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UNIVERSITY OF THE WESTERN CAPE

SCHOOL OF NATURAL MEDICINE
REGIMENTAL THERAPIES
877415
2009
CUPPING THERAPY
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What is Cupping?
Cupping is one of the oldest and most effeti!e methods of "eleasing to#ins f"om the
$od%&s tissues and o"gans' (the" te"ms fo" upping a"e) fi"e upping* $od% !auuming*
and the ho"n method' Cupping is the p"atie of appl%ing a pa"tial !auum $% means of
heat o" sution in one o" se!e"al $ell+shaped !essels ,sution ups- to pa"ts of the s.in'
This auses the tissues $eneath the up to $e d"a/n up and s/ell in"easing $lood flo/ to
the affeted a"ea' This enhaned $lood flo/ unde" the up d"a/s impu"ities and to#ins
a/a% f"om the nea"$% tissues and o"gans to/a"ds the su"fae fo" elimination' The time the
sution ups a"e left in plae !a"ies ao"ding to the patient&s age and ph%sial
onstitution* and the medial diso"de" $eing t"eated'
Cupping is a safe* non+in!asi!e and ine#pensi!e tehni0ue' It is used to alle!iate the pain
and disomfo"t a"ising f"om diso"de"s of the lungs and othe" inte"nal o"gans* musle
spasms* 1oint pains* and nume"ous othe" onditions'
“Cupping is the most helpful act for human beings to cure themselves with”
2P"ophet 3uhammad 2P4UH5
Cupping ats to d"a/ inflammation and p"essu"e a/a% f"om the deep o"gans ,espeiall%
the hea"t* $"ain* lungs* li!e" and .idne%s- to/a"ds the s.in' This failitates the healing
p"oess' P"atitione"s of upping ontend that this p"oess st"engthens the immune
s%stem* so enou"aging the optimum funtioning of the $od%' In other words, it assists
the actions of Physis. In doing so* it di!e"ts to#ins and othe" ha"mful impu"ities f"om
these !ital o"gans to/a"ds the less+!ital s.in* $efo"e e#pulsion' The $lood /hih is
di!e"ted allo/s fo" a f"esh 6st"eam& of $lood to that a"ea'
Histo"% of Cupping
Cupping in the Weste"n Wo"ld and the 3iddle East
The anient Eg%ptians /e"e the fi"st to use upping the"ap%' The oldest medial te#t
$oo.* /"itten in app"o#imatel% 1778 4C* in Eg%pt* des"i$es $leeding $% upping used to
6"emo!e the fo"eign matte" f"om the $od%&' Hippo"ates and Galen /e"e also g"eat
ad!oates of upping' In the ea"l% da%s the tehni0ue /as used solel% fo" $leeding
pu"poses' The"e /e"e t/o shools of thought as fa" as disease /as one"ned)
a- sta"!e the sou"e of the si.ness of the $od%
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$- $leed to d"ain it a/a%
Among the Eg%ptians and !a"ious nations* upping appea"s to ha!e $een onside"ed a
"emed% fo" almost e!e"% t%pe of disease as /ell as an impo"tant means of p"ese"!ing life'
In the $oo. 6Galen on Blood letting&* disease and health a"e defined in te"ms of natu"e*
6:isease is an unnatu"al state of the $od% /hih impai"s a funtion&' This statement ties
up /ith the philosophial p"iniples of Ti$$ /he"e 6im$alane ou"s as a "esult of an
indi!idual mo!ing a/a% f"om his;he" ideal 0ualitati!e state& < unnatu"al state "esulting in
the manifestation of disease' Galen ontinues)
!he nature does its best to restore unnatural states to their healthy condition. !he
function of the Physician is to cooperate with her. "hen a patient is suffering from a
disease, nature is struggling to overcome the Pathogenic agents and if she is plainly
succeeding the Physician should do nothing. If however she is getting the worse of the
struggle, he must come to her aid by doing what she would do if she could. !he Physician
must preserve what is according to nature, eliminating what is not.”
