
the patient thought that the injection had relieved the pain,
but probably the same thing would have happened even if
she didnt get an injection.
Fourth Treatment: July 13The posterior aspect of her
left shoulder still felt swollen and she could not move her
arm very much. Hearing about her reaction to the last treatment, I retained barely inserted needles in tender points
around the left shoulder and arm. Just before removing
them, I gently inserted the needles a little deeper. Next I

55

NAJOM
applied three small cones of moxibustion on the remaining
indurations and tender points around the left shoulder and
forearm. Then I bled SI10, BL42, and BL14 using suction
cups.
Fifth Treatment: July 27The night-time pain went
away, and the swelling seemed to have gone down completely. But she could raise her arm only 90 degrees forward. Also there was strong contracture in the lower
margin of her left pectoralis major muscle and in the lower
margin of the posterior deltoid muscle. I pretty much repeated the last treatment and also did some shiatsu to loosen the muscle tension and worked on the pectoralis major,
serratus anterior, deltoid, and teres major muscles.
Sixth to Ninth Treatments: August 3, 10, 25 & Sept.
15Treatments similar to those above were given four
times in a row. I always did some shiatsu after acupuncture
and moxibustion. The aim of this shiatsu was to soften tight
areas including the left side of the neck, the suprascapular and interscapular areas, the anterior and posterio0r
shoulder, and the medial and lateral aspects of the upper
arm. The pain and restriction in movement caused by the
contracture improved with each treatment after I did the
blood letting. It did take about two months to improve, the
progress was steady despite the fact that six treatments is
not that many for a case like this. By the last treatment on
September 15, the patient said she was able to work and
drive without much difficulty, and that the restriction in
movment was 30% better. Her shoulder still felt stiff in the
morning, so she said she would massage it herself.

Case 3:
K.N. 44 year old female
Occupation: office worker
First Visit: July 2, 2000 Main Complaints: This patient
came in with severe pain and restriction in movement in
the left shoulder with pain and swelling, and her condition
was similar to the last case.
First Treatment: I performed light simple insertion on
tender points followed by three small cones of moxibustion
on the same points as in the previous case.
Second Treatment: July 15After repeating the above
acupuncture and moxibustion treatment, I bled SI10 and
BL43 on the left side using suction cups.
Third Treatment: July 21The swelling in her shoulder
was greatly reduced and the pain was gone, so after performing some acupuncture and moxibustion, I did some
shiatsu around the deltoid and teres major muscles. The
next day she had strong pain and could not move her left
arm. Strangely enough, this patient went through the same
thing as the patient in case 2, and in this case also the pain
faded away in three days.
Fourth to Seventh Treatments: July 29, August 4, 11 &
Sept. 16The pain resolved almost completely with four
more treatments. When she came in for her last treatment,
her shoulder no longer posed a problem in her daily life.
Even so, she could still abduct her arm only 90 degrees to
horizontal. There was still some contracture in the muscles
around her shoulder, especially the teres major.

56

Observations
As I am writing this article today (Oct. 22), I have four
or five other female patients with the complaint of pain
and restricted motion in their left shoulder. Strangely
enough, only one patient has these same symptoms in her
right shoulder as well. When I was visiting Japan late this
August, I discussed this with Mr. Hamamura, a member
of NAJOM, and he said problems in the left shoulder are
related to blood stagnation, and that problems in the right
shoulder are related to dampness. I didnt find out where
he came up with this explanation, but since most all of my
female patients present with problems in their left shoulder,
it seems like a plausible explanation. All three of the above
cases had some swelling (inflammation). I did acupuncture
and moxibustion on the swollen area and increased circulation and raised the skin temperature. Then I did some
blood letting in the same area. The amount of blood was,
of course, more than average. In all three cases, the inflammation subsided dramatically, and I got the impression that
recovery was greatly accelerated. I had a lot of experience
with blood letting after acupuncture, but I hadnt done
blood letting right after direct moxibustion. I feel that blood
letting is very effective for inflammation. Also, in all of
these cases, there was extreme rigidity in the muscles on the
shoulder, and the cervical muscles were hard as well. This
rigidity might be considered as a sign of blood stagnation,
but other treatment of neck and shoulder stiffness is necessary. The trick to point location is to find the points which
are very tender. Usually I use the two step approach of needling these very tender points and reducing their number
and palpating the remaining tender points to apply direct
moxibustion. It is useful, when palpating the tender points
for the second time, to have the patient move the affected
arm to find the painful areas and locate points in these
areas. The points that I use most often for this condition include: LU1, 3, & 4, LI14 & 15, TB12, 13 & 14, BL41 & 43, SI9,
10 & 11, and GB21. Isaburo Fukaya, the modern Japanese
moxibustion master, said Here is a point not to be missed
at ST12 or lateral to it. This is a famous moxibustion point
for fifty year old (frozen) shoulder.1 This point on the anterior scalene muscle does in fact work very well. To treat a
frozen shoulder, Fukaya used his standard dosage of seven
half rice grain sized cones. As for myself, I usually get by
with three half rice grain sized cones or smaller. I dont
have a rule about it, so sometimes I end up applying ten to
twenty cones. I feel, however, that mild stimulation (three
cones) is a safer course. Finally, I failed to mention whole
body treatment, but I must add that for depleted patients
who need whole body treatment, treating the abdomen is
especially important.
References
1. Fukaya Isaburo, Okyu-de Byoki-o Naoshita Hanashi
(Stories of Diseases Cured with Moxibustion), Vol. 1, p.
18, Shinkyu-no-Sekai Co., 1992.
(November 2000, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (21)
Some Thoughts about Patients
I think I use moxibustion about 80% of the time in my
treatments. Almost always, I combine moxibustion with
acupuncture or shiatsu. I do treatments consisting only of
moxibustion about 5% of the time. These treatments take
time because with moxibustion, unlike acupuncture, you
cannot retain needles. This is similar to shiatsu or massage
where it is a one on one treatment which takes time. This
time is precious. Most of the time I am just chatting with
the patient, but now and then the patient reveals something
close to their heart. Also, there is time to explain about the
treatment, or to hear about their life-style and give advice
about diet or exercise. It can be said that my relationship of
trust with my patients is established in this time.
Moxibustion treatments are not as painful and do not
leave ugly scars as some think. People think so because
they do not really know about moxibustion. When moxibustion is applied skillfully, the body warms up comfortably and it feels great. When you chat with the patient in
this state, things which are hard to say ordinarily just pop
out, and they feel relieved. This is why moxibustion has a
great effect in treating stress conditions. This is the advantage of stimulation treatment, because the appropriate heat
stimulation relaxes both the mind and the body. This is an
effect which chemical drugs do not have. I doubt if even
tranquilizers have such an immediate effect.
There are all kind of patients among those I give moxibustion treatments to. Quite a few ask for moxibustion
right from the start. Patients who have heard about the
effect of moxibustion from others and think this is it, say
Ive received all sorts of treatments over a long time, and I
havent gotten very good results so its my last straw, I am
taking my chance with this.
Some say, As long as the symptom is relieved and I
feel better, Ill leave it up to you. Patients like this are easy
to work with. Their attitude is like that of a fish on the
cutting board, so I can select a cluster of points that need
treatment right away and apply moxibustion effectively.
Also the objective is clear, whether it is a short-term battle
for an acute condition or a drawn out war against chronic
conditions, it is easy to explain the strategy to the patient.
I do have quite a few patients who say, I dont like
this or that, so please treat just this. Some even say, The
last place I went I had both acupuncture and moxibustion,
but they didn'twork so neither is suited to me. Otherwise there are those with fixed ideas about acupuncture or
moxibustion. Some say, I absolutely refuse moxibustion,
since they are convinced that moxibustion is painful and
leaves scars. With acupuncture, I explain to my patients,
The needles are carefully managed. I used them for one
patient only. I autoclaved them after each use. Still there
are patients who do not accept this and say, I dont want
you to use any needles on me unless they are disposable.
Some stubborn patients do not listen to anything I say, even
though they may be socially conscious people who volunteer or donate money, and seem to be good people in every
other way. People like this are hard to treat, and it seems
their condition is often serious and intractable such as ar-

thritis or cancer.
On the other hand, there are those serious types, who
are very cautious, and do not go along so easily with my
suggestions. Patients like this, however, learn things slowly one step at a time as they acquire experience. As long as
you take the time, they will verify and confirm the effects of
acupuncture and moxibustion for themselves. As a result
they come to like the treatments and they do moxibustion
and exercises at home, and they are diligent about health
maintenance.

Cases of Home Treatment

Mr. A first came to me for treatment 8 years ago (he was
77 then) for the after-effects of an auto accident. He had
so called whiplash syndrome, and four months after the
accident, he still had pain his left neck, shoulder, arm and
chest. Initially he wanted shiatsu treatments, and he got
substantial relief after about six treatments. I taught him
the basic Sotai exercises, he started doing them daily, and
soon he was able to bend forward from a standing position
to touch the floor with his palms.
We continued bi-monthly treatments and at about the
tenth month, I suggested moxibustion which he was resistant to in the beginning. He was still afraid of direct moxibustion at this time, so I started out with indirect moxibustion (Kamaya Mini). He liked how it felt and he became a
fan. Two months after that I suggested he try acupuncture.
He was coming down with a cold so, with his permission, I
did some light simple insertion using a 30mm No. 1 needle
at BL10 and points in the shoulders and upper back. The
next time he came for treatment he said, I could feel greater ease in my body. In this way he came to like acupuncture as well.
Two years after starting treatments he got prostitis and
right after that he slipped and fell down some stairs and
was bruised from below the left scapula to the flank region.
After two and a half years, he had insomnia with bursitis
in his right shoulder. I suggested direct moxibustion from
around this time, and applied moxa on the inferior border
of the occiput and over the deltoid muscle, and he came to
love direct moxibustion. In this period he caught a lot of
colds and was coughing a lot, so I suggested home moxibustion treatments from about the third year, and he started
applying moxibustion on ST36 everyday. After that he had
nocturnal urinary frequency, low back pain, and cramps
in his legs at night, but he got over these problems after I
marked points on him on which his wife applied moxibustion.
On the fourth year, he fell from a ladder when trying to
put up a clothes line on a tree, and broke his right scapula.
He recovered from this injury with moxibustion at home
as well. So he had various problems in the eight years after he began treatments with me, but he overcame them
all with the help of moxibustion. In May of 2000, however,
his wife was diagnosed with cancer in her upper stomach.
The shock and worry over this caused a loss of weight and
insomnia. Actually, his wifes cancer did not start in 2000.
She came to me for treatment in 1994 with the complaints
of fatigue, dizziness, and tinnitis. I found abnormal tension
(focal distension) in the epigastric region, and I had her

57

NAJOM
husband apply indirect moxibustion (Kamaya Mini) on her
abdomen, neck, upper back, and legs for six months. After
that, the abnormal tension in the abdomen improved and
the symptoms of dizziness, tinnitis, and fatigue resolved,
so after nine months we concluded treatments. The abnormal tension in her upper abdomen was an unusual finding
which I still recall clearly.
Because of this experience with them, I explained to
them that this tumor was something that we could work
with. In this instance also, I instructed Mr. A to apply moxibustion on his wife. But she did not like direct moxibustion
and refused to go along. So I considered using the Kamaya
Mini again, but I was hesitant since I had to order more
from Japan, and it was expensive. Just around this time
(the timing was perfect) a local Japanese newspaper (June
1, July 6, and Aug. 3, 2000 issues of the Vancouver Shinpo)
featured a series of articles by Mr. Fukunishi titled Lets
apply moxibustion-Cancer and Moxibustion 1-3. It was an
article which explained in laymans terms how moxibustion was effective in restoring the function of the liver. This
article was a helping hand for me just when I needed it. I
copied this article and sent it to them with some moxa. After Mr. A read this article, I suggested to him that he try indirect moxibustion using ginger slices. Fortunately his wife
liked this garlic moxibustion, and he has been applying this
ginger moxibustion on his wife for over four months. As a
result, she didnt experience fatigue even during the time
she was undergoing chemotherapy, and she completed her
treatments in good shape. A test after showed that the cancer had not grown, and Mr. A learned that if anything the
tumor had consolidated, so he was greatly relieved and his
complexion improved. He is going to be 86 years old soon,
but he is enthusiastic about continuing moxibustion with
his wife and staying well together.
Ms. M first came for an acupuncture and shiatsu treatment 4 years ago. At the time she was a 21 year old student, and her main complaints were menstrual pain, eye
strain, and weakened eye sight. Abdominal diagnosis
revealed strong tenderness in the lower right quadrant,
and she had severe blood stasis. She felt much better after
I gave her two treatments of acupuncture and shiatsu four
days apart. Ever since then, she has consistently come for
monthly treatments.
When she came for treatment seven months after her
first visit, she complained of eye strain, so I applied moxibustion on BL10, and told her to get moxibustion on this
point at home. Just three weeks after that her grandfather
had a compression fracture in his lumbar vertebrae, and
he was carried into my clinic to treat the severe pain. At
this time I had the whole family come and I gave a class on
moxibustion so that they could all participate in his moxibustion treatments at home. The older son and his wife
and the younger son and his wife and their two children, a
total of six people, took turns giving him hour long whole
body treatments everyday for two months. As a result the
compression fracture healed and their 93 year old grandfather became active again.
This old man has visited Japan from Canada twice a
year since then. When he was in Japan last November, he
used a massage chair for too long and got a hairline crack

58

in his spine for which he had to be hospitalized. Fortunately, it was not a serious problem, and now he is convalescing
at home with a back brace. He is 96 years old now, and
usually a man his age with a fracture would be bed ridden,
but his speedy recovery from the fracture is a result of two
years of regular moxibustion treatment.
For the past two years, Ms. M continued giving her
grandfather moxibustion treatments whenever she had time
because he said they felt so good. She became a believer
in the power of moxibustion because she could see that his
strength increased and he had more energy. She also came
for her monthly acupuncture and moxibustion treatments
without fail, and her doctor told her that her vision was
improving. This made her like moxibustion even more. By
now, there is not one among her family and friends who
have not received the initiation of her moxibustion treatment. According to her mother, her brother and her give
each other moxibustion almost every day. Once she even
tried moxibustion on a terminal cancer patient, but realizing that this was beyond her ability, she referred the patient
on to me. Recently she has referred a few acquaintances to
me, and each time I am amazed at her skill because there
are no unsightly scars. In the last two years, she has become interested in acupuncture, and she asked me to show
her how to do acupuncture. So each time she came for
treatment, I showed her a little about how to insert needles.
Now she is able to treat her own headaches.
Even a layperson can take care of their own health with
acupuncture and moxibustion as long as they receive some
instruction and practice on their own body. It is wrong to
say that laypersons cannot do acupuncture and moxibustion. As long as they focus on their own health maintenance and do not treat others, there is no treatment which is
as harmless and safe. It is far safer than buying drugs from
a pharmacy and taking them. For this reason, as long as
they are sincere about learning acupuncture and moxibustion, I teach even my patients. Ms. M recently graduated
from college and received a Bachelors Degree. She is going
to Japan in January to give her grandfather moxibustion
treatments. She plans to return to Canada with her grandfather in the latter half of January. After that she wants to
come to my clinic to observe my treatments. Of course, I
will welcome her.
I have many other patients who have learned to treat
themselves. Ms. L, a Yoga instructor, returned her poorly
positioned fetus to a normal position using moxibustion.
She had a super easy delivery with just two hours of labor.
Everytime one of her students becomes pregnant, she insists that they do moxibustion on SP6 from about the sixth
month of pregnancy. She has reported three other cases of
super easy delivery with moxibustion. It is reassuring also
that everyone she recommended moxibustion to has had
great results. I have suggested moxibustion on BL67 and
SP6 for pregnant patients with fetal malpresentation, and
it has always worked. Almost everyone who has done this
home treatment had an easy delivery.
I have seventeen years of clinical experience with moxibustion to date. Of course, there are some patients who
have refused moxibustion. But their number, at around ten,
is very few. Once they experience moxibustion, most pa-

NAJOM
tients make comments like It feels good. Its relaxing. The
effects are unbelievably fast. And they become moxibustion fans. The higher the stress level, the more moxibustion
seems to work. From my experience, the effect of moxibustion is unrelated to age or race, and applies the world over.
People tend to fear the burning sensation of moxibustion, but once they experience it, there is nothing so pleasurable. The practitioners who are able to get patients to
experience this pleasure of moxibustion are the real professionals. For me moxibustion has become a tool which
becomes more and more reliable as I continue to use it for
treatment. I am convinced that my relationship of trust
with my patients will continue to grow with my use of
moxibustion.
(March 2001, Translated by Stephen Brown)

Practical Moxibustion Therapy (22)

1. Moxibustion therapy for infants
Not too long ago, a mother brought in her two and a
half month old daughter for treatment. The main problem
the baby had was crying and not sleeping at all during the
night. For the first month, the baby was allowed to sleep
face-down, and she slept very well this way. Starting with
her second month, however, she was placed face-up to
sleep following the doctors advice that it was better to
have the baby sleep face-up. For the month and a half since
then the babys eyes stayed wide open at night, and she
didnt sleep at all. Furthermore, she cried all through the
night. Each time she cried, the mother worried and gave
her milk to calm her down. This cycle of crying and feeding was repeated all night. Because of this, the mother had
become exhausted and slightly neurotic over the last month
and a half. The babys grandmother suggested that the
mother bring the baby to my clinic for a moxibustion treatment.
Acupuncture and moxibustion treatments of infants and
children have been quite popular in Western Japan and they
say there used to be signs around town advertising treatment for childrens irritability and crying at night. I myself
had an episode of crying at night when I was little. I must
have been in the second or third grade, but once I woke up
in the middle of the night for no reason, and I began to cry
because I became scared looking around the dark room.
This happened several nights in a row, and my crying must
have gotten loud enough to wake my father, because he
came to my room and applied some moxa on my back.
Strange as it may seem, direct moxibustion is not painful in
situations like this. I recall becoming drowsy even as I was
enduring the heat of four to five cones of moxa, and I slept
soundly afterward. I never had that problem again.
Little children have sensitive nervous systems, and their
autonomic nervous system gets out of balance when they
are exposed to certain unpleasant stimulation. When
this happens, infants will tend to vomit their milk, become
constipated, or start to cry at night. Little children, also
sensitive to adverse stimulation, will become irritable, start

squeaking, or experience indigestion. Sometimes even

adults experience such imbalances. In cases like this, the
heat stimulation of direct moxibustion acts as an anti-stress
agent which counters adverse stimulation. Moxibustion
works wonders in restoring balance when our nervous system is out of kilter.
I first taught the mother of this baby how to apply direct
moxibustion painlessly. Once the mother becomes confident and unafraid of moxibustion, she can do the moxibustion on her baby at home. I explained to her how a baby has
no idea about moxibustion being painful, so they are not
afraid. Since the slight burning sensation from minuscule
cones of moxa is not so unpleasant, children might flinch
a bit, but they get used to it. Next, I had this mother apply
seven cones of thread-like moxa on the baby at GV12 (the
depression below the third thoracic vertebrae). After the
fourth cone, the baby took two large yawns, and I knew we
had it made.
The babys grandmother came to see me two weeks later and told me that the baby slept for six hours straight the
night after her first treatment. In fact, she slept so well that
the mother began to worry. Every night after that the baby
slept well and the number of feedings at night decreased
considerably. This baby, who was chubby from drinking
too much milk, started to become thinner. She also learned
to suck on her fingers and her mood got better and she
was calmer. I was also told that she smiled a lot looking at
a baby toy which went round and round. In this way the
heat stimulation of moxibustion serves to restore balance
when there are sleep or behavioral problems with infants
and little children. GV12, the moxibustion point for treating
infants and children, is called Chirike in Japan. People in
the olden days recommended moxibustion on Chirike,
for getting children to grow up healthy and strong. My
own children also received moxibustion on Chirike for a
certain period after birth, and all three of them have grown
up healthy without having to rely on drugs and antibiotics
hardly at all.
Also moxibustion on GV12 on adults has an almost
tranquilizer-like effect, and GV12 is important point for
regulating the nervous system so I use it often. When its
done skillfully, moxibustion is relatively painless and there
are no side-effects, so it is an excellent therapy for home
that can be used without worry on babies as well as adults.
I hope more people in this modern era rediscover the value
of moxibustion therapy and begin to practice it at home
with their families.

2. Moxibustion therapy for cold hands

I have a 97 year old male patient who has had cold
hands for twenty years. He told me his hands got so cold
sometimes he couldnt even sleep at night. Feeling his
hands, they were indeed cold as ice. I have been seeing him
for almost two and a half years now. His main complaint
has been low back pain, so I have been doing a whole body
treatment with an emphasis on his low back and abdomen.
His cold hands, though, did not change very much. From
time to time though, I tried to warm up his hands by using points like LI4, LI5, TB5, LI10, and LI11, there was no
significant change. I was beginning to feel like, its too late

59

NAJOM
since he is as old as 97 years old.
When this patient came for treatment on February 8,
for the first time in six months, in addition to LI11, I tried
the piercing through moxibustion on TB4-PC7, and TB5PC6. I also had members of his family give him this treatment daily at home for over a month. When he came again
for treatment on March 14, the family member who came
with him said, He has stopped complaining about his cold
hands. When I asked him about it, he replied, They are a
little cold, but its not anything to worry about like before.
I have another patient, a 77 year old woman who had a
stroke 17 years ago. Now she is able to stand up on her own
with a four point support cane. If someone supports her,
she can shuffle forward very slowly taking two to four inch
steps. When she came for her first treatment on October 21,
2000, she complained of numbness in the left leg, pain in
the right midback, right knee pain, and left shoulder pain.
Her right leg was cold as ice from the knee down. The right
big toe was in pain, and she had it wrapped in a bandage. I
gave her a whole body moxibustion treatment with an emphasis on her left shoulder, right midback, and right knee.
I did piercing through moxibustion on the left leg below
the knee (ST34-SP10, GB34-SP9, & GB39-SP6), and have applied this strategy every time until now (May 8, 2001). The
other moxibustion points I have been using include SP3,
ST44, and ST41, but the level of coldness in her leg (which
was above her patella last October) started to descend, and
I could feel warmth progressively spreading downward. By
the middle of April, the coldness in her right leg was almost
gone and she no longer wears a bandage on the right big
toe. This patient had complained of cold hands, just as the
97 year old patient above. I started the piercing through
moxibustion on TB4-PC7, and TB5-PC6 late in March, and
her cold hands improved in two weeks. It is difficult to resolve numbness and coldness due to old age, accidents, and
strokes. The cold hands of the above two patients resolved
dramatically by using piercing through moxibustion on
TB4-PC7, and TB5-PC6. This piercing through moxibustion is described as follows in the chapter on arthritis in
Fukaya Isaburos book, Practical Applications of Moxibustion Therapy.
Arthritis is a type of inflammation. When there is
arthritic inflammation, I use the point selection method
known as piercing through moxibustion. For the knee
joint, for example, pairs of distal points are treated such as
ST34-SP10, GB34-SP9, LR9-GB32, and LR6-GB35. Likewise,
GB39-SP6 are used and for the ankle joint, and TB5-PC6
are used for the wrist joint. The secret is to use piercing
through moxibustion by selecting points distal to the affected area, using pairs of points that are interior and opposite to each other at the same level. Also it should be
understood that piercing through moxibustion is effective
not only for inflammation, but has a wide application.1
Thus the idea is to select points on the same segment
of the body which are opposite to each other and connect
the front and back, or the right and left sides. I use this
approach a lot to treat chilling in the extremities. For cold
toes, I often apply moxibustion on ST42 and KI1. For cases
of diabetes I sometimes do piercing through moxibustion on CV12 and GV6. The secret to locating points for

60

piercing through
moxibustion is to
find points where
there is a penetrating sensation when
pressure is applied.
For example, when
T B 5 a n d P C 6 a re
pressed from either
side with the thumb
a n d i n d e x f i n g e r Fig. 1
(Fig. 1), it should
feel like the fingertips are pushing right through to each
other. This means that these are good points for piercing
through moxibustion So these are not textbook locations,
but rather the points with a penetrating sensation which
connects two opposite points. This applies to acupuncture
as well, and when needles are inserted on opposite sides in
such points, the piercing through sensation is easily obtained. As Fukaya Isaburo stated, piercing through moxibustion is effective for reducing heat in cases of inflammation in addition to curing chilling in the extremities.

