As explained last week, gua sha is a form of AOM treatment that
primarily creates bleeding subcutaneously to aid in the moving and
release of many types of pathogens. This week, I'm blogging about
another blood related therapy, bloodletting, which purposefully
causes the patient to bleed to release pathogens. This may seem a
bit horrific, but it rarely hurts and offers significant healing
Bloodletting is an ancient form of AOM treatment. It produces
one or many punctures to the skin allowing blood to be released.
The discharge of blood releases pathogens such as trauma, heat,
cold, stagnation, and deficiency (under certain conditions).
Bloodletting improves circulation and qi flow in addition to many
There are many forms of bloodletting. One form of bloodletting
includes using either an acupuncture needle or a lancet to puncture
the skin. Upon extraction of the needle, bleeding occurs (as
pictured on the finger). At times, bleeding occurs naturally after
needle extraction. If bloodletting is indicated, but does not occur
naturally, the practitioner may apply pressure to aid in the
discharge of blood. This form of bloodletting is indicated for many
conditions. Some conditions include heat rash, common cold,
respiratory illness, GI pathology, mental or emotional disorder,
Another form of bloodletting occurs from using a plum blossom
(pictured) or seven start tool. The patient's skin is quickly
pricked repeatedly using the tool. While the tool looks like
something out of a medieval movie, this procedure is often
painless. Most patients have reported feeling a tapping or tickling
sensation. After the repeated pricks, a small amount of bleeding
often occurs. This therapy is useful for many conditions. I have
seen it used most for trauma and reducing hypertension.
The last form of bloodletting I'm going to discuss is
bloodletting through cupping. As discussed in previous blogs,
traditionally cupping uses glass cups that are heated momentarily
with fire to create suction on the patient's body. The fire is
placed momentarily into the cup using a hemostat and cotton ball.
The fire is removed quickly and the cup is placed on the body. The
temporary heating of the cup creates a vacuum on the body.
Cupping can be transitioned into bloodletting in several ways.
One way is to apply acupuncture to the patient, often on the
patient's back. After needle extraction, cups are applied. A
second option is to plum blossom the area first, instead of using
acupuncture needles. The vacuum from the cups draws blood to the
Clinically, I have found areas of the body that contain
acupuncture points most related to the patient's diagnosis manifest
with the most productive bloodletting. For example, if a patient is
diagnosed with excess stomach heat, the fire point on the stomach
channel typically discharges the most blood. By releasing the
blood, the body is clearing the excess heat.
Above is a picture of a patient's back showing the result of
bloodletting through cupping. The patient had acupuncture needles
extracted in all areas where cups had been placed. The red circles
indicate where the cups had been placed. The cups create sha, much
like gua sha. The patient bled in the region of the point that
mostly pertained to the patient's diagnosis. The patient reported
feeling much better post treatment.
A unique technique used in AOM is gua sha. Gua sha is a medical
therapy using strokes on the patient's body with applied pressure
to help return the body into balance and harmony. Gua sha can be
used for many AOM patterns. The most common clinical applications
are cold, heat, and stagnation.
For example, if a patient has a common cold, it's is often
diagnosed as a wind-cold or a wind-heat. That diagnosis means
either pathogenic wind and cold, or wind and heat has entered the
body and is causing the patient's defense qi (wei qi) to work to
push out the pathogen. Many times, applying gua sha to the patient
in the initial onset of the wind-cold or wind-heat can help the
body release the pathogen.
Another common indication for gua sha is when a muscular trauma
has occurred. If a patient is presenting a trauma with excess heat
(inflammation), cold, or qi and blood stasis (circulatory issue),
the use of gua sha can release the heat or cold as well as improve
circulation. There are many other indications for gua sha, but
these are among the most common.
A very strong gua sha response in a patient.
When applying gua sha to a patient, the practitioner is looking
for a sha response. Sha is the color the skin turns during and
after receiving gua sha. If the area becomes bright red, there is
pathogenic heat being released. If it becomes purple, cold or
stagnation is being released. If it is pale-pink, either cold is
being released or deficient energy is being moved.
Many types of tools can be used for making the gua sha strokes.
Some common tools are ladles, carved animal horns, and stones. I
have used many tools, but my tool of choice is a quarter. I have
found the ridges of the quarter help bring the sha to the surface
the best. Additionally, the thinness of the quarter allows easy
At times, the application of gua sha can be uncomfortable for
the patient. Since the strokes are applied in regions where
pathogens have accumulated, such as heat/inflammation and
stagnation, having pressure on these areas can temporarily provoke
more pain. But, the result of gua sha is often a relief or complete
absence of pain or pathogen. Patients often recover from colds and
muscular skeletal traumas very quickly after receiving gua sha.
Included in this blog are pictures of very strong gua sha
response. There are many apparent regions of sha. The placement of
the sha follows several acupuncture meridians. The sha response is
very red with a little purple. This response, along with other
clinical findings, indicates heat and stagnation have been
released. The sha usually disappears in 2-7 days.
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