By: Daihong, Liu
Pricking, Cupping and Qu Feng Tiao Ying Decoction for Treatment of Chronic Urticaria by Liu Daihong: Of a total 71 cases, there were 34 males and 37 females, aged between 18 and 58 (mean: 41.8) years, with a disease duration from 3 months to 15 years (mean: 3.2 years). Randomly, they were divided into 3 groups: the treatment group (N=26, treated with pricking, cupping and Qu Feng Tiao Ying (QFTY) decoction (Wind Dispelling and Ying System-Regulating Decoction); control group I (N=24, treated with QFTY decoction only), and control group II (N=21, treated with Western drugs). The three groups were statistically comparable in sex, age, disease course and severity of the illness (P>0.05). For the treatment group, pricking and cupping were applied at Dazhui DU-14, bilateral Feishu BL-13 and bilateral Zusanli ST-36. For those with emotional stress, Ganshu BL-18 was added; if there was damp-heat in the Spleen channel, Pishu BL-20 was added, and if there was general debility due to chronic illness, Shenshu BL-23 was added. In cases of severe facial swelling and fever, blood letting at the ear apex was performed where 3 to 5 points were pricked with a three-edged needle until a little amount of blood was drawn out. The treatment was given once every other day. Dazhui DU-14 was a must in each treatment session, while the other points were used alternately. The cupping therapy lasted for 10-15 minutes. The patients were also prescribed the QFTY decoction, which consisted of Shu Di Huang (Radix Rehmanniae Glutinosae Conquitae) 15g, Mu Dan Pi (Cortex Moutan Radicis) 12g, Chi Shao (Radix Paeoniae Rubrae) 12g, Jing Jie (Herba seu Flos Schizonepetae Tenuifoliae) 10g, Fang Feng (Radix Ledebouriellae Sesloidis) 10g, Xiao Hu Ma (Tenne) 12g, Ma Huang (Herba Ephedrae) 10g, Gui Zhi (Ramulus Cinnamomi Cassiae) 12g, Bai Shao (Radix Paeoniae Lactiflorae) 12g, Huang Qi (Radix Astragali) 15g, He Shou Wu (Radix Polygoni Multiflori) 15g, Ye Jiao Teng (Caulis Polygoni Multiflori) 30g and Gan Cao (Radix Glycyrrhizae Uralensis) 10g. The dosage of the wind-dispelling drugs was increased for severe itching, the heat-clearing and blood-cooling drugs for frequent onset, and the Spleen-invigorating and dampness-eliminating drugs for heaviness sensation in the lower limbs. Blood and qi-reinforcing drugs were added where there had been a long-standing disease. The hot decoction of about 250 ml was taken before going to bed. Immediately after that, 250 ml hot millet gruel was taken before covering the patient with a blanket to induce slight sweating. The decoction was taken once a day, 6 days constituting one therapeutic course. Control group II received, over a course of 6 days, intramuscular injection of 10 mg of chlorpheniramine and 5 mg dexamethasone for 3 days and oral 10 mg of cetirizine tablets once a day for 6 days. A second therapeutic course consisted of oral administration of 10 mg of cetirizine tablets once daily. Two weeks after termination of the treatment, 18 of the 26 in the treatment group were completely clear of wheals and itching, with another 4 showing only a few patches. In the control group of 24 cases, 10 were cured and another 5 markedly improved. In control group II (21 cases), 7 were cured and another 4 patients had a few patches remaining. Not only were the therapeutic effects in the treatment group were far superior to those in the control groups, the recurrence rate within 3 months was also significantly lower.
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Rabu, 28 Januari 2009
Comparison of the effects of electroacupuncture plus cupping with that of the electrical pulse therapy for different types of cervical spondylopathy
By: Huang Liemi
182 cases of cervical spondylopathy were divided into 4 types, and treated with electroacupuncture plus cupping in Group A (90 cases), and with moderate or low electrical pulses in Group B (92 cases). The therapeutic effects on each type of cervical spondylopathy were compared after 3 courses of treatments. The types were as follows: 1. 49 cases of cervical type (CT): local cervical pain and restriction of movement without numbness and pain radiating to the upper limbs. 2. 48 cases of nerve root type (NRT): rigidity in the neck, unilateral or bilateral shoulder pain or with pain radiating to the fingers, cold and weakness of the limbs, and numbness of the fingers. 3. 41 cases of vertebroarterial type (VAT): neck-shoulder pain or neck-occipital pain, and posture-induced vertigo. 4. 44 cases of sympathetic type (ST): occipital pain, dizziness, palpitation, congested sensation in the chest, cold limbs and skin, blurred vision. Of the 90 cases in Group A, 48 were male and 42 female, ranging from 24 to 76 years in age, and from 1 week to 30 years in disease duration. Of the 92 cases in Group B, 45 were male and 47 female; and the age and disease course ranges in this group were comparable to those in group A. Group A received electroacupuncture plus cupping using the following points: bilateral Fengchi GB-20 needled towards the opposite eyeball to a depth of 0.5 cun to cause a needling sensation which radiated to the vertex and temple, Taiyang (M-HN-9), Tianzhu BL-10 Baihui DU-20, Huatuojiaji (M-BW-35) on, above and below the affected cervical vertebra, bilateral Hegu LI-4 and Lieque LU-7. Dazhui DU-14 was needled to a depth of 0.5 cun to cause local soreness and distension sensation radiating to the shoulders. Bilateral Jianjing GB-21 and Jianwaishu SI-14 were added for pain and soreness in the shoulders and back. A G6805-1 electroacupuncture apparatus was used to deliver consecutive pulses, and the bipolar electrodes were connected to bilateral Fengchi GB-20 for cases with dizziness, to bilateral Huatuojiaji (M-BW-35) points for those mainly with pain in the neck and restricted movement, and to bilateral Jianjing GB-21 for those mainly with soreness in the shoulders and back. The treatment lasted for 20 minutes, followed by local cupping for 10 minutes, which was given once daily. The 92 cases in Group B received electrical pulse therapy using electrodes through damp cotton cushions 7cm X 10cm in size placed at the back of the neck and the affected area. A NMT91 multifunctional apparatus was used to deliver a bi-directional 2-4000 Hz electrical pulse for 20 minutes on a daily basis. For both the groups, 10 treatments constituted a therapeutic course, and the therapeutic effects were evaluated after 3 courses of treatment. It was found that the therapeutic effect in Group A in treating the nerve root type (NRT) and the vertebroarterial type (VAT) of cervical spondylopathy was better than that in Group B (P<0.05): Group A's NRT and VAT cases both had 20 effective cases and 2 ineffective each, whereas Group B had 17 effective NRT cases with 9 ineffective, and only 11 effective VAT cases and 8 ineffective VAT cases. The reverse was found in the sympathetic type of cervical spondylopathy. The effect in Group B was better (21 effective, 2 ineffective) than in Group A (13 effective, 8 ineffective) (P<0.05). There was no significant difference in therapeutic effects on the cervical type of spondylopathy between the two therapies (24 out of 25 patients effective in Group A, compared with 22 out of 24 patients in Group B). The authors argue that the appropriate therapies should be adopted for different types of cervical spondylopathy in order to obtain the best result.
182 cases of cervical spondylopathy were divided into 4 types, and treated with electroacupuncture plus cupping in Group A (90 cases), and with moderate or low electrical pulses in Group B (92 cases). The therapeutic effects on each type of cervical spondylopathy were compared after 3 courses of treatments. The types were as follows: 1. 49 cases of cervical type (CT): local cervical pain and restriction of movement without numbness and pain radiating to the upper limbs. 2. 48 cases of nerve root type (NRT): rigidity in the neck, unilateral or bilateral shoulder pain or with pain radiating to the fingers, cold and weakness of the limbs, and numbness of the fingers. 3. 41 cases of vertebroarterial type (VAT): neck-shoulder pain or neck-occipital pain, and posture-induced vertigo. 4. 44 cases of sympathetic type (ST): occipital pain, dizziness, palpitation, congested sensation in the chest, cold limbs and skin, blurred vision. Of the 90 cases in Group A, 48 were male and 42 female, ranging from 24 to 76 years in age, and from 1 week to 30 years in disease duration. Of the 92 cases in Group B, 45 were male and 47 female; and the age and disease course ranges in this group were comparable to those in group A. Group A received electroacupuncture plus cupping using the following points: bilateral Fengchi GB-20 needled towards the opposite eyeball to a depth of 0.5 cun to cause a needling sensation which radiated to the vertex and temple, Taiyang (M-HN-9), Tianzhu BL-10 Baihui DU-20, Huatuojiaji (M-BW-35) on, above and below the affected cervical vertebra, bilateral Hegu LI-4 and Lieque LU-7. Dazhui DU-14 was needled to a depth of 0.5 cun to cause local soreness and distension sensation radiating to the shoulders. Bilateral Jianjing GB-21 and Jianwaishu SI-14 were added for pain and soreness in the shoulders and back. A G6805-1 electroacupuncture apparatus was used to deliver consecutive pulses, and the bipolar electrodes were connected to bilateral Fengchi GB-20 for cases with dizziness, to bilateral Huatuojiaji (M-BW-35) points for those mainly with pain in the neck and restricted movement, and to bilateral Jianjing GB-21 for those mainly with soreness in the shoulders and back. The treatment lasted for 20 minutes, followed by local cupping for 10 minutes, which was given once daily. The 92 cases in Group B received electrical pulse therapy using electrodes through damp cotton cushions 7cm X 10cm in size placed at the back of the neck and the affected area. A NMT91 multifunctional apparatus was used to deliver a bi-directional 2-4000 Hz electrical pulse for 20 minutes on a daily basis. For both the groups, 10 treatments constituted a therapeutic course, and the therapeutic effects were evaluated after 3 courses of treatment. It was found that the therapeutic effect in Group A in treating the nerve root type (NRT) and the vertebroarterial type (VAT) of cervical spondylopathy was better than that in Group B (P<0.05): Group A's NRT and VAT cases both had 20 effective cases and 2 ineffective each, whereas Group B had 17 effective NRT cases with 9 ineffective, and only 11 effective VAT cases and 8 ineffective VAT cases. The reverse was found in the sympathetic type of cervical spondylopathy. The effect in Group B was better (21 effective, 2 ineffective) than in Group A (13 effective, 8 ineffective) (P<0.05). There was no significant difference in therapeutic effects on the cervical type of spondylopathy between the two therapies (24 out of 25 patients effective in Group A, compared with 22 out of 24 patients in Group B). The authors argue that the appropriate therapies should be adopted for different types of cervical spondylopathy in order to obtain the best result.