3. Personal experience with antibiotics

On February 18 of this year, I suddenly came down with
tonsillitis. Im not sure how I got it because I was not exposed to cold, and I dont recall being fatigued from having
stayed up late, or working too hard. In the three weeks preceding the onset, however, my body did feel a little heavy
and I had been thinking that I needed to start on a regimen of food therapy. Anyway, the condition was acute so
it came on fast. I had a funny sensation in my throat early
one afternoon, so I gargled with salt water and took some
Ge Gen Tang 2. I also applied five small cones of moxa on
three tender points on the right side of my throat. For sore
throatsI usually do something like this in addition to multiple cone moxibustion on LU5. For some reason I forgot
to treat LU5. Around 4pm the pain in my throat increased,
and I started having joint and muscle pain as well. I had a
lot of tasks to attend to that day, however, so I continued
working without a break.
Around 8:30pm I started getting chills, and the throat
pain extended up to my right ear. I did some moxibustion
on myself around 10pm on CV12, ST36, and LI11 as well
as multiple cone moxibustion on a tender point on my upper right throat. I took some Chai Ge Jie Ji Tang3 and went
to bed by 11pm, but I felt restless and I just couldnt get to
sleep. I would doze off for a while, but then I would wake
up with my loud snoring. I ended up getting up four times
to use the bathroom that night.
The next morning, on February 19, I had a bad headache
and the ocular pressure in my right eye was up, and it hurt.
I had pain in the vertex, occipital area, as well as around
the right ear. I had a slight fever at 37 C. The pain in my
throat as well as my joints was worse. I also felt unsteady
when I walked. In the afternoon a sharp pain started up
in my right midback and this pain quickly spread toward
LR14 on the right and turned into the excruciating pain of
intercostal neuralgia. At 3:30pm my temperature was up to
38.4 C. That night I gave myself a treatment by retaining

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needles in points in my occipital area, neck and shoulders,
and right midback. I also bled BL10 and GB20 on the right,
and the neuralgic pain on my left side diminished dramatically after that. Nevertheless, my headache and facial pain
were intense, and I snored so loudly I couldnt stay asleep
for more than ten minutes. I tossed and turned until 3:30
a.m., when I got up and took two pain killers for the first
time in my life. The treatments I gave myself that day, aside
from the above mentioned acupuncture, were the herbal
formulas Chai Ge Jie Ji Tang and Gan Cao Jie Geng Tang4
and Ishizakas potato compress on my cheek and throat.
On the third day I still had a sore throat, upper back
pain, and a fever (37.5 C), but I had the energy to walk for
an hour. My bowel movements were normal and my appetite started to return so it seemed like I was starting to
get over it. On the fourth day there was no change in my
sore throat, but the aches in my body were gone and I felt
quite a bit better. So I began to work again thinking that I
was well on my way to recovery. That night, however, I still
tossed and turned and could not sleep.
On the fifth day, unexpectedly the pain in my throat
spread to the left side, and I had to go through the same
process of pain spreading through my body that I had
experienced on the right side. Furthermore, the pain was
even more intense and intractable than the last time. I figured that this too would pass in three or four days and
continued to give myself acupuncture and moxibustion. I
also took Xiao Chai Hu Tang Jia Jie Geng Shi Gao5. Despite
my expectations, however, there was no improvement in
my symptoms by the eighth day, and in fact they were getting worse. On the evening of the ninth day, I lost my voice
entirely. There was slight improvement on the tenth day,
but I wanted to put an end to the vicious cycle of pain and
insomnia. So I decided to use antibiotics for the first time in
my life. I visited a doctor and got an eight day prescription
for 500ml of Amoxicillin.
I took two antibiotic pills that day and the day that followed, and the pain I had when swallowing improved by
70%. In the days preceding that, I had felt my sore throat
slowly getting better, but this change with the antibiotics
was dramatic. I took the antibiotics for three days and then
skipped a day, and took them for one more day and quit.
The reason I skipped a day was because my stools became
loose on the second day of taking antibiotics, and I got diarrhea on the third day. I had never gotten diarrhea like this
before, so I assumed it was a side-effect of the antibiotics.
My doctor advised me to take the entire eight day course of
antibiotics, but I still quit after just four days. I thought that
perhaps 20% of the germs were still left in my body, but I
wanted to see how my body would handle these remaining
germs.
On the 17th and 18th day, I continued recovering without any problems. I had no more pain and I felt great. I
continued taking Xiao Chai Hu Tang Jia Jie Geng Shi Gao.
On the 19th day the throat pain started up once more, and
it felt like it might get worse. This pain diminished day by
day, however, and it resolved completely by itself by the
25th day. Then on the 33rd day, I got a sore throat on both
sides, and it felt like I was in for a relapse. I gave myself
more acupuncture, moxibustion and herbs (Chai Ge Jie Ji

Tang, Ge Gen Tang, and Yin Qiao San Pian) to deal with
this. I changed my herbs to Xiao Chai Hu Tang Jia Jie Geng
Shi Gao and Yin Qiao San Pian 6 on the 35th day. My throat
still felt funny after the 40th day, as if something was stuck
in it, but this sensation went away completely in a week to
ten days. Therefore, it took me 50 days to recover completely from the onset of tonsillitis.
I used antibiotics from day 10 to 16, but I wonder
whether I would have reduced the number of days it took
to recover completely if I had continued with my course of
antibiotics. After I stopped taking the antibiotics on the 16th
day, I had minor relapses on the 19th and 33rd day. In both
cases, however, the symptoms resolved naturally without
any complications. Considering this outcome, it seems that
my bodys resistance was activated, and each time a relapse
started the germs were controlled and my immunity was
strengthened. What would have happened if I had killed
off all the germs with the antibiotics? I wonder if my natural resistance would have been activated with relapses and
whether my immunity against the germs would have been
strengthened. I believe the difference between drug assisted
healing and natural healing lies here. Another way to say
this is: one is drug dependent healing and the other is immunity dependent healing.
Using drugs in the acute phase is useful for getting the
body out of a tight spot and avoiding a crisis, and it can
be a powerful agent for preventing an untimely death. But
relying on drugs entirely leaves no room for the natural
healing capacity to activate, and the bodys resistance (immunity) is not developed. Even if some immunity is developed, compared to cases of natural healing, the resistance
developed is weak or incomplete. In order to strengthen
our immunity, there has to be some antagonistic agent
(germs). Actually, this includes is not only bacteria, but viruses and various other adverse conditions. Our immunity
is developed in response to antagonistic agents.
The thing I learned from this episode of tonsillitis is that,
even though it might take more time, if the dependence on
drugs is minimized and the natural healing capacity is allowed to activate, immunity will be strengthened. I have
a strong feeling that most likely I will never get tonsillitis
again, and even if I do it will not develop into a serious
condition again because my immunity is strong.

Notes
1. Fukaya Isaburo, Okyu Ryoho no Jissai (Practical Applications of Moxibustion Therapy), Midori Shobo, 1977, p.
157.
2. Ge Gen Tang (Pueraria Root Decoction)
3. Chai Ge Jie Ji Tang (Minor Blupleurum & Pueraria Open
Exterior Decoction)
4. Gan Cao Jie Geng Tang (Licorice & Platycodon Decoction)
5. Xiao Chai Hu Tang Jia Jie Geng Shi Gao (Minor Blupleurum Decoction with Platycodon & Gypsum)
6. Yin Qiao San Pian (Lonicera & Forsythia Tablets)
(July 2001, Translated by Stephen Brown)

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Practical Moxibustion Therapy (23)
Thoughts on ST-36
1.Preface
Recently I have been giving myself ST-36 moxibustion
every evening. I have done acupuncture and moxibustion
on ST-36 for myself on many occasions, and I have used
ST-36 for every patient. There are two reasons I have been
giving myself moxibustion on ST-36 this time. The first reason is that I have noticed my legs have been weaker since
this summer. My legs feel colder and the muscles in my
thigh are harder. The second reason is that I read an interview with Dr. Ohmura Yoshiaki by Tobe Uichirio, the publisher of Ido-no-Nippon (Journal of Japanese Acupuncture
and Moxibustion), which was titled ST-36 and Its Effects
on Cancer.1 This interview, particularly, was of sufficient
interest to make me want to begin the practice of moxibustion on ST-36 again. So I want to begin this article by introducing some of the contents of this interview.
2. Dr. Ohmuras Point Location
There are two points I found very interesting in this
interview. The first is Dr. Ohmuras location for ST-36, and
the second is that the telomere of normal cells increases
while that of cancer cells decreases with acupuncture and
moxibustion. I will quote Dr. Ohmura from the Ido-no-Nippon interview, first concerning the location of ST-36, then
concerning telomeres.
A line is drawn at the beginning (of the tibial tuberosity) and this line is followed laterally straight from the
tibial crest where one side of the circle, which is part of the
acupuncture point ST-36, touches. This line drawn horizontally corresponds to the diameter of the tubular meridian,
which is 1 to 1.3 cm across... This is ST-36. Looking at various texts, however, many agree up to the point of finding
the tibial tuberosity, but
ST-36 is located one unit
away from it. So if we say
its a unit estimated from
the width of the patient
s thumb or middle finger,
it could be between 1.7
to 2cm depending on the
person. When the diameter
of the point is 1 to 1.3cm,
going 1.7 to 2cm lateral
would put you 5 to 7mm Fig. 1
off the point in a completely unrelated place. (Fig. 1) 2
Dr. Ohmura explained as follows
concerning telomeres: The length of
telomeres, which are in the chromosome,
(Fig. 2)3 decrease more and more as cells
divide. Once it decreases to a certain
point, the cell can no longer divide, and
when certain conditions occur together
the cell dies (apoptosis, or programmed
Fig. 2
death). The amount of telomeres in the

62

cells of people over one hundred years old is far less than
that in babies, who will have the highest amount in their
lifetime (1500 to 5000 nanograms). The lowest count for
telomeres in a living person recorded so far is 100 nanograms. Dr. Ohmura went on to say, When acupuncture or
moxibustion are effectively applied to ST-36, the telomeres
of normal cells increase to twice or three times. And simultaneously the telomeres in lung or colon cancer cells, which
is two to three times the normal amount, decrease to less
than half of what it was before acupuncture.
I dont know about Dr. Ohmuras bi-digital O ring
test, and have no way of knowing how he came up with
his location of ST-36, or how he formulated the theory
about telomeres. Nevertheless, I found the above two
points very interesting, and this interview gave me a refreshing new perspective.

3. My Point Location
My point location method for ST-36 has been to press
laterally with my thumb from the bottom end of the tibial
tuberosity to find the tenderest point. I usually target tender points when I am locating moxibustion points for patients. The tender point does move around after a while so
the scars at my ST-36, where I have been applying moxa
for over twenty years, have gotten pretty large. And these
scars are a little off Dr. Ohmuras location in the lateral and
inferior direction. Comparing the tenderness under my
scar with Dr. Ohmuras location, I found the tenderness to
be about the same. I tried applying about ten cones of ricegrain sized moxa at Dr. Ohmuras location on both legs,
and the feeling of heat penetration and the moxibustion
sensation felt great. So I have continued applying moxibustion here for over two months. In the past, however, Ive
seen the scars on patients who have had other acupuncturists locate ST-36, or who have located it in their own way.
And many of these were different from my location of
ST-36. I myself have always targeted the tenderest point, so
you might say I had no set location for ST-36.
4. Point Location of Masters of the Past
Shi-Si Jing Fa-Hui (Elaboration of the Fourteen Meridians): Three units under the Eye of the Knee (Xiyan),
lateral to head of tibia in the big depression of the (tibialis
anterior) muscle. Locate with the leg flexed. When pressed
forcefully, the pulsation in the (dorsalis pedis) artery stops.
Although many classics say that ST-36 is three units below
the knee, three units under Xiyan, is most accurate.
Wakan Sansai Zukai (Japan-China Illustrated Encyclopedia): Flex the knee and place the foot on the floor and
use the handle of a brush to push upward along the tibia
until it stops. Lateral to the tibial tuberosity in the depression. This text offers an interesting technique for locating
ST-36.
Sawada Ken: One unit lateral to where the handle of a
brush comes to a stop when stoking up the anterior border
of the tibia, (the inferior border of the tibial tuberosity) in
the depression in the muscle. Locate with the knee flexed.4
The influence of the Wakan Sansai Zue is apparent.
Hara Shimetaro: Dr. Hara, who is famous for promoting
moxibustion on the Eight Points on the Back and ST-36,

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used a traditional moxibustion
location as follows: Flex the
knee joint to a right angle and
place the hand over the patella
so that the thumb and index
fingers wrap around the top.
Line the four fingers up with the
tibialis anterior muscle and keep
them on the skin as you reach as
far down as possible. It is at the
tip of the middle finger. (Fig. 3)
Also as the Hara Style Moxibustion Point Location, he had a second method he used as follows:
Draw an inverted (equilateral)
triangle with one side being the
Fig. 3 Dr. Haras method line between the head of the
tibia (the highest point between
lateral condyle medial condyle
the medial and lateral condyles)
and the head of the fibula. The
tuberosity moxibustion point for ST-36 is at
head of
of fibula the inferior tip of this triangle.
fibula
(Fig. 4) 5
Shirota Bunshi: The midanterior
point of the line connecting the
border
point one unit below the head of
the fibula (GB-34) and the infebody of
body of
rior border of the tibial tuberosity
fibula
tibia
(Where Sawada said the handle
of the pen came to a stop) is
ST-36. (Fig. 5) He states that, This
is the most accurate location
method. 6
medial
lateral
Fukaya Isaburo: Bend the
malleomalleolus
knee
and place the hand over the
lus
Fig. 4
knee cap as in the figure (same as
Fig. 3). Pressing hard with the tip
of the middle finger
will cause a strong
ST-33
sensation that can
be felt all the way
ST-34
GB-33 d o w n t o t h e t o e s .
two units
This method is for
Press the
pen against
head of fibula l o c a t i n g t h e p o i n t
the anterior
on ones own leg.
border of
one unit
When locating it on
the tibia
GB-34
someone else, have
and glide it
upwards. LoST-36 (the them flex the knee
cate the point
midpoint of to 60 degrees so that
where the
the line)
the thigh, the calf,
pen comes to
a stop.
and the floor form an
equilateral triangle.
Next press and slide
the finger up the
lateral border of the
ST-41
tibia until it comes to
a stop (at the tibial tuberosity). It is lateral
ST-44
to the tibial tuberosity where there is a
Fig.5 Shirotas method

strong sensation when pressed firmly. 7 In my opinion, this

is the most clinically useful explanation.

5. Indications for ST-36

If asked what the indications for ST-36 are, my reply
would be, It draws Qi down. ST-36 is the He Sea point of
the Stomach meridian, and it can be found in any text that
He Sea points control rebellious (counterflow) Qi and loss
of fluids. The phenomenon I experience when I do moxibustion on ST-36 for myself is that my nose clears immediately. Nasal congestion is a type of rebellious Qi, where Qi
becomes stuck in the upper half of the body. ST-36 works
amazingly well to draw this heat (Yang Qi) down.
It is written as follows in Shinkyu Chohoki (Treasured
Record of Acupuncture and Moxibustion ): When applying moxibustion on points like the Four Flowers,8 BL-43,
and GV-20, follow this up with moxibustion on Sanli (ST-36)
to pull down the heat above. So this passage seems to say
it is important to draw Qi down after doing a lot of work
on the upper half of the body.
Shirota Bunshi used ST-36 for neurasthenia, hysteria,
and psychosomatic conditions. When I do moxibustion on
ST-36 for myself, invariably I experience my head clearing and my feet warming up. And I always sleep soundly
afterward, so I think it takes the place of tranquilizers. This
must also be one of the effects of controlling rebellious Qi.
I have a 71-year old Caucasian male patient. He has
suffered from asthma for many years, and had been using
Prednisone for a long time. He was worried about the side
effects of long-term use of the drug and decided to try acupuncture. I gave him six treatments between June and August of 2001. Nevertheless, his asthma did not show much
improvement. He also had a bad case of edema in his legs
and even the skin on his upper body felt quite puffy. In his
abdomen there were two parallel bands of tension on either
side of the navel that were hard as sticks. He also had trouble with insomnia. In September, I decided to teach him to
do direct moxibustion on ST-36 so he could do it at home.
When he returned for treatment at the end of September,
the swelling in his legs had gone down considerably and
the puffiness in the skin of his back had also improved dramatically. He also reported that his asthma was getting better.
In mid-October, he was able to reduce his dosage of
Prednisone to previous levels (since he had been on an increased dosage to control his asthma). By mid-November,
the puffiness in the skin of his back was almost gone, and
his skin had become soft and smooth like that of a woman.
By December he had gained some weight and his pulse
felt stronger, so I added KI-6 and LU-5 (three cones each)
to his home regimen. This actually caused his asthma to
get worse. It calmed down after I had him stop doing these
points. Perhaps moxibustion on LU-5 had hindered the effect of drawing Qi down. Doing these points had also
caused some puffiness (congestion) in the occipital area and
bloodshot eyes. I decided that for this patient ST-36 was the
most effective moxibustion point, so I had him continue
treating 36 alone dramatically reduced the asthma (rebellious Qi) and resolved the other physical symptoms in a
relatively short time.

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Qi in the human body tends to rise easily, so it is important to sink this Qi from time to time. Doing moxibustion on ST-36 everyday over a period of time alleviates the
problems of chilling in the legs and flushing in the face
(hot above, cool below). It also helps to balance the circulatory system. This is, no doubt, the reason ST-36 is included
among the seven points for the prevention of strokes, 7
aside from being used widely as the moxibustion point for
prevention, general wellness, and longevity.

5. Conclusion
Ever since I read the interview in Ido-no-Nippon about
ST-36, I have been consciously employing Dr. Ohmuras
location. I am sure to locate the lower end of the tibial tuberosity precisely, and I look for a tender point that is about
1.3cm lateral to this. I used to look for a tender point in this
general area without a clear target. Now I have a clear aim
of finding what I am convinced is Dr. Ohmuras location for
ST-36. I now have a definite sense of getting the point, and
it feels like the acupuncture and moxibustion is working
better. An interesting thing about acupuncture and moxibustion is that, When you are strongly convinced that it is
effective, it is effective. This means that, It doesnt work
if you are doubtful. And when you locate the point with
certainty, your point location becomes more and more accurate.
As for my own treatment, I made a practice of applying seven cones of moxa on BL-62 and 60, as well as on Dr.
Ohmuras ST-36. After two months of this, my legs warmed
up and my chronic back pain improved considerably
so much so that I was in great shape during the busy time
before Christmas, and I breezed through it. This personal
experience was especially gratifying and this is the reason I
am very pleased with this new location.
In the case of my 71-year old patient above, however,
I started treating him before I came across Dr. Ohmuras
ST-36, and still we got good results. Furthermore, the location for ST-36 varies amongst practitioners of the past. It
therefore seems that the ST-36 is a fluid entity that is open
to interpretation. According to Fukaya, In many cases
good results cannot be obtained when ST-36 is located according to the Shi-Si Jing Fa-Hui or other texts. This is
because ST-36 also tends to move. He also said, Often it
moves to the right or left, or distal to the standard ST-36. So
one must locate this (reactive) point.10 As a practitioner, I
wholeheartedly agree with this view.
I have written down what came to mind about moxibustion on ST-36. I have used ST-36 most often among all
the points I have used to date, countless tens of thousands
of times. But, each time Ive located this point in the past
twenty years I have poked around thinking, Is it here, or
is it here? These days I have become more confident in its
location and this Three Mile Point has become even more
familiar and I am even more taken in by its potential.
Notes
1. Interview - ST-36 and Its Effects on Cancer (Dr. Ohmura
Yoshiaki & Tobe Uichirio), Ido-no-Nippon (Journal of
Japanese Acupuncture and Moxibustion), Oct. 2001, Vol.
60, No. 10, p. 129-150.

64

2. Fig. 1 - from Ido-no-Nippon Oct. 2001, Vol. 60, No. 10,

p. 136.
3. Fig. 2 - from Ido-no-Nippon Oct. 2001, Vol. 60, No. 10, p.
138.
4. Shirota Bunshi, Shinkyu Chiryo Kisogaku (Basic Study
of Acupuncture and Moxibustion Therapy), Ido-noNippon Sha, 1979, p. 112.
5. Hara Shimetaro, Manbyo-ni-Kiku Okyuho (Moxibustion
Therapy Effective for All Diseases), Jitsugyo-no-Nippon
Sha, 1933, p. 127.
6. Shirota Bunshi, Shinkyu Chiryo Kisogaku (Basic Study
of Acupuncture and Moxibustion Therapy), Ido-noNippon Sha, 1979, p. 112.
7. Fukaya Isaburo, Okyu Ryoho no Jissai (Practical Applications of Moxibustion Therapy), Midori Shobo, 1993, p.
68.
8. Four Flowers: see NAJOM, Vol.5, No. 12, March, 1998
9. Seven points for the prevention of strokes: GV-20, GB-7,
LI-15, LI-11, GB-31, ST-36 & GB-39.
10. Fukaya Isaburo, Kyudo Rinsho Yoroku Dai 5 (Anecdotes
from a Moxibustion Practice #5), Shinkyu-no-Sekai Sha,
p.65
(March 2002, Translated by Stephen Brown)

Practical Moxibustion Therapy (24)

I observe many changes (effects) as I give moxibustion
treatments to patients. I will list some of the main ones that
come to mind:
1. Improved blood circulation
a. Blood stasis clears up. - Roughness and dark areas in

skin clears up and skin becomes soft and clear.
b. Cooling of body goes away.
2. Increase in physical strength.
a. Stop catching colds.
b. Asthenic constitution improves so that one is less fa

tigued and has more energy.
c. Bones become stronger so there are fewer fractures

and faster recovery from osteoporosis.
3. Digestive function increases, appetite improves, and
constipation goes away
4. Nerve function is regulated, irritability from stress goes
away, sleep improves.
5. Hormonal secretion improves.
a. Dysmenorrhea improves, and infertility is resolved.
b. Skin becomes clear and one looks younger.
The effects I have listed above are the primary effects
of direct moxibustion that are commonly experienced. As
these changes are experienced, the disease begins to move
towards resolution with continued moxibustion treatment.
Eventually patients start to forget about their complaints,
and finally the disease is completely cured. From my experience with moxibustion therapy, I have the sense that
somewhat difficult disease take about a month and a half to
resolve. Fairly stubborn diseases take three to four months,
and even the most complicated diseases which I am at a
loss to treat resolved in six months to a year. Taking rheumatoid arthritis with strong pain and swelling in the hands
as well as inflammation in the wrist and knee joints as an

NAJOM
example, the pain is generally alleviated in about one and a
half months. Walking becomes easier in about six months,
and a year later the patient is able to play half a round of
golf. In the case of a vertebral compression fracture due to
osteoporosis it takes about two months of direct moxibustion to relieve the pain.
The number of points and cones applied in these cases
varies by the physical condition and illness of the patient,
but as a rule, moxibustion should be applied every day. This
is why home moxibustion treatments are required, and for
this, the cooperation of family members become necessary.
Doing home moxibustion treatments everyday is no small
feat both for the person giving it as well as the person receiving it since they are not proficient and it takes more time at
first and the heat sensations tend to be much greater due to
lack of experience. Be that as it may, I have seen countless
patients overcome difficult physical problems by consistent
moxibustion treatments. Recent examples include a couple
who cured a case of chronic arthritis through a year of moxibustion treatments, an 81 year old woman who alleviated
the pain of a compression fracture from osteoporosis with
two and a half months of moxibustion, and another couple
who cured a case of chronic low back pain, which persisted
for many years, with two months of moxibustion.
In this article I will present two case histories which
represent my recent experiences with the amazing effects of
moxibustion therapy.

