I was very surprised to see the article entitled “Unusual skin findings in a patient with liver disease.”1 The title implies that the skin manifestations described are due to liver disease and it also highlights that these findings are unusual.
Moxibustion has been used extensively in the Far East (Southeast Asia, China, India and Japan) for many centuries and for many kinds of diseases, including pleurisy, pneumonia, abdominal pain, chest pain and local pains, and is equivalent to the Western medicine practice of prescribing hot compresses as an anti-irritant to attract white blood cells and antibodies to the irritated area.
The term moxibustion refers to the application of a small amount of a dried plant material (Artimisia moxa), but it usually also involves scraping the skin with, traditionally, copper coins to create redness (see the right-hand figure in the CMAJ article). Glass cups are also used; these leave much larger marks than the ones shown in the left-hand figure (usually 2–3 cm in diameter). A drop of alcohol is placed in the cup, lit with a match and immediately applied to the painful area. Instantly, the flame goes out as the 20% oxygen is used up; the skin is sucked up into the cup and allowed to stay in place for a few minutes (creating a red area) and then pulled off. This process is sometimes associated with acupuncture.
I lived in China for 16 years and saw innumerable people with these skin manifestations.
Dwight I. Peretz Professor Emeritus Faculty of Medicine University of British Columbia Vancouver, BC
Reference
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