Cupping therapy for 103 cases of high fever due to infection of the upper respiratory tract
By: Yingdong, Lu
Cupping Therapy for 103 Cases of High Fever due to Infection of the Upper Respiratory Tract, by Lu Yingdong: In 103 cases treated, 92 had a temperature of 39-39.9 [degrees] and 11 cases were in excess of 39.9 [degrees]. Cupping was applied to Dazhui DU-14, Zhongfu LU-1 and Feishu BL-13 bilaterally for 5 -15 minutes over each point. For patients with restlessness, drowsiness or delirium, Lingtai DU-10 and Shendao DU-11 were added, using one cup for both points. The patients received only one treatment. To measure the effectiveness of the therapy, temperatures were taken at 1 hour, 4-6 hours, and 14-20 hours after treatment. After 14 hours, 31 cases had dropped to normal temperature range and remained there, while for 68 cases the temperature had dropped to normal range and was no more than 38 [degrees] 14 hours later. The authors explain selection of these points as follows: Dazhui DU-14, as the crossing point of all yang channels, has the action of dispelling pathogenic factors in the yang channels and clearing heat. Zhongfu LU-1 strengthens the defensive energy of the Lungs and purges chest heat, while Feishu BL-13 regulated Lung-qi and removes empty heat.
Cupping Therapy for 103 Cases of High Fever due to Infection of the Upper Respiratory Tract, by Lu Yingdong: In 103 cases treated, 92 had a temperature of 39-39.9 [degrees] and 11 cases were in excess of 39.9 [degrees]. Cupping was applied to Dazhui DU-14, Zhongfu LU-1 and Feishu BL-13 bilaterally for 5 -15 minutes over each point. For patients with restlessness, drowsiness or delirium, Lingtai DU-10 and Shendao DU-11 were added, using one cup for both points. The patients received only one treatment. To measure the effectiveness of the therapy, temperatures were taken at 1 hour, 4-6 hours, and 14-20 hours after treatment. After 14 hours, 31 cases had dropped to normal temperature range and remained there, while for 68 cases the temperature had dropped to normal range and was no more than 38 [degrees] 14 hours later. The authors explain selection of these points as follows: Dazhui DU-14, as the crossing point of all yang channels, has the action of dispelling pathogenic factors in the yang channels and clearing heat. Zhongfu LU-1 strengthens the defensive energy of the Lungs and purges chest heat, while Feishu BL-13 regulated Lung-qi and removes empty heat.
Cupping therapy
By: Shixi, Huang,Yu, Cao
Abstract
Cupping therapy is a special treatment within traditional Chinese medicine. Due to its characteristics of being easy to learn and apply and having no side effects, cupping therapy is widely used all over the world. This article introduces cupping materials, methods and manipulations.
It further outlines cupping treatment for eleven common diseases in detail: common cold, torticollis, sciatica, periarthritis of the shoulder, hemiplegia, epigastric pain, abdominal pain, lumbago, obesity, dysmenorrhoea and urticaria.
Keywords:
Cupping, acupuncture, needle, flash cupping, moving cupping
**********
Cupping is a therapy in which a hollow vessel is attached to the skin surface by suction in order to prevent and cure diseases. In ancient times it was also known as "horn cupping" and "bamboo jar therapy". There are many treatises on cupping therapy in the canon of Chinese medical literature, and it has always been popular and widely used. Cupping is easy to learn, quick, effective and safe. Historically the early focus of cupping was in treating haematomas and purulent swellings, but this was then later extended to hundreds of clinical diseases including internal medicine, surgery, gynaecology and paediatrics.
From a biomedical point of view, mechanical stimulation due to negative pressure in the jar activates local tissue metabolism, intensifies phagocytosis and promotes a healing response.
Abstract
Cupping therapy is a special treatment within traditional Chinese medicine. Due to its characteristics of being easy to learn and apply and having no side effects, cupping therapy is widely used all over the world. This article introduces cupping materials, methods and manipulations.
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It further outlines cupping treatment for eleven common diseases in detail: common cold, torticollis, sciatica, periarthritis of the shoulder, hemiplegia, epigastric pain, abdominal pain, lumbago, obesity, dysmenorrhoea and urticaria.
Keywords:
Cupping, acupuncture, needle, flash cupping, moving cupping
**********
Cupping is a therapy in which a hollow vessel is attached to the skin surface by suction in order to prevent and cure diseases. In ancient times it was also known as "horn cupping" and "bamboo jar therapy". There are many treatises on cupping therapy in the canon of Chinese medical literature, and it has always been popular and widely used. Cupping is easy to learn, quick, effective and safe. Historically the early focus of cupping was in treating haematomas and purulent swellings, but this was then later extended to hundreds of clinical diseases including internal medicine, surgery, gynaecology and paediatrics.
From a biomedical point of view, mechanical stimulation due to negative pressure in the jar activates local tissue metabolism, intensifies phagocytosis and promotes a healing response.
According to traditional Chinese medical theory, cupping therapy is guided by channel theory, and selecting the right points along the appropriate channel is essential. Internal diseases often manifest on the body surface as pain or sensitivity, typically at ashi points. Choosing the appropriate points for treatment can generate a significant and rapid treatment effect. At the same time, since surface petechiae and exudation caused by cupping need a few days to dissipate, this acts as a persistent stimulation of the cutaneous region which has the effect of balancing the ying and wei, circulating qi and blood, and dredging the channels. Generally, cupping has a variety of therapeutic functions including inducing sweating and dispelling exogenous pathogens, dredging the channels, relieving swelling and alleviating pain, warming the channels to expel cold, promoting qi and blood circulation, accelerating healing, and regulating body temperature.
Types of cupping jars
There are several different types of cups which may be used:
1. Horn cups. This ancient cupping tool used animal horn. It is economical and practical and can create good suction, but is not suitable for high temperature sterilisation.
2. Bamboo cups. Bamboo is light, economical and difficult to break. However it is easy to crack which will result in air leakage.
3. Metal cups. These are made from copper, iron or aluminium, but easily lead to scalding and so are seldom used.
4. Glass cups. These have a smooth mouth, and their transparency allows for greater observation. They are the most widely used in the clinical setting.
5. Vacuum cups. These are usually made of transparent plastic and are not easy to break. They are applied using a suction tube on the upper part of the jar and are commonly found in domestic settings.
Creating a vacuum
There are many ways of creating a vacuum, the most common being the fire method and the air suction method.
The fire method
The fire method creates a vacuum by inserting a naked flame into the cup so that the negative pressure attaches the jar to the skin. Common techniques used are:
1. The fire twinkling method
The fire twinkling method is the most commonly used fire method. Place the mouth of the jar downwards, clamp an alcohol soaked cotton ball (taking care that no alcohol is dripping from it) in a pair of forceps, light and quickly place the flame inside the cup and immediately take it out before rapidly placing the cup on the selected site. The vacuum that is created will make the cup attach to the skin.
2. The fire throwing method
Throw an ignited alcohol cotton ball or a piece of ignited paper into the cup, then rapidly place the cup firmly against the selected site. This method is suitable for cupping applied to the lateral aspect of the body where there is no risk of scalding the skin.
The air suction method
Place the cup on the skin, and fix the airbleeder tube on the valve of the jar. Extract the air to create a vacuum, which will then cause the cup to attach to the skin surface.