Case 1
Patient: G. U. male born in 1925
First Visit: February 21, 2002
Chief Complaint: After receiving radiation therapy for 25
days for prostate cancer, patient received titanium insertion
surgery in his prostate. Ever since then he has been bleeding from his rectum. Western medicine has not explained or
helped this bleeding. This patient was active as a Judo competitor and teacher for many years, so even though he is 76
years old and small, he has a powerful build.
Treatment: Stainless steel 50mm, No. 3 needles were
retained in CV-12, CV-4, CV-3, ST-36, SP-6, and KI-6 for
ten minutes with the patient supine. Then seven cones of
half rice grain sized cones of moxibustion were applied
on the same points. Next, needles were retained in BL-22,
BL-23,BL-25, Yaoyan, points 1.5 units lateral to Yaoyan,
BL-35, Denatsu (gluteal tender point), BL-40, and BL-57.
Also simple insertions were performed in the upper back
to release tight points. After removing the retained needles,
seven cones of half rice grain sized cones were applied on
the points needled on the lower back and legs. This patient
lived in a town over three hours distant from my clinic and
could not come for regular treatments, so I suggested home
moxibustion treatments and taught him how to do it. I also
showed him how to do No Shiatsu (1) on his abdomen and
concluded the treatment.
Progress: I almost forgot about this patient after that, but
I got a call from him on April 21, exactly two months later.
He told me that the rectal bleeding which had continued
for two years and four months had stopped. I asked him
if he had been doing moxa on all the points I prescribed,
and he said he had applied seven cones of everyday only

on ST-36 and otherwise did the No Shiatsu consistently. He

said he used to wear special diaper-like underwear to absorb the blood, but he didnt need it anymore. He still bled
a little when he lifted something heavy, or had more than
three bowel movements within an hour after getting up in
the morning, but it stopped quickly so it posed no problem.
(He normally had two bowel movements, and this did not
cause rectal bleeding.) His lower abdomen which had been
cold had warmed up and felt better, so he said he was going to continue with seven cones of moxibustion on ST-36
and the No Shiatsu. He asked me to send him more incense
and moxa material.
Observations: The effect of moxibustion on ST-36 is
phenomenal. As it says in the classics, ST-36 controls the
gut and stomach. The moxibustion on ST-36 most likely
improved the chilling in his abdomen and stopped the rectal bleeding. I presume that this bleeding was caused by the
venous congestion from the extreme circulatory obstruction
in the lower abdomen due to the surgical scars and radiation treatments. The patient experienced this circulatory
obstruction as coldness in his lower abdomen.
There is no concept in Western medicine for coldness in
the lower abdomen, and no way to alleviate localized cooling. So naturally there is no way to resolve such problems.
This cases speaks to the mysterious power of the combination of ST-36 and moxibustion therapy.

Case 2
Patient: H. I. male born in 1931
First Visit: May 13, 2002
Chief Complaint: This patient received an operation for
colon cancer in August 2000. He received chemotherapy
after that, and for about a year afterward it seemed as if
he was doing well. He had been told by his doctor some
time ago that he could eat anything he wanted, so he had
not been watching his diet. He had blood in his stools from
November 20, 2001 and he was quickly hospitalized on
November 22. He received an operation on November 25
in which parts of his colon were removed and an artificial
anus was implanted. He was discharged from the hospital
on December 2. He came to my clinic in on the way home
from the hospital, requesting that I locate moxibustion
points on him for home treatment.
On this visit, his wife told me that Even if parts of his colon were removed, there are three tumors which could not be
removed still in his colon, as well as two more tumors which
had metastasized to the lung, and the doctor has given him
two months to live. She added, I havent informed my
husband about this. I would like to try home moxibustion
treatments as a final effort. That is why we came to have you
locate some points even though it is Sunday.
This woman first came to me in 1995 for treatment of
Bells palsy and was completely cured with acupuncture and
moxibustion. Ever since she has continued to come for treatments once or twice a month. Also she came from a family
with a tradition of moxibustion for appendicitis, so she
was very fond of moxibustion and believed in its effects.
In my mind I connected Taikyoku Therapy of Sawada
and the statement of Dr. Ohmura that moxibustion on
ST-36 decreased the telomere of cancer cells. (2) I selected

65

NAJOM
the standard Sawada style points of ST-36, LI-11. CV-12.
BL-17, BL-18, and BL-23. To this I added GV-14 and KI-26 as
well as BL-25 and Yaoyan since the patient complained of
extreme coldness in his low back and hips. I applied seven
cones each on these points with the exception of ST-36, on
which I applied 20 cones. Later, for the home treatments,
the wife added the family tradition point for appendicitis (a
point about two units below GB-25 on the right).
As I stated, this woman came to me once or twice a month
for treatment, and her husband had been driving her to my
clinic each time. These visits continued and I had the chance
to talk with her husband each time. He said things like The
chemotherapy is even harder to take than before, but his
voice sounded strong and I found it hard to believe that he
was a terminal cancer patient. Four months went by and this
mans condition remained unchanged, he appeared just like
an ordinary person. In this four month period he missed only
two days of home moxibustion treatments. The coldness in
his low back gradually went away, so BL-25 and Yaoyan were
excluded from the treatment.
I got a call from the wife in mid-April of 2002, and she told
me, He received a examination at the hospital and all the
tumors had disappeared. Even with a CT scan, they could
not find a malignant tumor in the colon or the lungs. It was
a miracle and the doctors were mystified, but the most surprised was the husband who heard about his prognosis of two
months to live four months later. Of course, the chemotherapy
was discontinued at this point.
I asked the wife and got the husband to come to my clinic
for an examination. The ST-36 points has a little puss collected
under them and felt boggy. Also, there was some edema between his knees and ankles. His upper abdomen had some
pain ever since the operation, and the pain still got worse after
a meal. When his stomach pain got real bad, he would take
some morphine and this produced a need to defecate, and
he said that he would pass a phlegm-like substance. He had
strong muscle tension between CV-10 and KI-16, so I did five
cones of moxa on CV-10 and KI-16 on the left. I also added the
Shitsumin point (on the heel) for the edema in the lower legs,
and recommended that these points be added to the home
moxibustion treatment.
Observations: This is a rare case in which four months of
home moxibustion treatments eradicated terminal cancer. It is
the first time something like this has happened in my 19 years
of practice. I never dreamed that such miraculous results
would be obtained on December 2, when I selected points for
moxibustion on a patient given two months to live. I believe
the cause of this astounding result was the combination of the
effect of moxibustion therapy, the effect of ST-36, and the effect of Taikyoku Therapy. But most of all I attribute this result
to the physical strength of the patient. This patient was a carpenter for many years and was pretty strong and had a excess
type body. The chemotherapy together with his already strong
body and the stimulation of moxibustion must have all concentrated in the positive direction to bring such astounding
results in four months time. If he were a deficient patient, the
speed of decline would have been faster than that of recovery,
and he may have lost his life.
His blood circulation and quality must have dramatically
improved with four months of moxibustion therapy, and the

66

cancer cells must have been absorbed in the blood. The following related phenomena are listed in a recent issue of the
Journal of the Japan Society of Acupuncture and Moxibustion.(3)
1. Many cells involved in immunity (helper T cells, natural
killer cells) are released outside the blood vessels in the localized area of moxibustion stimulation.
2. It is hypothesized that the substance in moxa (caphetannin?)
has an activating effect on the cells involved in immunity,
and is involved in the release of these cells in the localized
area of moxibustion stimulation.
3. There is a rise in the appearance of cytokine (INF-v, IL2mRNA) in the lymph nodes associated with the localized
area of moxibustion stimulation.
I believe that immunity boosting effect of moxibustion
therapy is strongly connected with disappearance of cancer
cells in the above case.

Conclusion
The above two cases are examples of how non-professionals have continued moxibustion therapy over a long
period to increase the bodys ability to fight disease and
far exceeded the expectations of Western medicine. I have
seen many cases where patients whose condition seemed
hopeless improved with moxibustion therapy over a long
period. These two cases, however, have renewed my regard
for the enormity of the natural healing capacity of the human body. I have become more convinced than ever of the
power of moxibustion therapy which can draw out this natural healing capacity to the maximum. In this way, I have
become aware all over again that, by trusting in the power
of moxibustion and applying it over a long period, one is
sure to get good results. I will conclude this article with a
quote from the moxibustion master Sawada Ken .(4)
When a certain person was cremated, there was a lump
like a stone which would not reduce to ashes. I applied
moxibustion on this lump over and over and it began to
dissolve from the middle. As I continued to apply more and
more cones, only the perimeter remained, and finally it dissolved completely. Moxibustion is really mysterious, and it
seems to have the power of breaking up lumps. Looking at
it this way, I believe even the hard lumps of cancer can be
broken down by the power of moxibustion and dissolve.
Notes
1. See NAJOM, Vol. 5, No. 12, March 1998, p. 31 concerning
No Shiatsu.
2. See NAJOM, Vol. 9, No. 23, March 2002, p. 35 concerning
Dr. Ohmuras views on moxibustion on ST-36.
3. Tohya Kazuo, Kyuryoho-ni-Yoru-Menekigaku-tekiKouka-no-Hatsugen-ni-Kansuru-Kentou (Research
Related to the Activation of Immunological Effect with
Moxibustion Therapy), The Journal of the Japan Society
of Acupuncture and Moxibustion, Vol. 52, No. 1, February, 2002.
4. Shirota Bunshi, Sawada-ryu-Bunsho-Shinkyu-Shinzui
(Sawada Style Teachings: The Essence of Acupuncture
and Moxibustion), Ido-no-Nippon, 1978, p. 104.
(July 2002, Translated by Stephen Brown)

NAJOM
Practical Moxibustion Therapy (25)
1. The Autonomic Nervous System and Oriental Medicine
Recently I have come to think that the effects of acupuncture and moxibustion primarily come from the regulation of the autonomic nervous system. I have become
vaguely aware of this as I give treatments, but since I dont
have scientific data or results from research in my practice,
the evidence is fragmentary. Therefore, this article is basically my conjecture.
What we call Qi and Blood; Ying and Wei must be another way to describe the function of the autonomic nervous system. For example, saying that Qi circulates through
the meridians implies that there is a signal system which
controls the body. So the sympathetic and parasympathetic
nerves must be part of this. Otherwise, part of the function
of Qi must correspond to the autonomic nervous system.
Also, if the Wei (defensive Qi) is the immune system, it has
to be intimately connected with the autonomic nervous
system. This would include its relationship to the antibody
system (lymphocytes) or the parasympathetic nerves and
the phagocytic system (mostly granulo-cytes) or the sympathetic nerves.
Blood and Ying (nutritive Qi) could be the body fluids
and nutrients in them including blood and lymph. It is clear
that these are under the control of the autonomic nervous
system as the foundational substance which supports the immune system. To list some of the functions of the autonomic
nervous system from a physiology text,1 the following conditions are created by dominance of sympathetic nerves:
pupils dilate
breathing becomes rapid (smooth muscles of bronchi expand)
mouth becomes dry (reduction in digestive fluids)
heart rate increases
blood pressure rises
sweating increases
peristalsis in the gastrointestinal system decreases along
with reduction of gastric fluids
the adrenal medullas are stimulated to secrete adrenaline
In contrast to this, when the parasympathetic nerves
become dominant the exact opposite phenomena occur.
That is, the secretion of gastric fluids increases along with
peristalsis in the gastrointestinal system. Also blood vessels
dilate and blood pressure is reduced.
Considering the treatments I have been doing up to
now, the effect tends to be activation of the parasympathetic
nervous system. In other words, most often the effect was
that patients relax, their muscles relax, blood pressure goes
down, and appetite increases. Also there tends to be an
increase in tears, nasal discharge, or drooling, and it is common for patients to say they feel hungry after a treatment.
Often I observe a pattern of improved appetite, nutritional
state, and weight gain, which in turn increases energy.
Listing some of the symptoms of what is commonly
called utonomic dysfunction, there is a wide variety as
follows: headache, dizziness, fatigue, insomnia, shaking,
chilling of hands and feet, abnormal sweating, palpitations,
shortness of breath, chest pains or oppressive sensation in

chest, loss of appetite, bloating sensation in stomach, constipation, and diarrhea. We can recognize these as some of the
common symptoms we treat everyday as acupuncturists.
In modern life there is a tendency towards overstimulation, excess stress, and over work. This creates a constant
state of sympathetic dominance. When acupuncture and
moxibustion treatments are given to people in this state,
the parasympathetic nervous system becomes dominant
to restore the balance in the autonomic nervous system.
In this way complaints of general malaise, psychosomatic
conditions, and symptoms from stress are resolved. It is
no overstate-ment to say that such effects are the forte of
acupuncture and moxibustion therapy. Drug therapy (treating by causing a chemical reaction) and surgery (physically
invasive treatment) more than likely end up disrupting the
balance in the autonomic nervous system.
In general it seems that acupuncture causes the sympathetic nerves to become dominant while shiatsu and
moxibustion cause the parasympathetic nerves to become
dominant. This effect can of course be reversed when each
technique is applied a little differently, so that you really
cant say that acupuncture activates only the sympathetic
nerves while moxibustion activates only the parasympathetic nerves. For example, bronchial asthma occurs under
conditions of parasympathetic dominance, but in my day
to day experience a combination of acupuncture and moxibustion work to alleviate an asthma attack, and ultimately
improve the constitution so there are no more attacks. In
this case acupuncture and moxibustion work together to
stimulate the sympathetic nerves. This flexibility is one of
the special features of acupuncture and moxibustion, and
sometimes the same treatment has the completely opposite
effect. Even when the same patient is given the same treatment, sometimes they feel very relieved and relaxed as if
they are floating, while at other times they feel all energized
as if their batteries were recharged.
In Oriental medical terms, this different result comes
from the deficiency or excess of the patients symptoms
and the selection of tonification and dispersion techniques
to treat it. Viewing this in light of the autonomic nervous
system, it might be possible to replace judging deficiency or
excess with deciding which among the sympathetic or the
parasympathetic nerve is overactive or underactive, and to
replace tonification and dispersion with selecting the treatment which restores the balance in the autonomic nervous
system. The ancients came up with the Taiji (Taikyoku in
Japanese) symbol to aptly express the rise and fall of two
opposing aspects. This Taiji symbol clearly describes the
dynamic equilibrium of
opposing aspects, but this
could just as well be the dysympathetic nerves
namic equilibrium within
the autonomic nervous system. To take this even further, we might say that the
concept of Yin and Yang can
be applied perfectly here
to call the parasympathetic
parasympathetic nerves
nerves Yin and the sympathetic nerves Yang. (Fig. 1) Fig.1

67

NAJOM
2. The Autonomic Nervous System and the Bladder
Meridian
Very few acupuncturists do not make use the back Shu
points of the Bladder Meridian, except perhaps those who
use auricular or hand acupuncture exclusively. The back
Shu points are widely understood to exhibit referred pain
from the vicero-cutaneous reflex as discovered by Henry
Head (Head zones are one of the function of the autonomic
nervous system). I feel that the back Shu points are regulation points for the autonomic nervous system.
According to a medical dictionary,2 the first neuron of
the sympathetic nerve is normally found between the lateral angle of the eighth cervical nerve to the third lumbar
nerve (thoraco-lumbar system) and finally distributes in the
skin, blood vessels, and internal organs. The parasympathetic nerve is contained in four bilateral cranial nerves (oculomotor, facial, glossopharyngeal, and vagus nerves) and
in the second to fourth sacral nerves (cranio-sacral system)
and regulates dilation of the pupils, lacrimation, salivation,
as well as the heart rate and digestive function. The function of the autonomic nervous system is described as, enabling one to maintain a state of homeostasis in relation to
external and internal conditions by involuntary regulation
of the function of the internal organs. The sympathetic and
parasympathetic nerves each function in an antagonistic
fashion, but it is difficult to differentiate these nerves and in
some cases they perform the same function. Until recently
I really didnt understand why BL-32 was among the standard points in the Sawada Style. In the discussion for BL-32
in the Essence of Acupuncture, Shirota says, BL-32 is part
of the Bladder meridian so it is associated with tension in
the occipital region. Needling BL-32 will instantaneously
reduce tension when the occipital region around BL-10 is
tense. The meridians are truly mysterious. When just one
side of the occipital region remains tense, it is often a result
of my having located the moxibustion point for BL-32 in
the wrong place. (Sawada) Sensei often alleviated tension
in the occipital region by needling BL-32. 3
I used to make a vague connection between BL-32 and
the occipital region because it was on the path of the Bladder meridian. Yet I did not make good use of this point.
When you consider the cranio-sacral system of the parasympathetic nerves, however, the reason treatment of BL-32
can alleviate occipital tension becomes apparent. The use
of major back Shu points as standard points in the Sawada
Style, the utility of Huato Jiaji points just medial to the
Bladder meridian, and the focus of the Ishizaka Style4 on
back points can all be understood in light of the role of the
autonomic nervous system.
3. The Autonomic Nervous System and the Sawada
Style
When I was an acupuncture student, my teacher, a
practitioner of the Sawada Style told me, As long as you
treat CV-12 and TB-4 first, the patients symptoms will be
reduced. In this way I was taught to treat CV-12 first, no
matter what. At that time I rationalized this practice from
the simple understanding that CV-12 was the starting point
of all meridians, and that CV-12 was the central point for

68

the Middle Burner, which is the center of the Triple Burner.

Of course, this understanding is correct, but if we view
CV-12 as the representative point for the solar plexus (celiac
ganglion), it means that we have a handle on the largest
ganglion among all the ganglions of the autonomic nervous
system.
Manaka Yoshio, M. D. stated as follows concerning the
Taikyoku Therapy of the Sawada Style: Regardless of the
disease, Sawada Ken advocated using point combin-ations
which balanced the whole body, and he used these points
as the foundation on which to add or substitute individual
points effective for specific diseases. The intention of these
standard points was not to cure the disease but to gradually
adjust the condition of the body, and thus (this method) is
effective as a regimen for health, as well as for restoration
therapy (physiological regulation) for chronic diseases.5
This restoration therapy of Sawada which regulates
physiology is nothing other than the balancing of the autonomic nervous system. I am convinced that the even distribution of standard points in Taikyoku Therapy, including
important back Shu points, on the abdomen, four limbs,
and the Governor Vessel, is aimed at regulating the autonomic nervous system.

4. Effect of Techniques on the Autonomic Nervous

System
In order to regulate the autonomic nervous system,
one must determine whether the patients condition is one
of sympathetic or parasympathetic dominance. Once we
know which is dominant, our treatment strategy can be one
which makes the other side dominant, or which suppresses
the dominant side. It is no easy matter, however, to correctly assess the patients state and get the intended results
from treatment. As I mentioned before, the strategy of tonification and dispersion is used in Oriental medicine, but if
it were simply a matter of tonifying what is deficient and
dispersing what is excess, things would be easy indeed for
practitioners.
Few would argue if I defined acupuncture as stimulation therapy. And I believe that the techniques of tonification and dispersion are determined by the quality of stimulation. I think the ideal quality of stimulation in simple
terms is that which feels the best to the patients body. In
other words, regardless of the amount and intensity of
the stimulation, and the variety of technique (whether
acupuncture, moxibustion, or bodywork), the stimulation
which feels comfortable to the patient is the most beneficial
in terms of regulating the autonomic nervous system.
Therefore, it really doesnt matter whether one uses
deep needling or shallow needling, multiple cone moxa or
thread moxa, and strong pressure or gentle pressure. Each
one requires subtle adjustment according to the patient
s condition. The treatment is a success and the balance in
autonomic nervous system is restored as long as the patient
feels this subtle adjustment and says that it was comfortable at the conclusion of the treatment. I have no rational
explanation for this, but it seems to be true from my experience. I might go so far as to say that, a technique which
feels comfortable to the patient is a requirement for successful treatment, and this is central to the formation of the

NAJOM
concepts of tonification and dispersion.
When I attend seminars taught by senior practitioners, I
get the impression that beyond logic, they each adjust their
techniques subtly to achieve the effect of tonification and
dispersion. I conclude that there can be no tonification and
dispersion or regulation of the autonomic nervous system
without refining ones technique to be able to provide a
comfortable treatment for ones patients.
Finally, I am including some of the classifications of diseases by dominance of sympathetic and parasympathetic
nerves, 6 and hope that this will be an aid in your understanding.
allergic constitutions: atopic dermatitis, bronchial asthma,
hay fever, parasitic infestationparasympathetic dominance.
bacterial infection: suppurative diseases (tonsillitis, otitis
media, sinus infection, appendicitis, pneumonia, pleuritis, retinitis, etc.)sympathetic dominance.
viral infection: flu symptoms (nasal discharge, fever, fatigue)parasympathetic dominance.
viral infection: flu symptoms (hard yellow nasal discharge,
over-reactionsuppurative diseases such as tonsillitis
and pneumonia)sympathetic dominance.
herpes zostersympathetic dominance
structural disorders: gastric ulcers, ulcerative colitis, arthritissympathetic dominance.
irritable bowel syndrome (gastritis and constipation)
sympathetic dominance
low back pain, knee joint pain, neck and shoulder stiffnesssympathetic dominance
autoimmune disorders: chronic rheumatoid arthritis, lupus
erythematosus, Basdows disease, sclerodermasympathetic dominance.
cancerparasympathetic dominance.
morning sicknessover stimulation of parasympathetic
nerves.
infertilitysympathetic hyperactivity.
accelerated agingsympathetic hyper-activity.
Parkinsonss diseasesustained sympathetic hyperactivity
and extreme parasympathetic dominance.

References
1. Tanaka Etsuro. Irasuto de Manabu Seirigaku (Biology
with Illustrations). Igaku-Shoin. 2002. p.175.
2. Nanzan-Do Medical Dictionary (18th ed). System Soft
(CD-ROM ). 1998.
3. Shirota Bunshi. Shinkyu Shinzui (Essence of Acupuncture). Ido-no-Nippon. 1978. p.11.
4. Kubota Naoki. Ishizaka Style Acupuncture. NAJOM, Vol.
4, No. 9, March1997, p. 25.
5. Manaka Yoshio, M. D. Kyu to Hari (Moxibustion and
Acupuncture). Shufu-no-tomo. 1986. p. 89.
6. Abo Toru. Ede Wakaru Meneki (An Illustrated Guide to
Immunology). Kodansha Scientific. 2001.
(November 2002, Translated by Stephen Brown)

Practical Moxibustion Therapy (26)

Scatter Needling and Heat Massage
Preface
I attended Ikeda Masakazus seminar in Sacramento in
late March, and then in mid-April I attended Okada Akizo
s seminar in New York. Both of these teachers are Meridian Therapy practitioners, but their approach to treatment
is very different. What I found especially interesting was
the difference in their scatter needling (sanshin) techniques.
Both of whom use it extensively in their treatment. Ikeda
Senseis scatter needling technique is so swift, you can
hardly see what he is doing; he makes it look like some
magic trick. Okada Sensei, on the other hand, taps in the
needle a little rhythmically applying the same stimulation
one point after another.
If we compare acupuncture to cooking, retaining needles is like heating and cooking a dish slowly in an oven,
or slowly cooking a soup over low heat. Scatter needling is
more like frying peas or popping corn over high heat. Carrying this analogy a step further, simple insertion may be
likened unto serving raw foods such as green salads or raw
fish (sashimi).
As for my own scatter needling technique, my primary
intent is to apply something akin to a vibration. I apply it
with a sense that I am balancing things out by jostling the
system a bit. This is why I believe scatter needling is close
to Anma (traditional Japanese massage) and shiatsu in
terms of its effects. When I give shiatsu, I apply pressure to
an affected area which is just a little painful, this relaxes the
tissue and usually alleviates the pain that was there. I can
feel the sympathetic excitation in the patient subside, and
become parasympathetic dominant, i.e. relaxed. This is the
effect I look for when scatter needling.
Recently I have come to realize that you can get a similar effect to scatter needling with moxibustion therapy. In
acupuncture and moxibustion treatments it is customary
for effects to be sought through the use of acupuncture
points. Originally, however, these therapies started out as
tender point treatments where the painful point is the
treatment point. Tender points which had similar effects
were amassed through experience and named as acupuncture points. The meridian probably came about from studying the application and systematizing the use of such points
over a long period.
I never learned such a systematic approach, having
opened my practice right out of school without studying
with a master. The only application of meridians I knew
about then was the Sawada style Taikyoku (Taiji) Therapy, which was described in Shinkyu Shinzui (Essence of
Acupuncture and Moxibustion) by Shiroda Bunshi. I used
Taikyoku Therapy because, it was a simple system using
basic points plus symptomatic points. It was the easiest to
apply for a novice acupuncturist right out of school. The
thing that is the most instructive for a novice acupuncturist
is to touch the bodies of patients which is why I concentrated on giving shiatsu treatments in the first five years of
my practice. In this way I became adept at locating tender
points. When you overlay the experience of palpating ten-

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NAJOM
der points on the knowledge of acupuncture points gained
from books, you can become proficient at locating good
treatment points. When points like this are treated systematically like in Taikyoku Therapy, most diseases will resolve
as long as moxibustion is applied diligently for a certain
period and painful areas can be eliminated without fail
when multiple cones are applied repeatedly on local points.
As I practiced this way for some time, I came to realize
that one could also get an effect with moxibustion similar
to scatter needling, in which point location is not important. This type of moxibustion might be described as a kind
of heat massage. That is to say, moxibustion is applied
successively over a large number of tender points without
reference to meridians or points. Of course, this greatly increases the number of points treated, but actually the more
points you use, the more the patient seems to relax. So I select many moxibustion points in the area of treatment without reference to acupuncture points and apply three to five
small cones (less than half rice grain sized) using a bamboo
tube.1 After a while, the repeated slight burning sensations
begin to feel comfortable and the patient becomes parasympathetic dominant and dozes off. (Fig. 1)
This is a much simpler method of softening kori (tense areas)
and indurations compared to scatter needling which takes skill.
Anyone can get results
with moxibustion given a little practice. I can
understand how some
would prefer refined
techniques over such a
simple approach, but
there are some diseases
which cannot be cured
without this kind of
treatment. So it should
Fig. 1
not be looked down
upon as just a method
for novices.

