History of Cupping


Cupping is one of the oldest healing modalities known to mankind. We are uncertain to the precise roots of cupping, because it seems that it was in existence even before the use of written language. The first documentation of the use of cupping comes from Ancient Egypt, where we see evidence of cupping therapy being performed in hieroglyphics drawings. Later on, cupping is discussed in the earliest textbooks of Traditional Chinese Medicine. We are uncertain as to the direct origin of the techniques, but can see evidence of its use throughout the ages. Cupping is well known across Asia, Africa, and Europe, and is still used today in many countries as a home remedy.

An African medicine man cupping and bleeding two patients. Wood engraving.

Cupping is a type of negative pressure massage where suction is created on the surface of the body. Historically, the first instruments that were used for cupping were animal horns, and bamboo pots. In the early times, the practitioner would suck the air out of the instrument with their mouth, thereby drawing out the venom, infection, or whatever was trapped under the surface of the skin. As time and technology progressed, so did the instruments and the methods used for cupping.

An African medicine man or shaman applying the technique of cupping to a patient (using animal horns), which involves drawing blood to the surface of the body.

The next stage of development introduced the use of ceramic cups, and later yet glass cups were available. When using these instruments, the practitioner would create suction in the cup by placing the cup over fire, or a heat source to draw out the air, and create a vacuum inside the cup. The cup was then placed on the body. This vacuum would create suction, and the tissue would be drawn into the cup. This technique is called dry cupping.

There is another method of cupping which developed alongside this technique called wet cupping. With wet cupping, the same principles are applied, but a small puncture is made in the tissue to pierce the skin. When the cup is applied over the wound, the vacuum will draw a small amount of Blood out of the body. This technique was also called bloodletting, though there were many other forms of bloodletting that we will not discuss here.

A surgeon preparing to let blood by cupping, his apprentice warming the cupping glass. Oil painting attributed to Jan Baptist Lambrechts.

The purpose of ‘wet cupping’ was to draw out stale blood, infections, bacteria and poison from the body, thereby also reducing fever. The technique would stimulate the immune system, and the healing process would occur. This technique was popular for over a thousand years, until the advent of internal medicine and antibiotics in the 1800’s, when cupping and other ‘external medicine’ fell out of popularity in favour of the ‘new medicine’, what we define today as ‘science’.

However, many cultures kept utilizing cupping and the traditions continued, as often cupping treatments were used at home as the first method of treatment. In every village there would be someone, usually a woman, who was well versed in the use of cupping. If the cupping techniques did not work, and the persons condition continued to deteriorate, more severe and invasive medical applications would be applied. Trips to the doctor were not easy ventures, and villagers were very dependent on every member to do their part. So, losing one person to illness was problematic, but losing several pairs of hands to deliver the ill person to the nearest doctor could result in major losses in crops and supplies.

 

How Does Cupping Work?


Cupping therapy is a type of negative pressure massage where suction is applied to the surface of the body. With modern technology, we have developed a few different ways to produce suction. Historically, suction was created by placing the cup over fire, or a heat source to draw the air out of the cup, and create a vacuum inside the cup. The cup was then placed on the body. This vacuum would create suction, and the tissue would be drawn into the cup. More recently, there have been more simplistic and arguably equally as effective methods to produce suction.

A surgeon applying the method of cupping to a patient. Etching by A. Brambini

The first of these methods uses a plastic cup with a pump. The pump can either be a bulb on the end of the cup, or a detachable pump that is squeezed, and the air is removed. The second popular type of cups used are silicone cups which are flexible. In this case, the practitioner squeezes the cup, and places the cup on the body. The cup then creates suction,and takes up the skin inside the cup. The cups are typically kept on the body for 5-20 minutes. These techniques are referred to as dry cupping. There are other techniques involved with dry cupping as well. Depending on the location on the body, the strength of suction will be varied. Suction can be light, like with lymphatic drainage, medium, like with organ or abdominal cupping, and cupping on the elderly, weak, and small children, and strong cupping which is mostly performed on the backside of the body, ad legs. There are also variations in the cupping technique in the duration that the cups are retained.

A technique called ‘fast’ or ‘flash’ cupping is a style of cupping where the cups are quickly applied and removed and moved to another location several times. This technique is effective for improving circulation and blood flow.

The final style of cupping that we will introduce here is ‘sliding’, ‘gliding’ or ‘dragging’ cupping. I like to use the term gliding, as it sounds more appealing, and feels to fit the description most clearly. In this case, the area to be treated is covered with a gliding agent like a simple oil or liniment, and cup is applied with light or medium pressure. The practitioner moves the cup over the area to be treated. This method is very enjoyable for the receiver, and very effective for relieving muscle tension.