Galen ontinues in sa%ing that the p"iniple indiation fo" $lood letting is to eliminate
"esidues o" di!e"t $lood f"om one pa"t to anothe"' The ad!antage of $lood letting o!e"
othe" fo"ms of haemo""hage is that the doto" an stop the flo/ /hene!e" he;she /ishes'
Ao"ding to Galen&s s%stem of patholog%* all medial diseases a"e due to d%s"asia ,a
fault% state of the onstitution o" a mo$id ondition of the $lood due to some gene"al
disease-' He $elie!es that all doto"s need to do in suh i"umstanes is to "esto"e the
$alane of the humou"s in the $od%'
It is of g"eat impo"tane to e!aluate the onstitution of the indi!idual $efo"e
implementing a t"eatment plan as patients diffe" onside"a$l% in thei" health% and
diseased state* e'g' patients /ith a melanholi;phlegmati tempe"ament a"e mo"e li.el%
to suffe" f"om onditions assoiated /ith e#ess old suh as osteo+a"th"itis as oppose to
heat "elated onditions suh as $oils'
=
Cupping in the >e/ish t"adition
The hief Ra$$i of Eg%pt* Ra$$i 3oshe 4en 3aimon "efe""ed to this t%pe of the"ap% in
his medial $oo. #ishna !hora$%ilchot &eot' His $oo. fouses on $lood and diseases*
/he"e it is states that most diseases a"ises in the $lood* the"efo"e* it is not onside"ed a
"emed% $ut on the ont"a"%* $leeding and upping a"e "eommended as modes of the"ap%'
Cupping in the 3iddle East and the 3uslim Wo"ld
Cupping is .no/n as 6Ha1ama& in the A"a$i /o"ld /hih t"anslates 6to "esto"e to $asi
si?e& o" 6to diminish in !olume&' The P"ophet 3uhammed P4UH is "epo"ted to ha!e $een
a use" and ad!oate of upping the"ap%' It has $een "epo"ted that the P"ophet P4UH said)
Cupping and puncturing the veins are your best remedies.
The autho" of Al+@unun* I$n Aina* said) 6upping is not p"efe""ed in the $eginning no" the
end of the month' It is p"efe""ed in the middle of the month /hen the su$stanes ,of the
onstitution o" the ondition- aumulate and $eome agitated' In a diffe"ent Hadith) 6
The P"ophet P4UH use to ha!e upping done on the 1B
th
* 1C
th
and 91
st
da% of the luna"
month&* the most $enefiial time /as "epo"ted to $e 9+= hou"s afte" ta.ing a $ath' Dasting
a da% $efo"e the upping /as also "eommended'
Ea"l% Cupping Inst"uments
It is $elie!ed that upping /as fi"st used in the anient
p"atie to su. $lood f"om poisonous /ounds' The
ea"liest upping inst"uments /e"e hollo/ed ho"ns /ith a
small hole at the top th"ough /hih the uppe" /ould
su. up the $lood f"om the sa"ifiation p"e!iousl% made
/ith a $lade'
In time* !a"ious natu"al "esou"es $egan to $e used to "eate sution' Do" e#ample* nati!es
along the /est oast of No"th Ame"ia* in the !iinit% of Eanou!e" Island* used shells' In
Eu"ope* Asia* Af"ia and No"th Ame"ia* hollo/ animal ho"ns /e"e fashioned to p"o!ide
an effeti!e upping de!ie'
F
In No"th Ame"ia* the nati!es made thei" upping implements $% sliing off the point of a
$uffalo ho"n' The% /ould then plae the $ase of the ho"n on the $od% and su. the ai" out
th"ough the opening at the tip' When a !auum /as ahie!ed*
the opening of the ho"n /ould $e losed off $% the p"atitione"s
tongue' :u"ing the 4a$%lon + Ass%"ian Empi"e ,st"ething f"om
I"a0 to the 3edite""anean- massage /as p"atied as /ell as
Gupping $% su.ing* /ith the mouth o" $% using a $uffalo ho"n'
The sou"e of this info"mation /as p"esuma$l% found ins"i$ed
on la% ta$lets* /"itten in one of the ea"liest /"itten languages* i'e' uneifo"m s"ipt
a"ound B884C'
E(TIEE TA4HET "ep"esents upping and
