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Al-Hijamah Cupping Therapy
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Al-Hijamah Cupping Therapy
*Yesar MH AL- Shamma, MBChB, PhD(UK)
**Ali Abdil Razzaq,B.Sc.PH,MSC
*Department of Physiology, College of Medicine, University of Kufa
**Department of Basic science, College of Dentistry, University of Kufa
:‫اﻟﺨـﻼﺻـﺔ‬
.‫اﺳﺘﺨﺪﻣﺖ اﻟﺤﺠﺎﻣﺔ ﻗﺒﻞ آﻻف اﻟﺴﻨ ﻦ ﻟﻌﻼج ﺑﻌﺾ اﻹﻣﺮاض وﻟﺘﺨﻔ ﻒ ﺑﻌﺾ اﻵﻻم ﻓﻲ ﺟﺴﻢ اﻹﻧﺴﺎن‬
‫وﺗﻌ ﻮد طﺮ ﻘ ﺔ اﻟﺤﺠﺎﻣ ﺔ ﺣﺴ ﺐ اﻟﺘﺼ ﻨ ﻒ اﻟﻄﺒ ﻲ إﻟ ﻰ طﺮ ﻘ ﺔ اﻟ ﻮﺧﺰ اﻟﻤﺒﺎﺷ ﺮ واﻟ ﺬي ﻌﺘﻤ ﺪ ﻋﻠ ﻰ ﺣﺮﻛ ﺔ اﻟ ﺪم واﻟﻄﺎﻗ ﺔ‬
.‫واﻟﺴﻮاﺋﻞ ﻓﻲ اﻟﺪورة اﻟﺪﻣﻮ ﺔ ﻟﻺﻧﺴﺎن‬
‫ ﻮ رﻛ ﻮد اﻟ ﺪم واﻟﻄﺎﻗ ﺔ و اﻟﺴ ﻮاﺋﻞ اﻟﻠﻤﻔﺎو ﺔ داﺧ ﻞ ﺑﻌ ﺾ‬ª ‫وﻗ ﺪ أﻗ ﺮ اﻟﻄ ﺐ اﻟﺸ ﺮﻗﻲ ﻣﻨ ﺬ زﻣ ﻦ ﺑﻌ ﺪ إن ﺳ ﺒﺐ اﻵﻻم‬
‫اﻟﻤﻨﻌﻄﻔ ﺎت واﻷﺟ ﺰة ﻓ ﻲ ﺟﺴ ﻢ اﻹﻧﺴ ﺎن واﻟ ﺬي ﺆدي ﺑ ﺪوره إﻟ ﻰ ﻧﺘ ﺎﺋﺞ رد ﺌ ﺔ ﺗﺴ ﺒﺐ اﻷذى اﻟﻜﺒ ﺮ واﻹﺟ ﺎد ﻟ ﺪى‬
.‫اﻹﻧﺴﺎن‬
‫ ﺬا‬ª ‫وﻗ ﺪ اﻋﺘﻘ ﺪ اﻟﻌﻠﻤ ﺎء أن اﻟﺤﺠﺎﻣ ﺔ ﺗﺤﻔ ﺰ اﻧﺴ ﺎب اﻟ ﺪم واﻟﺴ ﻮاﺋﻞ اﻟﻠﻤﻔﺎو ﺔ واﻟﻄﺎﻗ ﺔ إﻟ ﻰ اﻟﻤﻨﻄﻘ ﺔ اﻟﻤﺼ ﺎﺑﺔ وﻋﻠ ﻰ‬
‫اﻷﺳ ﺎس ﻓ ﺎن اﻟﺤﺠﺎﻣ ﺔ ﺗﺰ ﻞ اﻷﻟ ﻢ ﻓ ﻲ اﻟﻌﻀ ﻼت وﺑ ﺎﻷﺧﺺ ﻓ ﻲ ﻣﻨﻄﻘ ﺔ اﻟﻈ ﺮ وذﻟ ﻚ ﺑﺈزاﻟ ﺔ اﻟﺘﺨﺸ ﺐ واﻟﺘﻘﻠﺼ ﺎت‬
‫ﻛﺬﻟﻚ ﺮى اﻟﺒﺎﺣﺜﻮن أن اﻟﺤﺠﺎﻣﺔ ﺗﺰ ﻞ اﻻﺣﺘﻘﺎن ﻓ ﻲ ﻣﻨﻄﻘ ﺔ اﻟﺼ ﺪر‬، ‫واﻟﺘﺸﻨﺠﺎت اﻟﻌﻀﻠ ﺔ واﻟﺘﻲ ﺗﻜﻮن ﺳﺒﺒﺎ ﻟ ﺬه اﻵﻻم‬
.‫واﻟﺬي ﺼﺎﺣﺐ أﻣﺮاض اﻟﺒﺮد واﻷﻧﻔﻠﻮﻧﺰا‬
‫ﺬه اﻟﺪراﺳﺔ ﺗﺄﺛ ﺮ اﻟﺤﺠﺎﻣﺔ ﻋﻠ ﻰ ﺿ ﻐﻂ اﻟ ﺪم وﺿ ﺮﺑﺎت اﻟﻘﻠ ﺐ وﻧﺴ ﺒﺔ اﻟ ﻤﻮﻛﻠ ﻮﺑ ﻦ وﻋ ﺪد ﻛﺮ ﺎت اﻟ ﺪم اﻟﺒ ﻀ ﺎء‬ª ‫ﺗﺒ ﻦ‬
‫وﻋﺪد اﻷﻗﺮاص اﻟﺪﻣﻮ ﺔ وﻧﺴﺒﺔ اﻟﻨ ﻮﺗﺮوﻓ ﻞ واﻷز ﻨﻮﻓ ﻞ واﻟﻤﻮﻧﻮﺳ ﺎ ﺖ واﻟﻠﻤﻔﻮﺳ ﺎ ﺖ ﻗﺒ ﻞ وﺑﻌ ﺪ إﺟ ﺮاء اﻟﺤﺠﺎﻣ ﺔ وﻗ ﺪ‬
