Dr Mohammad Shoaib Assistant Professor Department of Ilaj bit Tadbeer Faculty of Unani Medicine AMU Aligarh Definition Hijamah refers to an Unani mode of treatment which is carried out by ID: 911969
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Slide1
Hijamah (Cupping therapy)
Dr. Mohammad Shoaib
Assistant Professor
Department of Ilaj bit Tadbeer
Faculty of Unani Medicine
AMU, Aligarh
Slide2Definition:
Hijamah refers to an Unani mode of treatment which is carried out by
“creating a partial vacuum in the cupping glasses, placed on the body surface, by means of heat or suction in order to evacuate the morbid materials, to divert the material from the diseased part, to return a displaced organ to its normal position or to encourage the blood flow to the site of Hijamah.
Slide3Unani Concept of disease:Akhlat
-e-
arba
/ 4 body Humors
Health : Equilibrium and balance of natural body humours (blood, bile, black bile and phlegm).
Disease: The imbalance in the quality and quantity of these humours leads to diseases
Physician: Restore these imbalance
Hajjam
(Cupper)
Hijamah (Profession)
Slide4Ahadeeth:
Hijamah, Honey, Cauterization
Lunar month: 17, 19, 21
Mizaj
of the body in different hours:
3AM to 9AM –
Damvi
(best time for cupping)
9AM to 3PM –
Safravi
3PM to 9PM –
Saudavi
9PM to 3AM –
Balghami
As the need may arise, cupping may be performed at any time according to the condition or urgency.
Slide5Types of Hijamah / Cupping:
1)
Hijamat-Bil-shart
(wet cupping / cupping with scarification / Prophetic Therapy).
2)
Hijamat-bila-shart
(dry cupping / cupping without scarification / Chinese Therapy)
Hijamat-Bila-Shart
(Dry cupping)
Hijamat
-e-
ghair
Mutaharrikah
(Stationary cupping)
Hijamat
-e-
Mutaharrikah
(Gliding or moving cupping / Massage cupping)
Slide6Objective:
Diversion of morbid materials (
Fasid
madda
) from disease parts of the body (Hijamah
bila
shart
/ dry cupping) i.e.
Imale
Mawad
Evacuation of morbid material
(
Fasid
madda
)
from superficial part of the body
(Hijamah
bil
shart
/ wet cupping) i.e.
Tnqiyah
/
Istefraghe
Mawad
Preferably done in
hemodilution
than in
hemoconcentration
i.e. after use of
Munzijat
,
Musaffiyat
Slide7Synonyms of wet cupping
Minor surgical excretory procedure
pressure dependent excretory method
Artificial
percutaneous
route of excretion
of
Morbid Matter /
Fasid
Madda
/ Inflammatory mediators / Causative Pathological Substances (CPS) .
Slide8Hijamah bil
shart
/ Wet Cupping Therapy (WCT)
Simple and economic treatment.
Therapeutic benefit
depend on amount of excreted morbid matter
not the amount of
letted
blood.
Modern medicine
introducing new drugs
and chemicals into the body while WCT
withdraw harmful substances.
Slide9Drug used for Pain management
Modern medicine / Introducing drug:
NSAID
Steroid
Opioid
AE:
gastritis,
Nephrotoxic
,
HTN, DM, Osteoporosis
,
Addiction
Cupping therapy / Removal of morbid matter:
Imalae
Mawad
Dry Cupping / TCM
Tanqiya
Mawad
Wet Cupping / WCT
Slide10Etiology of Pain
Slide11S.No
.
Functions of Prostagladine-1
Applications
1.
Mucous coating on gastric mucosa
Peptic Ulcer
2.
Help in Platelets aggregation(TXA2)
To avoid platelets damage & improve harvesting
3.
Vasodilators(PGI2)
To maintain patency of Ductus Arteriosus(PGI2)
Nephrons vasodilators
Peripheral vascular diseases
4.
Cervix dilator and Uterine Contractor
Abortion,
Induction / Augmentation of labour (PGE2)
\Cervical Ripening (make soft)Post Partum Haemorrhage (PPH) due to atonic UterusS.No.Functions of Prostagladine-2:Applications1.Responsible for Pain & inflammation----
Cont..
Slide12Pain Gate
Theory by
Melzack and Wall
(
1965
)
:
In
substantia gelatinosa there is a
hypothetical gate
through which impulses travel towards the brain, by closing this gate
it
can modify or block the impulse to reach the brain or to the organ from brain.
In
spinal cord two chemicals are produces like Enkephalin (endogenous morphine) and
Substance-P (neurotransmitter
) which block and open the pain gate respectively.
Thus
we say that enkephalin (endorphin) produces analgesic effect by increasing the pain threshold / blocking the pain gate while Substance-P decreases the pain threshold by opening the pain gate in the spinal cord.
