What is Gua Sha?
By Emma Suttie, D.Ac
Gua Sha is a medical treatment used in Chinese medicine and throughout South East Asia. In Indonesia the technique is called Kerik, in Vietnam: Cao Yio and in Laos: Khoud Lam.
“Gua” means to scrape or rub. “Sha” is the term for the reddish raised skin rash that occurs as a result of the scraping. Sha refers to the blood stagnation in the subcutaneous tissues before and after it is raised as the reddish skin rash (petechiae) or bruising (ecchymosis).
Gua Sha involves lubricating the skin with oil (traditionally a thick oil such as peanut was used) and using a smooth edged instrument, the acupuncturist uses long or short strokes causing redness or bruising. The most common areas for treatment are the yang areas of the body such as the back, neck, shoulders, buttocks, limbs. Occasionally the chest and abdomen are used as well. There are also types of facial Gua Sha that are used in conjunction with cosmetic acupuncture treatments to help increase circulation, elasticity and firmness of the skin.
Gua Sha does however cause temporary ecchymosis (or bruising) which fades in 2-4 days. In TCM theory, the intensity/severity of the bruising is an indication of the severity of the toxicity, stagnation or fever inside the body.
What Does Gua Sha Treat?
Gua Sha is used to treat as well as prevent the common cold, flu, bronchitis, asthma, and pain both acute and chronic. It is also used to detoxify the body, and alleviates fevers as the scraping brings the excess heat and toxins to the surface of the body to be released.
When used for pain there may be an achy feeling, tenderness or knotted feeling in the muscles. It is excellent for treating colds or flus especially if there are respiratory problems or high fever. Any problems of qi or blood stagnation can be successfully treated with Gua Sha.
Gua Sha has a special function to relieve fevers and inflammation of the respiratory system, and performs very well in conjunction with acupuncture and cupping for these conditions.
What Does The “Sha” Tell You?
The colour and intensity of the Sha is both diagnostic and prognostic. If the Sha is very light in colour it indicates a deficiency of blood. If the Sha is a fresh and intense red, it means the condition is acute and has not yet penetrated deep into the body. If the Sha is black or purple in colour it indicates blood stagnation which means the condition has been long standing. If the Sha is brown, there may be dryness in the body and a deficiency of fluids. Dark deep red Sha indicates heat. The Sha is a good reflection of detoxification and fever release.
What Tools Do You Use for Gua Sha?
There are many things that can be used to do Gua Sha. Traditionally, a slice of water buffalo horn, a piece of jade, a Chinese soup spoon, or a coin were used. You can basically use anything with a rounded edge. Now there are many tools of various sizes and shapes that are used for Gua Sha. Below is a photo of some common Gua Sha tools.
It is also important to lubricate the skin before administering the Gus Sha. Various massage oils can be used. You can also use peanut oil, almond oil, coconut oil or vicks vaporub as a lubricant.
How is Gua Sha Applied?
The area of skin to be treated is applied with oil as a lubricating medium. The acupuncturist then takes the Gua Sha tool and strokes the skin in a downward motion until the petechia form. If there is no blood stasis, stagnation or fever, a rash (petechiae) will not form and the skin will only turn pink.
Gua Sha is stimulating to the immune system, detoxifies, increases circulation, regulates organ function, normalizes metabolic processes, removes stagnation and eases pain. After a Gua Sha treatment, a patient usually feels a shift or release especially if there was pain. There is often sweating which is the body’s way of releasing toxins that have been inside the body. Gua Sha revitalizes, rejuvenates, helps diminish stress, fatigue and severe exhaustion. It helps to release emotions, relaxes the body and helps to clear the mind and senses. Gua Sha is a simple treatment, but incredibly effective for many ailments which is why it has been used in China and South East Asia for thousands of years.
The Importance of Emotions in Traditional Chinese Medicine
The emotions are an extremely important aspect of Traditional Chinese Medicine (TCM). Emotional wellbeing is an integral part of health in the TCM model. Each emotion is associated with an organ, which, if out of balance will cause specific symptoms. These are what the experienced acupuncturist or practitioner of TCM is looking for when you walk into their office with a complaint.
Emotions are of course a natural part of being human. Feeling joy, sadness and anger are all perfectly normal experiences we have in our day to day lives. It is when these emotions become excessive or are repressed and turned inward that they can become pathological and cause disease. The belief is that balancing the organ associated with the emotion will balance the emotion. Sometimes the organ is out of balance and produces the emotional imbalance. But sometimes the emotional imbalance can produce the organ imbalance. The difference to the practitioner is important only in preventing a recurrence of the problem. For example, if a person is experiencing extreme fits of anger, frustration, red eyes, problems sleeping, migraines and constipation, they are seen to be suffering from an imbalance of the Liver. This can be corrected with acupuncture and herbs. The liver returns to balance, the migraines disappear, sleeping improves and the bowels return to normal. But, if the patient is in a job he hates, with coworkers that make him angry and is constantly fighting with his wife, his anger will remain and the Liver imbalance will return. This is why during the diagnostic process, the practitioner asks many questions, and to the patient, it might seem like they have no bearing on the presenting condition. The job of the practitioner is to evaluate all aspects, not just the physical so that once the imbalance is corrected, the environment that created that imbalance no longer exists.
