Untold Secrets of China’s Most Powerful
Massage Technique ©2013
By Dr. Harvey Kaltsas, A.P.
, Dipl. Ac. (NCCAOM)
“Those who give their
bodies a good cure (first) treat their skin and hair; their next treatment
concerns itself with the muscles and the flesh…”
Physician
Ch’i Po in the Nei Ching[1] (the
oldest book in the history of
traditional Chinese medicine)
When it comes to treating painful
afflictions, most Chinese grandmothers have it all over Western physicians.
They know how to make most pain go away (without expensive surgery or the use
of potentially addictive drugs laden with unhealthy side effects) by using a
simple massage technique known as gua sha.
This article will teach you the technique, but more importantly it will teach
you the how, when, and why to do gua sha massage. Practicing techniques without
understanding can be dangerous – hence the length of this article.
My own understanding
of gua sha all started one cold,
blustery day in December, 1974 when I was putting a Selkirk™ stainless steel
chimney through the roof of my farmhouse in Saskatchewan,
Canada.
The temperature was 20 below zero Fahrenheit with a stiff wind that knifed
through my overcoat as I wrestled with this cumbersome contraption, trying to maintain
my balance on the slanted, slippery roof.
I was hoisting the chimney pipe
into place while my friend Lew pushed it up from below. Somehow we got our
signals crossed, and the entire weight of the chimney was suddenly left to me.
As I struggled to keep the chimney from plummeting down below, it pulled, stretched, and tore most of the
attachments of my rhomboids to my left shoulder blade.
Even though I was then an
invincible and immortal twenty-seven years of age, it hurt like hell, and every
time the weather turned damp or cold or windy, which is virtually everyday in
Saskatchewan, I would writhe in agony from sporadic fits of pain, which
extended from my shoulder blade all the way down the backside of my arm to my
baby finger.
On occasion I would lean up against
a door jump and rub it to gain some relief, but basically I was miserable for a
year. The pain humbled me and left me despairing that
I would always be subject to its whims, never knowing when
it would flare up.
A year
later I moved back to Boston and had the very
good fortune to intern as an acupuncture apprentice with Dr. John Ho Fen Shen
at his clinic in Everett.
After a few days of watching him perform miracles with patients, I dared to
broach the subject of my own malady. In short order he diagnosed me with a wind
cold invasion of the triple warmer, small intestine, and urinary bladder
musculo-tendino meridians and inserted a few appropriately placed needles, at Triple
Warmer 3 being one I can distinctly remember.
Then he
uttered words I will never forget: “You need gua sha massage to release the wind.” Like most North Americans, I had never heard
of gua sha, even though unlike them I
had been studying macrobiotics with Michio Kushi since 1970 and had studied at
the North American College of Acupuncture in Vancouver from 1973 to 1975.
Dr. Shen
approached me with a jar of Tiger Balm™ and a plastic spoon left over from the
Chinese take-out food which we’d had for lunch. He smeared the Tiger Balm™ on
and started scraping the back of my left arm, shoulder, and shoulder blade.
To my
amazement, the reservoir of pain which had been pent up in those pathways drained
out of me like a dam had burst, and soon I was pain free for the first time in
a year. Over the next few weeks Dr. Shen gave me a few follow-up treatments –
to my relief with a proper porcelain spoon – and I was able to resume a
relatively pain free life, with only occasional flare-ups when the weather
turned bad. Those times were relieved by more gua sha massage.
During my
year of apprenticeship with Dr. Shen, gua
sha became my specialty, and I was called upon to do it to many, many
patients, most of whom experienced dramatic relief. It is the single most
effective massage technique I have ever used.
Dr. James
Tin Yau So became my other mentor at Dr. Shen’s clinic, and together they
taught me their underlying theories of how to do gua sha and why it works. Dr. Shen and Dr. So[2]
both instructed me that if a patient has pains in the neck, arms, back, and joints,
or even on the abdomen and intercostally, if the pain is intermittent, and
especially if the pain varies with changes in the weather, then the patient
probably suffers from a condition known as sha.
