The accompaniment of the instrument is essential to the ethnic minorities in China's southern province of Yunnan, such as the Lahu, Yi, Miao and Naxi, especially during their ritual Tage dancing.

[4] In southeast Asia, like Upper Myanmar, northern Laos, northeast Thailand, and Rattanakiri province in Cambodia, the gourd mouth organ is also an essential part of the people's daily and ceremonial lives.

[9] The gourd mouth organ is also recorded in several Chinese historical sources from the Tang dynasty onward, for example, in the Book of Odes (Shijing), Tangyuezhi and Manshu.

"[6] And in the Manshu (ninth century), it records: "Hulusheng was played by young men wandering on the streets in the evenings to express their love towards girls.

"[3] The mouth organ had its widest range of distribution around sixth century A.D.[2] It was spread to Persia from China and was called mushtaq sini, 'Chinese mushtak', or chubchiq.

[1] Slight variations in shape, size, height of the gourd mouth organ can  be observed among different minorities groups, for instance, the bamboo pipes used in Hei Miao can go up to fourteen feet high with brass reeds.

[6] In China, apart from using the gourd mouth organ at funerals and wedding ceremonies, it is also an essential part of the Tage dancing ("stomping songs") among ethnic minority groups like Yi, Naxi, Lahu, Miao, Tibetan, Bai, Hani, Jingpo, Achang, Lisu, Pumi, Nu, and Du-long people in southwest regions who are closely related to the ancient Diqiang people.

[4] With a tradition of 2500 years, Tage accompanied by Hulu Sheng is believed to significantly impact people's emotional outlooks, temperaments, and life desires.

[4] The dance is usually accompanied by Hulu Sheng, and on occasion, lusheng with a long pipe, together with horizontal and vertical bamboo flutes, three- and four-stringed plucked instruments, and suona.

[4] In Songshi (History of the Song dynasty) it also records that men and women from many ethnic groups in Yunnan would come together, playing instruments such as the gourd mouth organ and the flute; and when the musician began playing the gourd mouth organ, tens of other members joined in the dance, circling the musician and stomping their feet to make rhythmical beats similar to drums.

In Iam nithan, long tales derived from Buddhist sathaka (the stones of Buddha's previous births) were sung by a soloist accompanied by a Khene.

[12] And in rituals of healings and possessions, ritualists, generally elderly women accompanied by a khene, sing to invite the offended spirits to enter their bodies and explain the cause of the illness.

[5][15] In Thailand, similar healing ritual called Lam phi fa (curing ceremony) is also accompanied by Khaen (mouth organ in Thai).

[12] In Rattanakiri and Mundulkiri provinces of Cambodia, the Ploy (gourd mouth organ in Cambodian) and the bronze gong ensemble are played during the ritual sacrifice of buffalo (kapp krabey phoeuk sra).

Accompanied by the gourd mouth organ, the boys stamp their feet collectively, and the girls create a tight swinging circle around them.

[2] The Akha who are Tibeto-Burman-speaking people, play the gourd mouth organ (lachi), the Jew's harp (chau) and the three-stringed lute (döm) both during festivals and at leisure.