Shanghai Journal of Acupuncture and Moxibustion English Edition Primary Issue ·83·
Comment on Treatment of Heat Syndrome with Moxibustion Stated by the Monography on Moxibustion Therapy
The Second Hospital Attached To Wannan Medical College 241000
THERE are many statements on the treatment of heat syndrome with moxibustion. It has been a long debate issue if heat syndrome can be or cannot be treated with moxibustion. Some people say it can be, some say it cannot and others say that it can be used to treat any disease. Some people indicate it mustn’t be, but in fact, they somehow advocate it can be. Wu Yiding is one of them. So this paper will give some comments on the statements by Wu about the treatment of heat syndrome with moxibustion.
Theoretic recognition of the treatment of heat syndrome with moxibustion
1. The treatment of heat syndrome with moxibustion is a contrary treatment
Plain Question On The Most Important Quintessence of The Doctriness states: “Normal therapy signifies the adoption of methods and drugs with opposite nature to the disease, and contrary treatment signifies the adoption of methods and drugs with the same nature as the disease.” The treatment of heat syndrome with moxibustion is a contrary treatment used to treat heat syndromes with warm therapy, characterized by the nature of the pathologic conditions to exert eff. In Diagnosis and Treatment of Surgical Diseases, Wu said: “All sores and carbuncles can be treated with moxibustion. If painful it is moxibusted till the pain is alleviated; if painless it is moxibusted till the pain is induced. In this way, the pathogenic factors will be eliminated by moxibustion. This is contrary treatment and very effective.” There are two implications here: One is that in treating painless numb sores of yin nature, moxibustion can turn yin syndrome into yang and dissipate pathogen at the same time. Another is in treating serious sores and carbuncles of yang nature, moxibustion therapy can not only stop the pain but also dissipate the pathogens with high efficacy. Clearly, the treatment of heat syndromes by moxibustion is a contrary treatment characterized by treating heat syndromes with warm therapy, agreeing with the principle of contrary treatment elucidated in Neijing and signifying a practical application of “pyretic stagnation requiring dissipation”
2. The Treatment of heat syndrome with moxibustion can draw heat to dissipate pathogens
The treatment of heat syndrome with moxibustion is significantly effective because moxibustion can draw heat out and dissipate pathogens. In Diagnosis and Treatment of Surgical Diseases, Wu said, “Skin and external diseases are due to heart-fire stagnation to form pathogens so when the diseases are treated with moxibustion, the heart-fire is dissipated and pathogens are gone. This is always effective.” Skin and external diseases are often of yang syndrome, improper treatment may lead to fatal consequences, while moxibustion can dissipate heart-fire and pathogens and bring the dying back to life. It is clear that the treatment of heat syndrome with moxibustion has marvelous effects. No wonder Wu named the book “Marvelous Moxibustion”.
The treatment of heat syndrome can draw pathogens out, which also embodies the idea of prevention first and early treatment. In Diagnosis and Treatment of Surgical Diseases, Wu said: “sores and carbuncles at the incipient stage (less than 7 days) are treated with moxibustion which can soften the mass and draw pathogens out from the deep to the shallow. The effect is better than drugs”. Dissipation is key to the treatment of sores and carbuncles, so early moxibustion will result in better effects. Meanwhile, it pointed out again that the mechanism of the moxibustion therapy lay in the fact that “the moxibustion can soften the mass and draw pathogens out from the deep to the shallow”. Thus he expounded in theory on the mechanism of the treatment of heat syndrome with moxibustion.
The treatment of heat syndrome with moxibustion is applied extensively
Wu stated that the treatment of heat syndrome with moxibustion was practiced in clinics extensively. The book mentions over a hundred heat syndromes of which sthenia pyrosyndromes are nearly a hundred and asthenia pyrosyndromes are over ten. They are expounded respectively in the following.