If the
doctor assumes the patient simply has rheumatism and treats him/her for that
only with herbs, acupuncture, and/or moxa, the symptoms will probably come back
in a couple of days. If the doctor treats with gua sha massage, the patient will get much better.
Gua is Chinese for scraping. Sha is a Chinese medical term which
lacks an accurate English translation, but the word sha in Chinese means sand; and sharks, which have a sandy like
appearance to their skin, are called sand fish. When one performs gua sha massage, scraping the skin, the
skin develops petechiae or little bruises which give it this sand like
appearance.
Is Gwa Sha a Form of Detox?
I have read some explanations that sha is a condition “in which the waste products of cellular metabolism (the
burning of glucose in the cells for energy) become trapped in the muscle
fibers, often as the result of major trauma such as whiplash but sometimes from
accumulated smaller traumas from daily wear and tear and exercise.”[3]
However
neither Dr. Shen nor Dr. So ever mentioned toxins to me in relationship to sha, and it is probably an insufficient
understanding of what is really going on to think that sha represents an accumulation of toxins, at least in the Western
sense.
When too many toxins are released
into the bloodstream all at once, the patient often experiences a Herxheimer
reaction. “The Herxheimer reaction (also known as Jarisch-Herxheimer or herx) occurs when large quantities of
toxins are released into the body as bacteria (typically Spirochetal bacteria)
die, due to antibiotic treatment.
Typically the death of these bacteria and the associated release of endotoxins occur faster than the body can remove the
toxins via the natural detoxification process performed by the kidneys
and liver.
It is manifested by fever, chills, headache, myalgias, and exacerbation of
cutaneous lesions. Duration in syphilis is normally only a few hours but can be
much longer in other diseases. The intensity of the reaction reflects the
intensity of inflammation present.”[4]
The Herxheimer reaction
also happens when candida die off from anti-fungal treatments. Patients get
tired, achy, and even groggy during die off reactions when their eliminative
organs cannot process the sudden onrush of newly released toxins.
However, this does not occur when one does gua sha, even though there is a
dramatic, obvious reaction if sha is
present. Upon scraping, the skin can turn various colors, from pink to bright
red if the condition is new or to purple with little black spots if the blood
has been stuck a long time.
Something is obviously being released, upwards to
the surface, but patients do not feel tired or achy afterwards. If anything,
they feel relieved, refreshed, and free of pain and discomfort, often remarkably
so. This is uncharacteristic of a release of toxins as others have assumed.
Certainly some toxins are released in the process of doing gua sha, but detoxification is not the principal component in
patient’s quick recovery after this therapy.
What is Sha, Really?
What is happening then? Also, why do fried or
sugary foods contribute to sha? Why
does traumatic injury contribute to sha?
Why do changes in weather aggravate this condition, and are there any special
groups of patients on whom you should not perform gwa sha? These are all questions the acupuncture profession in America has
left largely unexamined and unanswered for decades. Until now.
Everyone in Traditional Chinese Medicine understands that sha impairs the circulation of blood,
but how? To comprehend the phenomenon of sha,
one must first consider the physiology of the circulatory system. Wikipedia
provides some help here:
“Blood flows from the heart to arteries,
which narrow into arterioles,
and then narrow further still into capillaries. After the tissue has been perfused, capillaries widen to become venules and then
widen more to become veins, which return blood to the heart.
“Capillaries are the smallest of a body’s blood vessels,
measuring 5-10 μm
[micrometres (1/1000 of a millimeter) in diameter], which connect arterioles and venules, and
enable the interchange of water, oxygen, carbon dioxide,
and many other nutrient
and waste chemical
substances between blood and
surrounding tissues.”
Capillaries, which are made of single layers of
epithelial cells, expand or contract in diameter as an indirect function of the
circulation of potent vasoconstricting hormones such as adrenaline, angiotensin
II, and endothelin or the
circulation of potent vasodilating hormones including prostacyclin and
nitric oxide.
