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gua sha (spooning, coining)

gua sha before and after






Gua sha is a traditional Chinese medicine (TCM) technique that bruises the patient with scraping tools. One of the traditional tools is a porcelain spoon, but other implements (e.g., bones, animal horns, coins) can be used as long as they can turn a clean, smooth, healthy looking skin surface into a bruised mess. The healthy-looking skin is deceptive, according to practitioners of gua sha. So is the bruising, they say. To the modern science-based medical doctor, the gua sha therapist is bruising the patient, i.e., causing damage to the capillaries beneath the skin. TCM practitioners say they are releasing unhealthy elements. This is why, I suppose, people who get punched and kicked by bullies feel so much better afterward. Those bruised and battered by bullies think the pain they feel is due to being beaten by some coward, but the pain is a sign that unhealthy elements are being released. On the other hand, maybe these TCM folks are wrong and all they're really doing is bruising people and making up a story about it being healthy and a way to release bad elements, whatever they might be. After all, they say, gua sha has been practiced for over 2,000 years, so it must be good for you. And it's holistic, treats the whole person, and is part of a paradigm that isn't mechanistic or reductionist. Best of all, gua sha, like all other parts of TCM was developed long before science and Big Pharma, so it has not been contaminated by the modern world.

The non-discerning reader might think scraping one's skin until it bruises is not natural and so can't be good for you. On the contrary, getting bruises is quite natural and so is the body's reaction to bruising. That purplish mark on the skin is caused by blood from busted capillaries being trapped beneath the skin. Your body breaks down the blood and carries it away eventually. Depending on the severity of the bruising, the process may take 2 or 3 weeks. It's all natural.

  • When a bruise is brand new, it will appear reddish due to the color of the blood that leaked from the capillaries under the skin.
  • At one to two days old, a bruise will take on a bluish or purple color. The swelling at the site of the bruise will cause oxygen to be cut off, and hemoglobin, the substance that carries iron in your blood, will turn blue.
  • At six days old, a bruise will turn a greenish color as the hemoglobin breaks down and the area begins to heal itself.
  • At eight to nine days old, a bruise will then turn yellow or brown. This is the final stage in the body's re-absorption of the blood.*

"If the bruise remains firm and gets bigger or more painful, a hematoma may have formed. This happens when blood collects under the skin or in the muscle, and instead of trying to fix this, your body walls the blood off. If this happens, you need to have the hematoma drained by a [real] doctor."* Or you could consult an acupuncturist to relieve your excess yang energy or a moxibustionist to suck off more unhealthy elements.

Gua sha is old, popular, and cheap. What more could a person ask for in a balanced healthcare treatment? As Margaret Chan, M.D., director-general of the WHO says, millions of poor people can't afford real medicine and wealthy people want natural products and a feeling that they have control over their health, which they get from holistic, nonspecialized, traditional medicine (Chan 2014). (Chan made news when she glossed over famine and malnutrition in North Korea by noting that they have no obesity problem there.* She also said that from what she had seen in Pyongyang most people had the same height and weight as Asians in other countries, which is odd because North Koreans who escape to South Korea are easy to spot because they are generally shorter and smaller than South Koreans due to malnutrition over generations.) Margaret Chan & Josephine Briggs

Josephine Briggs, director of the National Center for Complementary and Integrative Health, agrees with Dr. Chan. Briggs defends traditional medicine on the grounds that that's all that's available to millions of poor people around the world and in the rich nations many patients prefer traditional medicine to science-based treatments. Plus, she says TCM and Ayurvedic medicine have flourished "either in parallel or integrated with advanced modern care (Briggs 2014)." Somehow, the arguments of these two leading lights in the medical world seem fallacious and hollow. Just because something has been around for a long time, is popular, has many satisfied customers, or is natural, cheap, and difficult to replace with something better, doesn't mean it's good or should be promoted.

You can call intentionally bruising people "extravagating blood from the capillary bed" or "instrument-assisted unidirectional press-stroking of a lubricated area of the body surface to intentionally create transitory therapeutic patchier called ‘sha’ representing extravagation of blood in the sub cutis." But you are still just intentionally bruising a person. You may think you are releasing "unhealthy elements," but you have no evidence that what you are doing is good for anything. You may claim that "gua sha produces an anti-inflammatory and immune protective effect" but you are uttering nonsense. You have caused the inflammation and the immune system must now go to work to carry away the blood debris you have caused.

See also acupuncture, chi, chi kung (qi gong), moxibustion, traditional Chinese medicine, and Yellow Bamboo.

further reading

--- Nature editorial. 2007. 448, 105-106. Hard to swallow: Is it possible to gauge the true potential of traditional Chinese medicine? Published online 11 July. "...if traditional Chinese medicine is so great, why hasn't the qualitative study of its outcomes opened the door to a flood of cures? The most obvious answer is that it actually has little to offer: it is largely just pseudoscience, with no rational mechanism of action for most of its therapies."

Beyerstein, Barry L. Why Bogus Therapies Often Seem to Work 
I'd like to offer an eighth reason to Barry's list: Ignorance of the many failures of the therapy. Alternative healers don't keep records of their failures. The patients who never return, either because they realized the treatment was worthless or they died, are not reported. Dead patients don't make good anecdotes.

Briggs, Josephine. 2014. A global scientific challenge: Learning the right lessons from ancient healing practices. Science. 346 (6216 Supplement).

Chan, M. 2014. Supporting the integration and modernization of traditinoal medicine. Science. 346 (6216 Supplement).

Dorlo, Thomas, Willem Betz, and Cees Renckens. 2015. "WHO's Strategy on Traditional and Complementary Medicine: a Disgraceful Contempt for Evidence-Based Medicine." Skeptical Inquirer. vol 39. No. 3. May/June.

Gorski, David H. 2015. "Science Sells Out: Advertising Traditional Chinese Medicine in Three Supplements." Skeptical Inquirer. vol 39. No. 3. May/June.

Levinovit, Alan. 2013. Chairman Mao Invented Traditional Chinese Medicine. Slate. Oct. 22.

Taylor, Kim. 2011. Chinese Medicine in Early Communist China, 1945-1963: A Medicine of Revolution. Routledge reprint edition.

Websites & blogs

Traditional Chinese Pseudo-Medicine Hodgepodge by Mark Crislip (scroll down to the bit on gua sha "massage" for some insight into how pseudoscience promotes itself in TCM)

Why Health Professionals Become Quacks by William T. Jarvis, Ph.D.

Last updated 26-Apr-2015

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