Journal of - International Society for the History of Islamic Medicine

Hijamah (Cupping): A Graeco-Islamic Perspective Therapy
M. Manzar ALAM, A. MANNAN, Misbahuddin SIDDIQUE
and Ahsan ILAHI
2. The best time for voluntary cupping is daytime, especially
just before evening as it is the most moderate time
of the day. Narrated Kabshah daughter of Abu Bakrah:
(The narrator other than Musa said that Ayisha daughter
of Abu Bakrah said that her father used to forbid
his family to have themselves cupped on a Tuesday, and
used to assert on the authority of the Apostle of Allah
Prophet هيلع هللا ىلص)‏ ‏(ملسو that Tuesday is the day
of blood in which there is an hour when it does not stop.
3. It should be done in the summer season because due to
the heat harmful matters tend to be in their more dilute
form.
4. It should be applied to such persons who have more dilute
blood.
5. They should be advised some digestive & anti suppurative
syrup before the induction of voluntary cupping.
6. The application should be avoided in weak persons.
7. It is contraindicated in person less than two and above
sixty years of age.
8. It should not be done just after hammam except in persons
who have viscous blood.
9. Also cupping should not be done after a heavy work
load or a strenuous exercise [10,14].
Methods of Application of the cups (Mahjama)
1. Hijamah-bila-Shurt (Non invasive cupping)
In ancient periods the application of Mahjamah or
cups on the specific areas was achieved by holding a
small flame inside the cup, to create vacuum pressure,
the cups were then placed quickly on the skin over the
area to be treated and were allowed to be in the place for
ten to fifteen minutes. The strength of vacuum pressure
was modulated by the size of the flame, the time of exposure
to the flame and how quickly the cup was placed
on the affected area. Observance of safety precautions is
necessary while using a naked flame and glass around the
patients. John Brazier, principal of the college of Oriental
Body Balance based in Lythem, St. Annes has described
the following rules for safety precautions during the induction
of mahjama-nari:
1. Parts preparation should be done prior to application of
mahjama nari.
2. The Cup size should be selected according to the site of
cupping.
3. Cups (mahjama) should be clean and should not have
any chips and cracks.
4. Before the induction of mahjama nari, the temperature
of the cup-edge should be checked properly, by applying
it on one’s own hand.
5. For appropriate vacuum strength, there should be a
wait for sufficient time for appropriate intensity size of
flame [15].
Nowadays mahjama-nari is replaced by vacuum pumpcups
which can be used more easily by simply putting the
cup on the selected part and then attaching a pump to the
nipple of the cup to evacuate the air from the cup, due to
which a negative pressure is developed. It is easy to adjust
the amount of suction required, with the help of these
pumps, by releasing the nipple lock. The strong vacuum
created by the cupping can leave the patient with minor
bruises which usually disappear in a few days. Occasionally
moving cups are applied after lubricating the skin with a
thin layer of oil which allows the cups to slide over the skin,
applying suction to a larger area. This is known as cupping
massage.
2. Hijamah-bil-Shurt (Invasive cupping)
Before the induction of invasive cupping gross general
and systemic examinations were done and maintained the
pre-operative criteria of the patients i.e. assessment of hemoglobin
level, bleeding time, clotting time, blood sugar
level, aseptic measures and patient consent. After that cups
are placed on the affected area in the same way as is done
in non- invasive cupping and moderate vacuum pressure is
created for a short duration. This method should be done
repeatedly until the affected area becomes reddish & swollen.
Then shurt (incision) is done carefully, if the patient is
weak only one shurt is sufficient but it should be wider and
deeper. If blood is thick (concentrated), then shurt is done
for two times- one, for diluting blood flow and the other
for concentrating blood flow. If blood has some impurities
then one more shurt may be done to purify it. Only one
incision (shurt) is sufficient if less amount of bleeding is required,
while in case of heavy bleeding requirement many
incisions may be given [13].
Various sites for cupping application
Different eminent Unani scholars have described following
areas for the induction of hijamah.
a) Hijamah Qamahduwa and Yafookh: Hijamah-e-Qamahduwa
is done on the protuberance behind the ear
and the Hijamah-e-Yafookh is done on the middle and
crown of the head. According to some Unani physicians
these types of hijamah is beneficial in case of confusion,
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