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Gua Sha Smoothly scraping out the sha
Bruce Bentley has studied with expert gua sha practitioners at the Shanghai Hospital of Traditional Traditional Chinese Medicine (China), and with Mr Trang Lee when he completed a 12-month research project for the Victorian Government titled Folk Medical Practices within the Vietnamese Community . The latter proved an outstanding opportunity to gain rare information about gua sha from a lineage known as the Buddhist wandering monk medical tradition.
method, and can even be perormed t clothing (without the intention intention o ra
Meaning of the term
You may kn know ow it as a s “spoo “spooni ning” ng” “scrapin scraping” g”, but all these thes e recent Engli E ngli substitutes all short o the tidy mean sha has in Chinese language. The te comprises two characters. The frst, to rub or to scrape, and the second, name given to the distinctive type o and discolouration that appears at th ace during and ater a ter treatment. treatment. Gua s means to rub out sha sha.. By Bruce Bentley For this reason, I will nolonger ita Sign up to votewords, on thisastitle Chinese the real meaning better conveyed when ua sha Is tyPICAlly PerformeD  Useful  Not useful let as Chine by rubbing a smooth-edged instru- become part o the common vernacul ment across the skin surace where a term commonly used by the rural po subcutaneous injury or imbalance resides. When China is gua eng, meaning to “scra
G
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‘’
times when a person happened to rub a painul ly on his patients that he soon developed debilitatarea repeatedly against a stone jutting out rom ing hand injuries. Unable to continue his practice, a cave wall and noted that along with a show o he asked an engineer riend to make a tool he colour, their pain was reduced. could hold to allow him to resume his practice. He Gua sha is perormed throughout Asia, where it made an iron tool with rounded edges and to his Sha and the is especially popular in China, Taiwan, Vietnam, amazement, his treatments produced sha, which discolouration Cambodia, Laos and Indonesia. During the very he thought was his unique discovery. He interthe pathogenic sombre Khymer Rouge (Pol Pot) Era in Cambo- preted sha as “digging out ar thritis”. Despite the dia (1975–79), all traditional medical treatments, great pain that his style o treatment caused, he responsible or as well as biomedical practices, were strictly pro- had great success and soon had a remarkably large blockage, and hibited except or gua sha. Anyone ound practis- clientele. He was given the title “Iron Bar Bob”. been released, ing any therapy besides gua sha was executed, or Things went bad again when jealous colleagues in integrity o the i lucky sent to prison – or so a vil lage healer, who the massage raternity got upset about “Iron Bar” restored. was also a school teacher, inormed me when I and orced his disbarment rom practice. was in Cambodia in 2003. He himsel managed to Not to be deterred and looking or an income escape detection by perceiving what was in store during the Great Depression o the ’30s, he decidand pre-emptively leaving the area where he was ed to put his “discovery” to work on greyhounds. known, and travelling to the north where he acted So he and some mates bought retired greyhounds as a homeless “idiot” during those years. He told or next to nothing and rejuvenated their careers me that gua sha was such a common practice per- by getting rid o their ar thritis, as it was conceived. ormed by everyone that it was not considered the Brought back to orm, the dogs were then entered work o intellectuals and thereore not suspect by in races and bet on, to the disbelie and jeers o the Party. Even cupping and massage were orbid- the bookmakers – until they had to pay out! den. This was all told to me by “Iron Bar’s” one and Although experts in the method have developed only student (Bob was very protective o his disa broad array o uses or gua sha treatment, or covery) who came down to Melbourne to study most people gua sha is used as a preventative or You're with me during the ’90s. He was surprised and Reading a Preview as a frst-aid treatment or many common health relieved to learn that, ar rom being painul, gua conditions. The vast majority o its use is as a olk Unlock sha can perormed the same eect in a genfullbe access with a to free trial. medical practice in the domestic setting. In these tle and pleasant manner which, he agreed, makes households, usually mum or dad or a grandpar- it a much better technique. ent knows how to perorm it. As I have heard said Download With Free Trial by many Vietnamese Australians, “I do it or my- What is sha? sel” or, “It’s never hard to fnd someone who can help you with cao gio.” Sha is the term or the small reddish dots that Knowledge o the method is passed down the emerge rom the superfcial or deeper levels o generations by an oral and visual tradition, rather the body to the skin surace during gua sha treatthan rom book learning. There is also no par- ment. In biomedicine, sha is labelled petichiae by ticular gender divide with its practice. Men and dermatologists, and understood only as a pathowomen both perorm it, although it would be cor- logic abnormality. A more dispersed pattern o rect to say that it is done mostly by women, who redness, thought o as ecchymosis (bruising) in  Sign upisto vote on this title adopt the role o the care-giver in most traditional conventional Western medicine, also produced, households. Due to being a sae, eective and and is also seen only  as abnormal. However, Useful  Not useful cost-eective treatment, the Chinese Government when these orms o discolouration appear, gua in recent times has also encouraged its practice in sha practitioners are pleased and assured that the the broad social setting. treatment has been positive. In other words, with
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‘’
Qi and blood are both warm by nature, so when these two become compressed, as happens with blockage or stagnation, heat maniests and concentrates into a new substance, which is sha.