$leeding inst"uments f"om Temple of
Aslepius at Athens' In the ent"e* a
"ep"esentation of a folding ase ontaining
salpels of !a"ious fo"ms is depited' (n eithe"
side a"e upping !essels'
The deline of upping f"om the mid to late 1I88s
4% the mid to late 1I88s* upping /as sha"pl% "itii?ed $% the medial f"ate"nit% and had
fallen a/a% as a popula" method' The"e /e"e a fe/ speulations as to /h% this happened'
+ It /as du"ing this pe"iod that the ne/l% esta$lished sientifi model of mediine
$egan dis"editing all othe" p"e!iousl% esta$lished t"aditional the"apies in o"de" to
gain medial dominane'
(pposition to upping /as the"efo"e not $ased on a la. of effeti!eness* $ut $eause of
its la. of GGfitGG /ith the g"o/ing inte"ests and autho"it% of the medial f"ate"nit%' This /as
"ela%ed onto a set of soial p"oesses that stigmati?ed upping and hanged peopleGs
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attitude to man% t"aditional p"aties' Ho/e!e" o!e" the past ouple of deades the tide
has tu"ned and people a"e "ediso!e"ing that some p"aties ha!e plent% of me"it* hene
the "e+a/a.ening of upping as the"apeuti option'
4enefits of Cupping the"ap%
4efo"e listing the $enefits of upping the"ap%* it is impo"tant to fi"st loo. at the s.in and
its "elation to the inte"nal o"gans* the l%mphati and the immune s%stem'
A.in
An% topial stimulus destined to influene and
manipulate inte"nal o" e#te"nal o"gans must
sta"t at the s.in le!el' The s.in is ou" la"gest
o"gan* ontaining fluid* $lood* $lood !essels*
onneti!e tissue* musles and a "ih ne"!e
suppl%' (u" $od%&s fi"st di"et ontat /ith the
outside /o"ld is th"ough the s.in' It is also
t"ue to sa% that ou" s.in is the mi""o" of ou"
health) in good health the s.in is shin%* tight
and has a smooth te#tu"e' It "esponds to
hanges in tempe"atu"e and is gene"all% /a"m
/hen touhed' When the $od% is unhealth%* a
dull* lifeless s.in /ith little natu"al olou" is
o$se"!ed' Apa"t f"om p"oteting the $od% f"om e#te"nal pathogens* the s.in has a ma1o"
"ole in a num$e" of $od% funtions' It is the main o"gan of sensation* th"ough millions of
J
ne"!e endings ontained in its st"utu"e' A "ih net/o". of $lood !essels and glands
p"o!ides an effeti!e means of tempe"atu"e ont"ol' The"e a"e t/o main la%e"s of the
s.in) the oute" epide"mis and the inne" de"mis' The fatt% su$utaneous "egion lies $eneath
these t/o' The epide"mis is the ellula" la%e" of the s.in* !a"%ing in thi.ness f"om 8'1
mm in the e%elid to o!e" 1 mm on the palms and soles' It has no ne"!es* onneti!e tissue
o" $lood !essels' In stimulating a pa"tiula" point on the s.in* a p"atitione" an influene
and hange a pa"tiula" o"gan&s $lood flo/'
H%mphati s%stem
The l%mphati s%stem is made up of l%mphati
!essels and l%mph nodes that e#tend th"oughout
the $od%' It helps maintain the $alane of fluid
in the $od% $% d"aining e#ess fluid f"om the
tissues of the $od% and "etu"ning it to the $lood
s%stem' Closel% "elated to the a"dio!asula"
s%stem* the l%mphati s%stem has se!e"al ma1o"
funtions* e'g' filte"ing ou" $ate"ia* p"oduing
l%mpho%tes* gene"ating anti$odies* et' In
addition to l%mph ,fluid i"ulating in the
s%stem-* the s%stem inludes l%mphati
apilla"ies and la"ge !essels* l%mph nodes*
spleen* tonsils and th%mus' Apa"t f"om
p"oduing anti$odies* the l%mphati s%stem is
also "esponsi$le fo" the olletion of fatt%
glo$ules f"om the intestine'
The l%mph s%stem also p"ese"!es the fluid
$alane th"oughout the $od%' All fo"ms of
