A Blue Poppy blog post by Bob Quinn
Many people have by now read the extremely helpful material (literally life-saving for some patients) put out by Heiner Fruehauf, Ph.D. on the treatment of Gu syndrome. This was discussed in my last blog. Chronic Lyme disease is, in his opinion (and mine at this point), a modern instance of this ancient syndrome. Always the focus in Heiner’s material is herbal medicine. Here I want to briefly mention how direct half-rice grain moxa (or smaller) can be used to help these chronic Lyme patients.
The training in TCM in the US by and large gives short shrift to moxibustion, and this is tragic. Many, and perhaps most TCM colleges, train their students only minimally in moxibustion. Across the US many student intern clinic, if they use moxa at all, use only indirect smokeless moxa poles. So much more than that is possible with mugwort. Moxa as a therapy is of immense benefit, and you owe it to yourself to investigate it more closely.
A misconception that I encounter again and again is that if a patient has heat signs, we should not do any moxa. That is just not true; in fact, when done in the correct way, moxa can be used to treat heat. It is true that if a great deal of heat is introduced—say, for instance, a moxa box on the abdomen—problems will likely result in a patient with obvious signs of heat. However, there are many ways of doing moxa.
The ultra-pure gold moxa we sell at Blue Poppy when burned will burn 20 degrees or more cooler than less expensive crude, green moxa. The pieces we use are only half the size of a grain of rice. That’s quite small as you can imagine. Also possible is sesame seed-size pieces. A little herb paste called shiunko is used on the point, so that the moxa stays in place. We “tent” our fingers over the moxa as it burns down. If we do this artfully, and the piece is small enough, we can work it so that the tenting of the fingers starves it of oxygen right at the end. In this way it burns all the way down to the skin, going out on its own at the last moment. One has to be watchful though; if the moxa piece is a little larger, it might have too much heat and we might need to use our fingers at the last moment to gently pinch it out. This is not particularly hot, so don’t worry about your fingers. The trick is to have the piece of moxa quite narrow; how tall it is can vary as need be, but it is best if it is quite thin.
To get the moxa pieces this thin we use two small boards to roll it out into a thread-like consistency. If we have no rolling boards, we can use beer coasters. It’s a good excuse to go by your local brewpub and taste their products. Keep in mind that we want the pieces to roll out to half the diameter of rice. That is thin. We use this thread we have rolled to then pull off tiny pieces that we place on the points we are going to treat. We use an incense stick to light the piece of moxa. An affordable video is available at najom.org to teach this technique and a related technique with a bamboo tube. It would be money well spent.
What points do I typically find myself using for chronic Lyme patients? For the fatigue I frequently use CV-6, 12, TB-4. To descend the heat I rely on LI-11 and often ST-36 as well. The weak pulses can be treated with a little moxa on the respective back shu points, e.g., BL-20 moxa for a weak SP pulse. Other leg points can also be treated, such as SP-6, 9. Treating LR-5 is often helpful for shoulder complaints.
Many chronic Lyme patients have cold below, heat above. We see evidence for this if we assess the temperature of the feet and the chest and head. It is very common that the feet are ice cold and above is warm to the touch. This is taken as a sign of KD weakness. In these cases we want to make sure we do most of our moxa on the lower body, though LI-11 will be helpful in these instances as well. By lower body I mean below the umbilical plane.
One other thing to mention about chronic Lyme patients is that all of them have disturbed shen. It is in fact a hallmark of the disease. There is a unique type of anxiety that at this point is almost diagnostic for me. Above all keep your language always positive with these patients; they are so prone to putting a negative spin on anything that is said to them. What this type of moxa can contribute to anchoring and calming the shen is quite remarkable. It still surprises me even after years of witnessing it. Good moxa is magical.
So, what I recommend as a simple starter for those with chronic Lyme patients who are new to moxa is to do three pieces on each of the following points: CV-6, 12, TB-4, LI-11. Do that treatment along with the rest of what you are normally doing for the patient a number of times before you make a final assessment as to whether it has contributed something significant. At the end of treatment we could hope that the notably weaker pulses are in some measure stronger. Also if there were initially cold feet, we would hope to find them a bit warmer, and the shen of the patient should be significantly calmer.
In conclusion, for myself it is difficult to imagine successful Lyme treatment without direct moxa in the mix. I leave for another time a discussion of another moxa technique, chinetskyu, which can also be very helpful in these cases.