Cupping Therapy: An Ancient and Universal Practice Extending From East to West
The flight to Koala Lampur landed at around 9:00 AM on a rainy Saturday morning in 1992. After a 30-hour flight that started in Miami and made stops in Chicago and Tokyo, I felt that buzzing in my ears that told me a bout of a bad case of jet-lag was about to follow.
This was the third time I had been to Asia and my body had not learned to deal with the twelve hour or so difference in time between Eastern Standard and the Far East. My previous two trips to the Orient were abysmal. Besides falling asleep in meetings, I was not able to sleep at night. My brain was just not in-sink with the time zone. In the morning I wanted to sleep; at night I wanted to jog around the block.
After trying everything from melatonin to sleeping pills, someone suggested acupuncture. So when I arrived at the hotel, I asked the bellhop for a good place nearby I could go where some Eastern magic could be performed that would get my circadian rhythm in sync with my location.
He recommended a place a short cab-ride away. At noon I was sitting in the reception room of a body tuning Asian-style salon, where everything from foot massages, acupuncture, body massages and yes – cupping was performed.
After navigating through the initially torturous but necessary "Manglish" versus American English communication, the very nice middle-aged gentleman in a white lab coat convinced me that acupuncture was good, but an additional jaunt into the world of cupping was infinitely better.
Let’s face it, he explained; the bad chemicals that had accumulated in my body after all the hours sitting in the pressurized cabin of an airplane needed to be excised; sucked out. The circulation needed to be stimulated; oxygenated blood needed to reach all the crucial organs, including the brain. I acquiesced.
Willing to put my life in the hands of a very nice ethnic Chinese Malaysian, I stripped off my garments, laid on the massage table and put my face through the opening that allows the patient to breath while facing down. The body maven went to work. The gentle, golden hands of a skillful practitioner with the inherited knowledge of more than 3,000 years of tradition in the art and science of finding the critical convergence points of nerve and muscle, stuck dozens of needles throughout my body.
Before I knew it, the needles were removed and a gentle voice said: “I finish the needles. Now, I put cups.” While I could not see what he was doing, I could feel warm objects touching my skin. Shortly after each item was adhered to me, I felt a warm surging feeling. From the corner of my eyes I could see one cup sucking onto my left deltoid and one on the right. Another two cups, one each on the left and right triceps. Another two just above each elbow.
At the end of the session, I had dozens of reddish, purple circles throughout the rear of my upper torso and my arms.
On the way back to the hotel, I slung my sweater over my shoulder so that my short sleeve polo shirt allowed me to proudly show off my purplish circles as a badge of honor. I had successfully – or so I thought – crossed the cultural divide.
That evening, I slept better than I had after previous transcontinental flights, but the jury was still out. Was it the acupuncture? The cupping? Or was it the UV rays that entered through my optical nerve, telling my brain to begin the process of moving my body clock forward?
Let's dig deeper into this subject.
We often hear the term 'traditional medicine' and perhaps do not realize it involves a lot more than herbal and mineral based therapies and remedies. Traditional medicine also delves in the realm of the spiritual, manual techniques, exercises and animal parts converted into medicine, all as a way to diagnose, prevent and treat illness.
Under the general category of traditional medicine (TM), exist traditional Chinese medicine (TCM); Ayurveda, an ancient form of holistic (whole-body) medicine originating in India; Kampo, a traditional Japanese system of medical therapies; traditional Korean medicine; and Unani or Unani-Tibb, an Arabian or Islamic medicine system.
All employ natural products with histories going back thousands of years. Today, they have all evolved into regulated systems that are used worldwide. While many of their treatments are considered controversial, they all represent an extensive archive of human knowledge and accomplishment.
Western Scientific Medicine (WSM) has a philosophy and tradition homologous to technocentricity, in which the body is viewed as a machine that can be fixed, adapted and improved upon. On the other hand traditional medical systems in addition to taking the human body into consideration, look at the environmental, philosophical and spiritual dimensions as they relate to health and healing.
TCM contemplates philosophical notions such as the yin and the yang, the Five Elements and the human body Meridian system. The Indian medical system Ayurveda, seeks to create a balance between body, mind, spirit, and social well-being but its place in the universe as well.