massage o" the"apies in!ol!ing the stimulation of the s.in su"fae /ill "esult in the
imp"o!ement of $lood and l%mph i"ulation' (ne ad!antage that $lood i"ulation has
o!e" l%mph i"ulation is that $lood is pumped a"ound the $od% $% means of the hea"t' In
B
ont"ast* the i"ulation of l%mph "elies on $"eathing* mo!ement ,/al.ing o" e#e"ise- o"
e#te"nal p"essu"e'
As the l%mph i"ulates $et/een the ells* it ollets /aste matte" inluding dead $lood
ells and to#i mate"ials' While $lood is "esponsi$le fo" olleting and dist"i$uting
o#%gen* nut"ients and ho"mones nou"ishing the enti"e $od%* the l%mphati s%stem is
"esponsi$le fo" olleting and "emo!ing /aste p"oduts in the tissues' When this /aste is
not olleted ade0uatel% o" effeti!el%* it ong"egates as a loali?ed ongestion'
:u"ing upping the"ap%* $oth $lood and l%mph i"ulato"% s%stems a"e simultaneousl%
stimulated to /o". mo"e effiientl%' This "esults in a mo"e effiient olletion and
t"anspo"tation mehanism fo" to#i su$stanes* depositing it into the l%mphati s%stem to
$e dest"o%ed and allo/ing the i"ulation of f"esh l%mph in o"de" to nou"ish the tissues
and gene"ate a $ooste" fo" the immune s%stem'
K"hen energy flows, illness goesL 2Chinese apho"ism5
Cupping "egulates the ene"g% and $lood flo/' It helps d"a/ out and eliminate the
im$alaned 0ualit% i'e' heat* old* moistness* d"%ness' Cupping also opens the po"es of
the s.in thus allo/ing fo" the p"eipitation of pathogens th"ough the s.in' Nothing mo!es
$lood and ene"g% as effiientl% as upping' Whe"e the patient&s ene"g% is defiient* the
mo!ement of $lood /ould $e slo/* if the ene"g% is a$undant* the mo!ement /ill $e muh
0ui.e"' The main o$1eti!e of t"eatment is to "emo!e the ause of disha"mon% f"om the
$od%* "esto"e the i"ulation of $lood* ene"g% and fluids thus aiding ph%sis in "e+
esta$lishing homeostasis'
Effets of upping the"ap%
a- s.in
+ "ise in s.in tempe"atu"e
+ p"omotion of meta$olism in s.in tissue
+ $ette" funtioning s/eat and se$aeous
glands
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+ aele"ates the se"etion of salts and se$aeous matte" and e#"etion of /ate"
+ st"engthens the "ene/al po/e" of the s.in
+ in"ease s.ins "esistane to !a"ious ha"mful onditions
$- musles
+ stimulates the e#pansion of $lood !essels in the musle
hene in"ease $lood flo/
+ failitates the flo/ of l%mph
- 1oints
+ in"ease $lood flo/ to the 1oint
+ in"ease the se"etion of s%no!ial fluids
d- digesti!e o"gans
+ stimulates the ta"get o"gan
+ in"ease in pe"istalsi mo!ements
+ in"ease se"etion of digesti!e fluids
e- $lood
+ in"ease in $lood i"ulation
+ "ise in lo/ $lood p"essu"e
+ influenes the omposition of $lood)
R4C and W4C* pH
f- ne"!ous s%stem
+ stimulates senso"% ne"!es of the s.in
+ affets ANA
C
Typ! "# C$pp%&'
The"e a"e t/o main t%pes of upping)
D(y )$pp%&' M s.in immediatel% $elo/ the up is su.ed up $% a !auum "eated inside
the up
W* )$pp%&' M in /hih the s.in immediatel% $elo/ the up is "oss ut supe"fiiall%
se!e"al times M lightly lacerated M so that $lood /ould atuall% $e d"a/n out $% the
!auum f"om the s.in into the up'
Do" $oth fo"ms of upping* the patient should $e ad!ised to in"ease thei" /ate" inta.e'
&ry cupping is always used before wet cupping is considered'
The use of /hihe!e" fo"m of upping is at the dis"etion of the p"atitione"'
Clinial 4enefits of Cupping
The $enefits of upping ontinue fo" se!e"al da%s afte" the p"oedu"e M e'tended action.
