This article will summarize three of the nine ancient and modern theories of cupping that are covered in my book, Ancient and Modern Cupping Therapy. The theories covered here are:
- Blood stagnation or Eohyeol Theory
- Meridian Cupping Theory
- Counterirritation Theory
Blood stagnation or Eohyeol Theory
In Traditional Chinese Medicine (TCM), many symptoms and illnesses are caused by blood stagnation. If blood stagnation occurs locally, patients experience more local symptoms such as low back pain, neck pain, tendinitis, appendicitis, and arthritis. More general symptoms occur when blood stagnation is diffuse. Many chronic conditions such as chronic widespread pain, chronic fatigue, diabetes, autoimmune disorders, and fibromyalgia are due to diffuse blood stagnation. Blood becomes stagnant when normal flow is obstructed or when the physiological conditions are not fulfilled. Unhealthy lifestyles, daily stress, physical trauma and injuries, infections, drugs, chronic inflammation-mediated diseases including diabetes, allergies, arthritis and joint diseases, emotional disturbances, and climatic changes all can cause blood stagnation. From a TCM perspective, Qi stagnation or deficiency, Yang deficiency Cold, Exogenous pathogenic Cold or Heat, Blood loss or deficiency, and exhaustion are additional causes of blood stasis.
Eohyeol is modern counterpart of chronic inflammation. Chronic inflammation generally develops as part of the sequence of cellular events following acute inflammation. Tissue damage due to trauma, noxious compounds, and other etiologies as aforementioned can induce acute inflammation, which lasts a few days to several weeks. Chronic inflammation due to persistent inflammatory stimuli lasts for prolonged periods of several months to years. Generally, the extent and effects of chronic inflammation vary with the cause of the insult or injury and the ability of the body to repair and overcome the damage.
In chronic inflammation, tissue destruction occurs faster than cellular regeneration, causing pathological fibrosis to replace physiological apoptotic cells. Eventually, the tissue’s function will be reduced. In chronically inflamed tissue, the stimulus of the immune system is persistent. Therefore, recruitment of the monocytes is maintained, existing macrophages are tethered in place, and proliferation of macrophages is stimulated continuously. In this chronic process, the local or diffuse redness and heat sensation are less severe than in the acute process and are characterized as empty fire or Yin deficiency from a TCM perspective.
There are many ways to clear blood stagnation. Many dietary and lifestyle changes may be helpful in removing inflammation triggers and reducing inflammation. Weight loss is perhaps one of the most effective ways to reduce general diffuse chronic inflammation. Plenty of rest and sleep will enable the body’s lymphatic and circulatory system to absorb Eohyeol to some degree. Likewise, a proper amount of exercise can also enhance lymphatic and venous function, thus reducing Eohyeol as well. A balanced diet indirectly helps get rid of stagnant blood by optimizing each organ’s function. Stress reduction through meditation, positive thinking, living in the moment, and acceptance of reality are other important behavior modifications. Other effective techniques to treat Eohyeol-related illnesses are acupuncture, moxibustion, Chinese herbs, supplements, physical therapy, and massage. However, cupping therapy is one of the most efficient and effective modalities to either partially or completely remove Eohyeol from the body via negative pressure.
Meridian cupping theory
Chinese medicine believes there is a distribution network for the fundamental substances of Qi, Blood, and Body Fluids throughout the body. This distribution network is called Meridian System (Jing Luo), which looks like a giant web, linking interior Zang FU organs with various tissues of superficial areas of the body. Its pathway makes up a comprehensive yet complex body map that supplies vital energy to every part of the body. There are about 400 acupuncture points most of which are situated along the major 20 pathways including 12 primary and 8 extraordinary channels.
When these meridians are blocked by various etiologies obstructing the flow of Qi, the condition of the body becomes disordered. Subsequently, patients manifest different symptoms depending on which meridian is blocked. A similar analogy is the flow of water through a stream. When a stream is blocked due to a fallen tree, it floods above the blockage and dries up below the blockage. In a blocked stream, just cutting a small hole or crevice in the blockage will often clear the entire stream path, because the force of the water that penetrates the hole widens it continuously until the normal course is restored. In the human body, inserting acupuncture needles into the blocked meridian will have a similar effect.
Just as a stream may have certain points more easily accessed, the meridians have certain points which, if treated by needling, will have a significant impact on the flow pattern. In fact, many acupuncture points are named for geological structures such as mountains, oceans, streams, and ponds.
Fundamentally, all descriptions of acupuncture based on the traditional model involve rectifying a disturbance in the flow of Qi. Modern scientists studying how acupuncture works do not approach it as a mystical process. Instead, they make careful observations to learn more about acupuncture’s natural physiological basis. Some of the research done so far suggest that endorphins, which are proteins naturally produced by the body, play some role in the process. Endorphins have a chemical structure similar to that of morphine or opium and are known to block pain.
Acupuncture may stimulate the production of these and other compounds that affect how the brain perceives pain. Acupuncture also has been proven to release serotonin, a neurotransmitter made in the intestines and brain. Serotonin balance is essential for emotional and mental health, eating and sleeping patterns, and the degree of pain in the body. Research exploring a number of possible mechanisms for acupuncture’s pain-relieving effects is ongoing.
Counterirritation or Counterstimulation theory
Dr. James Ross wrote in 1869, “Counter-irritation is a term employed to designate any irritation artificially established with a view to influence some manner another morbid process existing in the body: and the agent employed to produce the artificial irritation is termed a counter-irritant.” From the earliest times to the beginning of the 20th-century counterirritation was one of the most important methods of treatment. Wet and dry cupping, blistering agents, setons (a procedure used to aid the healing of fistula), cautery, cantharides (blister beetles or Spanish Fly), and moxa were used as effective counterirritants in the past. In modern days, TENS (transcutaneous electrical nerve stimulation), heat and cold, trigger point therapy, menthol, camphor, massage, and cupping are more commonly used counterirritants.
Dr. Cameron Gilles in his The Theory And Practice of Counter-Irritation states several purposes of counterirritation: ‘’to quicken the process of repair, for the relief of pain, to promote the absorption and removal of pathological products, to aid and accelerate the natural effort to throw off dead tissues, to remove a state of passive congestion, to rouse from a state of unconsciousness, and to draw poisons and poisonous products from the tissues.’’
The counterirritant theory relates to pain aligns well with the modern gate control theory of pain, which describes how non-painful sensations can override and reduce painful sensations. This theory, first proposed in 1965 by Ronald Melzack and Patrick Wall, offers a physiological explanation for the previously observed effect of psychology on pain perception. The gate control theory asserts that both small(pain-transmitting) and large nerve fibers(touch, pressure, and vibration transmitting) synapse on projection or transmitting cells that carry the pain signal up to the brain and inhibitory interneurons that impede transmission cell activity within the dorsal horn of the spinal cord.
The control of this “gate” depends upon the relative activity in large-diameter fibers (A-beta) and small-diameter fibers (A-delta and C). Large-diameter myelinated fibers excite inhibitory interneurons and reduce the presynaptic input to the transmission cells, thereby inhibiting pain. Activity in small-diameter unmyelinated fibers inhibits the inhibitory neurons and facilitates the transmission of noxious impulses to the transmission cells, resulting in pain. Both wet and dry cupping, acting as counterirritants, stimulate larger A-beta fibers and block the transmission of nociceptive information, which explains the scientific rationale for the efficacy of cupping therapy. The principle of counter-irritation to reduce pain is also similar to the modern concept of diffuse noxious inhibitory controls.
To learn about more ancient and modern cupping theories, buy my book, Ancient and Modern Cupping Therapy.