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1, What is Hijama (cupping)?

Hijama (cupping) is an ancient treatment in which evacuated cups are ap-plied to intact or scarified skin in order to draw blood toward or through the skin surface. It was used for disorders associated with an excess of blood, one of the four humors of medieval physiology.

A partial vacuum is created in the cup placed on the skin by either applying a heated cup to the skin allowed it to cool [Fire Cupping], or by applying a suction device [Suction Cupping] The name “cupping “is referred to using the cup as a tool for therapeutic purposes.

Cupping practitioner may use a cup made of glass, metal, or wood [notably bamboo] and burn alcohol, alcohol-soaked cotton, wool, herds. Paper, or a taper therein. Before or after the burning is complete. The practitioner applies the cup upside- down to a relatively flat body surface and leaves it in this position for five to ten minutes.

Cupping also has several forms, the above description relates to the fire cupping method, also called “Traditional Cupping” Other forms of cupping `include the air pumping method, in which the air inside the cups is pumped either manually or by means of a machine [a suction device] for creation of a vacuum.

2. Types of cupping

Three different cupping methods have been used. These methods include dry cupping, wet cupping, and massage cupping.

1. Dry Cupping

Dry Cupping is the application of a suction cup over an area of intact skin. The cups are applied to the skin with heat from a flame to make a vacuum in the cup or by any other method to create negative pressure. The idea is to draw underlying blood and fluid to the surface of the skin, away from the area of inflammation. The method relieved the congestion from the inflamed area but did not remove fluid from the body. No cut [incision] is made in dry cupping.
Dry cupping produces a low amount of pressure. The cups are better suited for use on the softer tissue so that a secure and tight seal is allowed against the skin. The skin may also be lubricated so that the cups can be moved around from one area to a larger area.

2. Wet Cupping

When cupping is combined with bloodletting this is called “Wet Cupping” In wet cupping, the skin is previously incised, with a special lancet at selected points or sites followed by applying cups over and could be removed. Wet Cupping is also called “Cupping & Letting Therapy” or “Bloodletting Cupping”.
Wet cupping produces a milder suction or vacuum and can also be kept in place for up to three minutes like dry cupping therapy. However, during a wet cupping therapy session, the cupping therapist will make small cuts on the patient’s skin, typically by using a sterilized scalpel and then perform a second cupping session to draw out some of the blood. It can take up to ten days for the patient’s skin to return to normal after a wet cupping therapy session. It is important that the skin is cleaned before and after a wet cupping therapy session so that any risk of infection can be avoided.
Wet cupping is a form of bloodletting and is used to remove stagnant blood, expel heat, and provide pain relief.


3. Massage Cupping.

in massage cupping, the cups are moved around and glide them across the skin, and it is recognized as a form of massage therapy. Massage Cupping has been used for weight loss and cellulite reduction. Silicone therapy cups are more typically used for this form of cupping therapy because these therapy cups are softer and more flexible which makes it easier for the practitioner to glide them across the patient’s body.
In massage cupping therapy, the muscles are tended to with the application of pressure. Negative pressure is better to help with pain management than tissue compression.  With the cupping therapy method, the skin, tissue, and muscles are instead pulled upwards to enhance circulation and provide pain management.
Massage cupping therapy also utilizes different oils so that the cup can glide easily across the back of the patient. Massage cupping is considered an alternative medicine to help with pain management and induces feelings of relaxation and stress relief to ease tension.


3.Other Names for Cupping

The many forms of practice and schools of thought from various cultures and individuals have given rise to the different terms of cupping by textual investigation, considerable clear recognition can be reached on the names, cupping instrument, cupping measure, indications and contradictions in different historical stages. Cupping was originally called “Horn Therapy” in ancient China, but variations of it have been used in Turkey, Greece, France, Italy, and Eastern Europe. There were also many other names for cupping Therapy such as “Horning”, “Needle Horn”, “Sucking Method”, “Fire-Cupping”, “Boiling Bamboo Cylinder”, cupping is also known as “The Therapy with Sucker”, “Suction Tube Treatment” or “Blood- Stasis Treatment.”
The Arabs called cupping treatment “Al- Hijama”, The Arabic word “Hijama” means “sucking”. It comes from the Arabic root “Al- hajm”, which means “sucking”, and is used for the action of draining the breast when an infant is sucking his mother’s breast, as in the Arabic phrase [حجم الصبي ثدي أمه].
‘Al-hajjaam” is the name given to the cupper, and “hijama” is the name given to the tool or the vessel in which blood is collected, or to the lancet used by the cupper.
In conclusion “hijama” refers to the extraction of blood from the body by means of cupping using a suitable vessel or whatever modern equipment serves the same purpose.

2.Virtues of Cupping

Result of cupping include erythema (reddening of the skin due to capillary expansion), edema (excessive fluid accumulation in tissue spaces), and ecchymoses (purple discoloration of the skin due to rupture of blood vessels).
Cupping is the best deep tissue massage available. It has been found to affect the body up to four inches the tissues. When the cup is left in place on the skin for a few minutes, it draws up the underlying tissues causing superficial local congestion and localized heating takes place through allowing tissues to release toxins, activate the lymphatic system, veins, arteries and capillaries.
The technique is said promote blood circulation, remove stasis, and alleviate swelling and pain. It is employed for a variety of acute ailments and is favored for treatment of arthralgia. It was widespread throughout the whole of Europe and Asia as well as china and also in the Islamic societies where cupping therapy was and still a socially acceptable practice used as a remedy and supported by religious beliefs.