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{{Short description|Traditional Chinese medical practice}}
{{Use dmy dates|date=June 2021}}
{{Infobox interventions
| Name = Moxibustion
| Image = File:Moxibustion by Li Tang.jpg
| Caption = ''Moxibustion'' by [[Li Tang (painter)|Li Tang]], Song dynasty
| ICD10 =
| ICD9unlinked =
| MeshID = D009071
| OPS301 =
| OtherCodes =
}}
{{Alternative medicine sidebar}}

[[Image:Valentini Moxa 1714.jpg|thumb|upright|Moxibustion in Michael Bernhard Valentini's ''Museum Museorum'' (Frankfurt am Main, 1714)]]

'''Moxibustion''' ({{zh|c={{linktext|灸}}|p=jiǔ}}) is a [[traditional Chinese medicine]] therapy which consists of burning dried [[mugwort]] (''[[wikt:moxa|moxa]]'') on particular points on the body. It plays an important role in the traditional [[medicine|medical]] systems of China, Japan, Korea, Vietnam, and Mongolia. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a [[cigar]]-shaped stick. They can use it indirectly, with [[acupuncture]] needles, or burn it on the patient's skin.

Moxibustion is promoted as a treatment for a wide variety of conditions, but its use is not backed by good evidence and it carries a risk of [[adverse effect]]s.<ref name=ee150/>

== Terminology ==
The first Western remarks on moxibustion can be found in letters and reports written by Portuguese missionaries in 16th-century Japan. They called it ''botão de fogo'' ({{literal|fire button}}), a term originally used for round-headed Western [[cautery]] irons. Hermann Buschoff, who published the first Western book on this matter in 1674 (English edition 1676), used the Japanese pronunciation ''mogusa'' (from "''moe-gusa''", lit. burning herb). As the ''u'' is not very strongly enunciated, he spelled it "Moxa". Later authors [[Blend word|blend]]ed "Moxa" with the Latin word ''[[combustion|combustio]]'' ("burning").<ref>{{cite journal |title=Far Eastern Medicine in Seventeenth and Early Eighteenth Century Germany|author=Wolfgang Michel|author-link=Wolfgang Michel|journal=Gengo Bunka Ronkyū {{lang|ja|italics=no|言語文化論究}}|publisher=Kyushu University, Faculty of Languages and Cultures |volume=20 |year=2005 |pages=67–82 |issn=1341-0032|hdl=2324/2878}}</ref><ref>{{cite book |title=English Translation of Traditional Chinese Medicine: Theory and Practice |author=Li Zhaoguo |publisher={{lang|zh|上海三联书店}} |year=2013 |page=11 |isbn=978-7-5426-4084-0 }}</ref>

The name of the herb Artemisia (mugwort) species used to produce Moxa is called ''ài'' or ''àicǎo'' ({{lang|zh-Hant|艾}}, {{lang|zh-Hant|艾草}}) in Chinese<ref>There is a great variety of further Chinese names (''bingtai'' {{lang|zh-Hans|冰台}}、''ecao'' {{lang|zh-Hans|遏草}}、''xiang'ai'' {{lang|zh-Hans|香艾}}、''qiai'' {{lang|zh-Hans|蕲艾}}、''aihao'' {{lang|zh-Hans|艾蒿}}、''jiucao'' {{lang|zh-Hans|灸草}}﹑''yicao'' {{lang|zh-Hans|医草}}﹑''huangcao'' {{lang|zh-Hans|黄草}}﹑''airong'' {{lang|zh-Hans|艾绒}})</ref> and ''yomogi'' ({{lang|ja|蓬}}) in Japan.
The Chinese names for moxibustion are ''jiǔ'' ({{lang|zh-Hant|灸}}) or ''jiǔshù'' ({{lang|zh-Hant|灸術}}); the Japanese use the same characters and pronounce them as ''kyū'' and ''kyūjutsu''. In Korean the reading is ''tteum'' ({{lang|ko|뜸}}). Korean folklore attributes the development of moxibustion to the legendary emperor [[Dangun]].<ref>{{cite book | pages = [https://books.google.com/books?id=0&pg=PA262 262] | last = Needham | first = J | author-link = Joseph Needham |author2=Lu GD | year = 2002 | title = Celestial lancets: a history and rationale of acupuncture and moxa | publisher = [[Routledge]] | isbn = 0-7007-1458-8 }}</ref>