Case 1
Patient: 82 year old female
First Visit: January 8, 2003
Chief Complaint: She has had difficulty raising her arms
for about a year. Her right arm hurts especially and cant
be moved (frozen shoulder). She also has knee pain, which
makes it difficult for her to sit down and stand up, extreme
edema in her feet, all the joints in her body hurt, and at
times is so flushed that it becomes difficult to hear someone
talking to her.
Examination: She complains in a high pitched voice and
seems to be vigorous for her age. She has so much pain in
her body that she has difficulty lying down on the treatment table. (Sign of extreme sympathetic excitation.) Her
skin is ashen, rough, and hard with deep wrinkles, and it
appears almost as if artificial leather had been pasted over
it. Her pulse is floating and mushy (soft, without force).

70

Her abdomen is sunken in and

hard deeper down, like the hull
of a ship.
Treatment: (Jan. 8 ) Since it
was hard for her to lie down, I
treated this patient in a seated
position. After simple insertion
in some points using 40mm No.
1 needles, I applied five small
cones of moxa on the points
shown in Fig. 2.
(Feb. 12) I applied six small
Fig. 2
cones of moxa as shown on Fig.
3 on the abdomen: six points in the epigastric region and on
CV-4; and five cones each on LI-11, TB-4, ST-36, GB-29, and
SP-6.

Fig. 3

Subsequently I gave her similar treatments once a week.

On March 5 the appearance of her skin improved. On
March 19 the patient said, I think Im gradually getting
better. On April 9 the patient said, I feel a little lighter.
On April 16 the patient said, I think the pain is a little
less. I continued giving her treatments every other week
after that, and the darkness and roughness of her skin on
her chest, shoulders, and arms cleared up. She started looking better and had more energy, but the edema in her legs
still comes and goes.
Observations: Her pain went untreated for a year, becoming chronic, and giving her trouble lying down and
getting up. She improved with eleven treatments. She had
lost her husband a year earlier, became extremely stressed
(sympathetic dominant) developing intractable pain all
over. The pain subsided and she regained her energy with
the relaxation and improved circulation from the application of small cones of moxa on many points all over her
body. This is a case in which heat massage restored peripheral circulation in a relatively short period.

Case 2
Patient: 86 year old male
First Visit: April 25, 2003
Chief Complaint: Last week he used a ten pound hammer while standing on a stool to drive in three stakes, his
left shoulder began to hurt (he is left handed), and it also
hurts at night. This patient had been rear-ended in a car accident July 1992 injuring his left shoulder and having pain
in the interscapular region, chest, and pain down the upper
arm to the lateral forearm. Since then he has had episodes of
pain in his left shoulder about once every three years. In this
instance, the pain appears when he tries to lift his left arm.

NAJOM
Examination: The patient does hard physical work, despite his advanced age, that has caused some mild damage
in the muscles in his left posterior shoulder and interscapular region. This caused pain, contracture, and impaired his
range of motion. The reason the appearance of his skin and
abdomen are so good that one might think he was in his
early 70s is because he has been receiving acupuncture and
moxibustion treatments periodically for over ten years. His
pulse is also good.
Treatment: What was needed was to improve his circulation and release the contracture in his muscles. This type
of pain and restriction in the shoulder joint is very common
in Vancouver, and it may be called Damp Bi syndrome from
the wet winters of Vancouver.
In the prone position I retained 40mm No. 2 needles
shallowly (5 - 8mm) for 10 to 15 minutes in hard points in
the muscles. Next I applied five small cones of moxa on the
points which were still tight or tender (Fig. 4).

Fig. 4

After this I gave some light shiatsu to the Bladder meridian on the upper back for about 7 minutes. Finally with
the patient supine I applied four small cones of moxa on
many points around the shoulder which were tight or tender. With just this treatment he could easily raise his arm,
which he could not before, and the patient said he felt better.
Observations: Circulation in the muscles can be improved quickly by retaining the needles shallowly, applying five small cones of moxa, and doing some shiatsu on
the Bladder meridian. It may seem like this combination
of acupuncture, moxibustion, and shiatsu could be overstimulation, but as long as you give light stimulation working within the patients physical tolerance, the symptoms
can be resolved comfortably. Almost all pain associated
with compromised range of motion in the shoulder joint
can be dealt with in this manner. When the symptoms don
t resolve after giving a treatment like this several times, I
add some treatment on the abdomen. I usually apply five to
seven small cones on points like CV-12, ST-25, and CV-6. I
have experienced many cases where the symptoms quickly
improved after adding this abdominal treatment. This is

probably because facilitating better circulation in the abdomen reflexively increases circulation in the shoulder, and
stimulation of the (parasympathetic) vagus nerve resolves
the circulatory problem in the shoulder resulting from sympathetic dominance.

Conclusion
For acute myofascial pain like a back strain, I primarily
apply multiple cone moxibustion. I concentrate on key tender points, and apply cone after cone successively until the
sensation of heat is felt deep down. This type of acute muscle strain is very painful when there is underlying chronic
muscle contracture and compromised circulation. I tend to
use multiple cone moxibustion in cases like this because I
want to concentrate on treating the pain.
In cases of chronic muscle fatigue, however, the pain is
not that strong, and the pain tends to be associated with
movement because of the restricted range of motion. Muscles tend to get over-stretched and strained across the entire
length, and there is a dull pain across a broad area. I feel
that the best treatment for pain over a broad area like this is
scatter needling with acupuncture, or light stimulation on
many points with moxibustionwhat I call heat massage.
The secret to applying this technique is to give the right
amount of pressure with the bamboo tube after lighting
each cone and to keep the interval between each ignition
consistent. This principle applies not only to moxibustion,
but to scatter needling as well. Appropriate pressure with
the supporting hand and a consistent and comfortable
rhythm of repeated needling serves to increase the result of
treatment, just as it does with moxibustion. I believe that
sensing heat moxibustion (chinetsukyu) also has a similar
effect. Application of heat which warms the surface but
does not penetrate induces the release of heat and serves to
disperse congestion and swelling.
Stimulation like this improves circulation and quickly
revives fatigued muscles. This is why light stimulation with
moxibustion serves to relax the patient and relieve muscle
tension like stiff neck and shoulders (katakori), which often
comes from overactive sympathetic nerves associated with
stress. Conversely, when patients have a parasympathetic
dominant constitution and they have become overly relaxed, their response to stimulation is slow and muted. In
this case, I feel it is better to choose specific points based on
their symptoms and to apply more cones of direct moxibustion to get the heat to penetrate. In acupuncture, this corresponds to retaining needles.
In terms of selecting the type of treatment in relation to
areas of the body, I tend to use light moxibustion on many
points on the upper half of the body and I mostly use the
intensive moxibustion for heat penetration on tight or painful points below the waist. Also, for functional disorders
like stress related problems associated with sympathetic
dominance, I use light moxibustion (heat massage), and for
structural disorders like blood stasis, I often apply the penetrating moxibustion.
As for matching the treatment to the patients condition,
I tend to use light moxibustion for excess conditions, and
penetrating moxibustion for deficient conditions. When
I select and treat points with the intention of correcting

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NAJOM
meridian imbalances, I combine both light and penetrating moxibustion to treat points all over the body. This is
similar to how scatter needling and retaining needles are
combined in acupuncture treatments. In this way, I modify
my approach to moxibustion to suit the patients physical strength, deficient or excess condition, and symptoms.
When I am treating my patients in my busy practice from
day to day, however, I do not consciously decide on which
methods to use for what. I hope to establish a protocol
someday for more exactly matching a patients condition
with the method of moxibustion.

Note
1. For details on use of bamboo tube, see July 1998 issue of
NAJOM (Vol. 5, No. 13, p. 23)
(July 2003, Translated by Stephen Brown)

Practical Moxibustion Therapy (27)

In late August, I visited Ryo-anji Temple in Kyoto, 26
years after my last visit. The rock garden of this Zen temple
which was built in 1450 is one of the most famous. I have
been to this temple several times since first visiting it on
a school excursion at the age of fifteen. It was on this visit
that I realized that in this temple there was calligraphy of
the two characters Tsu-Ki (pass Ki through, or Qi passing
through). It was on a single-leaf wooden screen (used as a
room partition). I found it at the juncture between the corridor from the group entrance and the wooden floor of another small Genkan (entryway).

72

The last time I visited this temple was before I attended

acupuncture school. I must have failed to notice the calligraphy of Tsu-Ki, although it was in such a visible location.
The word Tsu-Ki is generally used to mean ventilation or
the circulation of air. When I set eyes on the wooden screen
with these characters, however, it seemed to say passing
Qi through. I felt as though I was beholding the secret of
acupuncture and moxibustion. I also felt a little ashamed
of myself for doing treatments often without giving much
thought to moving Qi through. The sound of those two
characters Tsu-Ki shot through my brain like an electrical
charge. I decided to write something about Tsu-Ki or moving Qi through because of this experience.
What happens when Qi moves through the body?
When a treatment goes well, the body warms up comfortably. It is a wonderful feeling as if you are soaking in a
hotspring, and you feel relaxed and at ease. Blood circulation throughout the body becomes balanced, skin temperature rises, and any sensation of coldness in the feet and
hands is forgotten. Patients say they feel very comfortable.
I believe the condition of Qi moving through the body is
achieved when patients enjoy this state and forget about
their symptoms. I feel that the aim of my acupuncture and
moxibustion treatments is to induce a state in my patients
so they say I feel very comfortable. When treatments like
this are repeated, before you know it the symptoms begin
to disappear and the patient feels more energy.
The actual treatment mechanism in this case can be described simply as improving circulation. When the conditions of poor circulation (chilling) and congestion (heat) are
resolved, and circulation is balanced throughout the body,
things that werent flowing begin to flow. It is as if a dried
up river bed after a drought starts to flow once again, or
otherwise like trash and junk blocking the flow of the river
being removed so the river flows freely without obstruction. In this way the river becomes alive again and animals
can live in it once again. Anyway, there is a wonderful
sensation like something is always flowing. This can also
be compared to the circulation of air mentioned earlier. Air
begins to circulate and it feels as if a gentle breeze is blowing. No matter what it is, it is a pleasurable sensation when
things flow through our body in a good way.
Considering flow in the human body, the thing that actually flows through our body is Blood. So I think the pleasant sensation of good Blood flow is what is experienced as
Qi passing through. When the flow of Qi becomes good,
circulation increases and the body warms up. In other
words, Qi and Blood are in a chicken and egg relationship,
originally being the same thing. When the functional aspect
is emphasized, it is called Qi. When the material aspect is
emphasized, it is called Blood.
The ancient Chinese said Blood flows inside the vessels
and Qi flows outside the vessels. In a living body Qi and
Blood move together. Blood flow comes to a stop when a
person dies. The physical functions cease and Qi dissipates
like a mist.
What I have been calling Blood here is, of course, Yin
(nutritive) Blood, which represents all body fluids including
blood, lymph, and interstitial fluids. Qi is Wei (defensive)
Qi, and exists as the control system of our body including

NAJOM
the autonomic nervous system, the endocrine system, and
the immune system. This control system regulates all our
body fluids, but this system declines when body fluids are
exhausted, and cannot exist without it. While one can use
the word Qi in the wider sense to mean mental or spiritual
powers, and Blood can include things like nutritional substances, in this article I want to keep things simple. So I am
speaking about Blood mostly as that which flows inside the
vessels.

How to get Qi to move through the body.

Master Sawada Ken said, Disease is not a special condition. It is merely a condition of blood circulation out of
balance. The purpose of treatment is to improve circulation
of blood which nourishes the body. 1
I believe the result of treatment like this is what creates
a state of Tsu-Ki, or Qi moving through the body. This is an
extremely simple treatment principle, but there are many
strategies to achieve this purpose. For example if you use
acupuncture and focus on Qi and the meridians, it is Meridian Therapy. If you use moxibustion it could be Taikyoku
Therapy of Sawada Ken. Further, if you focus on the structural imbalance of the body, you have something like Sotai
Therapy. If one was to work just with Qi to achieve the state
of Tsu-Ki, it would be something like Qigong. There is also
Chinese herbal medicine, so there are many possible strategies. Furthermore, there are countless different approaches
to employing each of these methods. In any case, no matter
whether the treatment focuses on moving Qi or Blood, TsuKi is achieved as long as one of them begins to flow the
body warms up and feels lighter.
I use a combination of acupuncture, moxibustion, Shiatsu, and massage in my treatments. In this article, however,
I want to delve into the mystery of Tsu-Ki by exploring the
treatment strategies of Taikyoku Therapy (which means
Taiji or the Grand Ultimate.)
The treatment strategy in the Sawada style is to select
standard points and symptomatic points. Shirota Bunshi
listed nine Sawada style standard points including CV-12,
BL-20, BL-23, BL-32, CV-12, TB-4, LI-11, ST-36, and KI-6.
Manaka Yoshio M. D. recommended the Sawada style
standard points and added CV-6, GV-20, BL-17, BL-18, and
BL-52. (Fig. 1)
Mapping the
location of these
standard points,
you find that it is
distributed fairly
evenly all over the
body. There is no
need to use all of
these points on all
patients, but they
are basic points for
a whole body treatment of serious and
chronic cases. They
are significant as
the root treatment
points addressing
Fig. 1

the cause of the disease. Sawada called this fundamental

treatment to balance the core of the Five Zang and Six Fu,
2
and he invented the term Taikyoku Therapy.
Recently I have come to realize that these standard
points not only cover all the parts of the body, but also
have a big significance in terms of regulating the autonomic nervous system. Sawada style treatments always
begin with CV-12 and TB-4, but CV-12 is directly over the
solar plexus, which is the largest nerve plexus of the parasympathetic nervous system. TB-4 is the Source point of
the Triple Burner meridian, and is the Pool of Yang as
its name implies. In other words, it stimulates physiological functions. The Triple Burner is said to be the source of
heat, which means it is the place in the body where oxygen is consumed. Thus it can be construed as the center of
the sympathetic nervous system. The mechanism by which
treatment of the Triple Burner meridian stimulates the
sympathetic nervous system can be confirmed by the statement, micropuncture (bleeding) of both Jing Well points of
the Triple Burner meridian controls the activity of the parasympathetic nerves, and thus promotes the activity of the
sympathetic nerves by the reciprocal phenomenon of the
autonomic nervous system. 3
Thus Master Sawada could have been trying to balance
the function of the autonomic nervous system in the very
beginning of his treatments by stimulating CV-12 and TB-4.
He could have then stimulated the parasym-pathetic system with GV-20 (cranial parasympathetic center), GV-12
(dispersing or scattering Qi/tension), BL-32 (pelvic nerve
plexus), and ST-36 (controlling conterflow of Qi). One
could also theorize that he was stimulating the parasympathetic nerves along the spinal cord by treating the Back Shu
points.
When you consider that the majority of diseases originate with sympathetic dominance,4 there is great significance to the standard points of the Sawada style which
serve to relax the body and create a state of parasympathetic dominance. This is especially true if we view the state of
Tsu-Ki as one of improved blod circulation. For this is nothing other than a state of para-sympathetic dominance.
In addition to the autonomic regulation effect by treating the Sawada standard points, the stimulation of burning
the skin by direct moxibustion produces denatured proteins (histotoxins), and further encourages parasympathetic
dominance by increasing white blood cells, and stimulating
production of lymphocytes. As a result, the digestive system is stimulated, and this has a positive effect on the central nervous system. Thus diseases are cured by improving
the defensive and self-regulation systems of the body - the
autonomic nervous system, immune system, and endocrine
system.
This is my understanding of the standard points of the
Sawada style, but symptomatic points are treated in addition to individualize treatments. These points are experiential points or anatomical points related to the symptom.
Thus the symptomatic treatment is often local treatment.
Even in the local treatment localized congestion or poor
circulation must be rectified in order to facilitate healing
when there is pain, inflammation, and an injury or surgical
wound, Here again increasing circulation becomes most

73

NAJOM
important. A state of parasympathetic dominance must be
achieved in order to obtain this effect.
For reference I will list the main local treatment points
from Shirotas text Essence of Acupuncture and Moxibustion. 5

Points for Various Blood Disorders

hemoptysis: PC-4, KI-6, LU-5, and midpoint between LI-11
& LU-6 (7 cones each)
gastric & intestinal hemorrhage: ST-34 & HT-7; for bleeding due to tumor use LI-10
rectal bleeding: LU-6 (apply multiple cones if bleeding
persists)
hematuria: ST-34 & HT-7
nose bleeds: Sawadas GB-20 (approx. 2 units lateral to
standard GB-20)
retinal hemorrhage: Sawadas GB-20, BL-10, Sawadas LI-4
(approx. 9mm distal to LI-5)
pharyngeal hemorrhage: LI-11 & KI-6
hemorrhage from injury: LI-11 (only for limited bleeding)
Points for Various Pain Disorders
migraines: TB-15, SI-17, (Shirota) BL-7 on the affected side
other headaches: GV-12, 16, 20 & 23, upper BL-10, SI-17,
Sawadas GB-20, Huato Jiaji points of organs related to
affected meridians
ear aches: KI-6, LI-10, TB-9, Huato Jiaji points of BL-23 or
25
throat pain: KI-6, LU-8, Ding Chuan, 20 cones on LU-5
toothache: upper jaw - BL-14 and its Huato Jiaji points, half
a unit posterior to LI-15, TB-10 lower jaw - Sawadas
LI-7 (until heat is felt) gum pain or pyorrhea - LI-10 or
11
chest pain: SI-11, BL-43; pain in the whole chest: LR-14;
vertical pain: KI-6; horizontal pain: LR-14
flank pain: same as for chest pain, multiple cones on BL-43;
ST-27 if indicated
breast pain: SI-11 on affected side, (Shirota) CV-17
gastric pain/stomach cramps: ST-34 on one or both sides
gallstone attack: CV-12, Huato Jiaji points of BL-19 (especially the right)
appendicitis: CV-6 (30 cones), use CV-3 or 4 in addition
abdominal pain: LR-13 or BL-52
bladder pain: CV-3, 4, & 6
urethral pain: CV-1, 2, & 3
hemorrhoids: LU-6, BL-33, GV-1
trigeminal neuralgia: SI-17, TB-20, LI-10 (multiple cones)
frozen shoulders: BL-23 (night-time pain) BL-25
intercostal neuragia: LR-14 on affected side
sciatica: BL-31, 32, 33, 36, 37 (Shirota) Bl-59 & 60, GB-30, extra point lateral to BL-37
heel pain: BL-61 & BL-33
knee pain: LR-8 & GB-33 (pierce through)
orchitis (testiclar pain): about one unit above SP-15
inguinal hernia: about one unit above SP-15
Points for Various Blood Disorders
high fevers: Huato Jiaji points of upper back and ST-24 &
27
cold injury: ST-24, 25, & 27, CV-6 & 9 (apply same number
of cones as age; no effect with few cones)
common cold: GV-12 & BL-12 (21 cones each)

74

pneumonia: GV-12 and extra points just lateral to BL-12 (66

cones each)
pleuritis: PC-4 (21 cones)
intermittent fever: GB-29 & SI-2
food poisoning: ST-44 and dorsal ST-44
mild fever: TB-4, CV-12, & BL-22
measles: extra points just inferior to the midpoint between
LI-11 and 15 (indurations)
the flu: see points for cold injury; also use GB-33
The above are some of the local treatment points used
in the Sawada style. It is quite interesting to note that the
selection of points for these symptoms are not necessarily
local, but instead are based mostly on the meridians.

Conclusion
I wrote whatever came to my mind from an impression I received from the calligraphy of Tsu-Ki (to pass Qi
through). Rather than discussing Qi as understood in the
classics or the meridians through which it is said to flow, I
interpreted Qi passing through as a patients state of feeling relaxed and comfortable. Furthermore, I construed this
as a state of parasympathetic dominance, which is a state of
good peripheral circulation. When you consider the statement ...white blood cells, which move around a great deal,
are under the control of the autonomic nervous system,
and make up the bodys defense system, 6 it is incredible
how this matches the classical concept of Blood (nutrients
inside the vessels) and Qi (control system outside the vessels) maintaining life. This interpretation also makes the
reasoning behind Taikyoku Therapy easy to understand.
I trust it s not stretching things too far to equate modern
concepts with classical ideas, as I have done, to illuminate
the function of Qi and meridians.
(November 2003, Translated by Stephen Brown)

Notes
1. Shirota Bunshi, Shinkyu Shinzui (Essence of Acupuncture
and Moxibustion), Ido-no-Nippon, 1978, p. 20.
2. Shirota Bunshi, Shinkyu Shinzui (Essence of Acupuncture
and Moxibustion), Ido-no-Nippon, 1978, p. 19.
3. Asami Testuo, Seiketsu Shiraku-gaku (Study of Bleeding
Jing Points), Kindai Bungei-sha, 1986, p. 11
4. Mizutani Junji, Practical Moxibustion Therapy (25), NAJOM, Nov. 2002 (Vol. 9, No. 26) p. 28.
5. Shirota Bunshi, Shinkyu Shinzui (Essence of Acupuncture
and Moxibustion, Ido-no-Nippon, 1978, p.290-298.
6. Abo Toru, Regulation of White Blood Cells by Autonomic
Nervous System: Mechanism of cure of diseases by acupuncture, NAJOM, July, 2003 (Vol. 10, No. 28) p. 3.

NAJOM
Practical Moxibustion Therapy (28)
Over the past decade, I have written 27 articles for the
Practical Moxibustion Therapy series. I chose the topic of
moxibustion therapy, which is an ancient treatment method, and wrote from my own experience. After ten years
of accumulating clinical experience, the content of these
articles has gradually changed. Writing about the same
topic over time, the articles reflect my own treatments, and
I have used these articles to reexamine them as I move on
to my next phase. It is great that I have been able to correct
my inaccuracies and inconsistencies in this way and consolidate my approach. Thinking about this undertaking now,
it seems I might have been overly ambitious to have chosen
the topic of moxibustion, which is relatively unknown in
North and South America. Considering that I get many requests to teach moxibustion workshops, however, I see that
the articles have promoted moxibustion therapy a little.
Ten years ago when I gave moxibustion treatments,
I only thought about it as an interesting modality that
seemed to work very well. When I started to write the
Practical Moxibustion Therapy series, I was not giving it
much serious thought. After a while, however, I began to
realize how incredibly effective moxibustion therapy could
be, and I became more and more captivated by it. Now I
spend more time doing moxibustion in my treatments than
acupuncture. This was a big shift for me, and I reached a
point where I began to see moxibustion as the only thing
that really does the trick for difficult conditions like cancer
and autoimmune disorders.
Although moxibustion has been used for over 2300
years, it is still filled with mystery. In meeting the challenge
of writing about it regularly, it seems I have become captivated by it. I want to take this opportunity to reflect a bit on
what I have been thinking and feeling about moxibustion
over the past ten years.

