These two techniques, Cupping and Guasha, are closely related and highly effective. They form part of the “folk medicine” of the Orient and deserve a worthy place in the tool kit of any Oriental Medicine practitioner or bodyworker. They achieve clinical results that are otherwise very labour intensive to attain.

Cupping technique is the better known of the two techniques, having appeared in the 1970’s film Zorba the Greek. Cupping technique is well known in many southern and eastern European cultures such as northern Italy, Greece, the Baltic states and Poland. I speculate the technique arrived in Europe from the Orient via the Silk Road trade route. The theory behind cupping technique blends well with ancient Greek theories of health and healing.

Early Chinese texts refer to cupping as a process to help expel “devils” or malevolent spirits. Similarly the Greeks referred to pathogenic “humours” or “winds” which could be expelled from the body.


The technique of cupping is simple. Generally, a specially made glass jar is used which is round and has a broad, flat edge. A flame is inserted briefly and rapidly into the jar; this is not enough to heat the jar but sufficient to heat the air in the jar and burn the oxygen. This has the effect of creating a partial vacuum. If the jar is quickly placed onto the skin, usually the back or belly, the vacuum causes the jar to stick to the skin. Indeed it will pull a quantity of skin and underlying tissue inside the rim of the cup. Effectively what is happening is the cup is acting like a local pump. By drawing on the tissues, the cupping automatically draws on or mobilises the local fluids. Therefore any of the pathogenic factors (“malevolent spirits”) such as Heat, Cold or Damp will be dispersed.

It is important to understand that this technique is operating at two different levels. Take for example a condition of Cold in the Stomach and Spleen. In such a case we would apply cups to the Front Mu points of the Stomach and Spleen, CV 12 and Liv 13. The cups would be retained for 10 – 15 minutes and on removal it is very likely the skin at those points would be literally cold to the touch. So there is a literal, local effect that is readily observable; but more than this, there is a systemic effect: the cups are sending a message to body to disperse Cold from the Spleen and Stomach or to put it another way, the micro is effecting the macro.

Cups will usually leave a bruise which will itself be indicative of the level of congestion or invasion of the local tissues. You will be able to observe through the glass jar an immediate discoloration of the skin: a red colour indicates Heat; dark red/purplish indicates chronic Heat and/or stagnant Blood; a white sheen is indicative of Cold; moisture gathering in the jar indicates the presence of Damp. Occasionally blistering will occur which is generally indicative of depletion of Qi. The bruise will disperse gradually over a few days; darker bruising may take a week or ten days to fade completely.

Cups are frequently used on the Back Shu points and can therefore be directed at specific organs such as Large Intestine, Kidney, Spleen or Lung. They can be used on the scapula or on top of the shoulders as well as around the sacrum and buttocks. It is highly effective way of dispersing stagnant Blood around old injuries or areas of overuse such as in frozen shoulder syndrome. Any area of soft tissue is available for cupping as long as the skin is flat enough to create the suction. It is not appropriate to cup areas with insufficient flesh, such as the sacrum of a male. Excessively hairy skin can first be oiled to facilitate a stronger grip.


This is a variation of the standard cupping technique. It is done on the middle and upper sections of the back. The back must first be well lubricated with oil. The jar is placed on the back with a lighter than usual suction. Some practice is usually required to attain the right level of grip; it must be strong enough to maintain a suction while the jar is manipulated, but a strong grip will be too difficult to move the cup and far too painful for the patient. Once the right level of grip is attained the jar is gripped close to its edge and then slid up and down the back along the line of the spinal muscles. Provided the patient has ample flesh the cup can also be slid along the spine itself and over the scapulae.

This technique is another version of a Guasha, which we will describe in a moment. Let us just say here that the sliding cup technique is a powerful therapy which allows a much stronger dispersion over a much greater surface area than single cupping will allow.


Guasha is the technique of scraping the body with a hard object. Its purpose is to stimulate the circulation and thereby to disperse inflammation or Heat in the body. As with Cupping Technique, Guasha is a folk medicine technique and is very common throughout China and South East Asia. It is not generally not taught in the Chinese acupuncture colleges, quite simply because everybody already knows how to use it. It is the equivalent of a hot lemon and honey drink for Westerners faced with a cold or flu and is indeed often used to resolve that condition.

A variety of tools can be used. Traditionally the Chinese used a piece of buffalo horn, moulded with a rounded edge. This has been replaced with the common ceramic spoon that you will see in any Chinese restaurant. Throughout Vietnam, Malaysia and Indonesia you will find practitioners using coins. The Australian twenty cent piece is ideal and makes the whole procedure very cheap medicine! Any other slightly softened sharp object can be used, such as the plastic or metal lid of a jar. The Japanese often use a particular tool known as a Yoneyama which is a small copper/bronze object with a rounded edge. Avoid any excessively sharp object, this will be too rough on the skin and will cause pain. Likewise avoid objects which are too soft; they will simply not be effective enough.

The technique is usually, but not always, applied with oil in order to minimise discomfort. The main site to apply Guasha is the back. The skin should be scraped with the Guasha tool fairly firmly but not excessively. Work in lines along the spine (provided it has ample flesh to protect it) and then along the bladder channel lines. If the tissues are distinctly congested or inflamed a crimson/red bruising will appear fairly quickly. This bruising is referred to as the Sha. A distinct, dark Sha indicates very inflamed tissues or areas of excess Heat. A mild Sha will appear as only a pinkish red flush with perhaps a few flecks of crimson.