It is important to remember that cause and effect in TCM is not linear but circular. We usually think that something is the cause of an act, or effect such as - eating too much will give you a stomach ache. Eating too much is the cause and the stomach ache is the effect. This is linear thinking. In TCM linear cause and effect does occur when symptoms are present, for example - going outside without enough warm clothes on in the middle of winter will cause you to catch a cold, resulting in symptoms like a runny nose, achy muscles and a fever. These symptoms are the effect of the cold which was the cause. However, in some cases, the symptoms are not a result of such straightforward reasoning which is especially true when we are dealing with emotions.
One very common cause of emotional imbalance in TCM is repressed emotions. TCM is all about balance and flow. If emotions are not being expressed, they are being stuck which can lead to a blockage of the flow or stagnation, which in turn can lead to disease. How the disease manifests is completely individualized depending on many factors, and it is up to the practitioner to determine the “how”. Releasing emotions can heal disease. Even things that are considered extreme and long-standing stagnation in TCM like cancer. Diseases which, in the West, are seen as incurable. Emotions that do not have avenues for expression and release can create disease and disharmony in the body manifesting as physical symptoms. So, it is very important to have a healthy emotional life, expressing your emotions freely and not allowing things to build up.
Photo by Cristian Newman on Unsplash
Here is a breakdown of the emotions, their related organs and some symptoms when an imbalance occurs...
HEART
Emotion - Joy
Emotion out of balance - Lack of enthusiasm and vitality, mental restlessness, depression, insomnia, despair, confusion, anxiety, fidgeting, easily startled
Organ Function - Regulates the heart and blood vessels, responsible for even and regular pulse, influences vitality and spirit. Connected to the tongue, complexion and arteries
Symptoms of organ imbalance - insomnia, heart palpitations, irregular heartbeat, excessive dreaming, poor memory and concentration, dizziness, spontaneous sweating
SPLEEN
Emotion - Worry, overthinking
Emotion out of balance - Dwelling or focusing too much on a particular topic, excessive mental work
Organ Function - Food digestion and nutrient absorption, the first step in the formation of Blood and Qi, holds blood in the vessels, connected to the muscles, mouth and lips, involved in thinking, studying and memory
Symptoms of organ imbalance - Tired, loss of appetite, mucous discharge, poor digestion, abdominal distension, loose stools or diarrhoea, weak muscles, pale lips, bruising easily, excessive menstrual blood flow, other bleeding disorders
LUNG
Emotion - Sadness
Emotion out of balance - Excessive sadness, grief, or detachment, uncontrolled crying
Organ Function - Respiration, controls sweat and body hair, creates energy (Qi) from the air and redistributes it throughout the body, works with Kidney to regulate the water metabolism, an important part of the immune system and helps protect the body from viruses and bacteria, provides moisture to the skin
Symptoms of organ imbalance - Shortness of breath, fatigue, cough, catching colds easily, fever with chills, sore throat, runny nose, headache, asthma, chest oppression, pale complexion, dry skin
KIDNEYS
Emotion - Fear
Emotion out of balance - Fearful, no willpower, insecure, aloof, isolated
Organ Function - Responsible for reproduction, growth and development & maturation, connected with lungs in water metabolism and respiration, responsible for bones, teeth, hearing and head hair
Symptoms of organ imbalance - Frequent urination, urinary incontinence, vertigo, night sweats, dry mouth, poor short term memory, low back pain, sore or weak knees, ringing in the ears, hearing loss, hair that turns grey prematurely, hair loss and osteoporosis, lowered libido
LIVER
Emotion - Anger
Emotion out of balance - Explosive anger, resentment, frustration, irritability, bitterness, moodiness
Organ Function - Stores the blood, responsible for the smooth flow of Blood and Qi throughout the body, regulates the secretion of bile, connected with the tendons, nails and eyes
Symptoms of organ imbalance - chest distension, red face, bitter taste in the mouth dizziness, ringing in the ears, jaundice, menstrual problems (cramps, irregular or heavy periods), headaches, tendonitis, nausea, vomiting, sighing, breast tenderness, swelling and/or itching of the genitals, blurred vision, floaters, dry skin and hair
Here are examples of some combination patterns:
Heart & Kidney
If a patient is experiencing extreme mood swings between Joy (mania) and Fear (depression), it indicates an imbalance between the Heart (Joy) and Kidney (Fear). We would see symptoms such as insomnia, dream disturbed sleep, heart palpitations and dizziness.
Liver & Lung
If a patient is experiencing violent mood swings between Anger and Grief, an imbalance between the Liver and Lung is present with symptoms involving breathing problems, issues with bowel movements and waking between 1-5 am.
The way the TCM model views emotions is very specific. For example, there are many different types of depression. It depends on which organs are involved. Here are some examples:
Liver
If the depression is actually anger turned inward on itself, which is common with many women, the Liver is out of balance. Symptoms could include PMS symptoms, cramps during the period, vomiting and nausea.
