Cupping Therapy: A Review

2. Faisal Azmi
‫بالحجامۃ‬ ‫عالج‬

3. Hijamah
 Hijamah comes from the original Arabic word
“Al-hajm” ,which means “ to restore to original
size” or “to diminish in volume” and “to suck”.
In Hijamah blood is sucked after applying cup to
specific areas of the body.
 Hijamah was also known as “Seenghi Lagwana”
as in ancient time, hollow horns were used as
cupping instruments for Hijamah. In Urdu
language the horns are known as “Seengh”.

4. Cont…..
 Hijamah, the Arabic word, is often translated
into English as Cupping. It is used with one or
several kind of cups such as bamboo cups,
glasses or earthen cups, placing them on desired
points on patient’s skin, sucking the air out and
creating a vacuum to produce a suction effect
that increases blood circulation to the local area
,relaxes muscles tissue. Vacuum can also be
produced by introducing heat into a glass cup.

5. Cont…
 The translation of Hijamah into cupping though is
not entirely accurate as it give the impression that
Hijamah encompasses all forms of cupping therapy,
Islamically Hijamah is usually explicit to one form
of cupping therapy which is blood cupping, also
known as wet cupping.

6. Historical Background of Hijamah (Cupping)
 Oldest document of Cupping was in Macedonia
mentioned in 3300 BC
 Ancient Papyrus 1550BC, also describes about the
common practice of Hijamah in the world
 Hippocrates described both dry and wet cupping in
his treatise “Guide to Clinical Treatment” which
has been widely employed for the cure of broad
range of conditions and gaining popularity
worldwide.

7. Cont…
 In further development of this aspect, there are so many voluble
contributions of different Unani physicians of that time as follows:--
 Raban Tabri 8th cent AD
 Zakariya Razi 850-923AD
 AliIbnAbbas Mazoosi 930-994AD
 Abul Qasim Al Zehrawi 936-1036AD
 Ibn Sina 980-1037AD
 Ismail zurzani 1136AD
 Ibn Habal 1213AD
 IbnAl Quful Masihi 1233-1286AD
 Qurshi 1210-1288AD

8. Cont…
 In 8th century AD Ali bin Rabban Tabri in his
book Firdosul hikmat describes cupping. Abul
qasim zehrawi(10th cent AD) describes the
way of application of cupping briefly in his
book Zarahiyate zehrawi .Razi also quote the
points of cupping in Kitab-al-mansoori in
same era. Ibnsina(11th cent AD) in his book Al
-kanoon mention the basic principle and use
of cupping. Ismail Jurjani (12th cent AD)in
Zakhira khwarzam shahi,Qurshi in Moojazal
Qanoon, Ibn quff in Kitabul umda fil
jarahat(13th cent AD), Hkm.Kabiruddin in
Kullayate qanoon and kulliyate
nafeesi(19th,20th cent AD) also wrote about
indication and type of cupping.

9. Cont…
 In Arabic this method of therapy was popularised by our
Prophet Muhammad (sallallahu alaiyhi wassallam) as stated in
many Hadith:
 ‫انس‬ ‫عن‬‫رض‬‫قال‬:‫هللا‬ ‫رسول‬ ‫قال‬‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلئ‬:‫به‬ ‫تداويتم‬ ‫ما‬ ‫امثل‬ ‫ان‬
‫وال‬ ، ‫الحجامة‬‫ق‬‫البحرئ‬ ‫سط‬
 Anas Ibn Maalik (may Allah be pleased upon him) reported
that the Prophet ( S.A.W) said, “Indeed the best of remedies
you have is cupping (hijama)…” [Saheeh al-Bukhaari (5371)].

10. Cont…
‫عن‬‫ابن‬‫عباس‬‫رض‬‫عن‬‫النبي‬‫صلئ‬‫هللا‬‫عليه‬‫وسلم‬‫قال‬:‫الشفاء‬‫في‬‫ثال‬‫ثة‬
:‫في‬‫شرطة‬‫محجم‬‫اؤ‬‫شربة‬،‫عسل‬‫او‬‫كية‬،‫بنار‬‫وانهي‬‫امتى‬
‫عن‬‫الكي‬
 Narrated Ibn Abbas: The Prophet Mohammad
(S.A.W) said “healing is in three things:
1. Cupping
2. A gulp of honey
3. Cauterization (branding with fire). But I forbid my
followers to use cauterization
Best time of hijama: 17th, 19th, or 21st day (of the lunar
month)

11. Types:-
On the basis of bloodletting and non
bloodletting Hijamah can be classified into
two type:-
 Hijamah-Bish- Shart (wet cupping)
 Hijamah –Bila- Shart (dry cupping)
 On the basis of method of cupping it is
divided into two part:-
 Hijamah-e-Nariya (cupping with fire)
 Hijamah-e-Ghair Nariya (cupping without
fire)