Slide13Pathway of Pain
Slide14Mechanism of action of WCT
Remove Morbid matter of both Hydrophilic & Hydrophobic in nature while only hydrophilic by kidney
Capillary pore size: 15-65 nm (Kidney) while 12-80nm skin) while size of blood cells is in micron
Filtration force: 10 mmHg (Kidney) while 150-420mmHg (negative pressure of Cupping) i.e.15-42 times higher
Slide15Cont…
Endogenous
opioid
production during scarification
NO: Vasodilator, Angiogenesis
Dilution of inflammatory mediators /CPS/ substance-P, IL-2, 6,
cytokins
,
bradykins
,
prostaglandine
,
Increase Blood circulation
Treat congestion
Clear blockage of
lymphatics
& blood vessels
Improve
oxygon
& nutrition supply to cells
Break muscular spasmRestore physiological haemostasisBreaking adhesion
Slide16Cont…
Remove fragmented RBCs
Cupping blood have less number of RBCs WBCs, Platelets,
monocytes
, granulocytes &
Hb
in comparison to venous blood
Enhance immunity: increase number of NK cells after scarification.
Open skin (largest organ) barrier by scarification and naturally excreted by sweat glands
Slide17Requirments:
Mihjam
(
Glass Cup)
Mishrat
(Blade / needle)
Suction pump
Spirit /
Betadine
Antiseptic solution
Gloves
Cotton / Gauze
Micropore
Tape
Slide18Method of Dry Cupping
A partial vacuum is created in the cup by heat or suction on the area
The skin and underlying tissue swells and becomes warm, and gets sucked into the cup
This produces blood congestion at the site and stimulates circulation
After a prescribed period of time the cup is gently
removed i.e. 10 minutes
No blood is removed from the body
18
Slide19Method of wet cupping
Step 1: Dry cupping should be performed in clean and aseptic conditions
Step 2: after cups removal and multiple incisions made by blade
(0.1mm mm deep)
on cupped areas. Hence, oozing blood will be sucked by cups.
Step 3: Repeatedly cups will be applied if necessary.
Slide20Skin:
Epidermis thickness is 0.07 – 0.12mm (0.1mm)
Dermis thickness 1 – 3mm (2mm) richly supplied by nerve & blood
Skin blood circulation increase 4 times during cupping
At Tender point 46% higher blood flow
In abscess both bacteria & toxin removed than antibiotic
Slide21Location for Cupping
Abul
Qasim
Zehrawi
has described the Hijamah in his book
Al-
Tasreef
leman
ajeza
an-
il
-
Talef
. Along with its types and uses, he has mentioned the following 14 sites of Hijamah:
Nuqra
(Nape)
Kahil
(upper part of the back/interscapular region)Akhd’ain (both lateral margins of neck)Zaqan/Ziqan (Chin)Katifain (both shoulders)Us’us (coccyx)Zandain/Zindain (both forearms)Saqain (both shanks)Urqubain (both Achilles tendon) (Zehrawi, 1908 AD)21
Slide22Contraindications for Cupping
children below the age of two years
Above the age of sixty years (
Jurjani
)
After physical exertion or fatigue
After meals
Pregnanacy
Cupping should not be done after bathing, except if the blood is unduly thickened; then, do it about an hour after bathing.
22
Slide23Benefits of
Hijamah
Hijamah
is known to benefit:
Oateo
-Arthritis
Rheumatoid Arthritis, Stiff or swollen joints, PMR
Cervical & Lumber pain, Disc Prolapsed,
Sciatiica
High
blood
pressure, Psychological disorders
Cellulitis
,
Skin
problems
(Eczema
,
Psoriasis, Acne
etc)
Gynaecological disorders, like Dysmenorrhea, MenorrhegiaMigraine headaches, Epilepsy, InsomniaFibromyalgia23
Slide24Some Benefits of
Hijamah
The Cupping Therapy Massage is, without doubt, one of the most effective treatments for reducing
muscular spasm.
The suction from the cups stimulates the fibroblast cells to increase collagen and
elastin
production.
With improved blood circulation and lymphatic drainage the skin tone and texture is vastly improved.
The same effects also help to keep the skin looking more youthful and rejuvenated in general.
24
Slide25Some Benefits of Hijamah
Draws blood flow to the area from the arteries to the capillaries. (From up to 4 inches deep)
Nutrition and oxygen reaches the area.
Drains excess fluids, body waste and toxins.
The negative pressure draws the blood from capillaries and then returns via the veins to be cleansed and disposes of toxins.
Clear blockage of blood vessels & Lymphatic channels
Increases blood & nutrition supply to the cells
Cupping, the technique, is very useful and very safe,
being free from side effects and can be easily learned
25
Slide26Side Effects of Cupping
26
Red
or purplish circular marks may appear on the skin for a few
days
Sometime cause itching
Slide27Cupping Photographs:
Applying vacuum to the cups
Slide28Incising the skin in the marked (red and raised)
area with a blade
Slide29Re-applying the cups and suctioning
Slide30Bleeding in progress into the cups
Slide31Diagrammatic presentation
Inflammatory site
Slide32Dry Cupping
Slide33Step-1 (Dry Cupping)
Slide34Step-2 (Scarification)
Slide35Step-3 (second Cupping)
Slide36Resolution of pathology & Restoration of Homeostasis
Slide37Thanks