Explore: The Journal of Science and Healing
Volume 3, Issue 5 , Pages 456-466 , September 2007

The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects

  • Arya Nielsen, PhD (cand), LAc

      Affiliations

    • Beth Israel Medical Center’s Continuum Center for Health and Healing, New York, NY
    • Tri-State College of Acupuncture, New York, NY
    • Union Institute & University, Cincinnati, OH
    • Corresponding Author InformationCorresponding Author. Address: 1923 Glasco Tnpk, Woodstock, NY 12498
    • ,
  • Nicola T.M. Knoblauch, MD

      Affiliations

    • Department of Integrative and Internal Medicine, University of Duisburg-Essen, Kliniken Essen-Mitte, Essen, Germany
    • ,
  • Gustav J. Dobos, MD

      Affiliations

    • Department of Integrative and Internal Medicine, University of Duisburg-Essen, Kliniken Essen-Mitte, Essen, Germany
    • Department of Complementary and Integrative Medicine, Alfried Krupp von Bohlen und Halbach Foundation, Essen, Germany
    • ,
  • Andreas Michalsen, MD

      Affiliations

    • Department of Integrative and Internal Medicine, University of Duisburg-Essen, Kliniken Essen-Mitte, Essen, Germany
    • ,
  • Ted J. Kaptchuk

      Affiliations

    • Osher Institute, Division for Research and Education in Complementary and Integrative Therapies, Harvard Medical School, Boston, MA

