Lesley Tierra, L.Ac., Dip. Ac.

From The Herbs of Life, Published by Crossing Press, 1992

The Barefoot Doctor healing techniques have mainly been identified as Chinese techniques used by the native healers of China. These practitioners would walk from village to village (thus, the name "barefoot" Doctors) and treat all manner of diseases using these tools. The Barefoot Doctor techniques include cupping, moxibustion, dermal hammer, scraping, needling, bleeding and massage. Barefoot Doctors were also skilled at bone setting.

Although they may sound like exotic Traditional Chinese Medicine therapies, these techniques are not native to just China. The Barefoot Doctor tools are actually folk remedies, which have been, and still are, used throughout most cultures in the world. Among the many cultures using some of these tools are Chile, Argentina, France, Germany, Poland, Turkey, Greece, Egypt, India, Bali, Java, Czech Republic, Russia, Iran, Mexico, Italy, Vietnam, Japan, China, Korea and several Native American Tribes of North and South America. People of these cultures have not only used them in the past, but many still practice them today, especially in rural areas. In fact, it is not unusual to meet people whose grandparents cupped them when sick with colds as a child. Thus, these techniques are universal folk remedies, which are ours to reclaim and begin using again.

One of the advantages of Barefoot Doctor techniques is not only their efficacy, but also their convenience. It is possible to perform all of these remedies with tools found in most homes. This makes them readily available wherever you may be. Of the seven traditional Chinese Barefoot Doctor techniques listed above, I will cover three here: cupping, moxibustion and scraping.

Cupping

Cupping is a technique which was (and may still be) widely used by folk people in Europe as well as China. Cupping can be seen in the movie, Zorba the Greek, and can be read about in Every Month Was May, by Evelyn Eaton when she experienced it in France in the '40s.

Cupping is the treatment of disease by suction of the skin surface. A vacuum is created in small jars that are then attached to the body surface. The vacuum causes a drawing up of the underlying tissues into the cups, pulling inner congestion in the body up and out. When effective in its job, the skin will appear reddened and bruised after the cup is removed. This marking can take several days to disappear, but it will go away. The person should notice an immediate difference in condition, be it congestion or pain.

To do cupping, you will need several jars or cups with even and smooth rims. Good cups to use are the small votive candleholders easily found where candles are purchased. However, wineglasses or other lightweight and thin glasses may be used. Bamboo cups are effective, too. Modern plastic and glass cups are available today and may be purchased from the East West Online Store. You will also need some cotton balls, forceps or other metal holder or stick for the cotton, or alternately a candle and some rubbing alcohol and matches.

Have the person and all your tools in place before starting. Then attach cotton ball to stick or forceps and dip in alcohol. Hold the cup so its mouth opening is down or the flame can bum your hand. Ignite cotton and while burning, insert it into mouth of cup. If you are using a candle, hold the cup over the flame for a short time, and then quickly place on the skin as above. This will evacuate some of the air, causing a partial vacuum within the cup. Withdraw cotton stick and quickly place mouth of cup firmly against the skin at desired location. Suction should hold it in place. Check by lightly tugging at the cup.

Be careful not to leave cotton stick in cup too long as this will cause a hot cup and could bum the person. Conversely, if cotton stick is not left in long enough, suction will not occur and cup will fall off when tugged gently. Practice will yield desired results, and it is easier to do than it may sound.

To remove, let air into cup by holding it in the left hand and pressing the skin at the rim of the jar with the right. You may need to gently slide your pressing finger down and under the rim in order to break the seal. The cup should then pop off,

If you are using a modern glass or plastic cupping set, to use, lift up the black "knob" on top of each cup before use. Then slid the plunger over the top of the cup, place the cup on the desired location on the body, and pump the plunger with a few stroke. This will draw out the oxygen in the cup and pull the underlying skin up into the cup. It is a very quick and effective device. To remove, either slide a finger under the cup, or pull up on the black knob on top of the cup, which will break the suction.

Another very effective cupping method is the one used in India. For this you need a few small coins, such as pennies, several two-inch square pieces of cloth, and thread or small rubber bands. Put the penny in a square of cloth, then tie the ends up above the penny together with the string or rubber band. This forms a wick.

To use, dip the wick in oil (olive or sesame oils are fine), light the oiled wick, gently place on the body where, you want to place the cup, then set the cup over the lit penny in the cloth. The oxygen will immediately be consumed, the flame will go out and the underlying skin will be sucked up into the cup. To remove, slide a finger under the cup to break the suction before lifting it off.

Cups should be retained in place from 5 to 15 minutes, depending on the strength of suction. Especially in hot weather, or when cupping over shallow flesh, the duration of treatment should not be too long. Often I have seen the cups pop off for no apparent reason. If the suction was good in the first place, then generally this is an indication that suction is not needed in that place, or there was too much body hair for the cup to hold. It is also possible for the cup to remain in place and still be unnecessary, and if so, no redness or bruising will occur. Bruises occurring under the cups indicate where the congestion has been. I have also seen blisters appear which should be dressed and treated to prevent infection.