1. Sthenia pyrosyndrome in clinical application
In nearly 100 excessive heat syndromes, they are widely concerned in internal medicine, external medicine, gynaecology, pediatrics, opthalmology, NT (nose-throat), stomatology, etc. There are some examples in internal medicine in treating malaria with moxibustion of Dazhui (Du14), Yixi (B45), Zhangmen (Liv13), Huantiao (GB30),, Chenshan (B57), Kunlun (B60), Feiyang (B58), Gongsun (Sp4), Hegu (LI4); Jaundice with moxibustion of Gongsun (Sp4), Zhiyang (Du9), Pishu (B20), Weishu (B21): Cough due to heat evil with moxibustion of Feishu (B13), Tanzhong (Ren17), Chize (L5), Taixi (K3); Phlegm-fire with moxibustion of Baihui (Du20) and Gaohuang (B43): Painful micturition with moxibustion of Leique (L7), Zhongfeng (Liv4), Geshu (B17), Shenshu (B23), Qihai (Ren6), etc. It is said in the Article on Cholera Morbus: “These diseases are treated much more effectively by moxibustion than by herbal decoction.” Diarrhea with blood and mucus is treated with moxibustion of Changqiang (Du1) and Mingmen (Du4). It is said in the Article on Dysentry: “Dysentry is caused by excessive heat stagnation and body fluid exhaustion ……. Moxibustion doctor treats it by selecting points to draw the fire out through warming yang, and it is quite different from abusing hot-natured drugs to ‘fight fire with fire’ regardless of a gastrointestinal condition.” The mechanism for the treatment of heat syndrome with moxibustion is “drawing heat out through warming yang”, not treating heat syndrome with heat drugs. There are other examples in external medicine in treating carbuncle on the nape with moxibustion of Shenmen (H7): pulmonary abscess is treated with moxibustion of Tanzhong (Ren17), Feishu (B13), Zhigou (SI6), Daling (P7), Shenshu (B23), Hegu (LI4), Taiyuan (L9): furnuncle with garlic moxibustion on it. All the heat syndromes such as furnuncle, carbuncle can be treated with moxibustion, heat hemorrhoids with moxibustion on painful regions. It is said: “To put some fresh ginger slices on the painful furnuncle region with moxibustion of three cones, the yellow liquid flows out and symptoms disappear … very effective.” Breast carbuncle of gynecology is treated with moxibustion of Lingdao (H4), Tiaokou (S38), Zusanli (S36); breast swelling with moxibustion of Shaoze (SI1) and Zulinqi (GB41): The women with heat evil attacking the blood chamber are treated with moxibustion of Qimen (Liv14); red and white leukorrhea with moxibustion of Shenshu (B23), Xuchai (Sp9), Daimai (GB26), Zhongfeng (Liv4), Sanyinjiao (Sp6), etc. It is also said, “Moxibustion of Cui’s Sihua points treat red and white leukorrhea very effectively”. It is cited from Wang Haizang: “Leukorrhea is caused by dysfunction of the spleen, which is with moxibustion of Zhangmen (Liv13), with the wheat-particle-like cones, very effective.” Acute and chronic infantile convulsion is treated with moxibustion of Baihui (Du20), Shuigou (Du26), Hegu (L14), Dadun (Liv1), Xingjian (Liv2), Chize (L5), ete: diarrhea with moxibustion of Weishu (B21), Shuifen (Ren9), Tianshu (S25), Shenque (Ren8): painful red and swelling eyes due to unclear cause in ENTT is treated with moxibustion of Hegu (LI4), Eriian (LI2), Ganshu (B18), Zusanli (S36); belpharitis marginailis due to wind-evil with moxibustion of Ganshu (B18), Danshu(B19), Juegu (GB39), Guangming (GB37); nasosinusitis with Shangxing (Du23), Quchai(B4), Fengmen(B12), Hegu(LI4); sore throat with Yangxi (LI5), Shaohai (H3), Yemen (SJ2); toothache and eczema all over the body due to infantile malnutrition with Chengjing (Ren24). All the examples mentioned above repeatedly prove the treatment of heat syndrome with moxibustion has miraculous effect, and aslo indicate the treatment of heat syndrome with moxibustion is different from the treatment of heat syndrome with heat drugs. This is because the moxibustion therapy can draw the fire out through warming yang and dissipate the pathogens.
