Van Morrison comes up with songs many different ways, sometimes a lyric or title idea sparks a song, and other times it's a melody. "Moondance" started as a jazz saxophone instrumental, and Van played that original sax solo he wrote for the song. He told Rolling Stone magazine: "I used to play this sax number over and over, anytime I picked up my horn."
That Rolling Stone quote is about all you're going to get from Van regarding the song. He is notoriously fickle when it comes to speaking about his music, as he feels that the songs should speak for themselves. The liner notes to the Moondance album were written by his girlfriend Janet Planet, and instead of a traditional explanation of the recording process or a list of thank-you's, these notes are a fable, telling the story of an artist in ancient times who has a great gift but keeps it to himself. When his wife gets sick, he cures her using his gift of song. She then asks, "But who will ease your pain, who will save you?"
The flute is a big part of this song. It was played by Collin Tilton, who replaced John Payne on the instrument for the Moondance album.
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