Common manipulations
Fire flash method
Usually used to treat wind diseases causing numbness, pain on the body surface, or a changeable disease location. This method uses the fire twinkling method and involves placing the jar on the selected site and immediately taking it off. Repeat this manipulation several times to expel the wind. Apply 15-30 times to the affected area, until the skin becomes red. Take care to avoid areas where the skin is broken.
Cup retaining method
Often used for diseases caused by cold when the location of the pain is fixed, clearly defined and deep, and also for problems caused by stagnation of qi and blood, channel blockage and long term dysfunction of the zangfu.
Place the cup on the selected site for five to 25 minutes to strengthen the effect of expelling the pathogenic factor. When treating children, the elderly and weak patients, the cups are usually only left in place for five to 15 minutes.
Moving cup method
Also known as the 'cup walking method', the 'cup pushing method', the 'cup pulling method', the 'cup shifting method' or the 'cup sliding method'. It is widely used and can be combined with the cup remaining method. Generally it is applied to a large and smooth area of the body surface. Firstly, put some lubricating oil on the skin, and spread it well with the mouth of cup. Secondly attach the cup to the skin (using one of the methods described above) and repeatedly push and pull the cup. Ensure that the mouth of cup is smooth without broken edges. This method combines the benefits of cupping with those of massage.
Cup with needle method
1. Sequential application: In this case acupuncture is used before or after cupping. It is especially suitable for patients with serious and complicated diseases. Needling is usually performed first and the needles are removed immediately after obtaining deqi. After removing the needles place the cup over the treated acupoints. Cupping can also take place before acupuncture. In both cases use the cup retaining method.
2. Simultaneous needling and cupping: Here the needle is inserted first, and after deqi is obtained the cup is applied over the needle. This combination of cupping and acupuncture increases the stimulation of the acupoints. This method is commonly applied in chronic diseases such as arthralgia.
Bleeding method
A commonly used method which combines cupping and bleeding treatment to produce a quick and powerful treatment effect. It has the function of promoting blood circulation and eliminating stasis, clearing heat, relieving pain and dredging the channels and is particularly suitable for excess heat patterns, for example apoplexy, coma, heat stroke, high fever, headache, sore throat, lumbago, carbuncles, erysipelas etc. Three-edged needles or plum-blossom needles are most often used for bleeding. Prick or tap on the selected site to make the skin red, weep or bleed, and then cup the area, retaining the cups for five to 15 minutes (the cup should not be retained for too long otherwise the healthy qi will be consumed).
After cupping
Withdrawing the cup
To withdraw the cup, tilt the cup with one hand and press the skin around the rim of the cup with the other, letting air in to break the vacuum. Take care not to pull the cup off roughly in order not to hurt the skin and cause pain.
Treatment after cupping
1. If there is local itching, avoid scratching, so as to prevent infection.
2. Some patients develop bruising, blisters or bleeding, all of which are considered a normal reaction. For yang, heat, and excess patterns, the bruising is bright red. For yin, cold patterns, the colour is purple/dark red. For deficiency conditions the bruising is pale. In cold and damp patterns blisters may form.
3. The bruising will be absorbed over time and light massage will facilitate the process. Any small blisters remaining after cupping do not require special management, but larger ones can be sterilised before puncturing with a sterile needle and then applying some gentian violet.
4. In the cup bleeding method, place gauze or absorbent cotton around the rim of cup before withdrawing the cup in order to absorb the blood, and then clean any pus and blood with a sterile gauze and cotton stick.
Precautions
Pay attention to the following precautions when cupping:
* Generally apply cups to areas with thick muscle, avoiding uneven sites and hairy areas of skin, since the cup will easily drop off here and these sites are therefore not suitable for cupping therapy.
* Choose a proper body position and a suitable size of cup.
* The time for retaining the cup should not be too long; generally five to ten minutes is appropriate for most cases.
* Pay attention not to burn or scald the skin by overheating the rim of the cup. If burning causes blisters, treat as discussed above.
* Do not cup over areas of skin with dermatitis, ulceration, swelling, or over an artery or the heart.
* It is not advisable to apply cupping to the abdominal, sacral and breast regions of a pregnant woman.
* Do not cup patients with bleeding disorders such as aplastic anaemia, haemophilia, leukaemia etc.
Cupping therapy for common diseases
1. The common cold
The common cold is a frequently occurring disease, characterised by fever, aversion to cold, headache, nasal obstruction, sneezing, runny nose etc. It is generally known as a wind attack and can be distinguished from the more severe manifestation of cold invasion which is influenza.
Prescription 1: Dazhui DU-14
Method: bleeding cup method. Firstly, sterilise Dazhui DU-14 with alcohol, then prick the point with a filiform needle or a three-edged needle two or three times. Apply cupping using the fire twinkling method described above and retain the cup for six to ten minutes to cause bleeding. Apply once a day for three consecutive days.
Prescription explanation: The Governing vessel is the sea of the yang channels and Dazhui DU-14 is a meeting point of the Governing vessel with the six yang channels of the hand and foot. Dazhui DU-14 has the function of regulating yang and yin, expelling exogenous pathogens and clearing heat. Cupping accompanied with bleeding can strengthen the action of dispersing the pathogens from the surface and dispel wind and heat.
Prescription 2: Dazhui DU-14, Fengchi GB-20, Taiyang (M-HN-9), Fengmen BL-12
Method: use the fire flash method on Taiyang (M-HN-9) until the skin becomes red. For the other three points apply cupping with fire twinkling method, and retain for ten minutes Apply once or twice a day.
Prescription explanation: Dazhui DU-14 is the convergence of the yang channels and has the function of expelling exogenous pathogens and clearing heat. Fengchi GB-20 is the convergence point of the Yang Linking vessel and the Gall Bladder channel, and also expels wind and exogeous pathogens. Taiyang (M-HN-9) can expel head wind and relieve pain. Fengmen BL-12 is used to expel exogenous pathogens, open the Lung qi and strengthen the wei qi.
2. Torticollis
Torticollis manifests as an acute neck spasm, associated with stiffness and pain in the neck and severe limitation of movement. Generally one side of the neck becomes painful after getting up, bending, lifting or turning the head. The pain can spread to the shoulders and the back, and is accompanied by muscle spasm on the affected side. Tenderness on the local site is obvious, but without redness, swelling or heat. According to Chinese medicine theory, such symptoms are mostly caused by an attack of wind and cold to the neck, which leads to channel obstruction and blockage of the qi and blood circulation.
Prescription 1: Dazhui DU-14, Ashi point, Jianwaishu SI-14
Method: grasp the cup with right hand, and using the top of the cup massage the painful area for ten minutes Then apply the cup with fire twinkling method and retain for ten minutes. Apply once a day.
Prescription explanation: massage to the local area can dredge the channels and circulate the qi and blood. Cupping on Dazhui DU-14, Ashi points and Jianwaishu SI-14 helps to warm the channels and expel cold, relax and activate the tendons, promote the circulation of qi and blood and relieve the pain.
Prescription 2: Ashi points, Jianjing GB-21, Fengmen BL-12
Method: light a moxa stick and warm the painful area for 10-20 minutes, then cup the above points with the fire twinkling method. Retain the cup for ten minutes and apply once a day.
Prescription explanation: moxibustion helps to warm the channels and expel cold; cupping on the affected area leads the exogenous pathogens out from the surface. Jianjing GB-21 and Fengmen BL-12 are used to expel wind and cold, and to relieve pain.
3. Sciatica
Sciatica refers to a radiating pain along the course of the sciatic nerve. Its main manifestation is a unilateral clonic pain of the lower back and legs, usually radiating from the lumbar region or buttock to the thigh, popliteal fossa, lateral side of the leg and lateral side of the dorsum of foot. The pain presents as a dull, distending, prickling or scorching pain, and the affected leg cannot be raised high. Coughing, sneezing, bending and squatting will aggravate the pain. Sciatica belongs to the category of arthralgia syndrome in traditional Chinese medicine.
Prescription 1: Ashi points (2-3 tender spots), Huantiao GB-30, Chengfu BL-36, Yinmen BL-37, Chengshan BL-57, Yanglingquan GB-34, Zhibian BL-54, Dachangshu BL-25 Method: First apply three to five cups on Huantiao GB-30, Chengfu BL-36 and ahshi points around the affected buttock. Then cup along the course of the affected channels. Retain the cups for 10-20 minutes and treat once a day, with ten treatments constituting a course.
Prescription explanation: the cups on the buttocks help to expel cold and circulate the blood, dredge the channels and relieve pain. Points along the affected channels play an important role in dredging the channels, expelling cold and relieving pain.
Prescription 2: ashi points along the sciatic nerve, Shenshu BL-23 and Yaoyangguan DU-3 as the main points; Huantiao GB-30, Weizhong BL-40, Chengshan BL-57, Tiaokou ST-38 as secondary points
Method: First cup on the ashi points along the sciatic nerve and then cup on the secondary points. Retain the cups for 10-20 minutes. Secondly apply moxibustion to the ashi points for 10-20 minutes. Treat once a day with ten treatments constituting a course.
