Native Plant Turns Fate of Breech Pregnancy

By Joshua Herr, L.Ac.

The cesarean rate for diagnosed breech presentations rose from 12% in 1970 to more than 95% today. A fetus that is in a breech position has its head at the top of the uterus instead of down against the cervix. This can create complications during delivery. For women who are planning on having a vaginal birth, this is a shocking statistic.

The trend began in 1959 when Dr. Ralph Wright called for mandatory cesareans for women with a baby in the breech position. The move towards mandatory cesareans for breech babies is affecting the clinical training of obstetricians and midwives, as fewer are having the chance to witness a vaginal breech birth. Coupled with the threat from malpractice insurance companies to not provide coverage for hospitals that permit planned vaginal breech births, the clinical skill is in jeopardy.

Acupuncturists are turning fate around for women with a breech presentation. A common plant found in the mountains and abandoned plots around North Carolina is the method of choice. The plant is called Artemisia vulgaris and has been used in Chinese medicine for thousands of years to stimulate acupuncture points with heat. The plant is dried and repeatedly ground and sifted until it forms into a soft, golden fluff called moxa.

Moxa is burned at a safe distance from the skin to gently stimulate selected acupuncture points. For women with a breech diagnosis, the point chosen is called Zhi Yin (Reaching Yin) and is found on the outside edge of the little toe.

In 1998, JAMA published a study led by Dr. Cardini, which demonstrated that moxibustion applied to Zhi Yin for 1-2 weeks beginning at the 33rd week of pregnancy resulted in the fetus turning head-first after treatment and at delivery. Cardini's group demonstrated over a 75% chance of success using the moxa technique.

Acupuncture is a safe and effective treatment for women during pregnancy. Acupuncture can resolve muscular pain that occurs during pregnancy and is a treatment of choice for a mother concerned about taking pharmaceuticals.

Women with severe morning sickness are also finding that the holistic approach of acupuncture is the best approach. Incorporating breathing and relaxation exercises along with acupuncture treatment, an expectant mother with morning sickness can keep food down and nourish her body, as well as her baby.

Induction of labor can also be performed with acupuncture. When using acupuncture to induce labor, contractions increase gradually, which gives the mother's body time to safely transition into active labor.

The current age of medicine has brought a tremendous wealth of skills and knowledge, both old and new. As science moves forward with new medical breakthroughs, it is also important to keep old methods of effective procedures alive. A medical community that thoughtfully integrates innovation with antiquity will have the resources available to meet the future's healthcare needs.

In Depth: Moxibustion

By Rachel Nowakowski, L.Ac.

As you walk into the Clinic, you often notice the familiar smoky odor of moxa. New patients usually ask, "What's that strange smell?" Some people love it, others do not.

What is moxibustion and what is it used for?

Moxibustion is a method of heating specific acupuncture points on the body by burning an herb material close to the skin. This technique can be used alone or in combination with acupuncture. In fact, the Chinese character for acupuncture literally means "acupuncture-moxibustion." The basic purpose of moxibustion is to warm the meridians to promote circulation of qi and blood.

What is moxa made of?

The herb material used is mugwort (Artemisia vulgaris, Ai Ye) an invasive weed, which grows in many climates, including Western North Carolina. Mugwort has a long history of use in folk medicine. It is believed that the Romans planted mugwort by roadsides to make it available to travelers to put in their shoes to relieve aching feet and protect them from exhaustion. Added to bath water, it is a soothing treatment for relief of muscle and joint aches - perhaps due to its ability to enhance the movement of qi and blood.

Mugwort gets its botanical name from the Greek moon goddess Artemis, a patron of women, and is a wonderful herb for gynecological conditions. In Chinese Herbal medicine, it is categorized as an emmenagogue, an agent that stops bleeding. Internally, it is used for heavy menstrual bleeding and uterine bleeding. It also increases blood circulation to the pelvic area to treat menstrual pain. Taken internally, it can warm the uterus and is used for threatened miscarriage. Moxibustion has successfully been used to turn breech babies into a normal head-down position prior to childbirth by increasing fetal movements.

Why mugwort and not some other herb?

Some sources say that mugwort is used because of its acrid, spicy odor. This property makes it able to travel through all of the meridians, regulate qi and blood, and expel cold. In addition, its bitter nature helps to resolve dampness. One of mugwort's active components, borneol, is commonly used in topical therapies for its analgesic effects.

Other explanations for the use of mugwort, as opposed to some other herb material, is that it grows easily in many places, is inexpensive, holds its shape when rolled or pressed, and burns slowly.

