Overview of Moxibustion Methods in the Neijing

In the Neijing, in addition to the Nine Needles, a variety of therapeutic methods are recorded, including guiding and stretching exercises, Dao Qi, massage, moxibustion, hot compresses, needling, and medicinal ingestion, as stated in Lingshu Bingchuan. Among these, moxibustion was one of the most important therapeutic methods. Suwen Yifa Fangyi Lun states that the northern regions are areas where Heaven and Earth are closed and stored, the land is elevated, with severe wind and cold. The people live in open fields and consume dairy products, and internal cold gives rise to distension disorders. Their treatment is therefore suited to moxibustion and cauterisation. This passage not only suggests the origin of moxibustion but also clarifies its indications.

When faced with multiple therapeutic methods, these two chapters reflect two different approaches adopted by ancient physicians. One is to adhere to a single method without deviation, whereby all conditions may be resolved, as stated in Lingshu Bingchuan. The other is to combine different methods so that each is applied where appropriate, as described in Suwen Yifa Fangyi Lun. The clinical application of moxibustion in the Neijing reflects both approaches. For example, Lingshu Jinfu records instructions such as using moxibustion alone or needling first and then applying moxibustion.

The Neijing states that what needling cannot accomplish may be appropriately treated with moxibustion, as recorded in Lingshu Guanneng, indicating a complementary relationship between acupuncture and moxibustion. This complementarity is generally understood as each method having its own advantageous indications, as later summarised by Zhang Jingyue in Leijing, who stated that conditions unsuitable for needling should be treated with moxibustion. The Neijing further points out that certain acupoints are suitable for moxibustion but not for needling, as stated in Lingshu Beishu.

Records of conditions suitable for moxibustion in the Neijing

When discussing the treatment of specific disorders, the Neijing directly identifies conditions for which moxibustion should be selected. These include the following.

1 Wind cold syndromes

Suwen Yuji Zhenzang Lun states that when wind and cold invade the body, resulting in bi syndrome, numbness, swelling, pain, or convulsive disorders, moxibustion, hot compresses, or fire needling may be used. If untreated, the disorder may transmit from the Kidney to the Heart, causing acute contraction of the sinews, at which point moxibustion or medication may be applied. This passage indicates that disorders caused by wind cold invasion are suitable for moxibustion and highlights its effects of warming the channels, dispersing cold, reducing swelling and pain, and relieving obstruction and tension.

2 Profuse sweating due to strong wind

Suwen Gukong Lun states that in cases of profuse sweating caused by strong wind, moxibustion should be applied to Yixi. Yixi is located three cun lateral to the spine on the lower back. When pressed, the patient responds vocally, confirming the point. This indicates that sweating caused by wind binding the exterior and opening the interstices is suitable for moxibustion, reflecting its function of harmonising nutritive and defensive Qi and stopping sweating.

3 Alternating cold and heat disorders

Suwen Gukong Lun records methods for treating cold and heat disorders with moxibustion, listing twenty-nine specific locations. Alternating chills and fever are common symptoms in many diseases, and this text specifies that such conditions should be treated by moxibustion at these twenty-nine sites.

4 Malaria

Suwen Ci Nüe states that when malaria presents with a full, large, and tense pulse, the back shu points should be needled. When the pulse is small, firm, and tense, moxibustion should first be applied to the Shaoyin region of the lower leg, followed by needling of the jing well points.

5 Internal cold and distension disorders

Suwen Yifa Fangyi Lun notes that internal cold gives rise to distension disorders and that treatment should be moxibustion and cauterisation. This indicates the application of moxibustion in cold and Qi stagnation disorders and reflects its functions of warming the channels, dispersing cold, promoting circulation, and relieving distension.

6 Food retention

Suwen Gukong Lun states that in cases of food injury, moxibustion should be applied first. If ineffective, further assessment of the affected channels should be made, with needling and medication used accordingly.

7 Gallbladder disorders

Lingshu Xieqi Zangfu Bingxing describes gallbladder disease as characterised by frequent sighing, bitter taste in the mouth, vomiting of retained fluids, fullness below the Heart, fearfulness, throat discomfort, and frequent spitting. When depression of the pulse is found at the root or terminal of the Foot Shaoyang channel, moxibustion should be applied.

8 Heaviness of the body with vexation and oppression

Suwen Shicongrong Lun states that deficiency of the Liver, Kidney, or Spleen may cause heaviness of the body with vexation and oppression, and that treatment may include moxibustion.

9 Epilepsy and mania

Lingshu Diankuang records that epilepsy and manic disorders should be treated with moxibustion at the sacrum and other specified regions. These passages indicate that disorders of consciousness and spirit are suitable for moxibustion and suggest its calming and spirit regulating effects.

10 Stiff neck

Suwen Gukong Lun states that a stiff neck can be treated by applying moxibustion to the centre of the spine.

These records indicate that during the Neijing era, moxibustion was primarily used for cold and cold heat disorders, but its application extended to internal diseases, surgical conditions, mental disorders, dog bites, and stiff neck, with a gradually expanding scope.

03 Contraindication

3.1 Deficiency of both Yin and Yang

The Lingshu, Endings and Beginnings, states that when both Yin and Yang are deficient, tonifying Yang will exhaust Yin, and draining Yin will cause Yang collapse. Such conditions should be treated with sweet medicines and should not be treated with moxibustion.

3.2 Excess of both Yin and Yang

The Lingshu, Endings and Beginnings, states that when both the Renying and Cunkou pulses are excessively strong, this is called excess of both Yin and Yang. Applying moxibustion in such cases will transform the condition into another disease.