Cupping has $een found to)
 Affet the $od% up to fou" inhes into the tissues* ausing them to "elease
to#ins
 Ati!ate the l%mphati s%stem
 Clea" olon $lo.ages
 Help ati!ate and lea" the !eins* a"te"ies and apilla"ies
 Ati!ate the s.in* lea" st"eth ma".s and imp"o!e !a"iose !eins
In the ase of /et upping ,/hih ma% o" ma% not follo/ d"% upping-* the follo/ing
additional $enefits follo/s)
• The "elease of to#ins f"om the upping site
• The "elease of p"essu"e;to#ins that ma% ha!e aumulated M espeiall% in
inflammation onditions an p"o!ide instant "elief
• The elimination of $lood !olume* ho/e!e" little* allo/s Ph%sis to "esto"e the humo"al
$alane $oth 0ualitati!el% and 0uantitati!el%
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Apeial p"eautions
Although the upping p"oedu"e is usuall% t"ou$le and onse0uene f"ee* ad!e"se
"eations an "esult f"om the patient&s ps%hologial "esponse' Do" e#ample* the sight of
$lood and the patient&s app"ehension an p"eipitate an undesi"ed "eation'
Ahould an% of the follo/ing s%mptoms appea" M paleness* nausea* di??iness* atual
!omiting* and pe"spi"ation M the p"oedu"e should $e disontinued and the patient
enou"aged to ha!e a "est* lie do/n* and ta.e a d"in. of natu"al o" suga"ed /ate"'
Although the"e a"e no fi"m ont"aindiations to upping* it should $e used /ith
i"umspetion in hild"en* se"iousl% ill patients* those /ith a$no"mall% lo/ $lood
p"essu"e* and the aged' In these ases upping an $e done /ith dis"etion* and unde"
speial and defined i"umstanes'
• :"% upping is not "eommended fo" hild"en $elo/ the age of = %ea"s'
• Wet upping should $e a!oided in hild"en $elo/ the age of J %ea"s'
• Wet upping should not $e a""ied out in patients a$o!e J7 %ea"s of age* although
d"% upping an $e used in the elde"l%'
• P"eautions should $e o$se"!ed fo" menst"uating /omen'
• It is not ad!isa$le to appl% upping to the patient /ith s.in ule"s* oedema* o" on
an a"eas o!e"l%ing la"ge $lood !essels o" e!en !a"iose !eins
• In addition* patients /ith high fe!e" o" /ho suffe" f"om on!ulsions should not $e
upped'
• Cupping should not $e applied to the a$dominal and sa"al "egions of the
p"egnant /omen'
• Wet upping should ne!e" $e applied to the female $"east* unless a$solutel%
neessa"%'
• Cupping on the ne. o" on the oipital $one is not ad!ised' This an ause
p"o$lems /ith e%esight and memo"%'
• Cupping on the fo"ehead is li.e/ise not ad!oated* as this an lead to emotional
insta$ilit%'
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• Ca"e should $e ta.en /ith /et upping of anaemi patients* o" those susepti$le
to spontaneous $leeding'
• Cupping should not $e done on patients /ho a"e !isi$l% fatigued ,ph%siall% o"
mentall%-* !e"% hung"%;thi"st%* dist"aught* o" /ho ha!e o!e"indulged in alohol'
Aafet% aspets of Cupping
• The p"atitione" must /ea" disposa$le late# glo!es /hilst a""%ing out $oth t%pes of
upping'
• 4efo"e upping atuall% $egins* the patient&s $lood p"essu"e and pulse should $e
he.ed'
• The $lades used fo" /et upping inisions should $e disposa$le'
• The inisions in /et upping should $e supe"fiial* in!ol!ing the epide"mis onl%'
• The patient should $e 0uestioned on ho/ he o" she feels M an% unusual sensation o"
fe!e"'
• All othe" neessa"% safet% measu"es should $e in plae'
The Cupping tehni0ue
P"elimina"ies)
• In o$ese pe"sons and in those suffe"ing f"om thi.ened $lood ,pol%%taemia-* a hot
$ath 1 to 9 hou"s $efo"e upping is "eommended' This helps to stimulate $lood flo/
