Cupping (Hijama) Between Arab and Chinese Traditions and Modern Medicine

Cupping is one of the traditional treatments that peoples have known since ancient times. Many cultures have used it, most notably Arab and Chinese medicine.

In this article we review the fundamental differences between Arab cupping, which includes dry and wet cupping (with superficial incisions and drawing blood) and forms the basis of most modern medical studies, and Chinese cupping, which is limited to dry cupping only and is based on a philosophy of energy.

Cupping in Chinese medicine

The Chinese believe that the body's energy map, known as "qi", is the foundation of traditional Chinese medicine practices. They believe that stimulating this energy through specific points (energy centres or chakras) and their pathways helps energy flow and improves health.

During the session, the practitioner places a burning piece of cotton in the cup to generate heat. They remove it quickly to create a vacuum that draws in the tissue; this is known as fire cupping.

The Chinese believe this method boosts the flow of "qi" and energy in the body. The heat helps relax the muscles, but the use of fire can cause skin burns, which calls for caution.

Cupping in Arab medicine

Arab cupping is completely different from Chinese cupping, both in its underlying beliefs and in how it is applied. It is closer to therapeutic medical cupping and is the focus of modern research.

Some practitioners confuse the two types. They use the Chinese energy map with dry fire cupping before wet cupping, which is a mistake caused by ignorance of the scientific sources.

Cupping as an Arab and Islamic heritage

In Arab and Islamic heritage, cupping is one of the Sunnah practices of healing recommended by the Prophet (peace be upon him). He said: "The best of what you treat yourselves with is cupping" (an authentic hadith). This guidance opened the door to scientific research and the development of its methods.

From the correct Islamic perspective, cupping is not linked to energy or its centres (chakras). Scientists classify energy sciences as pseudoscience, which lacks evidence and cannot be tested in practice.

How Arab cupping agrees with modern medicine

Modern evidence-based medicine agrees with Arab cupping in that it can be studied experimentally and in the laboratory according to a scientific methodology.

In modern medical practice, the practitioner uses cups to create suction with a hand pump that removes the air, without resorting to fire. The practitioner chooses the sites based either on pain points or on anatomical points.

It is authentically reported that the Prophet (peace be upon him) was cupped on his head for a headache, and on the top of his foot while in ihram because of pain. This shows that Prophetic cupping treats the site of the pain without being restricted to specific points.

After dry cupping, the practitioner removes the cups, makes superficial incisions at the chosen sites, then replaces the cups and draws out the air for 3–5 minutes depending on the assessment of the case, allowing the stagnant blood to be drawn out.