The acupoint Baihui (GV20) first appeared in the book Zhen Jiu Jia Yi Jing (針灸甲乙經) [1], which records that Baihui is “the intersection of the Governor Vessel and the Foot Greater Yang Bladder Meridian”. The book Lei Jing Tu Yi (類經圖翼) [2] also describes Baihui as “the meeting point of the Governor Vessel, the Bladder Meridian, the Lesser Yang of Hand and Foot, and the Foot Reverting Yin Liver Meridian”. The head is where the Yang Qi (陽氣) converges, acting as a junction station for all meridians. The Baihui acupoint is where the Qi of each meridian gathers, facilitating communication between Yin and Yang and connecting acupoints throughout the body. Baihui plays a crucial role in regulating the balance of Yin and Yang. According to historic articles, the Baihui acupoint is widely used in acupuncture and moxibustion [3,4].

Compared to acupuncture, Baihui moxibustion slowly penetrates through the heat effect, leaning towards the method of warming and tonifying, while acupuncture directly stimulates acupoints, rapidly invigorating meridian Qi and blood, leaning towards the method of purging. Baihui moxibustion was first documented in the Su wen Gu Kong Lun (素問 · 骨空論) [5], which states: “To balance cold and hot, first apply moxibustion to Dazhui on the neck, adjusting the number of sticks according to age, then apply moxibustion to Juegu ... one stick on the top of the head”. The “top of the head” refers to the Baihui acupoint. Ancient physicians used Baihui moxibustion to treat malaria, epilepsy, rectal prolapse, and other diseases [6], while modern researchers indicate that the primary indications of such moxibustion are neurological and genitourinary diseases [7]. Current studies on ancient literature about Baihui moxibustion focus on the number of moxibustions, the size of moxa sticks, and other specifics [4]. This study summarizes the ancient literature related to Baihui acupoint moxibustion, establishes a database, and analyzes it from the perspectives of dynastic characteristics and disease spectrum, aiming to summarize the developmental patterns and further expand the clinical applications of Baihui moxibustion.

1. Literature search

The fifth edition of Chinese Medical Classic [8] was used as the search source to search the whole database. The search terms included “Baihui” and its synonyms (Table 1), according to Meridian and Acupoint [9], Chinese Acupuncture and Moxibustion Acupoint Guide [10], and Chinese Acupuncture and Moxibustion Dictionary [11]. The search results were exported in xls format, and further screened in Excel 2013. “Ai” (艾) and “zhuang” (壯) were considered alternative expressions for moxibustion, while “zhi” (炙) was identified as a misspelling. Additionally, “yun” (熨), “lao” (烙) and “denghuo” (燈火) were recognized as other terms for moxibustion [12]. Articles that met the inclusion criteria were identified through a thorough independent review by two investigators; any disputes were discussed with a third investigator.

Table 1

Table of synonyms.

Original search term	Synonym
Baihui	Dianshang (巔上, top), Ding Zhongyang (頂中央, top center), Lingshang (嶺上, ridge), Niwan (泥丸, mud pills), Sanyang (三陽, tri-yang) , Wuhui (五會, five convergence), Sanyangwuhui (三陽五會, tri-yang and five convergence), Tianman (天滿), Weihui(維會)
Moxibustion	Ai (艾, Moxa), Zhuang (壯, stick), Zhi (炙, scorching), Yun (熨, ironing), Lao (烙, branding), Denghuo (燈火, lamp fire)

2. Inclusion criteria

Studies meeting the following criteria were included: (1) articles focusing on the use of Baihui moxibustion for disease treatment; (2) articles discussing the compound application of Baihui moxibustion; (3) medical cases related to Baihui moxibustion for disease treatment; (4) narrative articles outlining the indications of Baihui moxibustion; (5) articles in the pithy formula documenting the indications of Baihui moxibustion; (6) articles presenting opposing viewpoints on Baihui moxibustion.