Spleen
If obsessive thinking or worry characterizes the depression, we would suspect the spleen and look for symptoms such as decreased appetite, diarrhoea, fatigue, heavy bleeding with the periods, and bruising easily.
Kidney
Sometimes the depression comes with panic attacks (Fear). In this case, we would suspect the Kidneys. We would look for urinary changes (usually an increase in frequency), low back pain and weakness, tinnitus (ringing in the ears), poor appetite and diarrhoea.
Photo by Andy Chilton on Unsplash
Emotions are not the only factor contributing to disease. Another thing to consider is lifestyle. It is difficult to always avoid getting cold, having an umbrella for when it might rain, getting enough sleep and eating properly. We live in a fast-paced world full of stresses on both our minds and our bodies. We always seem to be rushing and there never seems to be enough time. And although sometimes we can’t help getting sick or feeling a little under the weather, it is important to remember that the cause of an imbalance may be occurring from events in your life. There is no needle for a bad relationship, stressful job or frustrating coworker. A practitioner can help you to deal with the stress in your life that may be causing the imbalance, but we can’t remove the stress. Only you can do that. Sometimes we feel that we are unable to change the circumstances that are causing stresses in our lives, but a practitioner can help you to deal with that stress by advising on how to eat healthily (eating with the seasons, and the incorporation of the 5 flavours - Sour, Salty, Spicy, Bitter, Sweet), and how to incorporate exercise and meditation techniques such as Tai Chi and Qi Gong into your life. The TCM practitioner is trained in how to live or the “Tao” (which comes from Taoist philosophy) helping both to rebalance a patient and educate him on how to retain that balance by living a healthy balanced life.
We are all living full, busy lives. Imbalance is everywhere, and staying healthy isn’t easy. I have found that in my practice people often feel overwhelmed and exhausted. I always suggest that they be kind and gentle with themselves, and to try to do at least one nice thing for themselves every day, as our happiness is so important for our health. We are living in a time when we are dealing with so much, so it is important to take the time to do things for yourself like have a bath, read a book, spend time with your children, or walk outside in nature. Whatever brings you happiness and makes you feel good. It is these small things that are the keys to wellness. Life is the journey we all share, and if we live it with mindfulness and wisdom, that journey will always lead to balance and happiness.
Photo by Blaise Vonlanthen on Unsplash
Lovely featured image photo by Tom Pumford on Unsplash
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What is Traditional Chinese Medicine?
By Emma Suttie, D.Ac, AP
Traditional Chinese Medicine (TCM) is an umbrella term for the many different modalities used in Chinese Medicine. These include Acupuncture (electro, auricular, cosmetic), Tui Na (Chinese medical massage), Herbal Medicine, Gua Sha (scraping), Moxibustion (the burning of the herb mugwort), Cupping, Dietary Therapy and Energy Work (Qi Gong, Tai Chi).
Traditional Chinese Medicine is one of the oldest continuous medical systems on earth, with instances dating back more than 4000 years. The philosophy of TCM is based on the Taoist view that human beings should strive to live in harmony with nature and their natural environment. Eating foods that grow locally and in season, practicing Tai Chi and Qi Gong, expressing our emotions, being self aware and listening to our needs and desires are, in the TCM view, the way to a healthy and balanced life.
The TCM philosophy offers us different approaches to looking at the workings of our bodies, the development of disease and the process of healing. The emotional self, for example, is just as important to the TCM practitioner as the physical body. When a patient arrives with a specific complaint, all physical as well as emotional and psychological aspects are evaluated, as it is the entire person who must be rebalanced, not just one aspect. This holistic approach is the strength of the TCM model, and why it is so effective. Treating the whole is in opposition to the reductionist model in the West which reduces the body into parts, not taking into consideration that they operate synergistically as a whole. This is one of the reasons why TCM is still able to treat a huge variety of ailments in the modern world.
Illness is described in the way it is seen to exist and develop, in natural terms. Terms like water, fire, wind and earth are used to describe a person and aspects of their health, personality and disease. Illness develops when something is out of balance, is deficient, in excess or stuck. The energy of the body, or Qi, must then be rebalanced, topped up, sedated, and moved depending on the presenting condition. Qi moves along specific pathways in the body called meridians. The acupuncture points are places where the Qi comes to the surface and is able to be manipulated by the acupuncture needles.
Herbs work internally to achieve the same goals. They are powerful tools and can be used alone or in conjunction with acupuncture or any of the other modalities, like Tui Na, Cupping or Gua Sha. All are used to rebalance the body and return it to a state of equilibrium. It is up to the practitioner to decide which ones or combinations are most effective for the patient and the imbalance that has led them to seek treatment.
In conclusion, Chinese medicine holds the body and its capacity for healing in great reverence. It does not see itself as an outside force that is able to heal the body, but as a way to help adjust the body and bring it back into balance so that health is restored. In essence, it is not the practitioner doing the healing, it is the body. Advice on nutrition, living with the seasons and moderation in life empowers the patient and enables him to participate in his own healing. The goal of the TCM practitioner is to use these concepts to guide the patient on how to live a healthy, happy and balanced life.