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historyofcuppingHistory of Cupping Therapy

Cupping Therapy, commonly referred to as Cupping, has been around for thousands of years.  It developed over time from the original use of hollowed out animal horns (the Horn Method) to treat boils and suck out the toxins out of snakebites and skin lesions. Horns slowly evolved into bamboo cups, which were eventually replaced by glass. Therapeutic applications evolved with the refinement of the cup itself, and with the cultures that employed cupping as a health care technique.

The true origin of cupping still remains uncertain to this day.  Some consider the Chinese to be responsible for cupping, however, the earliest pictorial records date back to the ancient Egyptians around 1500 B.C.  Translations of hieroglyphics in the Ebers Papyrus, the oldest  medical text book, detail the use of cupping for treating fever, pain, vertigo, menstrual imbalances, weakened appetite and helping to accelerate the healing crisis.

From the Egyptians, cupping was introduced to the ancient Greeks, where Hippocrates, the Father of Modern Medicine and cupping advocate, viewed cupping as a remedy for almost every type of disease.  In fact, other Greek physicians used the strong suction of cupping to restore spinal alignment by reducing dislocated vertebrae from protruding inward.

The earliest recorded use of cupping came from the famous alchemist and herbalist, Ge Hong (281-341 A.D.), who popularized the saying “Acupuncture and cupping, more than half of the ills cured.”

history2The Chinese expanded the utilization of cupping to include its use in surgery to divert blood flow from the surgery site.  In the 1950’s, after much extensive research, a collaborative effort between the former Soviet Union and China confirmed the clinical efficacy of cupping therapy. Since then, cupping has become a mainstay of government-sponsored hospitals of Traditional Chinese medicine.

Eventually, cupping spread to ancient cultures in many countries of Europe and even the Americas.  Throughout the 18th century, European and American doctors widely used cupping in their practices to treat common colds and chest infections, often in the form of Wet Cupping.  Wet Cupping, also known as Artificial Leeching and Hijamah in Muslim societies, is where the practitioner makes tiny incisions in the skin to dredge the blood or poisons out.

By the late 1800’s, cupping lessened in popularity and was severely criticized and discredited by the newly established scientific model of medicine. The new model defined medicine by making the body transparent, focusing on and treating the inside, in preference to the outside. Since cupping was a surface treatment, it was inconsistent with this new medical paradigm, which had shifted away from hands-on manipulative therapies.

Decades flew by as cupping therapy gradually became reduced to a mere curiosity of the past, collecting dust on practitioners’ shelves.  In 2004 Cupping re-emerged as a hot new celebrity trend in the lime light of a New York film festival, where actress Gwyneth Paltrow’s back revealed her fresh cupping marks.   Countless celebrities like Jennifer Aniston, Victoria Beckham and Denise Richards followed suit and became fast adopters of this hot new cupping trend.  Unfortunately, some of the Hollywood buzz viewed the celeb’s cupping marks as simply bruises and rolled their eyes at its potential benefits.

Until recently, there was scant published evidence in favor of cupping for pain relief.  Over the past three years however, a handful of new studies have shown it helps relieve back, neck, carpal tunnel and knee pain.  One thing is certain, and that is cupping is a powerful healing modality that can complement many healthcare modalities ranging from spa treatments to medical massage and physical therapy.

Ancient Cupping Equipment

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A Brief History of Cupping

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By Bruce Bentley

Way back in time, long before any historical or archeological evidence had been uncovered to support the application of cupping instruments to the body as a therapeutic procedure, prehistoric humans relied in part on their ability to suck and draw to the surface any irritations such as stings and thorns. Early humans also developed conceptualisations concerning their place in nature and the universe and the causes of ill health.

In their efforts to explain sickness, they held beliefs about that which could enter the body or mind such as evil spirits and cause pain and suffering. Many researchers including anthropologists have described how healers of these supernaturalistic traditions of illness causation applied oral suction to the surface of the body to withdraw the effects of these malevolent influences.

