Eb-160 Cupping Therapy Encyclopedia - Tamer Shaban-1.pdf

Cupping Therapy Encyclopedia Tamer Shaban Copyright © 2014 Tamer Shaban All rights reserved. ISBN-13: 978-1494780517 ISBN-10: 1494780518 DEDICATION To My Father and Mother To my wife and children To my professors With love DISCLAIMER Although the author and publisher have made every effort to ensure that the information in this book was correct at press time, the author and publisher do not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.. All information in this publication is for educational and information purposes only. For diagnosis or treatment of any medical problem, consult your own physician. The publisher and author are not responsible for any specific health or allergy needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application or preparation, to any person reading or following the information in this book. The Information on This publication does not dispense medical or professional advice, nor do they prescribe any treatment or strategy that should be tested without the advice of a professional. This book is not intended as a substitute for the medical advice of physicians. The reader should regularly consult a physician in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention.

For comments, Feedback please visit this website: www.acupuncturecupping.org Table of Contents Disclaimer ............................................................................................4 FIGURES INDEX.................................................................................8 TABLES INDEX.................................................................................10 Chapter 1............................................................................................11 History of cupping therapy .............................................................12 History of cupping technique .........................................................16 chapter 2 .............................................................................................19 mechanism of action of cupping therapy......................................20 Meridians system theory .................................................................20 segment cupping therapy or reflex zones theory.........................33 pain gate theory.................................................................................36 prostaglandin theory ........................................................................37 endorphins and encephalin production theory............................37 increasing blood circulation theory................................................38 nitric oxide theory.............................................................................38 Genetic Theory ..................................................................................39 Effects of cupping therapy...............................................................40 Precautions and Contra-Indications...............................................41 Side effects of cupping therapy.......................................................41 Chapter 3............................................................................................43 Cupping Therapy Types and Equipment......................................44 Dr. Tamer’s classification of cupping therapy types: ..................47 Types of Cups....................................................................................48 Cupping therapy patient positions ................................................53 Cupping Therapy sets ......................................................................54 how to do cupping therapy............................................................. 56 Cupping Therapy for home use ..................................................... 56 Professional Cupping therapy practice ......................................... 56 CUPPING THERAPIST ................................................................... 56 protocol of Cupping Therapy Treatments .................................... 62 Pigment reactions of cup prints...................................................... 62 Chapter 4............................................................................................ 65

Cupping Therapy Points ................................................................. 66 Cupping Therapy points FOR SOME diseases ............................ 72 Cupping Therapy for health promotion........................................ 72 Cervical pain: .................................................................................... 73 Frozen Shoulder................................................................................ 75 Knee pain: .......................................................................................... 77 Acute Lumbar Sprain....................................................................... 80 Sciatica and low back pain .............................................................. 80 Rheumatoid Arthritis....................................................................... 83 Gout .................................................................................................... 85 Headache ........................................................................................... 89 Common cold.................................................................................... 92 Bronchitis ........................................................................................... 95 Acute Bronchitis................................................................................ 95 Chronic Bronchitis............................................................................ 96 Bronchial Asthma ............................................................................. 97 Irritable bowel syndrome & spastic colon .................................. 101 Chronic gastritis.............................................................................. 104 Diarrhea ........................................................................................... 107 Constipation ....................................................................................110 Hypertension ...................................................................................113 Facial paralysis ................................................................................116 Obesity and Weight Reduction.....................................................118 Diabetes Mellitus.............................................................................122 Hemorrhoids ...................................................................................125 Dysmenorrhea .................................................................................128 Amenorrhea.....................................................................................131 Urticaria............................................................................................134 Enuresis ............................................................................................136 Female infertility .............................................................................139 Male infertility.................................................................................142 Impotence:........................................................................................144 Prostatitis:.........................................................................................147 Chapter 5..........................................................................................149 cupping therapy clinical trials.......................................................150 Reference ..........................................................................................165 Chapter 6..........................................................................................169

Intersting Topics..............................................................................170 FIGURES INDEX F IGURE1 THE FIVE ELEMENTS ...........................................................................21 FIGURE2 LUNG MERIDIAN................................................................................23 FIGURE3 LARGE INTESTINE MERIDIAN..............................................................24 FIGURE4 KIDNEY MERIDIAN..............................................................................24 FIGURE5 HEART MERIDIAN...............................................................................25 FIGURESMALL INTESTINE MERIDIAN6 ..............................................................26 FIGURE7 PERICARDIUM MERIDIAN....................................................................27 FIGURE8 SAN JIAO MERIDIAN............................................................................27 FIGURE9 STOMACH MERIDIAN...........................................................................28 FIGURE11 LIVER MERIDIAN...............................................................................29 FIGURE11 GB MERIDIAN...................................................................................29 FIGURE12 URINARY BLADDER MERIDIAN.........................................................30 FIGURE13 SPLEEN MERIDIAN.............................................................................31 FIGURE14 REN MERIDIAN .................................................................................32 FIGURE15 DU MERIDIAN...................................................................................33 FIGURE 16 REFLEX ZONES...................................................................................34 FIGURE17 PAIN GATE

THEORY..........................................................................37

FIGURE18 NITRIC OXIDE THEORY......................................................................38 FIGURE19 DRY CUPPING ...................................................................................44 FIGURE21 NEEDLE CUPPING..............................................................................45 FIGURE21 HOT CUPPING....................................................................................45 FIGURE22 LIGHT, MEDIUM AND STRONG CUPPING..........................................45 FIGURE23 BLEEDING CUPPING ..........................................................................46 FIGURE24 WATER CUPPING...............................................................................46 F IGURE 25 CLASSIFICATION OF CUPPING TYPES................................................47 FIGURE 26 TYPES OF CUPS..................................................................................52 FIGURE 27 SITTING POSITIONS...........................................................................53 F IGURE28 PRONE POSITION..............................................................................54 FIGURE29 SUPINE POSITION..............................................................................54 FIGURE31 LYING ON ONE SIDE POSITION .........................................................54 FIGURE31 CUPPING SKIN REACTIONS...............................................................63 FIGURE 32 BACK POINTS ....................................................................................70 FIGURE 33 FRONT POINTS...................................................................................71 FIGURE34 HEALTH PROMOTION.......................................................................72 FIGURE 35 CERVICAL PAIN.................................................................................74

FIGURE 36 FROZEN SHOULDER BACK POINTS....................................................75 F IGURE 37 FROZEN SHOULDER FRONT POINTS ..................................................76 FIGURE 38 KNEE PAIN BACK POINTS ..................................................................78 FIGURE 39 KNEE PAIN FRONT POINTS ................................................................79 FIGURE 40 SCIATICA BACK POINTS.....................................................................81 FIGURE 41RHEUMATOID ARTHRITIS BACK POINTS ............................................83 FIGURE 42 RHEUMATOID ARTHRITIS FRONT POINTS..........................................84 FIGURE 43 GOUT BACK POINTS...........................................................................87 FIGURE44 GOUT FRONT POINTS........................................................................88 FIGURE 45 HEADACHE BACK POINTS.................................................................90 FIGURE 46 HEADACHE FRONT POINTS...............................................................91 FIGURE 47 COMMON COLD BACK POINTS..........................................................93 FIGURE 48 COMMON COLD FRONT POINTS........................................................94 FIGURE 49 BRONCHITIS FRONT POINTS..............................................................95 FIGURE 50 BRONCHITIS BACK POINTS................................................................96 FIGURE 51 BRONCHIAL ASTHMA BACK POINTS .................................................98 FIGURE 52 BRONCHIAL ASTHMA FRONT POINTS ...............................................99 FIGURE 53 IBS BACK POINTS .............................................................................103

FIGURE 54 IBS FRONT POINTS ...........................................................................104 FIGURE 55 CHRONIC GASTERITIS BACK POINTS ...............................................105 FIGURE56 CHRONIC GASTERITIS FRONT POINTS.............................................106 FIGURE 57 DIARRHEA BACK POINTS.................................................................108 FIGURE 58 DIARRHEA FRONT POINTS...............................................................109 FIGURE 59 CONSTIPATION BACK POINT...........................................................111 FIGURE 60 CONSTIPATION FRONT POINTS .......................................................112 FIGURE 61 HYPERTENSION BACK POINTS.........................................................115 FIGURE 62 FACIAL PARALYSIS FRONT POINTS..................................................117 FIGURE 63 OBESITY BACK POINTS.....................................................................119 FIGURE 64 OBESITY FRONT POINTS...................................................................120 FIGURE 65 DIABETES BACK POINTS..................................................................124 FIGURE 66 DIABETES FRONT POINTS................................................................125 FIGURE 67 HEMORROIDS BACK POINTS ...........................................................127 FIGURE 68 HEMORROIDS FRONT POINTS .........................................................128 FIGURE 69 DYSMENORRHEA FRONT POINTS ....................................................129 FIGURE 70 DYSMENORRHEA BACK POINTS ......................................................130 FIGURE 71 AMENORRHEA FRONT POINTS........................................................132 FIGURE 72 AMENORRHEA BACK POINTS..........................................................133 FIGURE 73 URTICARIA BACK POINTS ...............................................................135 FIGURE 74 ENURESIS BACK

POINTS..................................................................137

FIGURE 75 ENURESIS FRONT POINTS.................................................................138 FIGURE 76 FEMALE INFERTILITY BACK POINTS.................................................140 FIGURE 77 FEMALE INFERTILITY FRONT POINTS...............................................141 FIGURE 78 MALE INFERTILITY BACK POINTS....................................................142 FIGURE 79 MALE INFERTILITY FRONT POINTS..................................................143 FIGURE 80 IMPOTENCE BACK POINTS...............................................................145 FIGURE 81 IMPOTENCE FRONT POINTS.............................................................146 FIGURE82 PROSTATITIS BACK POINTS.............................................................147 FIGURE83 PROSTATITIS FRONT POINTS...........................................................148 TABLES INDEX T ABLE 1 THE TWELVE MERIDIANS.....................................................................22 TABLE 2 REFLEX ZONES ......................................................................................35 TABLE 3 CLASSIFICATION OF CUPPING SETS......................................................55 TABLE 4 FRONT POINTS......................................................................................67 TABLE 5 BACK POINTS ........................................................................................68

CHAPTER 1 HISTORY OF CUPPING THERAPY Cupping therapy is one of the oldest methods of healing. It has been used for thousands of years effectively and was the cornerstone of healing practice in these years. The practice of cupping covered the whole world, east and west. No one knows exactly where the beginning of cupping therapy practice was. Ancient Chinese and ancient Egyptians were the first to practice cupping therapy. But in fact, the ancient medical texts that cupping therapy were written by ancient mentioned Egyptians. History of cupping therapy in china Chinese medicine is one of the oldest medical systems in the world. TCM or traditional Chinese medicine uses many healing therapies and practices including acupuncture, herbal medicine, and massage and cupping therapy. Cupping therapy has been the cornerstone in Chinese medicine and was used successfully for thousands of years for the treatment of many illnesses. Cupping therapy is used to stimulate acupuncture points and to remove Qi stagnation in the meridians and organs. stagnation in the meridians and organs. 341 a.d.) And described cupping as a handbook of prescriptions for emergencies. Several centuries later another medical book Su Sen Liang Fang recorded successful treatment of chronic cough and snake bites by cupping therapy. In the 1950th, the efficacy of cupping therapy was confirmed by medical research, cooperation between China and Soviet Union and from this date, cupping was practiced officially in all Chinese hospitals.

History of cupping therapy in Egypt Cupping therapy was practiced in Egypt for thousands of years. The ancient medical book Ebers papyrus, written in 1550 B.C.E. Mentioned cupping therapy and stated that wet cupping can remove foreign matter from the body. Ancient Egyptians prescribed cupping therapy for most of the diseases and passed the art of cupping therapy to the Greeks. Greek history of cupping

400 BCE

Hippocrates (460 BC –370 BC) is one of the most famous cupping therapy users. And he is also one of the greatest figures in the history of medicine. He is also called the father of western medicine. Hippocrates recommended using cupping therapy for a

variety of diseases. Samuel Bayfield (1839) wrote, “Hippocrates was a minute observer, and has left us some striking remarks on the shape and application of the cups. He recommends that they should be small in diameter, conical in shape, and light in their weight, even when the disease for which they are applied is deeply seated” Galen was one of the greatest physician and surgeons. He was also one of the greatest medical researchers and contributed by his researches in the fields of anatomy, physiology, pathology, pharmacology and neurology. Galen was one of cupping therapy users and he condemned Erasistratus, an Alexandrian physician, for not using cupping. Herodotus was a famous historian and physician. He wrote, in 413 BC: “ scarification with 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 towards to faint; of drawing deep-seated offending matter the surface; of drying up fluxions; checking

hemorrhages; promoting menstrual evacuations; arresting the tendency to putrefaction in fevers; allaying rigors; accelerating and moderating the crisis of diseases; removing a propensity to somnolence; conciliating natural repose; removing heaviness. These, and many analogous maladies, are relieved by the judicious application of the Cucurbits (cups), dry or bloody.” Then the art of cupping therapy was passed through the Alexandrians and Byzantines to Arab Muslims" and Asians. History of cupping therapy in Islam Prophet Mohammed (peace be upon him) the prophet of Islam, encouraged the use of cupping (hijama), saying “the hijama is the best of your remedies” Al-tibb al-nabawî was one of the famous Islamic books which was written by Ibn Qayyim al jawziyya and mentioned cupping therapy as a medical practice. Muhammad Ibn zakariyā rāzī (august 26, 865 – 925) was one of the best physicians and scientists in the history, he was the first to differentiate smallpox from measles, and was described as the father of pediatrics. He had benefited from cupping therapy in his treatment of many diseases. Ibn sīnā (Avicenna) (980– 1037) was one of the most famous physicians. The most famous works by him are the book of healing and the canon of medicine. The canon of medicine was used as a textbook in the universities of Montpellier and living as late as 1650. The canon of medicine book stated that cupping was known to be effective on more than 30 different diseases. History of cupping therapy in the west From the Egyptians and Greeks, cupping was spread to the entire world. Cupping therapy became a very popular therapy among European and

American doctors and was practiced successfully for a wide range of diseases during the eighteenth century and after. Many published research papers confirmed the efficacy of cupping therapy during the nineteenth century. Charles Kennedy, a famous surgeon wrote, in 1826: “ The art of cupping has been so well-known, and the benefits arising from it so long experienced, that it is quite unnecessary to bring forward testimonials in favor of what has received not only the approbation of modern times, but also the sanction of the remotest antiquity.” Sir Arthur Keith (5 February 1866 – 7 January 1955): was a Scottish anatomist and a fellow of the royal college of surgeons of England and the president of the royal anthropological institute. He was famous because he discovered the sino atrial node in 1907. Sir Arthur Keith wrote how he witnessed cupping performed with excellent success. In the UK the practice of cupping therapy also dates back a long way with one of the leading medical journals „the lancet" being named after this practice as it means the surgical instrument that can scrape the skin to do cupping. HISTORY OF CUPPING TECHNIQUE The first technique used for cupping was horn therapy, this involved using a hollow drilled horn with an opening on its tip and a piece of wax or a wad of dried grass. The ancient therapist created the suction by sucking air out by his mouth from the opening on the horn tip, then when the preferred suction was achieved, he put the dried grass or waxes by his tongue to close this opening. Another method developed later, was by using bamboo and making cups of it and closing one end by natural grass. They then boiled the bamboo cups in a pot, then they put a small piece of paper and burned it on the bottom of the bamboo cup to create the suction, a risk of this way of creating the suction is the possibility of burning the patient"s skin.