3. Exclusion criteria

Studies meeting the following criteria were excluded: (1) articles pertaining to positioning; (2) articles discussing Baihui alias; (3) articles focusing on the circulation of relevant meridians; (4) articles lacking clear descriptions of disease syndromes; (5) articles with unclear operational methods; (6) articles published after the Republic of China era.

The latter one of any two duplicate articles was excluded if: (1) the statements were consistent; (2) the meaning conveyed was the same; (3) the statements were different, but the diagnosis, patterns, acupuncture, and frequency were completely consistent; (4) the original article provided a marked source that could be traced; (5) the viewpoints expressed were similar to earlier articles without introducing new content.

4. Data indexing and specification

A database was established with index book serial numbers, dynasties, genre types, disease keywords, acupoints, compatible treatment methods, moxibustion quantities, and moxa sizes in Excel tables. Statistical analyses were conducted on the established database. Align the Jin Dynasty to the Song Dynasty based on actual years, and for cases where the dynasty is unknown, adhere to the research perspective of the most recent version. Genres were classed into medical theory, medical prescriptions, medical cases, and medical formulae based article style.

The diseases and patterns recorded in different ancient books differed and required standardization according to statistical requirements. Ancient Chinese medicine indexing differs from the modern literature, posing challenges for summarizing articles using contemporary terms [13]. At present, there is no clear indexing specification for ancient Chinese medicine books. To address this, the authors designed a keyword-based, four-level, disease-pattern indexing scheme:

1) Determination of the disease name

The original article was used to identify the diagnosis if a clear diagnosis was provided. In cases where the original article lacked a clear diagnosis but described patterns, the diagnosis was based on the primary pattern in the article. If a sentence included multiple diagnoses, all were listed without using the disease name itself as statistical content.

2) Indexing the primary disease category

Diseases were categorized under internal medicine, surgery, gynecology, pediatrics, and ophthalmology. Diseases such as vertigo and headache were classified as internal medicine.

3) Indexing the secondary disease category

Diseases were further categorized under internal medicine into subcategories like exogenous disease, hepatobiliary, cardiocerebral conditions, and spleen and stomach, lung, kidney, and limb meridians. Surgery was divided into limb meridians, trauma, anorectal and vulva, skin diseases, and mammary glands. Gynecology was divided into menstruation, vaginal discharge, obstetrics, anorectal, and vulva. Pediatric cases were re-indexed under pediatrics, if applicable. Five sense organs’ illness includes ophthalmology, ear disease, rhinopathy, mouth and teeth disease, and laryngeal disease. Oral and dental disease includes only independent oral and dental related diseases.

4) Identifying specific patterns

Patterns were summarized based on common features in disease descriptions, such as wind, blood, pain, convulsions, spasms, collapse, phlegm, cold, heat, and cold and heat. Diseases were classified based on common characteristics, and standardized according to disease names such as diarrhea, jaundice, sores and carbuncles, convulsions, silence, epilepsy, etc. For complex cases, categories were created like “head disease”, which encompassed various head-related conditions, such as head trauma, various encephalopathies, mental illnesses, ear, nose, and throat diseases, etc. Descriptors like “urgent pattern” were used for acute cases with words such as “Bao” (暴) and “Ji” (急). Words with “Jiu” (久) and “Qianyan” (遷延) were designated as “long time pattern”. The relevant disease patterns in the Treatise on Febrile Diseases and Synopsis of the Golden Chamber were labeled with the corresponding six meridian disease names.

5) Indexing various primary/secondary categories

Diseases treatable by different categories or with major and major-combined patterns were indexed accordingly. For instance, cases with wind or convulsion patterns alongside limb issues were indexed as “limb meridian patterns”, while cases with mental health concerns were categorized under “heart and brain”. Index examples are shown in Table 2.

Table 2

Index example.

