13 Moxa: Okyu (Direct Moxa) and Chinetsukyu (Warm Moxa) There is a long history of moxibustion practice in Japan involving both folk uses and medical uses by acupuncture practitioners and moxibustion specialists. Today, in Japan, there are separate licenses for acupuncture and moxibustion, which allow for a high degree of specialization in the use of moxa and for an extension of its uses into areas where it is currently not used by most acupuncturists outside of Japan. Much of the practice of moxibustion in Japan was based on historical precedents in China.1 There have been a number of specialized classical moxibustion books from China especially following the appearance in the 12th century of a separate tradition of moxa practice that appears in the publication of the Huang Di Ming Tang Jiu Jing (Yellow Emperor’s Ming Tang Moxa Text). By the 16th century in Japan, practitioners had begun imitating this tradition of independent moxibustion practice. Although moxibustion is primarily practiced as a clinical specialization in Japan today, it is still a common, though a less popular practice, to have patients apply some form of moxibustion technique on themselves or have a family member do it for them as a form of home therapy.2 __________________ A number of moxibustion specialists such as Isaburo Fukaya (Fukaya 1982) who practiced for over 60 years, his student Seiji Irie (Irie 1980), now the leading proponent of Fukaya’s style, Takeshi Sawada who inspired a whole generation of practitioners with his uniquely brilliant and powerful treatments, and his student Bunshi Shiroda (Shiroda 1982), all studied the Chinese historical literature extensively. For example, one of Fukaya’s favorite texts was the Huang Di Ming Tang Jiu Jing. Although these men are relatively modern in their techniques, much of their work originated in their studies of the classics. Between them they have authored many moxibustion specialty textbooks, which form the basis for much of the modern practice of moxibustion in Japan. Practitioners of shonishin have generally incorporated elements of these trends and styles into the treatment of children. The practice of moxibustion can be divided into two general categories. These are the “direct” and “non-direct” types of moxibustion techniques. The most common form of moxa used on children is one of the direct methods, called “okyu.”3 This section will describe details of the technique and how to decide when to use it. This technique involves placing very small pieces of moxa on the skin and burning them down so as to deliver a small pinch of heat or a stronger heat sensation. The other “direct” moxa technique I will describe briefly is the “chinetsukyu” moxa technique. While not commonly used on children, it can be a very useful technique for certain problems. It uses much larger cones of moxa than the okyu method and gives either no sensation of heat or a definite hot but comfortable sensation of heat. __________________ 3 See Birch and Ida 1998, pp. 105–111. For those unfamiliar with the history of moxa uses in China and modern uses in Japan it is useful to note that the okyu technique is used to treat all of the same diseases and symptoms that are usually treated with acupuncture. This extensive utilization occurs because moxa is not used to add heat to the point, in the manner that TCM has chosen to start using moxa, but rather as a method of stimulating the point, just as a needle stimulates the point. The conditions routinely treated with okyu include many conditions that would be contraindicated for the use of moxa in TCM because of the presence of “heat.” But since the method is not used to add heat, these contraindications do not apply. Besides, there are many questions in China today about the wisdom of this modern TCM restriction of the use of moxa (Tian and Wang 1987; Wang, Tian, and Li 1987). In the Japanese moxibustion literature there are long lists of diseases and symptoms treated with moxa. The method is empirical rather than theoretical. Experience has shown that characteristic reactions occur at certain acupuncture points in the presence of certain symptoms or diseases. One thus palpates the points indicated when those symptoms or diseases are present. If the points show the characteristic responses on palpation, one applies moxa to those points. The method has proven highly effective for the relief of symptoms.4 __________________ 4 For moxa treatments see: Manaka et al. 2005, pp. 206–217, and Birch and Ida 1998, pp. 126–130. In the early part of the 20th century, moxibustion became well known because of its successful use in the treatment of chronic infectious diseases such as tuberculosis. Following this a number of studies were made of the physiological effects of direct moxibustion, and ongoing work continues to investigate these. It is believed that moxa has a strong non-specific effect to stimulate the immune system (Manaka et al. 1995, pp. 353–354; Young and Craig 2009, 2010), and that it also stimulates anti-inflammatory responses. While it is thought to do other things as well (Manaka et al. 1995, pp. 353–354), it is the immunological and anti-inflammatory effects that are of interest to us. These effects make the okyu
Okyu—The Physiology of Direct Moxa
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