Healing through Suction

     Cupping, called Hijama by the Muslims, is the application of suction cups to the skin to draw out stagnant, congested blood and Vital Force, as well as other stagnant or morbid humors.  Usually, the cups are made of glass, but they can also be made of bamboo, bone, horn or metal. 
     The classical method for creating suction in the cup is to use fire to consume the air within it.  But more recently, squeezable cups with a rubber top, or cups drained by suction pumps are also used. 
     Cupping may be done either wet or dry.  Dry cupping is simply placing the suction cups on the skin.  Wet cupping, or Scarification and Cupping, is a form of bloodletting that involves first making an incision on the skin, then applying the suction cups to suck out small amounts of blood. 


cuppingHistory of Cupping

     Cupping therapy is an incredibly ancient and universal practice that spans both East and West.  In the primitive shamanistic practices of all the world's indigenous peoples, there were certain shamans who specialized in the sucking out of illness and infirmity from the body. 
     In the East, the Chinese have been practicing the art of cupping for at least three thousand years.  Along with Tui Na massage, acupuncture and moxibustion, cupping forms part of the traditional bodywork or physiotherapy system of TCM, or Traditional Chinese Medicine.  Cupping is applied to the acupuncture points to relieve the stagnation of Qi and blood, both locally and in the organ(s) activated by the point. 
     In the West, cupping therapy had its birth in Egypt.  The Ebers Papyrus, written around 1550 B.C.E., states that bleeding by wet cupping removes foreign matter from the body.  In cupping, the ancient Egyptians saw the remedy for just about every disorder. 
     The ancient Egyptians passed the art of cupping on to the ancient Greeks.  Both Hippocrates and Galen were staunch advocates and users of cupping therapy.  Galen once condemned Erasistratus, a noted physician in Alexandria, for not using cupping.  Herodotus, a famous Greek historian and physician, wrote, in 413 B.C.:

    "Scarification with Cupping possesses the power of evacuating offending matter from the head; of diminishing pain of the same part; of lessening inflammation; of restoring the appetite; of strengthening a weak stomach; of removing vertigo and a tendency to faint; of drawing deep-seated offending matter towards the surface; of drying up fluxions; checking hemorrhages; promoting menstrual evacuations; arresting the tendency to putrefaction in fevers; allaying rigors; accelerating and moderating the crisis of diseases; removing a propensity to somnolence; conciliating natural repose; removing heaviness.  These, and many analogous maladies, are relieved by the judicious application of the Cucurbits (Cups), dry or bloody."

     From the ancient Greeks and Romans, through the Alexandrians and Byzantines, cupping therapy was passed on to the Muslim Arabs and Persians.  The Prophet Mohammed even sanctioned the use of cupping.  Cupping is now an important and popular  therapeutic modality of Unani Medicine. 
     In the West, cupping remained an important part of medicine and therapy, both conventional, alternative, and folk-based, until the early 20th century.  The surgeon Charles Kennedy wrote, in 1826:
     "The art of cupping has been so well-known, and the benefits arising from it so long experienced, that it is quite unnecessary to bring forward testimonials in favor of what has received not only the approbation of modern times, but also the sanction of remotest antiquity."
     After fallingout of favor with medicine in the modern era, cupping therapy is enjoying a resurgence in popularity, promoted by acupuncturists and other holistic healthcare practitioners.  New and exciting variations on this ancient technique, like cupping massage, are also being developed.
     One secret of cupping's perennial popularity is its great ability to promote a state of deep pleasure and profound relaxation.  Hopefully, cupping is here to stay.


