Chen Yong, Le Yi-min, Wei Jia

1 Integrative Medical Center of Fuda Cancer Hospital, Guangzhou 510660, China

2 Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China

Acupuncture-moxibustion Theories of Ge Hong

Chen Yong1,2, Le Yi-min2, Wei Jia2

1 Integrative Medical Center of Fuda Cancer Hospital, Guangzhou 510660, China

2 Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China

Acupuncture-moxibustion Theory; Literature Study; Moxibustion Therapy; Indirect Moxibustion; Emergency Treatment; Zhou Hou Bei Ji Fang

1 Life History

Ge Hong (261-341), courtesy name Zhichuan, also known as Baopuzi or Ge Xianweng, born in Jurong of Danyang (present-day Jurong of Jiangsu Province), was a famous Taoist and physician during the Eastern Jin Dynasty. He had a reputation for broad reading, and was enthusiastic over Huang Di Nei Jing (Yellow Emperor’s Classic of Internal Medicine) and Nan Jing (Classic of Difficult Issues), esoteric arts, and alchemy. He was once an official of the Eastern Jin Dynasty, but later lived as a recluse on Luofu Mount of Guangdong Province. His one hundred scrolls of Yu Han Fang (Prescriptions Hidden in Golden Chamber) was supplemented later by Tao Hong-jing and Yang Yong-dao, and became Fu Guang Zhou Hou Bei Ji Fang (Supplement Handbook of Prescriptions for Emergency) [Zhou Hou Bei Ji Fang (Handbook of Prescriptions for Emergencies) for short] nowadays, in which, convenient, low-price, and effective treatment methods were included.

2 Academic Theories of Acupuncture-moxibustion Therapy

2.1 Moxibustion for acute diseases

Zhou Hou Bei Ji Fang is the earliest existing monography on diagnosis and treatment for emergencies, documenting methods for various emergencies. Of the total 73 chapters, over 30 chapters record acupuncture-moxibustion methods, including 102 moxibustion formulae, 28 indications, and in some chapters acupuncture-moxibustion treatment is listed as the first treatment choice. It reflects the remarkable and subtle medical techniques of Ge Hong, which are worth exploring and researching by scholars of later generations (table 1).

Ge Hong adopted moxibustion to treat acute diseases, represented by the treatment of loss of consciousness. Zhou Hou Bei Ji Fang has given a full description of pathogenesis, manifestations, and acupuncture-moxibustion treatments for loss of consciousness. He believed that unconsciousness, attackby pestilent factors, and cadaverous coma should all be led by dysfunction of the yin-yang qi activities in human body or external environment, either qi blocking or imbalance by insufficiency or excess, which are life-threatening but still reversible, because the essential qi is not run out. In cases of loss of consciousness, it may happen after the diagnosis of disease, but may also occur without any suggestive signs or onset during sleep. There are various acupuncture-moxibustion methods in treating unconsciousness. For example, when there is a millet-like spot inside of the tightly-closed upper lip, we can use a needle to prick it; digital-needling can also be applied by pinching the patient’s Shuigou (GV 26) hardly and making him awakened by pain; moxibustion method such as applying moxibustion to Shuigou (GV 26) by 3 cones is also useful.

To promote the application among ordinary people, Ge Hong simplified the treatment methods for emergencies by selecting fewer acupoints in acupuncture-moxibustion treatments. Of about 100 moxibustion formulae, only over 20 acupoints were recorded. He said that it would be easy for ordinary people to handle if we describe the detailed locations of acupointa instead of only telling the acupoint names, when introducing moxibustion treatment. Therefore, he seldom mentioned the names of acupoints but usually gave minute description of locations instead, such as “3 cun below precordium”, “depressions bilateral to the spine”, and “below the medial malleolus and above the dorso-ventral boundary”. Besides, moxibustion can also be applied directly to the affected areas, majorly in cases of carbuncles and swelling. These all make it convenient for readers to use.

Table 1. Moxibustion methods for emergencies recorded in Zhou Hou Bei Ji Fang

When measuring and marking acupoints, he also used rope, bamboo and other measurements besides common ones. For example, he used a part of the body to mark the acupoints or selected points by pressing. These methods are easy to operate and memorize, and consequently suitable for emergencies.

In moxibustion for emergencies, extremities, chest, and abdomen are the most frequently selected areas; on head, there are only a few points usually selected, such as Baihui (GV 20), Chengjiang (CV 24), Shuigou (GV 26), and Dicang (ST 4); on back, vertebrae are often used. These are the crucial points used by Ge Hong in treating emergencies, and should call for our great attention. Regarding his acupoint selection, extra points occupy a large proportion, e.g. the four sides of umbilicus, Yaoyan (EX-B 7), Shixuan (EX-UE 11), Zhongkui (EX-UE 4), the big toe, medial malleolus, external malleolus, area under scrotum, the second thoracic vertebra, and the fifth thoracic vertebra. It is an important progress on the basis of Nei Jing.