The development of these new cupping instruments have made cupping much more accessible to Western society, where concerns of regulation, fire safety and insurance may have been a restriction in the past. These new cupping instruments have most likely been the greatest contribution to the recent re-popularization of cupping therapy.

There is a second method of cupping which developed alongside dry cupping, called wet cupping. With wet cupping, the same principles are applied, but a small puncture is made in the tissue to pierce the skin. When the cup is applied over the wound, the vacuum will draw a small amount of Blood out of the body. This technique was also called bloodletting, though there were many other forms of bloodletting that we will not discuss here. The purpose of ‘wet cupping’ was to draw out stale blood, infections, bacteria and poison from the body, thereby also reducing fever. The technique would stimulate the immune system, and the healing process would occur.

 

Types of cups


Bamboo cups

Bamboo Cupping

Occasionally you will see a set of bamboo cups, which are great for doing herbal soaks with the cupping session. Virtually and spherical object will work in a pinch, of you have a method of creating a vacuum inside of it!!

Glass cups

Glass Cups

Glass cups have been the standard method of cupping since the turn of the century. The method of creating a vaccuum inside of a glass cup is as follows: attach a cotton ball to a stick or forceps and dip into 90% alcohol. Avoid alcohol of lesser distillation as it won’t burn hot enough to create a sufficient vacuum.

Ignite the alcohol-soaked cotton ball and thrust into the jar. This will evacuate some of the air in the jar creating a vacuum within it.

Quickly remove the cotton ball, as you don’t want to heat the jar, and very quickly place the jar onto the skin. Depending on the strength of the vacuum created, the muscle tissue will be sucked up into the jar. With practice this becomes a fairly simple maneuver.

Plastic Cups

Plastic Cups

Plastic cups are a good alternative to glass cups for stationary cupping. Instead of using heat for suction, plastic cups come with a suction gun or pump to remove the air from the inside of the cup to create suction. The cup is placed over the desired area of the body, and the air is released from the cup by squeezing the pump, or pressing on the suction gun until the skin is drawn up into the cup.

Silicone cups

Silicone Cups

Silicone cups are a good alternative for glass cups. They are especially effective in sliding cupping techniques, as they are flexible, and pass over bony areas easily. Silicone cups are used by pressing down on the top of the cup to remove the air from the inside of the cup, and then applied to the body.

 

 

 

 

Types of Cupping


Stationary Cupping
Depending on the type of cup you are using, you will apply the cup. Leave the cup in place for 5 – 20 minutes and then remove. Depending on the degree of toxicity in the muscle tissue treatment will result in either only a slight reddening of the skin for slight toxicity, or a rather nasty looking bruise of high toxicity.

Sliding Cupping
To make a better seal and to allow moving the cups around in a massage technique, a lubricant such as Olive Oil or White Flower ointment may be used. When doing sliding cupping, less tension is used in the cups. If the skin is lubricated, the cup should move freely on the skin.

Twinkling Cupping
In this method, a small alcohol soaked piece of paper is thrown into the jar and the jar applied to the skin. This method should be used while the patient is sitting up to avoid burning the skin.

Another method is to use an alcohol soaked piece of cotton to wet the inside of the cup, starting it on fire, and placing it on the patients’ body. This creates more heat, thereby increasing suction.

Fast Cupping
In this method, the cups are quickly moved from place to place on the spine. This is a good method where there is a large area of tension, and patients do not want excessive marking on their skin.

 

What Does Cupping Do?


typical glass cupping treatment

the histamine response when cups are removed

24 hours post cupping marks

abdominal cupping

Historically, it was said that cupping removed ‘wind’ from the body. What was meant by this, was that if an illness was brought on by a weather change or exposure to extreme climates then it would be treated with cupping. Application of cups (wet cupping) to draw out a small amount of blood on the upper back was considered the most effective cure. This area of the body, around T1 on the spine was considered in many cultures to be the prime location where ‘wind’ entered the body. In ancient times in many cultures, concepts like wind effected the upper body and the lungs the most profoundly. So, what could be seen was cupping being used to treat colds, flu, bacteria and fever.

Throughout the historical data available, we can see in many cultures cupping was used to reduce pain, muscular tension and injury.

Recently, studies have demonstrated that brain wave activity is effected with cupping treatment, suggesting that the pain response is indeed decreased.

Today, we consider fever to be a contraindication in cupping, but if a person is suffering from a cold or flu, asthma or another lung conditions, cupping can be very effective.

It helps to stimulate the lungs, increase diaphragmatic function to deepen breathing, and improve local blood circulation.

Some studies demonstrate that the suction function of cupping draws the blood from as deeply as 5 cm inside the body toward the surface. We cannot doubt that blood is being drawn to the surface, as in many cases with cupping we can see the effect of this mechanism through the deep red marks which sometimes occur.

