Cupping Therapy Seminar Held in the Institute of Acupuncture and Moxibustion,CACMS
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  • CHEN Zelin

    Associate Professor, Tianjin University of Traditional Chinese Medicine

    Director, Teaching and Research Section of Preclinical Acupuncture

    WU Zhongchao

    Professor, China Academy of Chinese Medical Sciences

    Former associate director of Institute of Acupuncture and Moxibustion

  • ZHANG Weibo

    Professor, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences

    ZHAO Jiping

    Director of Acupuncture and Moxibustion Department, Dongzhimen Hospital, Beijing University of Chinese Medicine

  • HUANG Tao

    Ph.D., China Academy of Chinese Medical Sciences (CACMS)

    Postdoctor, Harvard University

    QI Shulan

    Executive editor-in-chief, Chinese Acupuncture & Moxibustion

Those dark red spots dotting the limbs and backs of Michael Phelps and other Olympians at Rio have received worldwide attention. Chinese cupping spurted into popularity in social networks accidentally, jokingly referred to as “witchcraft of the East”. On October 28, International Publishing Center of CNKI and Editorial Department of the journal Chinese Acupuncture and Moxibustion jointly organized an expert forum “Leading Academic Seminar on Chinese acupuncture, moxibustion and cupping therapy” in the Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, which was expected to promote the studies on Chinese acupuncture, moxibustion and cupping therapy and the transmission of Chinese medical knowledge of health.

The notion of “healthy China, fitness of all” rose to the top level of national strategy in the Healthy China 2030 Project recently was released by the Central Committee of the Communist Party of China and the State Council of the People’s Republic of China. Chinese acupuncture, moxibustion and cupping therapy, as the precious legacy of China’s medical and scientific research, undertake a critical mission.

Acknowledged experts in this field attended this seminar and intensely discussed issues concerning cupping therapy, such as its efficacy, clinical application, scientific mechanism and the application of vesiculating cupping. Among them were Prof. Chen Zelin, Secretary General of the Pricking and Cupping Committee, China Association for Acupuncture-Moxibustion; Prof. Huang Zhongchao, previous Deputy Director of the Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences; Prof. Zhang Weibo, recognized meridian expert and Dr. Huang Tao from the same institute; and Director Zhao Jiping of Acupuncture and Moxibustion Department, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine. Director Li He of Editorial Department of the China Journal of Materia Medica and Deputy Director Wang Weixia of Editorial Department of the Chinese Journal of Integrated Traditional and Western Medicine participated in the meeting, which was chaired by executive editor-in-chief Qi Shulan of the journal Chinese Acupuncture and Moxibustion.

Origin of cupping therapy

The origin of cupping therapy was presented in detail in Dr. Huang’s article Horn method and cupping published in the Chinese Acupuncture and Moxibustion, Issue 10 of 2016. Cupping was called “horn method” in the ancient times, with different names and manipulations throughout history. In this study, Dr. Huang elucidated and investigated wet cupping, cupping after needling, cupping via heated water, fire cupping, etc. Nowadays, with the advance of technology and materials, diversified methods and instruments for cupping emerge.

In contrast, Prof. Chen introduced the origin of cupping therapy by comparing its use in the Chinese and Western history. Cupping therapy, one of the oldest forms of medical practices, appeared in the East and West at the same time, but it was passed down and expanded in China along with acupuncture & moxibustion, massage and scrapping therapy. The earliest recordings in the West were found in the Ebers Papyrus. In ancient Greece, it was commonly used alongside bloodletting therapy; however, regarding how to perform the therapy, there were no writings being uncovered. In the East the use of cupping dated back to the ancient literature of Chinese medicine, but it was called horn method at that time. In the book Prescription for Fifty-two Diseases unearthed from Mawangdui Han tombs, horn method was added in. Later generations constantly developed and promoted this therapy in terms of instruments, the texture of instruments and indications. Bamboo cup originating in the Tang Dynasty had been in use till the beginning of the Qin Dynasty. Fire cupping, still popular today, first appeared in the Qing Dynasty during which it was applied to the treatment of headache, abdominal pain etc. and even first aid for drowning. Suction cup was introduced into China during the Republican Era (1912-1949); since then its clinical application has been extended. In 1950s, methods of cupping flourished; there came movable cupping, sliding cupping, flying cupping, drifting cupping, etc.

Cupping spot and blister

The cupping spot results from capillary dilation under the local suction pressure, said Prof. Zhang. When there is rich arterial blood, the spot looks red; under stronger stimulation, capillaries rupture, and blood flows into the interstitial space in the surrounding area; once blood flow stops, due to the lack of oxygen in blood, the spot became dark purple, as we see on the skin surface. Physiologically, cupping spot shows the oxygen content of hemoglobin. In Dr. Huang’s view, cupping spot varies among people with different constitutions and diseases. Prof. Wu agreed that cupping spot came out quickly in patients with damp syndrome but slowly in those with insufficiency or cold syndrome.

