Traditional Chinese Medicine Technical Manual— Cupping Techniques (Static, Flash, and Sliding Cupping)
This article is excerpted from the “Traditional Chinese Medicine Technical Manual” published by the National Administration of Traditional Chinese Medicine, which includes eleven articles and ninety-three chapters covering various TCM techniques. It aims to strengthen the clinical application management of TCM medical techniques, promote the development and clinical application of TCM medical techniques, improve clinical efficacy, and ensure medical safety. The goal is to continuously enhance the existing level of TCM medical techniques, expand their applicable scope, and emphasize the full application of modern technological achievements under the guidance of TCM theory, developing a batch of high-level TCM medical techniques with good clinical efficacy, gradually forming a team of TCM medical technical talents with solid concepts, high technical levels, good clinical efficacy, and strong innovation capabilities.
Editorial Team: TCM Medical Technology Collaboration Group of the National Administration of Traditional Chinese Medicine
Chief Editor: Wang Guoqiang
Cupping therapy uses cups as tools, employing methods such as combustion, suction, and steam to create negative pressure inside the cup, allowing it to adhere to acupuncture points (zhuyin) or corresponding areas on the body surface, causing local skin congestion or bruising, thus serving as an external treatment method for disease prevention and treatment. It was historically known as the horn method and is also referred to as the suction tube method. It is commonly used for conditions such as colds, insomnia, shoulder stiffness, low back pain, and neck pain.
1. Common Tools and Basic Operation Methods
(1) Common Tools
Glass cups, bamboo cups, ceramic cups, and suction cups.
(2) Methods of Cupping
1. Fire Cupping Method
(1) Flash Fire Method: Use a needle holder or hemostat to grip a cotton ball soaked in 95% ethanol, holding a fire tool in one hand and the cup in the other, with the cup opening facing down. Ignite the cotton ball, quickly insert it into the cup, rotate it once, and then swiftly place the cup on the selected area.
Special Note: Instruct the patient to maintain a relatively fixed position; ensure the cup opening is smooth and undamaged; prevent ethanol from dripping and burning the skin during cupping; do not leave the ignited cotton ball in the cup for too long to avoid burning the skin.
(2) Fire Throwing Method: Ignite a cotton ball or paper, throw it into the cup, and quickly place the cup on the selected area.
Special Note: Due to the presence of burning material inside the cup, the fireball can easily burn the skin, so this method is only suitable for horizontal cupping on the side of the body.
(3) Cotton Stick Method: Use a cotton piece about 1-2 cm in size, stick it to the middle or lower part of the cup’s inner wall or the bottom, ignite it, and quickly place the cup on the selected area.
Special Note: Do not soak the cotton in too much ethanol to avoid burning the skin.
2. Boiling Cup Method
This method generally uses bamboo cups, which are inverted in boiling water or medicinal liquid for 1-2 minutes. Use tweezers to hold the bottom of the cup, remove it, and dry the surface with a towel, then apply it to the skin while hot. The medicinal liquid used can be determined based on the condition.
3. Suction Cup Method
Place the suction cup on the selected area, remove the air to create negative pressure, and adhere it to the body surface.
(3) Cupping Operation
1. Static Cupping: Also known as sitting cupping, this method involves placing the cup on the treatment area for 10-15 minutes after suctioning, then removing the cup.
Indications: This method is suitable for most clinical conditions and is the most commonly used cupping method.
Special Note: For children, the suction force should not be too strong, and the duration should not be too long; when cupping on weak muscles or with strong suction, the duration should also be limited.
2. Sliding Cupping: Also known as pushing cupping, apply a layer of lubricant on the cup opening or suction area, place the cup on the skin, hold the bottom of the cup with one hand, slightly tilt the cup body, and push and pull it back and forth or make circular movements repeatedly until the skin becomes flushed, deep red, or develops petechiae.
Indications: Pain from acute febrile diseases or deep tissue stagnation, external wind-cold, neuralgia, rheumatic pain, and widespread pain.
Special Note: Choose larger diameter, thicker, and smoother glass cups; the treatment area should be broad and muscular, such as the chest, back, waist, abdomen, and thighs.
3. Flash Cupping: This method involves using the flash fire method or suction method to attach the cup to the skin and then immediately remove it, repeating this process until the skin becomes flushed and warm.
Indications: Colds, skin numbness, facial conditions, post-stroke sequelae, or weakness.
Special Note: The technique should be skilled, with movements being light, quick, and precise; at least three cups of the same diameter should be used interchangeably to avoid burning the skin.
(4) Removing the Cup
To remove the cup, gently press beside the cup opening with the thumb or index finger to allow air to enter the cup, then remove it smoothly. Do not forcibly pull or twist the cup.
