"Gua sha therapy is closely related to the crucial TCM theory of meridians and collateral. The theory provides not only the theoretical foundation for diagnosis, but also guides treatments such as acupuncture, massage, cupping and gua sha."

Gua sha treatment is not painful, adherents say. According to practitioners, as the body is scraped it pushes a build-up of fluid ahead of it, and after it passes, it leaves an indention or vacuum behind that draws toxins out to the surface of the skin from deep within the tissue.

The toxic fluid (sha), floods to the surface and can be seen in small red, deep purple or light green pools of blood. It is also often hot on the area where the "toxic heat" is extracted.

The meridians and collaterals are like the pathways in which the flow of qi and blood circulate. They form a specific network that communicates with the internal organs and limbs and connects the upper to the lower and the exterior to the interior organs of the body.

"Gua sha can stimulate blood flow and remove coldness, negative energy, toxic-heat and promote lymphatic fluid from the body through the skin," Jonuscheit says. "Through the process, more blood serum is produced, and improves the body's immune system. Sometimes, when I go back to Germany, I often use this treatment on my family to remedy some ailment."

The color of the sha is both diagnostic and prognostic. Light-colored sha indicates blood deficiency. If the sha is purple or black, the blood stasis is long-standing. Dark red sha can also indicate heat, Jonuscheit says.

"Gua sha can be used to treat, alleviate and heal chronic degenerative diseases such as migraines, shoulder and back pain, menstrual disorders, insomnia, hypertension, vertigo, chronic infections, sciatica, rheumatoid arthritis and much more," says Liu Chunyan, from the third Affiliated Hospital of Beijing University of Chinese Medicine.

Gua sha is also used whenever a patient has pain associated with an acute or chronic disorder, or when there is an aching or knotty feeling in the muscles, TCM practitioners say. It can be used to similarly treat and prevent the common cold, flu, bronchitis, asthma, as well as any chronic disorder involving pain, congestion of the flow of qi and blood.

Sha is raised primarily at the yang (positive) surface of the body, for example the back, neck, shoulders, buttocks, and limbs. Sometimes, gua sha is applied at the chest and abdomen, according to the TCM diagnosis.

In most cases, the gua sha patient feels an immediate change in consciousness from the treatment. Gua sha motivates the blocked flow of qi and blood, and releases external sweating.

In modern medical terms, these fluids contain metabolic waste that has become congested in the skin surface tissues and muscles. Many consider it to be a valuable treatment for both external and internal pain, facilitating the resolution of both acute and chronic disorders.

Contraindications include hemophilia or bleeding disorders, leukemia, inflamed skin or open wounds. Weak elderly and those who are suffering from menstrual afflictions should also avoid the treatment.

There are two methods of gua sha; and one is called tonifying therapy. "The technique of scraping is slow, moderate and does not draw out sha each time," Liu says.

The other method, called purging therapy, involves heavy, fast rubbing and scraping to bring out as much sha as possible. This is the most common method and can be used to treat common ailments such as fever, influenza and apoplectic sequelae.

"The petechiae should fade in two to four days," Liu says. "Slower fading will indicate poor blood circulation."

yinyin@chinadaily.com.cn