<gallery heights=180 widths=180 class=center>
Tteum (moxibustion).jpg|a Korean set of ''tteum''
Tteum (moxibustion) 2.jpg|application of ''tteum'' on the back of a hand
Moxa-samples-from-Japan.jpg|Samples of Japanese Moxa. Left to right: processed mugwort (1st stage); processed mugwort (2nd stage); coarse Moxa for indirect moxibustion; usual quality for indirect and direct moxibustion; superior quality for direct moxibustion.
Ibuki moxa set.jpg|Traditional moxibustion set from [[Maibara, Shiga|Maibara]] (Japan)
Stick-on-moxa-rolls-japan.jpg|Stick–on moxa (left) and moxa rolls (right) used for indirect moxa heat treatment. The stick-on moxa is a modern product sold in Japan, Korea, and China. Usually the base is self-adhesive to the treatment point.
</gallery>

== Theory and practice ==
[[Image:Hara Shimetaro-Ijishimbun-1927.jpg|thumb|upright|First page of [[Shimetarō Hara]]: "Effects of Moxa on hemoglobin and RBC count". ''Iji Shinbun'', no. 1219, 10 Sept. 1927. (Summary in [[Esperanto]])]]

Practitioners use moxa to warm regions and [[acupuncture point|meridian points]]<ref>Not all acupuncture points can be used for moxibustion. A few of them are preferred in both classical literature and modern research: Zusanli (ST-36), Dazhui (GV-14).</ref> with the intention of stimulating [[circulatory system|circulation]] through the points and inducing a smoother flow of [[blood]] and [[qi]]. Some believe it can treat conditions associated with the "cold" or "yang deficiencies" in Chinese medicine.<ref>{{cite web | url=https://www.yinovacenter.com/chinese-medicine/moxibustion/ | title=Moxibustion | Chinese Medicine }}</ref> It is claimed that moxibustion mitigates against cold and dampness in the body, and can be used to treat lymphedema following intrapelvic lymph node dissection,<ref>{{cite journal |last1=Kanakura |first1=Y |last2=Niwa |first2=K |last3=Kometani |first3=K |last4=Nakazawa |first4=K |last5=Yamaguchi |first5=Y |last6=Ishikawa |first6=H |last7=Watanabe |first7=A |last8=Tokunaga |first8=Y |year=2002 |title=Effectiveness of acupuncture and moxibustion treatment for lymphedema following intrapelvic lymph node dissection: a preliminary report |journal=The American Journal of Chinese Medicine |volume=30 |issue=1 |pages=37–43 |doi=10.1142/S0192415X02000041 |pmid=12067095}}</ref> and help turn [[breech birth|breech babies]].<ref name=":0">{{Cite journal |last1=Coyle |first1=M E |last2=Smith |first2=C |last3=Peat |first3=B |date=2023-05-09 |title=Cephalic version by moxibustion for breech presentation |url= |journal=Cochrane Database of Systematic Reviews |volume=2023 |issue=5 |article-number=CD003928 |doi=10.1002/14651858.CD003928.pub4 |issn=1469-493X |pmid=37158339|pmc=10167788 }}</ref>

Practitioners claim moxibustion to be especially effective in the treatment of chronic problems, "deficient conditions" (weakness), and [[gerontology]]. [[Pien Ch'iao|Bian Que]] (''fl.'' ''circa'' 500 BCE), one of the most famous semi-legendary doctors of Chinese antiquity and the first specialist in moxibustion, discussed the benefits of moxa over acupuncture in his classic work ''Bian Que Neijing''. He asserted that moxa could add new energy to the body and could treat both excess and deficient conditions.

Practitioners may use acupuncture needles made of various materials in combination with moxa, depending on the direction of ''qi'' flow they wish to stimulate.

There are several methods of moxibustion. Three of them are direct scarring, direct non-scarring, and indirect moxibustion. Direct scarring moxibustion places a small cone of moxa on the skin at an acupuncture point and burns it until the skin blisters, which then scars after it heals.<ref name=MAT/> Direct non-scarring moxibustion removes the burning moxa before the skin burns enough to scar, unless the burning moxa is left on the skin too long.<ref name=MAT/> Indirect moxibustion holds a cigar made of moxa near the acupuncture point to heat the skin, or holds it on an acupuncture needle inserted in the skin to heat the needle.<ref name=MAT>{{cite web|url=http://acupuncturetoday.com/abc/moxibustion.php |title=Moxibustion, Acupuncture Today |publisher=Acupuncturetoday.com |access-date=2011-05-17}}</ref> There is also stick-on moxa.