References 

  1. Hautman MA. Self-care responses to respiratory illnesses among Vietnamese. West J Nurs Res. 1987;9:223–243
  2. Craig D. Familiar Medicine: Everyday Health Knowledge & Practice in Today’s Vietnam. In: Honolulu, HI: University of Hawaii Press; 2002;p. 118–119
  3. Fadiman A. The Spirit Catches You and You Fall Down. In: New York, NY: Farrar, Straus and Giroux; 1997;p. 64–65267
  4. Van Nguyen Q, Pivar M. Fourth Uncle in the Mountain (A Memoir of a Barefoot Doctor in Vietnam). In: New York, NY: St. Martin’s Press; 2004;p. 300
  5. Nielsen A. Gua Sha: A Traditional Technique for Modern Practice. Edinburgh, Scotland: Churchill Livingstone; 1995;
  6. Zhang X, Hao W. Holographic Meridian Scraping Therapy. Beijing, People’s Republic of China: Foreign Language Press; 2000;
  7. So JTY. Treatment of Disease with Acupuncture. In: Brookline, MA: Paradigm; 1987;p. 43
  8. Ou Ming. Chinese-English Dictionary of Traditional Chinese Medicine. Hong Kong, People’s Republic of China: Guandang Science and Technology Publishing House; 1988;
  9. Mathews R. Mathews’ Chinese-English Dictionary. Cambridge, MA: Harvard University Press; 1931;
  10. Jackson H. On the Efficacy of Certain External Applications. Philadelphia, PA: University of Pennsylvania; 1806;
  11. So JTY. Treatment of Disease with Acupuncture. In: Brookline, MA: Paradigm; 1987;p. 314–315
  12. Nielsen A. Gua Sha: Step-by-Step (A Visual Companion to Gua Sha: A Traditional Technique for Modern Practice). [Video] Kötzting, Germany: Verlag Für Ganzheitliche Medizin; 2002;
  13. In: A Barefoot Doctors Manual: The American Translation of the Official Chinese Paramedical Manual. Philadelphia, PA: Running Press; 1977;p. 79–80
  14. Kaptchuk T. Acupuncture: theory, efficacy, and practice. Ann Intern Med. 2002;136:374–383378
  15. Haller JS. American Medicine in Transition 1840-1910. In: 1981;p. 46–47Urbana, IL
  16. Zuijlmans CW, Winterberg DH. Rubbing with a coin is not abuse. [in Dutch] Ned Tijdschr Geneeskd. 1996;140:2552–2554
  17. Kemp C. Cambodian refugee health care beliefs and practices. J Comm Health Nurs. 1985;2:41–5245
  18. Frye B, D’Avanzo C. Themes in managing culturally defined illness in the Cambodian refugee family. J Community Health Nurs. 1994;117(27):89–9890
  19. Silfen E, Wyre HW. Factitial dermatitis–cao gio. Cutis. 1981;28:399–400
  20. David A, Mechinaud F, Roze JC, Stalder JF. A case of Cao-Gio (Possible confusion with abuse). [in French] Arch Fr Pediatr. 1986;43:147
  21. Davis RE. Cultural health care or child abuse? (The Southeast Asian practice of cao gio). J Am Acad Nurse Pract. 2000;12:89–95
  22. Primosch RE, Young SK. Pseudobattering of Vietnamese children (cao gio). J Am Dent Assoc. 1980;101:47–48
  23. Rampini SK, Schneemann M, Rentsch K, Bachli EB. Camphor intoxication after cao gio (coin rubbing). JAMA. 2002;288:45
  24. Schirmer L, Reigstad V, Aarskog D. Cao gio--a source of misdiagnosis. [in Norwegian] Tidsskr Nor Laegeforen. 1984;104:1415–1416
  25. Yeatman GW, Dang VV. Cao Gio (coin rubbing) (Vietnamese attitudes toward health care). JAMA. 1980;244:2748–2749
  26. Amshel CE, Caruso DM. Vietnamese “coining”: a burn case report and literature review. J Burn Care Rehabil. 2000;21:112–114
  27. Coin rubbing and related folk medicine. JAMA. 1981;245:1819
  28. Crutchfield CE, Bisig TJ. Images in clinical medicine (Coining). N Engl J Med. 1995;332:1552
  29. Hulewicz BS. Coin-rubbing injuries. Am J Forensic Med Pathol. 1994;15:257–260
  30. Longmire AW, Broom LA. Vietnamese coin rubbing. Ann Emerg Med. 1987;16:602
