Tuesday, August 19, 2008
Cạo gió in Vietnamese means "to scrape the wind." In Chinese it is known as gua sha 刮痧, or "to scrape sand." It is a method of healing used throughout East and Southeast Asia for a wide variety of maladies, such as the common cold, flu, abdominal discomfort, bronchitis, asthma, and any other kind of illnesses where there is a sensation of being "stuck." It is extremely effective for muscular pain of any kind, whether acute or chronic, and as you can see from the picture above, it worked wonders for me back in the summer of 2006.
Cạo gió is an adaptogenic treatment that is akin to myofascial release, though it does so much more. We learn this treatment method as part of our training in TCM school in the US. In Viet Nam, everyone in the family has had this done to them and/or has done it to someone else. It's like the equivalent of taking Tylenol when you've got a cold or headache; it's actually the first line of defense when you feel an illness coming on. As the Chinese medicine sayings go: "Wind is the chief of the hundreds of diseases," and "If there is damage, there must be wind." The treatment, therefore, would be to get the "wind" out.
Oil or ointment is first rubbed on the skin as a lubricant, usually on the neck, back, and upper shoulders, but occasionally on the limbs, upper chest, and abdomen. A coin, Asian ceramic soup spoon, carved water buffalo horn, or any other rounded blunt edge is then used to scrape the surface of the skin with an even amount of firm pressure that produces a redness that kind of looks like "sand" is coming to the surface. Collectively, the "sand" ends up looking like the person receiving cạo gió has just been beaten with a baseball bat, but, unlike a bruise, the marks are very superficial and disappear after 2-4 days. Also, unlike a bruise, the marks appear to be painful, but they are not.
(As a funny aside, when I was in kindergarten, my teacher asked me why I had bruises on my neck. I had to explain to her that I was sick, and that it helped me. There were two other Vietnamese kids in my class, and we all told her it was ok, so she was satisfied with the explanation. On the other hand, when my brother was in the first grade, his teacher thought he was being abused and immediately called my parents.)
So how does it work?
In biomedicine, the effects of cạo gió are largely attributed to the placebo effect. Since so many Asians have been using it as folk medicine for such a long time, the belief that it works for all kinds of health problems makes the person perceive that there really is a reduction in pain and symptoms. This placebo effect is an accepted explanation because there have not been studies conducted that can adequately explain why it works.
According to Chinese medicine, cạo gió works to release stagnation in the muscles, channels, and collaterals, bringing pathogenic qi to the surface and allowing it to release through the skin like sweating. Because stagnation is an excess condition that can be brought on by either a deficiency or excess of qi or blood, breaking up the stagnation can bring flow and balance that results in either tonification or sedation, depending on the problem. That makes cạo gió a very versatile modality, useful in both wind and pain conditions. Because the scraping is usually performed along the spine and ribs, it can be used to treat organic problems through the activation of the back Shu points as well. It is useful when large areas of the body require the breakup of stasis, as well as when smaller areas of the body like the neck, wrists, ankles, hands, and feet need myofascial release and cupping isn't possible or practical.
Just to give you an idea of what cạo gió is good for, I'll use myself as a case study. In 2006, I was hit by the door of a taxi cab while on my bicycle, commuting in Manhattan. I was knocked into traffic, and hit the asphalt on the left side of my body. I had been in a motorcycle accident just the year before, and had almost completely recovered from that when this happened. All of my symptoms came back: my back spasmed and seized, I had difficulty walking, my periods came every two weeks, and I was an emotional wreck. The first treatment I received involved needling of LI-14 Bi Nao 臂臑, LV-5 Li Gou 蠡遘, and cạo gió on my back as depicted above.
Bi Nao means "upper arm" and is the intersecting point of the hand tai yang, hand yang ming, and foot tai yang channels, and the yank linking vessel. Its alternate name is Tou Chong or "head thoroughfare." It is used as a point that helps one to "stop seeing ghosts." In my case, it was needled to disperse the qi and enable me to let go of the experience on both the physical, emotional, and psychological level.
Li Gou means "woodworm canal," connecting the two wood channels (LV/GB) together. Instead of tonifying or moving qi throughout the whole body, I believe the doctor was trying to divert the stagnant qi through the Luo point of the Liver channel specifically to affect qi and blood simultaneously.
The cạo gió unblocked the blood stasis from the traumatic injury, as well as the qi stagnation from emotional constraint that was causing the physical pain. My back was scraped all over, including my shoulders, upper, and lower back. However, as you can see from the picture, the marks appeared most noticeably in areas that gave me the most trouble: angry-red on the level of Heart Shu UB-15 to Liver Shu UB 18, more purple-red in the other areas, with no marks appearing at all on the tops of my shoulders and lower back.
After the treatment, there was a significant improvement in my physical condition. Even though my periods were still irregular, I no longer experienced any of the pain in my back and it didn't hurt to walk. I also felt less like a victim and more like "well, these things happen." The next time I received cạo gió, the color was lighter and the area affected was smaller. After a few more treatments with herbs and acupuncture, my periods were normal again and I was able to fully recuperate.
That, my friends, is the power of folk medicine.
Here's a good website if you want to read more on cạo gió, or gua sha.