Archive for tag: gua sha


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 benefits.  

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 other benefits.


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, and more.


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 surface.

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.

Gua Sha

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 maneuvering.

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.