Review of "Gua Sha A Traditional Technique for Modern Practice", by Arya Nielsen.
This is THE book to have if you want to learn more about the East Asian technique of Gua Sha. Arya Nielsen is an American acupuncturist taught in the classical lineage of Dr. James Tin Yau So and is the leading Western authority on Gua sha. The first edition was printed in 1995.
I'll be honest, this book is a lot of things. As a practitioner of Gua Sha for several years, this book has helped me to understand some of the finer points of this modality. As a registered massage therapist, I am not versed in TCM principles, but Arya finds a way to bridge both Western and Eastern worlds in a way that makes sense. I understand fascia, but i didn't understand fascia in relation to the Cou Li (the lining), nor did I understand about the "Three Paths of Qi" in relation to fascia which is quite fascinating. "Recent evidence suggests that a correspondence may exist between the network of meridians and the body wide network formed by connective tissue," Langevin (2006).
One of the benefits of Gua sha is that it can have an effect on the immune system. Arya explains that the ground substance found within the fascia (connective tissue) is in charge of all inter-cellular fluids. Nutrients, hormones, and plasma are carried from blood vessels to cells through this ground substance as is cellular waste carried from cells to blood and lymph cells. If the viscosity of the ground substance is altered or becomes "sticky" due to stress, trauma or disease, then there is a compromise in the passage of gases, hormones, waste, nutrients, and immune cells between the capillaries and tissue that they irrigate. Compartments within the fascia can influence the spread of toxins, infections, disease and tumors through the chemicals found within the connective tissue. Therefore, if the integrity of this tissue becomes compromised then so does its immune function. I really like her table 3.2 that explains traditional Chinese medicine concepts and their proposed anatomical/physiological equivalents. For example, a blockage of Qi can be considered an altered connective tissue matrix composition that can lead to altered signal transduction. A restoration of flow of Qi can be considered cellular activation/gene expression leading to a restored connective tissue matrix composition and signal transduction. Makes sense to me.
I have a better understanding of how the outside elements (wind, dampness, heat, cold, dryness) affect the body. As Arya says ,"Elements act in the body like they act outside". Coldness causes the body to contract and slow down. It inhibits circulation causing things to collect and get stuck. Dampness causes things to become wet, sluggish and collect as edema, diarrhea or discharge. Dryness deprives the body of moisture and injures all bodily functions dependent on fluid. Heat causes agitation and things to stir. It raises body temperature overall or at a specific site. It dries fluids causing elements to become concentrated. Wind moves stuff. It can penetrate the Cou Li and carries other elements into the body. When any of these elements become unbalanced the "channels" can become blocked. She also explains the quality of pain of each of these elements which I appreciate, because it gives me a better idea of what might be causing the clients issue. Pain from coldness represents as symptoms of chill, contraction, cramps and spasms. Pain from dampness represents as a steady heavy ache that is local. Dryness can cause dizziness, spasms and can cause dry stools, dark urine, fatigue and stiffness. Pain from heat is hot, irritable, and dense. Pain from wind can come on suddenly, it can move around or cause shooting pain and can cause rigidity.
She explains how Gua sha works. It dredges the channels which relieves local stasis due to the stretching of the tissue causing a manual stimulation propagating a mechanical and chemical signal within the connective tissue that is associated with healing. Gua sha vents heat. Stress from heat in the body can reduce cerebral blood velocity and can impair orthostatic tolerance in humans. Gua sha is a known remedy for heatstroke. It releases the exterior. (there is a quote that says "first treat the exterior, then the interior"). There are basically two ways to resolve sha and that is either through a fever or by performing Gua sha. Gua sha mimics sweating and releases the exterior by venting heat, moving Qi, blood, fluid, stabilizes the pores and stops the penetration of heat, cold, dampness, wind. Any pathogenic factor is believed to be weakened while the body's Qi is fortified. Gua sha resolves blood stagnation, which is caused by cold and wind. It releases blood within the tissue and appears as petechiae and confirms stuck blood at the surface. If there is no stagnation of blood there will be no sha. This is what I always say, "The sha does not lie." All of these factors make Gua sha an amazing tool for almost any disorder.
In her book, you will learn how to perform Gua sha, learn contraindications, how to treat infants and children and how to pick a tool. She uses mostly a lid as her tool of choice, but I prefer to use different tools myself. She lays out a stroking sequence and gives you suggestions on how to perform Gua Sha to each area of the body. She also walks you through a conversation to have with your clients about Gua Sha. You can see the results of Gua sha performed by Arya through her many pictures of tongue diagnosis, which include before and after pictures.
You'll find specific conditions categorized under Upper, Middle and Lower Jiao disorders. Problems with the head, neck, chest, heart, lungs and upper extremities fall under the upper Jiao. Disorders affecting the Middle Jiao affect the stomach, spleen, liver, gallbladder, and the trunk. Lower Jiao disorders affect the kidneys, bladder, intestines, genitals, reproductive system, pelvic region and lower extremities. For every disorder there is a treatment plan that involves needle points (acupuncture points) and areas to perform Gua sha. Weather you perform acupuncture or not, knowing these points is a great resource. There are also a ton of individual case studies and even a handout to give to your clients.
I'll be honest there were times where the read was tough, but that's to be expected when learning something new. I think my love for Gua sha and this book are evident through my longer than usual review of this book. This book is one that I will continue to come back and I'm sure I'll learn something new each time I do.