Prescription explanation: cupping and moxibustion on the ashi points along the sciatic nerve help to warm the channel, expel cold and relieve pain. In association with Shenshu BL-23 and Yaoyangguan DU-3 this treatment can, in addition, activate the yang and warm the interior. Other points along the channel strengthen the function of dredging the channel, expelling cold and relieving pain.
4. Periarthritis of the shoulder
Periarthritis of shoulder is also called frozen shoulder, or 'fifty year old shoulder'. It mainly manifests as sore shoulder with limited movements of the joint. In modern medicine it is a chronic inflammatory disease, mostly due to injury and retrogression of the shoulder joint capsule and the soft tissue around it. It belongs to the category of bi syndrome in traditional Chinese medicine and frequently occurs in middle-aged people.
Prescription: Ashi points, Jianyu L.I.-15, Jianzhen SI-9, Tianzong SI-11
Method: cup the above points with the fire twinkling method. This condition demands powerful suction to produce a good effect. Retain the cups for 10-15 minutes and apply once a day with ten treatments as a course.
Prescription explanation: The selected local points have the function of expelling cold, dredging the channels and alleviating pain, expelling dampness, and relaxing and activating the tendons.
5. Hemiplegia (cerebrovascular accident)
Cerebrovascular accident is known as wind stroke in traditional Chinese medicine. It frequently occurs in middle-aged and elderly people. This disease presents as paralysis (hemiplegia) on one side of the body, or just on the upper or lower limb. This is usually accompanied by deviation of the mouth, slurred speech and sore limbs. It is primarily a condition of deficiency (of the Liver and Kidney, qi and blood) with secondary excess (stirring up of fire and wind, accumulation of phlegm and dampness, qi and blood stagnation).
Prescription
First group: Jianyu L.I.-15, Jianliao SJ-14, Quchi L.I.-11, Tianzong SI-11, Fengshi GB-31, Huantiao GB-30, Yanglingquan GB-34, Chengshan BL-57, Heding M-LE-27.
Second group: Feishu BL-13, Xinshu BL-15, Ganshu BL-18, Pishu BL-20, Shenshu BL-23, Dazhui DU-14, Yaoyangguan DU-3.
Method: Simple cupping or cupping with needle. Select from the above two groups. In cases of only upper limb paralysis cup on the upper limb, whilst for cases of only lower limb paralysis cup on the lower limb. Apply the moving cup method on the back-shu points before retaining the cups. Use a light manipulation method for relatively weak people. Retain the cups for six to ten minutes Use one group of points a day with 15 treatments as a course.
Prescription explanation: Jianyu L.I.-15, Jianliao SJ-14, Fengshi GB-31, Huantiao GB-30, Yanglingquan GB-34 and Chengshan BL-57 are essential points for hemiplegia and play an important role in dredging the channels and promoting the circulation of qi and blood. Jianyu L.I.-15, Jianliao SJ-14, Quchi L.I.-11, Tianzong SI-11 and Heding M-LE-27 encircle the joints, thus alleviating pain and relaxing the joints. The back-shu points help to regulate the function of the five zang and strengthen the healthy qi. Dazhui DU-14 and Yaoyangguan DU-3 activate yang, regulate qi and strengthen the Kidney and lumbar region.
Note: Cupping has an especially effective role in the treatment of paralysis and pain caused by stroke. It has a notable ability to help relax tendons and alleviate pain and spasm, in order to improve functional activity and independence.
6. Epigastric pain
Epigastric pain is mostly caused or aggravated by irregular diet and excessive intake of cold food. Usually it presents as a distending or dull pain, and may be accompanied by nausea, vomiting, poor appetite, sighing etc. Sometimes strong emotional stress leads to stomach spasm.
Prescription: Zhongwan REN-12, Weishu BL-21, Liangqiu ST-34, Ganshu BL-18
Method: Apply cupping to Weishu BL-21 and Ganshu BL-18 and retain for ten minutes Then cup on Zhongwan REN-12 and Liangqiu ST-34 and retain for ten minutes. Treat once a day.
Prescription explanation: Zhongwan REN-12 is the front-mu point of the Stomach, as well as the hui-meeting point of the fu organs and Weishu BL-21 is the point where the Stomach qi infuses inwards, so these two points are very important for treating Stomach diseases. They have the function of regulating the Stomach qi, activating qi and alleviating pain. Liangqiu ST-34 is the xi-cleft point of the Stomach, and is especially useful for regulating the Stomach qi and alleviating pain. Ganshu BL-18 helps disperse depressed Liver qi, regulate Stomach qi and alleviate pain.
Note: If gastralgia is accompanied by vomiting blood or with blood in the stool, it should be combined with a referral to other appropriate treatment.
7. Abdominal pain
Abdominal pain refers to pain in the upper, lower and lateral abdomen. Abdominal pain can be caused by many organic diseases but in this case we are referring to discomfort caused by intestinal spasm and intestinal neurosis, mostly induced by invasion of cold, irregular diet or emotional stress.
Prescription
Main points: Shenque REN-8, Daheng SP-15, Shimen REN-5.
Associated points: Pishu BL-20, Dachangshu BL-25.
Method: Cupping with fire twinkling method. First cup on Shenque REN-8, Daheng SP-15 and Shimen REN-5 and retain for 10-20 minutes Then cup on Pishu BL-20 and Dachangshu BL-25 with the moving cup method.
Prescription explanation: Shenque REN-8 helps activate the yang and relax the bowels, regulates qi and alleviates pain. Daheng SP-15 clears the qi of the fu organs. Shimen REN-5 is the front-mu point of the Sanjiao, so it plays an important role in regulating qi, alleviating pain, and dredging the water passages. Pishu BL-20 can invigorate the Spleen and eliminate dampness, raise the clear yang and descend the turbid yin.
8. Lumbago
The affected area is along the spine itself or on one or both sides of the spine. In traditional Chinese medicine this disorder is divided into many different patterns such as cold-dampness lumbago, Kidney-deficiency lumbago, blood-stasis lumbago etc. It is usually seen in lumbar osteoarthropathy, lumbar muscle strain, soft tissue injury etc.
Prescription: Shenshu BL-23, Dachangshu BL-25, Ashi points, Weizhong BL-40
Method: Apply cups to all points and retain for 10-20 minutes.
Prescription explanation: the lumbar region is the 'mansion of the Kidney', and Shenshu BL-23 is the point where the Kidney qi moves inwards. It has the function of supplementing the Kidney and activating the yang, improving inspiration and dredging the water passages. Dachangshu BL-25 and Ashi points are local points and can regulate qi and expel cold, disperse blood stasis and alleviate pain. Weizhong BL-40 is the he-sea point of the foot taiyang channel and is an essential point for lumbago.
Note: Cupping is excellent for lumbago and the pain often disappears after cupping therapy.
9. Obesity
Obesity can be divided into two types, simple and secondary obesity. Simple obesity is mostly caused by an over-consumption of rich and sweet food; calorie intake exceeds calorie consumption which leads to the creation and storage of fat. In these cases there are no obvious endocrine dysfunctions. Secondary obesity is the result of cortisol hypersecretion from the diencephalon or pituitary gland, etc. It is usually accompanied by corresponding symptoms of nervous and endocrine dysfunction. According to Chinese medicine, obesity is mostly caused by the accumulation of water, phlegm and dampness.
Prescription
First group: Pishu BL-20, Sanjiaoshu BL-22, Dachangshu BL-25.
Second group: Jianyu L.I.-15, Fengmen BL-12, Jianjing GB-21, Quchi L.I.-11, Zhibian BL-54, Chengfu BL-36, Fengshi GB-31, Chengjin BL-56.
Third group: Daheng SP-15, Shuidao ST-28, Zhongwan REN-12, Qihai REN-6, Fenglong ST-40.
Method: Use the moving cup method on points from the first group once a week. Alternate with points from the second and third groups and retain for 15-25 minutes Apply once a day for the first month, and thereafter every other day.
Prescription explanation: the first group of points can invigorate the Spleen and eliminate dampness, digest fat and descend turbid yin, which together will promote the drainage of metabolites. The points in the second group are used as local points to help digest fat; cupping can break down local adipose tissue. The third group can regulate the Spleen and Stomach, inhibit gastrointestinal peristalsis, promote digestion and relieve dyspepsia, relax the bowels and eliminate dampness.
10. Dysmenorrhoea
Primary dysmenorrhoea occurs in patients without pathologic changes of the reproductive organs and is usually caused by endocrine dysfunction or emotional tension due to menarche. It frequently occurs in unmarried nullparous women not long after menarche. Secondary dysmenorrhoea is caused by pathologic changes of the reproductive organs such as endometriosis, acute or chronic pelvic inflammation, stenosis of the cervix etc. According to traditional Chinese medical theory it is the result of stagnation of qi and blood.
Prescription 1: Shiqizhuixia M-BW-25
Method: Apply cups and retain for 10-20 minutes.
Prescription explanation: Shiqizhuixia M-BW-25 is an extra point along the Governing vessel, which activates and regulates the yang. Selecting this point can quickly relieve painful uterine contractions and spasm.
Note: the pain usually disappears after cupping therapy.