2. Asthenia pyrosyndrome in clinical application
They are the examples in asthenia pyrosyndrome in treating hematemesis due to asthenic diseases with moxibustion of Shangwan (Ren23), Feishu (B13), Pishu (B20), Shenshu (B23), Daling (P7), Waiguan (SJ5); night sweat with moxibustion of Feishu (B13), Fuliu (K7), Yixi (B45): diabetes with moxibustion of Chengjiang (Ren24), Zhizheng (SJ7), Yangchi (SJ4), Zhaohai (K6), Shenshu (B23), Xiaochangshu (B27) and digitus mininus points of hand and foot (that is finger-tip); heat-foot caused by exhaustion of kidney yin or downward flow of damp-heat with moxibustion of Yongquan (K1) and Rangu (K2); fever due to consumption with moxibustion of Qihai (Ren6), Guanyuan (Ren4), Gaohuangshu (B43), Zusanli (S36), Neiguan (P6), Cui’s Sihua points (EX-CA): pulmonary tuberculosis with moxibustion of Guiyan (that is Yaoyan, EX-CA), Gaohuangshu (B43), Sanzhuigushang (EX-CA). It is said, “Pulmonary tuberculosis is very difficult to be cured and can only be treated with moxibustion.” It is clear pulmonary tuberculosis due to yin deficiency and lung-heat is treated much more effectively with moxibustion than drugs. This is repeatedly proved by many cases later.
It is ambiguous whether heat syndrome can be or cannot be treated with moxibustion
The Monography on Moxibustion Therapy is compiled by Wu Yiding who collected previous statements on moxibustion. It is not clear if heat syndrome can be or cannot be treated with moxibustion. He advocated treating heat syndrome with moxibustion, but meanwhile, he was against the treatment of heat syndrome with moxibustion when others against. So there are many contradictory statements in the book. In the Article of Moxibustion Forbidden, it says: “Moxibustion is not suitable for one with superficial, rapid and excessive pulse condition and one with dysphoria, dry mouth, sore throat, red complexion due to excessive fire, just after sweating and fever due to yin deficiency, etc.” In Zhongshenzhenglun, it is said: “One with superficial, surging, scattered pulse and fire syndromes cannot be treated with moxibustion in case the fire syndromes are treated with fire, which will aggravate the condition.” But in clinic application “exogenous febrile diseases with headache and fever are treated with moxibustion of Eriian (LI2), Hegu (LI4), Fengchi (B12), Qimen (Liv14)” and other points: “exogenous febrile diseases with fever, dysphoria, dry mouth with moxibustion of Quze (P3) and Yingiao (EX-CA)”: “fever all over the body with moxibustion of Bailao (EX-CA)”: “fever due to consumption with moxibustion of Qihai (Ren6), Guanyuan (Ren4), Gaohuangshu (B43), Zusanli (S36), etc”. Of course if can be inferred from “fever all over the body”, his pulse condition is superficial, surging, rapid and excessive, and has red complexion. So this almost repudiates some articles that moxibustion therapy is forbidden for heat syndromes. In the articles that exogenous febrile diseases are forbidden with moxibustion therapy, there are 5 statements, which are also contradictory in comparison with other articles. An example is “superficial pulse should be treated with sweating. If it is treated with moxibustion, the pathogens cannot go out because it is excessive due to fire”. When a superficial pulse is treated with sweating, there is certainly no sweating. In Marvelous Moxibustion, it is said: “One with the exogenous febrile disease has no sweating, eye red, deafness, chest pain, swelling of the maxillary region, Koujin (lockjaw unable to open the mouth), he is treated with moxibustion of Xiaxi (GB43) and Fuliu (K7)”, etc. While Wu was against the treatment of heat syndrome with moxibustion, he definitely advocated the treatment of heat syndrome with moxibustion, and there are some contradictory statements mentioned above.
