Hijama (حجامة‎) is the Arabic term for a therapeutic practice known as ‘cupping therapy’. Although there are multiples forms of cupping practices and techniques, hijama is synonymous with a specific type of cupping therapy, known as wet cupping.

The root meaning of the Arabic word Hijama (حجامة‎) means to reduce something in size or to restore it to its original state. This meaning holds a wider alignment with the founding principle and purpose of naturopathic medicine. The objective of health optimisation is to aid the body to return to its natural homeostatic state. 

Origins of Hijama

Hijama is not limited to the Arab population. Its practice is more notably prevalent throughout the Muslim world due to it’s strong recommendation by the Prophet Muhammad (peace be upon him). He described it as one of the best medicines gifted to mankind. He used the practice on a number of occasions for detoxification, migraine relief, and musculoskeletal injuries as well as prevention.

As a result, many Muslim cultures across the globe have kept the practice of Hijama alive within their native traditions as a primarily religious health practice. Although more recently it has experienced a more clinical resurgence. This includes North, East and West Africa, the Middle East, South Asia (including India, Pakistan, Indonesia and Malaysia), as well as parts of Europe such as Russia and Turkey.

Contrary to many perceptions, the practice of Hijama or wet cupping therapy does not originate from Islam. It was present prior to the dawn of the Islamic empires in Ancient Egypt and Ancient China. The Ancient Greeks practised this as one of their many forms of blood-letting practices, alongside leeching and venesection.

Blood letting practices including Hijama were a common practice among physicians in Europe up until the 1900s. After the introduction of patent acts this gave power to the pharmaceutical industry to have greater control over the practice of medicine. This resulted in the fading out of many natural practices (including Hijama). Prior to that, it was practised by the leading doctors and hospitals across the West. This included London, Glasgow, France, the USA, Germany and the Nordics. In Finland wet cupping is still to this day known as a traditional folk medicine. 

So what does Hijama actually involve? 

There are two main components to the Hijama or wet cupping process:

The first is the application of negative pressure or suction on the surface of the skin. In the term ‘wet cupping’, this aspect is the cupping part. The process involves multiple methods and materials. A cup-shaped object made from glass, bamboo or plastic is used. Air is pumped out of the cup like a syringe or is heated with fire to condense into a vacuum. Traditionally, air has even be sucked out manually using one’s mouth.

The second component of the Hijama process is the incisions or breaking of the skin. This is often performed using a specialised small sterile surgical blade or the edge of a small razor blade. In some cases, a small tool with multiple pins designed to pierce the skin. The incisions or breaks in the skin are not intended to be deep or large cuts. They are very small scratches with enough pressure to allow blood to be drawn when suction is applied. Similar to a finger prick blood test, but usually not as deep.

In Traditional Hijama, the suction is applied to the intended site of treatment first for a short duration. This is to encourage blood and tissue fluid to collect under the cup without breaking the surface of the skin. After this the cup is removed and small incisions are applied. Immediately after application of the scratches, the suction cup is reapplied, encouraging the site to bleed.

The cup will remain in place for a duration of approximately 10 minutes. In which time small quantities of blood is released from the skin and collect in the cup. The cup is then removed for the final time and any collected blood is disposed of. The area is cleaned thus completing the hijama or wet cupping process. 

The small scratches made during the treatment stop bleeding almost instantaneously in most cases. It is primarily the suction which encourages them to bleed. In some cases there is an increased tissue pressure under the skin. For example, a site of inflammation or on occasions where treatment is applied on the legs. Then there may be a small amount of blood that can weep from the site for up to 24 hours. However, this is easily stopped by applying light pressure and a skin dressing (only if necessary). Otherwise, the site heals over naturally without the need of any intervention. There may also be round marks after the procedure where the cups are applied. These too will gradually fade over the next 1-2 weeks depending on skin tone and general circulation to the site.   

Conclusion

Cupping therapy must performed in a professional manner by a qualified and competent practitioner. ICAHT-certified practitioners undergo vigorous training and education to ensure that they are able to deliver all forms of Hijama and cupping therapy in a safe and effective manner. They are trained to have awareness of circumstances and considerations in which the procedure may not be appropriate.

In general, Hijama is a very safe and effective natural therapy in the hands of a competent practitioner. It has been used for over 5000 years to treat a wide range of health conditions; ranging from gout to migraines to back pain, fertility issues, high blood pressure, fatigue and low energy, as well as general health maintenance. It does not involve the introduction of anything new or chemical into the body so has very few risks or side effects.