12. EQUIPMENTS USED IN CUPPING:-
 Cup (glass, plastic, etc)
 Vacuum pump
 Medical antiseptic ,,Betadine solution(Povidone-iodine) and
Spirit
 A lamp or candle
 Inflammable small cone of paper or camphor
 Sterilised gloves
 Kidney tray
 Sterilised medical blade
 A pack of cotton, sterilised medical gauze, micropore tape
 A razor to remove the hair of the site if needed

15. Mechanism of action with
scientific interpretation

16. Mechanisms of cupping therapy
according to Hong et al.
 Hong et al. reported that cupping
therapy works via creating specific
changes in local tissue structures
 as a result of local negative pressure
in the cups used which stretches the
nerve and muscle
 causing an increase in blood
circulation and causing autohemolysis

17. Mechanisms of cupping therapy
according to Gao et al.
• Gao et al. suggested that putting cups
on selected acupoints on the skin
produces hyperaemia or haemostasis
 which results in a therapeutic effect

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

20. Mechanism of Hijamah according to Unani system of
medicine.
Formation of akhlat-e-
fasida
Ijtema-e-mawad (sabab)
Marz
Imala-e-Mavad –
Diversion of
morbid material
Tanqiya-e-Mavad
(Evacuation of morbid
material)

21. Sites & indications of
Hijamah described in
Unani system of medicine.
Some Common Pathologies
&
Sites of Cupping

22. Hamah/Yafookh(‫یافوخ/ہامہ‬) Sinciput(‫حصہ‬ ‫میانی‬‫ر‬‫د‬ ‫کا‬‫)سر‬
Ikhtilat-e-
Aql
Delirium
Moorserj Iridoptosis
Duwar Vertigo
Jarb-ul-
Ain
Pruritus of
the Eye
Busur-ul-
Ain
Pustule of
the Eye

23. Qamhadwah (‫قمحدوہ‬) Occiput(‫اوپر‬‫سے‬‫)نقرہ‬
Ikhtilat-e-
aql
Delirium
Moorserj Iridoptosis
Duwar Vertigo
Jarb-ul-Ain Pruritus of
the Eye
Busur-ul-
Ain
Pustule of
the Eye

24. Nuqra (‫)گدی/قفا/نقرہ‬ Nape (‫اوپر‬ ‫انگلی‬ ‫چار‬ ‫سے‬ ‫)گردن‬
Waj-ul-Uznain Otalgia
Bakhr-ul-fam Fetide,Halitosis
Kalaf Melasma
Barash Freckles
Namash Naeve
Ramad Conjunctivitis
sulaq Blephritis
Jarab-ul-Ain Pruritus of eye
Siql-ur-Ras wal
Ajfan
Heaviness of
head and eyelid

25. Akhda’ain (‫ا‬‫خدعین‬) Lateral Aspect of the Neck(‫طرف‬ ‫ں‬‫دونو‬‫کے‬ ‫گردن‬ )
Waj-ul-asnan Toothache
Waj-ul-lisan Glossalgia
Warm-e-lisaa Gingivitis
Khunaq Diptheria
Warm-e-Uzn Otitis
Ramad Conjunctivitis
Shaqiqa Migraine
Suda’ Headache
Irteash-e-Ras Tremor of the Head
Chehra,daaqnt,kaan
,Ankh,gala,nak ke
Amraz
Disease of the
Face,tooth,ears,Eyes,
Throat & Nose

26. ZIqn (‫)ذقن‬ Chin(‫نیچے‬ ‫کے‬‫ی‬‫ڑ‬‫)ٹھو‬
Waram-ul-Lisan Glossitis
Qula’ stomatitis
Bakhr-ul-Fam Fetide
breath,Halitosis
Warm-ul-Lauzah Tonsillitis
Busur-ul-Fam Pustules of Mouth

27. Kahil ,Upper Back(‫میان‬‫ر‬‫د‬ ‫کے‬ ‫ں‬‫کندھو‬ ‫ں‬‫)دونو‬
Su’aal Cough
Nafs-ud-Dam Hemoptyysis
Waja-ul-Halaq Sore Throat
Rabw/Zeeq-un-
Nafas
Bronchial Asthma
Imtila Congestion
Khunaq-e-Damvi Sanguineous
diptheria
Waja-ul-katif Shoulder pain
Amraz-e-sadr
Damvi
Sanguineous
thoracic disease