Then during the 20th century, the therapists found and used glass cups. Glass cups were one of best aided methods of therapists" skills because they could see inside the cup and the ease of use and sterilization of these cups. Another method of suction was developed between 1930 and 1940 by putting a valve at the top of the cup and made suction by a manual suction pump that could make suction of air possible without fire. In 1940, many medical products companies began to make and sell these cupping sets. Scarificator bloodletting; featured a dozen retracing blades which were fired by pulling a trigger. After cupping has drawn blood to the surface of the skin this is was used in phlebotomy or this spring-loaded instrument

SCARIFICAT OR RBCM HH1988.2.90A

used to produce a many cuts at the same moment as a part of bloodletting therapy. Despite its ancient roots in Greek medicine this is no longer a common medical practice Now, there are many types of cupping sets, we will mention later and various types of new cups have been developed. Also there are many electrical cupping therapy machines which have been developed and being used in beauty centers and hospitals. Modern cupping therapy Today there are thousands of centers around the world offering dry, wet and massage cupping treatments and courses. They located around the world including the USA, Germany, South Africa, Middle East, Turkey, Asian countries and the United Kingdom. Many medical professional associations and communities around the world support these modalities and constructed to support practitioners and setting standards and guidelines for practice and education and to support and encourage research. Many insurance companies offer coverage for alternative and complementary therapy treatments. Many insurance companies offer professional liability coverage for complementary and alternative medicine practitioners and therapists. According to The National Health Interview Survey, adults in the United States spent about $33.9 billion on alternative therapies in 2007. Most of them ($22 billion) covered self-care products, materials, classes and homeopathic medicine; and $11.9 billion was spent on practitioner visits. There are 38.1 million adults made an estimated 354.2 million visits to practitioners, most of these visits to body – based and manipulative complementary and alternative medicine practitioners. The growing number of cupping therapy researches introduced it to the international medical community.

CHAPTER 2 MECHANISM OF ACTION OF CUPPING THERAPY There are 8 theories explain the mechanism of cupping therapy. The theories are: 1. Meridian system theory 2. Segment cupping therapy or reflex zone theory 3. Pain gate theory 4. Prostaglandin theory 5. Endorphins and encephalin production theory 6. Increasing blood circulation theory 7. Nitric oxide theory 8. Genetic Theory MERIDIANS SYSTEM THEORY The ancient Chinese believed that there was a distribution network to distribute (Qi) and other substances to all the body parts. Qi is a vital energy of the body. They also believed that cupping therapy can treat stagnation of vital energy (Qi). In Chinese language (meridian) is (Jing Luo). (Jing) means pathway and represented the vertical channels and (Luo) means network and represented the horizontal channels. Acupuncture points are concentrating areas of (Qi) which were found on the skin throughout meridian system. Meridian channel represented many acupuncture points. Stimulation of these points can lead to healing effects. Many ways can stimulate these meridians and points. (Qi) is divided into two equal and opposite forces, yin and yang. Yin represented female, passive, cold, water and darkness. Yang represented male, active, warm, fire and light. When these two forces

balanced they will work together to make the body in a healthy state and any upset of yin and yang balance, diseases will be the result. Body meridians are twenty channels, twelve of them are principal meridians and eight of them are extra meridians. Among the eight extra meridians, governing and conception vessels are the most important extra meridians. The Wu Xing (the five elements or phases): The five elements or phases are wood, fire, earth, metal and water. It is used to describe the interactions and relations between phenomena. Five elements theory also maps the relation between different substances in treatment and diagnosis. Fire

Earth Wood

Metal

Water

FIGURE1 THE FIVE ELEMENTS

The twelve meridians The twelve meridians take their names from the corresponding organs. There are six yin meridians and six yang meridians. Lung, heart, pericardium, spleen, kidney and liver meridian are yin meridians. Large intestine, small intestine, triple burner, stomach, bladder and gall bladder are yang meridians. TABLE 1 THE TWELVE MERIDIANS

Location Yin and Meridians Qi flow

yang Lung meridian 3 am- 5 am Yin Heart meridian 11 am – 1 pm Arm Pericardium meridian 7 pm – 9 pm Yang Large intestine meridian 5 am- 7 am Small intestine meridian 1 pm – 3 pm San Jiao (triple burner ) 9 pm – 11 pm meridian Leg Yin Spleen meridian 9 am – 11 am Kidney meridian 5 pm – 7 pm Liver meridian 1 am – 3 am Yang Stomach meridian 7 am – 9 am Bladder meridian 3 pm – 5 pm Gall bladder meridian 11 pm – 1 am This table represented the basic twelve channels; the name of each meridian is corresponding to an organ. Also the chart represented the Qi flow because Qi was prevalent in each channel at different times. Lung meridian

It is used to treat conditions related to the chest, lungs and nasal diseases. According to TCM theory, lungs were considered yin and belonged to metal. Lungs were also belonged to white color and autumn season.

FIGURE2 LUNG MERIDIAN

Large intestine channel The lungs (yin) and large intestine (yang) were considered paired opposite organs. They also have the same characters in five elements

theory. It is used to treat diseases related to head, nose, throat, intestines, face and febrile diseases

FIGURE 3 LARGE INTESTINE MERIDIAN

Kidney channel It is used to treat genital, urinary, abdominal and psychiatry (emotional) conditions. The kidneys are (yin) and paired with the

urinary bladder (yang). The kidneys according to TCM theory is the store of the original essence, so it is the responsible organ for growth, development and reproduction.

FIGURE 4KIDNEY

MERIDIAN

Heart channel It is used to treat heart, chest, sleep and emotional diseases. The heart is (yin) and is paired with the small intestine (yang) organ.

FIGURE 5HEART MERIDIAN

Small intestine channel It is used to treat head, neck, shoulders and eye diseases. The small intestine channel is (yang) , (fire ) in five phases theory, hot climate and summer season.

FIGURESMALL INTESTINE MERIDIAN 6

Pericardium channel It is used mainly to treat nausea, heart and lung conditions. The pericardium channel is (yin) organ and the San Jiao (yang) are paired organs.

FIGURE 7PERICARDIUM MERIDIAN

San Jiao (triple warmer) channel It is used to treat ears, eyes, chest, throat and shoulders diseases.

FIGURE8 SAN JIAO MERIDIAN

Stomach channel It is used to treat conditions related to head, throat, digestion, face and energy.

FIGURE9 STOMACH MERIDIAN

Liver channel It is used to treat conditions of mental, digestive and urogenital system origin. The liver is (yin) and is paired with gall bladder (yang) organ. They belong to wood in five phases theory, spring, and green color.

FIGURE

11LIVER MERIDIAN

Gall Bladder channel It is used to treat migraine and headaches, muscular pain, eye problems, chest and febrile conditions. The Gall bladder is (yang) and is paired with liver (yin) organ.

FIGURE11 GB

MERIDIAN

Urinary bladder channel It is the most used channel in cupping therapy. It is also used to treat many diseases. The Urinary bladder is (yang) and is paired with kidney (yin) organ.

FIGURE 12 URINARY BLADDER MERIDIAN

Spleen channel It is used mainly to treat spleen, stomach, intestines, urinary and genital problems. The spleen is (yin) and is paired with stomach (yang). They belong to earth in five phases, yellow color and the end of summer.

FIGURE13 SPLEEN MERIDIAN

Ren channel (conception vessel) It is used to treat conditions of infertility, urinary and digestive origin.

FIGURE14 REN MERIDIAN

DU channel (governing vessel) One of the most used channels in cupping therapy. The figure 15

shows The DU channel and its distribution points.

FIGURE15 DU MERIDIAN

SEGMENT CUPPING THERAPY OR REFLEX ZONES THEORY There are nervous connections and paths between internal organs and

the skin. Segment therapy is a treatment applied to the reflex zone area which has the same connection with the treated internal organ. The internal organ – skin connections was known and used by all civilizations to relieve pain. And this connection was also observed by the British neurologist (Henry Head) who lived between 1861 and 1940. Later on, other scientists explain and prove the relation between internal organs and the skin through the autonomic nervous system.

FIGURE 16 REFLEX ZONES

The body is divided into segments that begin with every vertebra. Spinal nerves carry motor, sensory and autonomic signals between the spinal cord and the body. The spinal nerves are 31 left- right pairs, and are corresponding to the segment of the vertebral column. On the 7th cervical vertebra at the end of the neck, an elevation named (hormone hump), as it is used by cupping therapists to treat conditions related to hormonal imbalance such as diabetes mellitus, pituitary gland diseases

and ovarian dysfunction. The following table describes the internal organs and related reflex zone: The organ Heart Aorta Lung and pleura Esophagus Stomach Duodenum Liver and gall bladder Pancreas Spleen Appendix Rectum Kidney Urinary bladder Uterus Ovary Testicle Colon C=cervical vertebra, t= thoracic vertebra, l= lumbar vertebra, s= sacrum vertebra TABLE 2 REFLEX ZONES

Location of reflex zone Head zones c3, c4, c8 to t9 C3, c4, c8 and t6 C3, c4, t2 to t9 T3 to t5 C3, c4, t5 to t9 C3, c4, t8, t10 C3, c4, t6 to t10 C4, t7 to t9 C3, c4, t7 C3, c4, t11 to l1 L5 to s5 C4, t9 to l2

T11 to s2 T12 to l4 T11 to l4 T12 to l3 C3, c4, t11 to l1 In brief, the diseased organ sends a signal to the skin through the autonomic nerves, the skin responds by becoming tender, painful or swelling. In opposite, skin also can send stimulus signals to the internal organs. It can explain why angina pectoris occurs in cold weather because a sudden cooling of the breast area can lead to a mortal heart attack. And on the other hand, skin can have a therapeutic effect on internal organs. The skin receptors are activated by applying cups to the skin. So this will increase the blood circulation and blood supply to the skin and to the internal organs through the nervous connections. Then cupping has double effects. It stimulates the skin local circulation, and stimulates the internal organ circulation, and in a few days connective tissue metabolism. This activates the body through autonomic nervous regulation system to come to health state again. PAIN GATE THEORY This theory stated that there is a gate or channel to transfer pain signals from its actual area or organ to the brain. Because of this, we can feel the pain. There are gates and channels that transmit the pain in our body. And when we do cupping therapy, the channel transmits pain from the cupping area to the brain that interferes with the actual pain which can"t transmit in the same gate or channel and this leads to kill the actual pain. Pain nerves

The Gate

Transmissionopen the gate

nerve cells

nerves close the other senseory

gate

Message from Message to the the brain brain

FIGURE17 PAIN GATE THEORY

PROSTAGLANDIN THEORY Prostaglandins are products of inflammation in our body. Prostaglandins transmit pain signals to the brain. By doing wet cupping therapy we take these products out from the body and this kills the pain. ENDORPHINS AND ENCEPHALIN PRODUCTION THEORY These are natural components released in our body and these components are called “endogenous pleasure substances” which reduce the pain and enhance the mood. INCREASING BLOOD CIRCULATION THEORY Cupping therapy can increase blood circulation as a result of applying the negative pressure, hemodynamic mechanism and removing the inflammatory products and toxins out by wet cupping. It's expected to reduce inflammation and pain.

NITRIC OXIDE THEORY

N

O

NO The researchers Ferid Murad, Ignarro and Furchgott, discovered nitric oxide. They won the Nobel Prize of medicine 1998 FIGURE18 NITRIC OXIDE THEORY

Nitric Oxide is a very important substance that released in the body as a result of any trauma. It is released also during and after cupping therapy. Functions of nitric oxide are: 1. Vasodilatation: this gives more blood to the area and has 2 ways vasodilatation effects 2. Muscle relaxation which cures spasms. 3. Anti-thrombotic: It protects the blood vessels from thrombosis. 4. Decrease of inflammation 5. Prevent stenosis of blood vessels as inhibit proliferation of the blood vessels walls. If there is an abnormality in nitric oxide release, this will lead to many diseases such as: obesity, hypertension, heart failure and many other diseases. All these effects can be obtained by cupping therapy GENETIC THEORY In a recent study in Canada by Mark Tarnopolsky and others found that massage therapy can help repair exercise induced muscle damage by decreasing inflammation and renewing mitochondria. They reported that five genes were differentially expressed after massage therapy which played a role in altering inflammation process. Cupping therapy is also a massage process. You can do massage cupping for the same conditions but cupping massage is deeper than regular massage. So cupping therapy theoretically can induce the same effect.

