Rice grain moxibustion is a traditional technique particularly associated with Japanese acupuncture and moxibustion practice. Known as okyū, it involves the use of very small pieces of processed mugwort, or moxa, applied to selected acupuncture points.
One of the best-known points associated with this practice is Zu San Li (ST36), located on the lower leg. Zu San Li has a long history in both Chinese and Japanese medicine, particularly in traditional accounts of health, vitality and longevity.
This article explores the historical New Moon Eight Day Method, the practice of rice grain moxibustion and the traditional dosage and cautions described in Japanese medical literature.
Why moxa Zu San Li?
Zu San Li is one of the most frequently discussed acupuncture points in classical Chinese medicine. It is used in acupuncture and moxibustion and has a particularly interesting place in Japanese traditions relating to longevity.
One advocate of this practice was Dr Shimetaro Hara, a Japanese physician who investigated moxibustion and its physiological effects. Hara reportedly lived beyond 100 years of age and advocated regular rice grain moxibustion at ST36.
Japanese folklore also tells the story of Manpei, a farmer from Mikawa who was said to have lived for 300 years through regular moxibustion at Zu San Li. His extraordinary age is clearly a legendary account rather than a reliable historical fact, but the story illustrates the importance traditionally placed on this point.
An old Japanese saying advises against travelling with someone who does not use moxa at ST36, reflecting the historical association between moxibustion, physical endurance and long journeys made on foot.
These accounts are interesting aspects of Japanese medical history. They are not evidence that moxibustion increases lifespan.
What is the New Moon Eight Day Method?
The New Moon Eight Day Method is a traditional Japanese practice involving rice grain moxibustion at Zu San Li on both legs.
As its name suggests, the practice was traditionally carried out over eight consecutive days, beginning with the new moon.
The method involves repeated applications of small moxa cones at ST36. The number of individual cones applied was an important part of the historical practice, with the amount described as the moxa dosage.
The lunar timing and repeated applications reflect traditional approaches to maintaining health. There is no established clinical evidence that performing moxibustion according to this particular lunar schedule improves health or extends life.
How was rice grain moxibustion traditionally performed?
Rice grain moxa uses finely processed mugwort, traditionally formed into small cones approximately the size of grains of rice.
In Japanese direct moxibustion, these miniature cones were placed at selected acupuncture points and ignited. The burning moxa transferred heat directly to the skin.
Practitioners developed different approaches to preparing the moxa, forming the cones and managing the heat. The consistency of the moxa, the size of the cones and the control of the burning material were considered important aspects of the practitioner's skill.
Historically, different forms of direct moxibustion were practised, including methods intended to produce varying degrees of skin reaction. Some techniques could result in blistering or scarring.
This differs from indirect moxibustion, where the burning material is separated from the skin.
Although rice grain moxa uses very small amounts of material, its size does not eliminate the potential for burns or other skin injuries.
Traditional rice grain moxa dosage
In rice grain moxibustion, dosage refers to the number of individual moxa cones applied, rather than the length of a treatment session.
Historical descriptions associated with Dr Shimetaro Hara refer to seven rice-grain-sized cones at Zu San Li on each leg per day.
For the New Moon Eight Day Method, these applications were traditionally repeated over eight consecutive days, beginning with the new moon.
Three cones per leg were also described as a more conservative historical dose, particularly for people less familiar with the technique.
These quantities are included to document how the method was historically practised. They are not contemporary dosage recommendations or instructions for self-treatment.
Even small amounts of burning moxa can cause skin injury, and neither quantity should be interpreted as an established safe starting dose.
Traditional cautions and contraindications
Historical Japanese moxibustion literature also included cautions about when and for whom the technique was considered appropriate.
One traditional recommendation was that this particular longevity practice should generally be undertaken after approximately 30 years of age.
Some classical accounts suggested that applying moxibustion at Zu San Li earlier in life could predispose a person to eye disorders. This reflects traditional medical beliefs; there is no established clinical evidence supporting that proposed relationship.
The original descriptions also recognised the possibility of local skin reactions, including blistering and scarring.
From a contemporary clinical perspective, direct moxibustion carries risks including burns, blistering, infection, scarring and potentially significant injury. Individual health circumstances, skin condition and sensitivity to heat may affect those risks.
These modern safety considerations should be distinguished from historical contraindications, which arose from the medical understanding of their time.
Learning more about rice grain moxibustion
Rice grain moxibustion is a technique requiring appropriate training, individual assessment and careful management of heat applied directly to the skin.
If you're interested in learning more about the method, I recommend discussing it with a registered Chinese medicine practitioner who has specific training and experience in direct moxibustion. They can explain the traditional practice, its risks and whether it is appropriate for your circumstances.
The detailed step-by-step preparation, ignition and application instructions previously included in this article have been removed because of the potential risks associated with performing direct moxibustion without appropriate training and supervision.
The historical description, eight-day schedule, traditional dosage and cautions have been retained for educational purposes.
I strongly discourage readers from attempting to reproduce these techniques on themselves or others without appropriate professional assessment and instruction.
Anyone who has received individual instruction from a treating practitioner should follow that practitioner's specific directions and precautions rather than relying on general information published online.
Rice grain moxibustion in Japanese medicine
Japanese acupuncture and moxibustion traditions have developed a variety of techniques, including direct and indirect methods of applying heat.
Rice grain moxibustion is particularly interesting because of the attention given to the preparation of the moxa, the precision of its application and the historical importance attached to particular acupuncture points.
Earlier explanations of moxibustion sometimes referred to theories about the blood, immunity and substances such as histotoxins. These formed part of historical attempts to explain the practice and should not be taken as established physiological effects.
The traditions associated with Dr Hara, Zu San Li and the New Moon Eight Day Method remain valuable subjects for understanding the history of East Asian medicine, even where their proposed health benefits have not been established through modern clinical research.
Historical sources and further reading
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Sources:
1. http://toyohaript.files.wordpress.com/2010/01/najom-dr-hara.pdf
2. http://www.culia.net/local121721moxa.html Source of the videos