Many years ago a patient came into my acupuncture clinic and asked me if I had moxie. Huh? I have been described as many things, including intense, impatient, and opinionated, so I guess you could say I have moxie, but why was she asking? After a few minutes of conversation, I realized that she was actually asking about moxa, or moxabustion, a method of warming in Chinese medicine. Close enough.
Moxabustion is an ancient way of applying heat in Chinese medicine, sometimes used independently of any other treatment methods. It involves burning the wooly fuzzy stuff from the leaves of the artemesia plant, also known as mugwort. Moxa is 
not only warming, but it is also drying. The warming nature of moxa works to get things moving, such as blocked energetic pathways and joints with limited range of motion. It also has a very strong smell (more on that later) which is extremely penetrating.
When the weather turns cold and/or damp, many people have aches and pains that act up. What they need and want is a way to warm up their achy joints, and In Chinese medicine, moxa is just the thing. It’s most commonly used for conditions that flare up in the cold and damp as well as for patients who have depleted Yang, which causes them to feel cold down to their core.
Moxa comes in a number of different forms and can be used in a variety of ways. Loose moxa wool is sometimes burned directly on the skin. This sounds scary, and in some cases for good reason. The moxa is applied in tiny little hair-like twists, which are placed directly on the skin and lit. Typically the moxa goes out before anyone gets hurt, but it’s not a practice I have ever used because the risk of burns is high.
The loose wool can also be used to warm up acupuncture points by compacting and placing the wool on the end of acupuncture needles that have been inserted into a patient. The wool is lit, which warms the needle, gently and deeply heating the acupuncture point. Again, the risk of burns is high, mostly from moxa falling off the needles.
One of the most common and safest ways to use moxabustion is through the use of moxa poles. These look a little bit like long thin cigars that can be lit and placed near the skin in a slow pecking motion. Moxa poles burn very hot, so moving the moxa close to the skin and backing away is necessary to avoid burns.
Because moxa poles burn so hot, they tend to stay lit a long time after you’re done and have to be extinguished with care. One way is to place the burning end of the pole into a mug of salt or sand and let it go out on its own. You can also purchase a moxa snuffer which looks a bit like a candle stick, but holds the burning pole until it goes out. Finally, you can wrap the lit end of the moxa in aluminum foil and place the pole in your oven until it it no longer hot.
Moxabustion also comes in the form of small cones. The moxa is usually set on a cardboard base, which is placed on the skin and then lit. The moxa goes out when it reaches the cardboard, so the risk of burns is low. Moxa cones tend not to burn as hot as moxa poles, but can be effective for some mild conditions.
Moxabustion is not for everybody. It generally shouldn’t be used on people with hot patterns. In addition, moxa is contraindicated in people with elevated blood pressure. Care using moxa should also be taken if a patient has numb areas, because they risk being burned if they’re unable to tell if the moxa is too hot. Finally, moxabustion should not be performed on the low back or abdomen of pregnant women.
Okay, about the smell. Moxabustion smells strong, which is good…and bad. The smell is penetrating and enters the energetic pathways of your body, which is therapeutic. In addition, the smell works a little like aromatherapy, which affects you through your sense of smell.
The problem with moxabustion is that is pretty much smells like you’re smoking pot when it’s lit. This isn’t a big deal if you’re in your own home, but in a busy office building, it’s an issue. The first (and only) time I lit moxa in my office, the smell was picked up and passed through the ventilation system to every other office in the building, including the accountant and psychologists down the hall. Not cool. When my practice partner, Shelley, tried to use moxa on a patient outside of our office, someone called the cops. I love my office, so now instead of using moxa in my clinic, I use a far infrared lamp to warm my patients in much the same way as burning moxa. Fortunately and unfortunately, there’s no smell.