A medical trial is needed to confirm this theory. EFFECTS OF CUPPING THERAPY The benefits and effects of cupping therapy are: 1. Increase blood circulation in general and especially in the area treated 2. Remove toxins and inflammatory products from the body or it move it from important areas such as (organs) to less important areas such as (skin) 3. Increase immunity by stimulation of body immune mechanism. 4. Kill or reduce body pains 5. Stabilize the mood by stimulating release of certain body substance 6. Stimulate production of NO with all its benefits 7. Regulate and balance hormones 8. Stimulate ovulation in women 9. Regulate intestinal motility We can explain the effects of cupping as 1. An action on the blood supply regulation. 2. A regulation of the acid-base conditions. 3. A regulation and modulation of the immune system. 4. A regulation of the hormonal system. 5. A genetic action (activation and deactivation). 6. A regulation of neurotransmitters and nervous system. 7. Stimulation and regulation of lymphatic drainage system. 8. A regulation of the coagulation and the anti-coagulation systems. PRECAUTIONS AND CONTRAINDICATIONS Always take sensible precautions when using cupping. These may include: Sterilization: this is the main key to success Use suitable Cups for the area being treated. Take extra Care with children and the elderly.

Do not apply strong

cupping especially for the face. Do not apply strong cupping for elderly or children. Do not treat pregnant women. Do not use cupping on inflamed skin. Take Extra Care when scraping the skin and do not cut a vein or artery. Do not treat people with a serious heart disease. cupping therapy for severely ill people.

Do not use

SIDE EFFECTS OF CUPPING THERAPY If we do cupping therapy accurately and in a true way there are no side effects. Malpractice may produce many side effects. A mild to moderate bruising or skin discoloration to bluish color is common and it will resolve in a few days. Fainting may occur especially with wet cupping therapy but it is usually a self-limited condition. If fainting occurred, remove cups immediately, lay the patient flat on his back, elevate the legs, and loose the tight clothing. Shake the patient; if s/he does not respond refer immediately to health care professional. If there is a blue face, difficulty breathing, chest pain, slow heartbeats, or confusion call the emergency number or refer to the nearest hospital. We must tell the patient about all expected side effects. In some rare conditions when we let the cup more than ten minutes skin burn may occur and must be treated as a true burn. Repeated excessive cupping therapy by unqualified cupping therapists may lead to anemia and skin pigmentations as reported by a study conducted in Korea by GI Young Yang et al. 1 Koebner phenomenon was common in psoriasis patients. A letter published in a dermatology online journal reported a patient with psoriasis who was treated by cupping therapy and subsequently developed the koebner phenomenon at the cupped sites.2 Michelle Gellis, a licensed, Board Certified acupuncturist (NCCAOM)

and a faculty member of the Tai Sophia Institute (USA) said “The most noted side effect of cupping is the marks that it can leave. I deal with this by first speaking with my patient and telling them that there may be marks on them after I am done. If at all possible I move the cups frequently as not to leave marks on the skin. Occasionally there is localized pain along the channel when cupping, such as with cupping down the leg or on the lower back. In this case, less suction is used.” Abdel Nasser Towhid, PHD said: “ Fainting sometimes occurs but this is not considered a side effect this is a reaction and putting the patient in recumbent position or on one side could solve this problem that occurs less than 2% of patients if Hijama done correctly. “ References: 1. Kun Hyung Kim,Tae-Hun Kim,Min Hwangbo,Gi Young Yang Anaemia and skin pigmentation after excessive cupping therapy by an unqualified therapist in Korea: a case report- Acupunct Med 2012;30:227-228 doi:10.1136/acupmed-2012-010185 2. Yu, Rui-xing; Hui, Yun; & Li, Cheng-rang. (2013). Köebner phenomenon induced by cupping therapy in a psoriasis patient. Dermatology Online Journal, 19(6). doj_18575. Retrieved from: http://escholarship.org/uc/item/2nq0903z

CHAPTER 3 CUPPING THERAPY TYPES AND EQUIPMENT Types of cupping: There are various different types of cupping such as:

Dry cupping: dry cupping therapy can be light / medium or strong according to the suction power.

Light cupping : create a weak suction in the cup to conduct light cupping; it is suitable for children and the elderly people.

Medium cupping : a medium strength, general purpose cupping.

Strong cupping: suction will be intense and

FIGURE19 DRY CUPPING

therefore it is not suitable for children and elderly people.

Moving or massage cupping is a great method of massage and is conducted by applying oil to the skin and moving the cup, by a weak suction, on the treated area. A partial light vacuum is created which enables to cup to be moved around the body site to be treated.

Needle cupping: acupuncture and cupping are conducted simultaneously in the same place by applying the needle first then the cup is applied over it.

FIGURE21 NEEDLE CUPPING

Hot cupping : dried Mugwort (Artemisia Vulgaris) leaves, sometimes called by its oriental name Moxa is a great warming herb. We use a needle, warmed by dried Mugwort, and then the cup is applied over it.

Flash cupping is the name given when several medium cupping is performed several times in quick succession along the area being

treated.

FIGURE21 HOT CUPPING

FIGURE22 LIGHT, MEDIUM AND STRONG CUPPING

Wet (Bleeding) cupping , also called full cupping or wet cupping, it is the most frequently used, oldest and often most effective method. A surgical instrument is used to scrape the skin and the cup is

then applied to collect blood. FIGURE23 BLEEDING CUPPING

It is called Al Hijama in Arabic. And it is very popular in Germany, UK, China, Indonesia, India, Pakistan, Iran, South Africa and all Arab countries

Herbal cupping : we put a suitable herbal tincture into the cup then apply the suction.

Water cupping is the least practiced method. It involves filling a third of the cup with warm water. Whilst holding the

cup close to the client with oneFIGURE24 WATER hand, bring it close to the point CUPPING to be cupped and insert

burning cotton wool into the cup, then swiftly and simultaneously turn the cup onto the skin. When performed properly, no water spillage occurs.

Ice cupping therapy: We Use ice in the cup in some cases of pain. DR. TAMER’S CLASSIFICATION OF CUPPING THERAPY TYPES: power of Technical Suction Types related

types Method Materials

of suction inside related cups

Types related types

Dry CuppingLight Herbal Fire

cuppingIce

water

medium Manual Ozone cupping cupping Wet Cupping Massage

cuppingHot or

Moxa

Electrical cupping Needle

Magnetic

Area treated related types Pedi Cupping Abdominal Cupping Facial cupping

Orthopedic cupping Flash strong cupping

FIGURE 25 CLASSIFICATION OF CUPPING TYPES

Cupping therapy types can be classified into five main types, technical types which include dry, wet, massage and flash cupping therapy. The second is the power of suction related types which include light, medium and strong cupping therapy. The third is a method of suction related types which include fire, manual suction, and electrical suction cupping therapy. The fourth is materials inside cups related types which include herbal, water, ozone, Moxa, needle and magnetic cupping therapy. The fifth is area treated related types. TYPES OF CUPS There are many types of cups used from animal horns used in the past to most modern cups Plastic cups It is made from clear plastic material with a valve attached to the top; used with manual or automatic vacuum apparatus. Advantage: Easy to use Disposable (one time use) and sterile

Inexpensive

Self-Suction Cups These cups are made from plastic and there is a handle of rubber attached to the top of the cup; or a top rotator to apply suction these cups

are used for dry cupping in children and old people

Disadvantage: Limit suction power; you can do only light and medium dry cupping by it. Bamboo cups Cups are made from bamboo and used mainly in China. There are some disadvantages of these cups: Difficult in cleaning Inadequate sterilization Very sharp edges The therapist can't see inside the cup to see the blood in wet cupping type or the skin More expensive

Glass cups Cups made from glass material with or without valve Advantage: Thick edges more than bamboo Inexpensive Easy to clean and sterilize Easy to use and the cups are clear so the therapist can see inside the cup Disadvantage: Breakable

Rubber cups Cups made from rubber material Advantage: Strong suction Can be used on sensitive areas because of the smooth edges Disadvantage: Can't be sterilized so these cups are for one use or for personal use only

Magnetic Cups These cups are made from clear hard plastic with a magnetic probe or plate inside the cup

These cups are used to stimulate the energy by cupping and by magnets . They have many types with various sizes These cups are for personal use.

Plastic Glass

Rubber Bamboo Magnetic Self Cups Cups Cups Cups CupsSuction

Cups

FIGURE 26 TYPES OF CUPS

Cupping equipment 1. Massage chair or table 2. Sterilizing solution 3. Cups of various sizes or cupping set 4. Vacuum pump 5. Acupuncture needles 6. Olive oil or lavender oil 7. Hand gloves and face masks 8. Surgical lancets 9. Moxa 10. Herbal remedies CUPPING THERAPY PATIENT POSITIONS 1. Sitting Position: you can use a massage chair, a massage table or an ordinary table and chair. This position is not preferred for the new patients especially who do cupping for the first time. 2. Supine Position or Lying on Back position. 3. Lying on one side (left or right) position. 4. Prone position or Lying face down: the best position for first time cupping therapy session.

FIGURE 27 SITTING POSITIONS

FIGURE28 PRONE POSITION

FIGURE29 SUPINE POSITION

FIGURE31 LYING ON ONE SIDE POSITION

CUPPING THERAPY SETS

We can classify cupping therapy sets to: We can classify cupping therapy sets to: Cupping sets related to the types of cups Plastic Cupping sets Glass cupping sets Rubber cupping sets Bamboo cupping set Bamboo cupping set Cupping sets related to the methods of suction: Manual cupping sets Automatic cupping sets Self-suction cupping sets Self-suction cupping sets Cupping sets related to the uses Facial Cupping Sets Female cupping set (for breast enlargement) Male cupping sets Massage cupping sets TABLE 3 CLASSIFICATION OF CUPPING SETS

Cupping sets related to the uses 1. Facial Cupping Sets 2. Female cupping set (for breast enlargeme nt) 3. Male cupping sets 4. Massage cupping sets Cupping sets related to the methods of suction 1. Manual cupping sets

2. Automatic cupping sets 3. Self-suction cupping sets Cupping sets related to the types of cups 1. Plastic Cuppin g sets 2. Glass cupping sets 3. Rubber cupping sets 4. Bamboo cupping set HOW TO DO CUPPING THERAPY Cupping therapy is a traditional therapy. You can use cupping therapy for home or personal use. Cupping therapists and professional healthcare workers use cupping therapy professionally to treat patients in their licensed clinics. CUPPING THERAPY FOR HOME USE Cupping therapy is simple and easy. People around the world used it for thousands of years. It is recommended to use a Plastic cupping set with a manual suction pump. You can easily follow the instructions to do dry, flash or massage cupping therapy. One day training is recommended to use cupping therapy safely at your home. You can use it for protective purposes or for simple ailments and pains. PROFESSIONAL CUPPING THERAPY PRACTICE CUPPING THERAPIST Cupping therapist is a recognized profession by the international classification of health workers (published by The World Health

Organization). It is based on The International Standard Classification of Occupation (ISCO, 2008 revision) under the code (3230). The Clinic: Every cupping therapy clinic shall be maintained in a clean and sanitary condition at all times. If the cupping therapist will use non disposable equipment such as glass cups, there shall be functioning sterilization equipment. The clinic must be equipped with professional cupping sets, suitable number of various types of cups. Treating patients: The cupping therapist"s hands shall be brush-scrubbed with soap and warm water immediately before examining patients or handling cupping cups and other instruments, and between patients. You should keep the cups in a sterile container or box. Cupping points, if you will do wet cupping, shall be cleaned with an appropriate antiseptic before scraping the skin and after cupping. Any complication, including uncontrolled fainting, bleeding or other complication arising out of cupping treatment shall be referred immediately to a hospital. Always use disposable cups and instruments. Discard all used instruments after the treatment safely. Lancets shall be disposed of by placing them in a sealed, unbreakable container. Follow instructions of your licensed authority. Keep complete and accurate records on each patient who is given cupping treatment in your clinic. Cupping therapist - Patient relationship A patient must have confidence in the competence of their cupping therapist. For therapists, the establishment of good rapport with a patient is important. The quality of the patient-therapist relationship is important to both parties. The better the relationship in terms of respect, trust and knowledge, the better the quality of treatment session. Formal relationship is recommended at first but some familiarity with a therapist

is recommended to make it easier for the patient to talk about the disease and be comfortable during the cupping session. Do not tell your patients that cupping can treat a disease without scientific evidence. How to do cupping Therapy? General steps: Inform the patient about what you will do Let the patient read and sign the written consent Take the patient medical history Check the patient physical condition Determine the point or points of treatment Choose the most appropriate type of cupping therapy according to the age and the disease Choose the most comfortable and suitable position for the patient. Lying positions are more comfortable and safer Choose the suitable cup size for the area treated. Other steps include: Wet or full cupping Wear your personal protective equipment Choose and define the cupping points you will do. Sterilize the skin with a suitable antiseptic solution. Put the cups and apply medium suction Leave the cup for 3 to 5 minutes Remove the cup Use the surgical blade or lancet to scrape skin to make scratches 0.3 to 0.5 cm in height and 0.1 to 0.4 mm in depth Be careful and made very small scratches from above downwards in the circle produced by the cup and make scratches in horizontal order in 3 or 4 rows

Put the cup again Apply suction Blood and sometimes gases get out from the scratches to fill the cup. Leave the cup for 3 to 5 minutes. Remove the cup and carefully clean the skin.. Repeat this again for 2 to 3 times Repeat this operation for every point You can do 3 to 5 points per session. Always begin with pain points = get more positive results. let too much blood get out, only 50 cc After the treatment setting permanently get rid of all used

Don't

equipment. Wash your hands before and after the treatment The typical treatment program is 1 treatment per month for 3 months, it can be used more frequently (every 2 weeks) for difficult cases. Massage cupping After doing general steps Define your treatment area. Put a few drops of olive or lavender oil on the skin. Massage the skin with your hand first. Put the a medium cup. Apply light suction. Begin to move the cup slowly across the area If the patient feels pain, remove the cup then apply the cup with a decrease in suction power until the patient feels comfortable Move the cup in straight directions. And circle around the patient's muscles. The treatment setting takes from 20 to 30 minutes. The typical treatment program is 2 to 3 times per week for 10

sessions. Dry cupping therapy Apply general steps Put the cup and apply suction. Leave the cup for 5 to 10 minutes according to the suction power Remove the cup You can use any number of points You can do many points at the same time It is a powerful method which everyone can do cups for yourself many times This type is suitable for home use