1. Stimulation Therapy
Both acupuncture and moxibustion stimulate the body.
Unlike drugs, which cause a chemical reaction to elicit a
physical response, acupuncture and moxibustion therapies
elicit a physical response by causing miniscule injuries
on the surface of the body by needling or burning. These
intentional miniscule injuries to the body (no matter how
small the injury) are what separate these therapies from
other approaches, such as Qigong, aromatherapy, massage,
heat therapy, and exercise therapy. So, there is an equation
here:
Injury to the skin or subcutaneous tissues = Stimulation =
Physical response = Stimulation of natural healing.
Inserting a needle or burning with moxa can be categorized as being radically different from the stimulation in
other types of therapy. I construe that inflicting small injuries on the body creates small artificial inflam-mations. This
may be hard to picture in the case of acupuncture, because
the insertion point is usually invisible. In the case of moxibustion, however, the burns left behind are nothing other

than small inflammations. So, moxibustion is a therapy

with which such small inflammations are created intentionally on the body surface to elicit a healing response.
Of course, when inflicting injury on the body, the negative repercussions are greater if the injury is substantial.
Acupuncture and moxibustion are therapies that skillfully
utilize miniscule injuries that do not detract from the natural healing response of the body. That being so, there is a
great deal of variation in acupuncturefrom super-superficial insertion to deep insertion, and in moxibustionfrom
superactive moxibustion to the use of bamboo tubes and
Shiunko ointment to keep the burn as small as possible.
In any case, how do these small artificial inflammations
actually draw out the natural healing response of the body?
I will list a few mechanisms that come to mind:
(1) histological changes: increase in white blood cells and
platelets increase circulation and purifying blood
(2) increase in cytokine (essential protein for cell metabolism)
(3) influence on hormone secretion: adrenaline, noradrenaline, acetylcholine, etc.
(4) release of metallic ions
(5) invigoration of metabolism
When these responses happen, the result is reabsorption of inflammation, healing, increased immunity, and improved balance of the autonomic nervous system.

2. Manner of Stimulation
The effects of acupuncture and moxibustion are not
produced through random stimulation. As I just stated, we
must skillfully utilize miniscule injuries. I call this process
jostling the body. When I see a patient, I try to determine
how much I need to jostle their body, then I use the stimulation of acupuncture, moxibustion, and shiatsu to treat what
I find. From a rational standpoint, this manner of jostling
should not be the same for different patients, but, putting
all patients in one large category of human beings, we find
there are many commonalities, and that similar treatment
strategies can be effective for many. So, drawing out specific effects by subtle variations in the treatment might just
be the pleasure of treatment.
When I speak of jostling, I think of the late Dr. Manaka
s use of the term bias, which he described as follows: There
is a term known as bias in electronics. Bias refers to phenomena such as changes or improvements in the efficiency
in the entire circuit when magnetism or static electricity is
applied on one part. When we expand this term to call all
phenomena where a little energy is added to a system internally or externally to change the operation of the system
bias, we can think of many kinds of bias. Even if the energy
input is very small, sometimes the influence can be great. 1
This idea of bias, or jostling, with its meaning of influencing the whole body with minute stimulation, is essentially the same as the principles of acupuncture and
moxibustion. I believe that this idea holds the key to understanding the unique stimulation of acupuncture and
moxibustion as it creates the small artificial inflammations.
Furthermore, when we select special sensitive points, (tsubo),
on the surface of the body for jostling, sometimes unimaginable changes are effected in the body as a whole.

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NAJOM
I believe that connecting the two key words, tsubo and
jostling, creates a link between stimulation therapy and
the meridian system. The ancient Chinese described the
treatment methods of tonification and dispersion in relation
to deficiency and excess conditions. When I interpret their
intention, they were applying jostling/bias according to
the patients disease state and physical tolerance. Thus, dispersion can be seen as relatively strong bias/jostling), and
tonification can be seen as appropriately soft bias/jostling.
In this way, rather than being seen as mutually exclusive,
the methods of tonification and dispersion are seen simply
as differences in the intensity or manner of stimulation.
Acupuncture and moxibustion are excellent tools for
treating both deficient and excess conditions, because the
variations of tonification and dispersion apply jostling
in flexible ways. I think because moxibustion stimulates
by burning, which causes histologic changes, such as an
increase in cytokine, it provides a broader bandwidth of
stimulation. This makes it easy to jostle the body, and the
wider bandwidth of stimulation makes it easier to apply.
This might be the reason moxibustion has been so popular
through the ages as a home remedy.

3. Meridians and the Autonomic Nervous System

Ever since I became involved in this profession, not a
day goes by that I dont think about the meridians. Even
so, honestly speaking, I was at a loss to understand it since
it is an energy system in which the real substance cannot
be grasped. In my practice I have had many seemingly miraculous experiences of healing, but they were not enough
to explain or substantiate the meridian system. Attempting to draw up a meridian chart in my own way, it seemed
implausible that meridian lines were laid out so neatly on
the body. Looking at the meridian lines on the head, back
or abdomen, many meridians are crammed into a small
space, but it seems unnatural that so many meridians can
be clearly distinguished without intermingling. It seems to
me that the lines on meridian charts are lines because that
is the only way the points can be connected to each other
in a two dimensional figure. It seems unlikely that there
are invisible lines on the body, and it would be simplistic to
believe so. Yet, when you think about the bias I spoke about
earlier, there has to be an invisible connection between
these points.
Since learning about Abo Torus theory 2 about two
years ago, however, my image of the meridians has begun
to overlap that of the autonomic nervous system. This is
not a connection on the body surface like the meridians or
the lines of Ryodoraku (a modern school of acupuncture
associating the meridians with lines of low electrical resistance). It is a functional connection that might be called the
meridian phenomenon. Even if it is a functional connection
though, it is not expressed so simply as meridian phenomenon = autonomic nervous system. My current understanding is that there is a layer of the meridian phenomenon and
another layer of autonomic nerve function and the two
overlap in many places. When I adopt the view of layering,
the many meridian lines do not have to intersect each other
on the same two-dimensional plane, and traffic control becomes unnecessary. It is only recently that I came up with

76

this image of layering, and I believe that there are many

layers to all the mind-body functions of a human being.
Each meridian could be a layer, and there could be larger
layers like that of the entire autonomic nervous system.
Returning to the subject of the autonomic nervous system, the interactive relationship between the two control
systemssympathetic and parasympathetic nerves
matches the dualism of Yin and Yang, which is the fundamental principle in Oriental medicine. This simplifies the
interpretation of Yin and Yang. The symptoms, which are
presented as deficiency or excess of the meridians, can thus
be understood as symptoms that manifest as autonomic
nerve imbalances between the sympathetic and parasympathetic nerves. I will not go into details here (see previous article...) but I believe that understanding the function of the
autonomic nervous system will serve as the break through
in understanding the meridian phenomenon. I think that
its not unrealistic to believe that a simpler and more convenient treatment system can be created if the therapeutic
mechanisms of acupuncture and moxibustion are analyzed
from this perspective.

4. Conclusion
I feel that my article has been a bit speculative this time.
Unlike Western medicine, which must perform treatments
according to the textbook, however, I believe Oriental
medicine can be practiced by feeling ones way along with
a rich imagination, paying attention to the feedback of the
body. This open-ended aspect is what captivates those who
take up the practice of acupuncture and moxibustion. I am
gratified if this article can be read as the thoughts of one
practitioner who has been captivated by this medicine.
(March 2004, Translated by Stephen Brown)

References
1. Manaka Yoshio Essay Compilation, Manaka Yoshio Essay Compilation Committee, 1988, p.40.
2. Abo Toru, Regulation of White Blood Cells by Autonomic Nervous System: Mechanism of cure of diseases by
acupuncture, NAJOM, July and November, 2003 (Volume
10, Numbers 27 and 28).

NAJOM
Practical Moxibustion Therapy (29)
About Coldness
In the last year or so coldness (hi-e) in my patients
has consumed most of my attention in my practice in terms
of diagnosis, treatment, and assessment of outcome. I always look for coldness, its location as well as the amount. I
then give treatment to diminish or remove the coldness in
the body, and I evaluate the outcome based on whether the
coldness has diminished. I use this criterion for treating all
conditions. I have been using changes in coldness I feel in
peoples bodies to get a handle on their physical condition,
much like Meridian Therapists seek changes in the pulse to
evaluate the outcome of a treatment,
The body has abnormally cold areas because there is
some circulatory insufficiency. I trace this sequence backward as coldness circulatory insufficiencysympathetic
dominance. The reverse, starting with causation, can be
expressed as sympathetic dominanceadrenaline secretionvaso-constrictioncoldness. Conversely, when one
has flushing or abnormal warming in certain areas, the
reverse sequence is hotnesscirculatory congestionparasympathetic dominance. In either case, they are circulatory
problems. Thus, the number one aim of my treatments is to
resolve the circulatory problem. This is the primary objective in Taikyoku Therapy of the Sawada Style.1 The aim of
root treatment in Meridian Therapy is to free up the flow of
Qi, which in effect is to improve the flow of blood throughout the body. I believe this is the main purpose of any root
treatment.
Considering that coldness = circulatory insufficiency,
one can appreciate the crucial role of the autonomic nervous system. It follows that treatments that reduce coldness serve to adjust the balance in the autonomic nervous
system. I believe this is the indispensable element in guiding diseases toward a cure.
The Cause of Coldness
Circulation is reduced and blood supply becomes insufficient (Blood deficiency) when the blood vessels become
hardened by arteriosclerosis. Vasomotion can become weak
(especially in the capillaries) or the internal diameter of
blood vessels can be reduced by the buildup of cholesterol
and other material. Let me list some factors that lead to
such Blood deficiency.
1. lack of exercise
2. poor diet
3. excessive exercise or labor
4. aging
5. injury or surgery
6. drugs and chemicals (hormones, pain killers, anti-inflammatory drugs, food additives, etc.)
7. jet lag
8. environment (natural and artificial)
9. mental conflicts, stress, anxiety, or fears
There is no end to such factors, but they are all included
in the three causes of Oriental medicine (internal, external,
and non-internal and non-external causes). At the root of

all these causes of diseases is the fact that, without exception, they put a stress on the body. The equation for disease
can therefore be expressed as follows: a variety of causes
stress on the systemsympathetic dominancevasoconstrictionBlood deficiency. 2 Whole body regulation
or treatment ameliorates the conditions in this equation to
restore circulation and remove coldness. This is my current
treatment strategy.

Where Coldness Appears

The first place I palpate is the tips of the fingers and
toes. I start from around the elbow and knees and stroke
down toward the fingers or toes to feel for the gradual
change in skin temperature. Eventually I find the coldness.
If I cant feel coldness even at their fingertips, the person is
normal. Warm fingertips indicate that the body is relatively
relaxed and the blood supply is ample. The person can be
considered a parasympathetic (relaxed) type.
Sometimes there are patients who are warm all the way
down to their palms or the tops of their feet, and I think
they must have good circulation, but the tips of their fingers or toes are extremely cold. There are patients like this,
so you will be fooled unless you check all the way down to
the tips of their fingers and toes. Also, even if they are not
cold, the tips of the fingers or toes may be dark red, and
this is a sign of coldness.
In some patients it is hard to tell whether their digits are
warm or cold, but often in cases like this my own hands
are cold. When this is the case, I use the medial aspect of
my forearm (around PC-6). It is almost always warm here
so you can accurately assess any coldness. In this way you
can quickly determine whether a patient has any coldness.
(Photo 1)

Photo 1

The fingertips, and especially the toes, are the farthest

away from the heart, so it makes sense to check the state
of circulation here. It isnt hard to understand why points
nearest the tips of the fingers and toes are designated as
Well points. The Akabane test of checking heat sensitivity
at the Well points also makes sense.
Coldness in the tips of both the fingers and toes is

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NAJOM
caused by poor peripheral circulation throughout the whole
body. This is the so called coldness or chilling syndrome
(hi-e sho). This overall coldness is a characteristic sign of
sympathetic dominance (over-excitation). On the other
hand, some people have extremely cold feet with warm
fingers. I consider this to be a combination type of chilling
and flushing (hi-e nobose), which is coldness below and
heat above. Examining the occipital area (BL-10 and above)
of a patient with flushing (a type of counterflow) I often see
that there is a mottled reddening in their skin (dark red) in
the area. I believe this is congestion caused by the counterflow. Sometimes this reddening appears in the vertex, but
the color at the vertex is more often pinkish.
The second place to look for coldness is the lower abdomen. There are patients who have a warm upper abdomen
but their lower abdomen is cool. Differences in temperature
must be noted during abdominal diagnosis. Coldness in the
lower abdomen is caused by circulatory problems in the
pelvic region, and this often indicates dysfunction in the
pelvic organs.
I once had a patient who had extreme coldness in his
lower abdomen who had rectal bleeding from his intestines
for four years from unknown causes. This patient had prostate surgery followed by radiation and his sympathetic nervous system had become extremely dominant. I surmised
that he had a circulatory problem in his intestines which
caused coldness, and that the veins in his intestines became
congested and every time abdominal pressure increased the
veins would burst and bleed. The rectal bleeding stopped
after I had the patient apply moxibustion on ST-36 every
day for two months.
The third place to look for coldness is the buttocks.
Reading the books of Fukaya Isaburo, the moxibustion master, I encounter his comical line, Cats noses and women
s buttocks are cold. It is true that coldness in the the buttocks is common in women with gynecological problems,
particularly those women who have been taking estrogen
for many years. When patients like this get sciatica, it seems
to take at least five times longer to cure as the usual sciatica
patient. When I do direct moxibustion on patients like this,
the area around the point does not become red; the skin
color remains unchanged. I believe this is due to severely
restricted vasomotion due to the hormone byproducts that
have accumulated in their blood vessels. There are also patients who have been taking various drugs for many years
who seem to have clear skin, but we must not be fooled by
appearances because they often have hidden coldness in
their body. When the patients pulse is thin or faint in cases
like this, we can diagnose them as having coldness.

Where to Treat Coldness

To treat coldness, select points and areas that guide
the body to a state of para-sympathetic dominance. This
includes points such as GV-20, BL-10, upper BL-10, BL-32,
ST-36, Jing Well points, CV-12, CV-6, CV-4, LI-11 and back
Shu points. These points happen to correspond to the standard treatment points in the Sawada Style. I dont know
whether Sawada Ken decided his standard points with the
autonomic nervous system in mind. Still, it is natural that
they would correspond, because he saw the stagnation

78

of Blood as a primary cause of disease, and the aim of his

treatment was to improve circulation.
Points on the head, such as GV-20, BL-10, and upper
BL-10 match with the cranial parasympathetic nerves. The
abdominal points CV-12, CV-6, and CV-4 match with the
vagus nerve, while BL-32 matches with the pelvic parasympathetic nerves. Treating BL-32 causes vasodilation in the
pelvic blood vessels. All the above points improve circulation and facilitate excretion and elimination. Points such as
ST-36 and LI-11, which are close to large joints of the limbs,
serve to draw circulation into the limbs. The ancient people
called this correcting counterflow and used it to counteract the tendency of flushing and hotheadedness.
I believe that not only the points around the large joint
of the limbs, but also the five-phase points are useful for
drawing blood down. The Jing Well points, especially,
are indispensable for resolving coldness below and heat
above. I believe this effect is part of the reason why Meridian Therapists use the five phases points first in their root
treatment.
Concerning the Jing Well points, however, there is a
theory that treatment of TB-1 stimulates the sympathetic
nerves. For this reason, I mainly use the Well point of
the middle finger and the Triple Burner meridian to treat
patients who are parasympathetic dominant. The Triple
Burner is like a boiler that is the source of heat in the body,
which warms the top, middle, and bottom sections of the
body. It circulates prenatal Source Qi around the body to
give the body its vitality. Therefore, I consider treating the
Triple Burner meridian as a way of stimulating the sympathetic nervous system and activating life functions.
The back Shu points run along either side of the spine
and correspond to the bilateral sympathetic nerve trunks
running along the spine. Tension in the back Shu points is
equivalent to tension in the sympathetic nerves, and the
sympathetic nerves do not calm down unless this tension
along the spine is released. Especially tension in the upper thoracic sympathetic nerves (heart and lungs) appears
clearly in the area from BL-13 to BL-17. Patients who have
a lot of tension in this area have an extremely high level of
stress and tend to get coldness below and heat above.

The Treatment of Coldness

I begin my treatments with the abdomen. Points such
as CV-12, ST-25, CV-6, and ST-27 are standard for me. In
addition, I treat a few points that are especially hard, cold,
or soft. I use acupuncture, moxibustion, or both on the abdominal points. Sometimes just treating the abdomen starts
to warm the feet up. Patients like this are easy to treat and
their prognosis is good.
Next, I treat the arms and legs. Coldness is far more
common in the legs, and any part of the leg that is cold
can be treated. My standard points from the top are SP-10,
LR-8, ST-36, SP-6, KI-6, ST-41, ST-42, ST-44, LR-3, and
BL-60. I usually retain needles shallowly, and apply three to
five half-rice-grain sized cones afterward. I retain needles
in Well points and squeeze some blood out after I remove
the needles, or otherwise I just use a lancet to bleed them.
When I try to bleed the Well points on patients who have
extreme coldness in their feet, sometimes I cant get any

NAJOM
blood to come out. In cases like this, I focus on warming
the feet up and apply moxibustion on the Well points, place
stick-on moxa (Kamaya Mini) on the Ba Feng points, or do
small cones on the tips of the toes.
To treat the arms, I palpate from the shoulder down to
the elbow and the fingertips to locate appropriate points
from the anterior shoulder down to the fingertips, but I
dont use nearly as many points as the legs. My standard
points are LI-11 and 10, LU-5, TB-9, 5, and 4, PC-7 and 8,
SI-4, and the Well points. I use whichever points seem appropriate. I also do bleeding at Well points as well as direct moxibustion on the palmar surface, Well points, and
both sides of the joint of middle and proximal phalanxes.
If the above treatment warms up the toes (fingers) Im
in luck, but when it does not raise the temperature at all,
I have the patient turn over onto their stomach and I go
the extra mile and select and apply needle moxa on four
points around BL-35, 53, and 54. This needle moxa in the
hip and sacral area is quite effective for drawing blood
into the lower limbs and resolving coldness.
To treat the back and lumbar areas I use shallow insertion (5-10 mm) and retain the needle about 5 to 10 minutes. After removing the needle, I palpate those points in
which the tenderness, induration, or referred pain has not
diminished and apply three to five half-rice-grain sized
cones. Direct moxi-bustion on the aforementioned interscapular area between BL-13 and 17 is indispensable for
relaxing tension and releasing stress. I use both techniques
of retaining the needle and scatter needling on the scalp.
My standard points for moxibustion are GV-20, BL-6,
BL-10 and upper BL-10, but I like to do bleeding at GV-20
and upper BL-10 for patients with counterflow. Squeezing
out a few drops of blood from these points works quickly
to calm the over excitation of the sympathetic nerves and
relieve the counter-flow and congestion.
In fact, blood letting at Jing Well points and cranial
points works wonders to increase blood flow and relieve
circulatory congestion. It works far faster than moxibustion and has a stronger effect of dispersion.
This is a little off the subject, but recently I made a
mistake blood letting at cranial points, so Id like to mention it for your information. It happened with a 75 year
old male patient with insomnia who came back to me for
a treatment after seven years absence. This patient became
paraplegic in 1994 after a cerebral thrombosis. I gave him
46 treatments from January of the following year. The
treatments in combination with his own exercise therapy
proved effective and he recovered to the point where he
could drive again. He had been exceedingly well for the
last seven years, so much so that he almost forgot about
being ill. He appeared quite robust when he came for
treatment. He had difficulty getting to sleep, and I examined him with the assumption that he was sympathetic
dominant. My guess was correct and his upper back was
extremely stiff and hard, his feet were cold, and there
were red spots in his occipital area, and even the skin on
the top of his head was pink. I gave him a treatment for
resolving coldness by doing moxibustion on his abdomen
and legs, and then retained needles and did moxibustion
on some upper back points. I finished the treatment with

some blood letting from BL-10 and GV-20.

He told me he slept well that night, but the next morning he couldnt move. He had a cerebral infarction in his
sleep. I presumed that the sudden increase in his cerebral
circulation provoked a cerebral thrombus and caused cerebral ischemia. By the time he came back for treatment a
month later, he was able to turn over in bed and walk on
his own.
This case drove home the point to me that, even if a
patient has an excess constitution, strong dispersion like
blood letting can cause a sudden change in circulation
and produce a rebound effect. This patient got away with
just a mild stroke and I managed to avert disaster, but it is
obvious that it was a mistake (mistreatment) to give him
such a powerful treatment without due consideration to
his age and history. Fortunately this patient still comes to
me for acupuncture and moxibustion for his rehab.

Conclusion
In this article I reviewed my recent treatment strategy.
I use the physical sign of coldness in a series of treatment processes as a ruler for gauging the balance in the
autonomic nervous system, for deciding treatment objectives, and for judging the effect of treatment. Coldness is
an exceedingly simple concept, but to me these days the
regulation of the balance in the autonomic nervous system
overlaps with the root treatment, so even such commonplace signs can be very useful. Its the equation of coldnesscirculatory insufficiencysympathetic dominance.
There is nothing as reassuring as having many approaches
to treatment for consistently resolving physical symptoms
which are commonplace. I feel that the joy of discovering
such effective methods is what makes acupuncture and
moxibustion so much fun.
References
1. NAJOM, No. 29, p.37 & p.72, November 2003
2 . For a more detailed discussion about this process, refer
to the article Regulation of White Blood Cells by Autonomic Nervous System by Abo Toru in the July and
November 2003 issues of NAJOM (No. 28 and 29).
(July 2004, Translated by Stephen Brown)

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NAJOM
Practical Moxibustion Therapy (30)
I received the following question for the NAJOM question column: How do you understand and treat atopic reactions? By this I mean patients who quickly develop a red
rash around an acupuncture needle or from scratching an
itch. These individuals also tend to have allergic symptoms
such as asthma, itchy eyes, nose, and throat, etc. (Sharon
Weizenbaum) The answer to this question can be found in
an article by Professor Abo Toru in a past issue of NAJOM.1
I would like to review Professor Abos theory in this article
to answer the above question, and contemplate the treatment strategy.

1. Patients whose skin turns red easily with acupuncture

When a patients skin turns very red when a needle is
inserted, or when scratching an itch, this means that they
have a para-sympathetic dominant or lymphocyte excessive constitution. Patients with this constitution, as Professor Abo explained in his article, vasodilate easily and their
peripheral circulation increases rapidly so that they often
experience itchiness or pain when they come into contact
with irritants. They have too many lymphocytes so they
over-react to even minute amounts of allergens. Thus they
tend to have allergies, hay fever, bronchitis, or chronic rhinitis.
One can also understand why inserting a needle causes
redness in the skin and itchiness from the following statement: Metals steal oxygen given their tendency to oxidize.
Metals dissolve into our bloodstream and there can be an
allergic reaction when a person has excessive lymphocytes.
So people who have allergic reactions to false teeth or
pierced earrings usually have excessive lymphocytes. Even
if a person does not have excessive lymphocytes, if he is
exposed constantly to toxic metals such as mercury, lead or
aluminum, he eventually acquires an allergic constitution.
In Professor Abos book Mirai-no-Meneki-gaku (Immunology of the Future), in the chapter on pierced earrings
and metallic false teeth, he further explains this issue.2 This
might be a bit repetitious, but it relates to the therapeutic
mechanism of acupuncture and intradermal needles, as
well as ion pumping cords, so I will include it.
When metals come into contact with body fluids, they
characteristically ionize. And the more a metal tends to
ionize, the more it tends to oxidize. Metals have strong
bonding properties with oxygen, so they (the positive ions
of metals) are also powerful antioxidants. When the ear is
pierced and an ear ring is placed in it, the more the metal
of the earring tends to ionize, the more it causes a localized
parasympathetic response and excessive lymphocytes are
produced. The visible sign of this is inflammation where
the earring contacts the ear. The characteristic of inflammation involving lymphocytes is redness, swelling, and heat,
unlike the inflammation with granulocytes.
When a person is parasympathetic dominant, the production of neurotransmitters is increased so that the sensory nerves become hypersensitive. Thus one experiences
extreme pain.

