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  • Allison, B.S, M.S, L.Ac.

Qi vs. Blood: Moxa and Guasha Explained

Acupuncture Overview

The goal of acupuncture is simply to balance energetic pathways, or channels, within the body. The channels were discovered thousands of years ago. There are 12 main channels pertaining to different organ systems and 8 extra channels, also called “extraordinary vessels”. When the energetic flow is impeded, an acupuncturist calls this “stagnation”. And, because there's stagnant, or pent up, energy in those channels, we can assume there is a lack of, vacancy, or “deficiency” of energy in other areas of the body. Acupuncture involves stainless steel needles inserted into points on the channels in order to accelerate the movement of energy in stagnant areas and ‘call’ that energy to the related areas of “deficiency”.

Qi vs. Blood

Qi is the term that acupuncturists use to describe the energy within the channels. It can also be translated as ‘life force’. In Ayurvedic (Indian) medicine and Yoga, it is called ‘Prana’.

Qi is not the only material though, that runs in the channels. Along with the qi, there is blood. Blood in Traditional Chinese Medicine (TCM) terminology encompasses a wide range of meaning- far more than blood cells.

For example, blood roots the spirit in the body and gives meaning to life. When a woman gives birth and has postpartum depression, everything seems ‘black and white”. Instead of being joyous, she feels apathetic. She has lost blood throughout her life/menstrual cycles without properly replenishing it and the blood loss from child birth has taken it’s toll, as well. There is no longer enough of it to hold meaning.

Take another example, lets say, “Bob”. Bob has been a vegan for years. He also likes to donate his blood. His tongue is pale and his pulse is thin. When he sleeps at night, his awakes at times, with numb hands or arms. Throughout the day, his feet or legs can go numb and tingly. He may see floaters (little black dots) in his field of vision and maybe, if he stands up from sitting quickly, he gets dizzy. He can get headaches too, and these headaches feel better when he puts pressure on his head. Likely, he get’s anxiety and feels uneasy in his body. His hands and feet get very cold in winter time. Bob presents with a classic pattern of “blood deficiency”. He may even have a diagnosis of anemia.

Blood Stagnation

Just as qi can get stagnant, so can “blood”. When qi is stagnant in areas of the body for long enough, a constant dull and achy pain is experienced. When blood is stagnant in an area, it feels like an intermittent, fixed, sharp and shooting pain.

Acupuncture is an excellent tool for moving qi but, there are better ways to move blood!

This is where alternative modalities like moxa, cupping, guasha, & blood-letting, come in. For the purpose of keeping the blog post fairly short, I’ll discuss just moxa and guasha in detail:

Moxa: Nourishing to the Blood

Moxa is short for moxibustion. It involves burning the herb mugwort, or Artemisia vulgaris. Yes, it does sound like something out of Harry Potter! (I love my job.) There are many ways to burn moxa. Direct Moxa involves rolling the loose herb into a small cone, placing it on an acupuncture point, lighting it with a small stick of incense, and taking it off before it touches the skin. Burning moxa in this way will have an effect on the blood of the organ system of the channel the moxa is placed on, as well as, elicit the indications of the specific point.

Whereas acupuncture is great for moving qi, moxa is excellent for nourishing and moving blood.

Alternatively, an acupuncturist can place a large triangular cone of the herb over an area. This is very helpful for inflammation and pain. I often use this method to warm the lower abdomen; doing so helps with circulation, immunity, metabolism, libido, and helping one to feel more connected to and grounded within their body.

Moxa can also be compressed into sticks and poles which burn slowly and can be hovered over acupuncture channels or used in a pecking motion over acupuncture points. For example, there's over an 80% success rate in turning a breech baby by using moxa in this manner on the tip of the pinky toe during the later stages of pregnancy.

Moxa sticks can also be placed in metal rolling devices that are moved along the pathway of the respective channel(s). These devices are called tiger warmers and lion warmers. Nightly use of a tiger warmer is my go-to home-care advice for carpel tunnel and sinusitis.

For a scientific explanation of how moxibustion works, see the article “The Mechanism of Moxibustion: Ancient Theory and Modern Research” by Hongyong Deng and Xueyong Shen at NCBI (National Center Biotechnology Information), U.S. National Library of Medicine. Excerpt below:

“The generally accepted view is that the meridian system combines with moxibustion physical and chemical effects to produce comprehensive effects. When physical and chemical factors act on the acupoint receptors, the signal enters the central nervous system through the peripheral pathways and outgos after being integrated, adjusting the nerve-endocrine-immune network and circulatory system, so as to regulate the internal environment of the body.”

Guasha: What is it?

When the blood is stagnant in larger areas of the body, guasha is my preferred technique to move it. Guasha radically increases blood flow through the area, which is essential for tissue healing, as it brings oxygen and nutrients to the area and carries away waste products. Guasha involves stroking motions over muscles and body tissue with a guasha tool. The tool can be anything; depending on the area I’m working on, I alternate between a ceramic soup spoon, a cap to a glass jar, and a stone guasha tool that a friend got me from China.

Of course, these are always sterilized, and massage oil or Chinese herbal liniment is applied to the skin to allow the tool to glide smoothly. In the 6 years I’ve been performing guasha, I have yet to meet one person that disliked the procedure. Personally, it is my favorite modality. Most patients state that it feels good and they enjoy the fact that it directly targets their area(s) of discomfort. Although the area can feel a bite sore the day of and the morning following treatment, patients often state that they feel lighter. They sometimes say they feel emotionally lighter.

Guasha: How does it work?

How does guasha work? When blood is stagnant, it pools within the capillaries so, guasha is used to break the capillaries and get it moving again. Once it’s outside the capillaries, the body can filter it and properly dispose of the waste and toxins that have accumulated. When the skin is stroked with the guasha tool, areas of the body with blood stagnation will show discoloration within 20 strokes. The deeper the blood stagnation in the body (ie. the longer it has been going on), the more purple the area. Blood stagnation that is fairly new will present as a bright red color, in comparison. Great areas for guasha include the IT band and thoraco-lumbar fascia (upper, mid, and low back).

If you watched the summer Olympics, you may be recalling the bruise-like circles on Michael Phelps’ back and wondering if these are similar. The procedure that Mr. Phelps made famous that year was cupping. Cupping is another fantastic modality that works along the same principle as guasha, but targets a local area and uses vacuum suction with a ‘cup’, instead of stroking with a guasha tool.

The best applications for guasha are breaking up adhesions and restrictions in muscles that have suffered injury/strain and have not completely healed. These areas can develop scar tissue that is not visible on the surface because when the tissue grew back after the injury, it did so in a disorganized manner, in comparison to healthy parallel bands of fibers. Within the disorganization of muscle fibers, tangles of collagen, elastin fibers, and glycoproteins ‘gum up’ the works, impeding proper circulation and preventing the muscle(s) from contracting normally.


Choosing the right technique and the ‘right tool for the right job’ is the name of the game in Chinese Medicine. I am fortunate to have thousands of years of knowledge to choose from in deciding how to fill up my toolbox. If you’re curious if moxa, guasha, or another technique would be helpful for your condition- mental, emotional, or physical- feel free to contact me for a complementary in-person or over-the-phone consultation.

Wishing you balance,

Allison, BS, MS, LAc

Basic Balance, PLLC


“The Mechanism of Moxibustion: Ancient Theory and Modern Research” buy Hongyong Deng and Xueyong Shen (link at end of article):

Qiological Podcast: May 19th, 2018. “Sinew Channels & Joint Stability” with Michael Max, L.Ac. and Anthony Von Der Muhll. Qi032.3

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