You can use the

The typical treatment program is 10 sessions daily or day after day. Needle cupping After applying general steps. Insert the needle in the selected point Put the cup above the needle Apply suction Leave the cup for 5 minutes Remove the cup Remove the needle

Water cupping Do general measures Fill one third of the cup of warm water Be careful and stand close to the point Apply the cup to the point If you do it quickly and truly, no water spillage will occur the cup for 5 minutes Carefully remove the cup by adding the cup in the true

Leave

position by asking the patient to move to correct the position of the cup and put the water into the cup not the skin. PROTOCOL OF CUPPING THERAPY TREATMENTS (Treatment Programs) There are many researches and studies used various protocols. Cupping therapy number of treatments varies according to the type of cupping therapy used, patient health condition and disease. Mohammed Abd Elgawad, a chest specialist and a published researcher who published a research in Indian Journal of Physiotherapy and Occupational Therapy under title of “evaluation of Cupping Therapy as

an adjuvant therapy in the management of bronchial asthma” said “I use wet cupping therapy type. I prescribe cupping therapy for 3 – 4 times These treatments are spaced once / month” Michelle Gellis, a licensed, Board Certified acupuncturist (NCCAOM) and a faculty member of the Tai Sophia Institute (USA) said ” The number of treatments is highly dependent on the type of condition I am treating. In the early stages (tai yang) of a disease, a 'cold' in western medicine, one or two treatments of cupping in two consecutive days can usually expel the pathogen. For pain related issues such as back, hip, shoulder pain, I tell my patients it will typically take a minimum of six treatments. Sometimes relief is felt after the first treatment, but for the effects to last, patients should continue treatment beyond the initial relief. These treatments are usually once a week .A full course of facial rejuvenation acupuncture and cupping treatments is from 12-20 treatments. This range depends on the health of the skin and the lifestyle of the patient. These treatments are spaced either once or twice a week.” PIGMENT REACTIONS OF CUP PRINTS Cupping therapy reactions are listed as follows: 1. Dark purple & black colors indicate deficient blood supply and blood stasis. 2. Scattered purple points indicate diseases of stagnancy of Qi and blood stasis. 3. Bright red color generally indicates diseases of deficiency of yin. 4. Dark red color indicates diseases of high blood fat and heat pathogen. 5. Cold and pale white color indicated diseases of cold deficiency and pathogenic damp. 6. Bright Pink color indicates healthy areas

FIGURE31 CUPPING SKIN REACTIONS

CHAPTER 4 CUPPING THERAPY POINTS In my professional guide to cupping therapy I put the points according to meridian system. In this book I put a classification for the most important cupping therapy points. This new classification is for discussion and feedback from doctors, researchers and therapists. This classification is (Front & Back Points Classification) (FBP) characterized by: characterized by: Frontal points are beginning with the letter (F). Frontal points are beginning with the letter (F). Back points are beginning with the letter (B). Back points are beginning with the letter (B). Right points are ending with (R) letter. Right points are ending with (R) letter. Left points are ending with (L) letter. It includes the most important 51 points, 25 on the front and 26 on the back. Note: This classification does not contain all cupping points. Example If the point is F 7-L, This means Point number 7 on the left side of front of the body. Some Expected benefits of the cupping therapy most important points. Front Points TABLE 4 FRONT POINTS

Point Uses F1 Cough, bronchial asthma, bronchitis, pharyngitis and to enhance respiratory muscles

F2 Chest pain, bronchial asthma, bronchitis, and to increase immunity F3 Chest pains, bronchial asthma, bronchitis, cough. F4 Gastritis, spastic colon, digestion problems. F5 Gastritis, spastic colon, diabetes F6 Disorders of menstruation, vaginal disorders, male and female infertility. F7 Bronchitis, bronchial asthma, cough. F8 Chest pain, liver disorders. F9 Liver disorders, diabetes F10 Constipation, pains, diarrhea. F11 Ovarian disorders, menstruation disorders, male and female infertility. F12 Disorders of menstruation, female infertility, nocturnal enuresis.. F13 Shoulder pain and shoulder arthritis. F14 Pain in thigh F15 Knee pain, knee arthritis, gout, hip pains. F16 Knee pain, knee arthritis, gout, menstruation disorders, thigh pains F17 Knee pain, knee arthritis, gout, menstruation disorders, pains F18 Nocturnal enuresis, disorders of menstruation, dysmenorrhea F19 Nocturnal enuresis, disorders of menstruation, dysmenorrhea F20 Liver disorders, amenorrhea, disorders of menstruation, nocturnal enuresis. F22 Trigeminal neuralgia, headache, migraine, facial paralysis and eye disorders F23 Ear disorders and inflammation, and pains in mandible. F24 Sinusitis, nasal disorders, trigeminal neuralgia, facial paralysis F25 Facial paralysis Back Points TABLE 5 BACK POINTS

Point Uses B1 First main point in wet cupping. It has many benefits for many diseases. B2 Bronchitis, bronchial asthma, and back pain

B3 Main points in wet cupping therapy. Used for back pains, and for many diseases as we will mention later. B4 Chest pain, bronchial asthma. B5 Some liver disorders, back pain. B6 Gastritis, diabetes mellitus. B7 Low back pain, impotence, disorders of menstruation B8 Back pain, impotence, disorders of menstruation. B9 Impotence, male infertility, and low back pain B10 Prostatitis, impotence, and low back pain B11 Prostatitis, impotence, and hemorrhoids B12 Stiff neck, cough, back pain. B13 Bronchitis, bronchial asthma, pneumonia, back pain. B14 Frozen shoulders, shoulder pains B15 Gastritis, diabetes mellitus. B16 Lower back pain, impotence, disorders of menstruation. B17 Lower back pain, impotence, irregular menstruation. B18 Vertebral diseases B19 Elbow arthritis. B20 Sciatica, hip pain B21 Lower back pain, sciatica, leg pains B22 Lower back pain, sciatica, leg pains. B23 Lower back pain, sciatica, leg pains, knee arthritis. B24 Sciatica, pains in leg, muscle cramps, rheumatoid arthritis. B25 Headache, migraine, insomnia, epilepsy, hypertension B26 Ear & eye disorders

FIGURE 32 BACK POINTS

FIGURE 33 FRONT POINTS

CUPPING THERAPY POINTS FOR SOME DISEASES CUPPING THERAPY FOR HEALTH PROMOTION

FIGURE34 HEALTH PROMOTION

You can use these points for protective purposes and for health promotion. Meridians classification Points: Meridians classification Points: Du 14 Du 14 BL 17 on both sides Cupping FBP classification Points: Cupping FBP classification Points: B1

B1 B3-L and B3-R Research: Kaleem Ullah and Ahmed Younis - An investigation into the effect of Cupping Therapy as a treatment for Anterior Knee Pain and its potential role in Health Promotion. The Internet Journal of Alternative Medicine 4(1). 2007. CERVICAL PAIN: Cervical pain is a pain in the neck region. The most common causes are trauma, muscle sprains, cervical disc prolapse, cervical vertebra diseases and other musculoskeletal diseases. Cupping Points Cupping Points B1 B1 B2 B2 B3-L and B3-R B3-L and B3-R B12-L and B12-R The cup always stimulates and involves more than one point because of the size of the cup in relation to the needle.

FIGURE 35 CERVICAL PAIN

Clinical Case: A man 46 years old was suffering from cervical pain and inability to rotate easily his neck due to cervical disc prolapse. After 3 wet cupping treatments, one each month, the severe pain was relieved, he was able to move his neck easily and he returned to his normal life. Research: Author: WAN Xue-wen Conclusion : “Research findings suggest acupuncture and cupping works well for all patterns of cervical spondylosis and can improve

cervical sclerodesmia or calcification.” Reference: WAN Xue-wen. Clinical Observation on Treatment of Cervical Spondylosis with Combined Acupuncture and Cupping Therapies DOI: 10.1007/s11726-007-0345-5 FROZEN SHOULDER

FIGURE 36 FROZEN SHOULDER BACK POINTS

Causes:

Its causes are not fully understood. It may be due to other diseases such as diabetes, cardiac diseases and thyroid diseases or prolonged

shoulder immobilization after surgery or accidents. Symptoms: Shoulder pain and stiffness

Then shoulder is very hard to move

It occurs in Women more than men

People between forty and sixty years are usually affected.

FIGURE 37 FROZEN SHOULDER FRONT POINTS

Cupping Therapy Points: Back points are: Back points are: B1 B1 B12-L and B12-R Front points: Front points: F7 On the affected side or both (F7-R and F7-L) Clinical Case: An Italian man 67 years old suffered from frozen shoulder for more than 5 years. He was unable to raise his arms to his head level. There is a difficulty in shoulder movement. Massage cupping for back and shoulder area followed by wet cupping therapy for one session was the treatment. Immediately after the session, he was able to raise his hands over his

head, and move easily his shoulder. Research: Dorina Sohn, Hyunmin Yoon, Hyangmi Jung, Effects of Dry Cupping Therapy on Shoulder Pain and Fatigue in NursesJournal of Acupuncture and Meridian Studies 1 December 2011 (volume 4 issue 4 Page 269 DOI: 10.1016/j.jams.2011.10.009) KNEE PAIN: We here take the anatomical position as our guide to do cupping around the knee and at the painful areas. Cupping Points: Back Points: Back Points: B1 B1 B23 on the affected side

FIGURE 38 KNEE PAIN BACK POINTS

Front points (On affected side left or right): Front points (On affected side left or right): F15 F15 F16 F16 F17 F17 F18

FIGURE 39 KNEE PAIN FRONT POINTS

Clinical Case: A man 35 years old was suffering from knee pain and arthritis. He was feeling severe pain when he walked. He had three wet cupping therapy treatments. He begins to feel a decrease of pain from the first session. He was completely relieved after 4 sessions. Research:

Research: K Ullah, A Younis, M Wali. An investigation into the effect of Cupping Therapy as a treatment for Anterior Knee Pain and its potential role in Health Promotion.. The Internet Journal of Alternative Medicine. 2006 Volume 4 Number 1. Journal of Alternative Medicine. 2006 Volume 4 Number 1. Michael Teut, Stefan Kaiser, Miriam Ortiz, Stephanie Roll, Sylvia Binting, Stefan N Willich and Benno Brinkhaus Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial - BMC Complementary and Alternative Medicine 2012, 12:184 doi:10.1186/1472-6882-12-184 ACUTE LUMBAR SPRAIN Causes: Excessive physical demands on Spine

Lifting heavy objects

Accidents

Heavy exercise Symptoms:

Back sharp pain

Pain during movement

Difficulty in movement

May be swelling or stiffness

SCIATICA AND LOW BACK PAIN Sciatica is a symptom of a medical condition not a condition itself and it refers to a pain, weakness and leg numbness due to injury to or a pressure on the sciatic nerve. Causes:

Pelvic injuries

Pelvic fractures

Tumors

Spinal disc herniation (pressing on sciatic nerve)

Some pain syndromes Symptoms:

Dull pain

Pain which may be worse at night or with coughing

Mild tingling or burning sensation

Sharp pain on one side of hip and numbness in other parts of the leg. The pain may also be felt at the back of the calf or on the sole of the foot.

FIGURE 40 SCIATICA BACK POINTS

Cupping Therapy points Back Points: Back Points: B1 B1 B9 B9

B17-L and B17-R B17-L and B17-R B20 on the affected side B20 on the affected side B21 on the affected side B21 on the affected side B22 on the affected side B22 on the affected side B23 on the affected side B23 on the affected side B24 on the affected side Front point: Front point: F17 on affected side Clinical case: A man 52 years old was suffering from sciatica and severe low back pain. After 4 massage cupping and wet cupping sessions, the pain was relieved. He was able to walk easily. He returned every year to do one wet cupping session to maintain the results. Research: Jong-In Kim, Tae-Hun Kim, Myeong Soo Lee, Jung Won Kang, Kun Hyung Kim, Jun-Yong Choi, Kyung-Won Kang, Ae-Ran Kim, Mi-Suk Shin, So-Young Jung and Sun-mi Cho - Evaluation of wet-cupping therapy for persistent nonspecific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial - Trials 2011, 12:146 doi:10.1186/1745-6215-12-146 [Hanan, S. Ali. and Eman, S. El-Said Cupping Therapy (AlHijama): It's Impact on Persistent Non-Specific Lower Back Pain and Client Disability. Life Sci J 2013;10(4s): 631-642] (ISSN:1097-8135). RHEUMATOID ARTHRITIS

FIGURE

Causes: The actual causes are unknown. It is considered an autoimmune disease. Symptoms: 41RHEUMATOID ARTHRITIS BACK POINTS

Morning stiffness

Joint pain usually on both sides

Joint may lose its range of motion and may become deformed

Other symptoms may include: dry eye and mouth, nodules under the skin, numbness in hands and feet and sleep difficulties.