80

I will quote Professor Abo just a little more from this

book: Once there is a localized allergic reaction, that area
gets increased secretion of various substances related to allergic reactions. There is secretion of prostaglandin primarily from macrophages, and secretion of histamine and seratonin from mast cells. All of these chemicals act to further
stimulate the parasympathetic nervous system and amplify
the allergic reaction.
In this way, it seems that irritating substances increase
and cause inflammation, and this in turn causes hypersensitivity and itchiness. Professor Abo further states that,
metals like aluminum, iron, lead, zinc, tin all tend to cause
localized allergic reactions. Gold, platinum, and titanium,
which tend to ionize less, do no irritate the surrounding tissues very much so they are good metals.
The above explanations solve the mystery of skin reddening after insertion of needles. There are also patients
who get itchy or break out in a rash when moxibustion is
applied over a period of time. This is based on the same
principle. Moxibustion involves no metals, but it activates
vasomotion and induces a parasympathetic dominant state.
It seems, also that, the denatured proteins from the small
burns cause a large surge in lymphocytes. There can also be
itchiness over the whole body for a short time after taking a
bath, when peripheral circulation increases all over. In my
experience, this type of localized response to treatment is
greater with moxibustion than acupuncture.
The stimulation of acupuncture and moxibustion increases white blood cells, especially lymphocytes. This in
turn increases sensitivity to irritants and prompts an allergic reaction. This reaction, however, is very temporary and
differs markedly from allergies to foods and external allergens. So in my experience there is no need for any concern.
This type of temporary allergy disappears as soon as a person stops receiving acupuncture and moxibustion. Patients
do not know about this, however, so we have to carefully
explain it to those with allergies or an excessive lymphocyte constitution.

2. Treatment for excessive parasympathetic dominance

For me the treatment of patients with allergic conditions
is one of my challenges. One of the reasons is I dont have
that much experience treating allergic patients, and I haven
t dealt with that many cases. This could be because allergic
conditions are essentially due to excessive parasympathetic
dominance. The majority of my patients have too much
stress (associated with sympathetic dominance) or musculo-skeletal conditions (this also tends to be sympathetic
dominance). For patients like this, the stimulation of acupuncture and moxibustion serves very well and it quickly
alleviates stress and induces parasympathetic dominance
to facilitate healing.
In contrast to this, it seems that the effect of acupuncture
and moxibustion is just not that decisive with patients who
have excess parasympathetic dominance. It just seems to
take a long time to achieve a cure with patients who have
allergic conditions. Even so, if acupuncture and moxibustion treatments are continued patiently, the symptoms do
gradually resolve. Ive seen cases where patients with quite

NAJOM
severe allergies forget all about their complaints after some
time.
I think that acupuncture and moxibustion are very effective treatments for improving the function of the parasympathetic nervous system. Parasympathetic dominance
begins to diminish when treatments are continued over a
long period, and the sympathetic nerves also become more
balanced. This is because even parasympathetic dominant patients, when their symptoms are bad, tend to have
overactive sympathetic nerves as well. The treatments
must alleviate this condition and restore some balance the
autonomic nervous system. The stimulation of acupuncture and moxibustion affects both the parasympathetic
and sympathetic nerves. This dual action is the interesting
thing about stimulation therapy.
In his article in NAJOM1 Professor Abo states as follows: I have realized that there is a dual effect to herbs
and acupuncture. Light or weak stimulation, and cases
where the subject is feeling some stress tend to elicit a
parasympathetic response. Conversely, when the stimulation is sustained, or when the subjects tends to be overly
relaxed, it tends to elicit a sympathetic response so that
they perk up. So there is this dual effect ...
I believe, as I mentioned earlier, that the stimulation of
acupuncture and moxibustion if anything is more effective
for those with sympathetic dominance. The quality and
amount of stimulation, however, does allow for the above
mentioned difference in effect. Classifying the stimulation
of acupuncture and moxibustion, I think in very simple
terms that acupuncture is good for sympathetic dominance
and moxibustion is good for parasympathetic dominance.
Of course, in my treatments I most often combine these
two modalities, but this is because it is hard to clearly distinguish a patient as being sympathetic dominant or parasympathetic dominant. Comparing the quality of stimulation and the effect of the two modalities, the stimulation of
moxibustion clearly seems to dramatically increase white
blood cells and lymphocytes compared to acupuncture.
This is because Ive often experienced exacerbation when
Ive used moxibustion on patients with conditions like
atopic dermatitis. This is not based on any scientific finding, but it is my personal impression. I hope that this issue
is studied in greater detail by those doing scientific investigations.
I have recommended half fasts and reducing the
amount of protein intake for those with serious allergies or
atopic dermatitis, and this alleviated the problem in some
cases. Sometimes this dietary approach is far more effective than acupuncture and moxibustion.
From my experience so far, fairly mild stimulation
seems to be the best for balancing the autonomic nervous
system. This would be the superficial insertion or contact
needling used in Meridian Therapy, or in terms of moxibustion it would be applying small cones with a bamboo
tube3. Regardless of sympathetic dominance or parasympathetic dominance, mild stimulation seems to be indicated, but I feel that the excessive parasympathetic dominant
patient benefits from the most mild stimulation. If we classify this in terms of tonification and dispersion, the whole
treatment would be tonifying.

As for my approach, I give dispersive treatments using

strong stimulation and deep insertion to adjust imbalances
in the musculo-skeletal system. In terms of point selection,
whole body treatment (using points all over the body) is indispensable for regulating the autonomic nervous system.
Therefore it is best to employ the root treatment of Meridian Therapy (using five phasic points on the arms and legs)
or the basic points of Taikyoku Therapy of the Sawada
style. These basic points, especially, seem to have been formulated with the regulation of the autonomic nervous system in mind.

3. Conclusion
I have written down what comes to mind about the
treatment of parasympathetic dominant or lymphocyte
excessive constitutions, but I dont really have a good solution. I am confident that acupuncture and moxibustion
treatments are effective for both sympathetic and parasympathetic dominant conditions, and that the treatments
should primarily be tonifying (mild stimulation). Beyond
that, however, I am not sure what to say because I dont
have a clearly defined treatment strategy for parasympathetic dominance.
This just might mean that treatment of parasympathetic
dominant or lymphocyte excessive constitutions is a drawn
out battle, and that whole body treatment is indispensable.
The topic of this article is a core issue for acupuncture and
moxibustion therapy, so I look forward to receiving feedback from our readers about this issue.
(November 2004, Translated by Stephen Brown)
Notes
1. Abo Toru. Regulation of White Blood Cells by Autonomic Nervous System Mechanism of cure of diseases
by acupuncture, NAJOM . Vol. 10, No. 29, Nov. 2003,
p3-7.
2. Abo Toru, Mirai-no-Meneki-gaku (Immunology of the
Future), Inter Medical Publishing Co., 1977.
3. Mizutani Junji. Bamboo tube: See Practical Moxibustion Therapy - Part 13, NAJOM No. 13, July 1998.

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NAJOM
Practical Moxibustion Therapy (31)
Sawada Style Point Selection
Before I entered an acupuncture school in 1980 I had
a good friend who introduced me to the book Shinkyu
Shinzui (Essence of Acupuncture and Moxibustion). He
was quite involved in Kendo (Japanese fencing). His Kendo
teacher was a dentist, but since his father was a disciple of
Sawada Ken, he became an acupuncturist under the tutelage
of Sawada before he became a dentist. My friend, under the
influence of his teacher, practiced Sawada Style acupuncture
even though he was a layman. In those days I was not well
acquainted with acupuncture and moxibustion, and I just
received treatments. I didnt know anything about Shinkyu
Shinzui or its author Shiroda Bunshi. I just started reading it
because my friend had recommended it.
I was getting treatments from Matsumoto Hiromi (Ed.
Note: currently a frequent contributor to NAJOM) in those
days because I had low back pain from a herniated lumbar
disc. I decided to enter acupuncture school without giving
it too much thought. I think reading Shinkyu Shinzui had a
lot to do with it. In the second year of acupuncture school,
I met my friends teacher, Suzuki Shichiro, who practiced
dentistry in Kodaka in Fukushima Prefecture. I began to
visit him regularly and Suzuki Sensei began to tell me
stories about Sawada Ken when we had tea together at
night. When Suzuki Sensei was a child, Ken Sawada used to
go up north to spend some time at Suzuki Senseis father
s place in the summer to get away from the heat in Tokyo.
Sawada loved children and he used to take baths together
with Suzuki Sensei and his sister Tomoko. He also brought
his Kendo gear and gave Suzuki Sensei some instruction.
Later Suzuki Sensei went on to study with Tojima Kotoku, a
master of the Sawada Style, and Yanagiya Sorei and became
an acupuncturist himself. I was told that his sister Tomoko
became a disciple of Shiroda Bunshi. So in my acupuncture
school days I learned a lot about the Sawada Style because
I repeatedly visited Suzuki Shichiro and Tomoko, teachers
who were close to Ken Sawada. In those days, however, both
these teachers mainly practiced Sawada Style acupuncture,
and I never got a chance to see their moxibustion.
Once I graduated, I practiced Sawada Style acupuncture
as best as I could. Later I visited Irie Seiji and learned
the Fukaya style bamboo tube moxibustion method, and
began to use a lot of moxibustion after that. Therefore, my
moxibustion had its origins in the Sawada style with the
book Shinkyu Shinzui, and then I learned Sawada Style
acupuncture from Suzuki Sensei, and then Fukaya Style
bamboo tube moxibustion was mixed in. So my practice
cannot be called Sawada Style in a strict sense. That is why
I often wonder about the point location and selection in the
Sawada Style. In this article I would like to delve into some
of the questions Ive had about Sawada Style point location
and my own understanding.
1. CV-12
The Sawada Style is known for Taikyoku Therapy.
In page 69 of the text, Shinkyu Rinsho Iten (Acupuncture
and Moxibustion Clinical Reference) Yoshio Manaka M.D.

82

explains this system as follows:

The late Sawada Ken advocated the use of a
combination of points in every kind of disease for
regulating the condition of the whole body (regulating
the function of the Zangfu). His method was to use these
points as a foundation and then add other points that
would work for specific diseases.
This is known as Sawada Style Taikyoku Therapy, and
the following standard points are designated:
Back GV-12, BL-18, BL-20, BL-23, BL-32
Abdomen CV-6, CV-12 (Chu-kan)
Arms LI-11, TB-4 (Yo-chi)
Legs ST-36, Sawada Style KI-3
This combination of points includes the primary points
all over the body, and it is said that various imbalances are
regulated when moxibustion is applied on these points
over a certain period.
Suzuki Sensei used to say, First do Kan-Yo, to teach
me the order of treatment in Taikyoku Therapy. This
referred to CV-12 and left TB-4, and the treatment started
here regardless of the situation. The patient lies supine
and places his left arm palm down on his chest, and
moxibustion is applied at CV-12 and left TB-4. Suzuki
Sensei told me that just treating these two points calmed
the patient down. When the patient is calm, the rest of the
treatment goes easy. He said that the treatment should start
with these two points regardless of the patients condition.
Ken Sawada said CV-12 is the middle of the three Kan
(Wan) points (CV-13, CV-12, and CV-10) and is also in the
center of the Upper, Middle, and Lower Burners. Therefore
the one point CV-12 resonates with the three Kan (Wan),
the Middle Burner, and the Triple Burner.
Since the solar plexus (the center of the parasympathetic
nerves in the abdomen) is under CV-12, I believe this is
a point that activates the parasympathetic nerves and
reduces excitation. TB-4, on the other hand, is said to
regulate the Lower Burner, and further, left TB-4 reduces
contraction or tenderness in the left rectus abdominus. In
Kampo, the left rectus abdominus in the lower abdomen
is the diagnostic area for Blood Stasis (Oketsu). Therefore I
think TB-4 is somehow related to resolving Blood Stasis.
I had the experience of applying multiple cone
moxibustion at CV-12 for over thirty minutes on a patient
who had melanoma and surgery to remove one eye.
Perhaps it was due to the effect of the anesthesia, but she
was exhausted with continuous nausea for two days. Her
nausea went away completely with repeated moxibustion
at CV-12. As I continued to apply moxibustion this patient
fell sound asleep.
Not only at CV-12, but Ive experienced several cases
where applying multiple cone moxibustion at CV-6
caused patients with appendicitis to fall asleep, and the
inflammation was completely gone the next day. Multiple
cone moxibustion on abdominal points is an amazing
technique that quickly reverses a condition of sympathetic
excitation to bring parasympathetic dominance and reduce
inflammation.

2. Sawada Style KI-3

KI-3 in the Sawada Style is said to be close to the

NAJOM
common location of KI-6. It is located at the midpoint of
the line connecting the top of the medial malleolus and
the lower margin of the navicular bone (Fig. 1). In Shiroda
s Shinkyu Chiryo Kisogaku (Basic Study of Acupuncture
Treatment) it says that acupuncture and moxibustion
applied on this point causes a radiating sensation to the
sole or the medial aspect of the calf. Its indications are
broad including kidney diseases, throat pain, bronchitis,
otitis media, tinnitus, tonsillitis, arthritis or rheumatism in
the ankle, osteomyelitis, beriberi, plantar pain, cold feet,
Fig. 2

Fig. 1

intermittent claudication, Raynauds disease, gangrene,

heel pain, and vertical pulling pain in the chest.
In the Sawada Style, the common KI-3 and the Sawada
Style KI-3 are used differently. The common KI-3 is
posterior to the medial malleolus where the pulsation
of the posterior tibial artery can be felt. It is said that
this artery cannot be palpated in cases of intermittent
claudication and gangrene, but that acupuncture and
moxibustion at this point can be effective for these
conditions.
Where then is KI-6 in the Sawada Style? The usual KI-2
is the Sawada Style KI-6, and Sawada Style KI-2 is located
one unit anterior to the usual KI-2 on the border of the red
and white skin (Fig. 2). Shiroda said that Sawada Style
KI-3 had the effects most fitting as the Source point of
the Kidney meridian. In the Five Phases classification the
Kidneys open to the ears, and he used it for diseases of the
ear, throat, and tonsils.
Because tenderness often appears below the medial
malleolus, I generally use the point that is the most tender.
I often see vascular spiders in this area. Sometimes many
veins appear close to the surface here, and the skin color
is dark and muddy. Patients like this often get serious
diseases like cancer, and Ive noticed that many already
have life threatening illnesses. It seems that those who
apply moxa here for a year or two and thereby get the skin
color to improve have a better prognosis. That might be the
reason that the Kidney is known as the organ that builds
vitality. This could be why the Sawada Style KI-3 is one
of the standard points in the Sawada Style. I consider this
point indispensable when I am using Taikyoku Therapy to
treat serious illness like cancer.

3. Governor Vessel Points

In the Sawada Style, all the points on the Governor

Vessel are located one vertebra above the usual location.
This difference comes from how they locate GV-14.
The location of the Sawada Style GV-14 is based on the
passage in the Shisijing Fahui (Exposition of the Fourteen
Channels, by Hua Shou, 1341) above the first spine, in
the depression, The first spine here refers to the spinous
process of the seventh cervical vertebra, and this spinous
process is indeed worthy of the name big spine (Dazhui)
because it sticks out when the neck is bent forward. This
is why the depression above the spinous process of the
seventh cervical vertebra was designated as GV-14 in the
Sawada Style. (Fig. 3)
On the other hand, with the common GV-14 the first
thoracic spine, which doesnt move when the head is
turned, is regarded as the big spine, and GV-14 is located
above it. This is then used as the standard for the location
of all points on the spine.
I get the impression that tenderness appears more often
in the common GV-14, so I tend to use this point. I often
do multiple cone moxibustion on GV-14 in the early stages
of a cold. Even if I have a slight fever, the cold goes away
as long as my upper back becomes warmed up by this
method. I also use this point for allergic conditions. In the
classics, GV-14 is referred to as the place where the Yang
meridians meet. For
this reason it seems to
be deeply related to
Yang symptoms like
allergies. The secret
to doing moxibustion
here is doing it until
the upper back is
warmed up.
In the Sawada
Style GV-12 is used
so often it is no
wonder its one of
the standard points.
Fig. 3
G V- 1 2 a l o n g w i t h
GV-4 is considered indispensable for pediatric diseases. Of
course, in this case, the location of GV-12 is the depression
between the second and third thoracic vertebrae. When I
treat the condition of pediatric neurosis known as Kannomushi (irritability and incessant crying), in cases of night
crying, for example, just applying three to five cones of
string-like moxa on GV-12 is sufficient to quiet the child

83

NAJOM
down. It really works quickly. This point is not only good
for children, it also has a tranquilizing effect for adults with
nervous conditions. Its also used for colds and respiratory
problems.
There is an interesting story from when Suzuki Sensei
was a student. The family he was boarding with at the
time had a boy who became ill, and fell unconscious. His
doctor couldnt revive him, and even the physician from
University Hospital who made a house call threw in the
towel. The parents knew that the student living with them
did moxibustion. Being desperate, they begged him to
do some moxibustion on their boy. Suzuki Sensei applied
moxibustion repeatedly on GV-12 and GV-4 for about half an
hour, and the boy came to. He got up, went to the porch, and
urinated copiously. He was completely better after that. The
boys father happened to be the president of a construction
company and was a wealthy man. I was told that he was so
grateful that he gifted Suzuki Sensei with a house. This is a
story from a different era, over sixty years ago.
GV-4 in the Sawada Style is under the spinous process
of the first lumbar vertebra because it says that its in
the space of the joint under the fourteenth spine in the
Shisijing Fahui. Be that as it may Sawada located two points
three tenths of a unit lateral to this point on either side and
then went up half a unit, and designated these points as the
Sawada Style GV-4. These points are close to the Huato Jiaji
points. In the Sawada Style, GV-4 or Mingmen is understood
literally to be the gate of life, and these points are used
for emergency treatment of acute and severe symptoms.
According to Sawada, Mingmen refers to the adrenals.
(November 2007, Transalted by Stephen Brown)
, References:
1. Shinkyu Shinzui (Essence of Acupuncture and
Moxibustion) Shiroda Bunshi, Ido-no-Nippon, 1978.
2. Shinkyu Chiryo Rinshogaku (Clinical Study of
Acupuncture) Shiroda Bunshi, Ido-no-Nippon, 1948.
3. Kyu to Hari no Ryoho (Therapy with Moxibustion and
Acupuncture) Shiroda Bunshi, Toto Shobo, 1965.
4. Shinkyu Chiryo Kisogaku (Basic Study of Acupuncture)
Shiroda Bunshi, Ido-no-Nippon, 1979.
5. Kotei Myodo Kyukyo Shakugi (Explanation of Yellow
Emperor Mingtang Moxibustion Classic) Fukaya
Isaburo, Kankan-do, 1978.
6. Kampo Gairon (Overview of Oriental Medicine: Acupoint
Volume), All Japan Oriental Medical School Association,
Ishiyaku Publishing,1980.

84

Practical Moxibustion Therapy (32)

The Essence of Acupuncture and
Moxibustion Part 1
1. Introduction
More than a year ago (see Sawada Style Point
Selection, NAJOM, Number 41), I wrote about how my
interest in acupuncture and moxibustion evolved, and
my connection with the Sawada Style. It was at that point
that I again felt a desire to study the Sawada Style in
depth, starting with the basics. The reason I say again is
because I had thought about doing this many times before,
but never fulfilled that wish. In addition, I have received
many questions and inquiries about the Sawada Style
from readers, but I havent been able to respond to many.
As I mentioned in the 41st issue of NAJOM, the transcript
of Sawadas teachings, The Essence of Acupuncture and
Moxibustion (Shinkyu Shinzui) by Shirota Bunshi was
influential in my decision to journey down the road of
acupuncture and moxibustion. In the articles to follow, I
would like to put together my 26 years of experience in
moxibustion therapy with a re-reading of the above text,
and use this as my opportunity to examine the Sawada
Style.
Be advised that this will not be a translation or even a
commentary of the above text. It is just part of my process
of studying the Sawada Style. I welcome criticism if
there is any reader who thinks I am drawing erroneous
conclusions. I will be pleased if these articles serve to aid
in the introduction of the Sawada Style to the West.
2. What is the Sawada Style transcript, The Essence
of Acupuncture and Moxibustion?
M y v e r s i o n o f t h e E s s e n c e o f A c u p u n c t u re a n d
Moxibustion (Shinkyu Shinzui) is the 11th edition
published by Ido-no-Nippon in 1978. The cover page says
that Nippon Shobo published the first edition in 1941. The
contents, as indicated by the Japanese term for Sawada
Style transcript (monjo), is a record of what Shirota
Bunshi heard Sawada Ken saying in 10 clinic observations
during his apprenticeship from 1927 to about 1937.
In the forward to this text the author Shirota explains:
Sawada Sensei never did anything like take me by the
hand and teach me things, but nevertheless, in moments
between his diagnosis and treatments he made comments
to no one in particular. I found many profound statements
in these words not necessarily intended as instruction,
which later aided self-discovery.
The words of (Sawada) Sensei that appear in this
text, because they were from conversations in reference to
particular situations, do not express a consistent ideology.
Also since these were things said to patients, they are not
systematic, and are rather plain and simple.
Sawada Sensei was a man who was constantly
growing. Because of this, there is a considerable difference
between the (thinking and) treatments of Sensei that

NAJOM
appear in my notes from the first and second clinic
observations (1927) and that of Sensei in his last years
(around 1937). Also for myself, there is a considerable
difference in attitude between the first encounters and the
last encounters. Because of this, the notes from my early
clinic observations and those in later years seem to have
some contradictions.
I would like to take from these clinic observation notes
what seem like important passages, and summarize them
and re-evaluate them, presented here in italics. I repeat
that this will of course draw from my 26 years of clinical
experience. Readers should understand this as they read
ahead.(JM)

3. Notes from first observation (June 1927)

Description of Sawada Sensei giving treatments (p.1
p.3): From 9:00 am to the evening, without any time out
for lunch, he treats 40 to 50 patients with his assistant Jyo
Ikkaku. Sensei examines the abdomen, back, arms and legs
and applies moxa on the abdomen and low back, while Mr.
Jyo applies moxa on the upper back and arms and legs,
as well as keeps patient records and collects fees. There
is a chart of Five Phases correspondences and the twelve
source points on the wall. When Shirota asks, Could you
please explain? he is rebuked with the words, This is
the quintessence of ancient acupuncture and moxibustion,
and cant be explained so simply. But Shirota persisted,
But then what should I do? Sensei responded, Just
keep looking at it everyday; eventually you will come to
understand.
The chart of Five Phases correspondences comes
primarily from the 5th chapter of the Simple Questions
(Suwen) and the chart of the twelve source points came
from the 66th chapter of the Classic of Difficulties
(Nanjing). It seems that Sawada Sensei hand copied
the latter chart from the Steel Mirror of the Classic of
Difficulties (Nangyo Tekkan: 1750) by Hiro-oka Sosen.
In my moxibustion treatments, in order to avoid the
burning sensation and discomfort, I use a Fukaya-style
bamboo tube and make the moxa cones as small as possible
(half-rice-grain-size). Because of this, in order to get better
results there is a tendency for the number of points and
number of cones per point to increase. This takes time.
Given my approach, there is no way I could handle 40
patients a day with one assistant as Sawada Sense did.
There are 10 to 15 standard points in the Sawada Style, and
this combined with symptomatic points would be 15 points
over the whole body. I imagine that two people could treat
40 patients a day if an average of five to seven rice-grainsize cones were applied on these points (JM).
In the explanation of Sawada Style points (p.8
p.17) Shirota records the points that Sawada Sensei used
frequently.
GV-12: A key point for the lungs, headache, vertigo,
asthma, infantile colic. 1 Connects to Large Intestine.
BL-18: Quite a few get moxa here, but not all. Location
is 1.5 units lateral to the bottom of the 9th thoracic
vertebra. (In the Sawada Style, the 7th cervical vertebra is
considered to be the first spine or T1, and the bottom of
the ninth vertebra means the space between the spinous

processes of T8 and T9. All the Governor Vessel and

Bladder meridian points in the Sawada Style are based on
starting above C7 instead of T1.) 2
A key point for the Liver. Moxibustion makes the spirit
robust. Used often on those with insomnia, neurasthenia,
eye disease, and pale faces. Treat with the patient seated.
BL-20: A key point for the Spleen and Stomach. Most
people have a problem in the Spleen and Kidney, and if
these are bad, the Liver is also affected, and they become
lacking in fortitude. The Spleen controls Intention (Yi) and
Will (Zhi). Treat with the patient prone.
BL-22: The meaning of the Triple Burner, based on
the 66th chapter of the Classic of Difficulties was a very
important issue in the Sawada Style. The Lower Burner
is the mesentery of the small Intestines, and when the
flow becomes bad through these, a person gets Blood
disorders. To cure gynecological disorders (chi-no-michi)
3
one applies moxa on left TB-4 and CV-12 and regulates
the Lower Burner. The reason women with gynecological
disorders have stiffness in their left neck and shoulder is
because of stagnation in the Lower Burner, and treating
TB-4 and CV-12 will relieve it. CV-12 is also connected to
the breasts, and milk production increases when the Lower
Burner is regulated, and this also stops leucorrhea. CV-12
is also connected to the pancreas, and in cases of diabetes
its important to regulate the Triple Burner by applying
moxa on points like CV-12, TB-4 and BL-22. Treat with the
patient prone.
BL-23: Most everyone receives moxa here. A very
important point. Most everyone has problems in the
Kidney. Signs of Kidney problems appear on the skin all
over the body, but especially on the facial skin as a blackish
color and also as whitish spots. When moxa is applied
on BL-23, these colors gradually diminish. Treat with the
patient prone.
BL-32: Most everyone receives moxa here. It treats
gynecological problems, male urogenital problems, arthritis,
rheumatism, and tension in the occipital area related to the
Bladder meridian.
Needling BL-32 can relieve tension around BL-10.
When there is tension in the occipital area on only one
side, Sawada Sensei says it is caused by applying moxa on
poorly located BL-32.
CV-12: Most everyone receives moxa here. Usually
children are not treated here. A key point for gastrointestinal
diseases. It is treated along with left TB-4 for malposition of
the uterus and masses in the abdomen (senshaku). Sawada
Sensei says masses in the abdomen and colic (senki) are
caused by spasms in muscles in the abdomen that restrict
the free movement of the intestines, and that this causes
obstructions in the mesentery and leads to all manner of
diseases.
I always use CV-12 to treat colds and other conditions in
children. Whether a child or an adult, it is essential to regulate
the gastrointestinal system in order to draw out the healing
power of the body (JM).
CV-6: Its the Sea of Source Energy, so its named the Sea
of Qi. A key point for intestinal diseases. Its a famous point
for remarkable effect with peritonitis and appendicitis.
Apply 20 to 30 cones.