‫ﻨ ﺎك اﻧﺨﻔﺎﺿ ﺎ ﻣﻌﻨﻮ ﺎ ﻓ ﻲ ﻣﻌ ﺪل ﺿ ﻐﻂ اﻟ ﺪم وﻋ ﺪد ﻛﺮ ﺎت اﻟ ﺪم اﻟﺒ ﻀ ﺎء وﻧﺴ ﺒﺔ اﻟﻨ ﻮﺗﺮوﻓ ﻞ‬ª ‫أظ ﺮت اﻟﻨﺘ ﺎﺋﺞ أن‬
‫واﻟﻤﻮﻧﻮﺳﺎ ﺖ ﺑ ﻨﻤﺎ أظ ﺮت اﻟﻨﺘﺎﺋﺞ ارﺗﻔﺎﻋﺎ ﻣﻌﻨﻮ ﺎ ﻓﻲ ﻧﺴﺒﺔ اﻟ ﻤﻮﻛﻠﻮﺑ ﻦ وﻋﺪد اﻷﻗﺮاص اﻟﺪﻣﻮ ﺔ و ﻧﺴﺒﺔ اﻟﻠﻤﻔﻮﺳﺎ ﺖ‬
. ‫وﻟﻢ ﺤﺼﻞ أي ﺗﻐ ﺮ ﻣﻌﻨﻮي ﻓﻲ ﺿﺮﺑﺎت اﻟﻘﻠﺐ وﻧﺴﺒﺔ اﻻز ﻨﻮﻓ ﻞ‬
Abstract:
Cupping therapy has been practiced for thousands of years ago for the treatment of
some disease and pain. It is a form of acupuncture that focuses on the movement of
blood, energy - called Qi - and body fluids, such as lymph - which circulates around the
body's tissues. Oriental medicine states that pain is due to stagnation of these systems.
This stagnation can be a result of injury or stress. Cupping is believed to stimulate flow
of blood, lymph and Qi to the affected area. Its uses include relieving pain in the
muscles, especially back pain from stiffness or injury, and clearing congestion in the
chest, which can occur with colds and flu. This study was carried out to investigate the
effect of Al-Hijamah on mean blood pressure(MBP), heart rate(HR) and blood
parameters like hemoglubin(Hb) %, platelets count, white blood cell(WBC) count,
Neutophils%(N),
Eosinophils(E)%,
Basophils(B)%,
Monocytes(M)%,
and
Lymphocytes(L)% before and after the performance of Al-Hijamah. The result indicate
that there are significant decrease in MBP, WBC count, N% and M%. However there
are significant increase in Hb%, platelets counts and L% but HR and E% were showed
no significant changes.Key words: Al-Hijamah, Cupping Therapy, Acupuncture.
