El Sayed SM, Mahmoud HS and Nabo MMH
Cupping therapy is a simple, effective and economic treatment. Cupping therapy is a formal treatment in Chinese hospitals and in some European countries. Here, we review history of wet cupping therapy and its two distinct methodologies. First method is puncturing and cupping (PC) method that includes five steps: skin demarcation, sterilization, puncturing, cupping and sterilization. Second method is cupping, puncturing and cupping (CPC) method that includes six steps: skin demarcation, sterilization, first cupping, puncturing, second cupping and sterilization. CPC method predominates in the Arabic world, while PC method has a worldwide distribution. We report here that our detailed evidence-based analysis of both methods reveals many novel advantages in the CPC method over the PC method. CPC method has a better analgesic effect and benefits more from the viscoelastic nature of the skin. During the first cupping step in the CPC method (not present in the PC method), a fluid mixture containing causative pathological substances (CPS) is collected inside skin uplifting due to the effect of negative pressure of sucking cups. CPS differs from disease to disease according to disease etiology and pathogenesis. That fluid mixture contains collected interstitial fluids with CPS, filtered fluids (from blood capillaries) with CPS, hemolyzed blood cells (hemolysed RBCs, WBCs and platelets). That fluid mixture does not contain intact blood cells as their sizes are much bigger than sizes of pores of skin capillaries and cannot be filtered. The fluid mixture is totally excreted in next steps. We review here that wet cupping therapy is a highly recommended treatment in prophetic medicine, medicine related to Prophet Mohammad peace be upon him who said: “The best among what you use in therapy is Al-hijamah (CPC method of wet cupping therapy)”. In conclusion, CPC method is better than PC method in clearing blood and interstitial spaces from CPS. Standardization of methodologies of cupping therapy seems essential to gain optimal therapeutic outcomes.
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