Although Wu said heat syndrome mustn’t be treated with moxibustion or advocated that heat syndrome can be treated with moxibustion, there are many contradictory statements in the book, the Monography on Moxibustion Therapy recognizes heat syndrome is suitable for moxibustion, which can draw heat out and dissipate pathogens. It is not heat syndrome treated wrongly with heat drugs, but it is the principle of contrary treatment from Neijing and it is the practical application of “fire stagnation requiring dissipation”. This is also applied extensively in clinics, concerning internal medicine, external medicine, gynaccology, pediatrics, ophthalmology, NT (nose-throat), stomatology, etc. The book gives over 100 cases of sthenia pyrosyndrome and asthenia pyrosyndrome treated with moxibustion points and methods, which indicates heat syndrome is suitable for moxibustion therapy, “whose treatment effect is better than drugs” and “it always has miraculous effect”. Therefore the book is still important literature in treating heat syndrome and acute symptoms with moxibustion. It is worthwhile for us to learn, analyze and testify to the statements from the book. Thus we will broaden the range of moxibustion therapy and make the way for the treatment of heat syndrome and acute symptoms with moxibustion.
Translator: Ding Ninnqing
在近百种热证中，广泛见于内科学、外科学、妇科、儿科、眼科、耳鼻喉科、口腔科等。艾灸大椎(Du14)、艺兮(B45)、章门(Liv13)、还条(GB30)、陈山(B57)、昆仑(B60)、杨妃(B58)、公孙(Sp4)、合谷(LI4)等治疗疟疾在内科也有实例；公孙(Sp4)、智阳(Du9)、脾俞(B20)、舒威(B21)灸治黄疸:舒菲(B13)、痰浊(Ren17)、赤泽(L5)、太溪(K3)灸治热毒咳嗽；艾灸百会、黄高痰火:艾灸雷que (L7)、中峰(Liv4)、舒歌(B17)、肾俞(B23)、气海(Ren6)等治疗尿痛。《霍乱弧菌》上有一篇文章说:“艾灸治疗这些疾病比中药汤剂有效得多。”艾灸肠腔(督1)、命门(督4)治疗血黏液腹泻。“入不敷出”篇曰:“入不敷出，因热壅盛，津液竭……艾灸医生通过温阳取穴引火来治疗，无论胃肠状况如何，都与滥用热毒“以火攻火”有很大不同。”艾灸治疗热证的作用机制为“温阳取热”，而非热药治疗热证。摘要:艾灸神门(H7)治疗项上痈，外用药亦有例:肺脓肿采用艾灸痰中(仁17)、舒菲(B13)、直沟(SI6)、大岭(P7)、肾俞(B23)、合谷(LI4)、太原(L9)治疗:以大蒜灸项上痈。凡须根、痈等热证均可艾灸治疗，热痔疮可艾灸患处。相传:“用三锥灸把一些生姜片放在患处，黄液流出，症状消失……非常有效。”艾灸灵道(H4)、条口(S38)、足三里(S36)治疗妇科乳腺痈；芍泽、祖琳琪灸治疗乳房肿胀:热毒袭血行者，用祁门灸治疗(liv 14)；艾灸肾俞(B23)、须柴(Sp9)、代脉(GB26)、中峰(Liv4)、三阴交(Sp6)等治疗红白带。又有“崔穴灸治疗赤白带十分有效”之说。引自王海藏:“白带乃脾功能失调所致，此与章门灸(Liv13)同用，其内有麦粒状锥体，颇为有效。”艾灸百会(督20)、水沟(督26)、合谷(L14)、大墩(Liv1)、醒酒(Liv2)、赤泽(L5)治疗急慢性小儿惊厥等:艾灸舒威(B21)、水粉(Ren9)、天枢(S25)、神阙(Ren8)腹泻:艾灸合谷(LI4)、埃里安(LI2)、肝俞(B18)、足三里(S36)；用肝俞(B18)、胆俞(B19)、厥骨(GB39)、光明(GB37)灸治风邪引起的睑缘炎；鼻窦炎伴上兴(毒23)、曲柴(B4)、风门(B12)、合谷(LI4)；咽喉肿痛伴阳西(LI5)、绍海(H3)、亦门(SJ2)；牙痛和湿疹全身由于婴儿营养不良与景程(伦24)。以上诸例反复印证了艾灸治疗热证的神奇功效，也说明艾灸治疗热证不同于热药治疗热证。这是因为艾灸疗法可以通过温阳引火，消散邪气。