to the s.in* so ma.es upping that muh mo"e effeti!e'
• As upping is pe"fo"med on the na.ed s.in* the t"eatment "oom should $e
omfo"ta$l% /a"m
• 3a.e su"e the patient is "ela#ed and not suffe"ing f"om an% deg"ee of an#iet%
• E#plain to the patient /hat %ou a$out to do* demonst"ate if neessa"% on %ou" o/n
a"m
• In o"de" to ahie!e $ette" ontat $et/een the up and the s.in* li$e"all% appl% a
suita$le massage oil to the upping intended a"ea
• The seleted a"eas of s.in ma% $e sha!ed* so that a good seal $et/een the up and
s.in an $e ahie!ed'
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• Patients a$out to unde"go upping ,espeiall% the /et !e"sion- should $e ad!ised to
ta.e a nut"itional d"in. $efo"e the upping'
• P"essu"e applied to ups /ill !a"% ao"ding to patients' Do" medium to la"ge f"ame
patients* and in patients /he"e the upping sites a"e endo/ed /ith e#ess fatt% tissue*
the p"essu"e an $e in"eased' This ensu"es that the a"ea $eneath the glass /ill
"espond at a faste" "ate than on patients /ho a"e leane"* and /ith less fatt% tissue'
• Cupping an also $e a""ied out in pa"allel to massage' Choose the $est position
suita$le fo" the patient and %ou as sudden mo!ements a"e not "eommended
The loation to $e t"eated is impo"tant in deiding the position of the patient' If the
upping is to $e pe"fo"med on the $a.* the most omfo"ta$le position /ill $e p"one on a
$ed o" flat su"fae a"eaN if on the stomah* a supine position is p"efe""ed' Do" the fae*
.nees* ne. and shoulde"s* a sitting position in a hai" ma% $e hosen' Do" the elde"l%*
se!e"e asthmatis o" patients /ho ha!e "eentl% suffe"ed fo"m an% hea"t onditions* an
up"ight sitting position should al/a%s $e p"efe""ed* see figu"es A+D'
1=
T+ p(")!!,
The !auum in the glass o" ha"d plasti sution up is usuall% "eated in one of t/o
diffe"ent /a%s'
In the t"aditional method* the up is heated $% a flame f"om an
alohol soa.ed otton pad o" tape"* then applied immediatel% to
the s.in' As the o#%gen $u"ns up* a !auum is "eated OsealingO
the 1a" to the s.in' The de!ie an $e "eleased easil% $% hand'
These da%s* a hand ope"ated !auum pump is attahed to the glass up* and sution
applied $% manual ation'
• The app"op"iate si?ed ups should $e used'
• Gene"all%* the ups should $e plaed on flat setions of the
s.in ,/hih is usuall% hai"+f"ee* /ith no $on% p"otu$e"anes*
and "elati!el% thi.-'
• When mo"e than one up is used simultaneousl%* the ups
should $e sepa"ated $% 1+9 entimete"s'
• If /et upping is to $e a""ied out* the site seleted fo" up appliation /ill $e inised
supe"fiiall% /ith a small $lade ,lanet-' A stinging* $ut not usuall% painful* sensation
/ill $e e#pe"iened'
• The up is then applied* and the ai" /ithin /ill $e e!auated /ith a small hand+held
pump' This /ill d"a/ 98 to 188mls $lood into the up* depending on the s.in
thi.ness of the appliation ?one' Afte" this* $leeding stops automatiall%* as
haemostati mehanisms ome into ope"ation'
• The p"oess lasts fo" a"ound 17 to 98 minutes f"om appliation of the up'
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• :u"ing upping* the patient must "emain as still as possi$le'
• P"eautions need to $e ta.en on /hen and /he"e the ups a"e plaed* and fo" ho/
long the% a"e applied'
A#*(-.(/!,
• An antisepti "eam should $e applied to the inisions afte" upping is te"minated'
The use of hone% is not onl% effeti!e as an antisepti $ut also assists in the healing of
the s.in'
• Ade0uate nut"itious li0uids should $e ta.en afte" upping'