Cupping is done over areas where there is swelling, pain or congestion, either of energy, blood or mucus. Thus, it is good for edema, swellings, asthma, bronchitis, dull aches and pains, arthritis, abdominal pain, stomach-ache, indigestion, headache, low back pain, painful menstruation, coughs from excessive mucus, and places where bodily movement is limited and painful.

Cautions: Cupping should not be done during high fever, convulsions or cramps, or over allergic skin conditions, ulcerated sores, or on the abdomen or lower back of pregnant women. It will also be ineffective over areas with irregular body angles, where the muscles are thin, the skin is not level or where there is a lot of body hair.

Moxibustion

Moxibustion is a method of burning herbs on or above the skin, usually at specific acupuncture points. The heat warms the energy (chi) and blood in the body and is useful in the treatment of disease and maintenance of health. Quite often pain and disease result from a blockage or improper flow of energy and blood, and moxibustion stimulates with heat to alleviate the original blockage and correct the flow. Moxibustion is wonderful for sprains, traumas and injuries. In addition, it stimulates and supports the immunity of the body, and eliminates cold and damp, thus promoting normal functioning of the organs.

Although it can be made from a variety of herbs, moxa (short for moxibustion) is generally made from the mugwort plant (Artemisia vulgaris). This herb, while its heat is mild, burns easily and penetrates deeply beneath the skin into the body. It comes in a variety of forms, either as the loose wool, in cones or as sticks, often called moxa cigars. It can be burned either directly on the body, or over the surface.

For home use we will only learn how to use moxa sticks over the surface of the body. This is a safe and universally useful method. The sticks may be purchased from the East West Online Store and are not expensive. Moxa sticks may be made at home by picking and drying mugwort, then grinding it into a fine powder, sifting and filtering it to remove coarse materials and then repeating this entire process until a fine, soft, woolly powder results. It is then tightly rolled up in tissue paper to form a 6" long thick 'cigar'. In a pinch a cigarette may be used as a substitute for a moxa stick.

To use, remove the commercial paper wrapper (not the white inner paper) from the stick and light one end. Hold it about 1 inch from the surface of the skin over the chosen area, the distance varying with the tolerance of the person and the amount of heat stimulation desired. With this method the stick is held still and only moved when the heat level becomes intolerant. It is not necessary to withstand the heat beyond tolerance levels or to become burned. Heating to the threshold level and then moving the stick away for a moment is sufficient.

If several points or areas are to be warmed, then the stick may be moved to the next place, coming back to the original point later. Normally, the moxa stick is burned from 5 to 10 minutes on each area, or until the skin becomes red in the vicinity of the point.

Another method is to use a circular motion with the stick moving around and over the desired area. This spreads the focus of the heat over large surface areas, and is especially good for soft tissue injuries, skin disorders and larger areas of pain. A third method is called 'sparrow pecking' the moxa stick is rapidly 'pecked' at the point without touching the skin. This enables the heat to penetrate deeply and so is good when strong stimulation is desired. Be sure to periodically tap the ashes off the stick into a container, as otherwise they will fall on the person's skin and bum.

Putting out the moxa stick is just as important as learning to use it. If not safely extinguished, it can easily continue to smolder and potentially cause a fire. Make sure the stick is no longer smoking before you leave it and turn your attention elsewhere.

To extinguish moxa sticks, either twist them down into a container of rice, place them in a jar and screw the lid on tight or wrap a piece of tin foil tightly around the lit end. With any of these methods you will not loose any of the stick. It is possible to cut off the burning end, dousing the cut end in water; however, much of the stick is then lost. Often one can find a small-holed candle holder which just fits the stick, and placing the lit end of the moxa down inside will effectively put it out. A major caution here is not to put the moxa stick out in dirt. Though this seems as if it will work, it doesn't, The moxa stick continues to quietly burn, potentially causing a fire.

The usefulness of moxa is endless. Be sure to save the moxa ashes to use in stopping bleeding and the smoke can be used therapeutically, too (see the chapter on Home Remedies under ashes and moxa smoke respectively). When used over the following areas it can help the conditions indicated:

Chest: lung congestion, cough, cold, flu, allergies, asthma, bronchitis, mucus, difficulty in breathing and other lung complaints.

Upper abdomen: poor digestion, gas, poor appetite, nausea, vomiting, local spasms and cramps and food congestion. Caution: do not use over the right upper abdomen near the rib cage as this is the residence of the liver, an organ already too prone to heat.

Middle abdomen: poor digestion, gas, diarrhea, local cramps and spasms, weakness, low energy.

Lower abdomen: gas, diarrhea, local cramps and spasms, bladder infections (without the appearance of blood), low energy, body coldness, lowered immunity, menstrual cramps and difficulty, frequent urination, night time urination, weakness, leukorrhea and other discharges, poor circulation and prostate difficulty.

Upper back: this will treat the same conditions as listed under chest, only this area is perhaps not as sensitive or vulnerable to treat on most people.

