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Fire cupping result
on Gwyneth Paltrow
Chinese doctors using a technique called moxibustion mix dried and powdered herbs such as mugwort into a peanut-size cotton ball or cone and ignite them above an acupuncture point on the skin. The ignited herbs are removed when a warm sensation is felt. The procedure is repeated several times. Doctors using a variation of this technique, called cupping, place bamboo jars or glass cups on a patients skin and light a taper (a piece of cotton or paper) and place it inside the cup long enough to suck out the air and create a vacuum. The sucking cup leaves behind a red circular mark that lasts for several days.

Acupuncture and moxibustion were inscribed in 2010 on the Representative List of the Intangible Cultural Heritage of Humanity. According to UNESCO: Acupuncture and moxibustion are forms of traditional Chinese medicine widely practised in China and also found in regions of south-east Asia, Europe and the Americas. The theories of acupuncture and moxibustion hold that the human body acts as a small universe connected by channels, and that by physically stimulating these channels the practitioner can promote the human body’s self-regulating functions and bring health to the patient. This stimulation involves the burning of moxa (mugwort) on these channels, with the aim to restore the body’s balance and prevent and treat disease. Moxibustion is usually divided into direct and indirect moxibustion, in which either moxa cones are placed directly on points or moxa sticks are held and kept at some distance from the body surface to warm the chosen area. Moxa cones and sticks are made of dried mugwort leaves. Acupuncture and moxibustion are taught through verbal instruction and demonstration, transmitted through master-disciple relations or through members of a clan. Currently, acupuncture and moxibustion are also transmitted through formal academic education. [Source: UNESCO]

Moxibustion is used as a treatment for cold, flus and chest pain. It has a long history. “Xinkan Buzhu Tongren Shuxue Zhenjiu Tujing” (“Illustrated Manual for the Practice of Acupuncture and Moxibustion with the Help of a Bronze Figure” was written by Wang Weiyi in the Song Dynasty (960 - 1279)

In recent years many athletes and trainers have embraced moxibustion as a way to reduce inflammation, increase blood circulation. Military veterans have been given the technique to treat brain injuries, bulging disks in the neck, bone spurs, headaches, numbness in the hands, and PTSD (Post-traumatic stress disorder), a condition that develops in some people who have experienced a shocking, scary, or dangerous event. Moxibustion has been approved by the United States Department of Veterans Affairs as a treatment that reduces the need for conventional drugs. [Source: National Geographic, January 2019]

Good Websites and Sources on Traditional Chinese Medicine (TCM): National Center for Complimentary and Alternative Medicine on Traditional Chinese Medicine (TCM) / ; National Center for Biotechnology Information resources on Chinese Medicine ; Skepticism of Chinese Medicine ; Chinese Medicine Chinese Text Project ; Wikipedia article on Traditional Chinese Medicine Wikipedia ; American Journal for Chinese Medicine On Moxibustion : Acupuncture ; Moxibustion Video YouTube ; Wikipedia article on Fire Cupping Wikipedia ; Article on Cupping

Acupressure, Massage and Bee Stings

Traditional Chinese medicine practices include: Dermabrasive procedures, which are based on hot/cold physiology, are often used to treat cough, myalgia, headache, nausea, backache, motion sickness, and other maladies. Cutaneous hematomas are made over the face, neck, anterior and posterior trunk (sparing the genitals) to release excessive air. These are made in many different ways; by pinching and pulling on the skin, by rubbing oiled skin with the edge of a coin or spoon or by cupping. [Source: Pamela LaBorde, MD, Ethnomed]

The Chinese also use massage to treat a number of ailments such as back pain and sore muscles. Most massages are performed by acupuncturists who sometimes use unorthodox techniques such as bloodletting and scraping the skin the skin with coins or porcelain spoons. Acupressure, also known as "shiatsu," is similar to acupuncture except that the meridians and points are stimulated by pressing them with fingertips, elbows or knees instead of punctures with needles.

Bee stings have been used on people with gangrene to prevent amputation. Reuters described the procedure on a 56-year-old diabetes suffer with gangrene that had begin spreading from his toes up his feet and legs. The bees were placed on the man’s foot and provoked to sting him to stimulate the flow of blood to the rotting, blackened flesh. Bee stings have been used in China for 3,000 years to treat back pain and rheumatism.. Now they are being used to ease inflammation and fight bacteria infection and are being investigated as a cure for liver ailments, diabetes and cancer.