FIGURE 42 RHEUMATOID ARTHRITIS FRONT POINTS

Cupping therapy points: Back points: Back points: B1 B1 B3-L and B3-R B3-L and B3-R B5 Front points: Front points: F7-L and F7-R F7-L and F7-R F2 F2 F13-L and F13-R F13-L and F13-R F17–L and F17-R F17–L and F17-R F21-L and F21-R Clinical case: A woman 55 years old was suffering from Rheumatoid arthritis. She was treated by wet, dry and massage cupping for 5 sessions. A decrease in pain and symptoms was noted. Research: Khalil AM, Al-Qaoud KM, Shaqqour HM. Investigation of Selected Immunocytogenetic Effects of Wet Cupping in Healthy Men. Spatula DD. 2013; 3(2): 51-57. doi:10.5455/spatula.20130712050838

Ahmed SM, Madbouly, NM, Maklad, SS, Abu-Shady EA. Immunomodulatory effects of bloodletting cupping therapy in patients with rheumatoid arthritis. Egypt J Immunol. 2005; 12:39-51. GOUT It is advised to continue drug therapy of gout like all conditions with cupping therapy treatment. Gout is a rheumatic disease, characterized by acute attacks of arthritis, usually in the great toe of the foot. It sometimes leads to deformity and chronic arthritis. Men are affected more than woman. 90% of gout sufferers are men over thirty years. There are more than two millions gout sufferers in the United States of America. In 2002, World Health Organization published Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. In this book, World Health Organization supported using acupuncture and cupping for the treatment of gout. The reviewed trial stated that: “Plumblossom needling together with cupping has been recommended for treating gouty arthritis". Symptoms of Gout: The inflammation is usually in one joint. An increase in blood uric acid is usually present due to a metabolic disorder. Acute gouty arthritis happens suddenly The most affected joint is the joint of great toe, but it may affect other

joints such as the knee, feet and ankles. The affected joint is very painful, swollen, red and warm. Fever is usually present. After the attack, the patient may be asymptomatic for years. Later, gout may become a chronic disease with a serious disability and deformity. Causes Excess alcohol, some infections, drugs and surgical operations may increase blood uric acid and lead to acute gouty arthritis. Gout treatment Bed rest is very helpful in the treatment of an acute attack. Hot and cold compresses may be helpful for some patients. Avoiding excess alcohol consumption, restriction of high purine foods like meat, kidney, sardines and liver, and avoiding drugs which increase blood uric acid such as diuretics are recommended.

FIGURE 43 GOUT BACK POINTS

GOUT FRONT POINTS44 FIGURE

Cupping therapy points: Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B15-L and B15-R B15-L and B15-R B23-L and B23-R Front points: Front points: F17-L and F11-R F17-L and F11-R F11-L and F11-R but only with dry cupping Clinical case: A man 28 years old was suffering from gout. The blood uric acid was high. His cholesterol level is also very high. He received 3 wet cupping and herbal treatments. He also continued his medical treatment. The blood uric acid returned to normal level. He was not suffering from any joint symptoms. His cholesterol returned to near normal level. Research: Pan HL. (Observation of 39 cases of gout treated with plum-blossom needling plus cupping) Zhenjiu Linchuang Zazhi, 1997, 13(3):29(in Chinese). HEADACHE One of the diseases treated very effectively with cupping therapy and acupuncture. Dry or wet Cupping is very powerful in decreasing headache pain.

Headache is defined as a pain in the area of the head or neck region. The pain varies in intensity, duration and the area affected. There are mainly two types of headaches: primary and secondary. A primary headache is the most common type of headache and the most common example of this type is migraine. Migraine is a pain in half of the head and is characterized by a throbbing pain associated with nausea, vomiting and visual disturbance. The secondary headache is caused by a problem or a disease in the head and neck. The most common causes are hemorrhage, thrombosis, inflammation, fever and raised pressure in the head and neck region. Headaches are the most common problem of the nervous system. According to the World Health Organization, it affects two thirds of men and 80% of women in developed countries. Migraine is the nineteenth most common cause of disability worldwide, and it reduces the social life of people who suffer from it by about 60% and may become a lifelong disability.

FIGURE 45 HEADACHE BACK POINTS

Cupping therapy points Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R

B2 B2 B25 (the center of the head) Some patients respond to cupping on DU 14 (B1) only, so try to begin the treatment with the most effective point and begin with a few points. Migraine is responding well to head points. The patient must shave his hair to apply cups on the head, or alternatively you can put a honey or Gel on the hair to do cupping therapy without shaving.

FIGURE 46 HEADACHE FRONT POINTS

Front points: Front points: F23-L and F23-R beside the eye on both sides (It is a very dangerous area) Clinical cases: A woman 30 years old was suffering from migraine, after one wet cupping session. The severity of pain and the frequency of migraine was

decreased significantly. A man 32 years old was suffering from very severe headache. After 2 wet cupping sessions, his pain was relieved and he was healthy and not suffering from headache for years. Research: Alireza Ahmadi, David C. Schwebel† and Mansour RezaeiThe efficacy of wet cupping in the treatment of tension and migraine headache - The American Journal of Chinese Medicine, 2008, Vol. 36, No. 1, 37–44 COMMON COLD Causes: One of the most common diseases in the world especially in winter but it can occur at any time. It caused by the cold virus which spread through air droplets so you can get a cold when a sick person coughs or sneezes near you or after you have touched a contaminated subject you touch your nose, eye or mouth. Symptoms: Sneezing

Nasal congestion and runny nose

Pain in the throat

May be fever

May be cough according to the type of the virus

Decrease of the appetite

Pain in muscles

FIGURE 47 COMMON COLD BACK POINTS

Cupping Points: Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B5 B5 B19-L and B19-R B19-L and B19-R B23-L and B23-R

FIGURE 48 COMMON COLD FRONT POINTS

Front Points:

Front Points: F6 Research: Ye XF, Zhang HF, Pang ZW. [Therapeutic effects of common cold of wind-cold type at early stage treated by different cupping duration]. Zhongguo Zhen Jiu. 2011 Apr;31(4):357-9

BRONCHITIS Is an inflammation of the bronchial tube which carry air to the lungs. ACUTE BRONCHITIS Causes: Many viruses can cause this inflammation and it transmitted the same way as the common cold.

Symptoms:

Cough

Shortness of breath

Wheezing

Chest tightness

FIGURE 49 BRONCHITIS FRONT POINTS

CHRONIC BRONCHITIS Causes: Cigarette smoking is the most common cause and long term breathing of dusts and other air pollution substances is another cause. It also called chronic obstructive pulmonary disease. Symptoms: Wet Cough (inflamed bronchi produced a lot of mucus)

Shortness of breath

Chest tightness

It is a chronic condition and it is not completely relieved by treatment

FIGURE 50 BRONCHITIS BACK POINTS

Cupping Therapy Points: Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B13-L and B13-R B13-L and B13-R

B15-L and B15-R Front Points: Front Points: F1 F1 F2 F2 F7-R and F7-L F7-R and F7-L F6 F6 F17-R and F17-L Clinical case: A man 54 years old was suffering from chronic bronchitis due to cigarette smoking. He was treated by wet cupping. There is an improvement in his symptoms. His chest tightness was decreased. Research: Zhang CQ, Liang TJ, Zhang W. [Effects of drug cupping therapy on immune function in chronic asthmatic bronchitis patients during protracted period]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Nov;26(11):984-7.

Zhao J. Combination of cupping therapy and antibiotic treatment of 220 pediatric cases with cough after acute upper respiratory infection [in Chinese]. Shanxi Journal of Traditional Chinese Medicine. 2010;26(8):34. BRONCHIAL ASTHMA Causes: It is caused by an airway inflammation In sensitive people, there are many triggers to asthma attach such as cigarette smoke, dust, pollen, exercise and respiratory infections. Symptoms: Cough

Chest tightness

Wheezing Dangerous symptoms include: bluish color, loss of breath, decreased level of alertness, rapid pulse, sweating or increased anxiety Sometimes it is a life threatening condition

FIGURE 51 BRONCHIAL ASTHMA BACK POINTS

Cupping Therapy Points: Front points: Front points: F7-L and F7-R F7-L and F7-R F1 F1 F2 F2

RN 17

N.B: the distribution of the points takes the normal anatomical position of lungs. Back Points: FIGURE 52 BRONCHIAL ASTHMA FRONT POINTS

Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B5 The patient with bronchial asthma need also: hypo allergenic diet

stop cigarette smoking and avoid passive smoking

avoid inhalation of perfumes and dust

take a lot of hot drinks such as anise and ginger Clinical cases:

A boy 13 years old was suffering from mild bronchial asthma. He received ten flash cupping therapy treatments. 2 sessions per week for five weeks. There was a significant increase in his pulmonary functions tests. There was a decrease in his bronchial asthma symptoms and a decrease in his frequent needs for the risk medication.

A man 24 years old was suffering from moderate to severe bronchial asthma. He was suffering from asthma acute attack frequently. He used the asthma risk medications more than 3 times per week. After 3 wet cupping sessions, the pulmonary functions, frequency of used risk medications, frequency of hospitalization was significantly decreased. After months, his quality of life was increased. He began to involve in exercises. His asthma degree was decreased to mild asthma. Research: Mohamed Elsayed Mohamed Abd al-Jawad, Saeed Adel Mohamed,

Badawy Ahmed Elsayed, Abd Elfattah Nevine M Mohamed - Evaluation of Wet Cupping Therapy (Hijama) as an Adjuvant Therapy in the Management of Bronchial Asthma - Indian Journal of Physiotherapy and Occupational Therapy - An International Journal Year : 2011, Volume : 5, Issue : 4 Tamer Shaban, Magdy Karam El-Deen, Rehab Abd El kader, The Role of Cupping Therapy As a Complementary Therapy On The Pulmonary Functions And Quality Of Life Of Asthmatic Children. Medical Studies Department, Institute of Postgraduate Childhood Studies, Ain Shams University- Egypt- Master Thesis – 2011 IRRITABLE BOWEL SYNDROME & SPASTIC COLON It is a bowel (intestinal) disease due to inflammation usually without known reason. This term refers to two major diseases Crohn's disease and Ulcerative Colitis. This is a harmful chronic disease and it is the main intestinal inflammatory disease in the developed countries. Irritable bowel syndrome is an adult disease, most frequently occurs between fifteen and twenty five years old. Causes: Genetic factors play an important role especially in Crohn's disease than in ulcerative colitis.

Environmental elements such as pollution and the quality of food and lifestyle.

Cigarette smoking, especially Crohn's disease. Crohn's disease: Symptoms:

May be there is no symptoms until sudden exacerbation

Low fever and diarrhea

Pain in the right side especially at the lower abdomen

A disease in the perianal area which is secreting pus such as an abscess Ulcerative colitis: Symptoms:

Diarrhea (loose stool) containing blood

Pain in the lower part of abdomen Prognosis: The inflammatory bowel disease if well diagnosed and treated by medical or surgical means according to the severity of the disease will controlled successfully and the patient will cope with and will be a productive individual without limitations or with minimal limitations. Other management procedures:

Diet therapy

Avoid stress

Relaxation techniques

Hypnotherapy treatment

FIGURE 53 IBS BACK POINTS

Cupping therapy points: Back Points:

Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B16-L and B16-R B16-L and B16-R B17-L and B17-R B17-L and B17-R B18-L and B18-R

FIGURE 54 IBS FRONT POINTS

Front points: Front points: F11-L and F11-R F11-L and F11-R F5 F5 F6

Research: MacPherson et al.: Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial. BMC Gastroenterology 2012 12:150. CHRONIC GASTRITIS It is a continuous inflammation of the stomach. Causes: Infection by bacteria called Helicobacter pylori

Malfunction of the immune system

Stress

FIGURE 55 CHRONIC GASTERITIS BACK POINTS

Pain in upper abdomen

Symptoms:

Nausea and vomiting Cupping Therapy Points Back Points: Back Points: B3-L and B3-R B3-L and B3-R B8 B8 B15-L B15-L B16-L and B16-R Front points: Front points: F3 F3 F8-L F8-L F11-L and F11-R Shuang He, Junfan Luo, Jingfen Chen - Clinical study on chronic gastritis treated by acupuncture - Journal of Acupuncture and Tuina Science - June 2011, Volume 9, Issue 3, pp 179181.

CHRONIC GASTERITIS FRONT POINTS56 FIGURE

Research: The total effective rate was more than 90% for using acupuncture plus cupping therapy at (EX –B2 ) point. DIARRHEA Diarrhea is a disease that increases a daily bowel movement to more than three times. The stool may be loose or watery. Causes:

Viral infections specially rotavirus

Infections by Bacteria and parasites

Inflammatory bowel disease

Irritable bowel syndrome

Malnutrition and malabsorption

Some tumors

Allergies to certain food and some medications

Surgery Symptoms: Three or more loose or watery bowel movements with or without the following symptoms:

Abdominal pain

Fever

Blood in stool

Weight loss

Symptoms of dehydration

Nausea and vomiting

Sense of urgency to go to bathroom

FIGURE 57 DIARRHEA BACK POINTS

Acute diarrhea is a life threatening condition especially in developing countries and immediate medical care is a must. Oral rehydration Solution must be started immediately to prevent dehydration.

FIGURE 58 DIARRHEA FRONT POINTS

Cupping therapy points: Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R B16-L and B16-R B16-L and B16-R B8 Front points: Front points: F11-L and F11-R (dry cupping)

F11-L and F11-R (dry cupping) F5 (dry cupping) F5 (dry cupping) F6 (dry cupping) Clinical case: A man 28 years old was suffering from moderate diarrhea and abdominal pain. He treated by usual western medical treatment and he received one cupping therapy treatment. The cupping session was a dry cupping session on front points. Improvement in symptoms and pain occurred in the same day. He was completely cured after 2 days. Research: Yao X. Clinical observation of cupping therapy combined with acupuncture on chronic diarrhea [in Chinese]. Jilin Medical Journal. 2006;27:1403–1404. CONSTIPATION Constipation is a common disease. The patient is suffering from inability to pass stool. There is a pain associated with constipation which may be light or medium or severe in its intensity. Diet modification with cupping therapy is recommended. We can modify the diet of the patient by: Increase the amount of fibers ingested by the patient

Increase the amount of fruits and green vegetables in the diet

One of the most effective methods is one spoon of olive oil and one spoon of honey in a cup of water before breakfast.

Walking and physical activity is also helpful in relieving constipation

FIGURE 59 CONSTIPATION BACK POINT

Cupping Therapy Points: Back Points: Back Points: B1 B1 B3-L and B3-R B3-L and B3-R

B16-L and B16-R B16-L and B16-R B17-L and B17-R B17-L and B17-R B9

FIGURE 60 CONSTIPATION FRONT POINTS

Front points:

Front points: F11-L and F11-R F11-L and F11-R F5 F5 F6 Clinical case: A woman 48 years old, suffering from chronic constipation. She received one cupping therapy treatment (wet and dry types) plus diet modification and gerbil remedies. She was relieved from constipation after 2 weeks of treatment. Diet therapy is recommended for her for maintain the improvement result.