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NAJOM
In my practice I apply 40 or even 50 cones until the skin
around the point turns pink (JM).
TB-4: Treat only the left wrist. A key point for regulating
the Lower Burner along with CV-12. After applying moxa on
these points the spasm in the left rectus abdominis muscle
relaxes, and tenderness goes away. Used for uterine spasms,
orchitis, masses in the abdomen (senshaku), and infantile
colic. TB-4 in the Sawada Style is located my stroking up the
lateral margin of the fourth finger from TB-1 to the crease on
the back of the wrist. So its located somewhat ulnar to the
center. This point is located with the patient supine, with the
left arm on the center of the chest palm down.
LI-11: Most everyone receives moxa here. Prevents
infectious skin diseases. In cases of eye diseases, vision
becomes clear when this point receives moxa. It is a point
that tends to be quite tender.
ST-36: Do not use for hyperacidity. It removes stomach
heat, and is a key point for nasal problems. Indispensable
for hot flashes. It has been a famous point for health
maintenance and longevity since the olden days, and is
indispensable for strengthening the immune system.
In my experience, suppurative moxibustion on ST-36 is a
powerful method (JM).
KI-3: In the Sawada Style, this is the
KI-6 of standard texts. A key point for the
medial malleolus
kidneys. Used for throat pain, tonsillitis,
otitis media, asthma, and gynecological
problems. (Fig. 1)
KI-3
BL-15: Not used that often. The Heart Sawada Style tuberosity
of
navicular bone
houses Spirit. The point is used for
neurasthenia (fatigue of neurotic origin). Fig. 1: Sawada Style KI-3
LI-10: Used in special cases. A key
point for facial paralysis. Also a key point for some skin
eruptions. If there is no heat sensation when applying
moxa here, more is applied until heat is felt. If there is heat
sensation here, moxa is applied until
heat is not felt. Those eruptions that
LI-11
LU-5
have not infected will disappear, and
SI-8
Sawada
those eruptions that are already infected
Style LU-6
will rapidly open up, release pus, and PC-4
LU-6
heal. Infectious skin eruptions heal
quickly when this point is used along styloid
process
with SI-6.
LU-6: Used in aspecial cases. LU-6 in Sawada
Style HT-7
the Sawada Style is three units distal to
LU-5, and its at the same level as LI-10.
This point relieves hemorrhoid pain. Fig. 2: Sawada Style LU-6
(Fig. 2)
LI-2 : In the Sawada Style LI-2 is
located on the crease on the medial
side of the index finger at the joint of
the middle and proximal phalanges. It
Sawada
is used along with GV-12 (or SP-1) for
Style
LI-2
infantile colic. LI-2 is also a special effect
moxa point for sties. (Fig. 3: Sawada Fig. 3: Sawada Style LI-2
Style LI-2).
SI-10: This point is in the middle between the top of the
posterior axillary crease and the tip of the acromion. This is
a point discovered by Sawada Sensei. A key point for high
blood pressure. Also cures stiffness and heaviness in the

86

occipital region. It is a famous point for treating frozen

shoulder.
Recently I have been using this point a lot. Most everyone
seems to have tenderness and or tension here (JM).
GV-8: Used for insomnia, neurasthenia (fatigue of
neurotic origin), heaviness in head, and irritability. It
contracts muscles that are too slack. It is a key point for
facial paralysis, polio, hemiplegia and stroke rehabilitation.
BL-13: Not used that often. Used in cases of pulmonary
tuberculosis, asthma, and colds.
GB-34: Used for muscular
disorders.
GV-12
BL-42
B L- 4 3 : I n t h e S a w a d a S t y l e
BL-43
BL-43 is located where BL-42 is
BL-45
in standard texts. A key point for Sawada Style
Kichikuba
hyperacidity of stomach.
Points
Kichikuba Points: These
are extra points one unit above
BL-18 and one unit lateral to the
Fig. 4: Sawada Style
midline. Used for ocular pain and
Kichikuba Points
detoxification. (Fig. 4)
In these notes there are lists of points used for
patients (p.17 - p.18). They include the points above, so I
will list them all.
1) Woman with uterus inclined to left (7 cones each,
requires about 45 days of moxa).
TB-15, GV-12, BL-20, BL-23, CV-12, left TB-4, LI-11,
ST-36, KI-3
2) Man with red face and shortness of breath. (Heart
disease?)
TB-15, GV-12, BL-15, BL-18, BL-20, BL-32 CV-12, LI-11,
ST-36, KI-3
3) Child with intestinal weakness. (Diarrhea?)
(i) Case 1 - about 2 years old: GV-12 & LI-2, three cones
each.
(ii) Case 2 - about 2 years old: GV-12, left BL-20 & LI-2,
three cones each.
(iii) Case 3 - about 7 years old: GV-12 & left BL-20, five
cones each.
These cones for children are third of rice-grain size, and
they were pressed out an instant before the heat reached
the skin.
(iv) A college student with scoliosis to the right,
empyema, somewhat neurasthenic.
GV-12, right BL-18, left BL-20, BL-23, BL-32 CV-12,
ST-36, KI-3, left TB-4, LI-11
The standard dosage for adults was 7 cones, and the
order of treatment was the upper back, abdomen, low
back, arms, and legs. Later on, however, the order changed
to abdomen, low back, upper back, arms, and legs.
The order of my treatments for patients needing a whole
body moxa treatment is often abdomen, low back, and upper
back, but when there is a strong tendency of heat above or
coldness, I treat the abdomen, legs, and arms to get the blood
moving. Then I treat the low back and hips, and end up with
the upper back.
For those cases that dont involve marked excess or deficiency
and can get by with just local moxa treatments, I first
alleviate the symptoms by treating them directly, and then I
often do some moxa on the abdomen. I use more moxa points

NAJOM
on the abdomen than the Sawada Style (JM).
The reason Taikyoku Therapy (p.19 - p.31)(Sawada
s term for whole body balancing) always puts great
emphasis on the treatment of the abdomen is because
the regulation of the Zangfu organs is the foundation
of treating all diseases. This is what Sawada meant by
Taikyoku (Taiji) Therapy.
Diseases are nothing unusual; they are situations
where the flow of blood has become imbalanced. The aim
of treatment is to improve the circulation of blood.
The aim of medicine is to assist the healing capacity of
nature.
This view of pathology and the stimulation of
moxibustion are well matched to vitalize the patients
body. It is quite clear and simple.
When you give Taikyoku Therapy, the lower abdomen
becomes stronger and the energy in the Tanden (Dantian)
becomes ample. The skin of the lower abdomen becomes
tighter and gains in resiliency to bounce back when
pressure is applied. When this happens, it means the
prognosis is good.
In my experience up to now, first the skin complexion
improves. Dark spots go away and the facial color improves,
and even the hair becomes darker. Dark brown spots on
the skin like mold gradually peel off and the skin returns
to normal. Next, the patients posture improves, and the
irregularities on the body surface smooth out. It improves the
range of motion in the joints. These are things I experience
all the time doing Taikyoku Therapy (JM).
In this section also, Sawada Sensei puts the Spleen and
Kidney at the center of Taikyoku Therapy. He holds that all
diseases concurrently resolve by regulating the abdominal
organs, and that the Spleen and Kidney are the root.
(p.32-p.38) This records the words of Sawada Sensei
during treatments, but I will omit it because it is redundant
with whats been stated above.
Moxa on GV-12 (p.39) Childrens diseases are cured
by moxa on GV-12. This (Lung) is connected to the Large
Intestine so this cures things like slackness in the intestines.
Infantile disorders like irritability, crying, and digestive
problems can be cured with the one point GV-12.
I did moxa on GV-12 for all of my children two weeks after
birth, applying three thread-like cones. They have all been
very easy to raise, and now the eldest is 20 years old, but
none of them have ever needed a doctor or antibiotics. Most
colds of infants resolve when three thread-like or sesamesized cones are applied three days in a row on GV-12, BL-13,
CV-12, ST-36, and LI-11. For children GV-12 is the point of
choice (JM).
Hyperacidity (p.39): TB-15, BL-13, BL-43 (in the Sawada
Style BL-43 is located where BL-42 is in standard texts).
ST-34: An amazing point that resolves gastric spasms
immediately. If moxa is applied on this point continuously,
it could cause constipation. If this happens, HT-7 is used
to cure it. In the Sawada Style HT-7 is located between the
Heart and Small Intestine meridians between the pisiform
bone and the styloid process of the ulna.
Below are Sawada Style special treatment points (p.40 p.44).
Uterus inclined anterior or posterior: CV-12.

Uterus inclined to left or right: TB-4 (left TB-4 for left

incline, right TB-4 for right incline).
Uterine spasm: TB-4 & BL-32.
O rc h i t i s : T B - 4 & B L - 5 2 . I n t h e
LI-15
Sawada Style, the conventional
BL-51 is designated as the Mu point
of the Kidney and BL-52 is located
one unit below it. In other words the
Style
Sawada Style BL-52 is the same as the Sawada
Datsumei point
conventional location of BL-52, three
units lateral to the point below L2
LI-11
(GV-4).
LI-10
Facial paralysis: GB-34, BL-18, GV-8,
LI-10, ST-4 (very small cones applied
on a point 0.4 units from the corner of
the mouth).
SI-6
Erysipelas 4 : Use the one point
Datsumei. This point is slightly distal
to the midpoint between LI-11 and 15.
An induration appears here in cases of
Fig.5: Sawada Style
Datsumei point
erysipelas. Apply 20 to 50 cones. (Fig. 5)
Furuncle & carbuncle: LI-10 & SI-6. From 20 to 30 to
50 cones. Apply moxa 2 to 3 times a day. The pain and
swelling subsides, and the chilling does away. Those that
have infected quickly break up and heal, while on those that
havent the swelling goes down and they clear up.
Appendicitis: CV-6, BL-23 & KI-3. For extreme pain
apply 30 to 50 cones on CV-6. Give whole body treatment
focusing on BL-23 & KI-3 to cure permanently.
Gastric spasm: ST-34, CV-12, BL-20 & ST-36. Apply many
cones on ST-34 to resolve spasms immediately. Give whole
body treatment focusing on CV-12, BL-20 & ST-36 to cure
permanently.
Nephritis & uremia: GV-12, GB-25, BL-23, BL-32,
CV-3, CV-9, BL-31, ST-36, & SP-6. Sawada Sensei says this
increases urine output.
I gave a similar whole body treatment to a patient with
terminal cancer who had such bad edema in his feet that he
couldnt walk. After one moxibustion treatment the swelling
went down and he was able to walk again (JM).
Syphilis: The Eight Back Points (BL-41, BL-43, the Iki,
and Kichikuba points) BL-41 in the Sawada Style is one unit
above the standard BL-41, BL-43 corresponds to BL-42, and
the Iki points correspond to BL-46.
Tooth pain: BL-14 for upper tooth pain, and LI-7 for
lower tooth pain. (LI-7 in the Sawada Style is located one
unit above LI-6.)
Periodontitis: BL-20 & BL-23.
Preventing infection: LI-11 (indispensable after surgery).
Hyperacidity: BL-17 & BL-43. Also the Jiaji point at the
level of BL-17 or GV-9. BL-43 is indispensable in serious
cases; also whole body treatment is required.

4. Summary of notes from first observation

The things Shirota and Sawada Sensei are saying are
very simple and natural. There is mention of the Nanjing,
but it is limited to citing the 66th chapter to explain the role
of the Triple Burner, and there is no clinging to concepts of
meridians or Qi. Even the Five Phases are mentioned only
in reference to the chart.

87

NAJOM
The main points about Sawada Style moxibustion
detailed in these notes can be summarized as two points.
1) The concept of pathogenesis is imbalance in blood
circulation as the cause of disease: Sawada uses whole
body moxibustion treatment called Taikyoku Therapy,
which regulates the Zangfu with the Triple Burner as the
center.
The standard points of Taikyoku Therapy are listed in
Fig. 6, but they are located in all the main areas of the
body including the spine, the joints of the limbs, and
the abdomen. Of course, not all of these points are used
every time, but the simple understanding that blood
circulation can be maximized as long as moxibustion
is applied over the entire body is a revelation. Also,
rather than thinking in terms of invisible things like Qi
or the meridians, the hallmark of the Sawada Style is its
pragmatism that concerns itself with blood circulation
and the Zangfu organs. It is this pragmatism and
simplicity thats compelled me to follow the Sawada
Style without hesitation.
2) Commentary on the standard Sawada Style points and
special effect points:
In this commentary on the special treatment points, you
notice infectious diseases from germs. This is a reflection
of those times, more than 80 years ago, but the high
standing of moxibustion therapy is apparent in the fact
that diseases like tuberculosis, appendicitis, erysipelas,
furuncles, carbuncles, and syphilis were treated in
the age before antibiotics. Incidentally, penicillin
was discovered in 1928, one year after these clinical
observation notes were taken. This is another aside, but
Dr. Hara Shimetaro 5 received his doctorate in 1929 with
his study of the effects of moxibustion. (Finding that
it strengthened immunity by increasing hemoglobin,
red and white blood cells, and lymphocytes.) When we
place this in the context of this age, I believe it indicates
that moxibustion could be applied for difficult diseases
related to immune disorders including cancer, infectious
diseases, and autoimmune diseases.
I would like to conclude with a comment from Shirota
about his clinical observation.
Along with the realization of how useless the
conventional acupuncture and moxibustion I had learned
up to that point was, I gained a tremendous trust and
respect for the superiority of the practice of traditional
acupuncture and moxibustion. I really had to start all over. I
had to throw away all that I had learned about acupuncture
and moxibustion up to that point, and I decided then to
humbly follow the way of traditional acupuncture and
moxibustion. 6
(to be continued)
(March 2009, Translated by Stephen Brown)
Notes
1. Infantile colic (Kan-no Mushi): A term in herbal medicine
for all pediatric neurotic diseases, including crying fits
and spasticity. It was believed that the Kan worm (mushi)
caused these conditions.
2. NAJOM, No. 41, Nov. 2007, p.70 p.71.
A condition that causes rigidity and spasticity over the
whole body (Meikyo Japanese Dictionary).

88

3. Chi-no-mic hi (gynecological disorders): A term

which means path of blood in Japan and refers to
various symptoms associated with women around
menstruation, menopause, and postpartum including
headaches, neck and shoulder tension, dizziness, and
sweating (Meikyo Japanese Dictionary).
4. Erysipelas: An acute inflammatory skin disease caused
by the invasion of streptococcus into wounds etc. A red
rash appears with a defined border, accompanied by
high fever and pain in the affected area.
5. NAJOM, No. 7, July 1996, p.25 p.28.
6. Shinkyu Shinzui (The Essence of Acupuncture and
Moxibustion), p.44 p.45.

Sawada Style Back Shu Points

spinous
process

midline

1 st line

2 nd line

GV-14
GV-13

GV-12

BL-11
BL-12

BL-41

BL-13

BL-42

BL-14

BL-43

GV-11

BL-15

BL-44

GV-10

BL-16

BL-45

GV-9

BL-17

BL-46

GV-8

BL-18

BL-47

GV-7

BL-19

BL-48

GV-6

BL-20

BL-49

BL-21

BL-50

GV-5

BL-22

GV-4

BL-23

BL-51

(BL-24)
GV-3

( Sawada
Style GB -25)
( Sawada Style
BL-52)

BL-25
(BL-26)
BL-27
BL-31

GV-2
apex of
coccyx

GV-1

BL-32 BL-28

BL-53

BL-33 BL-29

BL-54

BL-34

BL-30

NAJOM
Practical Moxibustion Therapy (33)
Essence of Acupuncture and
Moxibustion Part 2

1. Introduction
The notes from Shirotas first observation with Sawada
Sensei are from June 2. In the four months after that, until
he went for his second observation, one can see how
Shirotas treatments were becoming more practical. In his
first clinical observation Shirota focused on the points used
for individual diseases. The question regarding which
points are good for which diseases is one you always
hear from beginners. Shirota was surprised by Sawada
s treatments and personality and resolved to study the
traditional medicine of the Sawada style.
Shirotas record of his second observation is focused
on Sawada-style point selection, and shifts the focus to
whole body treatment (Taikyoku Therapy). One can sense
Shirotas desire to really absorb Sawadas point selection.
The notes from the second observation in the Essence of
Acupuncture and Moxibustion are extensive (p. 44 p.144)
and comprise over 45 percent of the whole book. It is a
valuable part of the text, and might be called a digest of
Sawadas point selection principles.
The Eyes and Liver
Patient: A university professor about 50 years old.
Nutrition poor, complexion pale.
Chief complaints: His eyes are bad. He has had a bad
liver; the doctor could do nothing for his eyes.
As he palpated his back, Sawada Sensei said, Your
liver is better now. As long as the Spleen and Kidney get
better, the liver also gets better. It is really mysterious, isn
t it? When your liver got better, didnt your eyes improve
too?
Your complexion has changed. Your paleness is much
better. Now just your spleen and kidney need to get
better. Then he refrained from treating BL-18, and selected
the following points to treat the Spleen and Kidney that
still needed improvement:
Points: GV-12, BL-20, BL-23,BL-32, CV-12, left TB-4,
LI-11, ST-36, and KI-6.
Moxibustion and Constitution
To one patient Sawada Sensei said, Your constitution
changes when you get (regular) moxibustion. Its no use to
hurry it. You should continue patiently. See, your body has
become this much more expanded.
Baby Hair
Patient: A woman who has a lot of thin baby hair on her
upper back.
Sawada Senseis explanation: Those young women
who have a weak constitution have lots of baby hair over
their skin. This is because there is deficiency of Qi in the
Lower Burner, which diminishes nutrition in the skin,
and the skin is cold. Hair grows to protect the skin. The
hair belongs to the skin and the skin is associated with

the Lung. In other words, the Lung grows hair to protect

the skin. When you tonify the Qi of the Lower Burner
by treating CV-12 and TB-4, the baby hair disappears
and the skin acquires luster. This is because the Qi in the
Lower Burner becomes ample and the nutrition in the skin
improves and there is no longer a need to defend the skin
with hair. When the skin becomes strong, the Lungs become
strong also.
Points: GV-12, BL-17, BL-15, BL-20, BL-23, BL-32, CV-12,
left TB-4, LI-11, ST-36, and KI-6.
Shirota noted: This patient seems to be anemic and
he selected BL-15. Does he select BL-15 when a patient
is anemic or the Heart is weak? When he selects BL-15,
Sawada Sensei often combines it with SI-10. The Heart and
Small Intestine are in a Yin-Yang relationship; SI-10 is a
Small Intestine point.
SI-10 and Blood Pressure
SI-10 in the Sawada style is the midpoint of the line
connecting the axillary crease and the tip of the acromion.
(Fig. 1) Sawada Sensei
palpates the level
TB-15
GV -12
of blood pressure
a t t h i s p o i n t , a n d SI-10
uses the point for
SI-10
releasing congestion
SI-10
in
the
and stiffness in the SI-11
Sawada style is
occipital region.
the midpoint of
the line connect(JM) I use SI-10
ing the axillary
crease and
often myself. This is BL-15
the tip of the
acromion
because almost all
patients have stiffness
Fig. 1
in this area.
Asthma in a Child
Patient: A child five or six years old. The mother says he
has been suffering from asthma for a long time.
Sawada Sensei
GV-12
explained, There is no
disease called asthma in
Kampo. The asthma will
resolve if we treat the
Kidney.
P o i n t s : C V- 1 2 , l e f t
Sawada style GV-4 (Jiaji
point medial to Sawada
Sawada style
style BL-23). He maintains GV-4 (Jiaji
met h a t m o s t d i s e a s e s o f point
dial to Sawada
style BL-23)
children can be taken care
of by treating CV-12, and
Fig. 2
his GV-4. (Fig. 2)
Scoliosis
Patient: A child with the spine protruding to the left at
T9 and to the right at T11.
Points: CV-12, right BL-18, left BL-20.
Sawada sensei explained, The spine curved because
the Liver and Spleen are bad. This can be corrected with
moxibustion, but children seem to correct better than adults.

