The therapeutic application of heat is a non-invasive practice. It encourages muscle relaxation, diminishes stiffness, locally increases blood circulation, stimulates the immune system… It is effective against pain. It has a special place in Traditional Chinese Medicine, where it is called Moxibustion.
Moxibustion, a thousand-year-old practice
The term moxibustion is inseparable from acupuncture, in the Chinese ideogram. The recent discovery of very old manuscripts in a Chinese tomb
(Ma-Wang-Dui) leads one to think that moxibustion might well be earlier and even at the origin of the definition of meridians and acupuncture! Used for millennia, stimulation by the heat from the flameless combustion of Artemisia is a daily practice, in China, of course, and also in Japan. It is currently the subject of scientific research and important clinics highlighting the many and various physiological mechanisms involved. For example, work has shown that the stimulation of specific points –bilateral 6Spleen / 67Bladder / 1Kidney – encourages the repositioning of the fetus in cephalic position in the weeks pre-ceding delivery.
Less impressive than needles
The old texts recommend very wide use of moxibustion, on a par with acupuncture. They present this technique as simpler, but also ta-king longer to apply, even if the results of the treatment are often quicker and more durable…The energy provided is obviously indicated in all the states of emptiness (Blood emptiness, Energy emptiness), being affected by perverse energies, Wind, Cold and Dampness, and also in the reduction of excess, in the cases of Damp Heat, for example.
All the deficiency syndromes are associated with a decrease of the defensive system. It is also always useful to reinforce the immune system, for both prevention and treatment. External energy intake is often more effective than just mobilising the energy of the patient, especially if the latter is limited or deficient.
Moxibustion is yang
Specifically, it is yang in nature, but it can tone yin and yang, qi and blood. It warms the cold, warms and reinforces the yang, and can also tone the yin, applied to the yin meridians that also transport the qi.
It allows quick mobilization of the Blood and Energy, eliminating stasis.
Your own experience is paramount
The practical application of moxibustion is per-fectly described in all the works dealing with Traditional Chinese Medicine, and is doubtless already part of your practice. Simply remember that the two basic medical counter-indications, in Traditional Chinese Me-dicine, are excess heat and the emptiness of Yin with heat or fire. Other counter-indications are relative and de-pend on the condition of the patient and the experience of the practitioner.
Scientific research identifies how moxibustion works
Thermosensitive ion channels
Researchers have identified 9 as being ther-mal sensors, each activated by a specific tem-perature threshold.These ion channels belong to the superfamily of the Transient Receptor Potential (TRP) and are identified as Ther-moTRP (TRPV1,TRPV2,TRPV3,TRPV4,TRPM2, TRPM4, TRPM5, TRPM8 and TRPA1). Studies have shown that these thermosensors were already present in the common ancestors of fish and tetrapods. Some have even been found in invertebrates. The evolution of vertebrates took place along the same lines, adapted to the specific needs of the species and their environment. For hu-mans, 15°C and 43°C represent the thresholds of unpleasant or painful sensations, and 6 ThermoTRP have been identified (of which 2 concern us more specifically here, TRPV1, triggered above 43° C, and TRPV2 above 52° C), that are also found in the corresponding primary neurons (sensory) as well as in all tissue. Each nociceptor has several ion sensors: sensitivity is very fine and extremely reactive.
Moxibustion, therefore, works by involving specific receptors
These thermoreceptors do not respond to mechanical stimulation. (As a reminder, recall that the mobilized mechanical receptors in acupunctural analgesia use the A-beta fibres, which are thicker fibres). The information mobilizes then the fine A-delta fibres and the C polymodal fibres, as well as the central neurons and the cells of the spinothalamic track. The inhibiting inter-neurons modulate nociperception, through DNIC (Diffuse Noxious Inhibitory Controls) that block part of the nerve information from moving back up towards the central nervous system (CNS) and cause local analgesia, but which take more time to implement and are more moderate than that induced by puncture. At the local level, the stimulation of the thermoreceptors (and other polymodal receptors) triggers the liberation of a number of mediators (substance P, somatostatin, …) that act immediately while causing inflammation:
– an initial vasoconstriction, of very short duration, probably a reflex of the vessel wall- an initial vasoconstriction, of very short duration, probably a reflex of the vessel wall- vasodilatation and increased blood flow, by antidromic stimulation of the corresponding axon- activation of the mast cells, and more generally the immune system (increase in white blood cell count and activity), over a rather long period (more than 2 weeks)
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