Al hijamah

CuppingThe forgotten

healing art

حيم الر حمن الر الله بسم

Cupping / Al-Hijama (الحجــامة)

Hijama, derived from the word Al-Hajm translated as cupping, literally

means to suck. It is practiced by applying cups on the body.

What is Cupping therapy ? Cupping is one of the oldest and most effective methods of releasing toxins from the body’s tissues and organs.

A partial vacuum is created in cups placed on the skin either by heat or suction. This draws up the underlying tissues and blood.

This enhanced blood flow under the cup draws impurities and toxins away from the nearby tissues and organs towards the surface for elimination.

History of cupping Cupping has been practiced since ancient times. The Ebers Papyrus (1550 BC) the oldest medical

textbooks in the world, describes the Egyptians' use of hijamah (cupping) to ‘remove the foreign matter from the body’ .

Evidence in China of cupping dates back to 1000 BC.

Hippocrates in 450 B.C describes cupping in his ‘Guide to Clinical Treatment ’

Excavated Votive table representing cupping and bleeding instruments from Temple of Asclepius at Athens (320 B.C).

Painting depicting Galen's (140 AD) in Rome using the technique of cupping, creating small vacuums in heated cups to "draw the poisons out."

Horn therapy – ancient cupping treatment using cattle horns (China 1400 A.D)

A Red Copper Cup Used in Fire Cupping from Mongolia dated 250 B.C

The Prophet Muhammed (ملسو هيلع هللا ىلص) is reported to have been a user and advocate of hijamah (cupping) therapy.

Anas ibn Maalik reported that the Messenger of Allah (ملسو هيلع هللا ىلص) said, "Indeed the best of remedies you

have is cupping (hijama)…" [Sahih al-Bukhari (5371)].

Types of CuppingThere are two main types of cupping:

Dry cupping (Hijamah-Bila-shurt) – skin immediately below the cup is sucked up by a vacuum created inside the cup

Wet cupping (Hijamah-Bil-shurt) – in which the skin immediately below the cup is cross cut superficially several times – lightly lacerated – so that blood would actually be drawn out by the vacuum from the skin into the cup.

Both dry and wet cuppings are further classified into two types:- (A) Cupping with fire - cupping in which any

inflammable thing is placed in the cup to produce fire which creates negative pressure and thus helps in attachment of the cups at the surface of the included area

(B) Cupping without fire - flame is not used to create the negative pressure, i.e. vacuum is created by any means other than flame (mostly by vacuum pressure pumps).

Instruments used for cupping

Fire Cupping set Aqua Flexi silicone Cupping set Bamboo Cupping set

Hijama Cupping set with pump Bell Cupping set Magnetic suction Cupping set

The cupping techniqueDry Cupping The vacuum in the glass or hard plastic suction cup is

usually created in one of two different ways.• either by holding a small flame inside the cups or• by using vacuum pump

The appropriate sized cups should be used. The skin and underlying tissue swells and becomes

warm, and gets sucked into the cup This produces blood congestion at the site and

stimulates circulation After a prescribed period of time the cup is gently

removed No blood is removed from the body

Wet cupping Dry cupping is first performed Small cuts are made in the cupped area then the cup is

replaced on the skin and suctioned again The cup is then applied, and the air within will be evacuated

with a small hand-held pump. The skin will be drawn into the cup and blood is sucked out of

the area This will draw 20 to 100 ml blood into the cup, depending on

the skin thickness of the application zone. After this, bleeding stops automatically, as haemostatic

mechanisms come into operation. The process lasts for around 15 to 20 minutes from application

of the cup.

Vacuum pressure applied:Weak (light) Cupping:

The amount of flesh drawn into the cup is minimal and hardly raised.

This method can be applied to almost anywhere on the body and may cause a slight reddening of the skin.

Weak cupping is the most gentle method of all cupping and is particularly suitable for debilitated adults, elderly patients and young children, especially those under 7 years of age

Medium cupping

This is the most frequently used method on patients.