Likewise, cupping does not necessarily give blisters. Director Zhao said, some patients may blister all over the body in less than one minute, while for those with typical damp syndrome and purple tongue, even prolonged retention time does not lead to blisters. Apart from individual differences, the occurrence of blister is affected by the site of cupping, the intensity of suction pressure, manipulation, retention time and the texture of cup. Prof. Wu cautioned the use of cupping in the area with thin layer of subcutaneous tissue where blister easily occurs, such as the chest.

He also proposed to reduce the intensity of cupping for the elderly who recover slowly and for patients who suffer from chronic diseases and need long-term treatment, and to slightly increase the intensity for those with acute diseases and a short treatment course.

Fire cupping, Bamboo cup or Suction cup

According to Director Zhao, bamboo cup is most favored in clinical application and receives positive feedback due to its gentle suction force, which distinguishes it from other cups. Prof. Wu further explained the differences between cups with different texture in pressure and thermal variation. Fire cupping experiences the sharpest drop in temperature, just the opposite of bamboo cup; nevertheless it is helpful if the condition of skin surface should be observed. Suction cup and bamboo cup rank first in view of security and efficacy, respectively. Cups should be selected to cater to individual needs.

Prof. Zhang, on the other hand, studied how cups of different texture improve the blood flow volume by introducing advanced instruments like laser Doppler flowmeter, hyperspectral imaging system and meridian dredging therapeutic device, with the finding that suction cup performed better than fire cup. The reason is that a certain amount of carbon dioxide still lingers during fire cupping while suction cup is connected to the outside air, which helps a lot.

Where do we put cups?

Textbooks recommend that cups be put on the area with larger body surface, such as the waist and the back. However, Director Zhao said, from her practical experience, small cups moving on the face of patients with peripheral facial paralysis obtained good results during convalescence and sequela. In addition, cups are generally put behind the ears in the case of facial cupping. Youngsters often choose quick cupping (or successive flash cupping) which produces smaller suction pressure in consideration of facial appearance.

Cupping spots on Michael Phelps' shoulders and back

Why did Phelps require cupping therapy? Dr. Huang, after analyzing those cupping spots, responded that dampness accumulated in swimming could be discharged through cupping. Prof. Zhang added, lactic acid generated after heavy exercise could be quickly degraded via cupping, getting athletes into a good state.

Efficacy of cupping therapy

How does cupping work? Prof. Zhang elucidated its mechanism by applying her professional knowledge of meridian science. Suction pressure produced during cupping accelerates the flow of tissue fluid, carrying wastes from the area deep inside the body to the surface where they are discharged through metabolic channels including skin.

Cupping ameliorates pain in patients with hypertension, as Dr. Huang observed in clinical application. For hypertension, treatment should be administered in the light of patients’ responses rather than indexes in the Western medicine. She illustrated her point by citing an example: a patient with hypertension felt comfortable after receiving several sessions of cupping therapy, though blood pressure remained high; when blood pressure fell after taking antihypertensive drugs, nausea, dizziness and other symptoms re-attacked. Traditional Chinese medicine (TCM) should display its advantages, taking patients’ feelings into account, instead of being limited by “indexes”. She suggested patients have more cupping therapy in spring and summer, but less in autumn and winter, since Yang qi moves to the exterior in the former two seasons but hides deep inside the body in the latter two seasons when it shouldn’t be suctioned out.

The technique of performing cupping therapy directly impacts efficacy, said Director Zhao. The clear sound produced when removing cups is what therapists and patients both seek after. Cupping is an operation in which every movement should be sophisticated and the handling of cups should be proficient to achieve the best results.

Cupping therapy has unique effects on rheumatoid arthritis, diseases caused by chronic strain, and cervical spondylosis, as Prof. Chen summarized from clinical experience and research. Cupping claims leading therapy among TCM therapies and when it is applied alongside other therapies like acupuncture, moxibustion, massage, and scrapping therapy, their effects can be enhanced. It can also be used in combination with medication, which demands further exploration. From liquid medicine infused into cups in the old times, movable cupping and cupping using powdered medicine, etc. are now developed.

Featured articles in Chinese Acupuncture and Moxibustion, Issue 10 and Issue 11 of 2016, introduced the origin of cupping therapy, studies on cupping spots and the application of vesiculating cupping, which are expected to facilitate relevant research, promotion and transmission of Chinese acupuncture, moxibustion and cupping therapy.

JTP's LIU Kang and JIN Ge contributed to this report.

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