Unani medicine is legitimately recognized in India as an indigenoussystem of alternative medicine and has been intimately connected to Muslimculture in south Asia. Hijamah or cupping therapy is one such element of theregimental therapies of Unani medicine that clings to olden times andconsidered as ancient technique of healing by Chinese, Unani, Korean, Tibetan,and Oriental medicine. Cupping procedure encompasses application of cups toselected skin points that creates a subatmospheric pressure, either by heat orby suction. Unani practitioners principally exercise two types of cups, onewith a narrow opening to cure deep accumulated fluids and the other with a wideropening to treat spread of pain. In Muslim countries, ‘Hijamah’ or cuppingneeds no introduction, because of its popularity through Arabic and Muslimphysicians such as Ibn Sina, Al-Zahrawi, and Abu Bakr Al-Razi. In European beltcupping therapy was one of the trendy treatments of gout and arthritis between14th and 17th century. The mechanism of action of cupping is still baffling butthe main proposed mechanisms include effect of subatmospheric pressure suction,promoting peripheral blood circulation, and improving immunity. So, its a needof the hour, to conduct clinical studies in cupping therapy vis-à-vis mechanismof action. Reported effects of Hijamah include promotion of the skin’s bloodflow, altering the skin’s biomechanical properties, improving local anaerobicmetabolism, reducing inflammation and modulation of the cellular immune system.Broadly cupping therapy is of two types, dry and wet but in the recent epoch ithas been categorized into six categories e.g., dry/wet, massage, flash, herbal,water, ozone, needle, moxa, and magnetic cupping. In this day and age, area treated cuppinglike facial, abdominal, female, male, and orthopaedic is in practice along withsports, cosmetic and aquatic cupping. Typical cupping therapy set shouldcontain six or more different-sized cups tailor fashioned in plastic, glass,rubber, bamboo, ceramic, metal, and silicone stuff. The prima facie goal ofcupping therapy is health promotion by preventing and treating diseases inpatients. A laundry list of scientific reports claim its boon in neck,shoulder, lower back pain, knee pain, headache/migraine, facial paralysis,brachialgia and hypertension. Additionally, cupping therapy is reported as therewarding remedy in diabetes mellitus, rheumatoid arthritis, and asthma. Inthis ancient therapy, sites are selected according to the treated ailment andback is the most frequent site of application, followed by the chest, abdomen,buttocks, and legs. Other areas, such as the face, head may also be treated bycupping. Our department in collaboration with Regional Research Institute ofUnani Medicine (RRIUM) Hazratbal, Srinagar intended for research trials and asa matter of fact I have personally observed patients receiving satisfactoryresults out of the blue by cupping therapy. Moreover, scientists working inRegional Research Institute of Unani Medicine (RRIUM), Hazratbal claims thatthey successfully take care of previously treated patients of alopecia withgood and satisfactory results.
Cupping therapy in animals is an emerging therapeutic contrivancepracticed by veterinary clinicians to treat various biological insults in dogs,cats, and horses. Christian Danner is a German expert in horse therapy, horseosteopathy, acupuncture and cupping therapy who has designed modern horsecupping machine that allows a clinician to set the air pressure, which provideseach mounted glass cup with the perfect amount of suction. This results in awide range of benefits like increased blood flow circulation of the tissues,stimulation of lymph flow, boosting the immune system along with reduction ofbodily tension and stiffness in horses. Cupping therapy is chiefly indicated inhorses for general ache/pain, cramps, rheumatism, arthritis, digestiveproblems, respiratory track sickness, symptoms of blood stasis and abnormallycold and hot body temperature. Keeping in view all these facts it’s imperativeto explore the medical vistas of cupping in human and animal medicine.
In general, cupping is contraindicated directly on veins, arteries,nerves, skin inflammation, any skin lesion, body orifices, eyes, lymph nodes,or varicose veins. Additionally it is also contraindicated on open wounds, bonefractures, and sites of deep vein thrombosis. Until we have sufficientinformation regarding the safety of cupping therapy, it is absolutelycontraindicated in cancer patients and those with any organ failure (renalfailure, hepatic failure, and heart failure). Patients using a pacemaker can’tundergo for cupping therapy and those suffering from haemophilia. Relativecupping therapy contraindications include acute infection, usinganticoagulants, severe chronic disease (such as heart diseases), pregnancy,puerperium, menstruation, anemia, recent wet cupping session, recent blooddonation, medical emergencies, and patient’s refusal of the procedure. Cuppingtherapy is relatively safe and its adverse events are infrequently reported.Most adverse events are mild to moderate in severity e.g., scar formations,followed by burns. Other observed adverse actions are headache, pruritus,dizziness, tiredness, muscle tension, anemia, nausea, bullae formation, smallhematoma or pain at cupping site, abscess formation, skin infection, insomnia,hyperpigmentation.
In order to combat cupping therapy related infections, control measuresis an essential part of the clinical practice. Hand washing is a criticalcomponent of any infection control program. Wearing personal protectiveequipment such as gloves, masks, protective eyewear, and gowns is important.Disinfection of the skin before cupping by US Food and Drug Administration(FDA)-approved or hospital-grade solutions is very important. Disinfection ofpatients’ beds or using disposable plastic bed covers is very important aftertreating each patient. Following medical waste segregation and disposalguidelines is essential. Using disposable cups, vacuum pumps, and surgicalblades is recommended. Try to use a secondary disposable container forlubricants/skin disinfectants used on a single patient before disposal.
Dr. Abrar Ul Haq Wani is a PhD Scholar, Dept. of Medicine, FVSC&AH,SKUAST K