These hormones directly
affect the metarterioles (or arterial capillaries) which are short vessels that link arterioles
and capillaries. Instead of a continuous tunica media, they have individual
muscle cells placed a short distance apart, each forming a precapillary
sphincter that encircles the entrance to one capillary. Constriction of these
sphincters reduces or shuts off blood flow through their respective capillaries
and diverts blood to tissues or organs elsewhere.”[5]
Also, endothelium
derived factors play an important role in controlling local blood flow. These
substances are either produced or modified in the vascular endothelium, and an
accumulation of metabolites such as CO2, K+, H+,
adenosine and lactate causes vasodilation.
Another factor in
whether arterial capillaries expand or contract, as any arthritis[6] or
Raynaud’s patient can tell you, is weather, with its increasing or decreasing
temperatures and changing barometric pressures which can affect osmotic
pressures in and around the blood cells.
“When you get cold and come inside, it feels hot
because your capillaries are constricting due to the overwhelming change in
external temperature. The osmotic pressure
is trying to increase, but the arteriole venue
will not let this process to develop, and so pain and heat become evident.”[7]
This should be a clue to us that
capillary expansion or contraction is somehow related to the phenomenon of sha, since one of the common indicators
of sha is that the pains vary with
the weather.
Acupuncture is
known to cause vasodilation by relaxing the sphincter muscles of the metarterioles.
This is probably why Dr. So suggested doing acupuncture first when treating
patients, because he found that makes the gua
sha more effective.
“The flow
of blood through the capillaries is fundamental to a feeling of well being,
which is why the “…walls of capillaries are composed of only a single layer of cells,
the endothelium.
This layer is so thin that molecules such as oxygen,
water
and lipids
can pass through them by diffusion and enter the tissues. Waste products such as carbon dioxide
and urea
can diffuse back into the blood
to be carried away for removal from the body. Capillaries are so small the red blood cells
need to partially fold into bullet-like shapes in order to pass through them in
single file.”[8]
Another
factor affected by weather is the flow of blood. As the Physician Ch’i
Po instructs in the Nei Ching,
“…when the weather is warm and the sun clear and bright, the blood of man flows
gently and his secretions protect his breath (vigor) and keep it volatile.
Hence the blood flows easily and the breath moves smoothly.
“When the weather
is cold and the sun darkened, man’s blood coagulates and does not flow, and his
hitherto protected breath sinks low and perishes.”[9]
Ch’i Po also says, “When a person is exposed to the wind,
either lying down to rest or walking about, his blood will be affected. The
blood then coagulates within the flesh, and the result is numbness in the hands
and the feet.”[10]
Besides their
effects on dilating or contracting the capillaries, how do changes in weather such
as cold and wind affect the flow of blood? The parts of the blood which concern
us with respect to gwa sha are red
blood cells and plasma.
Red blood cells or
erythrocytes “are bi-concave disks.
They are flattened and depressed in the center, with a dumbbell-shaped cross
section. This shape optimizes the cell for the exchange of oxygen with its
surroundings. The cells are flexible so as to fit through tiny capillaries, where they release their oxygen load into
surrounding tissue… The diameter of a typical human erythrocyte disk is 6–8 µm, much smaller than most other human cells.”[11]
Erythrocytes: (a) seen from surface; (b) in
profile, forming rouleaux; (c) rendered spherical by water; (d) rendered
crenate by salt. (c) and (d) do not normally occur in the body.[12]
It is very important to note that
the capillaries through which red blood cells must squeeze are 5-10 μm in diameter, and the erythrocytes themselves are 6–8 µm
in diameter. This can make for can be a very tight fit in the best of
circumstances. Add to this the fact that capillaries can be compressed by
excess extracellular (interstitial) water, and it can be a very tight fit
indeed for red blood cells to squeeze through the capillaries.
Mother nature helps out a bit here
by coating the inside of the capillaries with lecithin, a teflon™type substance
which makes the capillary walls smooth and slippery. Also it is good that it’s
a tight squeeze, because the red blood cells, pressed up against the sides of
the capillary walls, give up the oxygen they carry through osmosis to the
surrounding tissue and pick up carbon dioxide in return, which is eventually
exchanged in the lungs for more fresh oxygen.
