Indigenous Treatments: Coining

Coining is an ancient Southeast Asian folk remedy used to treat common minor illnesses. It is still frequently practiced today, and cross-cultural understanding is enhanced by knowledge of the procedure. A special ointment is placed on the skin. The edge of a coin or other object is then rubbed on the skin in downward parallel lines until redness, welts, or a small amount of bleeding occurs (see Figure 1). Family members, friends, or traditional healers may perform this procedure as the first line of therapy for cough, headache, vomiting, diarrhea, dizziness, fever, and other symptoms. The part of the body that is coined depends on the symptom that is being treated–for example, the back and chest may be coined to treat respiratory symptoms, and the arms, neck, and forehead may be coined to treat headaches. Coining is practiced in Vietnam, where it is referred to as cao gio (pronounced gow yaw), meaning “scratch the wind.” It is also practiced in Cambodia, China, Korea, Laos, and Thailand. Coining is also called coin rubbing, coin rolling, and skin scraping.

Southeast Asian folk practices reflect cultural beliefs about the causes of illness. Disease is seen as a state of imbalance. The four elements of the body– fire (heat), water (wetness), wind (cold), and earth (dryness)–must be in balance. Too much or too little wind is often related to disease states, and coining is believed to relieve the body of wind. The concept of wind does not refer literally to rapidly moving air but to a moving element of the human body that is associated with blood. The marks produced by the coining procedure affirm the presence of excess wind in the body and show that wind has left the body. The procedure aims to increase circulation, respiration, and warmth and stimulate trigger points.

Although the marks left by coining appear painful, many describe the process as pleasurable, similar to a massage. People who are unfamiliar with the practice may confuse coining with child abuse. Families are often devastated when this happens. The practice is otherwise benign and only rarely does the patient experience complications. Because the practice is so deeply embedded in Southeast Asian culture, attempts to dissuade people from practicing coining are unnecessary and ineffective.

Coining and other traditional healing practices can be beneficial. Patients may feel empowered by taking action to treat their symptoms and tend to believe that coining works. Their problems are recognized and attended to, which is comforting to them. Coining is well thought of and closely tied to family and culture, and patients remain connected with their traditions through its use. Coining can be detrimental if modern medical care is delayed for serious treatable conditions, [Page 248]but this is not the usual practice. Coining and other folk remedies remain prevalent among Southeast Asian immigrants, who are best served when both Western and traditional health care systems are recognized and accepted.