This method can safely be administered to children over 7 years of age.

With medium cupping, suction is firmer pulling the skin well into the cup creating a slight redness.

Medium cupping can safely be applied anywhere on the body.

Strong cupping

This is one of the most draining techniques.

A strong vacuum need to be produced, giving a strong pulling sensation of the skin inside the cup.

The skin will quickly turn red and shortly turn purple inside the cup and possible erythema in the skin surrounding the cup.

The cupping time should be short i.e. 5-10 minutes during the first session which can increase up to 20 minutes during later applications.

Strong cupping is often coupled with wet cupping.

Comparison between Weak (light), Medium and Strong Cupping

Other types of cupping Needle cupping - Not often practiced in Tibb as it

follows acupuncture treatment. The cup is placed over the inserted acupuncture needle

Moxa (hot needle) cupping – Same as needle cupping (hot needles are used)

Empty (flash) cupping - Empty cupping is also called flash cupping for its speed during application. This is actually medium to strong cupping applied

rapidly i.e. the cups remain in place for a very short period (<30 seconds).

It is used to stimulate and move blood and energy in the weak and frail. This can be repeated for between 5-10 minutes.

Herbal cupping - The cups are boiled in the pan with water and the prescribed herbs. The cups are then placed on the patient in the traditional way

using (Flame). The herbs are absorbed into the bamboo cups, which in turn

transfer their healing properties to the patient. Cups can be left on for 10-20 minutes.

Water cupping - This is one of the least used and practiced cupping methods. The technique involves filling a glass or bamboo cup one-third

full with warm water and employing the cupping process quickly

Herbal cupping technique

Water cupping technique

Post Procedure An antiseptic cream should be applied to the incisions

after cupping is terminated. The use of hone is not only effective as an antiseptic

but also assists in the healing of the skin. Adequate nutritious liquids should be taken after

cupping. Solid food intake should be avoided, if possible, for at

least 3 hours. No shower or bathing should be carried out for 12

hours after cupping. Sexual activity should be refrained from for at least

one day.

Sites on Human body for Cupping Therapy

Abdominal and back cupping

Limb and foot cupping

Precautions The practitioner must wear disposable latex gloves

whilst carrying out both types of cupping. Before cupping actually begins, the patient’s blood

pressure and pulse should be checked. The blades used for wet cupping incisions should be

disposable. The incisions in wet cupping should be superficial,

involving the epidermis only. The patient should be questioned on how he or she

feels – any unusual sensation or fever. Patients about to undergo cupping (especially the

wet version) should be advised to take a nutritional drink before the cupping.

Contraindication Dry cupping is not recommended for children below the age of 3

years. Wet cupping should be avoided in children below the age of 6

years. Wet cupping should not be carried out in patients above 65 years

of age, although dry cupping can be used in the elderly. It is not advisable to apply cupping to the patient with skin

ulcers, oedema, or on an areas overlying large blood vessels or even varicose veins

patients with high fever or who suffer from convulsions should not be cupped.

Cupping should not be applied to the abdominal and sacral regions of the pregnant women.

Wet cupping should never be applied to the female breast, unless absolutely necessary.

Care should be taken with wet cupping of anaemic patients, or those susceptible to spontaneous bleeding.

Physiology of cupping During cupping therapy, both blood and lymph

circulatory systems are simultaneously stimulated to work more efficiently.

This results in a more efficient collection and transportation mechanism for toxic substances, depositing it into the lymphatic system to be destroyed and allowing the circulation of fresh lymph in order to nourish the tissues and generate a booster for the immune system.

Cupping opens the pores of the skin thus allowing for the precipitation of toxin through the skin.

Circulatory system – an overview

Lymphatic system- an overview

The lymphatic system is made up of lymphatic vessels and lymph nodes that extend throughout the body.

It helps maintain the balance of fluid in the body by draining excess fluid from the tissues of the body and returning it to the blood system.