When red blood cells flow through the capillaries,
they do so single file, one at a time. Also, like all phenomena in nature, red
blood cells have their own yin/yang nature. Part of the red blood cell, being
composed of iron, carries a positive electrical charge and part of it carries a
negative electrical charge. As the red blood cells line up single file, they do
so with opposite polarities facing each other, positive to positive and
negative to negative. In this manner, the red blood cells to some extent repel
each other electromagnetically, and thus they do not stick together as they
flow through the narrowest passages of the circulatory system.
But what happens when they do stick together as in figure b
above? This is called a “rouleaux formation, a stack-like arrangement of
red blood cells in blood or in diluted suspensions of blood in which their bi-concave
surfaces are next to each other… “In large blood vessels, red blood cells sometimes occur as a stack,
flat side next to flat side… and it occurs more often if the levels of certain
serum proteins are elevated, as for instance during inflammation.”[13]
Why would nature design certain
molecules found during inflammatory processes to cause red blood cells to stick
together? The answer is because after traumatic injury, the body is at risk of
bleeding to death. When red blood cells stick together they have a much harder
time passing though the capillaries and out of the body. The proteins found
during inflammation serve as a localized shut off valve to keep the rest of the
body alive by preventing the wounded area from spilling out too many red blood
cells.
In rouleaux formation, erythrocytes can pass
easily though the larger arteries and arterioles, but they have a very hard
time fitting through the capillaries. Clumping together like this is also
called hemagglutination, and for red blood cells, it’s like a logjam on a
river. The logs (red blood cells) get stuck together, jam up against the opening
of the river (the capillary mouth) and can’t flow downstream.
As a result, the tissues in that area get deprived
of the vital oxygen which the red blood cells are supposed to transport to
them. You know how your lungs start to scream in pain when deprived of oxygen
for a few minutes? Imagine what tissues deprived of oxygen must feel like.
This, in my humble opinion, is the physiological
nature of sha and the reason why it
hurts.
These same tissues also have waste carbon dioxide
they need to exchange for oxygen, but this is not such a big problem, because
93% of the carbon dioxide given off by tissues is carried away in plasma in the
form of bicarbonates.
Fortunately, much plasma does continue to flow,
since it is a thinner solution, mostly 91.5% water which acts as a solvent to
carry other substances, namely proteins (7%), and salts, nutrients,
enzymes, hormones, and nitrogenous waste products (1.5%). [14]
However, some
plasma flow is restricted, and this, along with the clumping of red blood
cells, causes localized edema in areas of sha.
Plasma has other
qualities and functions as well:“The higher concentration of protein in [plasma]
prevents water from moving from the blood into the interstitial fluid. Without
this osmotic protection, water would move from the blood into the interstitial
fluid, causing a rapid loss of blood volume.
“The most abundant
of the plasma proteins is albumin, a protein also found in egg white. Albumin
concentration is four times higher in the blood than in the interstitial fluid
(the watery fluid that bathes tissues, but is located outside and between
cells). This high concentration of albumin in plasma serves an important
osmotic function…
“The other
components of plasma are salts, nutrients, enzymes, hormones, and nitrogenous
waste products. Together, these substances account for 1.5% of plasma. The
salts present in plasma include sodium, potassium, calcium, magnesium, chloride, and bicarbonate…plasma contains
nutrients that nourish tissues. The nutrients found in plasma include amino
acids, the building blocks of proteins; glucose and other sugars; and fatty
acids and glycerol, the components of lipids
(fats).
“In addition to
nutrients, plasma also contains enzymes, or small proteins that function in
chemical reactions, and hormones, which are transported from glands to body
tissues. Waste products from the breakdown of proteins are also found in
plasma. These waste products include creatinine, uric acid, and ammonium salts.
Blood transports these waste products from the body tissues to the kidneys, where they are filtered from the blood and excreted
in the urine.”[15]
To summarize, when
red blood cells stick together and jam up at the mouths of capillaries, the
tissues they were supposed to nourish are deprived of oxygen, but they do get
other vital nutrients from plasma. These tissues can survive but not thrive. I
suspect that when sha is present it
is the lack of oxygen to the tissues and the pressure on surrounding tissues caused
from excess fluid accumulating in the area which people experience as pain.