HYPERTENSION Hypertension is called the High Blood Pressure Disease. Hypertension can be defined as a chronic disease of elevated arterial blood pressure. Normal blood pressure is 120/80 mmHg measured by special device (blood pressure monitor). Hypertension is diagnosed when your blood pressure is over 140/90 mmHg. Causes: No causes: it is also called essential hypertension, and it is a common type of hypertension Secondary hypertension : kidney diseases, birth control bills, diet pills, diseases of the adrenal gland and pregnancy are some causes. Risk factors: Obesity Cigarettes smoking Drinking alcohol Diabetic patients Previous family history of hypertension Stressful life condition Anxiety These risk factors increase the chance of getting hypertension. Symptoms: No symptoms of essential hypertension in most of cases so the elderly people must measure their blood pressure regularly. Other symptoms: Headache

Nausea

Vomiting

Blurred vision

Cupping Therapy Points: Back Points: 1. B1 2. B3-L and B3-R 3. B15-R 4. B16-L and B16-R 5. B8 6. BL 23 on both sides Essential hypertension is the most common type of hypertension without known cause. Cupping therapy decreases blood pressure to a normal level Blood pressure monitor is needed and a full cupping therapy treatment course is recommended. Cupping therapy doesn't interfere with any medication.

FIGURE 61 HYPERTENSION BACK POINTS

Clinical case: A man 55 years old was suffering from essential hypertension. His blood pressure was 160-90 before the treatment. After the wet cupping therapy session his blood pressure decreased to 140-85. He continued his usual drug therapy and continue to monitor his blood pressure.

Cupping therapy can decrease the blood pressure but it is not confirmed yet as a treatment for hypertension. So cupping therapy is a useful complementary treatment with drugs in hypertension. Research: Lee MS, Choi TY, Shin BC, Nam SS. Cupping for hypertension: A systematic review. Clin Exp Hypertens. 2010;32:423–425 FACIAL PARALYSIS It is a paralysis in one side of the face. It may involve one muscle or multiple muscles of the face. Causes:

Facial nerve trauma, inflammation or injury.

Brain disease or injury involved the brain part which controls the facial muscles.

Some tumors.

Stroke. Symptoms: The main symptom is Inability to move one or more muscles of the face on one side. Cupping Therapy points: Back Points: 1. B1 2. B3-L and B3-R Front points:

1. F22-L or F22-R (Affected side) 2. F23-L or F23-R (Affected side) 3. F24-L or F24-R (Affected side) 4. F25

FIGURE 62 FACIAL PARALYSIS FRONT POINTS

Research:

Huang LP, Cao RL, Bi YF, Han ZC, Yue BA, et al. Combination of flash cupping and acupuncture on treating of 115 cases with peripheral facial paralysis [in Chinese]. Shanxi Journal of Traditional Chinese Medicine. 2009;30:597–599.

Li P. Clinical observation on treatment of 60 cases of acute peripheral facial paralysis with acupuncture and flash cupping therapy [in Chinese]. Journal of Shanxi College of Traditional Chinese Medicine. 2010;33(4):83–84 OBESITY AND WEIGHT REDUCTION Obesity: According to the World Health Organization, in 2008, more than 200 million men and nearly 300 million women were obese. 11% of worldwide adults aged 20 and over were obese. Obesity is to have or accumulate too much fat in the body which may lead to health problems. Obesity increases the risk of some cancers such as colon cancer, diabetes, heart diseases, stroke and arthritis. Causes: There are many causes: Excess food intake and lack of physical activity (The main cause) Genetic factors Some psychiatric disorders Increasing urbanization

FIGURE 63 OBESITY BACK POINTS

FIGURE 64 OBESITY FRONT POINTS

Cupping therapy points: Front points: 1. F2 2. F3 3. F10-R and F10-L 4. F11-R and F11-L 5. F6 and 3 cm below 6. F12-R and F12-L 7. F14 – R and F14-L 8. F15 –R and F15-L 9. F18-R and F18-L 10. F19 – R and F19-L 11. F21-R and F21-L Back points 1. B1 2. B13-R and B13-L 3. B19-R and B19-L 4. B16-R and B16-L 5. B17-R and B17-L Exercises and diet therapy are recommended and very important. Research: Bu TW, Tian XL, Wang SJ, Liu W, Li XL, et al. Comparison and analysis of therapeutic effects of different therapies on simple obesity [in Chinese]. Chinese Acupuncture & Moxibustion. 2007;27:337–340. DIABETES MELLITUS Diabetes is a metabolic disorder. A diabetic patient has a high blood sugar due to failure of the pancreas to produce the right amount of insulin

which used to move sugar from the blood into cells or the cells do not respond in a right way to the produced insulin. Types There are many types but the three main types are: Type 1 diabetes is an autoimmune disease Type 2 diabetes is the most common type Gestational diabetes is diagnosed during pregnancy Causes: Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells in the pancreas. Type 2 diabetes is caused by a combination of factors, including increased insulin resistance and lack or decrease of insulin production. The trigger factors include overweight and obesity, environmental factors, genetic factors and stressful life condition. Symptoms: Fatigue

Frequent urination

Increased thirst

Increased hunger

Weight loss

Slow healing of wounds the patient

These points used to enhance the condition of

with type 2 diabetes Cupping Therapy Points: Back Points: 1. B1 2. B3-L and B3-R 3. B15-R 4. B16-L and B16-R 5. B17-L and B17-R 6. B9 Front points: 1. F2 2. F3 Research: Ramazani M, Shariatzade S, Malekirad A, Akbari A, Shariatzade M. Effect of cupping on blood factors and oxidative stress in diabetes type II. Arak University of Medical Sciences Journal. 2013; 15 (8) :54-60

Ashraf Hussein Hassan, Farag Mohammed Farag, Mohammed Elmahdy H.Sarhan, Mohammed Yakout Abdel Aziz, and Mohammed Ahmed Abo Elela. Evaluation of cupping therapy in some chronic diseases (Rheumatoid Arthritis, Type 2 DM and chronic HCV infection). Thesis Submitted in partial fulfillment for M.D Degree of Internal Medicine. 253. 2006.

FIGURE 65 DIABETES BACK POINTS

FIGURE 66 DIABETES FRONT POINTS

HEMORRHOIDS It is defined as swollen veins in the anal canal. It may be internal hemorrhoid or external hemorrhoids Causes: Continuous sever pressure in pelvic and rectal veins such as pregnancy, over weight and chronic constipation Symptoms: Bloody stool due to bleeding during defecation Rectal pain and itching Cupping Therapy Points: Back Points: 1. B1

2. B3-L and B3-R 3. B15-R 4. B16-L and B16-R 5. B8 Front points: 1. F12-L and F12-R 2. F6 Hemorrhoids need also diet modification to avoid constipation with a diet rich in green vegetables and fruits.

FIGURE 67 HEMORROIDS BACK POINTS

FIGURE 68 HEMORROIDS FRONT POINTS

DYSMENORRHEA It is defined as a pain with menstruation or the painful menstruation. It is classified into primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is a recurrent menstrual cramps not related to any other diseases. The secondary dysmenorrhea is a menstrual pain due to reproductive system disease. Causes: Primary dysmenorrhea may be due to uterine contractions Secondary dysmenorrhea is due to reproductive system diseases such as endometriosis. Symptoms: Abdominal pain Abdominal heaviness or pressure thighs

Pain in the back, hips and inner

FIGURE 69 DYSMENORRHEA FRONT POINTS

Cupping Therapy Points: Front Points 1. F6 2. F12-R and F12-L 3. F17-R and F17-L 4. F21-R and F21-L

FIGURE 70 DYSMENORRHEA BACK POINTS

Back Points

1. B8 2. B16-R and B16-L 3. B17-R and B17-L Research: Arshiya Sultana, Khaleeq ur Rahman, Muzn. Farzana, and Azad Lone Efficacy of Hijamat Bila Shurt (Dry Cupping) on Intensity of Pain in Dysmenorrhoea-A Preliminary Study - Anc Sci Life. 2010 Oct-Dec; 30(2): 47–50.

Caroline A. Smith, Caroline A. Crowther, Oswald Petrucco, Justin Beilby, and Hannah Dent, “Acupuncture to Treat Primary Dysmenorrhea in Women: A Randomized Controlled Trial,” Evidence-Based Complementary and Alternative Medicine, vol. 2011, Article ID 612464, 11 pages, 2011. doi:10.1093/ecam/nep239 AMENORRHEA Amenorrhea is a disease characterized by the absence of a monthly menstruation period. It is classified as primary and secondary amenorrhea. Primary amenorrhea is a disease of young girls who do not menstruate by the age of 16. Secondary amenorrhea is an absence of menstruation cycle in a woman after having normal menstruation cycles. Causes:

Primary Amenorrhea: Disease of ovaries Reproductive organs deformity or poor formation hormonal diseases

Neurological or

Secondary amenorrhea Pregnancy Breast feeding Menopause Due to action of some birth control methods or cessation of birth control bills Poor nutrition Emotional stress and psychiatric diseases Chronic diseases Tumors Symptoms:

No monthly menstrual flow

Cupping Therapy Points

FIGURE 71 AMENORRHEA FRONT POINTS

1. F6 2. F12-R and F12-L 3. F17-R and F17-L 4. F21-R and F21-L

Front Points

FIGURE 72 AMENORRHEA BACK POINTS

Back Points

1. B9 2. B16-R and B16-L 3. B17-R and B17-L Research: RUQIYYA PARVEEN - Clinical efficacy of Hijamat Bil Shurt (Wet Cupping) in the management of Ehtebas Tams Sanwi (Secondary Amenorrhea) – 2012 - Rajiv Gandhi University of Health Sciences,Karnataka,Bangalore – Disseration http://hdl.handle.net/123456789/7796 URTICARIA Urticaria is a very common problem. About 20% of people suffer from it during the course of their life. Urticaria is characterized by itchy swollen areas that appear on the skin. It can be classified into allergic urticaria and non-allergic urticaria Causes: Unknown causes for about 50% of cases Allergy to substances such as latex Infections Heat or cold Certain chemical exposure Emotional stress Symptoms: Urticaria is also known as hives. A raised, itchy rash May involve small or Large areas of the skin May develop Angioderma or swelling of a deeper layer of

skin.

FIGURE 73 URTICARIA BACK POINTS

Cupping Therapy Points: Back Points: 1. B1 2. B3- L and B3-R 3. B16-L and B16-R 4. B17-L and B17-R 5. And above the both elbows Research: Mohammad Sharif Sharifi, and Hamidollah Afrasiabian Evaluation of Wet Cupping Treatment in Patients with Chronic Urticaria and Angioedema - The Open Conference Proceedings Journal, 2013, 3, 1-5 ENURESIS Enuresis is known as Bed-wetting The disease is not diagnosed unless the child is 6 years or maybe 7. Nocturnal enuresis, or bed-wetting at night, is the most common type. Causes: The most common causes: A small bladder Urinary tract infections Stress or psychic disease Chronic constipation Hormonal imbalance

Diabetes

Symptoms: Repeated bed-wetting at least 2 times per week for longer than 3 months. Cupping Therapy Points: Back Points: 1. B1

2. B3-L and B3-R 3. B8 4. B15-L and B15-R (dry cupping) 5. B16-L and B16-R (dry cupping) 6. B17-L and B17-R (dry cupping)

FIGURE 74 ENURESIS BACK POINTS

Front points: 1. F5 (dry cupping) 2. F6 (dry cupping) 3. F11-L and F11-R (dry cupping) Research: Zhu Wei-ping - Clinical observation of 82 cases of enuresis treated by ginger-partitioned moxibustion plus cupping therapy - Journal of

Acupuncture and Tuina Science December 2003, Volume 1, Issue 6, pp 24-25

FIGURE 75 ENURESIS FRONT POINTS

FEMALE INFERTILITY It is the inability of the female to be pregnant after 2 years of marriage with regular intercourse and without using any contraceptive devices. The prevalence among couples is about 10% to 20%, so this method can help married infertile women to have normal ovulation and more chance to get pregnant. There were abundant clinical experiences and medical records for infertility in traditional medicine and cupping therapy. So we follow the world trend to do the research on traditional medicine since WHO launched the first global strategy on traditional and complementary/alternative medicine (TM/CAM) to assist countries to create a stronger evidence base about the safety, efficacy and quality of

the TM/CAM products and practices Causes The most common causes are hormonal disturbance or poly cystic ovary and hypo-ovarianism. Cupping Therapy can regulate the hormonal system and stimulate ovulation. If the husband is normal - pregnancy may occur from 1 to 6 months after the first cupping therapy session. Cupping stimulates ovulation and stimulates ovaries and regulates sex hormones. Cupping Therapy Points:

FIGURE 76 FEMALE INFERTILITY BACK POINTS

1. B1 2. B2 3. B3-L and B3-R 4. B15-R 5. B16-L and B16-R 6. B8

Back Points:

FIGURE 77 FEMALE INFERTILITY FRONT POINTS

Front points:

1. F3 2. F12 on both sides(dry cupping therapy) The most important points are B1 and F12 on both sides (ovarian sites)

Other interventions include diet therapy if the female is obese. Clinical Case: A female 28 years old and married 5 years ago, was suffering from infertility, poly cystic ovaries, anovoulatory periods and obesity. Pregnancy occurred after the first cupping therapy session. She delivered a twin (two boys) and they were healthy and normal. Research: Rong Zhao, Acupuncture-moxibustion treatment for polycystic ovary infertility: A report of 20 cases - Journal of Acupuncture and Tuina Science - April 2012, Volume 10, Issue 2, pp 89-91. MALE INFERTILITY Many causes of male infertility and in general it is the inability to have children. The causes may include azospermia (no sperms), Varicocele, decreased number of sperms, decreased motility of sperms and abnormal shape of sperms. Cupping Therapy Points:

FIGURE 78 MALE INFERTILITY BACK POINTS

Back points: 1. B1 2. B3-L and B3-R 3. B15-R 4. B5 5. B16-L and B16-R 6. B8

FIGURE 79 MALE INFERTILITY FRONT POINTS

Front points: 1. F12-L and F12-R (Dry cupping) 2. F6 Other interventions include: Using multivitamins with zinc supplements Using royal jelly Asian ginseng (herbal supplement) Dietary interventions Avoid stress and fatigue Case study: A male 34 years old was suffering from infertility, his seminal analysis was not normal. Sperm count was about three millions with a decrease in motility. After cupping treatment and nutritional therapy. His sperm counts were twelve millions. And his wife got pregnant after 2 months. Research:

Hennawy, M. (2004). "Cupping Therapy and Infertility". Website: http://www.obgyn.net/english/pubs/features/presentations /hennawy15/280,1 IMPOTENCE: It is a common male disease which has many causes from psychological causes and fatigue to severe somatic causes and uses of certain drugs. The definition of impotence is inability to do sexual intercourse due to the failure of erection maintenance.