Prescription 2: Guanyuan REN-4, Guilai ST-29, Sanyinjiao SP-6
Method: Cup and retain for 10-20 minutes Treat three days before menstruation and continue until the pain is alleviated. Cupping treatment can be combined with moxibustion.
Prescription explanation: Guanyuan REN-4 is the crossing point of the Conception vessel and three foot yin channels, and plays an important role in regulating the Penetrating and Conception vessels, activating qi and blood, expelling cold and dredging the channels. Guilai ST-29 helps to circulate qi and disperse depressed Liver qi. Sanyinjiao SP-6, the crossing point of the three foot yin channels, can invigorate Spleen qi, regulate Liver and Kidney qi, promote blood circulation and dredge the channels.
Note: Usually the pain disappears after cupping therapy. Continue treatment for three to five menstrual cycles after which time a complete cure of dysmenorrhoea is possible.
11. Urticaria
Urticaria is an allergic dermatosis known in traditional Chinese medicine as wind rash. It is characterised mainly by rapid onset and a bright red or pale rash of various sizes with a clear border, and often appears on the upper half of the body. Differentiation of patterns includes wind-cold, wind-heat, wind-dampness and deficiency of qi and blood. Cupping may be used for both acute and chronic urticaria, though it has a better effect for the former.
Prescription 1: Shenque REN-8, Xuehai SP-10, Quchi L.I.-11
Method: Cup and retain for 10-20 minutes; treat once or twice a day.
Prescription explanation: Shenque REN-8 helps to activate the yang, open the exterior, eliminate dampness and transform turbid yin. Xuehai SP-10 has the function of circulating blood, expelling wind and alleviating itching. Theis reflects the principle of resolving blood in the treatment of wind diseases (the wind will be expelled when the blood circulates smoothly). Quchi L.I.-11 can expel wind and clear heat.
Prescription 2: Dazhui DU-14, Fengmen BL-12, Geshu BL-17
Method: Cup and retain for 10-20 minutes; treat once or twice a day.
Prescription explanation: Dazhui DU-14 is the crossing point of the yang channels and can activate the yang and expel pathogens. Geshu BL-17 has the function of circulating blood, expelling wind and alleviating itching. Fengmen BL-12 can circulate the inhibited Lung qi and strengthen the exterior.
Note: Cupping can achieve a rapid and satisfactory effect in treating urticaria.
Conclusion
Cupping therapy has been widely applied and developed throughout the history of Chinese medicine. It has many advantages such as simple, inexpensive tools and an easy method of application, together with good clinical effects and virtually no side effects. It is suitable for people from all walks of life for a variety of conditions and can be used both in the hospital and at home to promote health and wellbeing.
Huang Shixi graduated from Guang Zhou University of Traditional Chinese Medicine and has practised acupunture for 20 years. He is a Trustee of Beijing Rehabiliation Society of Chinese Medical Association, member of the Chinese Society of Acupuncture and vice-chief physician of Guang An Men Hospital affiliated to the China Academy of TCM.
Abstract
Cupping therapy is a special treatment within traditional Chinese medicine. Due to its characteristics of being easy to learn and apply and having no side effects, cupping therapy is widely used all over the world. This article introduces cupping materials, methods and manipulations.
It further outlines cupping treatment for eleven common diseases in detail: common cold, torticollis, sciatica, periarthritis of the shoulder, hemiplegia, epigastric pain, abdominal pain, lumbago, obesity, dysmenorrhoea and urticaria.
Keywords:
Cupping, acupuncture, needle, flash cupping, moving cupping
**********
Cupping is a therapy in which a hollow vessel is attached to the skin surface by suction in order to prevent and cure diseases. In ancient times it was also known as "horn cupping" and "bamboo jar therapy". There are many treatises on cupping therapy in the canon of Chinese medical literature, and it has always been popular and widely used. Cupping is easy to learn, quick, effective and safe. Historically the early focus of cupping was in treating haematomas and purulent swellings, but this was then later extended to hundreds of clinical diseases including internal medicine, surgery, gynaecology and paediatrics.
From a biomedical point of view, mechanical stimulation due to negative pressure in the jar activates local tissue metabolism, intensifies phagocytosis and promotes a healing response.
Abstract
Cupping therapy is a special treatment within traditional Chinese medicine. Due to its characteristics of being easy to learn and apply and having no side effects, cupping therapy is widely used all over the world. This article introduces cupping materials, methods and manipulations.
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It further outlines cupping treatment for eleven common diseases in detail: common cold, torticollis, sciatica, periarthritis of the shoulder, hemiplegia, epigastric pain, abdominal pain, lumbago, obesity, dysmenorrhoea and urticaria.
Keywords:
Cupping, acupuncture, needle, flash cupping, moving cupping
**********
Cupping is a therapy in which a hollow vessel is attached to the skin surface by suction in order to prevent and cure diseases. In ancient times it was also known as "horn cupping" and "bamboo jar therapy". There are many treatises on cupping therapy in the canon of Chinese medical literature, and it has always been popular and widely used. Cupping is easy to learn, quick, effective and safe. Historically the early focus of cupping was in treating haematomas and purulent swellings, but this was then later extended to hundreds of clinical diseases including internal medicine, surgery, gynaecology and paediatrics.
From a biomedical point of view, mechanical stimulation due to negative pressure in the jar activates local tissue metabolism, intensifies phagocytosis and promotes a healing response.
According to traditional Chinese medical theory, cupping therapy is guided by channel theory, and selecting the right points along the appropriate channel is essential. Internal diseases often manifest on the body surface as pain or sensitivity, typically at ashi points. Choosing the appropriate points for treatment can generate a significant and rapid treatment effect. At the same time, since surface petechiae and exudation caused by cupping need a few days to dissipate, this acts as a persistent stimulation of the cutaneous region which has the effect of balancing the ying and wei, circulating qi and blood, and dredging the channels. Generally, cupping has a variety of therapeutic functions including inducing sweating and dispelling exogenous pathogens, dredging the channels, relieving swelling and alleviating pain, warming the channels to expel cold, promoting qi and blood circulation, accelerating healing, and regulating body temperature.
Types of cupping jars
There are several different types of cups which may be used:
1. Horn cups. This ancient cupping tool used animal horn. It is economical and practical and can create good suction, but is not suitable for high temperature sterilisation.
2. Bamboo cups. Bamboo is light, economical and difficult to break. However it is easy to crack which will result in air leakage.
3. Metal cups. These are made from copper, iron or aluminium, but easily lead to scalding and so are seldom used.
4. Glass cups. These have a smooth mouth, and their transparency allows for greater observation. They are the most widely used in the clinical setting.
5. Vacuum cups. These are usually made of transparent plastic and are not easy to break. They are applied using a suction tube on the upper part of the jar and are commonly found in domestic settings.
Creating a vacuum
There are many ways of creating a vacuum, the most common being the fire method and the air suction method.
The fire method
The fire method creates a vacuum by inserting a naked flame into the cup so that the negative pressure attaches the jar to the skin. Common techniques used are:
1. The fire twinkling method
The fire twinkling method is the most commonly used fire method. Place the mouth of the jar downwards, clamp an alcohol soaked cotton ball (taking care that no alcohol is dripping from it) in a pair of forceps, light and quickly place the flame inside the cup and immediately take it out before rapidly placing the cup on the selected site. The vacuum that is created will make the cup attach to the skin.
2. The fire throwing method
Throw an ignited alcohol cotton ball or a piece of ignited paper into the cup, then rapidly place the cup firmly against the selected site. This method is suitable for cupping applied to the lateral aspect of the body where there is no risk of scalding the skin.
The air suction method
Place the cup on the skin, and fix the airbleeder tube on the valve of the jar. Extract the air to create a vacuum, which will then cause the cup to attach to the skin surface.
Common manipulations
Fire flash method
Usually used to treat wind diseases causing numbness, pain on the body surface, or a changeable disease location. This method uses the fire twinkling method and involves placing the jar on the selected site and immediately taking it off. Repeat this manipulation several times to expel the wind. Apply 15-30 times to the affected area, until the skin becomes red. Take care to avoid areas where the skin is broken.
Cup retaining method
Often used for diseases caused by cold when the location of the pain is fixed, clearly defined and deep, and also for problems caused by stagnation of qi and blood, channel blockage and long term dysfunction of the zangfu.
Place the cup on the selected site for five to 25 minutes to strengthen the effect of expelling the pathogenic factor. When treating children, the elderly and weak patients, the cups are usually only left in place for five to 15 minutes.
Moving cup method
Also known as the 'cup walking method', the 'cup pushing method', the 'cup pulling method', the 'cup shifting method' or the 'cup sliding method'. It is widely used and can be combined with the cup remaining method. Generally it is applied to a large and smooth area of the body surface. Firstly, put some lubricating oil on the skin, and spread it well with the mouth of cup. Secondly attach the cup to the skin (using one of the methods described above) and repeatedly push and pull the cup. Ensure that the mouth of cup is smooth without broken edges. This method combines the benefits of cupping with those of massage.
