Fire cupping or simply cupping is a form of traditional medicine found
in many cultures worldwide. It involves placing cups containing reduced
air pressure (suction) on the skin. It is known in local languages as
baguan/baguar, badkesh, banki, bahnkes, bekam, buhang, bentusa, kuyukaku,
gak hoi, hijama, and many other names.
Although there is reason to believe the practice dates from as early as
3000 B.C., the earliest record of cupping is in Ebers Papyrus, one of
the oldest medical textbooks in the world. It describes in 1,550 B.C.
Egyptians used cupping. Archaeologists have found evidence in China of
cupping dating back to 1,000 B.C. In ancient Greece, Hippocrates (c. 400
B.C.) used cupping for internal disease and structural problems. This
method in multiple forms spread into medicine in Asian and European
Cupping in Europe and the Middle East grew from humoral medicine, a
system of health ancient Greeks used to restore balance through the four
"humors" in the body: blood, phlegm, yellow bile and black bile. This
system was pervasive in European and Middle-East cultures at the time.
To apply a cup, its oxygen has to be extinguished, enabling the cup to
suck the skin and draw blood to that area. To let blood, punctures were
made before applying the cup, after removing the cup or in the following
sequence to increase bloodletting, the removal of excess blood to
restore health. Humoral medicine had a brief revival in European
medicine in the 18th and 19th centuries, and cupping was used widely in
In traditional Chinese medicine (TCM) cupping is a method of applying
acupressure by creating a vacuum on the patient's skin. The therapy is
used to dispel stagnation—stagnant blood and lymph, thereby improving qi
flow—to treat respiratory diseases such as the common cold, pneumonia
and bronchitis. Cupping also is used on back, neck, shoulder and other
musculoskeletal conditions. Its advocates say it has other applications,
The cupping procedure commonly involves creating a small area of low air
pressure next to the skin. However, there is variety in the tools used,
the method of creating the low pressure, and the procedures followed
during the treatment.
The cups themselves can be various shapes including balls or bells, and
may range in size from 1 to 3 inches (25mm – 75mm) across the opening.
Plastic and glass are the most common materials used today, replacing
the horn, pottery, bronze and bamboo cups used in earlier times. The low
air pressure required may be created by heating the cup or the air
inside it with an open flame or a bath in hot scented oils, then placing
it against the skin. As the air inside the cup cools, it contracts and
draws the skin slightly inside. More recently, vacuum can be created
with a mechanical suction pump acting through a valve located at the top
of the cup. Rubber cups are also available that squeeze the air out and
adapt to uneven or bony surfaces.
In practice, cups are normally used only on softer tissue that can form
a good seal with the edge of the cup. They may be used singly or in
large number to cover a larger area. They may be used by themselves or
placed over an acupuncture needle. Skin may be lubricated, allowing the
cup to move across the skin slowly. The skin may be lanced before
placing the cup so that the vacuum draws fluids, primarily blood, into
the cup as part of the treatment.
Depending on the specific treatment, skin marking is common after the
cups are removed. This may be a simple red ring that disappears quickly,
but more aggressive treatments can result in deeper bruising. In
general, the longer a cup is left on, the more of a circular mark is
created. Usually treatments are not painful, but treatment should be
discontinued if the person receiving it experiences more than minor