Ode to the TDP Lamp

While teaching a preceptorship class at a school, I found myself asking for a TDP lamp from the student clinic only to be told that the lamps were all in storage. It was at that moment that I realized that many, or even most, practitioners do not use TDP lamps much in their practices. In my clinic, however, many of my patients receive TDP heat therapy while their acupuncture needles are retained. We started using TDP therapy instead of conventional moxibustion to accommodate the large number of patients who were unable to tolerate the smoke, whether firsthand or secondhand, produced by burning dried mugwort. Given my extensive experience with TDP lamps, it seemed worthwhile to explain the how and why of their successful use in my clinic for almost 25 years.

Acumoxatherapy

If practicing Chinese medicine in translation, it may not be apparent that the actual Chinese term for the care most of us provide is 针灸 zhen jiu or acumoxatherapy—i.e., a term for a modality which includes both acupuncture and moxibustion. In Chinese, these two form a yin-yang pair, with acupuncture, literally “needle”, being the yin component, and moxibustion comprising the yang component. Considering the pride of place afforded moxibustion in this amalgam term, heat therapies should logically play a major role in clinical work, administered whenever circumstances warrant their usage.

Moxibustion generally conjures up images of the smokey combustion of dried mugwort, but the Chinese term 灸 jiu is considerably broader in meaning. Generally speaking, moxibustion or 灸 jiu refers to any Chinese therapy that employs heat. This includes not only the familiar pole moxibustion, direct moxibustion, and their variations, but also techniques as seemingly disparate as sun moxibustion and moxibustion with agents which chemically generate the feeling of warmth on the skin. Considering the large number of treatments which fall under the umbrella term of moxibustion, some translators have proposed the term “cautery” to better describe all of the various moxibustion methods.

Clearly, TDP heat lamps are included under the rubric of moxibustion. Once we understand TDP heat therapy as a form of moxibustion treatment, the regular clinical use of TDP lamps ensures that patients are able to receive the full spectrum of care, from yin acupuncture to yang moxibustion. In school, however, we are taught that moxibustion is indicated for cold and contraindicated with signs and symptoms of heat. Here we examine the indications for “electric” moxibustion with a TDP lamp and explain why moxibustion (especially the gentle moxibustion of TDP heat) may be warranted more often than we are taught.

Indications for TDP Heat Therapy

The Huang Di Nei Jing Yellow Emperor’s Inner Classic observes that if acupuncture fails, one should use moxibustion. Noted Chinese medical authority Bob Flaws explains that it is simply the intensity of the moxibustion heat, delivering a stronger stimulation, that explains why moxibustion can achieve results when acupuncture alone cannot. Regardless of the exact reasons, heat therapies have been seen as a a highly effective form of care since the early beginnings of our medicine, so heat therapy is always worthy of consideration.

One of the actions of moxibustion is to supplement qi. If we consider that warming is one of the five basic functions of qi, we understand why warming treatment can boost qi. The living body is, after all, inherently warm and begins to cool at the moment of death. By warming the body using moxibustion, we not only treat cold but can also increase the availability of qi in the body. In addition, since heat, based on its relationship to qi, can move and transform, moxibustion also has the ability to remediate stagnation. These actions make moxibustion, especially the mild, dispersed heat of TDP therapy, clinically indispensable.

We are cautioned in school about using moxibustion with heat signs and symptoms. While one might argue that anyone will benefit from a method that supplements qi and eliminates stagnation, every modality has contraindications. In cases with high heat effusion, i.e., a high fever, or severe local inflammation (mumps or measles would be good examples), one should avoid any heat therapy, including TDP lamps. On the other hand, there are cases where, despite moderate heat signs and symptoms, it can be beneficial to use a TDP lamp to dissipate and disperse evil heat, paradoxically using therapeutic heat to resolve pathological heat. (This method is utilized in dermatology.)

Practical Guidance on Using a TDP Lamp

There are many reasons to favor TDP lamps over other forms of moxibustion. Unlike using moxibustion that requires combustion of mugwort, TDP heat therapy does not generate the smoke or odor which can be very tricky given your clinical space or patient preferences and needs. As the practitioner, you, too, are spared excessive exposure to secondhand smoke. Once mastered, TDP lamps do not demand as much clinician effort or oversight and are far safer to use. Finally, TDP heat therapy is more environmentally friendly and economical than moxibustion which involves the consumption of materials. TDP heat lamps even offer unique therapeutic benefits not provided by any other form of moxibustion (see note).

In our clinic, we often place the TDP lamp at ST-36. This is inspired by Daoist yang sheng longevity techniques based on the principles that “the spleen fears cold” and “the spleen is the latter heaven source of engenderment of qi and blood”. By warming the center burner and, thus, supporting the spleen’s engenderment of righteous resources, one can produce more qi and blood to replete the channels and improve the efficacy of acupuncture, not to mention the benefits to overall health.

Similarly, the TDP lamp, called 神灯 shen deng or spirit lamp in Chinese, can be positioned during acupuncture over REN-4 guan yuan, REN-6 qi hai, or DU-4 ming men on the lumbus to warm and assist yang. Another option is to use the lamp over patients’ feet above KI-3 tai xi for a similar kidney-boosting effect. Each of these placements of the TDP lamp follows the ancient yang sheng methods for wellness and longevity proven over thousands of years.

Alternatively, TDP heat therapy can be used as a substitute for pole or direct moxa treatment by positioning the lamp over selected points. This application, however, is often not ideal as TDP lamps do not offer the focused accuracy of conventional moxa therapies. Using TDP instead of moxa for stimulating individual points only makes sense when moxibustion with mugwort cannot be utilized—for example, when a patient presents a pulmonary condition which contraindicates using a smokey therapy. In these cases, one might also consider using a moxa extract on the point with the TDP heat therapy to better replicate traditional moxibustion. Moxa tinctures can also be applied for other applications with TDP heat for stronger affects.

Safe and Effective Use of Spirit Lamps

Finally, some have voiced concerns regarding the safety of TDP lamp treatment. With about 80,000 hours of experience administering TDP heat therapy, we can attest to the fact that the TDP lamp is quite safe when used correctly. The basic guidelines include

  • When lamps are left in position for a longer period, 15” is approximately the minimum distance from the skin for safe care. Some patients may require even less intensity.

  • Carefully monitor the treatment. There should be no or very minimal reddening of the skin with appropriate positioning of the lamp.

  • Communicate with your patient and ask for feedback. If the patient feels uncomfortable with the heat, the lamp should be repositioned or the therapy discontinued. Understand that the deep relaxation of acupuncture may prevent the patient from realizing if the area warmed by the lamp has become too hot.

  • Not for use in pregnancy, young children, or patients with severe or acute conditions.

  • If the skin becomes red, Chinese burn salves may be employed as needed.

In our experience, the vast majority of our patients love TDP heat therapy and make a point of mentioning how much they enjoy it. The coverage and mildness of TDP heat is comforting and pleasant. Some of our patients have even bought their own TDP lamps for home use. Therapeutically, TDP lamps can be utilized both when conventional moxibustion cannot be used or, more often, when we want to supplement qi and blood to improve the efficacy of acupuncture and to bolster wellness. Applied appropriately, we are confident that TDP lamps will become one of your favorite clinical tools to facilitate better outcomes and to increase patient satisfaction.

NOTE: TDP lamps feature special mineral plates coated with up to 33 minerals to create far infrared in harmony with the human body. As with other types of moxibustion therapy, the actions of TDP lamps are not limited to their core warming action. Specifically, TDP therapy stimulates micro-circulation, promotes healing, and boosts immunity. TDP is often used for pain syndromes and metabolic disorders.