Book	Text	Keyword
Shen Ying Jing	Sick for a long time and have a runny nose: Baihui moxibustion.	ENT, nose disease, internal medicine, lung disease, long pattern, head disease
Gu Jin Yi Tong Da Quan: Tuo Gang Hou	Baihui, on the top of head, has three sticks of moxibustion to treat pediatric prolapse.	Pediatric, surgery, proctology and vulvar disease, collapse pattern
Tai Ping Sheng Hui Fang: Ti Huang Zheng Hou	Patients who have yellow body, yellow face, sore and stuffy feet and knees, not warm on the body, restless in the heart, slightly aerated in the abdomen, better or worse appetite, prefer covering, but want to sleep in a cold place, should have moxibustion on Baihui, back center and one to two inches, three inches, four inches, and five inches below the heart.	Internal medicine, hepatobiliary disease, jaundice, limb meridians. cold and heat pattern, head disease, heart and brain disease, pain pattern

5. Statistical analyses

This study was conducted using SPSS version 24.0 software (IBM Corp., Armonk, NY, USA). Frequencies and proportions were calculated as descriptive statistics. Prism software (version 8.0.2; USA) was used to plot the results.

A total of 7193 articles with “Baihui” and its synonyms were retrieved, along with 580 articles retrieved through searches for moxibustion and its synonyms. Overall, 554 articles were obtained, excluding duplicates and articles unrelated to Baihui. As the Chinese Medical Classic was searched by full text, instances arose where a single chapter addressed multiple diseases and treatment options. Following manual division of the entire text into 689 articles, further exclusion of duplicates and articles with unclear operational methods led to the inclusion of 326 articles. During reading, five articles related to Baihui moxibustion from the Chinese Medical Classic were manually added because they were missing from the original search results. A total of 320 articles, from 99 ancient books from the Western Han Dynasty to the Qing Dynasty, were ultimately included in the study (Fig. 1).

Figure 1. Flow diagram of the search and screening of the texts included in this study.

1. The ancient book information of Baihui moxibustion method

A total of 320 texts from 99 ancient books were examined, with the earliest two being the Inner Conon of Huangdi ^· Su Wen from the Western Han Dynasty and the Zhou Hou Bei Ji Fang from the Eastern Jin Dynasty.

Among all the ancient books, the greatest number of texts on Baihui moxibustion was found in Zhen Jiu Ji Chen (針灸集成) of the Qing Dynasty, with 29 texts, representing 8.8% of the total. The top 10 ancient books contained 155 texts related to Baihui moxibustion, making up 48.4% of the total (Table 3). The dynasties with the most texts on Baihui moxibustion were the Ming and Qing Dynasties, with 122 and 101 texts, respectively, accounting for 38.1% and 31.6% of the total. The Northern Song Dynasty had 38 texts, the Southern Song Dynasty 25, the Tang Dynasty 19, and the Yuan Dynasty 13, whereas the Western Han and Eastern Jin Dynasties each had one text; all of these texts originated primarily from 36 books on the Ming Dynasty and 43 on the Qing Dynasty (Fig. 2).

Table 3

The top 10 ancient books in terms of texts.

Ancient book name	Dynasty	Rank	Text	Proportion (%)
Zheng jiu ji cheng	Qing	1	28	8.8
Pu ji fang	Ming	2	27	8.4
Sheng ji zong lu	Northern Song	3	21	6.6
Zhen jiu zi sheng ji	Southern Song	4	17	5.3
Tai ping sheng hui fang	Northern Song	5	16	5.0
Gu jin yi tong da quan	Ming	6	10	3.1
Bei ji qian ji nyao fang	Tang	7	9	2.8
Jiu fa mi chuan	Qing	8	8	2.5
Yi xue gang mu	Ming	9	7	2.2
Zhen jiu da cheng	Ming	10	6	1.9
Qian jin yi fang	Tang	10	6	1.9

Figure 2. Frequency of texts and books by dynasty.