traumatic injury or to the penetration o adverse climatic actors such as wind or internal pathogenic conditions. In Chinese there is a amous medical saying that goes: “Where there is blockage o qi and blood, there is also pain.” Qi and blood are both warm by nature, so when these two become compressed, as happens with blockage or stagnation, heat maniests and concentrates into a new substance, which is sha. Sha and the associated discolouration also contains the pathogenic actor(s) responsible or the blockage, and when it has been released, normal integrity o the area is restored due to the qi and blood being able to resume owing smoothly. In the case o musculo-skeletal conditions many people amiliar with gua sha oten have it perormed as a frst-line treatment, in the k nowledge that ridding the body o sha takes out the irritant toxins that clog and cause pain. From a well-inormed traditional perspective, massaging the area intended or gua sha is essential to disperse any strong concentration o qi and blood that can cause painul knotting during treatment.
icine: Application and Sae Practice cal Practices in the Vietnamese Commu tribution throughout the Vietnamese as well as to health-care services and institutions. The therapies ocused o sha (cao gio), cupping, pinching, stea sage and diet. With regards to gua sha reasons why Vietnamese community l so keen on this research project was to community about the sae and eect in which it should be perormed. The very common practice o usi cially when used in a orceul way (as is) can cause pain, besides the chanc When the skin is broken this can lea inection o blood-born diseases such and AIDS. An important chapter in the report the common misinterpretation o the ater gua sha (and cupping) by Wes practitioners or social workers and th report explained that these should n used as bruising due to abuse or as t o a misinormed therapeutic practice I also had the good ortune, Demonstrating gua sha my contacts, to become the yea You're Reading a Preview dent o a reclusive Vietnamese m It is always a ascinating time or me when I get a holder o the disappearing he the opportunity toUnlock demonstrate guawith shaato stufull access free trial. age known as the Buddhist Wande dents or the frst time — to see the amazement Medical Tradition – a topic or submi on their aces. What does convince them o its Lantern in the uture. Some o the in Download With Free Trial this essay comes rom this source. B bona fdes is the way such a vivid display o sha so readily appears with just a ew benevolent light is a brie account o some o the more stroking applications over the painul regions. results gathered rom 360 oral questio They can appreciate that under “normal” circum- 25 in-depth interviews conducted or stances, there is no way that such discolouration According to the questionnaire resu would appear. is the most popular orm o treatment What is also convincing is how the receiver will Vietnamese community in Melbourn immediately report that they eel much better. A age rate o 63 per cent. This means th good demonstration o the efcacy o gua sha is medical interventions available to th when a person in class with a sti and sore neck ese, including other traditional  thera Sign up to vote on this title nominates themselves as a “model”. as Western pharmacological medicin Beore treatment it is always worthwhile to  test Useful popular all was gua sha. The 63 pe useful o Not their range o movement or observers to note the means that gua sha is the frst contac increase in range and comort level aterwards. preerred by this large percentage o p Comments such as “intriguing” or “totally unAmong the questionnaires, some o
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Cao gio is eective. I have always used it. (Male aged 22). “It seems to work every time I have a cold”. (Female, aged 22). Many times cao gio eels very eective, thereore I use it requently. (Male, aged 67). I believe that cao gio is good because when you take the Wind out you eel very well. (Female, aged 16) It gives a quick result. My frst preerence is to treat mysel beore I go to see a doctor. (Male aged 61). I don’t like it because it’s painul – but it’s eective when I have been struck by poison Wind. (Female, aged 18). Quick, convenient and eective. (Male, aged 18).