FIGURE 80 IMPOTENCE BACK POINTS

Cupping Therapy Points: Back Points:

1. B1 2. B3-L and B3-R 3. B15-R 4. B16-L and B16-R 5. B8

Front points: 1. F12 on both sides (dry cupping therapy) Other interventions include: FIGURE 81 IMPOTENCE FRONT POINTS

Using multivitamins with zinc supplements Using royal jelly Asian ginseng (herbal supplement) Dietary interventions Avoid stress and fatigue PROSTATITIS: Prostatitis is inflammation of the prostate which is very common in old age which may be acute or chronic inflammation.

FIGURE82 PROSTATITIS BACK POINTS

There are many causes of this disease and it has many symptoms such as: pain, discharge and difficulty in passing urine.

Cupping Therapy Points Back Points: 1. B1 2. B3-L and B3-R 3. B16-L and B16-R 4. B8 Front points: 1. F12 on both sides 2. F 6

FIGURE83 PROSTATITIS FRONT POINTS

CHAPTER 5 CUPPING THERAPY CLINICAL TRIALS We can classify cupping therapy clinical trials into 5 categories: categories: Mechanism of action trials: The aim is to find, report and understand the mechanism of action of cupping therapy. cupping therapy. Safety trials: The aim is to report safety and side effects of various cupping therapy types. effects of various cupping therapy types. Survey researches: The aim is to report use, attitude and knowledge of cupping therapy among certain groups of participants. certain groups of participants. Clinical treatment trials: The aim is to evaluate the effectiveness of cupping therapy to treat certain disease or diseases. This may include: number of cupping therapy treatments, cost effectiveness and quality of life of participants. This also may include reporting a clinical case or cases or clinical trials reporting a clinical case or cases or clinical trials Review researches: The aim is to review previous cupping therapy trials in certain disease(s) or symptom(s) and to reach a conclusion for effectiveness of cupping therapy. effectiveness of cupping therapy. Mechanism 2-Safety of action trials trials 3-Survey4- Clinical 5- Review Researchestreatment researchestrials

There are many published studies and researches to evaluate the effectiveness of cupping therapy and there are many master and

doctorate dissertations about acupuncture and cupping therapy. And the clinical trials in this field are growing. There were a good anecdotal evidence that cupping therapy had a in treating some diseases. The need for quality designed, well controlled trials are increasing to confirm the previous researched results and to evaluate more diseases. We will discuss here some of previous randomized controlled trials and their conclusion. The randomized controlled trials are researches that randomly assigned participated patients into 2 or more groups as a test and control groups. The clinical trial areas of research included: Skin Scars Childhood bronchial asthma Hypertension Diabetes mellitus Low back pain Headache and migraine Brain infarction accompanying disorders Acne Acute facial paralysis Adult bronchial Asthma Urticaria Senile habitual constipation Hypo-ovarianism Fibromyalgia syndrome Brachialgia paraesthetica nocturna Ankylosing spondylitis Gouty arthritis Rheumatoid Arthritis Atherosclerosis Tietz syndrome Hiccup in cases of cerebrovascular accident.

Diagnosis and

treatment of early external pathogenic invasion Simple obesity Acute eczema Neurodermatitis Senile psycho physiologic disorders Pregnant suffering from early and late gestational toxicosis. Anterior Knee Pain Neck pain Clinical Treatment trials Brain infarction accompanying disorders A research was conducted by Irina Kim in Russia to evaluate the effectiveness of using acupuncture, Auriculotherapy, cupping massage and Moxibustions for treatment of Brain infarction accompanying disorders, the total effective rate was 86%. And the cured rate was 40%. The researcher concluded“Acupuncture is safe and effective method to cure consequence of BI 1

". Acne A research was conducted by Song SJ in China to evaluate the effectiveness of using ear point bloodletting combined with cupping for the treatment of acne. The researcher concluded: " The therapeutic effect of ear point blood-letting combined with cupping at Back-shu points is significantly better 2

".

Another study conducted by Moetaz El-Domyati et al. to evaluate the effectiveness of Cupping Therapy in some dermatoses concluded:“Chinese wet cupping can be considered an effective alternative or complementary therapy for chronic idiopathic urticarial (CIU) and acne vulgaris patients.”31 Acute facial paralysis A research was conducted by Wei-Hong Li from china to evaluate the effectiveness of using Western medicines, plum-blossom needle and cupping, and then local radiation by TDP for the treatment of acute facial paralysis, the cured rate was 81.2%. The researcher concluded:" Plumblossom needle therapy combined with cupping at the affected side can help restore functions of facial nerves, and obviously increase the cured rate and shorten the therapeutic course for acute facial paralysis"3. Asthma A research was conducted by Zhang et al to evaluate the effectiveness of using orally taken Liuwei Dihuang Pill (LDP) and drug cupping therapy for treatment of asthma. The effective rate was (90.0% vs. 59.5%)4 . Another study conducted by Shao Jingming to evaluate the effectiveness of using acupuncture, Moxa, and cupping therapy for asthma. The researcher found that 98.2% were improved or markedly improved and a comparison of the effects of Bl13, Du 14 and Bl12 using acupuncture with cupping, acupuncture with Moxa and no treatment showed the greatest improvement for acupuncture with cupping.5 Another study conducted by Mohamed Abd Elgawad et al to evaluate the effectiveness of cupping therapy as an adjuvant therapy in the management of patient with bronchial asthma reported significant improvement in pulmonary functions and daytime symptoms in a group treated by cupping therapy and asthma drug therapy.26

Urticaria A research was conducted by Yang YL et al to evaluate the effectiveness of using cupping therapy on shenque point to treat urticaria. There were improvement symptoms in 93.8%, and 35.8% of patients were cured6. Senile habitual constipation A research was conducted by Jiang et al to evaluate the effectiveness of using moving cupping and moxibustion to treat senile habitual constipation. The clinical cured-markedly effective rate was 84.4%7. Hypo-ovarianism A research was conducted by Ma et al to evaluate the effectiveness of using Body acupuncture (manual) plus cupping for the treatment of hypo ovarianism. The effective rate was 76.8% vs.47.3%. The researcher also reported the long term effect of the acupuncture plus cupping by hormonal assay8. Fibromyalgia syndrome A research was conducted by Li CD et al to evaluate the effectiveness of acupuncture at five mental points, moving cupping on the back on fibromyalgia patients. The researcher concluded:" Combination of acupuncture with cupping therapy is an effective therapy for fibromyalgia syndrome"9. Brachialgia paraesthetica nocturna A research was conducted by Ludtke et al in Germany to evaluate the effectiveness of using wet cupping once to treat brachialgia paraethetica nocturna. This study reported shortterm effects of a single wet cupping

therapy session, which remained at least for 1 week10. Ankylosing spondylitis A research was conducted by Xue-wen Wan to evaluate the effectiveness of using acupuncture combined with cupping therapy to treat ankylosing spondylitis. The researcher concluded :" clinical remission rate was 62.5%vs 33.3%, the total effective rate 93.8% vs. 83.3%, the recurrence rate after one year was 3.3%vs 24.0%."11. Gouty arthritis A research was conducted by Pan to evaluate the effectiveness of using Plum-blossom needling plus cupping for the treatment of gouty arthritis. The researcher concluded:" After 6 weeks of treatment, a marked improvement was observed in: 100% of the test group, 65% of the control group"12. Rheumatoid Arthritis A research (Master thesis) was conducted in Egypt by Sahbaa M. Ahmed et al and published in the Egyptian journal of immunology to evaluate the effectiveness of bloodletting cupping therapy for treatment of rheumatoid arthritis as a complementary therapy. The researcher concluded: " blood-letting cupping combined with conventional medicinal therapy has several advantages. It exerts marked improvement on the clinical condition of patients, especially visual analogue scale of pain"13. Atherosclerosis A research was conducted by Niasari et al from Iran to evaluate the effectiveness of wet cupping therapy for treatment of atherosclerosis

concluded:" Wet cupping may be an effective method of reducing LDL cholesterol in men and consequently may have a preventive effect against atherosclerosis"14. Tietz syndrome A research was conducted by Yang, 1997 to evaluate the effectiveness of acupuncture plus cupping therapy for the treatment of Tietz syndrome. The cure rate was 64.8% vs. 37.5% in the control group15. Hiccup in cases of cerebrovascular accident A research was conducted by Hongliang et al to evaluate the effectiveness of acupuncture and cupping for treatment of hiccup in cases of cerebrovascular accident. The result was total effective rate is 92.5% vs. 72.5%. The researcher concluded :" The effect of acupuncture and cupping for hiccup due to cerebrovascular accident was noticeably superior to Ritaline"16. Diagnosis and treatment of early external pathogenic invasion A research was conducted in New York by Moses et al who use cupping around the area of Zhongfu (LU 1) to diagnose and treat early pathogenic invasion. The total effective rate was 96.0%. The research concluded :" Application of cupping around the area of Zhongfu (LU 1) seems to be able to diagnose, prevent and treat early stage of external pathogenic invasion. This modality has significant clinical value, and further research is warranted."17. Simple obesity

A research was conducted by Yin et al by using electro acupuncture, movable cupping plus acupoint catgut embedding to treat simple obesity. The total effective rate was 90.0%. The researchers concluded:" Acupuncture, cupping plus acupoint catgut embedding therapy can increase therapeutic effect on simple obesity of stomach and intestine excess-heat type, and it is a better method for treatment of this disease"18. Acute eczema A research was conducted by Yao J et al. They pricked the affected parts with three-edge needle and bloodletting, puncturing and cupping at back-Shu points with a threeedge needle. The total effective rate is 100.0% and markedly effective rate is 89.1%. The researcher concluded: " Pricking and bloodletting and cupping with a three-edge needle has a definite therapeutic effect on acute eczema, which is better than that of the western medicine."19. Neurodermatitis A research was conducted by Zhang Y et al by using hot-red needle therapy combined with bloodletting puncturing and cupping for the test group versus medical cream for the control group. The effective rate was 96.3% vs. 81.0%. The cured rate was 51.9%vs 28.6%20. Senile psycho physiologic disorders A research was conducted by Qie YL by using acupuncture and Moxibustion combined with rapid and repeated cupping. The researcher concluded:" Acupuncture and moxibustion combined with rapid and repeated cupping at points on the back can more rapidly alleviate the psychotic symptoms of thinking more and misgivings."21. Pregnant suffering from early and late gestational toxicosis

A research was conducted by Tamara et al at Women Hospital, Korsakov, Russia the researcher used cuppingglasses massage for the test and the result was 70%vs25% and the researcher reported very important points about cupping therapy, the researcher concluded:" Vacuum therapy is an effective method of treatment in obstetrics. Advantage: it has no collateral effects on the pregnant body and fetus. It sufficiently improves the uteroplancental circulation of blood. It's a preventive measure against infant's and mother's death. Treatment is carried out in outpatient conditions that's why being highly effective it doesn't require the pregnant women to be hospitalized."22. Anterior Knee Pain A research was conducted by Ahmed Younis et al. At the University of East Anglia, UK to evaluate the effectiveness of cupping therapy for the treatment of anterior knee pain. The researcher concluded:" The efficacy of the treatment of Cupping Therapy for Anterior Knee Pain, wellbeing and range of motion has been researched and results reveal improvements in participants as a result of Cupping Therapy"23. Skin scars A research was conducted in Egypt to evaluate the subcision –suction method in the subcision –suction method in the treatment of depressed scars (post acne scars, chicken pox scars and post-traumatic scars) by Rehab Lotfy et al. The researchers concluded that“At the end the treatment by Subcision-suction method, all groups showed improvement after the treatment. But results showed highly significant correlation between the suction session’s regularity and the improvement of scar”24 Lumbar disc prolapse A research was conducted in Egypt to evaluate the efficacy of cupping in management of lumbar disc prolapse by Shaimaa Atwa et al. The

researcher concluded : “Comparison of patients treated with cupping therapy and patients treated with physical therapy and the same therapeutic exercise program displayed significant better improvement in patients received cupping therapy in the same outcomes”25. Childhood bronchial asthma A research was conducted by Tamer Shaban et al (The book author) in Ain Shams University to evaluate the effectiveness of Cupping Therapy as a complementary therapy on the pulmonary functions and quality of life of asthmatic children. Full treatment program and results will be published in a separate book. Abstract The aim of this study was to evaluate the effectiveness of Cupping Therapy as a complementary therapy on the pulmonary functions and quality of life of asthmatic children and adolescent. Patients in the study were 60 children with diagnosed Mild persistent asthma divided into two groups, thirty children with mild persistent asthma (8 Female and 22 Male) enrolled in this study as a study group (Cupping therapy + drug treatment). And matched age and sex of thirty children with mild persistent asthma (7 Female and 23 Male) as a control group (drug treatment only) for comparative purpose. Pediatric Quality of Life Questionnaire and Pulmonary functions (FEV1, FVC, FEV1/FVC Ratio, and FEF 25%-75%) were measured before and after the treatment for both groups. Changes in all pulmonary function tests (FEV1, FVC, FEV1/FVC and FEF 25%- 75%) and Pediatric Quality of Life Questionnaire were found to be significantly higher in (Study group) than in the control group (p-value < 0.05). Conclusion: “Cupping Therapy is an effective complementary treatment in asthmatic children and has a significant improvement effect on the pulmonary function and on the quality of life of asthmatic children.”27