2. Literary style of Baihui moxibustion

The literary style of Baihui moxibustion recorded in ancient books was divided into four categories. The largest category consisted of medical prescriptions, with 202 texts (63.1%), followed by 92 medical expounds (28.8%), 19 medical cases (5.9%), and 7 pithy formulas (2.2%). Pithy formulas were found exclusively in texts from the Ming and Qing Dynasties. The Western Han Dynasty and Eastern Jin Dynasty produced the two medical expounds (Fig. 3).

Figure 3. Proportion of Baihui moxibustion’s literary style. (A) Total proportion, (B) proportion by dynasty.

3. Methods of Baihui moxibustion

Among the methods of Baihui moxibustion, multi-acupoint Baihui moxibustion was the most common, with 180 texts, representing 56.3% of the total. The second most common method was single-acupoint Baihui moxibustion, with 79 texts, accounting for 24.7% of the total. Combinations of acupuncture and moxibustion were found in 15 texts (4.7%), while combinations of acupuncture, moxibustion, and medicine were present in 46 texts (14.4%). The Western Han and Eastern Jin Dynasties mostly used multi-acupoint moxibustion, which decreased to 48.1% in the Qing Dynasty. Single-acupoint moxibustion and the combination of multiple therapies showed increasing trends over time (Fig. 4).

Figure 4. Proportion of Baihui moxibustion’s operation method. (A) Total proportion, (B) proportion by dynasty.

4. Disease characteristics of Baihui moxibustion

A total of 45 keywords were identified for the disease. Among the primary categories, internal medicine had the highest frequency of mention (263 times). The top five secondary categories were limb meridians (156), heart and brain disease (130), hepatology (35), spleen and stomach disease (32), and anorectal and vulval disease (28). The top five specific patterns were head disease (105), wind (76), collapse (46), and diarrhea and epilepsy (34; Table 4 and Fig. 5).

Table 4

Indications of Baihui Moxibustion.

Category	Keyword (frequency)
Primary category	Internal medicine (263), pediatric (71), surgery (46), ENT (29), gynaecology (11)
Secondary category	Limb meridians (156), heart and brain (130), hepatology (35), spleen and stomach (32), anorectal and vulva (28), nose disease (11), exogenous disease (9), lung disease (8), trauma (8), eye disease (6), obstetrics (5), dental disease (5), kidney disease (5), skin disease (4), ear disease (3), throat disease (3), leucorrhea disease (2), postpartum disease (2)
Specific pattern	Head disease (105), wind pattern (76), collapse pattern (46), diarrhea (34), epilepsy (34), jaundice (33), acute pattern (32), infantile convulsions (26), syncope (25), prostration (24), pain pattern (21), cold pattern (19), long time pattern (18), silence (16), cold and hot pattern (15), Shaoyin disease (13), hot pattern (9), convulsions (8), blood pattern (6), phlegm wet pattern (4), sores and carbuncles (2), jueyin disease (1)

Figure 5. Indications of Baihui Moxibustion.

5. Disease characteristics of single-acupoint and multi-acupoint Baihui moxibustion

There were 79 texts on single-acupoint Baihui moxibustion, encompassing 39 disease keywords. Among the primary categories, internal medicine had the highest frequency (60 occurrences). The top five secondary categories were heart and brain disease (28), limb meridians (23), and anorectal and vulval disease (14). The top three specific patterns were collapse (22), diarrhea (22), and head disease (19). For multi-acupoint Baihui moxibustion, there were 180 texts involving 41 disease keywords. Internal medicine remained the primary category with the highest frequency (153 occurrences). The top three secondary categories were limb meridians (96), heart and brain disease (73), and hepatology (31). The top three specific patterns were head disease (59), wind (49), and jaundice (29; Table 5).

*Omit keywords with frequency less than 5..

&md=tbl&idx=5' data-target="#file-modal"">Table 5

Indications of single-acupoint Baihui moxibustion and multi-acupoint Baihui moxibustion.