The Japanese medical system Kampo, as an offshoot of TCM adds the concept that the human body and the mind are inseparable and therefore a balance between the two are essential for health. As a compilation of Eastern philosophy, traditional Korean medicine, was developed through medical exchanges between China and Japan, therefore it is considered to be a mixture of its own treatments with those of the other two Asian countries. It looks at the yin and the yang, the Five Elements theory and the Meridian system but adds the holistic notion of healing found in Japanese Kampo.
Finally Unani-Tibb, is perhaps the more pragmatic of the traditional medicines. Originating from the teachings of Hippocrates and Galen it postulates that given the body has an uncanny ability to heal itself, treatments are designed to enhance self-healing through personal lifestyle in addition to judicious usage of therapeutic measure that include herbal medications, hand-on treatments and dietary changes.
Interestingly, cupping plays a prominent role in all the traditional medicines discussed above, with the exception of Japanese Kampo.
Manual Therapies and the History of Cupping
Among the therapies considered manual, some of the more popular are body massage, foot massage, acupuncture, acupressure and cupping.
Cupping Therapy has been around for thousands of years. It started as a way of drawing toxins from snakebites, boils, and skin lesions through the usage of hollow animal horns that could be sucked through to create a suction effect. Horns, slowly gave way to bamboo cups; later to copper cones; finally, today to glass as the material most commonly used.
While most people believe cupping to originate in China, there are records indicating Egyptians used the technique as far back as 1600 B.C. Translations of ancient Egyptian medical textbooks indicate it was used to relieve fever, vertigo, pain, menstrual discomfort, lack of appetite and for general healing.
The ancient Egyptians passed the art of cupping to ancient Greece, where both Hippocrates and Galen were devoted advocates and users. In 413 B.C., Herodotus, a famous Greek historian and physician, wrote:
” ...cupping possesses the power of evacuating offending matter from the head; of diminishing pain of the same part; of lessening inflammation; of restoring the appetite; of strengthening a weak stomach; of removing vertigo and a tendency to faint; of drawing deep-seated offending matter towards the surface; of drying up fluxions; checking hemorrhages; promoting menstrual evacuations; arresting the tendency to putrefaction in fevers; accelerating and moderating the crisis of diseases.. these, and many analogous maladies, are relieved by the judicious application of the Cucurbits (cups)..."
From ancient Greece, cupping was passed onto the Romans from whom the Alexandrians and Byzantines adopted the practice. The Muslim Arabs and Persians picked up the practice from there as it was approved and sanctioned by the Prophet Mohammed.
While it is unknown how China developed the art of cupping or from whom they received the knowledge, the earliest recorded usage came from the writings of herbalist Ge Hong sometime around 300 A.D. who wrote “Acupuncture and cupping, more than half of the ills cured.” In Chinese lore, cupping therapy is said to be able to warm the meridians and invigorate the small vessels, enhancing "Qi" movement and removing blood stasis, dissolving clots, reducing swelling, pain and getting rid of cold pathogens.
Today, practitioners of traditional Chinese medicine claim that cupping can treat a wide array of ailments; rheumatic pain; neck and shoulder pain; sports injuries; numbness of the limbs; abdominal pain; back pain; menstrual pain, and headaches. The faith and devotion that the Chinese have expressed for this ancient practice is such that government-sponsored traditional Chinese medicine hospitals all throughout the Middle Kingdom offer it to their patients.
Types of Cupping
There are two types of cupping: Dry or fire cupping and wet cupping.
Dry and Fire Cupping
Dry and fire cupping are the two most common ways of administering this therapy. In fire cupping a cotton ball soaked in alcohol is placed into the cup and quickly removed almost simultaneously as the cup is placed on the skin of the patient. The fire uses up all the oxygen in the cup, creating a vacuum. The negative pressure sucks up the skin and the cup will remain in place until it is removed. During this time, the blood of the patient rushes to the surface of the skin, leaving a purple-reddish mark after the cup is removed.
In dry cupping, a plastic cup with a suction device on top is used to pump air out and suck the skin upward into the device. Both methods yield the same result, which is to suck the skin into the cupping device and in the interim cause a capillary rupture just under the epidermis.
Wet cupping is basically bloodletting, as it involves puncturing the patient's skin before starting the procedure. The suction of the cup will bring blood in the cupping device. This method will leave round bruises on the patient's skin where the blood vessels burst.