• Aolid food inta.e should $e a!oided* if possi$le* fo" at least = hou"s'
• No sho/e" o" $athing should $e a""ied out fo" 19 hou"s afte" upping'
• Ae#ual ati!it% should $e "ef"ained f"om fo" at least one da%'
• Afte" upping* the follo/ing signs ma% $e e!ident)
 Redness of the s.in ,e"%thema- /hih disappea"s afte" a fe/ /ee.s
 Alight ithing* as the healing p"oess ta.es plae* at the upping sites ma%
de!elop and pe"sist fo" a fe/ da%s' A"athing should $e disou"aged'
 Hight sa""ing as pa"t of the healing p"oess'
17

11 3ethods of Cupping
In total the"e a"e 11 methods of upping designed to help the p"atitione" hoose the most
app"op"iate upping method fo" the patient' These methods a"e)
 Wea. ,light- upping
 3edium upping
 At"ong upping
 3o!ing upping
 Hight mo!ing upping
 Needle upping
 3o#a ,hot needle- upping
 Empt% ,flash- upping
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 Dull ,$leeding;/et- upping
 He"$al upping
 Wate" upping
Wea. ,light- Cupping
It is emplo%ed /hen $lood and ene"g% a"e sluggish o" stagnant' The intention is mo!e the
stagnation and at the same time tonif% the /ea. ene"g%' The .e% fato" in deiding /hen
to appl% /ea. upping is the p"esent ene"geti state of the patient' E!aluation of the pulse
and tongue should all point to /ea.ness' The amount of flesh d"a/n into the up should
$e minimal and ha"dl% "aised' This method an $e applied to almost an%/he"e on the
$od% and ma% ause a slight "eddening of the s.in' Wea. upping is the most gentle
method of all upping and is pa"tiula"l% suita$le fo" de$ilitated adults* elde"l% patients
and %oung hild"en* espeiall% those unde" B %ea"s of age'
3edium upping
This is the most f"e0uentl% used method on patients' This method an safel% $e
administe"ed to hild"en o!e" B %ea"s of age' With medium upping* sution is fi"me"
pulling the s.in /ell into the up "eating a slight "edness' 3edium upping an safel% $e
applied an%/he"e on the $od%'
At"ong upping
This is one of the most d"aining tehni0ues' The"efo"e $efo"e deiding on this method*
the p"atitione" must ensu"e the suita$ilit% of the patient' Pulse and tongue diagnosis
should emphasi?e e#ess o" fullness' This method ma% sometimes lea!e the patient
feeling ti"ed o" d"ained' A st"ong !auum need to $e p"odued* gi!ing a st"ong pulling
sensation of the s.in inside the up' 4eause of the st"ong natu"e of the pulling ation* the
s.in /ill 0ui.l% tu"n "ed and sho"tl% tu"n pu"ple inside the up and possi$le e"%thema in
the s.in su""ounding the up' When using the st"ong upping method fo" the fi"st time*
the ma". is ine!ita$le and an ta.e 17+98 da%s to disappea" ompletel%' The upping time
should $e sho"t i'e' 7+18 minutes du"ing the fi"st session /hih an in"ease up to 98
minutes du"ing late" appliations' At"ong upping is often oupled /ith /et upping'
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3o!ing upping
The o$1eti!e of this t"eatment is to appl% st"ong upping to a muh la"ge" a"ea of the
$od% $% the mo!ing;sliding ation of the up' This is the most painful upping method
and is often not p"atied in Ti$$'
Hight mo!ing upping
Hight mo!ing upping is p"atied mainl% on patients /ith "elati!el% full;e#essi!e
ene"g%' It is useful and onside"ed the onl% safe method in the management of l%mphati
d"ainage as /ell as $eing the e#lusi!e upping method in the management of ellulite
omplaints' :u"ing the appliation* slight pin.ish upping ma".s appea" on the s.in*
no"mall% follo/ing the di"etion and mo!ement of the up' At no time should deep* da".