Category	Single-acupoint Baihui moxibustion (frequency)	Multi-acupoint Baihui moxibustion (frequency)
Primary category	Internal medicine (60), pediatric (24), surgery (19), ENT (4), gynaecology (4)	Internal medicine (153), pediatric (37), surgery (19), ENT (19), gynaecology (4)
Secondary category	Heart and brain (28), limb meridians (23), anorectal and vulva (14), spleen and stomach (14)	Limb meridians (96), heart and brain (73), hepatology (31), spleen and stomach (9), exogenous disease (8), anorectal and vulva (8), lung disease (5), nose disease (5)
Specific pattern	Collapse pattern (22), diarrhea (22), head disease (19), wind pattern (14), Shaoyin disease (12), long time pattern (9), infantile convulsions (9), prostration (8), epilepsy (8), acute pattern (7)	Head disease (59), wind pattern (49), jaundice (29), epilepsy (21), acute pattern (19), silence (15), infantile convulsions (13), prostration (12), collapse pattern (12), cold and hot pattern (12), pain pattern (10), syncope (10), cold pattern (8), diarrhea (6), hot pattern (6), convulsions (5)

*Omit keywords with frequency less than 5..

6. Specific methods of Baihui moxibustion

Besides direct moxibustion, ancient books also recorded indirect Baihui moxibustion: two mentions each of moxibustion on garlic, moxibustion on ginger, and plaster; and one mention each of moxibustion on locust bark, and lampwick moxibustion.

Statistical analyses revealed that Baihui moxibustion was documented across various dynasties. Apart from the Western Han and Eastern Jin Dynasties, where only medical treatises mention Baihui moxibustion, the genre predominantly consists of medical prescriptions in all other dynasties. Since the Yuan Dynasty, the prevalence of medical expounds has gradually increased. Baihui moxibustion involving multiple acupoints has received more attention than single-acupoint moxibustion. During the Northern Song Dynasty, single-acupoint moxibustion was the least frequently mentioned, with only two occurrences. The prevalence of single-acupoint moxibustion gradually increased from the Yuan Dynasty to the Ming Dynasty and further to the Qing Dynasty.

The therapeutic indications of Baihui moxibustion encompass various physiologic systems. The Baihui acupoint serves as the convergence point of Yang qi and the central hub of all meridians [14]. It is efficacious in treating both upper and lower body ailments and can be used for tonification, purgation, invigoration, and constriction. Mugwort, the primary herb used in moxibustion, exhibits properties of divergence, warmth, and bitterness, possessing pure yang attributes. Its application can rescue patients from collapse and facilitate unobstructed flow of the body’s meridians. Internal medicine constitutes the predominant domain within the primary categories of Baihui moxibustion, underscoring the overall leadership role of the Baihui acupoint. Within the secondary categories, the main indications revolve around limb meridian disorders and cerebrovascular ailments, suggesting that Baihui moxibustion can invigorate mental faculties and enhance overall vitality through meridian stimulation. Specific patterns of application predominantly target cranial disorders and wind-related syndromes, indicating the efficacy of Baihui moxibustion in addressing ailments proximal to the Baihui acupoint.

Single-acupoint Baihui moxibustion is effective in treating internal medicine ailments, particularly those affecting the heart and brain, diarrhea, and collapse disorders. Such moxibustion functions by enhancing yang energy and uplifting sinking qi. For example, in the Huang Di Ming Tang Jiu Jing (黃帝明堂灸經) [15], it is mentioned that: “If a child experiences anal prolapse or diarrhea, and has abdominal pain when defecating, the child can have Baihui moxibustion centrally on the head with three sticks. Each stick is as big as wheat”.