Moxibustion Philosophy and History

Moxibustion utilizes mugwort ground to a powder and processed into a stick that resembles a cigar. Practitioners burn the fluff, or stick, near or on a patients skin to stimulate the flow of qi. They say it replenishes yang energy in the body and helps alleviate conditions caused by a deficiency of yang. These include indigestion, shortness of breath, fatigue, menstruation pain, and problems with the neck, shoulders, waist and legs.

According to tradition moxibustion appeared around the time that Chinese learned to use fire. Early healers believed that disease-causing yin energy and spirits could be repelled by fire. Moxa was said to have a pure yang nature that allowed it, when burned, to carry away “bad spirits” with the smoke. Moxibustion is said to have been widely practiced in the Tang and Song dynasties but went into decline in Qing Dynasty (1644-1911), when the Emperor’s doctors insisted it was indecent for the Emperor to expose his body to acupuncture or moxibustion and therefore was banned among the upper classes.

Moxibustion is not widely practiced in China. Li Weiheng, director of the China Association of Acupuncture and Moxibustion, told the China Daily that there are two reasons for this: 1) smoke is generally not tolerated in hospitals and clinics and 2) there is little money in it. The sticks don’t cost very much and the practitioner spend a lot of time holding the moxa stick,

On the benefits of moxibustion over acupuncture, Li said, “While acupuncture serves to direct and divert the energy patients already have, the problems with most people nowadays is that they don’t have enough qi and blood. Moxibustion can replenish this energy.”

Moxibustion Treatment

Cupping is done by heating the air in a cup with a flame, then placing the cup onto the skin. As the air cools, it contracts and pulls on the skin, leaving an ecchymotic area. Small circular superficial burns on the torso, head, and neck are made by igniting combustible material placed on the skin or with sticks of burning incense. This is often combined with acupuncture, which is used widely for musculoskeletal ailments such as arthritis pain, and for stroke, visual problems, and other ailments. [Source: Pamela LaBorde, MD, Ethnomed]

Moxibustion sessions usually start with a consultation that helps the practitioner determine which acupuncture points to target. The point for the diaphragm for example is a couple finger widths from the naval. Indigestion is treated at a point four fingers above the naval and four finger to the right. According to National Geographic: In a fire treatment session in Chengdu, an alcohol-soaked cloth is draped over a patient and set alight to warm the skin and open the pores; an herb-infused oil is then applied. The therapy aims to treat joint pain and other ailments, but research has yet to prove such claims.

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Fire cupping

Describing a moxibustion session given to businessman named Cheng, Ye June wrote in the China Daily, “After slipping into the pajamas provided he lies down...The moxibustionist burns a stick of moxa, or dried mugwort herb, 15 centimeters long and four centimeters thick. He holds the stick about an inch above Cheng’s skin, focusing the heat on three different acupuncture points for about 10-15 minutes each....The entire session takes about 80 minutes, including 20 minutes of massage.”

Cheng sought the treatment for the stress and wear and tear of a busy day, “It is an intensely warming and relaxing experience.” he said. The experience also helps his general wellness he said: “I used to catch a cold often. But in the past five months, I have had a cold only once.”

The marks left by cupping are clearly seen as tennis-ball-size red circles, of on the back. Cupping draws out “bad wind” The heat under the small glass cup creates a vacuum and stimulates the small blood vessels.

Moxibustion in 11th Century Chinese Art

“Moxibustion” by the Song Dynasty artist Li Tang (ca. 1070-after 1150), is a is an ink and colors on silk hanging scroll, measuring 68.8 x 58.7 centimeters. According to the National Palace Museum, Taipei: “ This painting shows an itinerant doctor treating a patient screaming in pain during a traditional treatment of moxibustion — burning wormwood to draw out pus. Each person cleverly arranged by the artist here plays a role. The drapery lines were rendered with a centered brush to make fine yet powerful strokes for "nail-head, rat-tail" lines, which aptly describe the coarse clothing of common folk in the countryside. The exaggerated, almost comical, expressions and gestures of the figures present a facet of rural life before our eyes, the brushwork and coloring following the style of naturalism practiced in the Song dynasty. This is a masterpiece of realistic genre painting from the Painting Academy of the Southern Song (1127-1279) court. [Source: National Palace Museum, Taipei]

