Cupping / Blood letting

In Malay this practice is known as ‘BEKAM’ and in Arabic it is called ‘AL-HIJAAMAH’ while in China ‘GUA-SHA’. Ancient Egyptians used cupping as far back as 1550 B.C. Archaeologists have found evidence in China of cupping dating back to 1000 B.C. In ancient Greece, Hippocrates (c. 400 B.C.) used cupping for internal disease and structural problems. While the history of wet cupping (Hijaamah) may date back thousands of years, the first documented uses are found in the teachings of Nabi Muhammad (Sallallahu Alayhi wa Sallam).

The  Talmud recommended a specific day of the week and days of the month for bloodletting, it was central to Arabic surgery (found in Kitab al-Qanun) and was also known in Ayurvedic medicine, described in the Susruta Samhita.

Leeches became especially popular in the early nineteenth century. In the 1830s, the French imported about forty million leeches a year for medical purposes, and in the next decade, England imported six million leeches a year from France alone. Through the early decades of the century, hundreds of millions of leeches were used by physicians throughout Europe.

“Hijaamah” comes from the root “al hajm”, which means “sucking” Al hajjaam is the name given to the cupper, and hijaamah is the name given to this profession. Al mihjam is the name given to the tool in which blood is collected, or to the knife used by the cupper. Cupping is a therapeutic process of removing this unclean blood from the body. It is a form of medical treatment which has been recommended by Islam.

Cupping is a method of treatment in which a jar is attached to the skin surface to cause local congestion through the negative pressure created. For wet cupping, incisions are made to allow the congested blood to ooze out. No incisions are made for dry cupping. This type of treatment has been practised by the Chinese and the Arabs for thousand of years.

Ibn ‘Abbaas (radhiyallahu anhu) reported that Rasooulllah (Sallallahu alayhi wa sallam) said: “Healing is to be found in three things: drinking honey, the knife of the cupper, and cauterization of fire.” (Bukhaari, 10/136).
According to a hadeeth narrated by Jaabir (radhiyallahu anhu), said: Rasooulllah (Sallallahu alayhi wa sallam) “If there is any good in your medical treatments, it is in the knife of the cupper, drinking honey, or cauterization with fire, as appropriate to the cause of the illness, but I would not like to be cauterized.” (Bukhaari, 10/139)

According to a hadeeth narrated by Anas ibn Maalik, (radhiyallahu anhu), Rasooulllah (Sallallahu alayhi wa sallam) said: “I did not pass by any group on the night when I was taken on the Night Journey (Isra’), but they said to me, ‘O Muhammad, tell your ummah to do cupping.’” (Ibn Maajah; it has corroborating evidence which strengthens it).

The dry cupping method/gua-sha or scraping (chinese) has the function of warming and promoting the flow of energy in the blood thus dispelling cold, dampness, toxins and winds. It also diminishes swellings and pains.
The hijaamah method (wet cupping) has the benefits of the chinese dry cupping but is more effective as the toxins in the blood (of the localised are) are removed. New blood is produced in the body thereby dispelling cold and diminishing pain.

There are different cupping methods used and it varies from place to place. I remember some 26 years ago my father had cupping done by a doctor from Thailand while he was in India. The doctor used a buffalo horn, as the Kelantanese Malays do. Then he made incisions for the blood to trickle out. (It is said that the ancient Chinese and Arabs had used animal horns for cupping).

Today most people use Vacuum cupping. It is very easy to use. The cupping set consists of a vacuum pump (for suctioning the cup which is usually plastic) and 6 to 24 different sized cups. Other sets even have magnets inside for balancing and a connector tube should you want to do cupping for yourself in a hard to reach place.

The top of the cup is arranged onto the vacuum pump, placed on the skin and suctioned. Meaning the trigger of the pump is pulled about three times, could be more depending on which part of the body it is placed. The air inside the cup cools and contracts forming a partial vacuum, enabling the cup to suck the skin, pulling in soft tissue, and drawing blood to that area. You will see the inside of the cup become misty. This may be a simple reddish-purple ring that disappears quickly, but more aggressive treatments can result in deeper bruising. In general, the longer a cup is left on, the more of a dark circular mark (ecchymosis) is created. Several light incisions are lightly made to allow the congested blood to ooze out.

I have many women ask me whether hijaamah will leave scars and as such they seem hesitant to practice this sunnah. When cupping is properly performed, using tiny incisions and not leaving the cups on longer than necessary, cupping leaves no marks or scarring.
The hijaamah method cautions against cupping in the lying down position and sleeping or resting following any cupping procedure, claiming that the one real danger of cupping is the potential risk of blood clotting following a procedure. Patients should take a brisk thirty minute walk following any cupping treatment.
It is essential that cupping be done by one who is experienced. Instruments should be sterilized before/after use. The cupper must also ensure that no blood reaches the stomach of the patient. It is also a pre-cautionery measure for the cupper to wear latex gloves when doing wet-cupping.

In our next post Insha’allah we will cover when is the best suitable to for hijaamah.