The Dan Xi Zhi Fa Xin Yao (丹溪治法心要) [16] states: “People suffering from Qi deficiency after a prolonged illness and those with persistent diarrhea can have Baihui moxibustion with three sticks”. The book Tai Chan Xu Zhi (胎產須知) [17] states: “If a woman’s uterus cannot be retracted after childbirth, disinfection and washing with a Fructus aurantii, myrobalan, gallnut, and alum decoction can be used. If this does not work, Baihui moxibustion repeated several times can be effective.” From the Yuan Dynasty to the Qing Dynasty, the prevalence of single-acupoint Baihui moxibustion gradually increased. Whether it is rectal prolapse in children, postpartum prolapse, or prolonged diarrhea, the pathogenesis is the sinking of qi. Baihui moxibustion, which can elevate yang and lift the sunken, has a good effect on qi deficiency and collapse pattern, and is also used to treat anal or gastric prolapse [18]. Multi-acupoint Baihui moxibustion produces a synergistic effect and is mainly used in limb meridian diseases, head diseases, and wind pattern, but is less frequently used for collapse or diarrhea. Therefore, it is necessary to be familiar with the clinical specificity of the effect of single-acupoint Baihui moxibustion, rather than increasing the number of acupoints blindly. Indeed, when treating diseases related to qi deficiency and collapse, single-acupoint Baihui moxibustion can achieve better clinical efficacy.

The Treatise on Cold Damage Diseases [19] documents that “Shaoyin disease-induced diarrhea, with a slightly unsmooth pulse, necessitates changing clothes multiple times due to vomiting and sweating. If the condition is the opposite, warming the upper part and applying moxibustion”. Although the original text does not elaborate on “warming the part”, Guo Yong (郭雍) of the Southern Song Dynasty initially associated it with “Baihui” in his book Shang Han Bu Wang Lun (傷寒補亡論) [20]. Throughout the Ming and Qing Dynasties, numerous scholars echoed similar sentiments with some physicians providing further insights into the principles of Baihui moxibustion. For example, Shang Han Cuan Lun (傷寒纀論) [21] suggests that moxibustion at the top of the head warms the upper part, thereby elevating yang qi, which in turn alleviates diarrhea symptoms. Conversely, Shang Han Lun Zhu (傷寒論注) [22] explains that faint, unsmooth pulse accompanied by vomiting and sweating indicates yang qi deficiency. Emergency Baihui moxibustion can warm the upper part, potentially restoring yang qi. Baihui moxibustion is believed to gather yang qi to dispel yin evil, a concept widely accepted by most practitioners, although some dissenting opinions exist. Qian Huang of the Qing Dynasty, in his Shang Han Su Yuan Ji (傷寒溯源集) [23], advocated moxibustion on the Shaoyin, or possibly Shangwan (RN13), Zhongwan (RN12), or Xiawan (RN10). Other experts suggested Zusanli (ST36), Taichong (LR3), and Taixi (KI3) [24]. Most of the Qing Dynasty interpretations of Baihui moxibustion may be related to the use of Baihui alone, which is like the effect of Baihui moxibustion on raising yang and lifting the sunken.

Baihui moxibustion encompasses effects such as yang-warming, alleviation of collapse, awakening the mind, and calming agitation, making such moxibustion a versatile treatment for various cognitive disturbances. As stated in Shou Shi Bao Yuan (壽世保元) [25]: “Emergency intervention at the Baihui acupoint, located on top of the head, with three sticks of moxibustion, can revive nearly fatally injured individuals”. Yi Xue Yan Yue (醫學研悅) [26] recommended three sticks of moxibustion on Baihui and Zusanli, applied to the left side for males and the right side for females, for individuals with convulsions and unconsciousness. Baihui moxibustion can also be used to treat mental disorders such as palpitations and insomnia. For example, Zhen Jiu Zi Sheng Jing (針灸資生經) [27] recorded: “Individuals suffering from heart qi, overthinking, palpitations, or sad feelings must have Baihui moxibustion, because Baihui can treat the symptoms of insufficient heart strength and forgetfulness”. Modern practice frequently employs Baihui moxibustion for neurologic and psychologic disorders such as Alzheimer’s disease [28], depression [29], vertigo [30], and insomnia [31], as such moxibustion is known to enhance cerebral blood flow, improve neurologic function, and regulate mental well-being.

