Cupping is an ancient practice that goes back at least 18 centuries. The first record of cupping in China is from the book A Handbook of Prescriptions for Emergencies, by Ge Hong, a noted Taoist herbalist and alchemist who lived in the 3rd and 4th centuries C.E. Ge Hong described the use of animal horns for draining pustules. Later, in the Tang Dynasty, a book called Necessities of a Frontier Official prescribed cupping for pulmonary tuberculosis or related disorders.
Cupping is however found in many other parts of the world. Hippocrates wrote of its efficacy for treating menstrual problems, and advised on the best shape and size of cups. It is believed that the Greeks learned of cupping from Egypt, where there are pictograms and descriptions of cupping used to treat fever, pain, menstrual problems and vertigo. Cupping is also known in Arabia, Africa and was practiced by some of the tribes of North America. Many experts believe that cupping originated in China, and spread through India to Europe and Africa, though it is possible that the practice originated simultaneously in multiple regions.
During the Qing Dynasty, the first record is found of pottery or bamboo cups being used in China, instead of animal horns. Zhao Xuemin wrote Supplement to Outline of Materia Medica, which includes a chapter on what the author calls fire jar qi or huoquan qi. This chapter describes the use of bamboo or pottery cups in treating wind-cold type headaches, wind-caused bi syndrome, dizziness and pain in the abdomen. He notes that for greater effect, the cups can be placed over acupuncture needles during treatment.
Variations in cupping technique developed over time. This includes shuiguanfa or liquid cupping, such as when bamboo cups were boiled in an herbal tea before being applied; luoci or vein pricking, letting a small amount of blood before applying the cup to promote circulations and get rid of stasis; and gliding cupping, were the cup is moved over the surface of the skin while the suction is still active.
Cupping continued to be used around the world until modern times. In Europe and America doctors used cupping to treat colds and chest infections. In Islamic societies, cupping is known as hijamah. Russia and China worked together for a time to confirm the clinical efficacy of cupping. In China, cupping eventually developed a new use: to divert blood from the site of surgery and reduce bleeding at the incision.
Early in the 20th century, glass drinking cups replaces pottery or bamboo. Bamboo cups deteriorated over time and with repeated heating, and pottery cups tended to break extremely easily. Eventually glass devices were developed specifically for cupping. In addition to being sturdy and easy to make, glass cups made it possible for practitioners to see the skin under the cup. This made it easier to judge the response of the skin.
The glass cups were heated with fire using one of two techniques. Shanhuofa or flash fire cupping, involved lighting an alcohol soaked cotton ball inside the cup. It burned quickly, heating the air inside the cup and creating suction as the sup was placed on the skin. Dijiufa or alcohol fire cupping used a small amount of alcohol inside the cup. The alcohol was lit and burnt off, then the cup was placed on the skin.
Both these and traditional techniques relied on heat to create a vacuum. For this reason traditional uses of cupping emphasize it's effectiveness against cold. The next development changed this.
In the late 20th century, a method of cupping was developed which creating suction mechanically. Cupping jars were made with valves in the top. The practitioner attached a hand pump to the valves and pumped the air out to create a vacuum.
This method, called baguanfa or suction cup therapy has a number of advantages and some disadvantages. The major advantages are the greater control over the amount of suction and the hazards involve with using fire are avoided. However without the use of fire to provide heat, the method of cupping is not effective for treating cold conditions. Also, plastic cups are sometimes used in place of glass, and the plastic does not slide over the skin, making gliding cupping unworkable.
Cupping has evolved a great deal in its nearly two millenia. As western medical science continues to investigate this ancient treatment, it is likely that we see it continue to evolve in new directions.
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