Sha, then is a situation wherein a vital component
of the nutritive qi (energy), oxygen,
does not flow with the blood to nourish tissues. Not coincidentally, when there
is deficiency of qi in an area, qi cannot hold the blood, and there may
be hemorrhages, since “Qi is the
commander of Blood.”[16]
What Causes Sha?
What causes this clumping together of red blood
cells? One factor is the presence of proteins associated with inflammation, as
occurs after a traumatic injury. Everyone who treats sha knows that it often develops after trauma.
Another well known fact is that certain viruses
can cause hemagglutination. Evil winds and viruses are often synonymous in
traditional Chinese medicine.
A third factor is that trauma can depolarize
magnets and the magnetic qualities of red blood cells, causing them to stick
together rather than repel each other.
High levels of sugar and/or fats in the blood also
cause red blood cells to stick together, especially if the surface of the
nearby skin under which the sugar and fat rich blood flows is exposed to a cold
wind. The blood is 98.6 degrees Fahrenheit. A cold wind can be 40, 30, 20
degress or less Fahrenheit, which can
cause the blood to gel up, like oil in a car motor on a very cold winter day or
water in a frozen stream.
As the Nei Ching says, “When Heaven is cold and
the earth is icy (frozen), the then main arteries of water are stiffened and
frozen.”[17]
The following drawing from Wikipedia show the
effects that weather, which has a direct impact upon intracellular and
extracellular osmotic pressure, has on red blood cells themselves. If the
osmotic pressure is too great, the erythrocytes look like those in the
hypertonic picture; if just right, they look like those in the isotonic
picture; and if too little, they look like those in the hypotonic picture. Does
this remind anyone else of the Goldilocks story?
osmotic pressure on red
blood cells
All these Western physiology understandings
of the blood and circulatory systems fit in well with what my Chinese masters said
about sha. Drs. Shen and So taught me
that sha is created from an internal
condition of overheating in the body, and it is aggravated by the consumption
of overheating foods such as a diet rich in sugars, fried food, or starchy,
baked goods. The qi and blood get stuck,
don’t flow, and pain ensues.
Also, as they often said, since “the
wind is the cause of 100 diseases,” a cold wind can get into the body and
become trapped. The patient, they told me, interprets as pain the struggle
between the wei qi (defensive energy)
trying to push the evil wind out of the body and the evil qi trying to penetrate deeper. The Vietnamese term for gwa sha literally means “scratch the
wind.”
Dr. So once recounted that he would
often eat fried rice at night which led to overheating of his intestines while
he was asleep. Since he was sleeping, he couldn’t drink appropriate teas to
counter the overheating, and this led to severe pain in his spleen area.
Dr. So’s father suggested the
problem was sha. He scratched Dr.
So’s abdomen, and this resulted in a cure. For one week thereafter Dr. So
abstained from rice and ate potato and soybeans instead. The pain did not come
back.
Drs. Shen and So also explained
that sha can result from traumatic
injuries, and from my years of observation, I know this also to be true.
They advised me that to diagnose if
sha is present, press down firmly on
the skin and underlying tissue with the thumb or fingertips. If the skin turns
white and stays white for more than a few seconds, leaving a vestigial image of
the thumb or fingers after taking them away, then a condition of sha exists.
In Western medicine, this is
referred to as “capillary refill - when pressure is applied to skin or a finger
nail, it goes white. When the pressure is released, the colour rapidly returns
within 2-3 seconds. This is capillary refill, and is prolonged when the
peripheral circulation is poor.”[18]
“Sometimes if the sha has been there many years,” Dr. So
would say, “it sinks down so deep that you can’t see it, even when pressing on
the skin. If needling or moxa don’t improve the patient’s condition, then gua sha might still be indicated.”