Low Back Pain A research was conducted in Egypt by Amal Desouki et al. To evaluate the effects of the intervention technique (epidural analgesia) versus traditional technique (Cupping therapy) for pain relief in patients with low back pain which failed to recover with the conservative medical treatment. The researcher concluded:“The epidural injection of steroids and local anesthetics for the relief of low back pain is effective, and has wonderful results. Also, the wet cupping therapy has the similar effect but without any complications, safe and cost effective.”28 Hypertension and cardiovascular diseases A research was conducted in the Faculty of Medicine at Tanta University by Mohammed Hamed Gabriel et al. to answer this question: Cupping therapy (al-hijama) does it have a medical role in cardiovascular diseases? And the researchers concluded:” cupping therapy has the capacity of controlling various risk factors of heart diseases, like hypertension, diabetes mellitus and hyperlipidaemia. In hypertension, cupping therapy was proved by the traditional Chinese medicine to be an effective therapy for controlling the blood pressure of many cases”29. Diabetes Mellitus A research (doctorate dissertation) was conducted by Ashraf H. H. Mohamed et al. for evaluation of cupping therapy in some chronic diseases (Rheumatoid Arthritis, Type 2 DM and chronic HCV infection). The researchers concluded:“Cupping therapy plays an important role in controlling blood sugar and improving symptoms as an adjuvant therapy”30. Neck Pain

A research was conducted by Romy Lauche et al. to evaluate the effectiveness of traditional Cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain. The researcher concluded:“A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in chronic nonspecific neck pain (CNP).”32 Conclusion There were several trials reported the positive effects of cupping therapy and its great promising effects and positive results, we encourage all research centers and organizations to design and organize high quality randomized controlled trials in the field cupping therapy. We encourage the translation of cupping therapy trials from other languages specially Chinese, Korean, German and Japanese to English facilitating access these translations. The practice of cupping therapy regulated in some countries but not in all countries, In the USA the certified acupuncturist usually can practice cupping therapy as a part of the practice license, in some states the physicians can practice cupping therapy in as a part of the practice license. Some states required certain training hours practice. In the same time, there are many countries without regulation procedures, so we encourage these countries to take steps into the regulation of CAM therapies, and the world health organization encouraged that in its traditional medicine strategy plan. The future is for integrating medical and complementary medicine treatments especially for complex and chronic diseases. WHO (World Health Organization) encouraged governments to integrate the traditional medicine therapies into the main healthcare stream as they are cost effective therapies for many conditions. I believe there is a cure for every disease we will discover someday. We may not find yet the appropriate treatment but someone will do. Our duty as a medical

community is to search and try various treatments. We must use every piece of our knowledge, to discover a cure for diseases like cancer, diabetes, hypertension and many other diseases. REFERENCE 1. Irina Kim (Acupuncture for the treatment of brain infarct) ICMART '97 International Medical Acupuncture Symposium 2. Song SJ [Observation on therapeutic effect of ear point blood-letting combined with cupping on Back-shu points for treatment of acne vulgaris] Zhongguo Zhen Jiu. 2007 Aug;27(8):626-8 3. Wei-Hong Li (Clinical observation on plum-blossom needle therapy combined with cupping for treatment of acute facial paralysis] Zhongguo Zhen Jiu. 2005 Nov ;25 (11):765-7 16335199 4. Zhang CQ, Liang TJ, Zhang W. [Effects of drug cupping therapy on immune function in chronic asthmatic bronchitis patients during protracted period] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Nov; 26(11):984-7. 5. Shao Jingming (1985) Clinical Observation on 111 cases of Asthma Treated by Acupuncture and Moxibustion. Journal of Traditional Chinese. Medicine. 5(1): 23-25. 6. Yang YL, Lo HC." Cupping of shenque point to treat chronic urticaria" [in Chinese]. Chin Acupunct Moxibustion. 1993; 13:51. 7. Jiang ZY,Li CD, Li JC, Gao L, Wang QF, [Clinical observation on moving cupping therapy combined with moxibustion for treatment of senile habitual constipation], Zhongguo Zhen Jiu. 2005 Dec; 25(12):8534. 8. Ma RH et al. [Clinical observation of 56 cases of hypoovarianism treated with acupuncture.] Chinese Acupuncture and Moxibustion, 1997, 17(7):395–396 [in Chinese]. 9. Li CD, Fu XY, Jiang ZY, Yang XG,Huang SQ,Wang QF, Liu J, Chen Y. [Clinical study on combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome], Zhongguo Zhen Jiu. 2006 Jan; 26(1):8-10. 10. Ludtke R, Albrecht U, Stange R, Uehleke B. "Brachialgia paraesthetica nocturna can be relieved by "wet cupping"-

results of a randomized pilot study". Complement Ther Med. 2006 Dec; 14(4):247-53. Epub 2006 Sep 26. 11. Xue-wen Wan [Clinical observation on acupuncture combined with cupping therapy for treatment of ankylosing spondylitis] Zhongguo Zhen Jiu. 2005 Aug ;25 (8):551-2 16309054 12. Pan HL. [Observation of 39 cases of gout treated with plum-blossom needling plus cupping.] Zhenjiu Linchuang Zazhi, 1997, 13(3):29 [in Chinese]. 13. Sahbaa M. Ahmed, Nour H. Madbouly, Soheir S. Maklad and Eman A. Abu-Shady(Immunomodulatory Effects of Blood Letting Cupping Therapy in Patients with Rheumatoid Arthritis) THE EGYPTIAN JOURNAL OF IMMUNOLOGY(Vol. 12 (2), 2005 Page: 39-51) 14. Niasari M, Kosari F, Ahmadi A. (The effect of wet cupping on serum lipid concentrations of clinically healthy young men: a randomized controlled trial) J Altern Complement Med. 2007 JanFeb;13(1):79-82 15. Yang XT. [Observation of 108 cases of Tietze's syndrome treated with short needling plus cupping.] Chinese Acupuncture and Moxibustion, 1997, 17(7):435–436 [in Chinese]. 16. Hongliang X, Xuemei C, Shizhao H, Chaofeng L. "Acupuncture and cupping for treatment of hiccup in cases of cerebrovascular accident". J Tradit Chin Med. 2006 Sep; 26(3):175-6. 17. Moses L, Wang BX. "Study on cupping for diagnosis and treatment of early external pathogenic invasion] Zhongguo Zhen Jiu. 2005 Sep; 25(9):636-8. 18. Yin Shi, Lin-shan Zhang, Chen Zhao, Chun-qing He (Comparison of therapeutic effects of acupuncture-cupping plus acupoint catgut embedding and electroacupuncture on simple obesity of stomach and intestine excess-heat type] Zhongguo Zhen Jiu. 2006 Aug ;26 (8):547-50 16941970 19. Yao J, Li NF [Clinical observation on pricking and bloodletting and cupping with a three-edge needle for treatment letting and cupping with a three-edge needle for treatment 6 20. Zhang Y, Zhou JW, Huang S, Chen CT, Deng Y, Huang YH [Observation on the therapeutic effect of a red-hot needle therapy combined with blood-letting puncture and cupping for treatment of Neurodermatitis] Zhongguo Zhen Jiu. 2007 Apr;27(4):252-4 21. Qie YL [Observation on therapeutic effect of acupuncture and

moxibustion combined with cupping on senile psychophysiologic disorders] Zhongguo Zhen Jiu. 2005 May;25(5):329-30 22. Dr.Tamara Khvan, Tatyana Kim (Vacuum therapy in obstetrics) abstracts of ICMART '97 International Medical Acupuncture Symposium. http://altmed.iatp.org.ua/acupuncture/treatment/icmart97/ p41.html 23. Ahmed Younis, Kaleem Ullah: An investigation into the effect of Cupping Therapy as a treatment for Anterior Knee Pain and its potential role in Health Promotion. The Internet Journal of Alternative Medicine. 2007. Volume 4 Number 1. 24. Rehab Lotfy Ajjour ;Mohammed Zaki Kenawi, Asmaa Mohammed El-Refaey - Subcision-suction method - a new combination therapy in treatment of some acne scars and other depressed scars. Thesis (M.S)Banha university. faculty of medicine. department of venereology and andrology – 2012 25. Shaimaa Atwa Mohammad Ali ; Ibrahim Abdullah ElBoghdady and Mona Ahmed Mohsen - Efficacy of cupping in management of lumbar disc prolapse - Essay (M.S.)Mansoura University. Faculty of Medicine. Department of Rheumatology – 2009 26. Mohamed Elsayed Mohamed Abd Elgawad, Adel Mohamed Saeed,Ahmed Elsayed Badawy,Nevine M. Mohamed Abd Elfattah evaluation ofcupping therapy as an adjuvant therapy in management of bronchial asthma - thesisM.SFaculty of Medicine. Ain Shams University.Chest Diseases 2009. 27. Tamer Shaban, Magdy Karam El-Deen Aly Daif,Rehab Abd El kader Mahmoud - Thesis (Master) Ain Shams universityInstitute of Postgraduate Childhood Studies,Department of childhood medical studies -2010. 28. Amal Desouki Abdel-Aal;Salah Naguib Ahmed EL-Tallawy, Sahar Adly Hashish, Ali Mohamed Ramadan - Comparison of Interventional versus Alternative Techniques for Low Back Pain – Master thesis - ELMinia University – 2005 29. Mohammed Hamed Gabre Sherif; Fathia Ahmed ElSheshtawy, Samia Sharaf El-Den, Mahmoud Zaky ElAmroussy - Cupping therapy(al-hijama)does it have a medical role in cardiovascular diseases - Thesis(M.Sc)Tanta university.Faculty of medicine.cardiology department – 2008

30. Ashraf Hussein Hassan Mohamed ,Farag Mohamed Farag, Mohamed Ahmed Abu El-Ela, Mohamed El-Mahdy Sarhan, Mohamed Yakout Abd El--Aziz - Evaluation of cupping therapy in some chronic diseases (Rheumatoid Arthritis, Type 2 DM and chronic HCV infection) - Thesis (Ph.D.)- Mansoura University. Faculty of Medicine. Department of Internal Medicin – 2006 31. Moetaz El-Domyati, Fatma Saleh, Manal Barakat and Nageh Mohamed - Evaluation of Cupping Therapy in Some Dermatoses Egyptian Dermatology Online Journal - Vol. 9 No 1: 2, June 2013 32. Romy Lauche, Holger Cramer, Claudia Hohmann, et al., “The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 429718, 10 pages, 2012. doi:10.1155/2012/429718

CHAPTER 6 INTERSTING TOPICS One or two direction massage: Using massage or moving cupping therapy in one direction or two directions? A study was conducted by Tian YY et al confirmed the effect of moving (massage) cupping therapy on increasing the skin blood flow and concluded: “It is suggested that the dual-directional moving cupping is applicable for the treatment of local disorders and the abscopal effect is better with moving cupping against the meridian running direction”1 Two directions are recommended. Massage cupping against the meridian running direction is more superior in increasing the skin blood flow. Interesting Trial Cupping: A method to obtain epithelial grafts for the management of resistant localized vitiligo. Cupping therapy used to help the surgeons to obtain blisters from the thigh skin to use for grafting on derma braded vitiliginous patches. There was 80% success rate without any side effects. A research was conducted with a faculty of medicine at Minia University by Sherif Shoukry Awad concluded:” Chinese cupping is a simple and easy-to-use method to obtain epithelial grafts for vitiligo management.”2 Creativity in the cupping therapy field

Patents: there are many patents and creative progress in the field of cupping therapy, there are creative patents every day in this field. For example, multi functions cupping apparatus, instant pressure adjustable full automatic cupping apparatus and a full cupping therapy system patent. There are no limits to the creativity of the humankind. And I think we are just in the beginning in the field of cupping therapy inventions. We can classify inventions in this field to: We can classify inventions in this field to: New cup shapes and functions patents New cup shapes and functions patents Scraping techniques and apparatus patents Scraping techniques and apparatus patents A combination of cupping and other healing method patents patents Full automatic cupping therapy patents Full automatic cupping therapy patents Cupping therapy apparatus for certain disease patents New Cups: There is creativity in the shapes of cupping therapy cups. There are new curved cups of various sized to suit the shapes of joints. The hexagonal honeycomb cupping set is another new creative cup shape. New and sometimes rare materials used to produce some new cups. Silicone cups as an example are now popular especially for facial and massage cupping therapy. New cupping types: Aquatic cupping therapy is an example of the new cupping therapy methods. The patient receives a dry cupping therapy by rubber cups session underwater in a swimming pool.

Facial cupping and foot cupping are other examples of methods of cupping therapy related to the area treated. The development of new techniques in the treatment methods and art of the treatment of one area is essential for the cupping therapists. It leads to more professional skilled therapists and more sub specialty in cupping therapy careers. References: 1. Tian YY, Wang GJ, Huang T, Jia SY, Zhang YQ, Zhang WB - Impacts on skin blood flow under moving cupping along meridians in different directions - Zhongguo Zhen Jiu. 2013 Mar;33(3):247-51.. 2. Sherif Shoukry Awad - Chinese cupping: A simple method to obtain epithelial grafts for the management of resistant localized vitiligo dermatologic surgery journal-no 9 – volume 34 – pages 1186-1193 – Sep 2008 Dr. Tamer Shaban Master of Child Health and Nutrition. MBBCh (bachelor of medicine and surgery) D.H.P (diploma of hypnotherapy and psychotherapy) D.C.M.T (diploma of complete mind therapy)

S.N.H.S Dip. (Nutrition) S.N.H.S Dip. (Herbalism) Postgraduate certificate of cupping therapy Member of the Royle Institute of Hypnotherapy and Psychotherapy (UK) Member of the Complete Mind therapists Association (UK) Fellowship member of the school of natural health sciences Author of the professional guide to cupping therapy book For comments, questions, feedback and advices please visit this website: www.acupuncturecupping.org

Notes