  31. Overbosch D, Fibbe WE, Stuiver PC. Pseudo-bleeding disorder due to coin rubbing. Neth J Med. 1984;27:16–17
  32. Ponder A, Lehman LB. ‘Coining’ and ‘coning’: an unusual complication of unconventional medicine. Neurology. 1994;44:774–775
  33. Roberts JR. Beware: Vietnamese coin rubbing. Ann Emerg Med. 1988;17:384
  34. Rosenblat H, Hong P. Coin rolling misdiagnosed as child abuse. CMAJ. 1989;140:417
  35. Schneir AB, Clark RF. Coin rubbing and camphor intoxication. JAMA. 2002;288:1471;author reply 1471
  36. Walterspiel JN, Rogers JR, Kemp C. Coin rubbing and acute phase reactants. Aust Paediatr J. 1987;23:309
  37. Wong HC, Wong JK, Wong NY. Signs of physical abuse or evidence of moxibustion, cupping or coining. CMAJ. 1998;160:785–786
  38. Leung AK. Echymosis from spoon scratching simulating child abuse. Clin Pediatr. 1986;25:98
  39. Look KM, Look RM. Skin scraping, cupping, and moxibustion that may mimic physical abuse. J Forensic Sci. 1997;42:103–105
  40. Aliye UC, Bishop W, Sanders K. Camphor hepatotoxicity. South Med J. 2000;93:596–598
  41. Amshel CE, Caruso DM. Vietnamese “coining”: a burn case report and literature review. J Burn Care Rehabil. 2000;21:112–114
  42. Anh NT. The ‘pseudo-battered chilld’ syndrome. JAMA. 1976;236:2288
  43. Ashworth M. Child abuse–true or false?. Practitioner. 1993;237:108–109
  44. Asnes RS, Wisotsky DH. Cupping lesions simulationg child abuse. J Pediatr. 1981;99:267–268
  45. Bays J. Conditions mistaken for child abuse. In:  Reece RM editors. Child Abuse: Medical Diagnosis and Management. Philadelphia, PA: Lea & Febiger; 1994;p. 358
  46. Buchwald D, Panwala S, Hooton TM. Use of traditional health practices by Southeast Asian refugees in a primary care clinic. West J Med. 1992;156:507–511
  47. Du JN. Pseudobattered child syndrome in Vietnamese immigrant children. CMA J. 1980;122:394–395
  48. Flores G, Rabke-Verani J, Pine W, Sabharwal A. The importance of cultural and linguistic issues in the emergency care of children. Ped Emerg Care. 2002;18:271–284
  49. Gellis S, Feingold M. Pseudo-battering in Vietnamese children. Am J Dis Child. 1976;130:857–858
  50. Golden S, Duster M. Hazards of misdiagnosis due to Vietnamese folk medicine. Clin Pediatr. 1977;16:949–950
  51. Hansen KK. Folk remedies and child abuse: a review with emphasis on caida de mollera and its relationship to shaken baby syndrome. Child Abuse Negl. 1998;22:117–127
  52. Hefner ME, Kempe RS, Krugman RD. The Battered Child. 5th ed.. Chicago, Ill: University of Chicago Press; 1997;
  53. Kaplan JM. Pseudoabuse–the misdiagnosis of child abuse. J Forensic Sci. 1986;31:1420
  54. Keller EL, Apthorp J. Folk remedies vs child battering. Am J Dis Child. 1977;131:1173
  55. Leung AK. Evaluating the child with purpura. Am Fam Phys. 2001;64:419–428
  56. Levin NR, Levin DL. A folk medical practice mimicking child abuse. Hosp Pract (Off Ed). 1982;17:17
  57. Mudd SS, Findlay JS. The cutaneous manifestations and common mimmickers of physical child abuse. J Pediatr Health Care. 2004;18:123–129
  58. Overbosch D, Fibbe WE, Stuiver PC. Pseudo-bleeding disorder due to coin rubbing. Neth J Med. 1994;27:16–17
  59. Randall BB. Fatal hypokalemic thyrotoxic periodic paralysis presenting as the sudden, unexplained death of a Cambodian refugee. Am J Forensic Med Pathol. 1992;13:204–206
  60. Reese R, Ludwig S. Child Abuse: Medical Diagnosis and Mangement. 2nd ed.. Philadelphia, PA: Lippincott Williams & Wilkins; 2001;
  61. Saulsbury FT, Hayden GF. Skin conditions simulating child abuse. Pediatr Emerg Care. 1985;1:147–150
  62. Scales JW, Fleischer AB, Sinal SH, Krowchuk DP. Skin lesions that mimic abuse. Contemp Pediatr. 1999;16:137–145