Gua sha instruments
While a Chinese porcelain soup spoon or a better way depends on the strength o the person A cin  gu smooth-edged coin or metal top rom a glass jar receiving treatment. I the patient is robust, then n, anging  are commonly used to perorm gua sha, nothing gua sha can be applied quite slowly with a degree ga hn, an d accomplishes the task better than a polished wa- o pressure. However, or anyone who is weak or wih wdn han ter bualo horn tool made specifcally or the job. ill, the pressure should be light and brisk to inain pn,  B These are manuactured in China. Besides having vigorate the points and clear the channels. It is (Artwork and photos fr an excellent smooth edge, according to the Chi- most unortunate that some practitioners use ar nese materia medica, water bualo horn taken You're too much pressureawhen they perorm gua sha. I Reading Preview internally clears heat and fre toxin in the blood. have heard many stories rom people complainUsed externally as a gua sha tool, it releases sha Unlock ing that shawith wasapainul, full gua access free trial.even excruciating. actors o wind and heat. This is bad practice, completely unnecessary and It is also good to note, as I trust my inormant wrecks the reputation o the treatment. was correct, that the water bualo are not killed Download With Free Trial or their horns – they are ar too valuable as do- Informed consent mestic arm animals. Instead, once they have died naturally, their horns are taken and slices are One o the challenges or practitioners during ashioned into gua sha tools. Other means, when the process o obtaining inormed consent beore resources are scarce, can be the knuckles o the proceeding with the therapy, is explaining to the fngers, or even as I observed in the Taiwanese patient what gua sha is; and the likelihood that countyside in the 1970s, a man using a bundle o even with light stroking, a series o markings are horse mane hairs, wrapped around the index fn- likely to appear. In a nutshell, this is how I usually gers o his hands to treat his neighbour’s aching go about it. The explanation serves a better pur Signbrie. up toLet’s voteimagine on this title muscles. pose i it is inormative and this patient has painul shoulders.  Useful  Not useful
Diagnosis
One way to diagnose the presence o sha is to
I think it would be a good idea to do some gua sha or you. It’s a Chinese method or relieving sore
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I fnd most people are receptive to this explanation. The only reusals are when the patient had received gua sha previously rom a practitioner who had been ar too strong with their application. Ater a treatment, it is also a really good idea to have two mirrors in your practice room so the patient can see the reected image rom behind. It can be very disconcerting or someone to see the markings later when the practitioner is not present to provide reassurance.
After gua sha Allow the receiver to rest or a while and give him or her a glass o warm water. n Instruct the receiver not to shower or bathe within one hour ater treatment. A cold water shower or bath should be avoided or at least 24 hours. n Inorm the receiver it is important to keep all treatment areas covered up and warm. They should also be sure to keep away rom windy conditions including ans and air-conditioning. n
How to perform gua sha Cautions and contraindications Gua sha is applied primarily on the back, neck, shoulders, buttocks and limbs. A thickish oil is spread over the area to be rubbed. The instrument is held comortably in the hand and the practitioner usually makes 10 to 30 strokes in a downward direction away rom the head. A simple measure to be certain the orce used is correct is to ask the person receiving i they are comortable with the pressure. For best results, gua sha is emphasised on both local and distal acupuncture points determined by diagnosis.
