Is home moxibustion safe for older paren

Short take: TCM uses moxibustion (艾灸) to warm channels, drive out cold and damp, lift yang, and as a daily tonic at a few key points — but for an older parent, the "dose" is much gentler than for a healthy adult, and the burn your relative left on your mom's knee is a clear signal that Sunday's session needs a reset before anyone lights a stick.

What TCM uses moxibustion for (and where it fits for an older parent)

From the textbook line on moxa's purpose (《针灸学》现行本):温经通络、行气活血、祛湿散寒 (cold/damp joint pain), 温补中气、回阳固脱 (chronic loose stools, prolapse, cold limbs), 消瘀散结 (early mastitis, scrofula), and 保健灸 at four points (足三里、关元、气海、大椎) to bolster zheng qi.

In practice for an older parent at home, the realistic targets are: chronic knee or low-back ache that worsens in cold/rain, cold hands and feet, frequent clear-urine nighttime trips, and general "tired, no appetite, easily chilled" — the kind of slow, dull, cold-pattern picture. Acute hot, swollen, red joints, fever, sudden weakness/numbness, chest tightness — those are not moxa targets. The closest classic line: 《灵枢·官能》「針所不為，灸之所宜」 — when needles aren't the right tool, moxa is. (Source: `references/40` and `scripts/lookup_classic.py` 灵枢·官能第七十三.)

A pattern call without tongue and pulse is guesswork — Sunday's session should not start until you have one of these: a single visit with a licensed TCM practitioner, or a clear, slow, cold-worse picture (not hot/red/sweating/thirsty).

(1) What you already tried vs better alternatives

(2) Avoid list (things to NOT do Sunday)

• Skip moxa at home if mom has any of these — bring her to a licensed practitioner instead:

- Diabetes, especially with numb/tingling feet or hands (can't feel burns coming)
- On blood thinners (aspirin, warfarin, clopidogrel, etc.) — a blister that won't stop bleeding is a real risk
- Recent stroke, uncontrolled high blood pressure, pacemaker
- Active cancer, or any unexplained lump where you'd moxa
- Memory loss / confusion (can't reliably say "too hot")
- Fever, even low-grade, or a hot/swollen/red joint today

• Don't moxa: face, neck front, the spine's bony ridge, the kneecap bone itself, any skin that's red, broken, rashy, scarred, or where she's had a knee replacement; the spot that was burned until it's fully healed (2–4 weeks).
• Don't: leave her alone with a lit stick; do it right after a bath, on an empty stomach, or within an hour of a meal; moxa in a closed room with the smoke alarm — either disable it for the 15 min and re-arm, or do it on the balcony with mom inside the doorframe; pile on multiple spots at once ("more is better" is wrong here).

(3) Red flags — stop DIY, get clinical/urgent help

The burn from earlier today is the first red flag. If it's still red, blistered, or sore:

• Blister smaller than a fingernail, skin unbroken → keep clean and dry, no popping, watch 3 days.
• Blister bigger than a fingernail, broken skin, pus, red streaking, increasing warmth, or pain that keeps her awake tonight → see a clinician this week, not Sunday (urgent care / GP / dermatologist, whichever is open soonest). Bring this record with you.

Stop the moxa session and call for help if, during or right after, mom has:

• Dizziness, paleness, cold sweat, nausea, faintness → lay her flat, head low, warm, sips of warm water; if not better in 5 min → call your local emergency number.
• Chest pain, one-sided weakness/numbness, trouble breathing, slurred speech → emergency now, do not finish the session.
• A burn that blisters bigger than 1 cm, or any burn that whitens/charms the skin → cool with running tap water 10 min, then urgent care.

Pattern is wrong for moxa (do not retry until a practitioner confirms): the knee is hot, swollen, red, or the pain is worse in warmth and better with cold; she has night sweats, dry mouth, a red tongue with little coating, or a fast pulse — these are heat/yin-deficiency signs, and moxa makes them worse.

A screenshot-friendly Sunday plan (≤20 min, mom is the patient, you run it)

1. 5 min before — window open + kitchen fan on; smoke alarm paused; metal tin + lid ready; a chair with a back; water within reach.
2. Health screen (1 min, tick all or stop): no fever • no diabetes numbness • no blood thinners • no pacemaker • no cancer at the site • able to say "hot" right now. Any "no" → no home moxa, book a practitioner visit.
3. One spot only for a first session — pick the easiest, safest target: 足三里 (outside the leg, a hand-width below the knee cap, one finger-width outside the shin bone). This is the textbook保健灸 point; useful for tired-leg, mild cold signs. Locator from `39-针灸-十四经穴与奇穴.md` (足三里行).
4. Technique (≤5 min per side):

- Light the stick, let the flame settle to a steady ember.
- Hold the stick 3–4 cm above the spot (older skin = further away, not closer).
- Your other hand's index and middle finger sit on the skin on either side of the spot to feel real temperature — when those fingers say "warm but not stinging", that's right.
- Move the stick in tiny circles, never let it sit still.
- 2 minutes per side, then stop. Skin should be a faint pink, not red. Any "ouch", any white spot, any blister → stop and treat as above.

1. Close (2 min): snuff the stick in the metal tin with the lid on; let it cool 5 min before the bin; re-arm the smoke alarm; mom rests with a cup of warm water; no bath, no wind on the leg for the next hour.
2. Write down: which side, how many minutes, how skin looked, how she felt 30 min later. This is the note you bring to a practitioner if anything is off next time.

If Sunday goes well and she's clearly in the cold-pattern picture (not hot/red/thirsty), the same routine can repeat every other day for a week, then 2× a week. Anything stronger — adding points, longer time, or moving to joints — wait for a licensed practitioner to show you in person.

What "success" looks like in 24 hours

• No new burns, no dizziness, no missed medication, smoke alarm still works.
• Mom feels warmer in her hands/feet that evening or the next morning, or she feels no change — both are fine.
• She is willing to try again another time, or she decides moxa isn't for her — also fine.
• You have a one-line log ready, and a question to ask the GP or a licensed TCM practitioner at the next visit: *「我妈想在家做艾灸保健，足三里为主。她有 ___病、在吃 ___ 药，这个方案对她这个个体来说行不行？」*

Bring this to the practitioner (screenshot the bottom)

> 艾叶在《安全-配伍妊娠禁忌与毒性药.md》标 `toxic`，家用走悬灸（A⁻ 级），不作家用剂量，不灸婴幼儿与孕妇腹部腰骶；不确定寒热虚实时先让执业者辨证再灸。