Gua Sha (Chinese: 刮痧; pinyin: guā shā), literally “to scrape away fever” in Chinese (more loosely, “to scrape away disease by allowing the disease to escape as sandy-looking objects through the skin”), is an ancient medical treatment.
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” (i.e., friction-stroking) — or along the pathway of the acupuncture meridians, along the surface of the skin, with each stroke being about 4-6 inches long.
This causes extravasation of blood from the peripheral capillaries (petechiae) and may result in sub-cutaneous blemishing (ecchymosis), 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.
In classical Chinese practice, the Gua Sha technique is most commonly used to:
- Reduce fever (the technique was used to treat cholera).
- Treat fatigue caused by exposure to heat (often used to treat heat-stroke) 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 (Chinese: 拔痧; pinyin: bá shā, literally “to pull out fever”), or ‘tsien sha’, 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.