Middle back (waist level): kidney and bladder disorders, frequent and night time urination, low back pain, bone and disc problems, hair loss, knee and other joint pains, lowered immunity and resistance, poor circulation, coldness, weakness, low energy. Heating this area will raise the resistance and energy level of the entire body, thus aiding all other bodily organs and systems and any diseases being experienced. It is especially good for vegetarians who tend to have more internal coldness than others.

Lower back: low back pain, 'menstrual difficulties, leukorrhea, bladder infections and diarrhea.

Joints: local pain and swelling, arthritis, aches, soreness, local injuries, coldness and congestion.

Other body parts: moxa is useful over other body parts where there is tension, soreness, ache, arthritis, cramps or spasms or any type of blockage, and where healing is not occurring.

Cautions: A few cautions do exist in using moxa. One should avoid using it directly over the liver as indicated above, under the upper abdomen; avoid burning the person; do not use moxa when a fever exists; do not use over areas of inflammation or infection; do not use over the lower back or abdomen of pregnant women; avoid use in the vicinity of sensory organs or mucous membranes. If an area is numb or there is little feeling or poor circulation, take special care not to over use on those areas because the person cannot feel as well in those places and burning could easily occur,

If for some reason the person does get burned, then a blister will form. Take care not to let small blisters break. The fluid will be absorbed without infection. Large blisters may break and so should be dressed to prevent infection.

Note: An interesting note here is the use of moxibustion for injuries. Western medicine usually defines any injury as inflammation and thus, promotes the use of ice over the affected area. Seemingly heat would be contraindicated in these situations.

Yet, from the viewpoint of Chinese medicine the opposite is true. While ice numbs and stops the heavy influx of inflammation and infection-fighting cells thus decreasing the pain, the long-term results are blocked energy and blood (which coldness causes), a slower healing process and a longer-term pain. Ice and coldness slow down circulation and congeal the blood, just as ice on a river stops the flow of water on the top. The flow of energy is then blocked, also.

With the application of heat (the sooner the better), fresh energy and blood are immediately brought to the location for healing with continued circulation. The heat also alleviates the pain and actually quickens the healing process, especially over the long run. This is true of wounds, too. The only time moxa should not be used in these cases is where a true inflammation occurs, and this will be indicated by extreme redness of the skin and possible pus formation. For injuries such as broken bones, ice can be used first, alternating with moxibustion.

I will give you an example. My family and I were playing volleyball with some friends. One person got her hand smashed by the ball and the pain was excruciating. We immediately obtained some heat (no moxa was on hand but we found a person with a cigarette) and applied it over her swollen and painful fingers. Within five minutes the pain had lessened substantially and after 15 minutes she could play volleyball again! With ice she would have remained out of the game with dull aching fingers for quite a few days.

As another example, I have treated numerous people with injuries where with the use of ice the problem and pain were slowly subsiding over several weeks time. Yet, with the use of moxa, the condition and pain were lessened substantially within days to a week. Experiment with using heat on injuries rather than ice, and see how effective it is.

Other: If moxibustion is not available and heat is needed, a hot water bottle, or stones or bags of sand or salt heated in an oven or on a woodstove are good alternatives.

Scraping

Scraping is a technique of rubbing the skin vigorously with a smooth blunt object until it reddens. This pulls any underlying congestion out to the surface of the skin, allowing the natural flow of energy to restore itself I have seen miraculous results with this technique on exceedingly painful shoulders and stiff neck, and fevers lowered when lightly done over the spine. It is generally done on the site of congestion such as the neck, shoulders, along the spine, chest, behind the elbows and knees and between the eyebrows. Fevers, painful joints, indigestion, heat stroke, headaches and stiff neck and shoulders all respond well to this technique.

Originally an old copper coin was used and first dipped in wine or water before scraping. Today, a ring of smooth jade is commonly employed and the skin rubbed with oil before scraping. A Chinese porcelain soupspoon or the smooth narrow edge of a polished stone work well as tools. Do not use the edge of a glass or silverware as the former could break and the latter is too sharp.

To scrape, first lightly apply oil to the area to protect the skin. Next, firmly hold your object, and rub it back and forth over the desired area with strong pressure. The firm pressure is important, as too light a pressure is irritating and doesn't yield results. It is better to use firm pressure and a quick motion and then lighten up if necessary. It can be painful, but a 'good' pain, as at the same time the pain of the stiff congested area becomes tremendously reduced. If it is uncomfortable, lighten up on your pressure or stop altogether. The skin will get very red where there is congestion, just as in cupping, even resulting in small red skin marks. Avoid breaking open the skin or causing bleeding.

If scraping many areas of the body, start at the top of the body and then move to the bottom, first doing the back and then the front of the body. When the area gets very red and the tension or pain is lessened considerably or gone, then you are done, usually within five to ten minutes. The redness will disappear within several days. Be sure to tell the person that the redness may show for several days but will go away.

In Java, scraping is a fine art with very specific directions for application. It is often done between the ribs on the back to relieve certain types of fever, yet, they scrape almost anywhere on the body. The technique taught here is fine for the conditions listed above.

Cautions: Do not use over areas where there are skin irritations, broken skin, ulcers, allergic skin conditions, boils or over the lower back or abdomen of pregnant women.

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