Why Moxa Zu San Li?

Zu San Li (ST36) is a very famous acupuncture point that is used not only for inserting needles but also for applying moxa. One such advocate was Dr Shimetaro Hara who lived to over 100. He also approved of the New Moon Eight Day Method. This method entails daily rice grain moxibustion from the start of the new lunar month at new moon for 8 days.

'Moxibustion on ST36 has been famous in Japan since the olden days as a regimen for health and longevity. In the Edo period (1596-i868) a farmer by the name of Manpei in the district of Mikawa is said to have lived to the age of 300 by applying moxibustion on ST36 religiously. Manpei was summoned at the age of 196 to be questioned by officials on
his secret to longevity. When he was 242 he was invited to the opening of the Eitai Bridge in Edo. In addition to Manpei's extraordinary longevity, many members of his family lived to an extremely old age. We can safely assume that this reported age is likely to be a significant exaggeration.

In Japan there is an old saying, "Don't go on a trip with anyone who doesn't moxa ST36." (This came from a time when most travel was by foot.) Dr. Hara is reputed to have said that regular moxibustion on ST36 would "destroy doctors." His approach involves burning seven rice grain sized cones (about 2-5 mm at the base and 5 mm high) on adults and one to three on little children. If done everyday, this would mean burning more than 5110 cones on both legs in a year- The generation of small amounts of "histotoxin" in this way enhances hematological functions to its highest possible level, and is thus effective in promoting health. The reason Dr. Hara suggests rice grain sized cones is because the combustion temperature of these cones is between 70 and 80 degrees Centigrade, which he considers to be the most effective temperature for the production of "histotoxin".

What tools will I need to perform moxa?

As a minimum to perform rice grain moxa you will need some high quality gold moxa and some incense to light it with. Generally japanese style incense such as senko is more preferable, however extruded solid incenses such as tibetan incenses will also work. In a bind, normal everyday incense will work quite well.

To make rolling the moxa easier you can also use small cork or wooden boards for the purpose. I provide balsa wood boards available from a craft store to my patients to assist with rolling their moxa.

The final thing required is a medium to stick the small moxa cones to the skin. Both ointments and water can be used to adhere the moxa. 

Method of applying rice grain moxa

A simple way of applying rice grain is first to get everything you need ready and then follow the method below. Videos of each step can be found below the text.  Remember that at first this can be a little awkward but you will become better with time.

 Locate Zu San Li: 

There are many methods of locating Zu San Li. A simple approach is to hold your hand underneath your patella and mark a line below where your little finger meets the skin. Then mark another intersecting line 1-2 finger breadths laterally from the tibia (shin bone). Usually you will find a palpable tenderness in this area. Refer to the Picture below for guidance

Rolling Moxa

Roll out a small piece of gold moxa (split mung bean size) into a thin long worm either by hand or using two small boards. If using the boards do this lightly as a tightly compressed piece burns hotter and slower. A simple way of checking if you have rolled the worm too tightly is to to hold it by one end and see if it stands up. If it does it has been too tightly compressed and start again. Aim to ensure the moxa worm is about 2mm thick or so. 
Keep the moxa worm held between thumb and forefinger of your left hand

Adhering moxa cones
 

A medium such as water or ointment is needed to adhere the moxa cone to the marked point. Ointments such as Shiunko, Ching Wan Hung burn cream or even a Chapstick can be used. I have found that ointments can get on your fingers, making them greasy causing difficulty in placing the cones and water is more preferable.  Traditionally the practitioners saliva was used to place the moxa cones, now due to modern asepsis requirements this method is no longer used. Instead special silver rings which can hold wet cotton wool balls can be used or even a small bowl of water. I find a small soy sauce dish with a wet cotton ball placed in it works just as well.

Making the rice grain

Small pieces of moxa are pinched off the worm held in the left hand by the thumb and forefinger of your right hand. Generally one should aim to pitch off a piece 3-4mm long, the size of a rice grain. Roll the end of the small piece of moxa with a small motion once between the thumb and forefinger prior to placement to ensure the tip has a tapered end. This tapered tip reduces the contact area between the moxa and the skin and reduces the heat sensation. Now place the cone carefully onto the shiunko/water of the point being treated. 
 

Lighting moxa and mediating heat

Now it is time to light the small moxa cone. This is best achieved by using the end of a lit stick of incense held between the first knuckles of the forefinger and ring finger. To prevent the piece of moxa being lifted off with the ash tap or blow of the ash prior to lighting the moxa. The moxa will take only a few seconds to burn down.

To mediate the heat of the moxa burning to the skin a number of methods can be employed. One easy method is to cowl the moxa with the thumb and forefinger of the right hand when the moxa cone has burned 75%. This interrupts the oxygen supply to the moxa and extinguishes it. Other methods of heat mitigation include tapping it out with the forefinger when it has reached 75% or pressing or stretching the skin around the area of the moxa. 
 

Moxa Dosage

As mentioned above the New Moon Eight Day method of moxibustion for longevity requires one to moxa the acupoint Zu San Li on both legs daily from the first day of the new moon to the eight day. The date of the upcoming new moon can be found here. Dosage when discussing rice grain moxa is given in cones. This means how many cones should be applied. This method requires that 7 cones are applied to the acupoint each leg.  For those beginning to try this technique 3 cones are sufficient and likely to offer benefit

Cautions

Traditionally this method is suggested best to be applied after the age of 30. In some classical  texts it is suggested that use of this point prior to this age can predispose oneself to eye disorders, although there is no evidence to suggest this is true.

If done correctly and carefully the risk of small burns and scars can be minimised. On occasion a small blister may develop. If this does occur cease moxibustion at that site, avoid piercing the blister, keep the area clean and allow it to heal naturally.

This article is for informational purposes only and is not to be considered either instructive or health advice. Readers are advised to contact their Chinese medicine practitioner for advice specific to their circumstances.  

Call us to arrange an appointment on 03 9041 6569 or click the button 

Sources:
1. http://toyohaript.files.wordpress.com/2010/01/najom-dr-hara.pdf
2. http://www.culia.net/local121721moxa.html Source of the videos