''Chuanwu lingji lu'' (the Record of Sovereign Teachings), by Zhang Youheng, was a treatise on acu-moxa completed in 1869 and featuring several colour illustrations of the points on the body where moxa could be applied to treat the complaint.
<gallery mode=packed heights=180>
File:C19 Chinese MS moxibustion point chart; Cervix point Wellcome L0039501.jpg|The cervix point was used to treat retained placenta and intrauterine death.
File:C19 Chinese MS moxibustion point chart; Neiting Wellcome L0039489.jpg|The Neiting point was used to remedy retrograde cold (jueni) in the limbs; aversion to noise; profuse breakout of pox; painful, inflamed throats; unremitting toothache; yawning and somnolence; lack of appetite for food and drink; tinnitus (lit. cricket chirp [chanming] in the ear); ague (nüeji), etc.
File:C19 Chinese MS moxibustion point chart; Yanglingquan Wellcome L0039497.jpg|The Yanglingquan point was used pain and swelling in the feet and knees; wind-cold-damp blockage disease (bi); one-sided paralysis; heavy, aching feeling in the back, making it difficult to sit or stand; facial oedema (fuzhong); distention and feeling of fullness (zhangman) in the chest, etc.
File:C19 Chinese MS moxibustion point chart; Taichong Wellcome L0039494.jpg|The Taichong point was indicated for acute and chronic infantile convulsions (lit. wind fright, jingfeng); epilepsy (dianxian) and spasms; sore throat; distention and feeling of fullness (zhangman) in the chest and sides; cold-damp beri-beri (jiaoqi); difficulty in walking; hernia (shanqi); dim vision; backache, etc.
File:C19 Chinese MS moxibustion point chart; Malign attack Wellcome L0039507.jpg|The zhong 'e point was targeted for corpse infection (shizhu) and inimical visitation (kewu), malign attack (zhong 'e) [forms of demonic possession], etc. Moxibustion takes place on the left for male patients and the right for female patients.
File:C19 Chinese MS moxibustion point chart; Scrofula point Wellcome L0039512.jpg|Scrofula was to be treated at the point where it occurred, with garlic-partition moxibustion (gesuan jiufa).
</gallery>

== Uses and effectiveness ==

Most research into moxibustion comes from China and is generally of low quality.<ref name=ee150>{{cite book |author=Ernst E |author-link=Edzard Ernst |publisher=Springer |title=Alternative Medicine – A Critical Assessment of 150 Modalities |isbn=978-3-030-12600-1 |doi=10.1007/978-3-030-12601-8 |year=2019 |pages=182–183|s2cid=34148480 }}</ref> Claims are made for its effectiveness for a wide variety of conditions, with some practitioners promoting it as a [[Panacea (medicine)|panacea]].<ref name=ee150/>

=== Pregnancy ===
There is some evidence to suggest that moxibustion, when included along with other procedures that are usual to care for a person who is at risk of a breech birth, may decrease the chances that the baby presents in the breech position and may decrease the chances of a person requiring oxytocin to help labour start or progress.<ref name=":0" /> This evidence is considered to be of the "moderate" level of certainty by a 2023 Cochrane Systematic Review, however, the safety profile was not clear in these studies as adverse effects were not well considered or properly reported.<ref name=":0" /> In addition, the need or role of turning the baby by performing an [[external cephalic version]] to prevent a breech birth along with these treatments is not known.<ref name=":0" /> There is no evidence that moxibustion, when combined with standard care practices, helps reduce the risk of a person requiring a [[caesarean section]].<ref name=":0" /> It is also not clear if there are any benefits for preventing early [[Membrane rupture|membrane ruptures]] or a protective effect on the [[umbilical cord blood]] [[pH]] level.<ref name=":0" />