Similar to the ancient practice of bloodletting in which blood and other bodily fluids were regarded as "humours" that needed to remain in a proper balance in order for good health to be attained. Claimed to have been the most common medical practice performed until the late 19th century, it is no longer used with the exception of some very specific medical purposes. Bloodletting was somewhat effective in the temporary relief of high blood pressure. Today, any sort of blood loss has dubious benefits.
While wet cupping continues to be a fairly common practice in all parts of the world, it is more frequently used in the many parts of the Muslim world.
Popularity of Cupping in China
Guangzhou, the older sister city of modern Shenzhen is perhaps one of the most traditional of all the first-tier cities in China. Its back alleys and old courtyard residences called hutongs in Chinese are legendary for their mom and pop stores, slow moving bicycle traffic and the occasional barber cutting a customer's hair out in the open air. A tropical climate placing November temperatures in the upper 70s, even lower 80s, Guangzhou in general and its hutongs in particular represent a pedestrian paradise.
When in the winter of 2011 I decided to escape Beijings subzero temperatures, this city of 13 million inhabitants was the solution to my desires. And the overnight high speed train number D923 to Tiange Station was my choice of travel to this wonderful old Canton (now Guangdong) city. After a few hours of sleep in a spacious but relatively inexpensive seat and upon its arrival at 6:45 AM, I caught a cab to a small - somewhat smelly - hotel in the Lingjing Hutong.
A couple of hours nap, a quick shower and a hunt for some sweet and sour pork, followed by Shuāng pí nǎi (double skin milk dessert) put me in the center of this maze-like back alley. After walking for approximately 15 minutes I came across two Chinese men sitting on chairs on the tiled street of the hutong.
Figuring I would use them and the location they inhabited as a landmark as to avoid getting lost in those labyrinthine alleys, I turned the corner. I immediately came across a balding middle age man sitting shirtless on an upside-down plastic bucket, bending over and receiving a cupping treatment from a young 30-something year old woman with a long ponytail.
Cupping is so popular in China, that in some cities it is not uncommon to see people doing it in the street. From a hygienic perspective, it might not be such a great idea, however. Certainly, wet cupping, which is the drawing of blood by sucking it out through the skin via a small puncture wound in addition to the suction of the cups, calls for extremely clean and disinfected tools as well as a more hermetically closed environment absent of street dirt and pollution.
Popularity of Cupping in the U.S.
While there are no reliable numbers available, it is not hard to estimate that hundreds of millions of people receive cupping therapy on a world wide scale every year.
The popularity of cupping has spread throughout Western countries. In the United States Hollywood stars such as Jennifer Aniston, and swimming gold medalist Michael Phelps have received cupping treatments. In addition to Phelps, swimmer Natalie Coughlin, gymnast Alex Naddour and other olympians have been known to sport the reddish-purple circles that give away their cupping practice.
In Hollywood, where certain out-of-the-norm practices become en vogue, the list of actors who have embraced cupping seems to be growing. Besides Aniston who reportedly had cupping therapy as a way to boost her fertility, other well known stars such as Freida Pinto, Lady Gaga, Justin Bieber, Victoria Beckham and many more have jumped on this ancient practice's bandwagon.
Today, almost every city, big or small in the U.S. and Canada has practitioners of acupuncture and massage therapy that have added cupping to their repertoire of treatments they offer.
Efficacy of Cupping
While cupping therapy has been used for thousands of years, modern science has not been able to confirm all the benefits claimed by its practitioners. Some studies have shown that combined with other treatments such as acupuncture and medication, cupping can be mildly beneficial for certain pain conditions, herpes zoster, some types of cough, dyspnea (difficult and painful breathing), cervical spondylosis (wear and tear of spinal disks), some types of facial paralysis and acne.
Cupping practitioners claim the therapy works by creating hyperemia (increasing blood flow) or hemostasis (decreasing blood flow) around the patient's skin. For the most part, however, cupping just seems to have a placebo effect.
In the case of world-class athletes it is possible cupping acts as a deep tissue message, and could aid in recuperation after extreme workouts, rehabilitation after injury or as a way of reducing pain. Other more extreme claims made by cupping therapists and enthusiast, can only be described as...quackery.