Introduction:
Allah the Most High stated in surah An-Najm:And he does not speak of his own desire.
It is but an inspiration inspired. Taught to him by the firm and powerful (1)and in surah
Al-Hashr, The Almighty says;And whatsoever the messenger brings forth to you, and
then accept it, and whatever he keeps from you, then abstain from it! And Fear Allah, he
is firm in judgment (2)From the above translation of the verses, the idea has established
that anything attributed to the Prophet Mohammed (peace and blessings be upon him)
(P&B) which is known to be correct, it must be accepted that it as part of Islam and the
Sunnah. The Prophet said “There is not a single disease for which there is not a
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
cure”, and it's known that there is no cure for death. One of the many remedies the
Blessed Prophet informed us about was that of Al-Hijamah or Cupping Therapy as it
known in the west. There are numerous ahadith concerning Al-Hijamah. However,
what is accepted unanimously is that Al-Hijamah was practiced by the Prophet
Mohammed (P&B) and he encouraged others to do so. It is also documented that he
paid the cupper his wages(3).Cupping Therapy is an ancient therapy used all over the
world, but it's only a recent phenomenon in the Western part of the world. It is a process
of removing toxins that naturally build up in people's bodies over time(4).
Prophet Mohammed (P&B) said: "the best therapy is Al-Hijamah; it removes blood,
cures the solid and clears vision". And he said (P&B): "the best slave is the cupper; he
removes blood, makes the solid dry and clears vision". Removes blood that is it
removes spoiled blood that Prophet Mohammed (P&B) described as: "any body who
bleeds off this blood would not suffer if not treated with any thing for any thing". And
his words - (P&B) :" don't let blood be so excited to kill you". All above means that
extracting this spoiled blood from the body decreases tendency for disease and
strengthens immunity and comes as a first aid for the cases of excited blood as in
sudden rise of blood pressure, anger, intense allergic reactions, diabetic coma and acute
renal failure. The lab studies on a sample of blood extruded by wet cupping (AlHijamah) proved that it is rich in aged RBCs with an impaired oxygen carriage capacity
and easy staggering in the minute circulation of the skin and vital organs as well leading
to vascular disorders; acute and chronic ischemia of the old patients. This blood also
proved to be rich in blood urea nitrogen(BUN) which is one of the kidney toxins
extraction of which resembles a dialysis(5). Cupping therapy cures and dries the solidskeleton-: It is one of the benefits of Al-Hijamah that Mohammed (P&B) mentioned.
The solid here may be the skeleton, so it heals bone disease. Mohammed (P&B) had
cupping on the dorsum of the foot to treat an ankle sprain that happened to him while
starting a ride on his horse. The solid may be the vertebrae; one of the most common
cause of complaints. For Arab people language it is the sacrum; an important bone for
the bed - ridden people, prescaral edema develops and wet cupping relieves it
effectively(14).Sacrum may be prone to repetitive trauma from riding to become
painful, cupping over the sacrum in traditional Chinese medicine(TCM) and German
alternative medicine is very important in the treatment of: hypertension (a main point),
prostate disease, perianal complaints, cystitis, and this is most probably the explanation
of Mohammed (P&B)words:" it cures and dries the solid".Wet cupping therapy
increases the visual acuity: regarding his words (P&B) it "clears vision", any one could
see how it is true. Wet cupping over the external jugular vein stimulates the cerebral
circulation and comes over the optic cortex to stimulate it also. Site around the eye are
very beneficial. Every patient after Al-Hijamah tells that vision got sharp and
clear(5).Al-Hijamah also used for treatment of senile habitual constipation (6).
Cupping therapy or Al-Hijamah used as an alternative treatment for eczema. The
therapy can help clear your skin of pathogens being the same ones that trigger an
eczema flare-up. Cupping therapy also improves blood circulation and enhances its
purification(7).Conditions Which Can Benefit From CuppingConditions which can
benefit from cupping include headache, back pain, joint and muscular pain, infertility,
sexual disorders, rheumatic diseases, hypertension, breast enhancement, bed wetting,
common colds and flu, insomnia, stroke, fever, constipation and diarrhea, chest pain,
asthma and blood disorders (8).