2. Common Diseases Treated with Cupping Therapy
(1) Colds (Common Cold and Influenza)
A cold is a common external disease characterized by nasal congestion, runny nose, sneezing, headache, chills, fever, and general malaise. It is often caused by pathogenic factors invading the body’s surface. If the pathogenic qi enters through the skin and hair or the mouth and nose, and if it is predominantly cold, it can cause cold pathogens to bind the surface, obstruct lung qi, and block the pores; if it is predominantly heat, it can cause heat pathogens to scorch the lungs, leading to loss of clear lung function. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of TCM Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994. This therapy is most effective for early symptoms, especially for treating wind-cold type colds.
[Treatment Principle] Disperse wind, resolve the exterior, and open the meridians.
[Operation Steps] Focus on the back’s governor vessel and bladder meridian points, using sliding cupping and static cupping methods.
[Acupoints] Dazhui (大椎), Fengmen (风门), Feishu (肺俞), Shenzhu (身柱).
[Precautions] The selected cups should not be too large, and the stimulation should not be too strong, aiming for skin flushing; instruct the patient to keep their back warm.
(2) Cough (Acute and Chronic Bronchitis)
Coughing is the main symptom of lung diseases. External pathogens invade the lungs, either entering through the mouth and nose or affecting the skin and hair. When the lung’s defensive qi is affected, it loses its ability to disperse and clear, causing lung qi to rebel and resulting in coughing. The lungs are delicate organs that prefer moisture and dislike dryness; if dryness injures the lungs, it can deplete lung yin, leading to a lack of moisture and difficulty in expectorating phlegm. Phlegm and fluids can accumulate, obstructing lung qi, and if lung qi does not descend, it results in coughing with abundant phlegm. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of TCM Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Treatment Principle] Disseminate lung qi, regulate qi, stop cough, and transform phlegm.
[Operation Steps] Focus on the back’s acupoints, using sliding cupping and static cupping methods.
[Acupoints] Dingchuan (定喘), Feishu (肺俞), Feidi (肺底) (an experiential point located at the midpoint of the line connecting the posterior midline and the posterior axillary line at the level of the seventh thoracic vertebra).
(3) Low Back Pain (Lumbar Disc Herniation)
Low back pain is a type of condition characterized by self-reported pain in the lower back, presenting as heavy pain, soreness, numbness, and stiffness, making it difficult to bend or stretch. Coughing or sneezing can exacerbate the pain; there may be limitations in movement in all directions, particularly in extension and flexion. The occurrence of this condition is mainly related to the invasion of external pathogens, falls, injuries, or excessive labor. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of TCM Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Treatment Principle] Relax the muscles, invigorate blood circulation, open the meridians, and relieve pain.
[Operation Steps] Focus on the back’s governor vessel and bladder meridian points, using sliding cupping and static cupping methods.
[Acupoints] Dachangshu (大肠俞), Yaoyan (腰眼), Shenfu (肾俞), Ashi points (阿是穴).
3. Contraindications
1. Individuals who are overly tense, intoxicated, excessively hungry, overly full, fatigued, or experiencing convulsions are not suitable for treatment.
2. Patients with severe heart disease, respiratory failure, local skin ulceration or high sensitivity, active pulmonary tuberculosis, significant weight loss leading to loss of skin elasticity, generalized edema, or malignant tumors.
3. Individuals with bleeding disorders.
4. Pregnant women should avoid cupping on the abdomen, lower back, facial areas, and the perineum; heavy techniques should not be used on the face or children.
5. Local areas with hernias (such as umbilical hernia, abdominal wall hernia, inguinal hernia), varicose veins, tumors, etc.
4. Precautions
1. When cupping, choose appropriate positions and areas with sufficient muscle; areas with uneven bones or excessive hair are not suitable.
2. Select cups of appropriate size based on different areas, and the suction strength should be adjusted according to the condition; stronger individuals can tolerate slightly stronger suction, while the elderly, weak, and children should have lighter suction.
3. During cupping and static cupping, observe the patient’s reactions; if the patient feels discomfort, the cup should be removed immediately; in severe cases, the patient can lie down, keep warm, and drink hot water or sugar water, and acupoints such as Neiguan (内关), Hegu (合谷), Taiyang (太阳), and Zusanli (足三里) can be massaged.
4. Be careful not to burn or scald the skin; if burns occur or if the cupping time is too long, causing blisters, do not treat the blisters; simply cover them with disinfected gauze to prevent rupture. If the blisters are large, use a disinfected needle to release the fluid, apply gentian violet, or cover with disinfected gauze to prevent infection.
5. Individuals with skin allergies, ulcers, edema, high fever, convulsions, and pregnant women should avoid cupping on the abdomen and lower back.
6. Take precautions against fire during cupping.
Read and Reflect
duersi
Diagnose diseases with precision, understand deeply, observe the signs carefully, and miss no details. — Tang Dynasty, Sun Simiao, “Essential Prescriptions Worth a Thousand Gold for Emergency”
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