"Moxibustion," portrays a rural doctor treating a patient by burning mugwort cones on his back. The contorted face of the patient being pinned down difficult to forget. The itinerant doctor has the instruments of his trade tucked into his bonnet as he burns mugwort cones on a patient's back, which appears inflamed. The patient struggles in pain, requiring three others to restrain and keep him still by stepping on his legs, holding his arms and pressing his shoulder. In contrast with the man's pained expression is the concerned look of the other three, as if commiserating with him. To the right is the doctor's assistant with paraphernalia, such as a fan, which indicate his role in preparing medicinal patches. He is shown blowing on a patch to apply medicine on the patient's back.

The brushwork and coloring in this painting is refined and realistic, being a masterpiece of Southern Song genre painting in the academic style. Despite the seriousness of the subject, the artist seems to have given it a comical touch by rendering the figures' expressions with exaggeration and animation, offering a memorable record of life in the countryside.

Cupping, Gwyneth Paltrow and the Olympics

Gwyneth Paltrow showed up at the 2004 premiere of "Anchorman" with cupping marks on her back. According to Business Insider: At the time, the images inspired a media storm, with publications across the world writing about the practice that resulted in the strange marks on her back. Five years later, in a post on Paltrow's lifestyle website Goop, the actress wrote of her love for Eastern medicine— and cupping in particular. "Eastern medicine has a different approach than Western medicine — it’s more holistic," Paltrow wrote. "The root of the problem is addressed, as opposed to a symptom being attended to with prescription medication, only to return." The actress added that she's "thankful as hell" for antibiotics or surgery when necessary, but that she's been helped "tremendously by various practices that help the body heal itself."

A number of Olympians have been spotted with large red dots left behind by moxibustion. At the 2016 Olympics in Rio de Janeiro swimmer Michael Phelps and gymnast Alex Naddour were observed with such marks. Naddour called the do-it-yourself cupping kit he bought on Amazon his "secret" to staying healthy: "It's been better than any money I've spent on anything else."

Rachel Vreeman, MD, director of research at the Indiana University Center for Global Health, told said: "As the air trapped between the heated glass and the skin begins to cool, it creates suction against the skin. The sucking causes small blood vessels under the skin to break, and a cup-shaped bruise to form. The therapy can also be done using a mechanical device to create suction between the skin and the cup, Dr. Vreeman adds. Cupping may sound painful, but it's not really, she says. "Basically, it feels like getting a hickey." [Source: Jacqueline Andriakos,, August 10th, 2016]

According to “While athletes use cupping as a recovery tool Dr. Vreeman points out that there's little research behind it: "There are no health benefits to cupping documented in the scientific literature," she says. "The only study I have seen ... with any impact related to cupping is one that rigorously examined various therapies for back pain, and suggested that any impact from cupping was likely related to a placebo effect."

“That placebo effect could help explain why Olympians swear by the practice, says Dr. Vreeman. Our brains are very powerful, Dr. Vreeman explains. "If we think that something is going to work, it may help us focus or compete better. The marks cupping leaves behind may play a role as well: "I would guess that [they] provide a tangible reminder to the athlete of this therapy, reinforcing the placebo effect...Cupping usually does not cause any harm beyond the temporary bruising, but occasionally it can cause a skin ulceration when done repeatedly.

According to Medical Express: The Chinese media cheered cupping's appearance at the Olympics as proof of the value of traditional culture, with both the official Xinhua news agency and Communist Party mouthpiece People's Daily touting the soft-power benefits. "Chinese traditions and products proliferate Olympic village", read one headline on the People's Daily website. Ding Hui, manager of the Lily Spring Health & Spa in Beijing, said she has seen a 30 percent jump in clients asking for cupping treatment since the Olympics started. "Even though Chinese people have known about it for a long time, they see a great athlete does it and see it really works," Ding said. "For athletes, they build up harmful lactic acid in the body and cupping can help relieve it." [Source: Medical Express, August 11, 2016

Image Sources: Wellington Physiotherapy; Wedgeweeod Acupuncture; Acupuncture Products; Qi Gong Foundation; Micheal Moon at Lotus Space; Wikipedia; BBC

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated September 2022

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