  63. Seigel E, Wason S. Camphor toxicity. Pediatr Clin North Am. 1986;332:375–379
  64. Sicard A. The therapeutic pinch in Vietnam. [in French] Presse Med. 1968;76:773–775
  65. Sills RM, Pena ME, Parsons K. The battered child. In:  Bosker G editors. The Textbook of Primary and Acute Care Medicine: Emergency Medicine Reports. Atlanta, GA: Thompson American Health Consultants; 2004;
  66. Stewart GM, Rosenberg NM. Conditions mistaken for child abuse: Part II. Pediatr Emerg Care. 1996;12:217–221
  67. Wang Q, Li H, Zhang Z. Causes and countermeasures about adverse reaction of traditional Chinese medicine. [in Chinese] Zhong Yao Cai. 2001;24:430–433
  68. Yeatman FW, Shaw C, Barlow MJ, et al. Pseudo-battering in Vietnamese children. Pediatrics. 1976;58:616–618
  69. Yerao SY, Borrego J, Urquiza AJ. A reporting and response model for culture and child maltreatment. Child Maltreat. 2001;6:158–168
  70. Ahearn AM. Viet Cong medicine. Mil Med. 1966;131:219–221
  71. Bodeker GC. Traditional medical practitioner in Vietnam. J Altern Complement Med. 1996;2:333–334
  72. Calhoun MA. The Vietnamese woman: health/illness attitude and behaviors. Health Care Women Int. 1985;6:61–72
  73. Chng CL. Vietnamese in America: a case study in cross-cultural health education. Health Values. 1984;8:16–20
  74. Craig D. Practical logics: the shapes and lessons of popular medical knowledge and practice–examples from Vietnam and Indigenous Australia. Soc Sci Med. 2000;51:703–711
  75. Her C, Culhane-Pera KA. Culturally responsive care for Hmong patients (Collaboration is a key treatment component). Postgrad Med. 2004;116:39–4245-46
  76. Dub O. Traditional medicine in Vietnam. [in Czech] Cas Lek Cesk. 1978;117:1512
  77. Duong Ba B. The traditional medicine of Vietnam in close union with European medicine. [in French] Scalpel (Brux). 1956;109:698–702
  78. Dzierzanowski R. Basic concepts of Sino-Vietnamese medicine (II. Pathological and diagnostic concepts). [in Polish] Wiad Lek. 1969;1355–1359
  79. Dzierzanowski R. The basic principles of sino-Vietnamese medicine (I. General principles, anatomy, physiology). [in Polish] Wiad Lek. 1969;22:1241–1247
  80. Fasano MB, Hayes J, Wilson R. Traditional beliefs and use of health care services by Vietnamese and Laotian refugees. Tex Med. 1986;82:33–36
  81. Flores G, Rabke-Verani J, Pine W, Sabharwal A. The importance of cultural and linguistic issues in the emergency care of children. Ped Emerg Care. 2002;18:271–284
  82. Halfvarsson J, Heijne N, Ljungman P, Ham MN, Holmgren G, Tomson G. Knowing when but not how!–mothers’ perceptions and use of antibiotics in a rural area of Viet Nam. Trop Doct. 2000;30:6–10
  83. Hautman MA. Self-care responses to respiratory illnesses among Vietnamese. West J Nurs Res. 1987;9:223–243
  84. Hoang GN, Erickson RV. Cultural barriers to effective medical care among Indochinese patients. Annu Rev Med. 1985;36:229–239
  85. Jenkins CN, Le T, McPhee SJ, Stewart S, Ha NT. Health care access and preventive care among Vietnamese immigrants: do traditional beliefs and practices pose barriers?. Soc Sci Med. 1996;43:1049–1056
  86. Kalmykova OL. The traditional medicine of Vietnam: its history and use in clinical practice. [in Russian] Feldsher Akush. 1990;55(2):59–61
  87. Kalmykova OL. Traditional medicine of Vietnam: history and current trends. [in Russian] Sov Zdravookhr. 1990;7:74–76
  88. Kalmykova OL. Traditional Vietnamese medicine in the treatment of pain syndromes. [in Russian] Feldsher Akush. 1990;55(12):32–34