Closely related to the cardiovascular system, the lymphatic system has several major functions, e.g. filtering our bacteria, producing lymphocytes, generating antibodies, etc.

Cupping therapy enhances blood circulation, treats congestion and stops the inflammatory extravasations (escaping of some body fluids e.g. blood) from the tissues.

Wet Cupping Therapy may affect the autonomic nervous system and help to reduce pain .

Cupping therapy may induce deformation or injury to the skin leading to stimulation of Aβ fibers in the painful region and distal skin regions and stimulation of inhibitory receptive fields of the multi-receptive dorsal horn neurons at the level of the spinal cord. In addition, cupping therapy may simulate special naturopathic setting leading to relaxation and comfort of the patient

Wet cupping therapy

Cupping therapy penetrates deep into the body; approximately 4” deep and promotes blood circulation and nourishment to all the internal organs.

It strengthens the immune system and increases the white blood cell count. When the localised ‘bruising’ or congestion occurs, the body assumes it is hurt.

So the immune system sends out more white blood cells to heal the area quickly. It engages the parasympathetic nervous system, which increases relaxation and promotes pain relief.

Cupping therapy stimulates the nervous system reflex to the cerebral cortex and aids in faster recovery from sickness and pain

Clinical Benefits of Cupping

On a general, systemic level, cupping improves the circulation of blood and lymph. 

Regulates and improves the functioning of the autonomic nervous system.  

Relief of pain and increased suppleness of stiff tendons and muscles. 

Cupping increases the flow of lymph, while removing congested blood from the muscles. 

The blood flow to the joint is increased and there's an increased secretion of synoivial fluid into the joint cavity. 

Cupping has a dramatic detoxifying effect on the skin and circulatory system.

 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. 

Scientific Evidence of benefits from cupping“There is evidence that wet-cupping is effective in the treatment of nonspecific low back pain”Alireza Ahmadi, David C. Schwebel, and Mansour Rezaei. The Efficacy of Wet-Cupping in the Treatment of Tension and Migraine Headache.

The American Journal of Chinese Medicine 2008 36:01, 37-44 

“Clinical studies have shown that wet cupping have beneficial effect on herpes zoster compared with western medication”

Huijuan Cao,Chenjun Zhu, Jianping Liu. Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized

controlled trials. Alternate Therapy for Health Medicine. 2010 Nov-Dec; 16(6): 48–54.

“Cupping therapy is a complex therapy having multidimensional roles and benefits in various diseases including acne, herpes zoster, paralysis, and pain management.”

Piyush Mehta , Vividha Dhapte. Cupping therapy: A prudent remedy for a plethora of medical ailments. Journal of

Traditional and Complementary Medicine.2015, 5:3,127–134.

“hijama is not just a simple technique of taking blood, but it is as a curative procedure”

Mohammad Reza Vaez Mahdavi, Tooba Ghazanfari, Marjan Aghajani, Farideh Danyali, Mohsen Naseri. Evaluation of the

Effects of Traditional Cupping on the Biochemical, Hematological and Immunological Factors of Human

Venous Blood. A Compendium of Essays on Alternative Therapy. InTech, Croatia (2012), pp. 67–88

A. Michalsen, S. Bock, R. Ludtke, et al. Effects of traditional cupping therapy in patients with carpal

tunnel syndrome: a randomized controlled trial J Pain, 10 (2009), pp. 601–608

M. Teut, S. Kaiser, M. Ortiz, et al. Pulsatile dry cupping in patients with osteoarthritis of the knee–a randomized controlled exploratory trial BMC

Complement Altern Med, 12 (2012), pp. 1–9

S. Ahmed, N. Madbouly, S. Maklad, E. Abu-Shady Immuno modulatory effects of blood -letting cupping therapy in patients with rheumatoid arthritis Egypt J Immunol, 12 (2005), pp. 39–51

I do not advise anyone to try Cupping Therapy without the knowledge of certain medical conditions or unless under the

supervision of a Doctor or specialist in this field

….Thank you!!!!