Method of practice I you are right handed then hold the gua sha instrument in your right hand. Your arm should be comortable and relaxed. 1. Your instrument should be held at a 45degree angle to the area you wish to treat. 2. Begin with sot scraping or the frst ew strokes, then apply a little more pressure i required. From this point, do not get heavier with your scraping. Remain consistent, applying a suitable strength and rhythm. 3. Try to perorm long (15–18 cm or about 6–7 inches) uninterrupted strokes where possible. 4. Scrape in the same direction, ie. downwards – do not scrape downwards and
Take care to avoid pimples, moles and other skin irregularities that may be scratched or broken i an instrument is rubbed over it. Care must also be taken to rub the area with appropriate pressure. The frst rule o any therapeutic procedure is DO NO HARM.
opens the yang channels thro head has the most eective an ability to remove wind-based pa iently and quickly. This is pert we recall the principle rom Basi chapter 5: “It is best to treat (dis level o) the skin and hair.” A terrifc i llustration o gua sh brighten the senses and allow th to circulate can be elt by per ollowing practice. Take your gu close your eyes and or a ew min comprehensively throughout o your orehead (very lightly) and occipital line and on down the j (otherwise known as the uppe muscle). Allow yoursel to rest open your eyes. How does th compared to the other?
Case study 1
In 1998 I was conducting resea jiang province in north-west Ch ling by bus to a town that was kn o China’s “three urnaces”. In t mering desert landscapes peo live underground and not a s when the sun is high. On the w passed “Flaming Mountain”, m by its description in the classic the West. It was incredibly hot as back seat o a bus or our hou sun beating down on the back o When I arrived, as I was getting I elt a bit shaky and an hour sun began to sink I really began Gua sha or cupping? unwell and emotionally disorien It was my frst experience o s While there are some similar applications or syndrome (heat exhaustion) a gua sha and cupping, gua sha does a better my hotel manager knew  what Sign up to vote on this title job o removing sha. Sometimes sha can be sat outdoors in the eating area observed when stationary cups are applied, vines, he noticed how I Useful grape useful  Not and oten even more is drawn to the surace said: “We get this all the time, le with the sliding cup method. However, gua up.” He did gua sha to the top sha has the superior ability to thoroughly beginning at the point Bai Hui Do not apply gua sha: 1. To people who are too weak to tolerate the treatment. 2. To people withReading bleeding disorders. You're a Preview 3. To people who are taking anti-coagulant medication, Unlock eg. fullwararin. access with a free trial. 4. During pregnancy. 5. Soon ater surgery. Free Trial 6. Over Download varicose veins,With skin disease or open wounds, scratches etc. 7. To a person suering rom a serious communicable disease. 8. Within one hour beore or ater eating.
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which rises in the body (as heat does), was efciently vented at and around the Bai Hui point as well as released rom the neck and upper back. My scalp and trapezius were a veritable mass o sha – and I could not have been happier. Isn’t it terrifc when we practitioners have such an eective and insightul healing experience – and having a hotel manager cum gua sha practitioner do it on site is just one example o what I love about Asia.
Case study 2 During a tuina class, I introduced gua sha and asked or a volunteer who had a sore and sti neck. The frst hand that shot up belonged to a male aged in his 20s who worked with computers all day. Immediately ater the treatment he elt much relieved and all the students witnessed a dramatic show o sha throughout the back o his neck and upper back. They also noted ollowing a mobility test beore treatment how much more movement was possible or him compared with two minutes beore. He reported in class a week later that the area still elt much better. The other students o course clamoured to get a look at his neck to see whether markings remained, but true to orm, all had completely aded by then. A ew months passed and I was teaching a Gua
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Sha Day course. I again asked or a volunteer or the frst demonstration o the day. I asked or someone with a sore back and the same person as beore got in frst. Now, I am not making it up – I had completely orgotten I had previously perormed a treatment on this guy. I began doing gua sha along his occipital line, down both trapezius and across his upper shoulders … and nothing! It is times li ke this as a teacher when you need to keep a brave ace! Anyway, I proceeded (in desperation) and remarkably, as i a line had been drawn, a mass o sha appeared rom the upper margin o the scapula and throughout the rest o the interscapular margin. Strong sha was also released rom both inraspinatus regions. Whew! But I was perplexed, and remarked how strange it was or the upper area to be ree o sha while the rest o the area had such a ush o the stu. Then my “model” perked up and said: “Don’t you remember that you did the neck and shoulders in a quick demo a couple o months ago at school?” His reminder then proved to be a superlative example o gua sha. Firstly, it showed in the best way possible that only when there is a problem does sha emerge, and second, in this case at least, even though the person did the same job, the area that was afrst treated had maintained a You're Reading Preview good level o comort and mobility.
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