An article about moxa published in D&G green Handbook 2010
Artemisia vulgaris (mugwort) is a plant that grows in temperate climates across the Northern Hemisphere, often in tall clumps along roadsides and in waste places. Despite its ordinary appearance, this plant and its close relatives have remarkable medicinal properties and have been important in the herbal medicine of many cultures for thousands of years.
Mugwort leaves are whitish underneath due to many tiny hairs, which contain aromatic oils. Due to the therapeutic and antibacterial properties of the essential oils and tannins in the leaves, tinctures and topical applications have been used to treat many conditions including digestive problems, infections, fevers, sore throat and parasitic worms. The leaves are also used as insect repellent, and in ancient folklore were hung in doorways to ward off evil spirits.
Within Oriental Medicine, particularly in China, Korea and Japan, mugwort is used in a different way. Following a traditional process, the leaves are dried, ground and repeatedly sieved to remove fibrous material. Progressive stages of refinement and ageing provide different grades of a soft, fluffy substance called moxa.
Relatively unrefined, coarse moxa is a greenish colour and still contains some larger fibres. The purest Japanese grades, which can take up to 3 years to produce, are very fine textured and yellow, containing large amounts of essential oils.
When moxa is burnt it smoulders to release heat and volatile oils – this process, known as “moxibustion”, is done close to or directly on the skin to provide various therapeutic effects. Historical records going back to around 400BC suggest that moxibustion probably predates the development of acupuncture, but the two therapies have been used alongside each other for about 2,000 years. Moxa is still widely used in China and is an integral part of acupuncture practice for many practitioners in the UK.
There are many different ways of using moxa. Coarse moxa may be rolled in paper to form a cigar-like stick, which is lit and held above the skin to give a gentle radiating warmth, similar to an infra red lamp.
An inserted acupuncture needle can be heated
by fixing a malteser-sized ball of moxa to its handle. The heat from the burning moxa passes down the needle to warm up the deep tissues, providing relief for conditions such as back pain and sciatica. Another method of application is to burn a cone shaped piece of moxa on top of a slice of ginger or garlic that is placed on the skin. This provides heat from both the moxa and the ginger/garlic, and can be very useful in relieving pain and stiffness due to internal cold or stagnation.
In Japan the practice of burning pure grade moxa directly on the skin has been developed to a sophisticated level. This may sound a bit barbaric, but in fact when done correctly it need not be painful or cause burns. Once patients get used to the idea, most of them do not find it uncomfortable, and even enjoy it. In my treatments I often use small cones of moxa, placed on the skin and burnt only half way down. This gives a lovely feeling of deeply penetrating warmth, wonderful for any cold or tense areas of the body. Or I might use tiny pieces the size of a sesame seed, which burn down to a fine point. Applied regularly at appropriate places on the body, this can be very beneficial for circulation and general health and can relieve painful conditions like arthritis. Moxa has also been shown to have very specific effects – for example used on the little toe it can turn a breached baby.
Medical research in Japan has shown that tiny amounts of tissue injury caused by direct moxa can have immediate beneficial effects on the blood and immune system. Japanese moxa therapists use specific points on the body to treat a very wide range of conditions and to improve general health and stamina. Some dramatic claims are made for the benefits of moxa in old Japanese literature. The most extreme (and doubtless highly exaggerated) tells of farmer called Manpei, in the Edo period, who apparently lived to 243 years of age. When questioned by authorities about his longevity, he reported that he had no secret other than burning moxa on his leg every day, just like his ancestors. His wife reputedly lived to 242, and his son to 196, so it clearly was a healthy family obsession!
Much more recently, Dr Shimetaro Hara (1883-1991) was another proponent for regular moxa use, surviving to the age of 108. For the last few weeks of his life he held the official title of “oldest male in Japan”, for some years having practiced as the oldest practising physician in Japan (probably the world). Dr Hara was something of a moxa expert, and during the 1930s in Japan, before antibiotics were available, he used moxa to successfully treat many severe illnesses including TB. He also carried out the first experiments to find out how moxa was affecting the immune system. His work has inspired the foundation of a charity called Moxafrica, set up in 2008 by myself and a fellow acupuncturist Merlin Young. As acupuncturists we regularly use direct moxa in our clinics, and had first hand experience of how beneficial it can be toour patients.
