Cup/heat generates negative pressure. Air feels warm in the local area this way. Air method generates the pressure without the heat. The important thing is the neg pressure.
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Originally used animal horn - old method was called "Horn method" - and was used to remove infection and pus. Later abt 1000bc = bamboo cups. Used in Europe also in much the same way.
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Types of cups / jars
Glass cupAir pump cupBamboo cupPorcelain cup
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Usually plastic.
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Actions of cupping and applications
Moving Qi and blood, stopping pain
Expelling wind and cold
Dissipating swelling and clump, clearing heat and removing toxin (with bleeding)
Local area on front or on back shu, jia ji, where spinal nerves run. Middle back for stomach ache, over spine/bladder channel for dysmenorrhea, low back. Above sacrum ok too.
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Because it expels wind and cold, damp too. Use local points as well as along whole channel. (like down back of leg for sciatica). For common cold/asthma/cough, back of neck (common cold, expel wind), upper back (smaller cups - bladder 13 for lung, bladder 12, gb 21, bl 17. Can also cover upper back with cups.) LU 1 and 2 also if enough muscle there.
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Prick to open sore, cup to suck out the badness. Like snakebite kit. Suck it out until color of blood changes to normal per tradition. For acne, not on local area - choose jia ji points (1/2 cun beside spine). palpate - feel for texture changes from normal. These are reactive points. P 3, BL 40, DU 14 for sunstroke to let out heat.
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Choose points as appropriate, change sizes of cups to fit the application.
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Manipulations:Cup-placing method
Fire-twinkling method
Fire-throwing methodMainly on lateral side of the body
Cotton-attaching methodMainly on lateral side of the body
Air pumping method
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Fire twinkling most common method. Fire throwing method and cotton attaching method very similar. On side of body or when pt sitting upright put fire inside cup then place cup on point. Fire actually stays in side the cup, air burns out, cup sucks to the body. Much stronger than the fire twinkling. With cotton attaching, attach cotton into cup, light, place cup on pt. Both fire throwing and cotton attaching are very hot. thus not so common!
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Manipulations:Cup-manipulating method
Single cuppingOn acupoints or ashi pointsFor disorders involve smaller area
Multiple cuppingFor disorders involve bigger area
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If pt has pain in a certain point, use single cupping, leave it on for a little. Can be repeated. W/H invasion, i.e., single cup Du-14 to expel.
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For whole channel, for large areas, to regulate several organ functions.
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Retaining cupping 5-15 minutes until skin is reddish-pupleish.Less time for big cup with strong suction
Flashing cuppingFor areas that skin is loose with difficulty of suctionFor Local skin numbness and deficiency, hypofunction
Sliding cupping / moving cuppingFor bigger area, muscular area, such as upper back, low back, thigh, etc
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Glass and plastic cups - can see the skin color change easily. If you leave a cup in place too long can cause blistering. boo. When skin is red/purple time to remove, but then again, sometimes doesn't change color much - never leave on more than 20 min regardless.
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Flashing cupping=cup on point, immediately release, repeat. Approp for older ppl, very tight places where the cup won't stay on, numbness of skin and deficiency - fire warms the area.
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NOTE: cup gets HOT! You feel it on the round part, but it's even hotter on rim. Beware of burning patient. If it gets too hot, change cups.
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Sliding cupping = on back or thigh. Similar to massage/gua sha. Used more for pain, shoulder tightness/pain, back pain, sciatica pain, wind/cold invasion w/cold and/or cough in upper back area.
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choice of stay or move method - sliding for pain and covering a large area and for wind/cold.
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Needling & cuppingMainly for Wind Cold Damp BiNot in chest and upper back area
Bloodletting & cuppingFor disorders due to Qi and blood stagnation, heat retention, etcNo bloodletting & cupping on big blood vessel in case causing too much bleeding
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First, needle the point, then cup goes over the needle so it is in the center. Choose a cup that is much taller than the needle, do not press the needle - mostly for w/c/d bi arthritis, pain deep inside muscle or close to bone. Needle deeper. Dangerous on the chest/upper back - changes the needle depth. Let's not!
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Bleed first, cup next.
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Removing the cup
Press one side of the skin with finger to release the vacuum slowly
Avoid pulling up forcefullyAvoid twist it offAvoid sudden decrease of the pressure
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Blass cups: slide finger below border of the cup, gradually let the air out of the cup.
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After-effectAfter cupping, there are red/purple spots or bruise at the local area. Generally, it will disappear several days later. Blisters may occur on patients who are hypersensitive, or when the cups were retained too long time.
Small blisters will be absorbed naturally in several days.Severe blisters: drain the liquid with a sterile needle, cover with sterile gauze to prevent infection.
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Definitely warn the patient about the possible bruises! Some ppl retain bruises for a day, some for 10. This is normal and wanted - with stagnation will be even darker color.
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This is what you DON"T want!
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Cleaning the cup
Cupping devices can be autoclaved or sterilized in a chemical disinfectant bathIf there was bleeding,
gloves should be used, cups should be isolated, double sterilization procedure
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Glass cups, that is. 10% bleach for 10 minutes works, except if there was bleeding...dbl sterilization. 2 separate bleach solutions.
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PrecautionsUsed on areas where the muscle is abundant and elastic, not on hairy & bony areasCups of different sizes are used according to the cupping locationFor first treatment, weak patients, nervous patients, the elderly, children, etc,
select small cups, less cupsLying positionObserve closely
Do not burn the patient ! Do not heat the rim.Do not retain the cup for too long time in summer, or on areas with thinner muscleThe patient should select a comfortable position, and not to change position during manipulation to prevent the cups from dropping.
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Not for hairy backs! Seriously! Also, not over spine, over scapula. How bony is your patient? Might be able to cover Du 14, but for bony patients, don't use sliding cupping. Discomfort.
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Fire thru the cup quickly is probably fine...the long the fire is in the cup the more likely the burn potential.
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ContraindicationsPatient susceptible to spontaneous bleeding, such as suffering from hemophilia, purpura haemorrhagica, leukemia, etcSevere edemaHypersensitivity of skin, lack of elasticity of skin, skin wound, skin sores/ulcer, fracture area, varicose vein area, tumor area, hernia area.Patients with high fever and convulsion, patients who can not cooperate.On heart beat area, five sense organs and anus areaAbdomen, lumbosacral area of pregnant woman
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Capillaries break causing the color changes - don't do this for easy bleeders! Edema - water will flow to cupping area. NEVER for high fever/convulsions.