"ed upping ma".s $e seen' All upping ma".s should fade a/a% in a da% o" t/o' The
/hole o$1eti!e of light upping is to dispe"se stasis o" stagnation /ithout d"aining the
patient' All mo!ing upping should "e0ui"e speial attention pa"tiula"l% /hen the s.in
su"fae is $"o.en* e'g' s"athes* uts* $"uises* open /ounds* et'
A!oid upping o!e" s.in moles'
Needle upping and 3o#a ,hot needle- upping
Not often p"atied in Ti$$ as it follo/s aupuntu"e t"eatment' The up is plaed o!e"
the inse"ted aupuntu"e needle'
Empt% ,flash- upping
Empt% upping is also alled flash upping fo" its speed du"ing appliation' This is
atuall% medium to st"ong upping applied "apidl% i'e' the ups "emain in plae fo" a !e"%
sho"t pe"iod ,P=8 seonds-' It is used to stimulate and mo!e $lood and ene"g% in the /ea.
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and f"ail' The sho"t du"ation is enough to stimulate ph%sis and mo!e $lood $ut not
enough to d"ain the patient' This an $e "epeated fo" $et/een 7+18 minutes'
Dull ,$leeding;/et- upping
This is the most fa!o"ed and p"atied method $% p"atitione"s' It is used in the t"eatment
of a sudden in"ease in $lood p"essu"e* high fe!e"s* $lood stasis and in disha"ging pus
f"om $oils' This method is often om$ined /ith st"ong upping' Afte" the initial st"ong
upping* the up is "emo!ed and slight supe"fiial lae"ations a"e made' The up is then
plaed $a. on the site' 3ost of the $lood in the up /ill $e semioagulated and the"efo"e
still 0uite fluid' 4efo"e "emo!ing the up* the p"atitione" should /ea" disposa$le su"gial
glo!es on $oth hands' Remo!e the ups gentle' It is not "eommended to $leed the patient
mo"e than one a month and not to d"a/ mo"e than 188ml of $lood at an% one time'
He"$al upping
Do" this method one "e0ui"es a fe/ $am$oo ups* a "elati!el% deep pan* /ate"* metal
lamps* some fo"m of fi"e and he"$s $ased in a p"es"iption $ased on the t"eatment' The
ups a"e $oiled in the pan /ith /ate" and the
p"es"i$ed he"$s' The ups a"e then plaed on the
patient in the t"aditional /a% using ,Dlame-' The
he"$s a"e a$so"$ed into the $am$oo ups* /hih
in tu"n t"ansfe" thei" healing p"ope"ties to the
patient' Cups an $e left on fo" 18+98 minutes'
Precaution( follo/ing the $oiling p"oess* some
steam "emains inside the up* "esulting in a
p"essu"e $uild+up /hih pushes the up a/a% f"om the s.in' This an $e "etified $%
"esting the hot $am$oo ups on a d"% to/el fo" up to a minute in o"de" to a$so"$ e#ess
/ate" and at the same time "eduing the p"essu"e inside the up'
Wate" upping
This is one of the least used and p"atied upping methods' The tehni0ue in!ol!es
filling a glass o" $am$oo up one+thi"d full /ith /a"m /ate" and emplo%ing the upping
p"oess 0ui.l%' Hold the up lose to the patient /ith one hand* $"ing it lose to the
point to $e upped and inse"t the $u"ning otton /ool* s/iftl% and simultaneousl% tu"ning
1C
the up onto the s.in' This method is said to dispe"se ene"g% and "esol!e phlegm ma.ing
it !e"% $enefiial fo" asthma* pa"tiula"l% in hild"en' The"e is usuall% no ma". left /ith
this method'
Ho/ often an upping $e applied?
Child"en unde" the age of 1J + one a /ee. is onside"ed the aepta$le f"e0uen%' Adults
unde" the age of J8 + as muh as t/ie a /ee. ,/ith the e#eption of /et upping-
Adults o!e" the age of B8 M one a /ee.
Ho/e!e"* du"ing the 6aute stage& of a disease* t"eatment T:A o" e!en one e!e"% da% an
$e $enefiial' Aimila"l%* in all age g"oups /hen light* empt% o" light mo!ing upping is
emplo%ed* t"eatment f"e0uen% an $e in"eased to as muh as one e!e"% othe" da%' This
is $eause $lood* ene"g% and the l%mphati fluids a"e gentl% stimulated "athe" than
fo"efull% manipulated'
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