An additional benefit of moxa is that the smoke may help to prevent transmission of diseases when used in acupuncture clinics. In hospitals in China, incense made of artemisia and other herbal ingredients has been used to inhibit viruses and to reduce the bacterial count in the air.

What is moxibustion used for?

• To warm meridians and expel cold. Cold slows the flow of qi, resulting in stagnation and pain. Moxa is used for pain that is worse with exposure to cold or damp weather, as with some types of arthritis pain.
• To promote the smooth flow of qi and blood. Used on the abdomen, moxa helps with digestive problems or menstrual pain due to stagnation. It can be used to promote circulation over areas of chronic pain or muscle tension.
• To guide qi and blood upward or downward. Energies in the body must flow in the correct direction. Disruption of this movement results in disease. For example, moxibustion at the point Kidney 1 (on the sole of the foot) guides qi downward and is used to treat disorders caused by excess energy in the upper body, like headaches or dizziness.
• To strengthen yang from collapse. Yang collapse refers to extreme exhaustion, shock and fainting. Moxa can be used to restore the yang and revive the patient.
• To prevent diseases and maintain health. Moxibustion can be used as a tonification treatment to help strengthen the organs and immune system.

What are the different techniques of moxa?

In the Clinic, we mostly use indirect types of moxa: needle moxa, stick moxa and moxa bowls. With all moxa, the patient feels a mild to moderate heat sensation on the area being treated.

• Needle moxa: a rolled piece of moxa is placed on the end of an inserted needle and ignited.
• Stick moxa: a moxa stick (about the shape and size of a cigar) is lit and held close to the skin.
• Moxa bowls: pieces of moxa are inserted into a small disk that is placed on the skin.

Moxa can also be used with other substances to give different effects. For example, a piece of moxa can be placed on top of a slice of fresh ginger for severe cases of digestive weakness. Moxa can be placed on top of salt applied over the belly button to treat hernia pain or prolonged diarrhea.

Another type of moxa is direct moxa. In direct moxibustion, a small cone of moxa is placed directly on an acupuncture point and burned, but is extinguished or removed before it burns the skin. The patient experiences a heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring.

Traditionally, direct moxa involved scarring moxibustion. The moxa would be placed on a point and left on the point until it burns out completely. This would lead to localized blisters and scarring after healing. The prolonged healing process is thought to increase qi and blood flow to the point, making the treatment stronger. This type of moxa therapy is not done at the Clinic.

Any type heat applied to the body can increase the flow of qi and blood. Heat lamps, heating pads or warming liniments can give a similar effect to moxibustion. But the heat combined with the powerful healing properties of mugwort gives moxibustion a proven advantage.

References:

Chinese Acupuncture and Moxibustion, Beijing: Foreign Language Press, 1987.

Subhuti Dharmananda, Ph.D., 'Moxibustion: Practical Considerations for Modern Use of an Ancient Technique'

www.acupuncturetoday.com/abc/moxibustion.php

Providing Chinese Medicine in Rural Guatemala

By Eric Aufdencamp, L.Ac.

In May 2008, I had the privilege of doing volunteer work with a non-profit called GUAMAP, the Guatemala Acunpuncture and Medical Aid Project. The organization sends Spanish-speaking acupuncturists and other health care volunteers to remote villages in northern Guatemala. They teach health promoters acupuncture skills so they can treat those in need. Health promoters are Guatemalans who receive special training in basic medicine to help the people in their communities. I am looking forward to returning this summer as well.

The first time around each practitioner was interviewed to assess the effectiveness of their treatments. Everyone responded that they were pleased with their results. They also reported that the demand and request for treatments continues to grow.

One of the more seasoned practitioners was pleased to tell us about a practitioner from the level two training, who had successfully treated four cases of poisonous snake bites with moxa. He was impressed, because he had always had access to western medicine and did not want to take the risk of seeing if the treatment would be successful. However, his colleague, who did not have any other options since he lived far from any western medical facility, treated him just with moxa.

The health promoters are working to create a local acupuncture committee to support each other, as well as to improve their status as health practitioners. Indeed, many of them provide other types of healthcare education, such as oral hygiene. The level of enthusiasm and interest in Chinese medicine shows that it will continue to flourish in a country where many lack access to basic medical services.

During my time teaching and treating patients, I was reminded of the ability of Chinese medicine to heal and improve the lives of so many people. I look forward to working with GUAMAP again this year and thank all of you who so generously supported my participation in this wonderful program.