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Types of Cupping ;
There are various types of cupping such as:Light Cupping: Use a weak suction in cup
to do light cupping; it is suitable for children and elderly people.Medium Cupping: A
medium strength, general purpose cupping.Strong Cupping: Suction will be great and
therefore it is not suitable for children and elderly people.Moving Cupping or Massage
Cupping: is a great method of massage and will be done by applying oil to the skin and
moving the cup, by a weak suction, on the area to be treated.Needle Cupping: By doing
acupuncture and cupping in the same place by applying the needle first then the cup is
applied over it Hot Cupping: Dried Mugwort (Artemisia vulgaris) leaves, sometimes
called by its oriental name Moxa is a great warming herb. They have used a needle,
warmed by Dried Mugwort, and then the cup is applied over it.Flash Cupping: is the
name given when several medium cupping are preformed several times in quick
succession along the area being treated to stimulate it.Bleeding Cupping, also called
Full Cupping or Wet Cupping, it is the most frequently used, oldest and often most
effective method. A surgical instrument is use to scrape the skin and the cup is then
applied to collect blood.Herbal Cupping: By putting a suitable herbal tincture into the
cup then applying suction.Water Cupping: is the least practiced method. It involves
filling a third of the cup with warm water. Whilst holding the cup close to the client
with one hand, bring it close to the point to be cupped and insert burning cotton wool
into the cup, then swiftly and simultaneously turn the cup onto the skin. When
performed properly, no water spillage occurs(9).After the Cupping Treatment After
your cupping treatment you may notice some red marks in the form of circles on your
skin. This is a sign that the cupping technique has worked to increase your circulation.
You will also feel deeply relaxed and the areas that have been treated will feel flexible
and light(10).
Methods and materials:
Al-Hijamah was done on 15 persons by the following steps:At first the MBP and HR
was measured for each person by Beurer (German company) which is un instrument for
measurement of MBP and HR.Then, 5ml of venous blood has been taken from each
one.
Each one subjected to cupping process by place a special cup that has a valve on its
back that connect by screw with vacuum pump to make a negative pressure inside a cup
which placed on skin of back's person then wait 5-10 min to become skin inside the cup
unsensitized.After that the cup was removed and many incisions was made on the
unsensitized skin by sterilized scalpel so when blood rush out, the cup was replaced
again and made a negative pressure by manual vacuum pump and leave the cup to
collect blood and when rushing of blood stopping, the cup was removed and this take a
period approximate by10-15 minutes.(11)A necessary dressing for wounds was made
for each person.Another time, MBP and HR was measured
Then, 5ml of venous blood was taken to measure Hb, WBC, Platelets, N%, E%, B%,
M%, and L%.The MBP calculated by the equation:Diastolic pressure + 1/3(Systolic
pressure – Diastolic pressure (12)For statistical analysis, data are given as mean ±
S.E.M values. The results of changes in the all parameters were analyzed by using
Paired Sample T-test with significant level at 0.05.
Results:
Table(1) and figures 1,2,3,4,5 and 6 show the changes of MBP,HR, Hb%, WBC
count, Platelets count, N%, E%, B%, M% and L% 10 min before and 10 min after the
performance of Al-Hijamah.
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Table(1):The effect of Al-Hijamah on mean blood pressure, heart rate, Hb%,
WBC count, Platelets count, N%, E%, B%, M% and L%.
Parameter
N
15
15
15
15
15
AlHijama
h
(before)
96.4933
75.3333
11.3533
6913.333
252.4000
Mean BP
Heart Rate
Hb%
WBC count
Platelets
count
N%
E%
M%
L%
15
15
15
15
53.9333
4.1333
9.6667
32.6000
Std. Error
Mean
1.9296
2.3898
0.2303
374.403
12.3195
AlHijama
h
(after)
91.2600
75.6667
11.8600
6140.000
286.4000
Std. Error
Mean
2.0606
2.4293
0.2340
365.122
13.8968
Sig.
(2-tailed)
P < 0.05
0.009
0.885NS
0.000
0.001
0.000
1.1931
0.3634
0.7216
0.9040
45.4000
4.2000
8.5333
34.2667
3.9204
0.3677
0.5925
1.0164
0.024
0.860NS
0.006
0.034
The results indicate that MBP was significantly decreased from 96.4933 to 91.2600
P<0.05)
fig(1) while the heart rate shows no significant changes between the two measurements
fig(2).