When the blood is drawn to the surface of the body, old and stale blood becomes more readily available to be cleaned by the lymphatic system. In this way, cupping has a detoxifying effect on the systems.

What are the red marks?

Many people believe that the red marks that are often seen after receiving cupping are bruises. This is actually not the case. Bruises are an injury to the blood vessel, take several days to a week to heal, and are painful to the touch. Cupping marks are from the effect of the negative pressure effect of the cups. They are not painful whatsoever, and no blood vessels are injured. When suction is applied, some people have what is called a histamine response, where a redness appears on the tissue. It is part of the natural healing response of the body. This is the redness we see in the second photograph. The coloration disappears within minutes to hours of receiving cupping.

Some people have a stronger histamine response than others, depending of their skin type. The second set of marks that we can see in the third photograph are the result of local blood congestion. If muscle tissue is injured, or not functioning correctly, or there is some kind of local congestion these marks may appear. This is due to the tiny capillaries bursting as the blood moves toward the surface of the body. These marks fade, and disappear in 1-3 days depending on the condition. In more severe cases, the marks may remain for 3-5 days.

Cupping is considered to be beneficial to treat the following conditions:

  • arthritic pain
  • abdominal pain, stomach ache, indigestion
  • headache and migraine
  • hypertension
  • common cold and cough, asthma, cough, bronchitis
  • back and body pain
  • painful menstrual cycles
  • insect and poisonous snake bites
  • edema and swelling
  • limited range of motion

 

How is Cupping Used Today?


Today, most cupping practitioners are using plastic or silicone cups to perform dry cupping treatments. The techniques are very simple and easy to use, and the techniques are very safe. Very few health care professionals are qualified to practice wet cupping, and proper sterilization methods must be strictly adhered to. Following are the most common conditions treated with cupping, and their clinical effect.

 

Muscle Strain

 

Stress

Stress

 

Facial Rejuvenation

 

Muscle pain and strain
These days, the most common complaint we see being treated with cupping is muscular pain and tension. We see many individuals participating in sporting activities that create micro-tears in the muscles when are the muscles are being exercised. This muscle tearing is a normal function of muscle growth, as muscle must be torn ever so slightly (micro-tear) to increase in volume. If the micro-tears are too extreme, the body creates an inflammatory response to ‘protect’ the injured area. This response occurs in the 12-36 hours after exercise. When we keep the activity within 10% of what we normally do, we do not experience this condition. Recent studies have demonstrated that certain activities after exercise can minimize this inflammation such as warm baths, massage, low intensity workouts, sauna etc… cupping can be included in this list without clear evidence as of yet. Cupping treatments would be helpful in decreasing inflammation, increasing circulation, and realigning muscle fibres to speed up the healing process.

Stress
Often pain and tension is increased by high stress levels in the body. Clients report feeling extremely relaxed after cupping treatments. This may be due to the consideration that the effect of negative pressure massage is increasing blood circulation. With increased blood circulation, the body is able to more easily nourish its tissues, and transfer from ‘fight or flight’ or sympathetic response to ‘rest and repair’ or the parasympathetic response. More study needs to be conducted in this area, as at this point we are relying on patient reports for the data. What we do know is that in its natural state the human body is meant to spend no more than 40% of the time in sympathetic response (fight or flight) and at least 60% of the time in parasympathetic mode. Current research demonstrates that 25% of Americans are experiencing high levels of stress, while 50% are experiencing moderate levels of stress. Some of the effects of prolonged stress are high blood pressure, brain changes that can lead to anxiety, depression, and addiction, and can lead to obesity, just to name a few.

Facial Rejuvenation
More recently, cupping has been used increasingly for facial rejuvenation. In this case, light cupping is used. The idea here is that the negative pressure created with cupping draws blood to the surface of the skin, brightening the colour of the skin, and nourishing the skin cells. This helps with skin discolorations, and dark circles. It would also assist in drawing toxins and bacteria out of the skin cells. The negative pressure also is said to increase collagen fibre production which decreases with age.

Colds, cough, asthma, and lung issues
Cupping is very helpful for conditions of the lungs. Historically, this was the major use of cupping, and in Europe cupping is knows as vendosa, vendeuse etc… which is the latin work for ‘wind’ In earlier times there would be one person in each family or village to perform cupping on a family member or neighbour if someone felt under the weather. In Traditional Chinese Medicine, cupping is the primary treatment method for colds, cough, and asthma. Little clinical study has been done on this aspect, though observing clinical application it is demonstrable that cupping increases diaphragmatic movement and in doing so increases lung capacity. When cupping is employed, the decrease in wheezing can be heard and felt by the patient.

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