How Cupping Works

     Traditional healers have long recognized the association between pain and conditions of congestion, stagnation and blockage.  An old Chinese medical maxim states:  Where there's stagnation, there will be pain.  Remove the stagnation, and you remove the pain.
     Not only pain, but the vast majority of all illness and disease comes from stagnation, congestion and blockage - of energy, like the Vital Force, or of vital fluids or humors, like blood, phlegm or lymph.  The suction applied by cupping sucks out and breaks up that congestion, stagnation, or blockage, restoring a free flow to the vital energies and humors of the organism.
     Actually, pain is the essence of disease.  Suffering, or dis-ease, is experienced when things aren't flowing right, when there's some difficulty or obstruction to the natural flow and functioning of the body.  This is what Galen meant when he spole of disease as being the state contrary to Nature.
     In addition to dispersing and breaking up stagnation and congestion in the flow of the Vital Force, blood and other humors, cupping also disperses pathogenic heat, toxins and inflammation by bringing them to the surface for release.  Pathogenic heat and toxins can fester and eat away at the organism when they're submerged and under pressure, but they find release at the surface.  Cupping can even be instrumental in mitigating or relieving fevers in the acute crisis stage, and in mitigating and reducing the putrefaction of blood and other humors, a common cause of fevers.
     By drawing congested energy, blood, or other humors to the surface, cupping is a form of derivation therapy.  Derivation means the drawing away or diversion of vital energies or substances away from the site of blockage and obstruction in order to relieve congestion and restore health and patency to the organism. 
     Toxins, morbid humors and other congested offending matter can do more harm when they're deep within the organism, obstructing the functioning of the vital organs at the body's core.  The organism, whenever it can, will try to peripheralize such morbid matter by sending it to the service in the form of various cysts, boils or eruptions, even though they nay be unsightly.  Cupping is a way of activating this peripheralization and relieving pathogenic congestion to the internal organs, thus averting or preventing more serious disorders.
     By improving the circulation of blood, lymph and other vital fluids and breaking up and dispersing blockages and congestions of offending waste matter, toxins and morbid humors, cupping improves the eliminative functions and the evacuation of wastes from the organism.  In Greek Medicine, the proper and timely evacuation of wastes from the body forms an important aspect of hygiene.  Whether it be constipation, urinary retention, or even suppressed menses, the undue retention of anything that should be expelled is a major cause of morbidity and disease.


The Benefits of Cupping

     The benefits of cupping are many.  On a general, systemic level, cupping improves the circulation of blood and lymph.  It also regulates and improves the functioning of the autonomic nervous system. 
     Locally, the most obvious benefit of cupping are a relief of pain and a relaxation and increased suppleness of stiff tendons and muscles.  Cupping increases the cleansing flow of lymph, while removing congested blood from the muscles.  If cupping is applied to the joints, the blood flow to the joint is increased and there's an increased secretion of synoivial fluid into the joint cavity. 
     Cupping's effect on the digestive organs is to increase their digestive secretions and enhance their peristaltic movement.  Cupping can awaken the appetite, strengthen the stomach and digestion, improve the bile flow and metabolism, relieve constipation and promote regularity of the bowels. 
     Cupping has a dramatic detoxifying effect on the skin and circulatory system.  By increasing the flow of blood and plasma through the veins and arteries, cupping enhances the cleansing and removal of toxins.  This detoxification may not be observable after just one treatment, but after about three to five treatments, there will be a noticeable improvement in the color of one's complexion.
     Cupping is beneficial and indicated for multiple disorders affecting multiple organ systems:
     Digestive system:  constipation, diarrhea, irritable bowel syndrome (IBS)
     Vital, Metabolic:  low energy, fatigue, anemia, atrophy of the tissues, cellulite, emaciation, weight gain - normalizes body weight.
     Nervous system:  headaches, depression, emotional problems - balances the nervous system.
     Gynecological:  menstrual pain, suppressed or irregular menses 
     Musculoskeletal:  Local application, as appropriate, for back pain, arthritis, traumatic injuries, lumbago, sciatica.
     Respiratory & Circulatory:  asthma, bronchitis, common cold and flu, high blood pressure.  Increased blood flow to the skin is therapeutic for many different skin disorders.