Cup with needle method
1. Sequential application: In this case acupuncture is used before or after cupping. It is especially suitable for patients with serious and complicated diseases. Needling is usually performed first and the needles are removed immediately after obtaining deqi. After removing the needles place the cup over the treated acupoints. Cupping can also take place before acupuncture. In both cases use the cup retaining method.
2. Simultaneous needling and cupping: Here the needle is inserted first, and after deqi is obtained the cup is applied over the needle. This combination of cupping and acupuncture increases the stimulation of the acupoints. This method is commonly applied in chronic diseases such as arthralgia.
Bleeding method
A commonly used method which combines cupping and bleeding treatment to produce a quick and powerful treatment effect. It has the function of promoting blood circulation and eliminating stasis, clearing heat, relieving pain and dredging the channels and is particularly suitable for excess heat patterns, for example apoplexy, coma, heat stroke, high fever, headache, sore throat, lumbago, carbuncles, erysipelas etc. Three-edged needles or plum-blossom needles are most often used for bleeding. Prick or tap on the selected site to make the skin red, weep or bleed, and then cup the area, retaining the cups for five to 15 minutes (the cup should not be retained for too long otherwise the healthy qi will be consumed).
After cupping
Withdrawing the cup
To withdraw the cup, tilt the cup with one hand and press the skin around the rim of the cup with the other, letting air in to break the vacuum. Take care not to pull the cup off roughly in order not to hurt the skin and cause pain.
Treatment after cupping
1. If there is local itching, avoid scratching, so as to prevent infection.
2. Some patients develop bruising, blisters or bleeding, all of which are considered a normal reaction. For yang, heat, and excess patterns, the bruising is bright red. For yin, cold patterns, the colour is purple/dark red. For deficiency conditions the bruising is pale. In cold and damp patterns blisters may form.
3. The bruising will be absorbed over time and light massage will facilitate the process. Any small blisters remaining after cupping do not require special management, but larger ones can be sterilised before puncturing with a sterile needle and then applying some gentian violet.
4. In the cup bleeding method, place gauze or absorbent cotton around the rim of cup before withdrawing the cup in order to absorb the blood, and then clean any pus and blood with a sterile gauze and cotton stick.
Precautions
Pay attention to the following precautions when cupping:
* Generally apply cups to areas with thick muscle, avoiding uneven sites and hairy areas of skin, since the cup will easily drop off here and these sites are therefore not suitable for cupping therapy.
* Choose a proper body position and a suitable size of cup.
* The time for retaining the cup should not be too long; generally five to ten minutes is appropriate for most cases.
* Pay attention not to burn or scald the skin by overheating the rim of the cup. If burning causes blisters, treat as discussed above.
* Do not cup over areas of skin with dermatitis, ulceration, swelling, or over an artery or the heart.
* It is not advisable to apply cupping to the abdominal, sacral and breast regions of a pregnant woman.
* Do not cup patients with bleeding disorders such as aplastic anaemia, haemophilia, leukaemia etc.
Cupping therapy for common diseases
1. The common cold
The common cold is a frequently occurring disease, characterised by fever, aversion to cold, headache, nasal obstruction, sneezing, runny nose etc. It is generally known as a wind attack and can be distinguished from the more severe manifestation of cold invasion which is influenza.
Prescription 1: Dazhui DU-14
Method: bleeding cup method. Firstly, sterilise Dazhui DU-14 with alcohol, then prick the point with a filiform needle or a three-edged needle two or three times. Apply cupping using the fire twinkling method described above and retain the cup for six to ten minutes to cause bleeding. Apply once a day for three consecutive days.
Prescription explanation: The Governing vessel is the sea of the yang channels and Dazhui DU-14 is a meeting point of the Governing vessel with the six yang channels of the hand and foot. Dazhui DU-14 has the function of regulating yang and yin, expelling exogenous pathogens and clearing heat. Cupping accompanied with bleeding can strengthen the action of dispersing the pathogens from the surface and dispel wind and heat.
Prescription 2: Dazhui DU-14, Fengchi GB-20, Taiyang (M-HN-9), Fengmen BL-12
Method: use the fire flash method on Taiyang (M-HN-9) until the skin becomes red. For the other three points apply cupping with fire twinkling method, and retain for ten minutes Apply once or twice a day.
Prescription explanation: Dazhui DU-14 is the convergence of the yang channels and has the function of expelling exogenous pathogens and clearing heat. Fengchi GB-20 is the convergence point of the Yang Linking vessel and the Gall Bladder channel, and also expels wind and exogeous pathogens. Taiyang (M-HN-9) can expel head wind and relieve pain. Fengmen BL-12 is used to expel exogenous pathogens, open the Lung qi and strengthen the wei qi.
2. Torticollis
Torticollis manifests as an acute neck spasm, associated with stiffness and pain in the neck and severe limitation of movement. Generally one side of the neck becomes painful after getting up, bending, lifting or turning the head. The pain can spread to the shoulders and the back, and is accompanied by muscle spasm on the affected side. Tenderness on the local site is obvious, but without redness, swelling or heat. According to Chinese medicine theory, such symptoms are mostly caused by an attack of wind and cold to the neck, which leads to channel obstruction and blockage of the qi and blood circulation.
Prescription 1: Dazhui DU-14, Ashi point, Jianwaishu SI-14
Method: grasp the cup with right hand, and using the top of the cup massage the painful area for ten minutes Then apply the cup with fire twinkling method and retain for ten minutes. Apply once a day.
Prescription explanation: massage to the local area can dredge the channels and circulate the qi and blood. Cupping on Dazhui DU-14, Ashi points and Jianwaishu SI-14 helps to warm the channels and expel cold, relax and activate the tendons, promote the circulation of qi and blood and relieve the pain.
Prescription 2: Ashi points, Jianjing GB-21, Fengmen BL-12
Method: light a moxa stick and warm the painful area for 10-20 minutes, then cup the above points with the fire twinkling method. Retain the cup for ten minutes and apply once a day.
Prescription explanation: moxibustion helps to warm the channels and expel cold; cupping on the affected area leads the exogenous pathogens out from the surface. Jianjing GB-21 and Fengmen BL-12 are used to expel wind and cold, and to relieve pain.
3. Sciatica
Sciatica refers to a radiating pain along the course of the sciatic nerve. Its main manifestation is a unilateral clonic pain of the lower back and legs, usually radiating from the lumbar region or buttock to the thigh, popliteal fossa, lateral side of the leg and lateral side of the dorsum of foot. The pain presents as a dull, distending, prickling or scorching pain, and the affected leg cannot be raised high. Coughing, sneezing, bending and squatting will aggravate the pain. Sciatica belongs to the category of arthralgia syndrome in traditional Chinese medicine.
Prescription 1: Ashi points (2-3 tender spots), Huantiao GB-30, Chengfu BL-36, Yinmen BL-37, Chengshan BL-57, Yanglingquan GB-34, Zhibian BL-54, Dachangshu BL-25 Method: First apply three to five cups on Huantiao GB-30, Chengfu BL-36 and ahshi points around the affected buttock. Then cup along the course of the affected channels. Retain the cups for 10-20 minutes and treat once a day, with ten treatments constituting a course.
Prescription explanation: the cups on the buttocks help to expel cold and circulate the blood, dredge the channels and relieve pain. Points along the affected channels play an important role in dredging the channels, expelling cold and relieving pain.
Prescription 2: ashi points along the sciatic nerve, Shenshu BL-23 and Yaoyangguan DU-3 as the main points; Huantiao GB-30, Weizhong BL-40, Chengshan BL-57, Tiaokou ST-38 as secondary points
Method: First cup on the ashi points along the sciatic nerve and then cup on the secondary points. Retain the cups for 10-20 minutes. Secondly apply moxibustion to the ashi points for 10-20 minutes. Treat once a day with ten treatments constituting a course.
Prescription explanation: cupping and moxibustion on the ashi points along the sciatic nerve help to warm the channel, expel cold and relieve pain. In association with Shenshu BL-23 and Yaoyangguan DU-3 this treatment can, in addition, activate the yang and warm the interior. Other points along the channel strengthen the function of dredging the channel, expelling cold and relieving pain.
4. Periarthritis of the shoulder
Periarthritis of shoulder is also called frozen shoulder, or 'fifty year old shoulder'. It mainly manifests as sore shoulder with limited movements of the joint. In modern medicine it is a chronic inflammatory disease, mostly due to injury and retrogression of the shoulder joint capsule and the soft tissue around it. It belongs to the category of bi syndrome in traditional Chinese medicine and frequently occurs in middle-aged people.
Prescription: Ashi points, Jianyu L.I.-15, Jianzhen SI-9, Tianzong SI-11
Method: cup the above points with the fire twinkling method. This condition demands powerful suction to produce a good effect. Retain the cups for 10-15 minutes and apply once a day with ten treatments as a course.
Prescription explanation: The selected local points have the function of expelling cold, dredging the channels and alleviating pain, expelling dampness, and relaxing and activating the tendons.
