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Some people also take medicine such as paracetamol and aspirin after applying kerokan. The sick person will feel relieved and sleepy, then will get better and feel refreshed after several hours of sleep. The illness will be cured within two or three days after the sick person takes total rest at home.
Indonesian folk medicine is influenced by a Chinese philosophy of health and illness. Chinese traditional medicine has influenced Southeast Asia since the fifth century. According to Chinese beliefs, health is a state of spiritual and physical harmony with nature. A healthy body is in a state of balance between yin and yang , which are generally translated as hot yang and cold yin , but these refer to qualities, not temperatures.
In some societies, responses to illness are grounded in a system of beliefs and practices, which have their own logical structure. From a scientific standpoint, beliefs about the source of illness might be irrational, but the treatments are a logical consequence of those beliefs.
In the case of kerokan , Indonesian people believe the practice is done to release excess cold wind which is considered responsible for the illness. It is said that the reddish mark symbolises the disappearance of the cold wind from the body.
People also believe that if the sick person sweats a lot and lets out a fart, this is a sign of the cold wind leaving the body. Within this theory, emphasis is placed on delivering respectful care for patients and their families.
The religion and customs of a patient's culture becomes an integral consideration when planning nursing care. Trust and communication are thought to be enhanced within an understanding of the sociocultural and multidimensional aspects of a patient's beliefs. The potential for misconceptions is thereby diminished [ 2 ]. The acquisition of cultural competence is an ongoing process that requires self-awareness in a provider. Optimal care also incorporates a sincere interest in various cultures, values and beliefs.
This in turn is evidenced by actively listening to patients' expressions of their principles and convictions. Awareness of a patient's culture will then enable a provider to formulate individualized care plans with respect, genuine concern and attention to cultural details [ 3 , 4 ]. The cultural beliefs of providers and those of patients or their families may differ widely or present ethical dilemmas.
There may not always be clear solutions to issues that cannot be easily reconciled [ 5 ]. As an example of misconceptions by nursing staff is illustrated through a case scenario See Clinical Scenario in which multiple body marks on an elderly man resembling burns and bruises caused concern for his nurses. Elder abuse was suspected until it was found that the skin marks in question were actually a result of a cultural practice known as Cao gio, coining or press scraping.
Gua sha [ 6 ] or coining translates to "scraping or bruising" Figure 1 and Figure 2. It has also been termed Cao gio which means "catch the wind".
It is an important part of medicine in various cultures including southeastern Asian. Skin lubricated with an oil is scraped with a ceramic spoon, worn coin or metal cap. The elongated bruises resulting from this procedure are considered signs of balance, stimulated blood flow and the restoration of health. These measures are taken to correct imbalances attributed to poor nutrition, stress, fatigue, overexposures to "wind", and asymmetries between yin and yang.
The balance of Yang and Yang from Chinese philosophy indicates negative and positive interacting forces that maintain the harmony of the universe [ 7 ]. Success in ridding the body of bad "wind" is estimated by the degree of redness evident after the scraping treatment. The shade of the marks illustrates the severity of the illness present [ 8 ].
The skin is vigorously rubbed in a linear manner for minutes over the spine, ribs or head. Cao Gio is a Vietnamese word pronounced gow yaw. That is the therapeutic secret of Cao Gio. Despite the substantial similarity with Chinese Gua Sha, it has its peculiarities and identity. Many consider Gua Sha and Cao Gio to be the same. They belong to the joint stable of ancient Southeastern traditional and ethnic medicines but retain regional or localized subtleties.
In this therapy, the skin gets scraped in a particular way. The scraping brings the bad wind of the blood just under the surface of the skin. From there, it escapes through the pathways abrasive bruises created by scraping the skin. The only requirement is that the edges should be smooth to prevent cuts on the skins. However, in Gua Sha, many tools are used depending on which body part needs treatment. Some warm oil also applied to the affected area.
Further, with the help of the coin, the skin is scraped in long strokes. The strokes are made parallel to one another. It should be unidirectional, going outward. Unidirectional here means the scraping motion should be only in one direction, and that is, inwards to outwards. The oil serves as a lubricant for one, and the other benefit is these oils also have medicinal properties, which aids the therapy.
The most popular oil used are peppermint oil, wintergreen oil, eucalyptus oil, and camphor-based oil. Tiger balm is also very popular because of its pain-relieving properties.
These coin scrapings result in ecchymosis linear discoloration of skin because of bleeding underneath. The blood from the squashed capillaries leaks out and spread just beneath the skin surface. It is here that the bad wind from the flowing blood escapes out from the skin along the length of a bruise. That is the therapeutic action according to ancient medical science.
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