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July 3, 2002

Camphor Intoxication After Cao Gío (Coin Rubbing)

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(1):45. doi:10.1001/jama.288.1.42

To the Editor: Cao gío, also known as "coining'" or "coin rubbing," is a dermabrasive therapy used to relieve symptoms in a variety of illnesses,1 and is most commonly used by Cambodians and other ethnic groups from Southeast Asia.2 This traditional health practice is said to release excess "wind" or energy considered responsible for illness.2 The skin is first lubricated with medical oils or balms and subsequently rubbed firmly using the edge of a coin to produce parallel ecchymoses on the chest and the back.3 This procedure often generates skin eruptions in a pine tree pattern with 2 long vertical marks along either side of the spine and several lines paralleling the ribs. Known complications of this procedure are burns after application of heated oil and cerebral hemorrhage.4 In addition, parents who applied coining to children have been falsely accused of child abuse.3 Oils and balms may also contain potentially toxic components if systemically absorbed. We report a case of camphor intoxication from a balm used in coining.