Wet Cupping Therapy

Background: Cupping therapy is a well-known traditional treatment modality, and has been used in various diseases around the world since ancient times. This method is reported to have a better clinical as well as adverse events (AEs) profile as found in various studies conducted around the world. Aim: This study identifies, assesses, and classifies the adverse events profile of various types of cupping therapies in studies conducted in twenty one century. Methods: Using electronic and hand searches, three databases including Pub Med, Google Scholar and Cochrane library were searched from the year 2000 to 2016. Studies were included in this review provided they reported adverse effects related to cupping therapy. Observational studies were assessed using the WHO-UMC causality scale. Randomized controlled trials were assessed in accordance to the quality of reporting for harm data. Results: Nine hundred seventy nine (n=979) articles were identified. Based on exclusion and Review Article Al-Bedah et al.; BJMMR, 15(8): 1-12, 2016; Article no.BJMMR.26285 2 inclusion criteria and extensive review of all retrieved articles by two independent reviewers, only 25 studies that included six RCTs, sixteen single case reports and three case series were finally selected. The mostly observed adverse events of cupping therapy were scar formation reported in four studies that described fifty nine cases, and burns reported in two studies described sixteen cases, respectively. The adverse events of cupping therapy could be classified into local and systemic adverse events. Conclusion: Cupping therapy adverse events were infrequently reported, but they were not rare. Most of adverse effects were mild to moderate in severity. Some of the cupping therapy adverse events were preventable by following the general infection control guidelines, hygienic techniques, safety protocols and rigorous training of cupping therapists. Cupping adverse events should be reported in all studies on cupping, and this therapy should be practiced only by qualified medical professionals.

The Unani system of medicine originated from Greece. Hippocrates is the father of medicine who initiated the humoural theory. Then Arab and Persian physicians like Rhazes, Avicenna constructed and developed this system. The aim of this study is to provide comprehensive review in cupping therapy which is now practiced effectively worldwide. This review was done by analyzing authentic Unani texts, thesis reports and published scientific journals. According to that the humoural theory which consists four humours, and proper balance of these humours ensures efficient metabolism, prevents the build-up of toxins, and maintains optimum health. Imbalance is often the root cause for origin and development of diseases. When treating such ailments, it is carried out by correcting qualitative and quantitative imbalances of humours. Hijamah is a method used to correct, evacuate or divert morbid humours in Unani medicine. According to Avicenna ‗cupping depurates and balances the humours. Thus cupping removes bad or morbid matters from the body, neutralizes the humours and helps to regain the health. Nowadays, it is being proved by various clinical trials that cupping therapy has beneficial effects on human beings. According to latest scientific interpretation, the mechanism of action most likely involves a local increase and activation of blood flow and increases the elimination of metabolites or moves them from one part to another part of body. Furthermore it activates the immune system. Therefore it removes the pathogenic factors lead to ease local symptoms and helps to regain the health. 9 | P a g e