Gua Sha Precautions and
Prohibitions
To treat sha by doing gua sha
massage, traditionally the Chinese applied cooking
oil to the skin and then rubbed the skin with a coin, spoon,
or other smooth-edged instrument. For the rubbing tool, I do not use the cap of the Tiger Balm™ jar
or Vicks Vapo-Rub™ jar as do some practitioners. I’m concerned that reuse without proper
sterilization will make the cap a vector for transmission of blood-borne
diseases, especially since the cap is metal, has a lip that curves inward, and
is much harder to clean than a porcelain spoon. Instead, I prefer to use Tiger
Balm™ and a porcelain spoon with its smooth round edge.
Although gua sha is recognized correctly in the acupuncture community as
being one of the safest and most effective tools we have to get patients well,
it is not a therapy without risks and harmful side effects. These should be
understood before commencing treatment.
It is very
important first to learn if the patient is either a diabetic and/or on blood
thinning drugs such as coumadin. Do NOT
perform gua sha on diabetic patients
unless you are sure their blood sugar has been in normal range for an extended
period of time.
Why is
this? Because if there is a great deal of sugar in the blood, there will be
hemagglutination everywhere. Sha will
be everywhere, and it will not drain away readily once rubbed. It will just
hurt, unlike after doing gua sha to
patients with normal blood sugar levels, and the bruises will last a long time.
Conversely,
if patients are on coumadin or other blood thinning agents, their normal
tissues which are not affected by sha
will often hemorrhage and bleed when rubbed. It can be a problem getting this
bleeding to stop.
Also, the skin of elderly women who
are very low in estrogen can become very thin, with little fat beneath the
layer of epidermis, in the hypodermis level, so that it can be almost like
paper. Please be careful when considering
doing gua sha to them, as you can
literally scrape their skin off and cause significant gashes in the upper level
of skin.
The same holds true for people who
have been on prednisone for extended periods of time. Their skin becomes quite
thin and fragile, and they are not good candidates for gua sha massage.
The drawing below is from Wikipedia
and shows the various levels of skin and their components.
An equally
important precaution to take before doing gua
sha is to warn the patient that a reddish or even purplish bruise may
develop. Otherwise they may freak out. This has happened to me too often to
want to go through that again. Also, advise them to tell their spouse that the
treatment was gentle, did not hurt, despite appearances, and the bruises will
go away in a few days. I’ve had more than one husband threaten to inflict
bodily harm on me when their wives forgot to explain before taking off their
clothes what had happened at my office.
Tell your patient that you will be applying
Tiger Balm™, some other balm, or oil to their skin to make it slippery and that
you will then be rubbing on their skin with a porcelain spoon. Explain that
although you will be rubbing several areas with the same moderate intensity,
not all of them will bruise – only those areas where the blood had been stuck
and causing them pain.
The redness and reddish purplish
spots which look like sand represent old red blood cells which had formerly
been stuck together but now have been broken up into smaller particles. Now the
capillaries will be unclogged and fresh red blood cells will be able to flow
though, bringing fresh oxygen to the tissues and often near immediate relief. With
that communicated, your patient will receive the treatment much more
comfortably.
How to Do Gua Sha
1. Again,
apply Tiger Balm™ or some other oil liberally to the surface of the afflicted
area.
2. Take
a porcelain spoon and face the hollow side towards the patient’s skin.
3. Rub
downward and outward with moderate intensity (more on intensity later) along
the various acupuncture meridians associated with the patient’s pain:
a. on
the back, go downwards one inch lateral to the spine;
b. on
the neck, go downwards from below the earlobe cleft to along the top of the
shoulder on the Gall Bladder meridian;
c. stroke
downwards along the urinary bladder meridians on the neck and back, along both the inner and outer U.B.
meridians;
d. stroke
downwards along the medial aspects of the shoulder blades, that is along the
rhomboid attachments to the shoulder blades;
e. stroke
between the ribs in the intercostal spaces, from the center of the chest
outward;
f.
stroke down the center line of the chest, gently as
there is little subcutaneous fat there;
g. stroke downwards along the acupuncture
meridians (triple warmer, large intestine, small intestine) of the posterior
aspect of the arms;
h. stroke
downwards along the acupuncture meridians (urinary bladder, gall bladder,
stomach) of the lateral and posterior aspects of the leg; and
i.
only occasionally stroke downwards along the medial
aspects of the acupuncture meridians of the arms (heart, pericardium, lungs)
and legs (spleen, liver, kidney).
