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  • Writer's picturePhilip Niño Tan-Gatue

What is Gua Sha?

A Personal Anectode

I write this on a Sunday, my day off, and boy do I need a day off!  The past week had been hectic, with both my wife and daughter catching the recent flu bug that has been circulating throughout the metropolis.  My daughter had started feeling ill last Monday , and it blew into a full scale fever that night.  By Tuesday morning, she had asked me to treat her with a method that she very much enjoyed – Gua Sha.

What is Gua Sha?

Literally, gua sha means to scrape and get “sha”.  Nielsen et al define it as:

…therapeutic surface frictioning that intentionally raises transitory petechiae and ecchymosis… [1]

Which in plain English means using a tool to create friction to intentionally cause bruising and red dots to appear on the surface of the skin.  It is colloquially also called coining or spooning.

Chinese Soup Spoons are sometimes used in Gua Sha, hence the term "spooning"

Chinese Soup Spoons are sometimes used in Gua Sha, hence the term “spooning”

Soup spoons work much better than coins.  I prefer using the real tools though:

Gua Sha Tools

Gua Sha Tools

Gua Sha tools may be made of animal horn, jade, obsidian or special ceramics.

According to my book, “Illustrations of Guasha Therapy”,

It works well for seasonal diseases in summer or autumn such as sunstroke, external contraction, and gastrointestinal disorders.” [2]

Well, my daughter had the flu, which is, in Chinese Medicine, an externally contracted disease.

How is it done?

According to Zhang, et al., the doctor:

…exerts force on specific body parts or points with tools or hand manipulations to treat disorders and strengthen the body… guasha therapy can directly stimulate subcutaneous peripheral nerves, improve local circulation of blood and lymph fluid, speed up the metabolism, promote nutritional function through the nerve-endocrine-immunoregulation network and facilitate the body’s defensive capabilities” [3]

Nielsen’s research also shows that

Gua Sha increases microcirculation local to a treated area, and that increase in circulation may play a role in local and distal decrease in myalgia. Decrease in myalgia at sites distal to a treated area is not due to distal increase in microcirculation. There is an unidentified pain-relieving biomechanism associated with Gua Sha. [4]

The objective of Gua Sha is to produce the “sha” or reddish dots.  They look a bit scary but let me tell you, there IS a reason why my daughter loves it.

Scraping motion is done to produce reddish bruises and red dots (petechiae)

Scraping motion is done to produce reddish bruises and red dots (petechiae)

Now, not just anyone can do this.  The scraping and pressure is based on point and channel selection based on Traditional Chinese Medicine diagnosis.  In my daughter’s case the goal was to release the exterior, and thus expel the Wind-Heat.  In western medicine terms, we could say that we are forcing the autonomic system to regularize.

Red bruising after gua sha

Red bruising after gua sha.  It can actually be full of red dots.

Gua Sha effect

Gua Sha effect

So what happened with my daughter after the treatment?  She immediately broke into a sweat and her fever was reduced from 38.8 degrees to 38.1 degrees.  She then slept all afternoon while perspiring (we had to keep on wiping her sweat).

By early evening, she was already well, and she went back to school the next day.

Care to give Gua Sha therapy a try?


[1] Nielsen A, Knoblauch NTM, Dobos GJ, Michalsen A, Kaptchuk TJ. The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects. Explore (NY). 2007;3(5) (October):456-466.

[2] Zhang, M. F. and He, F. R. (editors) Illustrations of Guasha Therapy (English Edition) (2009) Shanghai Scientific And Technical Publishers.  Shanghai. pp. 2-3

[3] ibid, p. 5

[4] Nielsen A, et al

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