=== Other ===
Moxibustion has also been studied for the treatment of pain,<ref>{{cite journal |last1=Lee |first1=Myeong Soo |last2=Choi |first2=Tae-Young |last3=Kang |first3=Jung Won |last4=Lee |first4=Beom-Joon |last5=Ernst |first5=Edzard |year=2010 |title=Moxibustion for Treating Pain: A Systematic Review |journal=The American Journal of Chinese Medicine |volume=38 |issue=5 |pages=829–38 |doi=10.1142/S0192415X10008275 |pmid=20821815 |s2cid=8383035}}</ref> [[cancer]],<ref>{{cite journal |last1=Lee |first1=Myeong Soo |last2=Choi |first2=Tae-Young |last3=Park |first3=Ji-Eun |last4=Lee |first4=Song-Shil |last5=Ernst |first5=Edzard |year=2010 |title=Moxibustion for cancer care: A systematic review and meta-analysis |journal=BMC Cancer |volume=10 |page=130 |doi=10.1186/1471-2407-10-130 |pmc=2873382 |pmid=20374659 |doi-access=free }}</ref> [[stroke]],<ref>{{cite journal |last1=Lee |first1=M. S. |last2=Shin |first2=B.-C. |last3=Kim |first3=J.-I. |last4=Han |first4=C.-h. |last5=Ernst |first5=E. |year=2010 |title=Moxibustion for Stroke Rehabilitation: Systematic Review |journal=Stroke |volume=41 |issue=4 |pages=817–20 |doi=10.1161/STROKEAHA.109.566851 |pmid=20150551 |doi-access=free}}</ref> [[ulcerative colitis]],<ref>{{cite journal |last1=Lee |first1=Dong-Hyo |last2=Kim |first2=Jong-In |last3=Lee |first3=Myeong Soo |last4=Choi |first4=Tae-Young |last5=Choi |first5=Sun-Mi |last6=Ernst |first6=Edzard |year=2010 |title=Moxibustion for ulcerative colitis: A systematic review and meta-analysis |journal=BMC Gastroenterology |volume=10 |page=36 |doi=10.1186/1471-230X-10-36 |pmc=2864201 |pmid=20374658 |doi-access=free }}</ref> [[constipation]],<ref>{{cite journal |last1=Lee |first1=Myeong Soo |last2=Choi |first2=Tae-Young |last3=Park |first3=Ji-Eun |last4=Ernst |first4=Edzard |year=2010 |title=Effects of moxibustion for constipation treatment: A systematic review of randomized controlled trials |journal=Chinese Medicine |volume=5 |page=28 |doi=10.1186/1749-8546-5-28 |pmc=2922210 |pmid=20687948 |doi-access=free }}</ref> and [[hypertension]].<ref>{{cite journal |last1=Kim |first1=Jong-In |last2=Choi |first2=Jun-Yong |last3=Lee |first3=Hyangsook |last4=Lee |first4=Myeong Soo |last5=Ernst |first5=Edzard |year=2010 |title=Moxibustion for hypertension: A systematic review |journal=BMC Cardiovascular Disorders |volume=10 |page=33 |doi=10.1186/1471-2261-10-33 |pmc=2912786 |pmid=20602794 |doi-access=free }}</ref> Systematic reviews have found that these studies are of low quality and positive findings could be due to [[publication bias]].<ref>{{cite journal |last1=Lee |first1=Myeong Soo |last2=Kang |first2=Jung Won |last3=Ernst |first3=Edzard |year=2010 |title=Does moxibustion work? An overview of systematic reviews |journal=BMC Research Notes |volume=3 |page=284 |doi=10.1186/1756-0500-3-284 |pmc=2987875 |pmid=21054851 |doi-access=free }}</ref>

== Adverse effects ==
Moxibustion carries a risk of [[adverse effect]]s including burns and infection.<ref name="ee150" /> Some side effects that have been reported include nausea, throat irritation, and abdominal pain from contractions when used in pregnancy.

== Parallel uses of mugwort ==
Mugwort amongst other herbs was often bound into [[smudge stick]]s. The [[Chumash people]] from southern California have a similar ritual.<ref>{{cite book |title=Chumash Ethnobotany: Plant Knowledge among the Chumash People of Southern California |last=Timbrook |first=Janice|year=2007 |publisher=Santa Barbara Museum of Natural History |isbn= 978-1-59714-048-5}}{{page needed|date=February 2015}}</ref> Europeans placed sprigs of mugwort under pillows to provoke dreams; and the herb had associations with the practice of [[magic (paranormal)|magic]] in [[Anglo-Saxon England|Anglo-Saxon]] times.<ref>{{Cite journal|last=Knight|first=Katherine|date=2002-01-01|title=A Precious Medicine: Tradition and Magic in Some Seventeenth-Century Household Remedies|journal=Folklore|volume=113|issue=2|pages=237–247|doi=10.1080/0015587022000015347|s2cid=162291104|issn=0015-587X}}</ref>

== See also ==
* {{Annotated link|Acupuncture}}
** {{Annotated link|Fire needle acupuncture}}
* {{Annotated link|Cupping therapy}}
* {{Annotated link|Traditional Chinese medicine}}
* {{Annotated link|Jieba}}
* {{annotated link|Electric moxa}}

== References ==
{{Reflist}}

== External links ==
{{Commons category|Moxibustion}}
{{wiktionary}}
* [[Wolfgang Michel-Zaitsu|W Michel]]: [http://hdl.handle.net/2324/2878 Far Eastern Medicine in Seventeenth and Early Eighteenth Century Germany]
* [http://hdl.handle.net/2324/2936 Hermann Buschoff, ''The gout, more narrowly searcht, and found out; together with the certain cure thereof''. London 1676. W Michel ed. Fukuoka, March 2003. (Japanese introduction by the editor, English text)]

{{Traditional Medicine}}
{{Authority control}}

[[Category:Traditional Chinese medicine]]
[[Category:Alternative medicine]]
[[Category:Traditions involving fire]]

Moxibustion - Revision history

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