The Horn methodcupping.history

In time, various natural resources began to be used to effect suction – which makes good sense because indigenous groups could exploit their natural resources. For example, natives along the west coast of North America, in the vicinity of Vancouver Island, used shells. In Europe, Asia, Africa and North America, hollow animal horns were fashioned to provide an effective cupping device. In North America, the natives made their cupping implements by slicing off thc point of a buffalo horn. They would then place the base of the horn on the body and suck the air out through the opening at the tip. When a vacuum was achieved, a wad of dried grass would be immediately thrust into the opening by the nimble workings of the tongue. By this method the medicine men, with their powerful facial muscles and considerable agility, can make a very succcssful job of cupping. (Brockbank, 1987:22). Another technique used to withdraw disease was by sucking through a bone tube. During the Babylon – Assyrian Empire (stretching from Iraq to the Mediterranean) massage was practised as well as 'cupping by sucking, with the mouth or by using a buffalo horn' (Mettler, 1947:320). The source of this information was presumably found inscribed on clay tablets, written in one of the earliest written languages, ie. cuneiform script around 700BC.

Hippocrates and the European traditions of cupping

Textual evidence on cupping can be found in thc writings of Hippocrates (C.460-377 BC), known as the Father of Modern Medicine. During this golden era of the early Greek state, Hippocrates and his followers were devoted to an empiric approach to healing and sought naturalistic explanations why people became ill. They thoroughly rejected causes like spirits or ghosts, and instead reasoned that poor diet, insufficient exercise, exposure to adverse weather, an unbalanced lifestyle and emotional factors were the chief agents of ill health. In his guide to clinical treatment, Hippocrates recommended cupping for the treatment of angina, menstrual irregularities and other disorders.

In the 1800's, the British cupper Samuel Bayfield (1839: 51-52), wrote: "Hippocrates was a minute observer, and has left us some striking remarks on the shape and application of the cups. He recommends that they should be small in diameter, conical in shape, and light in their weight, even when the disease for which they are applied is deeply seated".

Cupping refers to an ancient Chinese practice in which a cup is applied to the skin and the pressure in the cup is reduced (by using change in heat or by suctioning out air), so that the skin and superficial muscle layer is drawn into and held in the cup.  In some cases, the cup may be moved while the suction of skin is active, causing a regional pulling of the skin and muscle (the technique is called gliding cupping).

This treatment has some relation to certain massage techniques, such as the rapid skin pinching along the back that is an important aspect of tuina (12).  In that practice, the skin is pinched, sometimes at specific points (e.g., bladder meridian points), until a redness is generated.  Cupping is applied by acupuncturists to certain acupuncture points, as well as to regions of the body that are affected by pain (where the pain is deeper than the tissues to be pulled).  When the cups are moved along the surface of the skin, the treatment is somewhat like guasha (literally, sand scraping), a folk remedy of southeast Asia which is often carried out by scraping the skin with a coin or other object with the intention of breaking up stagnation.  Movement of the cups is a gentler technique than guasha, as a lubricant allows the cup to slide without causing as much of the subcutaneous bruising that is an objective of guasha.  Still, a certain amount of bruising is expected both from fixed position cupping (especially at the site of the cup rim) and with movement of the cups.

Traditional cupping, with use of heated cups, also has some similarity to moxibustion therapy.  Heating of the cups was the method used to obtain suction: the hot air in the cups has a low density and, as the cups cool with the opening sealed by the skin, the pressure within the cups declines, sucking the skin into it.  In this case, the cups are hot and have a stimulating effect something like that of burning moxa wool.

In some cases, a small amount of blood letting (luoci; vein pricking) is done first, using a pricking needle, and then the cup is applied over the site.  The pricking is usually done with a three-edged needle, applied to a vein, and it typically draws 3–4 drops of blood (sometimes the skin on either side is squeezed to aid release of blood).  A standard thick-gauge acupuncture needle or plum blossom needle may be used instead.  This technique is said to promote blood circulation, remove stasis, and alleviate swelling and pain.  It is employed especially when there is a toxic heat syndrome and for a variety of acute ailments.

The following report is derived mainly from a survey of reported cupping techniques published in 1989 (1), supplemented by information from acupuncture text books (5–9).