Some doctors have proposed unique insights on the clinical application of Baihui moxibustion. Song Feng Shuo Yi (松峰說疫) [32] argues against the use of Baihui moxibustion for treating head shaking. “The head is the meeting of the various yang meridians. If yang is activated, the head will shake. As the Neijing says, the dizziness of the various winds belongs to liver wood. The phenomenon of wind and wood shaking is mostly caused by rising wind and fire. In ancient times, it was treated by moxibustion on acupoints such as Baihui and Fengfu (DU16), but I did not agree. The reason for head shaking was that heat produced wind. If you clear the evil heat, the shaking will be settled, so why attack with fire?” While Baihui moxibustion effectively treats various head disorders such as headaches, dizziness, strabismus, headwind, and epilepsy, its application should be guided by syndrome differentiation to optimize clinical outcomes. It is prudent to avoid Baihui moxibustion in cases of heat, yang, or excess syndromes to mitigate potential adverse effects.

The primary method of Baihui moxibustion was direct moxibustion, although alternative approaches such as using garlic, ginger, or locust bark were also documented. Historic texts mention combining Baihui moxibustion with external medicine to address conditions like wind-induced head rotation and nasal congestion. For instance, Sheng Ji Zong Lu (聖濟總錄) [33] recommended 21 sticks of Baihui moxibustion after three days of medication, followed by applying a plaster. Similarly, Pu Ji Fang (普济方) [34] suggested three sticks of Baihui moxibustion, followed by shaving the hair for cleanliness and applying ointment on a silk patch on Baihui. Natural moxibustion is the application of stimulating drugs to the acupoints causing localized skin congestion and blistering, potentially accelerating the foaming process and enhancing the therapeutic effect.

In researching Baihui acupoint-related practices, Taoist techniques like “storing mud pills” were considered. The Yi Xin Fang (醫心方) [35] describes this practice as rubbing the hands together until, then rubbing them from the forehead to the top of the head eighteen times. It may have first come from Zhang Zhan’s Yang Sheng Yao Ji (養生要集) in the Eastern Jin Dynasty. The original book has been lost, and the relevant content has been introduced into the Tai Ping Yu Lan (太平禦覽) of the Song Dynasty [36] and the contemporary Japanese Yi Xin Fang. Taoism believed that medicine had no effect on tonifying the brain. Only by practicing according to the mechanism of yin and yang, ascending to the end of the mud pill, descending from the beginning of the mud pill, and the former ascending and the latter descending, can the spiritual essence be transformed. After accumulating over time, the brain marrow will be enriched [37]. While storing mud pills serve as a health guide practice focusing on ascending yang in the morning, distinct from the therapeutic focus of Baihui moxibustion, both share connotations of “top” and “warmth”. Despite their exclusion from this research due to their non-therapeutic nature, the conceptual similarities with Baihui moxibustion merit further exploration.

With the advancement of acupuncture and moxibustion, the clinical use of Baihui moxibustion has evolved across various dynasties, showcasing its versatile methodologies. Indications for Baihui moxibustion are reflected in commanding the whole body and the close treatment effect of local diseases, as well as following the main treatment of meridians and the application of syndrome differentiation and treatment. Single-acupoint Baihui moxibustion potently tonifies and elevates sinking qi, making it effective for conditions characterized by qi deficiency and descent. This research only covered the texts related to Baihui moxibustion in ancient books included in the Chinese Medical Classic (5th edition).

This research was funded by the Shanghai University of Traditional Chinese Medicine 16th Batch of Student Innovation Activity Program Project (No. 202310268131, SHUTCM2023096).

Ma YY and Qu CC performed the texts’ search and screen. Ma YY and Chen LM performed the writing. Ji J proposed guidance and modifications. All the authors reviewed and approved the final manuscript.

The authors declare no conflict of interest.