89

NAJOM
Empyema
Sawada Sensei explained, When the Kidney and Spleen
get better, diseases like empyema also improve. The nose
and flesh are associated with the Spleen, and empyema and
hypertrophic rhinitis are diseases of the flesh so they are
related to the Spleen. The nose is associated with the Lung
in the Suwen and Lingshu, but the nose problems in this
case indicate nasal catarrh, or nasal discharge during a cold.
The points that work for the nose are ST-36 and ST-37.
Sawada Sensei said that he had cleared up nasal
congestion in patients by needling ST-36 and ST-37.
Meridians and Diagnosis Without Questioning: Sleep and
Liver, Spleen, and Kidney
Patient: A man about 35 or 36.
As he examined the patients back Sawada Sensei said,
You cant sleep at night, so you want to sleep during the
day, dont you? The patient responded, Actually, I haven
t been able to sleep good for about half a month. Sawada
Sensei explained that the area around BL-18 was puffy and
raised. Cases with findings like this often have insomnia.
Difficulty in sleeping at night is related to the Liver.
Wanting to sleep during the day is related to the Spleen.
Spleen is what enables thinking, and houses Yi and Zhi.
When it is bad, one thinks incessantly, memory diminishes,
and one becomes sleepy during the day. When the Liver is
overworked and becomes congested, because the Liver is
connected to the meridians of eyes, the eyes become more
active and one cant sleep.
(JM) Using the Liver meridian for sleep problems is one of
the characteristics of the Sawada style. Here the explanation
is that Liver Qi Rising in the form of congestion in the liver
activates the eyes. I feel that it would be better to explain
this as the pooling of blood in the head from over-use of the
brain, preventing blood from returning to the Liver and the
abdominal cavity. One can of course do moxibustion on the
abdomen to draw the blood, which has pooled in the head, back
to the abdomen and legs. In addition I often do needle moxa
(kyuto-shin) on points like BL-32, 33, 28, 29 and 30, as well as
multiple cone moxa on Shitsumin point on the heel.
Points: GV-12, BL-18, GV-8, BL-20, BL-32, CV-12, left
TB-4, LU-6, ST-36, and KI-6.
These meridians are really precious things. When the
Kidney and Spleen are healed the Liver becomes better.
In other words, when the Water and Earth are regulated,
the Wood is regulated by itself. The Spleen is in charge of
blood sugar, and when the Spleen becomes weak, sugar is
excreted in urine. This is diabetes. And protein is associated
with the Kidney. The Kidney is related to fear, and one has
senseless fears and when the Spleen is weak one also falls
into the habit of thinking all the time. Once you understand
Taikyoku Therapy this way, treatment becomes quite
simple.
The character Mu means to gather, and the Mu point
of the Gallbladder means that its the place where the
Gallbladder disease gathers.
A patient complained that his temples hurt, and the
temples are associated with the Gallbladder meridian so
I palpated BL-19 and they were tense. There was also a
reaction at GB-34.

90

The meridians are really amazing. The disease was

expressed in BL-19, GB-24, and GB-34 (He Sea point), or
three points associated with the Gallbladder meridian, so I
found out that it was a Gallbladder disease.
Liver and Reproductive Organs
Sawada Sensei explained: Hysteria and problems in
the reproductive organs are all related to the Liver. It will
become better when the blood stasis in the Liver meridian
is cleared.
Shirotas comment: Blood stasis in the Liver is always
bad in patients with diseases of the reproductive organs.
Marked blood stasis appears especially between LR-5 and
LR-6 on the medial border of the tibia. Of course, it goes
without saying that a reaction also appears between LR-9
and LR-10 on the medial thigh.
Points for reproductive organs: For the Liver meridian
use BL-18, LR-8, SP-6, LR-1. For the Gallbladder meridian
(exterior to Liver) use GB-34. Also use CV-3 and CV-2
which the Liver meridian connects to. For the Kidney
meridian use BL-23 and 32. Otherwise use the standard
points of Taikyoku Therapy.
Location of LR-1
Its lateral to the corner of the nail of the big toe the
width of a leek leaf. The point just proximal to the nail bed
at the midpoint is where the Spleen and Liver meridians
cross.
Location of Sawada style LR-10
A little above the midpoint on the Liver meridian on
the thigh (Fig. 3).
Indications: eye diseases like glaucoma, cataracts, and
near sightedness
Liver Meridian
Treatment of trachoma
Patient: Woman about
30 years old. Her eyelids
LR-12
LR-11
are swollen. Congestion in
conjunctiva.
S a w a d a S e n s e i Sawada style LR-10
LR-10
explained, Trachoma is
LR-9
a disease of the Spleen
and Stomach. The upper
LR-8
eyelid is associated with
LR-7
the Stomach and the lower
eyelid is associated with the
Spleen, so its a weakness in
LR-6
the Spleen and Stomach.
LR-5
Points: GV-12, TB-15,
SP-6
SI-11, BL-20, BL-23, BL-32,
LR-3
LR-2
CV-12, left TB-4, ST-36, and
LR-1
KI-6. LR-10 wasnt used
LR-4
Fig. 3
because it didnt have a
reaction.
BL-17 and Blood Diseases
Patient: Woman about 33 years old.
Her skin is dark blue. She has skin eruptions all over
her body. Her skin is extremely dirty.
Points: GV-12, BL-17, BL-18, GV-8, BL-20, BL-32, CV-12,

NAJOM
left TB-4, LU-6, ST-36, and KI-6.
I t s a y s i n Wa k a n S a n s a i ( a n e a r l y J a p a n e s e
encyclopedia) that BL-17 is the confluent point of Blood.
Apply moxa here for various Blood diseases. It is clear
that this woman has a Blood disease. The Western doctor
diagnosed her with posterior inclination of the uterus, but
she has Blood Stasis. It wad decided that she had Blood
disease from a weakness in the Kidney and Liver.
Myelitis
Sawada Sensei explained, Myelitis is a dysfunction of
the Kidney because Kidney governs the marrow. So one
should treat the Kidney. This is a treatment using the Five
Phases associations.
Liver Meridian and Sleep
When you cant sleep while traveling because of
sleeping in a different bed, you can get to sleep by
thoroughly massaging the Liver meridian on the thighs.
The Liver meridian controls sleep.
The Kidney and Hair
Patient: A woman with infertility. Her hair turned red
after surgery for uterus inclined to the left.
Sawada Sensei explained, The Kidney was damaged
by the surgery. The reason hair is black is because the
color of the Kidney is black. So when the Kidney is cured
it resolves problems like blackish complexion and red hair
on the head. This will also raise the body temperature and
she will get pregnant.
Points: GV-12, SI-10, BL-15, BL-20, BL-23, BL-32, CV-12,
left TB-4, LI-11, ST-36, LR-8 and KI-6.
Triple Burner and Pericardium
Patient: A woman about 30 years old with a red face.
Sawada sensei explained, When I say that the Triple
Burner is bad, that means that there is poor absorption of
nutrients by the mesentery of the small intestines. So the
problem spreads from the Triple Burner to the Pericardium
in an external-internal relationship, and finally it causes a
defect in the heart valves. The heart valves (Pericardium)
are damaged because the uterus is out of place.
Points: GV-12, TB-15, BL-15, BL-20, BL-23, BL-32,
CV-12, left TB-4, LI-11, ST-36 and KI-6.
The Heart and Tanden
Sawada Sensei explained, In Oriental medicine it
s said that the Spirit (Jing and Shen) settles at the Tanden
(Dantian). Jing resides in the Kidney and Shen resides
in the Heart. To treat heart diseases, the Tanden should
be regulated so the Spirit (Jing and Shen) settles at the
Tanden. Tanden means the field of life. CV-4 is the Lower
Tanden and the brain is the Upper Tanden.
Correcting Excess Kyphosis in the Spine
Sawada Sensei explained, The front of the body tenses
up to cause a forward bending posture because the Spleen
and Liver are weak. CV-14 corrects the tension in the
Conception Vessel and allows the Conception Vessel to
stretch so that the spine becomes straighter.
Example of Point Selection: GV-12, SI-10, BL-15,

Kichikuba points*, BL-18, GV-8, BL-20, BL-22, BL-23, BL-24,

Sawada style BL-52, BL-32, CV-14, CV-12, ST-21, left TB-4,
LI-11, ST-36 and KI-6.
* Kichikuba Points: These are extra points one unit above
BL-18 and one unit lateral to the midline. It is used for ocular
pain and detoxification. (See previous issue, NAJOM #45 for
Fig.)
Sawada style BL-52
In the Sawada style BL-52 is lateral to Sawada style
BL-22 that is 3 units on either side of the point below L2.
Usually BL-52 is lateral to BL-23, but in the Sawada style
it is called GB-25 (Mu point of KI). So Sawada style BL-52
is Sawada Senseis own creation. BL-52 is effective for
low back pain, but in his day it was used for orchitis and
gonorrhea.
How Points Move
Patient: After marking points in the seated position,
the patient received moxa at CV-12, TB-15, and SI-10. Then
his left shoulder that was stiff and immobile suddenly
relaxed and the location of all the previously marked points
changed. All the points had to be re-located.
Sawada Sensei explained, There are big muscles under
TB-15, so just doing moxa on this point can change the
(location of) points to a surprising degree. There was this
much change in the location for this patient, so he is going
to get better quickly.
Points: GV-12, TB-15, SI-10, BL-15, BL-20, BL-23, BL-32,
CV-12, left TB-4, LI-11, ST-36 and KI-6.
Conclusion for This Section
As I said in the beginning, in this second record of
clinical observation the main focus was the whole body
treatments of Taikyoku Therapy. Looking at the points
used, it is clear that the standard points of the Sawada-style
Taikyoku Therapy were well established by this period. The
standard points were TB-15, BL-18, BL-20, BL-23, BL-32,
ST-36, KI-6, CV-12, left TB-4 and LI-11. In later years points
like GV-20, GV-12, and CV-6 were added.
The explanations given by Sawada Sensei seem to be
mostly based on classical Chinese concepts. That is to say,
the Five Phases associations. The meridians also are closely
related with the Five Phases associations. This is one of the
main features of the Sawada style.
In the next article I would like to continue on this theme
and move closer to the essence of Taikyoku Therapy.
(July 2009, Translated by Stephen Brown)

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NAJOM
Practical Moxibustion Therapy (34)
Essence of Acupuncture and
Moxibustion Part 3

LI-5
Sawadas LI-4
SI-6

LI-4
TW -4

Case 1: Stroke Patient

Fig. 2

55- or 56-year-old woman who had a stroke

This patient has hemiplegia, with difficulty walking and
sitting. Sawada Sensei applied moxibustion with patient
seated in seiza (sitting on folded legs). He treated GV-12,
TB-15, SI-10, SI-11, BL-15 and BL-20. Next he had the patient
lie supine, but her leg muscles were stiff and she couldnt
extend her legs. Her legs straightened out easily, however,
once he applied moxa on CV-12 and TB-4 on the left. Then
the patient got on her stomach with some difficulty, and she
felt unbearable stiffness in her arms. Sawada Sensei applied
moxibustion on BL-21, BL-27, and BL-32 and the stiffness in
her arms went away. He said that BL-32 is good for relaxing
tension and stiffness in the arm. He then applied more moxa
on LI-11, LI-4, GB-34, and KI-6. This made it much easier for
the patient to lie down and get up.
(Mizutani comment) There is no mention here about how
many cones were applied on each point, but if it were me
I would apply at least five to seven half rice-grain sized
cones. The key points are moxa on CV-12 and TB-4 allowing
the leg to straighten, and moxa on BL-27 to relax stiffness in
the arms.
Sawada Senseis explanation of rheumatism (arthritis)
Patients with rheumatism have heat in the small
intestine, and acupuncture or moxibustion at BL-27 (SI
back shu point) can cure it.
12th rib
BL 20
BL 22
Sawadas Kiddny
Mu point

BL 23
BL 27
BL 31

BL 25

BL 32

posterior superior
iliac spine

Fig. 1
Sawadas location of BL-27 (Fig. 1)

Sawada-style location for BL-27

Half a unit (15mm) above BL-31 (first sacral foramina)
at the margin of the sacrum. There is a close connection
between BL-27 and the Arm Taiyang Small Intestine
Meridian. Stiffness and pain in the arm Taiyang meridian
can be alleviated immediately by acupuncture at BL-27 (e.g.
acute rheumatoid arthritis, and bursitis in shoulder).

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Sawadas location of LI-4 (Fig. 2)

Sawada-style location for LI-4

In the depression distal to the standard location of LI-5.
It is located on the artery, and moxibustion is applied over
the pulsation. This is a special effect point for cataracts,
glaucoma, ocular congestion (red eyes). It is also used for
high blood pressure, strokes, and ovary dysfunctions.

Case 2: Body Hair

A young woman with excess body hair
Sawada Senseis explanation: Qi doesnt flow due to
stagnation in the Triple Burner so nutrition to the skin is
compromised, and to protect the weakened skin the Lungs
cause the growth of body hair. When the Qi circulation of
the Triple Burner is restored, nutrition improves in the skin
and the hair falls out and the skin gains luster.
This patient gets a fever of about 37 C every day,
Sawada Sensei said, The fever comes from the uterus.
The points he used were GV-12, TB-15, BL-17, BL-18, GV-8,
BL-23, BL-32, CV-12, left TB-4, LI-11, ST-36, KI-6, LR-8, and
SP-6.
(Mizutani comment) This is a typical Sawada-style
Taikyoku Therapy point selection. CV-12 and TB-4 serve to
open the Triple Burner. One can also understand how heat
in the uterus can be treated by liver-related points, such as
BL-18, GV-8, and LR-8.

Case 3: Scrofulosis1
Male about 40 years old
Patient complains that he cant warm up on one side of
his body when taking a bath.
Sawada Sen seis ex pla nat ion : After palpating the
interscapular area, he called it hereditary syphilis.
Diseases like this present with a floating and weak pulse. It
is a disease where the body becomes cold, and it used to be
called hie (getting chilled).
The moxa points were located with the patient hugging
his knees to open up the interscapular area. He treated
eight points on the upper back, the so-called Moxa points
to treat syphilis (BL-41, BL-43, BL-45, and Kichikuba:
extra points see Fig-3).
In addition to the above points GV-12, BL-16, BL-20,
BL-32, CV-12, CV-13, left TB-4, LI-11, KI-6, KI-9, left GB-25
were treated to make it a whole body Taikyoku treatment.
Since the location of the eight points on the upper back

NAJOM
is Sawada style, they may
actually be BL-42, BL-44, BL46 and BL-17 by standard
t e x t s . B e c a u s e t h e y w e re
located by palpation relying
on finger sensitivity with the
scapula spread out, however,
one should not be too
concerned about the exact
location.
H e re K I - 9 , t h e s p e c i a l
point for detoxification (a
Sawada-style special-effect
point), is used.

GV-12
BL-41
BL-43
BL-45
Kichikuba
BL-20
BL-23

BL-32

they are on antibiotics. Thus both these patients and I have

been able to confirm a reduction in the double suffering
mentioned above and the recovery back to more normal
living.
Moxibustion treatments take time, but they can also
be done at home, and I am convinced that its far more
effective than antibiotics if patients also get moxibustion
at home. In Sawadas time, Taikyoku therapy increased
patients immunity and cured even syphilis.

Case 4: Malpositioning of the uterus

Female about 50 years old

Fig. 3

Sawada-style location for

KI-9
The center of the medial aspect of the calf, in the
depression between the gastrocnemius and the soleus
muscles at the level of SP-7. There is one strand of muscle
between KI-9 and SP-7. It is posterior to the Spleen
meridian. The path of the Kidney meridian is stroked
upward from the medial malleolus until the finger comes
to a stop. Its main indications are detoxing fetal poisons of
infants, syphilis, gonorrhea, chemical and food poisoning.
Its a famous point for eliminating various toxins.
In the Sawada style, patients with syphilis receive
moxibustion on GB-34 instead of ST-36. Also sometimes
LI-10 is treated. LI-10 is a famous point for skin lesions
like furuncles and carbuncles, but its also an important
point even used for tumors. Sawada Sensei used BL14 for patients with syphilis who had upper tooth pain,
and LI-7 (Fig. 4) for those with lower tooth pain. LI-7 in
the Sawada style is at the end of the middle finger on
the Large Intestine meridian anterior border of radius
when the hands are crossed
at the web between the index
fingers and thumbs. Also, BL43 is the special-effect point Sawadas LI-7
LU-7
for patients with hyperacidity,
liver diseases, and pleural
Fig. 4
diseases.
Sawada Senseis explanation: When syphilis patients
receive moxibustion on the eight back points or the
extra point and KI-9, they often get diarrhea. This serves
to eliminate the toxins of the disease, so the diarrhea must
run its course and must not be stopped. If it is stopped,
the toxins of the disease go to the brain to cause cerebral
syphilis.
(Mizutani comment) I used to think that syphilis was a
disease of the past. But in North America Lymes disease
is increasing even more than AIDS. Patients with diseases
like this suffer doubly from symptoms of the disease as
well as from the antibiotics prescribed by doctors. They are
unable to work or lead a normal life. In the past two years
I have treated two patients with Lymes disease about
once a week using Taikyoku therapy. My moxibustion
treatments using the bamboo tube are gentler, but these
patients are steadily recovering their strength even though

Her skin is pale and yellowish. Her posture is inclined

to the right.
Sawada Senseis explanation: The respiratory organ on
the left is bad, and this is caused by the uterus. When
menopause comes, extra things (old waste products)
tend to collect in the body. This can be eliminated by
moxibustion for the Triple Burner (CV-12 and TB-4).
When the malpositioning of the uterus is corrected by
moxibustion on CV-12 and TB-4, the deficiency in the lower
abdomen is improved and the kidneys, bladder, and ovaries
that are connected to the small intestines are strengthened.
Treatment on CV-12 also lowers the uterus, adjusts its
position, and gathers the spirit in the lower abdomen.
CV-12 is located where the pancreatic enzymes enter
into the duodenum, so the pancreas can be regulated by
moxibustion on CV-12. Also treatment of CV-12 improves
the flow through the mesentery, and eliminates the gas that
forms due to poor flow. Circulation is compromised when
this gas collects and gets around the body, and this causes
cold hands and feet.
Moxibustion points: GV-12, TB-15, BL-13, BL-20, BL-23,
BL-32, CV-12 left TB-4, ST-36, GB-34, and KI-6.

Senshaku (hernia accumulation) and Kanshaku (liver

accumulation)
Sawada Senseis explanation: The so-called Senki (hernia
qi) or Senshaku (hernia accumulation) begins with the Triple
Burner, and its a stagnation in the Lower Burner. Spasms in
the uterus belongs in this category and treating CV-12 and
TB-4 will take care of it. The Lower Burner is where gas is
created, so if there is stagnation in the Lower Burner the gas
circulates around the body causing auto-toxicity and pain
occurs in the body. (Shaku and jyu are the same thing.)
Kanshaku (liver accumulation), on the other hand, is
caused by problems in the liver, and gastric spasms are one
manifestation of this condition. ST-34 is good for stopping
such pain, but CV-12, BL-20 and ST-36 must be treated to
cure this condition completely.
Points used to treat Senshaku: GV-12, TB-15, BL-20, BL-22,
BL-23, BL-32, CV-12, left TB-4, LI-11, ST-36 and KI-6.
(Mizutani comment) I deal with acute abdominal pain by
doing multiple cone moxibustion on CV-12 and ST-34. ST34 on the left side is especially effective.

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NAJOM
Moxibustion for facial furuncles (boils)
Sawada Senseis explanation: LI-10 is the special-effect
point. When the skin lesion forms on the right, use LI10 on the right. When on the left, treat the left side. The
number of cones can be 30 or 50; the more the better. When
moxibustion does not feel hot, continue applying until
it becomes hot. When it feels hot to begin with, continue
applying until it is not longer hot.
Furuncles and carbuncles are caused by stagnation in the
Large Intestine, so they improve when the flow of Qi in the
Large Intestine is unblocked by using the source point of the
Large Intestine meridian. Source points are important for
regulating the Lower Burner. The Xi-cleft point of the Small
Intestine meridian also works for furuncles and carbuncles.
Xi-cleft points are also important for alleviating acute pain.
(Mizutani comment) These days thanks to antibiotics, we
can deal with infectious lesions and inflammation, but there
are patients whose inflammation doesnt get any better no
matter how many antibiotics they take. Direct moxibustion
is the most effective treatment in cases like this. When our
immunity is weak, no matter how much the infection is
suppressed with antibiotics, the germs become reactivated
within the body and eventually resistant strains of the germ
develop. For cases in which there is no improvement after
a one-week course of antibiotics, the best approach is to
activate the immune system with moxibustion and prevent
the side effects of antibiotics.

Case 5: Uterine fibroid tumors

A female patient is concerned
about copious uterine bleeding
a f t e r re c e i v i n g a mo x i b u s t i o n
treatment from Sawada Sensei.
S a w a d a S e n s e i s e x p l a n a tion: Blood stasis and lumps are
accumulations of unnecessary
matter, so it should be expelled (by
bleeding). Fibroids are no different.
Point selection: CV-2, CV-3, CV4 , S P - 6 , a n d f o r t h e Ta i k y o k u
treatment GV-12, BL-20, BL-23, BL32, CV-12, left TB-4, LI-11, ST-36,
and KI-6. (Fig. 5)

CV-12
CV-3

CV-4
ST-29

Fig. 5

CV-2

Moxibustion on BL-32
Sawada Senseis explanation: Along with BL-27, BL-32 is
a famous point for rheumatism, neuralgia, and arthritis. In
addition to this, all diseases in the lower abdomen appear
at BL-32. Moxibustion on BL-23 and BL-32 can be applied in
all kinds of situations including prostatitis and cold hands
and feet, not to mention easing labor.
According to Dr. Onodera Naosuke, 2 when there is
tenderness at BL-32 in women, this indicates that there is
disease in the uterine cervix, or the ovaries, or that they
are pregnant or menstruating. The diseased side is tender.
In the case of diseases of the uterus itself, however, such
as endometriosis or uterine fibroids, there is no tenderness

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at BL-32. When this point is tender in males, it indicates

prostate disease.

Moxibustion on GV-4
GV-4 in the Sawada style is different from the standard
location. It is half unit lateral to the 14th spinous process
below the 7th cervical vertebra, medial to Sawada-style BL23. There is a reaction at these points when ovarian tumors
or uterine fibroids become bad. Sawada Sensei would treat
only GV-12 for pediatric patients, but sometimes he added
his GV-4. Usually only the right or left GV-4 was used,
and it was extremely rare that he used both. He must have
added GV-4 for serious pediatric diseases.
The main indications for GV-4 are listed in Shirotas text
Shinkyu Chiryo Kisogaku (Fundamentals of Acupuncture
& Moxibustion Therapy). 3 For emergency treatment.
Used commonly for severe headaches, acute and severe
abdominal pain, intestinal volvulus, intestinal bleeding,
severe vomiting, nephritis, pyelitis, incontinence, for all
pediatric diseases, also to strengthen children with weak
constitutions, and hernias.

Concluding Remarks
In this article I have summarized Shirotas second
observation with Sawada (Oct. 21-Nov. 9, 1927) recorded
in S h i n k y u S h i n z u i (Essence of Acupuncture and
Moxibustion). It consists of just 20 pages (pp. 67-87) of this
text. Shirota was 27 when he recorded this. Maybe because
the author is young, you can feel the excitement in his
writing. Yet because this is just a record of what he saw
and heard, it lacks consistency and one cant help but feel
that there is a lot of going back and forth.
Even if the ancients created a digital (dualistic) system
like Yin-Yang, or deficiency-excess, it is far removed from
the digital (dualistic) perspective and methodology of the
modern age. With Yin-Yang and deficiency-excess, one
cannot clearly define where deficiency or excess begins
and ends. This is why acupuncture and moxibustion
arent therapies that clearly differentiate back and white.
The Qi of the patient can be perceived precisely because
acupuncture and moxibustion is intuitive and subjective
and began with the laying on of hands. This is why
acupuncture and moxibustion belong to a very analog
paradigm.
There is a tendency today to welcome digitization
of everything, but we can gather from the above record
how the principle of hands-on healing was operating in
Sawadas clinic and information was being picked up and
fed back to the body. I said the subject wandered back
and forth. So readers might feel mystified by some of
what they read. But we have no choice but to confirm by
trial and error those places where the black and white
is not clearly defined. That is our job. As I read this text
repeatedly, each time I feel the richness of its contents
anew. And I return to the basics of Taikyoku Therapy,
which is to study the living body. I would be gratified
if readers feel just a little closer to the roots of the Sawada
style.

NAJOM
Notes
1. Scrofulosis: This name refers to a weak constitution
susceptible to disease. It was used in times past for
anemic children that tended to get tuberculin nodes in
their cervical lymph nodes (scrofula).
2. Onodera Naosuke: A Japanese physician and internist
(1883-1968) who was born in Iwate Prefecture and
graduated from the Kyoto Imperial University School
of Medicine. His specialty was gastroenterology, and
he devised the Onodera pressure point diagnosis
system for GI conditions. He was awarded the Order
of Cultural Merit in 1963, and also received the Order
of the Rising Sun in 1964.
3. Sh i n k y u C h i r yo K i sog a k u : (Fundamentals of
Acupuncture & Moxibustion Therapy) by Shirota
Bunshi, first edition 1940, Ido-no-Nippon, p. 274.
(November 2010, Transalted by Stephen Brown)

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