28. Mankibain/Katifain(‫)کتفین/منکب‬ Shoulder ( ‫کی‬‫پیچھے‬‫مقابل‬ ‫کے‬ ‫ترقوہ‬
‫)جگہ‬
Humma-e-
Rib’
Tertian fever
Auja-ut-Tihal Spleenalgia
Auja-ul-Kabid
Harah aur
deegar Amraz-
e-Kabid
Hepatalgia
due to heat
and other
disease of
Liver
Khafqan
bawajah
Imtila and
Hararat
Palpitation
due to
congestion and
Heat

29. Qutn(‫)قطن‬ Lumbar Region
Niqras Gout
Bawaseer Haemorrhoid
Da-ul-fel Filaria
Damamel-e-Fakhiz Boil’s of Thigh
Busur-e-Fakhiz Papules of Thigh
Jarb-e-Fakhiz Pruritis of Thigh
Hikkat-ul-Zahr Pruritis of Back
Riyah-ul-Masanah
and Raham
Emphysema of The
Bladder of Uterus

30. Warikain(‫کین‬‫ر‬‫)و‬ Hip
Warm-e-Rahm Metritis
Warm-e-Unsiyain Oophritis
Hikaa-e-Rehm Pruritus Uteri
Badbu-e-Rehm Offensive smell of Uterus
Bail-ul-Dam Haematuria
Harqat-ul-Baul Burning Micturation
Hararat-ul-Kulyatain Heat of The kidney
Bawaser Haemorrhoid
Warm-e-Maq’ad Proctitis
Zarban-e-Maq’ad Anal Throbbing
Sailan-ul-Dam-min-Afwah-
il-Uruq
Hemorrhage from the
opening of the blood vessels
Nazf-ul-Dam Hemorrhage
Damamel-e-Fakhzain Boils of thigh

31. Us’us(‫)عصعص‬ Coccyx
Bawaseer Haemorrhoid
Sailan-ul-Dam-min-al-
Maq’ad
Anal Haemorrhage
Warm-e-Unsayain oophritis
Hikkat-ul-Farj Pruritus vulvae
Natan-ul-Farj Offensive smell of
Vagina
Baul-ul-Dam Haematuria
Hirqat-ul-Baul Burning micturation
Harat-ul-Kulliyatain Heat of Kidney
Zarren Jism ke Zakhm Wound of the lower
part of the body

32. Zahr-ul-Fakhiz(‫)فخذین‬ Dorsal Aspect of Thigh
Warm-e-
Khusiyah
Orchitis
Warm-e-Rehm Metritis
Sailan-ul-Dam-
min-al-Rehm
Uterine
Haemorrhage
Quruh-e-
mutaffina-fil
Saaq
Infective Ulcer
of shank
(Varicose Ulcer)
Sailan-ul-Dam-
min-Afwah-il-
Uruq
Hemorrhage
from the
opening of the
blood Vessels

33. Batan-al-Fakhiz( ‫فخذی‬‫ن‬ ) Ventral Aspect of Thigh
Bawaseer Haemorrhoid
Shiqaq-e-Maq’ad Fissure in Ano
Warm-e-Khusiya Orchitis
Warm-e-Rehm Metritis
Sailan-ul-Dam min –a-
rehm
Uterine Hemorrhage
Quruh-e-mot’affinah
fil saq
Infective ulcer of
Shank
Sailan-ul-Dam min
Afwah-il-Uruq
Hemorrhage of the
opening of blood
vessels

34. Rukbah(‫)الرکبہ‬ Knee
Waj-ul-
mafasil damvi
Sanguineous
arthtritis
Warm-e-
rukba
Swelling of
Knee
Zarban-e-
Rukbah har
Throbbing of
Knee due to
heat
Quruh-e-
mutaffinah fil
Fakhiz
Infective ulcer
of thigh

35. Saqain(‫)ساقین‬ Both Shank
Khunaq Diptheria
Zubha Angina
Namla Herpes
Waj-ul-Rukbah
Muzmin
Chronic arthritis of
knee
Waj-ul-masana
muzmin
Chronic cystalgia
Waj-ul-Rehm
Muzmin
Chronic metritis
Ihtebas-e-Tams Amenorrhoea
Busur wa
Damamel
Papules and Boils

36. Urqubain(‫)عرقوبین‬ Achilles Tendon
Khunaq Diptheria
Zubha Angina
Namla Herpes
Waj-ul-Rukbah
Muzmin
Chronic arthritis
of knee
Waj-ul-Masana
Muzmin
Chronic cystalgia
Waj-ul-Rehm
Muzmin
Chronic metritis
Ihtebas-e-tams Amenorrhoea
Busur wa
Damamel
Papules and Boils

37. Kabain(‫)کعبین‬ External & Internal Malleolus
Ihteba-e-Tams Amenorrhoea
Irq-ul-Nisa Sciatica
Niqris Gout

38. Side effect of Hijamah

39. ‫شکریہ‬