Is direct moxibustion justified on clinical grounds in ethical practice?

[Guest guest]

Hi All,

 

Direct (scarring / suppurative) moxibustion does harm (admittedly minor

harm) in most cases.

 

IMO, practitioners who to the ethic of " First Do No Harm " , must

question the use direct moxibustion, or at least reserve its use to cases that

have not responded to gentler methods.

 

Are there any well designed trials that compared the clinical outcomes of

indirect (non-scarring) versus direct moxibustion?

 

Do those trials produce sound evidence of a significantly better outcome

from scarring / suppurative moxibustion over the milder form?

 

A of Medline search produced only 2 hits for the profile:

moxibustion AND (indirect OR non-scarring) AND (direct OR scarring OR

suppurative) AND ( " comparison of " OR compare*)

 

As one might expect, those hits confirmed that moxibustion increases skin

temperature and permeability. One study concluded: " Direct moxibustion

with a traditional moxa stick may produce its potent therapeutic effects by

thermal action, while traditional indirect moxibustion may act by producing

modest thermal action and a sympathetic vibration at the skin surface. Non-

traditional thermal materials and media may not be suitable substitutes for

traditional materials. The data provide a scientific, biophysical rationale for

traditional moxibustion " . NEITHER study compared the clinical outcomes of

the two methods (direct versus indirect).

 

Tatiana cited an article from Blue Poppy [ " Clinical Use of Suppurative

Moxibustion " by Li Ming-zhi, Shang Hai Zhen Jiu Za Zhi (Shanghai Journal

of Acupuncture & Moxibustion), #3, 1992, p. 33-34

www.bluepoppy.com/press/download/articles/acup_tuina_rr.cfm ], which

said:

 

" Following administration of suppurative moxibustion, one may often

observe the immediate resolution of lingering illness. The *Zi Sheng Jing

(The Classic of Nourishing Life)* states that, " All moxa should must produce

a sore in order for the patient to recover. " As a result of this, it would

seem that suppurative moxibustion has a distinctive therapeutic effect.

 

Without citing evidence, http://www.jcrows.com/moxaarticles.html said:

 

" Because of the difference of quality and processing of moxa between

Japan and China, Japanese acupuncturists in general prefer direct

moxibustion while Chinese therapists do indirect moxibustion, especially

stick moxa. It requires a great deal of training for a therapist to master the

direct moxibustion techniques, but it is much more effective than indirect

moxibustion. "

 

In a very detailed review, " MOXIBUSTION: Practical Considerations for

Modern Use of an Ancient Technique " [ www.itmonline.org/arts/moxibustion

], Subhuti Dharmananda said:

 

" [scarring / suppurative] moxa therapy is not discussed in any detail as part

of Western acupuncture training because it is not allowable in Western

practice. "

 

He cites a Chinese study:

 

" The authors suggested that indirect moxibustion was preferred by patients

over acupuncture because of lack of pain & discomfort (needling in Chinese

clinics is far more vigorous than in Western clinics). This is in contrast to

the

situation w direct moxibustion, which can be more painful than acupuncture;

the painful nature of usual direct moxibustion being mentioned in several

texts. "

 

Subhuti concludes his review as follows:

 

" It is difficult to know, based on the literature review, whether moxibustion is

more effective than acupuncture or other stimulus methods administered for

the same condition. In the absence of more detailed studies, moxa is

applied primarily on the basis of the Chinese traditional medical descriptions,

such as treating syndromes associated with cold, retention of food, spasms,

immune deficiency, and local stagnation of fluids with formation of masses.

Moxa may be utilized in some cases of heat syndromes. "

 

So, taking the data above into consideration, and apart from local / state

legislation on the topic, where does the profession stand on the justification

(or otherwise) of using direct moxibustion in clinical practice?

 

Best regards,