Is Moxibustion Suitable for Everyone?

After my article "Do Not Moxibustion Recklessly" was published, people who had suffered physical harm from moxibustion came to consult me through various channels about what to do. I cannot give a uniform answer, because there is no single answer; there is only the gold standard Zhang Zhongjing advocated—"treat according to the pattern" (sui zheng zhi zhi)—taking measures based on the patient's bodily response and pulse. There was a Dr. Zhou Meisheng who advocated that all patients, regardless of cold or heat, could moxibustion, but he has passed away and there is no way to verify whether his results were really as good as he claimed. Nowadays many who tout moxibustion as universal, claiming that the hundred diseases are all yang deficiency, are quite a headache. Since ancient times most physicians have agreed that heat syndromes should avoid moxibustion. The Suwen of the Huangdi Neijing states that the fundamental principle of treating heat disease is "treating heat with cold." The Shanghan Lun also frequently mentions "the physician mistakenly forced sweating with fire"; the common means of "forcing with fire" is moxibustion. Under the line for Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction), there is further mention that "forcing with fire" causes the patient to become "spirit-clouded and delirious," showing how serious the consequences of improper or excessive moxibustion can be. Half-baked TCM practitioners really should not come out and harm people. Excessive moxibustion easily causes dual damage to qi and yin, withered fluids and dry blood, floating yang uprising, and insecure defensive yang. By the way, similar situations occur in those taking Da Qinglong Tang (Major Bluegreen Dragon Decoction) and Mahuang Tang (Ephedra Decoction). Da Qinglong Tang and Mahuang Tang should be drunk only once for a given illness, not for a whole day. In my early years I gave two doses of Mahuang Tang for my son's cold fever with no sweat; that night he was burning hot, with nosebleed and a red throat, restless and manic. Fortunately I stopped it with a blood-cooling formula, and from then on I dared not use warming methods recklessly. Only recently, reading Duan Fujin's Lectures on Formulaology, did I realize it was because I used two doses of Mahuang Tang. Many of our TCM formulas aim to effect a cure "as soon as the cup is turned over"—meaning the patient should be cured in just one dose; a second dose is harmful rather than helpful. As for handling floating yang uprising, I have seen Professor Liu Duzhou quote, in his Shanghan Lun Lectures, a case of the veteran physician Chen Shenwu: Dr. Chen used the blood of a rooster's comb, applied to the eyes, to treat the patient, and after applying it for a while cured him. This case seems to be under the Mahuang Tang or Da Qinglong Tang line in the taiyang-disease section of Liu Duzhou's Shanghan lectures; interested readers may look it up themselves. Because I am currently on the high-speed train to Yueyang, I cannot check the books I cited above to verify them, so I must return to Beijing, verify them, and then write them up. I hope fellow TCM physicians, after clinical work, will read more books so as not to take human lives. The veteran physician Yue Meizhong said that TCM proficiency has several levels; the lowest level is seeing a certain disease and applying a certain method, often knowing its benefits but not its harms, and as a result treating the patient into a dizzy mess—which is truly frightening. Opening a book brings benefit; we must read more and see more, so as to raise our own level by several notches.