  89. Ladinsky JL, Volk ND, Robinson M. The influence of traditional medicine in shaping medical care practices in Vietnam today. Soc Sci Med. 1987;25:1105–1110
  90. Montgomery L. Folk Medicine of the Indochinese. San Diego, Calif: Refuge Women’s Task Force.
  91. Muecke MA. Caring for Southeast Asian refugee patients in the USA. Am J Public Health. 1983;73:431–438
  92. Nguyen Aea. Folk Medicine, Folk Nutrition, Superstitions. Washington, DC: TEAM Associates; 1980;
  93. Osborn DG. Conflict and collaboration in cross-cultural health care. World Health Forum. 1992;13:315–319
  94. Pearson R. Understanding the Vietnamese in Britain (Part III: health beliefs, birth and child care). Health Visit. 1982;55:533–540
  95. Pham TM, Rosenthal MP, Diamond JJ. Hypertension, cardiovascular disease, and health care dilemmas in the Philadelphia Vietnamese community. Fam Med. 1999;31:647–651
  96. Poss JE. Providing health care for Southeast Asian refugees. J NY State Nurses Assoc. 1989;20:4–6
  97. Rich NM, Dimond FC. Results of Vietnamese acupuncture seen at the Second Surgical Hospital. Mil Med. 1967;132:791–795
  98. Schreiner D. Southeast Asian Folk Healing. Portland, OR: Community Health Services; 1981;
  99. Shareski D. Integrating traditional beliefs with Western practice. Nurs BC. 1996;28:27–29
  100. Tripp-Reimer T, Thieman K. Traditional health beliefs/practices of Vietnamese refugees. J Iowa Med Soc. 1981;71:533–535
  101. So J. Treatment of Disease with Acupuncture. 1976;Xeroxed handouts
  102. The Essentials of Chinese Acupuncture. Beijing, People’s Republic of China: Foreign Language Press; 1980;
  103. Shanghai College of Traditional Medicine. Acupuncture: A Comprehensive Text. Bensky D, O’Connor J, trans Chicago, Ill: Eastland Press; 1981;
  104. Nielsen A. Gua Sha and the Scientific Gaze: Original Research on an Ancient Therapy in a Call for Discourse in Philosophies of Medicine. [doctoral dissertation] Union Institute & University; 2007;June
  105. Tuncez F, Bagci Y, Kurtipek GS, et al. Skin trauma due to cultural practices: cupping and coin rubbing. 14th Congress of the European Academy of Dermatology and Venereology 2005;London, England. P04.30.
  106. Campbell WW, Sartori RJ. Nummular erythema in a patient with chronic daily headache. Headache. 2003;43:1112
  107. Chin WY. Blue spots, coining, and cupping: how ethnic minority parents can be misreported as child abusers. J Law Soc. 2005;7:88–115
  108. Saez AMO, Mosel F, Nürnberger J, et al. Laser Doppler imager (LDI) scanner and intradermal injection for in vivo pharmacology in human skin microcirculation: responses to acetylcholine, endothelin-1 and their repeatability. Brit J Clin Pharmacol. 2005;59:511–519
  109. Kuo T-C, Lin C-W, Ho F-M. The soreness and numbness effect of acupuncture on skin blood flow. Am J Chin Med. 2004;32:117–129
  110. Kaim S. Dissertatio Inauguralis Medica de Frictionibus. Chipok R, trans Vienna, Austria: Kaliwodian Press; 1756;
  111. Schubert V, Perbeck L, Schubert PA. Skin microcirculatory and thermal changes in elderly subjects with early stage of pressure sores. Clin Phys. 1994;14(1):1–13
  112. Stucker M, Heese A, Hoffmann K, Rochling A, Altmeyer P. Precision of laser Doppler scanning in clinical use. Clin Exp Dermatol. 1995;20:371–376
  113. Jasik M, Liebert A, Juskowa J, Karnafel W, Maniewski R. Use of laser-doppler perfusion for evaluation of microcirculation in patients with diabetes type I. [in Polish] Pol Arch Med Wewn. 1998;100:119–124
  114. Nielsen A. Gua Sha, Eine traditionelle Technik für die moderne Medizin. In: Kötzting, Germany: Verlag Für Ganzheitliche Medzin; 2000;p. 170
