The practitioner can grasp it through various changes of the patient, such as flare, sweating, the skin getting brighter, tissues getting tightened.
Next, concerning the amount of stimulation influencing the body, it depends on the duration of stimulation and the durability of the treatment effect.
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About moxibustion, the amount of stimulation is influenced by the duration of performing moxa treatment, but even during the same period, it also affected by the numbers of moxa cones. Shorter the interval between each cones, the influence is stronger. In addition, it also related to the amount of heat, when performing moxibustion with the certain amount of heat and certain interval, the amount of stimulation gets stronger in proportion to time.
However, the weak point of moxibustion is that the practitioner cannot judge whether the amount of stimulation is appropriate or not during the treatment, and this is different from acupuncture.
But, concerning the persistence of the effect to the body after the treatment, it can be inferred that the moxa effect mentioned above is more persistent than needling. Clinically speaking, when the interval of treatment sessions is short, for example treating the same patient twice or three times a week, one has to be sure to lessen the amount of moxa in each session. If one ignores this, sometimes the patient gets the state not being able to consume heat properly, such as eczema on the skin, increasing yang excess condition and so on.
In this way, the practitioner can adjust the amount of stimulation during treatment, what one always has to keep in mind is the most appropriate amount of stimulation. Some people might think that more serious the patient's condition is, the practitioner adds stimulation more. However, to absorb the certain amount of stimulation, it requires certain power for the recipient body as well. If one increases the amount of stimulation more than enough, it leads to the indigestion of the amount of stimulation, rather the condition gets worse.
Concerning the quality of stimulation of acupuncture and moxibustion in this way, the light stimulation is more suitable with needling, so when the disorder of qi is on the surface, and conversely when the patient's condition is extremely serious and the damage of qi is as deep as the shape of the body changes, the stimulation of acupuncture is more suitable because it makes the body itself fill out the qi, in other words creating heat on one's own.
What is the condition suitable for moxa stimulation then? You can imagine the old human body for this. That is, the condition that qi is loosen all over the body, and when the body itself does not have enough power to create heat, moxibustion is suitable for these condition regardless of age.
Another issue is whether we can consider inner bladder line, outer bladder line, JJ line and the GV channel as equal in terms of the quality and quantity of stimulation. As mentioned before, the response closer to the GV channel indicates more severe the deficiency of Jin qi is. Especially the GV channel is important in this state.
Clinically speaking, for the symptoms difficult to change, for example, serious knee pain, lower back pain, inner organ pain and heat of inner organs, one can experience the symptom released after moxibustion on GV channel.
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However, one has to pay attention when the patient is in condition is as serious as he/she cannot absorb the heat of moxibustion. Multiple cones of moxas on GV channel might cause deterioration of symptoms instead, so the practitioner has to be careful. One starts from two or three cones, checking the condition, and stops it if one thinks the change is not what expected.
As a conclusion, needling is the base for the stimulation to the body, and for the moxa stimulation, it is important to check whether or not the patient has enough power to accept it.
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*This article is translated from the book of "Toyo igaku koza dai 10 kan, Keiraku-Shakuju chiryo hen (Oriental Medicine Lectures, Vol.10, Meridian Shakuju Treatment)"