Successful Aging In the Division of General Medical Disciplines

Culturally Appropriate Geriatric Care:
Fund of Knowledge

Traditional Healing Modalities

Many elders prefer being treated with traditional home remedies for physical symptoms of either natural or spiritual illness. Headaches, muscle aches, swelling, tingling, back pains, chest pains, and abdominal pains are often interpreted as being caused by a build-up of pressure that must be released. Techniques used to dim pa (release the pressure) include cupping, coining, and massage. Residual marks (i.e., linear petechiae and eccymotic lesions) appear on the skin surface at the site of the procedure (i.e., back, neck, temporal areas, nasal bridge, and chest) and usually resolve within a few days.

Txhuav or Nqus (cupping)

Refers to a glass cup, bamboo jar, or water buffalo horn that is placed on the location of the pain, and then a vacuum is applied to the skin by heat or mouth suction, which causes a bruise. Cups are often cleaned with alcohol and fire before being placed on the skin.

Kav (coining or spooning)

Involves rubbing the skin with a flat edged object such as a silver coin or spoon. In advance of this treatment, oil or Tiger Balm is applied to soothe the skin and increase circulation.

Zuaj ib ce (massage)

A vigorous body massage that may be done alone, or followed by cupping or coining. The purpose of the massage is to loosen the body (muscles/tendons/veins) and to promote better circulation.

Hno (pricking the skin with a needle)

Can be done alone, after massage, or in conjunction with cupping and coining. Pricking often occurs at the bruised skin site after cupping or coining or at the fingertips after massage. Pricking is conducted both to release pressure and toxins causing the illness, as well as to determine the severity of the illness by examining the released drop of blood. The color and consistency of the blood are visually analyzed; the darker and thicker the blood, the more severe the illness.

Elders often use these remedies before seeking medical care, but they may also use them during or after medical care. It is important for health care providers to be aware of these modalities since some cause bruising of the skin and should not be misinterpreted as elder abuse. These traditional methods are perceived to have healing properties by those who continue to use them. One effective way of asking whether these methods are used, is to first inform the Hmong elder that you are aware of these methods of treatment, and then ask what the patient does to alleviate pain.

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