  115. Netten PM, Wollersheim H, Thien T, Lutterman JA. Skin microcirculation of the foot in diabetic neuropathy. Clin Sci. 1996;91:559–565
  116. Junger M, Hahn U, Bort S, Klyscz T, Hahn M, Rassner G. Significance of cutaneous microangiopathy for the pathogenesis of dermatitis in venous congestion due to chronic venous insufficiency. [in German] Wien Med Wochenschr. 1994;144:206–210
  117. Junger M, Klyscz T, Hahn M, Rassner G. Disturbed blood flow regulation in venous leg ulcers. Int J Microcirc Clin Exp. 1996;16:259–265
  118. Junger M, Zuder D, Steins A, Hahn M, Klyscz T. Treatment of venous ulcers with low frequency pulsed current (Dermapulse): effects on cutaneous microcirculation. [in German] Hautarzt. 1997;48:897–903
  119. Koman LA, Ruch DS, Aldridge M, Smith BP, Holden MB, Fulcher M. Arterial reconstruction in the ischemic hand and wrist: effects on microvascular physiology and health-related quality of life. J Hand Surg (Am). 1998;23:773–782
  120. Vollmar B, Menger MD. The use of intravital microscopy in surgical research (Twenty-six years of experience analyzed by studies presented at the Surgical Forum of the Annual Congress of the German Society of Surgery). Langenbecks Arch Surg. 1998;383:282–285
  121. Droog EJ, Steenbergen W, Sjober F. Measurement of depth of burns by laser Doppler perfusion imaging. Burns. 2001;27:561–568
  122. Ackerman WE, Zhang J, Munir MA, Ahmad M, Ackerman C. Efficacy of laser Doppler fluxmetry for the diagnosis of CRPS I, PD.37. In: Chicago, IL: American Society of Regional Anesthesia and Pain Medicine; 2002;p. 37;27th Annual Meeting on Regional Anesthesia. April 27th, 2002
  123. Wahlberg E, Olofsson P, Swedenborg J, Fagrell B. Level of arterial obstruction in patients with peripheral arterial occlusive disease (PAOD) determined by laser Doppler fluxmetry. Eur J Vasc Surg. 1993;7:684–689
  124. Rosen L, Ostergren J, Fagrell B, Stranden E. Skin microvascular circulation in the sympathetic dystrophies evaluated by videophotometric capillaroscopy and laser Doppler fluxmetry. Eur J Clin Invest. 1988;18:305–308
  125. Mars M, Maharaj SS, Tufts M. The effect of compressed air massage on skin blood flow and temperature. Cardiovasc J S Afr. 2005;16:215–219
  126. Sandberg M, Lundeberg T, Lindberg LG, Gerdle B. Effects of acupuncture on skin and muscle blood flow in healthy subjects. Eur J Appl Physiol. 2003;90:114–119
  127. Langevin HM, Churchill DL, Fox JR, Badger GJ, Garra BS, Krag MH. Biomechanical response to acupuncture needling in humans. J Appl Physiol. 2001;91:2471–2478
  128. Langevin HM, Churchill DL, Wu J, et al. Evidence of connective tissue involvement in acupuncture. FASEB J. 2002;16:872–874
  129. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002;269:257–265
  130. Langevin HM, Bouffard NA, Badger GJ, Iatridis JC, Howe AK. Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo. Am J Physiol Cell Physiol. 2005;288:747–756
  131. Langevin HM, Storch KN, Cipolla MJ, White SL, Buttolph TR, Taatjes DJ. Fibroblast spreading induced by connective tissue stretch involves intracellular redistribution of alpha- and beta-actin. Histochem Cell Biol. 2006;125:487–495
  132. Langevin HM. Connective tissue: a body-wide signaling network?. Med Hypotheses. 2006;66:1074–1077
  133. Berman B, Lao L, Langenberg P, Lee WL, Gilpin A, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized controlled trial. Ann Intern Med. 2004;141:901–910909

PII: S1550-8307(07)00177-2

doi: 10.1016/j.explore.2007.06.001

Explore: The Journal of Science and Healing
Volume 3, Issue 5 , Pages 456-466 , September 2007

Article Tools

* Image Usage & Resolution