5. Hemiplegia (cerebrovascular accident)
Cerebrovascular accident is known as wind stroke in traditional Chinese medicine. It frequently occurs in middle-aged and elderly people. This disease presents as paralysis (hemiplegia) on one side of the body, or just on the upper or lower limb. This is usually accompanied by deviation of the mouth, slurred speech and sore limbs. It is primarily a condition of deficiency (of the Liver and Kidney, qi and blood) with secondary excess (stirring up of fire and wind, accumulation of phlegm and dampness, qi and blood stagnation).
Prescription
First group: Jianyu L.I.-15, Jianliao SJ-14, Quchi L.I.-11, Tianzong SI-11, Fengshi GB-31, Huantiao GB-30, Yanglingquan GB-34, Chengshan BL-57, Heding M-LE-27.
Second group: Feishu BL-13, Xinshu BL-15, Ganshu BL-18, Pishu BL-20, Shenshu BL-23, Dazhui DU-14, Yaoyangguan DU-3.
Method: Simple cupping or cupping with needle. Select from the above two groups. In cases of only upper limb paralysis cup on the upper limb, whilst for cases of only lower limb paralysis cup on the lower limb. Apply the moving cup method on the back-shu points before retaining the cups. Use a light manipulation method for relatively weak people. Retain the cups for six to ten minutes Use one group of points a day with 15 treatments as a course.
Prescription explanation: Jianyu L.I.-15, Jianliao SJ-14, Fengshi GB-31, Huantiao GB-30, Yanglingquan GB-34 and Chengshan BL-57 are essential points for hemiplegia and play an important role in dredging the channels and promoting the circulation of qi and blood. Jianyu L.I.-15, Jianliao SJ-14, Quchi L.I.-11, Tianzong SI-11 and Heding M-LE-27 encircle the joints, thus alleviating pain and relaxing the joints. The back-shu points help to regulate the function of the five zang and strengthen the healthy qi. Dazhui DU-14 and Yaoyangguan DU-3 activate yang, regulate qi and strengthen the Kidney and lumbar region.
Note: Cupping has an especially effective role in the treatment of paralysis and pain caused by stroke. It has a notable ability to help relax tendons and alleviate pain and spasm, in order to improve functional activity and independence.
6. Epigastric pain
Epigastric pain is mostly caused or aggravated by irregular diet and excessive intake of cold food. Usually it presents as a distending or dull pain, and may be accompanied by nausea, vomiting, poor appetite, sighing etc. Sometimes strong emotional stress leads to stomach spasm.
Prescription: Zhongwan REN-12, Weishu BL-21, Liangqiu ST-34, Ganshu BL-18
Method: Apply cupping to Weishu BL-21 and Ganshu BL-18 and retain for ten minutes Then cup on Zhongwan REN-12 and Liangqiu ST-34 and retain for ten minutes. Treat once a day.
Prescription explanation: Zhongwan REN-12 is the front-mu point of the Stomach, as well as the hui-meeting point of the fu organs and Weishu BL-21 is the point where the Stomach qi infuses inwards, so these two points are very important for treating Stomach diseases. They have the function of regulating the Stomach qi, activating qi and alleviating pain. Liangqiu ST-34 is the xi-cleft point of the Stomach, and is especially useful for regulating the Stomach qi and alleviating pain. Ganshu BL-18 helps disperse depressed Liver qi, regulate Stomach qi and alleviate pain.
Note: If gastralgia is accompanied by vomiting blood or with blood in the stool, it should be combined with a referral to other appropriate treatment.
7. Abdominal pain
Abdominal pain refers to pain in the upper, lower and lateral abdomen. Abdominal pain can be caused by many organic diseases but in this case we are referring to discomfort caused by intestinal spasm and intestinal neurosis, mostly induced by invasion of cold, irregular diet or emotional stress.
Prescription
Main points: Shenque REN-8, Daheng SP-15, Shimen REN-5.
Associated points: Pishu BL-20, Dachangshu BL-25.
Method: Cupping with fire twinkling method. First cup on Shenque REN-8, Daheng SP-15 and Shimen REN-5 and retain for 10-20 minutes Then cup on Pishu BL-20 and Dachangshu BL-25 with the moving cup method.
Prescription explanation: Shenque REN-8 helps activate the yang and relax the bowels, regulates qi and alleviates pain. Daheng SP-15 clears the qi of the fu organs. Shimen REN-5 is the front-mu point of the Sanjiao, so it plays an important role in regulating qi, alleviating pain, and dredging the water passages. Pishu BL-20 can invigorate the Spleen and eliminate dampness, raise the clear yang and descend the turbid yin.
8. Lumbago
The affected area is along the spine itself or on one or both sides of the spine. In traditional Chinese medicine this disorder is divided into many different patterns such as cold-dampness lumbago, Kidney-deficiency lumbago, blood-stasis lumbago etc. It is usually seen in lumbar osteoarthropathy, lumbar muscle strain, soft tissue injury etc.
Prescription: Shenshu BL-23, Dachangshu BL-25, Ashi points, Weizhong BL-40
Method: Apply cups to all points and retain for 10-20 minutes.
Prescription explanation: the lumbar region is the 'mansion of the Kidney', and Shenshu BL-23 is the point where the Kidney qi moves inwards. It has the function of supplementing the Kidney and activating the yang, improving inspiration and dredging the water passages. Dachangshu BL-25 and Ashi points are local points and can regulate qi and expel cold, disperse blood stasis and alleviate pain. Weizhong BL-40 is the he-sea point of the foot taiyang channel and is an essential point for lumbago.
Note: Cupping is excellent for lumbago and the pain often disappears after cupping therapy.
9. Obesity
Obesity can be divided into two types, simple and secondary obesity. Simple obesity is mostly caused by an over-consumption of rich and sweet food; calorie intake exceeds calorie consumption which leads to the creation and storage of fat. In these cases there are no obvious endocrine dysfunctions. Secondary obesity is the result of cortisol hypersecretion from the diencephalon or pituitary gland, etc. It is usually accompanied by corresponding symptoms of nervous and endocrine dysfunction. According to Chinese medicine, obesity is mostly caused by the accumulation of water, phlegm and dampness.
Prescription
First group: Pishu BL-20, Sanjiaoshu BL-22, Dachangshu BL-25.
Second group: Jianyu L.I.-15, Fengmen BL-12, Jianjing GB-21, Quchi L.I.-11, Zhibian BL-54, Chengfu BL-36, Fengshi GB-31, Chengjin BL-56.
Third group: Daheng SP-15, Shuidao ST-28, Zhongwan REN-12, Qihai REN-6, Fenglong ST-40.
Method: Use the moving cup method on points from the first group once a week. Alternate with points from the second and third groups and retain for 15-25 minutes Apply once a day for the first month, and thereafter every other day.
Prescription explanation: the first group of points can invigorate the Spleen and eliminate dampness, digest fat and descend turbid yin, which together will promote the drainage of metabolites. The points in the second group are used as local points to help digest fat; cupping can break down local adipose tissue. The third group can regulate the Spleen and Stomach, inhibit gastrointestinal peristalsis, promote digestion and relieve dyspepsia, relax the bowels and eliminate dampness.
10. Dysmenorrhoea
Primary dysmenorrhoea occurs in patients without pathologic changes of the reproductive organs and is usually caused by endocrine dysfunction or emotional tension due to menarche. It frequently occurs in unmarried nullparous women not long after menarche. Secondary dysmenorrhoea is caused by pathologic changes of the reproductive organs such as endometriosis, acute or chronic pelvic inflammation, stenosis of the cervix etc. According to traditional Chinese medical theory it is the result of stagnation of qi and blood.
Prescription 1: Shiqizhuixia M-BW-25
Method: Apply cups and retain for 10-20 minutes.
Prescription explanation: Shiqizhuixia M-BW-25 is an extra point along the Governing vessel, which activates and regulates the yang. Selecting this point can quickly relieve painful uterine contractions and spasm.
Note: the pain usually disappears after cupping therapy.
Prescription 2: Guanyuan REN-4, Guilai ST-29, Sanyinjiao SP-6
Method: Cup and retain for 10-20 minutes Treat three days before menstruation and continue until the pain is alleviated. Cupping treatment can be combined with moxibustion.
Prescription explanation: Guanyuan REN-4 is the crossing point of the Conception vessel and three foot yin channels, and plays an important role in regulating the Penetrating and Conception vessels, activating qi and blood, expelling cold and dredging the channels. Guilai ST-29 helps to circulate qi and disperse depressed Liver qi. Sanyinjiao SP-6, the crossing point of the three foot yin channels, can invigorate Spleen qi, regulate Liver and Kidney qi, promote blood circulation and dredge the channels.
Note: Usually the pain disappears after cupping therapy. Continue treatment for three to five menstrual cycles after which time a complete cure of dysmenorrhoea is possible.
11. Urticaria
Urticaria is an allergic dermatosis known in traditional Chinese medicine as wind rash. It is characterised mainly by rapid onset and a bright red or pale rash of various sizes with a clear border, and often appears on the upper half of the body. Differentiation of patterns includes wind-cold, wind-heat, wind-dampness and deficiency of qi and blood. Cupping may be used for both acute and chronic urticaria, though it has a better effect for the former.