4. Also
important: avoid rubbing over moles and areas of broken skin.
5. Do
not rub over the vertebrae, bump, bump, bumpety, bump, bump; rub downwards
alongside them. Gua sha strokes
should be smooth and firm, but gentle.
6. Do
not rub over the ribs, bump, bump, bumpety, bump, bump. Rub laterally, between
the ribs from the center of the chest and abdomen outward to the sides.
7. Keep
reapplying Tiger Balm™ or oil to the skin after you have wiped it off with your
spoon. You can scoop out the Tiger Balm™ which has accumulated inside your
spoon.
8. Use
about four pounds of pressure - maximum - when making your strokes. You can
ascertain what five pounds of pressure is by pressing down with your thumb or
fingers on a bathroom scale. Stroke, don’t fan the skin, in one direction –
downward. Your level of pressure should not hurt the patient. I have seen one
colleague produce deep dark reddish bruises wherever he rubs because he uses
too much pressure. He rubs as if he’s digging for gold with that porcelain
spoon. He’s not releasing sha; he’s actually breaking otherwise healthy
capillaries. Don’t do that!
9. Rub
general areas at first till you see redness appear in some areas.
10. Then
concentrate your rubbing in the reddened areas.
11. Continue
rubbing these reddened areas till little red or back dots show up or till the
redness doesn’t get any redder – that is, stop rubbing once the redness has
leveled off and doesn’t get any redder.
12. After
you’re done with the massage, wipe the residual Tiger Balm™ or oil off your
patient to prevent clothing from getting stained.
13. Advise your
patient to avoid fatty and sugary foods and to keep out of cold drafts. This is
very important. Explain that you’ve opened the skin for the body to push out
the evil qi, but the door is also now open for cold wind to enter. So tell them to keep warm and out
of drafts. This holds true even in Florida,
where air conditioning both at home and in the car can penetrate and make a
patient’s condition worse.
14. Remember: gua sha is very good for treating muscle
spasms, especially in conjunction with acupuncture, after needles have been
inserted and withdrawn from around the perimeter of the muscle. The acupuncture
needles relax the sphincter muscles around the ends of capillaries, allowing
for easier blood flow.
15. Expect to
hear reports of miraculous recoveries.
16. Wait till
all the redness goes away before performing gua
sha again. This usually takes three or four days. The next time you do it
there will probably be less sha
appearing. Eventually, after a few treatments, there will hardly be any sha appearing at all. This does not mean
you are doing the technique incorrectly. It means that the patient has
recovered, and there is little if any sha
left. Congratulations. I’m sure your patient will be thanking you by then.
[1] Huang Ti Nei Ching Su Wen, p.
123, translated by Ilza Veith,
University of California Press, Berkeley
and Los Angeles, 2002
[2] Dr. So
founded the New England School of Acupuncture in Massachusetts
and Dr. Shen founded what would later would become the National College of
Oriental Medicine in Orlando.
[3] By Jim Martin, Licensed Acupuncturists; http://newconnexion.net/article/05-01/gwasha.html
[4]
Wikipedia
[5]
Wikipedia
[6] “Weather, Arthritis Pain Link
Confirmed, Arthritis Pain Increases With Cool Temps, Barometric Changes,” by Miranda Hitti, WebMD Medical News, Oct.
18, 2004
[7]
Wikipedia
[8]
Wikipedia
[9] Huang Ti Nei Ching Su Wen, p.
217, translated by Ilza Veith, University
of California Press, Berkeley and Los
Angeles, 2002
[10] Ibid., p. 42
[11]
Wikipedia
[12]
Wikipedia
[13]
Wikipedia
[14] Kathleen Scogna, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health,
2002
[15] Ibid.,
[16] The
Foundations of Chinese Medicine, 1989, Giovanni Maciocia, p.52, Churchill
Livingstone, New York
[17] Huang Ti Nei Ching Su Wen, p.
223, translated by Ilza Veith,
University of California Press, Berkeley
and Los Angeles, 2002
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