Blood pressure
MBP mm/Hg
98
96
before
94
after
92
90
88
Mean BP
Fig (1)
Fig(1) shows the significant changes in MBP before and after Al-Hijamah
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Heart Rate
75.7
HR beat/min
75.6
75.5
before
75.4
after
75.3
75.2
75.1
Heart Rate
Fig (2)
Fig(2) shows there's no significant changes in HR before and after Al-Hijamah
The Hb% shows a significantly increase from 11.3533 to 11.8600 (P<0.05) fig (3)
and the same occur for Platelets count was significantly increased from 252.4000 to
286.4000 (P<0.05) fig (4).
Heamoglubin count
Hb count %
12
11.8
before
11.6
after
11.4
11.2
11
Hb
Fig (3)
Fig(3) shows the significant changes in Hb% before and after Al-Hijamah
Fig (4)
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Platelets Count
Platletets Count
290
280
270
before
260
after
250
240
230
Platelets
Fig(4) shows the significant changes in Platelets count before and after Al-Hijamah
while the WBC count was significantly decreased from 6913.333 to 365.122
(P<0.05) fig (5).
White Blood Cell Count
7000
WBC count
6800
6600
before
6400
after
6200
6000
5800
5600
WBC
Fig(5) shows the significant changes in WBC count before and after Al-Hijamah
The N% and M% were significantly decreased from 53.9333 to 45.4000 (P<0.05)
and from 9.6667 to 8.5333(P<0.05) respectively fig(6). While L% was significantly
increased from 32.6000 to 34.2667 (P<0.05) but still E% was no significantly
changed fig(6).
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Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Neutrophils,Eosinophils,Monocytes & Lymphocytes
N%, E%, M% & L%
60
50
40
before
30
after
20
10
0
N%
E%
M%
L%
Fig(5) shows the significant changes in N%, M% and L% before and after AlHijamah, but E% shows no significant changes.
Discussion: The result of this study indicate that there was a significant decrease in
blood pressure after Al-Hijamah which is most likely due to a decrease in blood volume
according to the following equation:Mean blood pressure (MBP) = cardiac output
(CO) × peripheral vascular resistance (PVR) (13)Since PVR is maintained by a decrease
in blood flow (CO) and MBP, so that the advantage of Al-Hijamah is to lower blood
pressure which may have a great benefit in management of hypertension(13).The heart
rate shows no significant changes in response to Al-Hijamah due to maintenance of
inhibitory responses of barro-receptor by the effect of lowered blood pressure(14).Hb%
significantly increase due to the fact that Al-Hijamah can get rid of access volume of
plasma and to get rid of aged RBCs with
impaired O2 carriage capacity (5).Platelets count significantly increase due to bleeding
caused by Al-Hijamah which is most likely a part of homeostasis process.
WBC count, N% and M% significantly lowered and L% significantly increased with no
significant changes for E%. All these changes in blood parameters most likely due to
various mechanism caused by bleeding of Al-Hijamah.
References:
1-Quraan Kareem surat al-Najm(53):3-5 .
2- Quraan Kareem surat al-Hashr(59):7
3-www.Islam.com
4- http://www.ehow.com/how_2107619_use-cupping-therapy-enhance-breathing.html.
5-http://www.quransite.com/vb/archive/index.php/t-3905.
6- Jiang ZY, Li CD, Li JC, Gao L, Wang QF Affiliated Hospital of Chengdu University
of TCM, Sichuan 610072, China. zhenya@163.com.
7- http://www.spiritualosophy.com/articles.
8- Cupping: From a biomechanical perspective by L.M. Thama, H.P. Leea,b,_, C. Lua
(Journal of Biomechanics) June 2005 (http://www.elsevier.com/locate/jbiomech.
9- Journal of Biomechanics (2005), researchers L. M. Thama, H. P. Leea, and C.
10- Cupping by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional
Medicine, Portland, Oregon (http://www.itmonline.org/arts/cupping.htm) Ancient
55
Kufa Med.Journal 2009.VOL.12.No1. ___________________________
Chinese Technique of Cupping Offers Pain Relief Without Drugs or Surgery.
11http://ezinearticles.com/?The-Benefits-of-Cupping-Therapy-forFibromyalgia&id=494751.
12- Rushmer RF,1976(cardiovascular dynamics 4th edition, pp176-186).
13- Guton Physiology textbook,2006.
14-Yong-Suk Kim1, Hyungjoon Jun1, Younbyoung Chae2, Hi-Joon Park3, Bong Hyun
Kim4,Il-Moo Chang4, Sung-keel Kang5 and Hye-Jung Lee2.The Practice of Korean
Medicine: An Overview of Clinical Trialsin Acupuncture, Advance Access Publication
3 August 2005.
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