We were also becoming aware of the escalating pandemic of TB raging through most African countries, and the alarming reports of drug resistant strains of the disease, making it increasingly uncontrollable. We set out to investigate whether the use of moxa to boost the immune system could help in the fight against this dreadful disease, which currently kills over 2,000 Africans every day. Mostly it attacks young people of child-bearing age, making it all the more devastating for communities.
Establishing Moxafrica has been a long road and a lot of hard work – we researched Japanese literature (almost nothing is written about moxa in English), consulted moxa experts throughout the world, and set up a simple treatment protocol suitable for TB patients. Moxa is ideal as a home therapy and can easily be taught to patients. A treatment only takes a few minutes but to treat infectious diseases it has to be done every day for many months, even if the patients are already taking medication. Our plan was to train African health workers how to use it, so that they could then teach their patients. We would supply the moxa and everything they needed, and they would monitor the patients’ progress for us over a 12 month period. Initially we needed to do a pilot study just to see whether African health workers and patients would accept this therapy, which is completely unknown in Africa, and whether the success that Dr Hara reported with his TB patients could be repeated in modern day Africa.
After months of planning and fundraising, we set up our first program in March 2010 at Kiswa clinic in Kampala, Uganda. Facilities there are very poor, but TB drugs are available and effective except in drug resistant cases. However, they have to be taken for 8 months and often produce very debilitating side effects. Many patients stop taking their drugs because of this, which is a nightmare for medical staff as it can lead to relapse and development of drug resistance. In Uganda drug-resistant TB is simply too costly to treat (up to £170,000 per patient), and in some cases is incurable, so patients are simply left to die. The clinic staff, desperate for any help they can get in this situation, welcomed us enthusiastically and have been very supportive to our project.
Over 100 patients have been trained in moxa use, and we have been able to meet many of them on our subsequent visits. Their response has been very rewarding for us – the patients love using moxa and many are even afraid to stop using it! They are used to traditional healing methods so they don’t find it too strange, and overwhelmingly they are reporting beneficial effects. They have found that using moxa reduces or completely removes the drug side effects, helping them to get better more quickly and regain their strength. The nurses all confirm how much faster people recover and become non-infective when using moxa rather than TB drugs alone. They believe that moxa helps the drugs to work better, even for patients who also have HIV/AIDS as well as TB. The significance of these results is huge – the inclusion of moxa treatment into a medical TB drug regime might really help to improve the outcome. And moxa is relatively cheap (a 12 month supply for one patient would cost around £30) compared with the conventional drugs.
Our study has shown us that moxa is acceptable to African cultures and that it has huge potential to help millions of TB sufferers. This year we have set up two new programs in South Africa and we have been invited to collaborate in a medical research project with Makarere University in Kampala, where they will look in detail at the body’s immune responses to moxa. This is tremendously exciting for us, as it is the first time that anyone from the medical world has taken our work seriously. As with any unresearched traditional therapy, there is always a huge battle to win over the cynics! We hope that some well-conducted clinical trials will open the door to a wider acceptance of moxa as a valuable therapy, and also will make it easier for us to obtain funding for our work.
Fund-raising has always been difficult, because moxa is not a recognised therapy. So far we have had to rely mostly on donations from friends, family and colleagues, but we have also held a few fundraising events. Moxa workshops are fun and have proved popular in many parts of the UK, and I’d love to organise one in Dumfries & Galloway. So if you’d like to find out more about moxa and how to use it, whether you are a therapist or just interested in self-help, please let me know (firstname.lastname@example.org).
You can also visit the website www.moxafrica.org, where you’ll find lots of information and video clips, and can also make donations to this very worthwhile cause.