2.2 Emphasizing partitioned moxibustion

Zhou Hou Bei Ji Fang is a quite early literature having partitioned moxibustion recorded, including garlic-partitioned moxibustion, salt-partitioned moxibustion, earthen-basin-partitioned moxibustion, and flour-pepper-partitioned moxibustion. Partitioned moxibustion not only enhances the treatment effect, but also reduces the pain produced by direct moxibustion, and thus it had become very popular at that time.

2.2.1 Garlic-partitioned moxibustion

Of all the partitioned moxibustion methods, garlic-partitioned moxibustion was the most commonly used one, such as in the treatment of swelling: a garlic was transversely cut at 0.1 cun and put on the head of swelling, and moxa made into size of phoenix tree seed was placed on garlic slice and ignited by over 100 cones. If swelling was not gone, moxibustion treatment should continue, the more the better. During the treatment, we have to pay attention that the temperature shouldn’t be too high during moxibustion, and the garlic needs lifting up when there is pain produced, and the garlic slice should be replaced by new one when it’s over-burnt, to prevent hurting skin and flesh.

Ge Hong once experienced this method by himself in treating a large swelling in lower abdomen, and the swelling was relieved immediately after moxibustion treatment, and he always achieved remarkable effect when using this method to treat swelling.

2.2.2 Salt-partitioned moxibustion

There are two different methods of salt-partitioned moxibustion. One is to fill salt into umbilicus. For example, in treating acute enteritis and dysphoric fullness, salt is filled into umbilicus and moxa is placed on salt to be ignited by 14 cones in total. The other one is to spit chewed salt onto wounds and then apply moxibustion. For example, in treating venomous snake bite, spit chewed salt onto the wound, and apply moxibustion by 3 cones, and then spit chewed salt again onto the wound.

2.2.3 Earthen-basin-partitioned moxibustion

Earthen-basin-partitioned moxibustion is a kind of fumigating moxibustion invented by Ge Hong, in order to treat spastic pain and numbness after stroke.

Method: Make dry moxa leaves into small balls and put them into a gallipot, then ignite moxa balls to fumigate the diseased areas.

2.2.4 Flour-pepper-partitioned moxibustion

Flour-pepper-partitioned moxibustion is often used to treat unbearable carbuncle pain.

Method: Make flour paste first and surround the carbuncle as a circle, then fill the circle with pepper and cover the carbuncle with a paste. Perform moxibustion on the paste till hot painful feeling produced around the carbuncle, and the patient can be recovered.

Besides, there is a tube fumigation method in treating external genitalia diseases, by burning moxa in a tube and induce the smoke into external genitalia. It will gain better effect if Xionghuang (Realgar) is added.

Thus it can be seen that Zhou Hou Bei Ji Fang has established multiply branches in the development of moxibustion.

2.3 Emphasizing the moxibustion order and the cone amount

Regarding the sequence of moxibustion, Ge Hong usually performed from yang aspect to yin aspect. For example, in the treatment of beriberi, moxibustion should be performed from “the top”, i.e. in the order from head to foot. Head is the joint of yang. Therefore, moxibustion on head firstly can achieve a faster regulation of yang qi. Treating from yang to yin aspect reflects his Taoism conception of emphasizing yang aspect and the theory that moxibustion tonifies yang aspect, and also manifests the importance to treat from yang to yin and adopting yang to restrict yin in the treatment of acute cold symptoms.

Moxibustion for tonifying yang aspect is also shown by the cone amount of moxibustion, which is often an odd number, e.g. 1 cone, 3 cones, 5 cones, 7 cones, and the multiples of seven, such as 14, 21, 28 etc., namely described as 2 plus 7 cones, 3 plus 7 cones. Odd number belongs to yang aspect, and ancient people often took 7 as the representative of yang, and that’s why Ge Hong adopted the multiple numbers of 7 to be the cone amount according to disease conditions and different requirements for tonifying yang with moxibustion.

It therefore follows that Ge Hong believed moxibustion majorly for enhancing yang aspect. Regarding that the recorded diseases and syndromes are mainly caused by excess of coldness or disorder ofqi activity, hence an odd number of cones should be spontaneously used in moxibustion for reinforcing yang, to achieve the best treatment effect.

3 Other Academic Achievements

Zhou Hou Bei Ji Fang is not only a monograph of medical prescriptions for emergencies, but also a quite early ancient medical classic of recording relatively many moxibustion treatments. It records totally 99 moxibustion formulae, which are widely used in treating diseases of internal medicine, external medicine, gynecology, pediatric, and ophthalmology and otorhinolaryngology. It takes a general view of the function, effect, operation, indication, and contraindication of moxibustion treatment. Moreover, Ge Hong also wrote and composed Shen Xian Zhuan (Biographies of Various Immortals) and Bao Pu Zi (Master Who Embraces Simplicity).

4 Summary

Ge Hong not only had a rich contribution to medical writings, but also was a famous Taoist leader in the Eastern Jin Dynasty. He not only had a great contribution to the development of Taoism theory, but also had a profound knowledge in various fields, making achievements in music and literature. His medical writings have played a relatively crucial role in enriching acupuncture-moxibustion theory and boosting the development of acupuncture-moxibustion technique.

Translator: Hong Jue

R2-09

A

Date: November 25, 2012

Author: Chen Yong, M.M., attending physician. E-mail: 13576049679@163.com