Techniques of Cupping

     Cups can be applied to any part of the body where the skin surface is level, smooth and fleshy enough to permit a firm seal.  These parts include the neck, temples, forehead, back, chest, abdomen, hips, buttocks, thighs, knees, and calves. 
     The classical method for creating suction in the cups is with fire.  Hold a cotton ball in a set of forceps and soak it in olive oil, or in rubbing alcohol.  Ignite the cotton ball and whisk it around quickly inside the cup right before placing it on the skin in the desired location.  This should create a powerful suction
     In recent years, more modern suction methods have been developed.  Some cups have spherical rubber tops that can be squeezed to create suction.  Other cups come with a special suction pump that pumps out the air to create an even more powerful vacuum. 
     The basic cupping method is called stationary cupping.  The cup is placed on in the desired location and left on in the same spot for ten to fifteen minutes.  Several cups may be applied in a single treatment.  Pressing the skin around the cup breaks the seal for removal. 
     In flash cupping, a series of cups are applied and quickly popped off in rapid succession.  This creates a stimulating effect that's a lot like pinching and pulling the flesh in massage.
     Cupping can also be combined with moxibustion, or the burning of balls of Mugwort wool on slabs of fresh Ginger root.  The Mugwort wool is ignited and allowed to burn for a while so that its heat may penetrate the point.  Then, a cup is placed over the burning Mugwort and the Ginger slab, and the flame consumes all the air in the cup, creating a powerful suction before it goes out.  This form of cupping combines the healing benefits of both heat and suction. 
     In cupping massage, the area to be treated is anointed with a liberal amount of medicated oil.  This allows the cups, once applied, to be moved around while still maintaining a therapeutic suction bond. 
     Cupping massage can be applied differently to different parts of the body.  The stomach, thighs and hips, being delicate, need gentler suction.  Vigorous circles are great to use on the hips, thighs and shoulders.  And on both sides of the spinal column, long gliding strokes up and down massage important pressure points connected to every major organ in the body.
     There are many therapeutic benefits of cupping massage.  It mimicks the powerful rolling strokes of deep tissue massage without the discomfort.  Massage cupping improves the skin absorption of medicated oils and liniments that are used in conjunction with it.  Cupping massage has also been found to be helpful to relieve the pain of fibromyalgia, and for treating anxiety, insomnia, post-injury trauma, chronic pain, post-surgery adhesions, cellulite and a sluggish colon.


Where to Cup

     Where there's stagnation, there will be pain.  Since cupping relieves stagnation, a good basic way to look for where to cup is to palpate the patient's body to find out which points are painful and tender, and especially which points are the tenderest.  It's here that you place the cups. 
     To draw congestion and inflammation out of a certain internal organ, you cup on the point that's over it.  If you're going to treat cholecystitis, or inflammation of the gall bladder, for example, you would cup right over it on the upper right quadrant of the abdomen, right below the ribs, at the outer edge of the rectus abdominus muscle; that's the gall bladder point. 
     To know where to cup, it helps to be familiar with various trigger point systems, like the Chinese acupuncture points or the Ayurvedic Marma points.  Actually, they are networks of reflex relationships between the internal organs and points on the body's surface.  Major Chinese acupuncture points suitable for cupping are the bladder meridian points on the back, running down both sides of the spinal column, and the alarm points of the various internal organs on the abdomen.  These are major reflex points for activating the internal organs. 
     For lung congestion, for example, cups are placed on both sides of the spine, between the shoulder blades.  Not only are these points over the lungs, but they're also important acupuncture points on the bladder meridian that activate the lungs.  To activate the stomach and digestion, cup on the point located on the midline of the abdomen, midway between the navel and the bottom of the breastbone.  That's the stomach's alarm point; it's also right over the stomach.
     In addition to knowing where to cup, one should also know where not to cup.  The places not to cup are: over the breasts in women - it will disrupt the menses; all bony protuberances; sites that are predisposed to cramping; and over superficial blood vessels, varicose veins, lymph nodes and tumors.
     Those wanting to know more about the traditional Unani art of cupping, including a list of cupping sites and their traditional indications in Unani Medicine, are invited to peruse the following web page:  www.unani.com/cupping.htm


When to Cup

     Although cupping is most always beneficial, it is traditionally considered to be more effective at certain times of the month than at others.  It's generally not advised around the time of the New Moon, because the humors are too compacted.  The best time for cupping is generally considered to be around the middle of the lunar month, when the moon is large and full of light, because the humors are more expansive and exuberant at this time.  The best time of all for cupping is considered to be around the 16th or 17th days of the lunar month, just about 2 to 3 days after the Full Moon. 
     The best time of day to cup is generally considered to be the three hours following Sunrise, or the 2nd half of the Sanguine period, when the blood is waxing exuberant.  Cupping should not be done after bathing, except if the blood is unduly thickened; then, do it about an hour after bathing. 


Precautions for Cupping

     The great thing about cupping is its pleasantness, its non-invasive nature, and its relatively high degree of safety.  But still, even cupping has its precautions and contraindications. 
     Cupping should not be done on infants; neither should it be done on the very young or the very old.  And cupping is contraindicated in pregnancy, since it strongly activates and disperses the blood.
     Also, cupping produces circular bruises or discolorations where the cups were applied, which are, in effect, large "hickies".  One should understand and accept this possibility, that there may be marks that will last for a few days, before one decides to undergo cupping therapy. 



Internet Resources

     Besides the web pages already mentioned in this article, there are also a number of excellent web sites and pages on cupping on the internet.  The ones I referred to in preparing this article were: