Cupping in the Middle East and the Muslim World (Hijama)

It was a rare occasion when I came across detailed and systematic information regarding cupping therapy outside TCM practice. ‘Hijama’, as it is known in the Arabic world – which also translates ‘to restore to basic size’ or ‘to diminish in volume’ – has been quite extensively practiced by the Arab nations throughout history. The Prophet Mohammed (peace be upon him, pbuh) is reported to have been a fervent user and advocate of cupping therapy (Hijama). In the book, Healing with the Medicine of the Prophet, Written by Imam Ibn Al-Qayyim, an eminent scholar of Hadith (sayings of the Prophet Mohammed-pbuh) who lived in Damascus (1292-1350), and cupping therapy is prescribed for many illnesses. It was reported that the Prophet said:

Cupping and puncturing the veins are your best remedies. This Hadith is directed at people of Hijaz and warm areas in general, for their blood is delicate and circulates closer to the surface of the skin, while the pores on their skin are wide and their strength weakened (i.e. during summer).Puncturing of each of the veins a special benefit. For instance, puncturing the basilica vein ‘the large vein running on the inner side of the upper arm) is useful against the eat of the liver and spleen and various blood-related tumours in these two organs. It is also useful for tumors the lungs, arterial pulsation, pleurisy and all blood related diseases of vein in the lower part of the knee to the hip. Further puncturing of the median vein helps against the various swellings that appear throughout the entire body, especially when the swelling is blood-related, and contains spoiled blood in general, hi addition, puncturing of the arm’s vein helps against the ailments in the head and neck that result from excessive amounts of blood or from septic blood. Puncturing of the jugular vein helps against the ailments of the spleen, asthma, thoracic cavity and forehead pain. Cupping the upper section of the back helps against the aches of the shoulder and the throat. Further, cupping the two jugular veins helps against the ailments of the head, face, teeth, ears, eyes, nose and throat, if these ailments were caused by excessive presence of blood, soiled blood or both. The Messenger of Allah used to apply cupping on the two jugular veins and the upper part of the back.

Abu Dawud Healing with the Medicine of the Prophet:

It was not only cupping therapy in general that was advised, but also the benefits of such therapy and the locations of cups to be applied, depending on the condition of the patient as well as the correct timing of such therapy according to the lunar date. The author of Al-Qanun, Ibn-Sina, said: ‘Cupping is not preferred in the beginning of the month, because the body’s various conditions will not be agitated then, nor is it preferred in the end of the month, because by then the conditions would have decreased. Cupping is preferred in the middle of the month when the substances [of the constitution or condition J accumulate and become agitated.' In different Hadith: 'The messenger of Allah used to have cupping on the jugular veins and upper part of the back on the seventeenth, nineteenth or twenty first day of the month', the most beneficial time of the day being 2-3 hours after taking a bath. Dietary recommendations were also given, including fasting a day before the cupping, total avoidance of milk and milk products during the days of cupping, and plenty of green, leafy vegetables and tomatoes during and after the treatment. Advice was also given to the practitioner: 'Refrain from cupping treatment on full stomach.' In separate Hadith: 'There is a cure provided in three substances - a drink of honey, a cut with a knife for cupping and cauterizing by fire. I forbid my Ummah [Muslim Nation] from cauterizing by fire.’Although cupping therapy was regarded as ‘very effective’, it was also considered ‘quite dangerous’ in unskilled hands. Diseases were also categorized as Hot, Cold, Wet and Dry types. While warm honey was given to cold conditions, cupping therapy was administered for hot (febrile) conditions. It goes on to say: ‘The heat of the fever is a breath of the Hell fire; cool it with water.’ Here, we can clearly see some similarities with TCM where excessive heat is considered a ‘pathogenic factor’ which has to be cooled or removed from the body.

In a more recent study reported by the Arabic News (18 August 2001), a Syrian medical team headed by Dr. Ahmad Takreiti (heart surgeon) conducted a series of studies and lectures to fellow doctors on the benefits of cupping therapy. The study was conducted on 300 patients of both sexes. When cupping was applied to the upper back, between the scapulas, for 3 minutes, positive therapeutic results were reported in the treatment of hemophilia, lymphoma, migraine, Hypercholesterolemia, gout, paralysis, asthma, rheumatism and certain chest complaints.

The Hijama Cupping Symposium was reported in the Syria Times (17 June 2003) where cupping was described as the ‘most popular medical method practiced by the majority of people in Syria. The Minister of Health, Dr. Mohammad Iyad Al-Shatti, and the Chairman of the Physicians Union in Syria, Dr R. Ramadan, attending the symposium, drew particular attention to the false expectations and assumption that cupping is a “cure for all’ and in particular to the safety and hygiene issues regarding cupping therapy among lay persons in the country. Also pointed out were the dangers to public health when cupping is not practiced in a clinical environment (published by Teshreen Press and Publishing Foundation, 2003).

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