Gua Sha - AbsoluteAstronomy.com

Gua sha literally "to scrape away fever" in Chinese

Chinese language

The Chinese language is a language or language family consisting of varieties which are mutually intelligible to varying degrees. Originally the indigenous languages spoken by the Han Chinese in China, it forms one of the branches of Sino-Tibetan family of languages...

(more loosely, "to scrape away disease by allowing the disease to escape as sandy-looking objects through the skin"), is an ancient medical treatment.
Sometimes referred to as "spooning" or "coining" by English speakers, it has also been given the descriptive French name, "tribo-effleurage

Effleurage

Effleurage, a French word meaning "to skim" or "to touch lightly on", is a series of massage strokes used in Swedish massage to warm up the muscle before deep tissue work using petrissage....

".

The Vietnamese

Vietnamese language

Vietnamese is the national and official language of Vietnam. It is the mother tongue of 86% of Vietnam's population, and of about three million overseas Vietnamese. It is also spoken as a second language by many ethnic minorities of Vietnam...

term for this practice is cạo gió . This term translates roughly "to scrape wind", as in Vietnamese culture "catching a cold" or fever is often referred to as trúng gió, "to catch wind". The origin of this term is the Shang Han Lun

Shang Han Lun

The Shang Han Lun or Shang Han Za Bing Lun , known in English as the Treatise on Cold Damage Disorders or the Treatise on Cold Injury, is a Chinese medical treatise that was compiled by Zhang Zhongjing sometime before the year 220, at the end of the Han dynasty...

, a ~220 CE Chinese Medical text on cold induced disease - like most Asian countries China's medical sciences were a profound influence in Vietnam, especially between the 5th and 7th Centuries CE. Cạo gió is an extremely common remedy in Vietnam and for overseas Vietnamese. There are many variants of Cạo gió. Some methods use oil balm and a coin to apply pressure to the skin. Others use a boiled egg with a coin inserted in the middle of the yolk. The egg is wrapped in a piece of cloth and rubbed over the forehead (in the case of a fever) and other areas of skin. After the rubbing, when the coin is removed from the egg, it will appear black.

It is also used in Indonesia. It is a traditional Javanese technique, known as kerikan (lit., "scraping technique") or kerokan
Kerokan
Kerokan is a traditional Indonesian folk cure, wherein a coin or ladle is drawn across the back. This action supposedly helps to release "wind" from the body by increasing blood flow near the skin's surface...

, and it is very widely used, as a form of "folk" medicine, upon members of individual households.

"Folk" technique

In describing the gua sha techniques as a form of "folk" medicine, the term "folk" is not being used in any pejorative

Pejorative

Pejoratives , including name slurs, are words or grammatical forms that connote negativity and express contempt or distaste. A term can be regarded as pejorative in some social groups but not in others, e.g., hacker is a term used for computer criminals as well as quick and clever computer experts...

sense. It is used to emphasize:

the extremely widespread domestic use of the technique (thus, used by the "folk") as a method of first-contact intervention,
that complex medical diagnosis is not required (and, thus, any decision to use or not use gua sha can be reliably made by the "folk"), and
the overall safety of the technique (meaning that it is safe for the "folk" to use).

Notwithstanding, the gua sha technique is just as important a part of the legitimate practice of the specialist practitioners of Traditional Chinese Medicine as is the use of fire cupping

Fire cupping

Cupping therapy is an ancient form of alternative medicine in which a local suction is created on the skin; practitioners believe this mobilizes blood flow in order to promote healing. Suction is created using heat or mechanical devices...

; among professional practitioners it is a highly reputable technique that is applied just as it is applied by the "folk" users.

Technique

gua sha involves repeated pressured strokes over lubricated skin with a smooth edge. Commonly a ceramic

Ceramic

A ceramic is an inorganic, nonmetallic solid prepared by the action of heat and subsequent cooling. Ceramic materials may have a crystalline or partly crystalline structure, or may be amorphous...

Chinese soup spoon was used, or a well worn coin, even honed animal bones, water buffalo horn, or jade. A simple metal cap with a rounded edge is commonly used.

In cases of fatigue from heavy work a piece of ginger root soaked in rice wine is sometimes used to rub down the spine from head to tail.

The smooth edge is placed against the pre-oiled skin surface, pressed down firmly, and then moved down the muscles—hence the term "tribo-effleurage

Effleurage

Effleurage, a French word meaning "to skim" or "to touch lightly on", is a series of massage strokes used in Swedish massage to warm up the muscle before deep tissue work using petrissage....

" (i.e., friction-stroking) -- or along the pathway of the acupuncture

Acupuncture

Acupuncture is a type of alternative medicine that treats patients by insertion and manipulation of solid, generally thin needles in the body....

meridian

Meridian (Chinese medicine)

The meridian is a path through which the life-energy known as "qi" is believed to flow, in traditional Chinese medicine. There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians.- Main concepts :...

s, along the surface of the skin, with each stroke being about 4-6 inches long.

