Sometimes referred to as "spooning" by English speakers, it has also been given the descriptive French name, "tribo-effleurage".
The term for this practice is c?o gió , meaning roughly to "scrape wind", as in Vietnamese culture catching a cold or fever is often referred to as ''trúng gió'', "to catch wind". C?o gió is an extremely common remedy in Vietnam and for .
It is also used in Indonesia. It is a traditional Javanese technique, known as kerikan or kerok, and it is very widely used, as a form of "folk" medicine, upon members of individual households.
Gua Sha: the "folk" technique
In describing the Gua Sha techniques as a form of "folk" medicine, the term "folk" is not being used in any pejorative sense. It is used to emphasize:
* the extremely widespread domestic use of the technique as a method of first-contact intervention,
* that complex medical diagnosis is not required , and
* the overall safety of the technique .
Notwithstanding this, 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; and it is a highly reputable technique that is applied just as much by these highly trained experts as it is applied by the "folk" users.
As with many of the "folk" methods that are used domestically as a form of first intervention, the use of Gua Sha often precludes any need for any more complex medical treatment; and, because its use means that further medical treatment is unnecessary, the technique, although extremely widespread, is often hidden from view, and its role as a very significant and very important participant in the overall health care of a community may not be immediately apparent.
Therefore, in the case of Gua Sha, the term "folk" medicine should not be thought of as separate from the practice of more complex Traditional Chinese Medicine, but far more as an immediate form of domestic "first-aid" intervention that serves to prevent any need for further medical intervention by a medical professional.
The Gua Sha technique
''Gua Sha'' involves repeated pressured strokes over lubricated skin with a smooth edge. Commonly a ceramic 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" -- or along the pathway of the acupuncture 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 and may result in sub-cutaneous blemishing , 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. The techniques are not used together.
Indications
In classical Chinese practice, the Gua Sha technique is most commonly used to:
* Reduce fever .
* Treat fatigue caused by exposure to heat 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' literally "to lift up for cholera", 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, using the edges of coins, rather than porcelain, is practiced as a "folk medicine" technique, by individuals amongst their own family members, in many Asian cultures such as Vietnam , in Cambodia, and in their immigrant communities abroad.
C?o gió was introduced to the USA in 1975, when large numbers of Vietnamese were airlifted from South Vietnam near the end of the military conflict between North and South. Well-meaning practitioners of western medicine are sometimes shocked at the sight of these marks and fear that a child with the marks has been abused. The practice was observed by military physicians who publicized the harmless nature of this practice.
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.
''Gua Sha'' is not known to be harmful. The technique called cupping also leaves distinctive, petechial marks on the skin, but is also harmless.
In 2001, a movie called "Gua Sha" was made addressing this practice and the cultural misunderstandings it causes. The movie stars Tony Leung Ka-Fai.
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