EARLY HISTORY

The earliest use of cupping that is recorded is from the famous Taoist alchemist and herbalist, Ge Hong (281–341 A.D.).  The method was described in his book A Handbook of Prescriptions for Emergencies, in which the cups were actually animal horns, used for draining pustules.  As a result of using horns, cupping has been known as jiaofa, or the horn technique.  In a Tang Dynasty book, Necessities of a Frontier Official, cupping was prescribed for the treatment of pulmonary tuberculosis (or a similar disorder).  More recently, Zhao Xuemin, during the Qing Dynasty, wrote Supplement to Outline of Materia Medica, including an entire chapter on “fire jar qi” (huoquan qi).  In it, he emphasized the value of this treatment, using cups made of bamboo or pottery, in alleviating headache of wind-cold type, bi syndrome of wind origin, dizziness, and abdominal pain.  The cups could be placed over acupuncture needles for these treatments.  One of the traditional indications for cupping is dispelling cold in the channels.  This indication is partly the result of applying hot cups.  For example, bamboo cups would be boiled in an herbal decoction just prior to applying to the skin (this is one type of shuiguanfa, or liquid cupping, so-called because a liquid is incorporated into the treatment). Both liquid cupping and cupping over an acupuncture needle are favored for treatment of arthralgia.  Cupping also is thought to dispel cold by virtue of its ability to release external pathogenic factors, including invasion of wind, damp, and cold.

MODERN CUPPING

During the 20th century, new glass cups were developed (see Figure 1).  Common drinking glasses have been used for this purpose, but thick glass cupping devices have also been produced and are preferred.  The introduction of glass cups helped greatly, since the pottery cups broke very easily and the bamboo cups would deteriorate with repeated heating.  Glass cups were easier to make than the brass or iron cups that were sometimes used as sturdy substitutes for the others; further, one could see the skin within the cup and evaluate the degree of response.

The glass cups are depressurized by providing some fire in the cup to heat up the air within just prior to placement.  For example, hold a cotton ball dipped in alcohol with a pincer, ignite it, hold it in the cup, then rapidly apply to the skin; this is called shanhuofa (flash-fire cupping; see Figure 2).  Sometimes, a small amount alcohol is put in the cup and lit; this method is called dijiufa (alcohol-fire cupping).

At the end of the 20th century, another method of suction was developed in which a valve was constructed at the top of the jar and a small hand-operated pump is attached so that the practitioner could suction out air without relying on fire (thus avoiding some hazards and having greater control over the amount of suction).  Both glass and plastic cups were developed, though the plastic ones are not very well suited to moving along the skin once in place, as the edges are not entirely smooth and the strength of the cups is limited.  The modern name for cupping is baguanfa (suction cup therapy).

In order to allow easy movement of the glass cups along the skin, some oil is applied.  Medicated massage oils (with extracts of herbs) are particularly useful for this purpose.  Since the cups are applied at room temperature, the indication of removing cold from the channels is no longer as applicable, at least to stationary cups.  There is some friction generated with moving cups, so that there is a small but significant amount of heat applied by that method, especially if a warming oil is used as lubricant.

Generally, the cup is left in place for about 10 minutes (typical range is 5–15 minutes).  The skin becomes reddened due to the congestion of blood flow.  The cup is removed by pressing the skin along side it to allow some outside air to leak into it, thus equalizing the pressure and releasing it.  Some bruising along the site of the rim of the cup is expected.

Today, cupping is mainly recommended for the treatment of pain, gastro-intestinal disorders, lung diseases (especially chronic cough and asthma), and paralysis, though it can be used for other disorders as well.  The areas of the body that are fleshy are preferred sites for cupping.  Contraindications for cupping include: areas of skin that are inflamed; cases of high fever, convulsions or cramping, or easy bleeding (i.e., pathological level of low platelets); or the abdominal area or lower back during pregnancy.  Movement of the cups is limited to fleshy areas: the movement should not cross bony ridges, such as the spine.  Following are some of the recommended treatment sites for various disorders.

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