This causes extravasation of blood from the peripheral capillaries (petechiae) and may result in sub-cutaneous blemishing (ecchymosis

Ecchymosis

An ecchymosis is the medical term for a subcutaneous purpura larger than 1 centimeter or a hematoma, commonly called a bruise. It can be located in the skin or in a mucous membrane.-Presentation:...

), which usually takes 2–4 days to fade. Sha rash does not represent capillary rupture as in bruising, as is evidenced by the immediate fading of petechiae to echymosis, and the rapid resolution of sha as compared to bruising. The color of sha varies according to the severity of the patient's blood stasis—which may correlate with the nature, severity and type of their disorder—appearing from a dark blue-black to a light pink, but is most often a shade of red. Although the marks on the skin look painful, they are not. Patients typically feel immediate sense of relief and change.

Practitioners tend to follow the tradition they were taught to obtain sha: typically using either gua sha or fire cupping

Fire cupping

. The techniques are not used together.

Indications

In classical Chinese practice, the gua sha technique is most commonly used to:

Reduce fever (the technique was used to treat cholera).
Treat fatigue caused by exposure to heat (often used to treat heat-stroke) or cold.
Cough and dyspnea: bronchitis, asthma, emphysema.
Treat muscle and tendon injuries.
Push sluggish circulation, fibromyalgia.
Treat headache.
Treat sunstrokes / heat syncope and nausea.
Treat stiffness, pain, immobility.
Treat digestive disorders.
Treat urinary, gynecological disorders.
To assist with reactions to food poisoning.

There is an allied technique, ba sha , or 'tsien sha', which has a similar application to gua sha. It is performed by gripping the skin, lifting and then flicking between the fingers until petechiae appear. It is used more often on the tendons, at the center of the brow, or than over specific acupuncture points.

Cross-cultural confusion with physical abuse

A slightly different form of gua sha uses the edges of coins rather than porcelain items is practiced as a "folk medicine" technique. Individuals practice this "coining" amongst their own family members in many Asian cultures such as Vietnam (where the coin scraping, or "coining" is known as "cạo gió", 'scraping for wind'), in Cambodia, and in their respective immigrant communities abroad. For example, health care practitioners in hospitals Orange County, CA routinely see evidence of coining among hospitalized Vietnamese patients.

In 1980, it was found that many Vietnamese still distrusted US medical practitioners in part due to fear of being falsely accused of child abuse.

For professionals in this position, it is helpful to be familiar with the appearance of gua sha marks and to understand its traditional therapeutic value, and to be able to make the distinction between gua sha marks and signs of abuse. Nonetheless, if the practice results in physical injury to children or the elderly, physicians in the United States are required to make a report to the appropriate family social service agency; the intent to injure (or lack thereof) has no bearing on this requirement.

Gua sha is not known to be harmful. The technique called cupping

Cupping

Cupping can refer to:* Coffee cupping* Fire cupping, and other alternative health cupping methods* "Cupping", a form of unusual tire wear due to bad wheel alignment...

also leaves distinctive, petechial marks on the skin, but is also harmless.

In 2001, a movie called "gua sha" (see The Treatment) was made addressing this practice and the cultural misunderstandings it causes. The movie stars Tony Leung Ka-Fai

Tony Leung Ka-Fai

Tony Leung Ka-fai is a three-time Hong Kong Film Award-winning Chinese film actor.Because he is often confused with actor Tony Leung Chiu-Wai, Tony Leung Ka-fai is known as "Big Tony", while Tony Leung Chiu-Wai is known as "Little Tony", nicknames which correspond to the actors' respective...

Artwork portraying gua sha

The 2000 movie Beijing Herbs was made in Hong Kong

Hong Kong

Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...

showing gua sha among other things. The movie starred Tony Leung Ka-Fai

Tony Leung Ka-Fai

, Jiang Wenli

Jiang Wenli

Jiang Wenli is a famous Chinese actress. She is a native of Tianjin, and graduated from Beijing Film Academy in 1992. She married director Gu Changwei in 1993. Jiang Wenli was one of the members of the jury of the Shanghai International Film Festival in 2005.Wenli Jiang was born in a highbrow family...

, Zhu Xu

Zhu Xu

Zhu Xu is a Chinese actor. He is well known for his roles in Zhang Yang's Shower and Wu Tianming's The King of Masks, the latter film helping him garner a Best Actor prize at the Tokyo International Film Festival.-Filmography:...

.

The 2001 film The Treatment is about gua sha being mistaken as child abuse.

"Folk" technique

Technique

Indications

Cross-cultural confusion with physical abuse

Artwork portraying gua sha

See also