Prescription 1: Shenque REN-8, Xuehai SP-10, Quchi L.I.-11
Method: Cup and retain for 10-20 minutes; treat once or twice a day.
Prescription explanation: Shenque REN-8 helps to activate the yang, open the exterior, eliminate dampness and transform turbid yin. Xuehai SP-10 has the function of circulating blood, expelling wind and alleviating itching. Theis reflects the principle of resolving blood in the treatment of wind diseases (the wind will be expelled when the blood circulates smoothly). Quchi L.I.-11 can expel wind and clear heat.
Prescription 2: Dazhui DU-14, Fengmen BL-12, Geshu BL-17
Method: Cup and retain for 10-20 minutes; treat once or twice a day.
Prescription explanation: Dazhui DU-14 is the crossing point of the yang channels and can activate the yang and expel pathogens. Geshu BL-17 has the function of circulating blood, expelling wind and alleviating itching. Fengmen BL-12 can circulate the inhibited Lung qi and strengthen the exterior.
Note: Cupping can achieve a rapid and satisfactory effect in treating urticaria.
Conclusion
Cupping therapy has been widely applied and developed throughout the history of Chinese medicine. It has many advantages such as simple, inexpensive tools and an easy method of application, together with good clinical effects and virtually no side effects. It is suitable for people from all walks of life for a variety of conditions and can be used both in the hospital and at home to promote health and wellbeing.
Huang Shixi graduated from Guang Zhou University of Traditional Chinese Medicine and has practised acupunture for 20 years. He is a Trustee of Beijing Rehabiliation Society of Chinese Medical Association, member of the Chinese Society of Acupuncture and vice-chief physician of Guang An Men Hospital affiliated to the China Academy of TCM.
Treatment of acute sore throat with bloodletting therapy
By: Zhang Hong
Acute sore throat is a commonly seen disease in the clinic, presenting as acute tonsillitis, acute laryngitis, etc. It is caused by bacterial or viral infection in the region of the throat and is characterised mainly by a sore throat and difficulty in swallowing due to severe pain in the throat.
Some patients have fever and physical weakness. If treated too late or improperly, some patients may develop chronic pharyngitis or secondary myocarditis, nephritis, arthritis, etc. The author has adopted a method of bloodletting therapy to treat 148 patients with acute sore throat. The report is as follows.
1. Clinical data
Of 148 cases, 61 were male and 87 female, with an age ranging from 2 to 65 years and an average age of 37 years. The course of the disease was from 1 to 7 days, averaging 2.9 days. All of the patients had sore throat with severe pain on swallowing, and examination showed a hyperaemic and swollen throat. 56 of the cases were accompanied by fever and weakness, and white blood cell count was raised in 47.
2. Therapeutic method
Point selection: Shaoshang LU-11, Shangyang L.I.-1.
Manipulation: After sterilising the selected points on both hands, the points were rapidly pricked with a three-edged needle which was immediately removed. After that, swqueezing was applied to encourage bleeding of about 10 drops of stagnant blood from the punctured hole. Usually, the first few drops of blood are dark, which shows excess of pathogenic heat in the channel. The bleeding is encouraged until the dark-red blood becomes light-red, which indicates the excess of pathogenic heat has been discharged from the channel. The treatment is given once daily, with one to three treatments to a course.
3. Therapeutic results
88 cases (59.5%) were fully recovered (disappearance of clinical symptoms) after one treatment, 32 (21.6%) after two treatments, and 17 (11.5%) after three treatments. 11 cases (7.4%) were unchanged or worse after three treatments.
4. Case examples
* Gao, male, 8 years old, had a sore throat and severe pain on swallowing, with fever, chills and weakness for 2 days. His temperature was 38.9?C. His throat was hyperaemic and swollen and his tonsils were enlarged. His white blood cell count was 10.5g/L. The patient had taken some antibiotics with no improvement. After a single bloodletting treatment, the patient experienced relief of the sore throat and his temperature was reduced to 37.1?C by the evening. By the next day all of the clinical symptoms had disappeared and the white blood cell count was reduced to normal (5.6g/L).
* Wang, female, 39 years old, had suffered from a sore throat for about one week, with difficulty in swallowing due to severe pain in the throat, but without fever. An examination found the throat to be reddened and swollen. White blood cell count was normal. The patient had taken many drugs and ultra-short wave treatment with no improvement. After a single treatment with bloodletting therapy, she experienced immediate relief of the sore throat. After a further treatment, all symptoms had disappeared.
5. Discussion
Traditional Chinese medicine holds that acute, reddened, swollen, sore throat and fever mainly result from heat pathogen in the Lung channel of hand-taiyin and the Large Intestine channel of hand-yangming burning upwards to the throat. The treatment method is to reduce heat and relieve pain by bloodletting (reducing method). Shaoshang LU-11 and Shangyang L.I.-1 are the jing-well points of the Lung and Large Intestine channels respectively. These points can eliminate heat from the channel, whilst bloodletting therapy can reduce heat and dredge the channel. After three treatments most patients have their symptoms relieved or eliminated. Generally the white blood cell count is reduced to a normal level within one or two days.
This method has the advantages of simple application and no side effects. However it is not a desirable method for treating chronic pharyngitis, suppurative tonsillitis or peritonsillar abscess.
Zhang Hong M.D. works at The Acupuncture Department, General Air Force Hospital, 30 Fuchen Road, Beijing 1000036, China.
by Zhang Hong
Acute sore throat is a commonly seen disease in the clinic, presenting as acute tonsillitis, acute laryngitis, etc. It is caused by bacterial or viral infection in the region of the throat and is characterised mainly by a sore throat and difficulty in swallowing due to severe pain in the throat.
Some patients have fever and physical weakness. If treated too late or improperly, some patients may develop chronic pharyngitis or secondary myocarditis, nephritis, arthritis, etc. The author has adopted a method of bloodletting therapy to treat 148 patients with acute sore throat. The report is as follows.
1. Clinical data
Of 148 cases, 61 were male and 87 female, with an age ranging from 2 to 65 years and an average age of 37 years. The course of the disease was from 1 to 7 days, averaging 2.9 days. All of the patients had sore throat with severe pain on swallowing, and examination showed a hyperaemic and swollen throat. 56 of the cases were accompanied by fever and weakness, and white blood cell count was raised in 47.
2. Therapeutic method
Point selection: Shaoshang LU-11, Shangyang L.I.-1.
Manipulation: After sterilising the selected points on both hands, the points were rapidly pricked with a three-edged needle which was immediately removed. After that, swqueezing was applied to encourage bleeding of about 10 drops of stagnant blood from the punctured hole. Usually, the first few drops of blood are dark, which shows excess of pathogenic heat in the channel. The bleeding is encouraged until the dark-red blood becomes light-red, which indicates the excess of pathogenic heat has been discharged from the channel. The treatment is given once daily, with one to three treatments to a course.
3. Therapeutic results
88 cases (59.5%) were fully recovered (disappearance of clinical symptoms) after one treatment, 32 (21.6%) after two treatments, and 17 (11.5%) after three treatments. 11 cases (7.4%) were unchanged or worse after three treatments.
4. Case examples
* Gao, male, 8 years old, had a sore throat and severe pain on swallowing, with fever, chills and weakness for 2 days. His temperature was 38.9?C. His throat was hyperaemic and swollen and his tonsils were enlarged. His white blood cell count was 10.5g/L. The patient had taken some antibiotics with no improvement. After a single bloodletting treatment, the patient experienced relief of the sore throat and his temperature was reduced to 37.1?C by the evening. By the next day all of the clinical symptoms had disappeared and the white blood cell count was reduced to normal (5.6g/L).
* Wang, female, 39 years old, had suffered from a sore throat for about one week, with difficulty in swallowing due to severe pain in the throat, but without fever. An examination found the throat to be reddened and swollen. White blood cell count was normal. The patient had taken many drugs and ultra-short wave treatment with no improvement. After a single treatment with bloodletting therapy, she experienced immediate relief of the sore throat. After a further treatment, all symptoms had disappeared.
5. Discussion
Traditional Chinese medicine holds that acute, reddened, swollen, sore throat and fever mainly result from heat pathogen in the Lung channel of hand-taiyin and the Large Intestine channel of hand-yangming burning upwards to the throat. The treatment method is to reduce heat and relieve pain by bloodletting (reducing method). Shaoshang LU-11 and Shangyang L.I.-1 are the jing-well points of the Lung and Large Intestine channels respectively. These points can eliminate heat from the channel, whilst bloodletting therapy can reduce heat and dredge the channel. After three treatments most patients have their symptoms relieved or eliminated. Generally the white blood cell count is reduced to a normal level within one or two days.
This method has the advantages of simple application and no side effects. However it is not a desirable method for treating chronic pharyngitis, suppurative tonsillitis or peritonsillar abscess.
Zhang Hong M.D. works at The Acupuncture Department, General Air Force Hospital, 30 Fuchen Road, Beijing 1000036, China.
by Zhang Hong
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