Cupping is a traditional Chinese Medicine therapy. It uses a jar placed on the skin through the negative pressure to induce local congestion and blood stasis for treating diseases. It was called the “horn method” in ancient China, now it is known as “Ba Guan” or “Ba Huo Guan”. The cupping dates back to about 3000 years and has been used as a part of the primary heath care service offered in China. The types, manipulations, functions and indications of cupping are as follow.
Types of jars: Glass cup, bamboo jar and ceramic cup.
Manipulations:

A cup is attached to the skin surface through the negative pressure created by a fire inside the cup. Following are the five methods: fire twinkling method, fire throwing method, alcohol firing method, cotton firing method and firing method for cup laid on treatment location.

Clamp a cotton ball soaked with95% alcohol with a forceps or nipper, ignite it and insert it into the cup, turn the ignited cotton for one circle inside the cup and immediately take it out and press the cup on the selected location. This method being simple and safe, not restricted by the body postures, is commonly applied in the clinic.

(2)Fire Throwing Method:
Throw a piece of ignited paper or an alcohol cotton ball into the cup, then rapidly put the mouth of the cup firmly against the skin on the desired position.
This method is applied to the lateral side of the body.

(3)Alcohol Firing Method:

Place one to three drops of alcohol into a cup (not much so as to prevent it from dripping out of the cup to burn the skin), distribute evenly the alcohol on the wall by turning the cup. Then the alcohol is ignited and the cup is immediately pressed on to the place to be treated.

(4)Cotton Firing Method:
Stick a piece of proper sized alcohol cotton on the lower one third of the inner wall of the cup, ignite the cotton and the cup is then placed on the selected 1ocation.

(5)Firing Method for Cup Laid on Treatment Location:
Prior to firing, place a few drops of 95% alcohol or a piece of alcohol cotton into a non-combustive and slow heat conducting container ,such as bottle cover, or small wine cup which previously laid on the treatment location, ignite the alcohol or cotton ,press the rapidly on the position.

(6)Boiling Method:
Fasten herbs in a cloth pouch, boil the herbal pouch in plain water to make into liquid of proper density ,put the bamboo jar into the liquid, boiling about 15 minutes, take out the jar form the liquid and pour out the liquid inside the jar, the mouth of the jar is firmly pressed against a cold towel, the jar is then immediately placed on the selected location on the skin surface. The herbs in this method serve to enhance the effect of dispelling wind and relieving pain, often applied for wind-damp Bi syndrome and some soft tissue disorders. The herbs used possess the properties of dispelling wind, clearing obstruction in the meridians and promoting blood circulation.

Special method of cupping:
(1)Movable Cupping
Prior to the treatment, apply lubricant oil, such as Vaseline, on the skin, the cup then is sucked to the skin in the way as explained in the previous methods. Hold the cup with the right hand and slide it around and back to the affected area until the skin becomes congested. It is suitable for treatment of a large area, such as the back, the lumbus, the buttocks, and the thigh.

(2)Successive Flash Cupping
DIn this method, apply repeatedly and swiftly the cup over the same place until the skin becomes hyperaemic.

(3)Blood-letting Puncture and Cupping!

After the disinfection of the local place, puncture it with three-edged needle to let blood or tap with plum-blossom needle, then apply cupping. It enhances blood circulation and relieves swelling and pain by removing the blood stasis.

Functions of cupping:
Warm meridians and invigorate collateral Move qi and promote blood Diminishing cold and dispel damp Reduce swelling and relieving pain
Indications:
The Cupping method is usually used for internal diseases, gynecological diseases, pediatric diseases external diseases, and trauma, etc.
It’s mainly used to treat Bi syndrome caused by wind dampness, such as pain in the low back, shoulders, neck and limbs; gastrointestinal disorders such as stomach ache, abdominal pain, vomiting, hiccup, dysentery, constipation and diarrhea; lung disease such as common cold, cough and asthma; kidney diseases such as enuresis, impotence and spermatorrhea; gynecological diseases such as irregular menstruation, dysmenorrheal, uterine bleeding and morbid leucorrhea; and external diseases, including erysipelas, neurodermatitis, psoriasis, etc.
The cupping method often is combined with bloodletting and is specially suitable to treat acute sprains accompanied by blood stasis, blood stasis syndrome, heat syndrome, excess cold syndrome, intractable Bi syndrome, and summer sunstroke, etc.

Precautions
(1)The patient should be in a comfortable position. Cups in different sizes are used according to the cupping location. Generally’, the place where the muscle is large and thick, free from hairs and bone ridges are selected.

(2)The burning flame should be strong enough to create a vacuum. Hold the cup with the rim close to the local place and cup it to the skin rapidly and deftly, otherwise the therapeutic effect will be attenuated.

(3)It is not advisable to apply cupping to the patient with skin ulcer, edema, or on a place supplied with large blood vessels, to the patient with high fever and convulsion ;or to the abdominal and sacral locations of the pregnant women.

(4)It is not suitable to apply cupping to the patient with bleeding tendency. Caution for burning or scalding the skin. If blisters appear due to scalding or long retaining of cup, no treatment is needed. Blister for the small blister or the big one, drainage of liquid with a sterile syringe, application of gentian viol,et and gauze to prevent infection are indicated.