What is Cupping?
By Emma Suttie, D.Ac, AP
With the close of the Olympics, there has been a sudden flurry of interest in Chinese cupping. It seems that many members of the US swim team were touting large red circular marks on their backs which got a lot of attention in the media and piqued people's curiosity about the ancient technique. Those marks are from a modality that is part of Chinese medicine and is many thousands of years old. It is called cupping.
There are many modalities that fall under the umbrella of Chinese medicine. Acupuncture, Chinese herbs, tui na (Chinese therapeutic massage), moxibustion (the burning of the Chinese herb Artemesia), auricular acupuncture (acupuncture of the ear), gua sha (scraping) and cupping are all the modalities of Chinese medicine and the tools that the TCM practitioner uses to rebalance and heal their patients.
Cupping is a little discussed (outside Chinese medicine circles) but much-loved practice by both practitioners and patients. Even though the results may look a bit alarming, it is painless and in fact, a very relaxing treatment and many of my patients request cupping when they are feeling stressed out or "wound up" because it helps them to unwind and relax. Cupping has many health benefits, which make it an invaluable part of the expansive toolbox that is Chinese medicine.
What Does Cupping Treat?
At the heart of Chinese medicine theory is the concept of "Qi". Qi can be described in many ways, energy, life force, prana... and all would be correct. It is the force that brings things to life and must be kept moving for us to be healthy. Each one of us has Qi. It is a close partner of blood and the two work together to keep things circulating throughout the body. If our Qi is abundant and moving smoothly, then we are healthy. However, if Qi becomes blocked, or "stagnant" then illness can occur. Diseases in Chinese medicine are seen as blockages of Qi, and often the longer the Qi has been blocked, the more severe the illness is seen to be. So, one of the main goals of all Chinese medicine modalities, including cupping is to move Qi. There are specific things, though, that cupping treats very well. They are listed below.
Cupping Treats the Following Conditions
- Pain in the back, neck, legs and arms
- Colds & flu
- Detoxification
- Inflammation
- Respiratory illnesses - bronchitis, asthma, cough
- Digestive problems - stomachaches, vomiting, diarrhea
- Anxiety
- Fatigue
- High blood pressure
- Cellulite
- Migraines
- Edema (swelling)
- Arthritis
How Does Cupping Work?
Bamboo Cups
this lovely image from ameliaislandmassages.com
There are different kinds of cups, the traditional type being made of bamboo, and the modern type usually made of glass. A cotton ball soaked in alcohol is lit on fire and placed briefly into the glass cup to heat the air inside. It is then immediately placed on the skin, the heat creating a suction. The skin and first layers of connective tissue and muscles are lifted into the cup, and a mark is usually formed, from a light red to a deep, dark purple. The cups are left on anywhere from a few minutes to 30 minutes depending on what is being treated. The theory is that the darker the mark left by the cup, the more toxins and stagnation are in the area being treated. The cups come in different sizes and are indicated for large muscle groups like the back, upper thighs and sometimes, the abdomen. The suction created inside the cup can be from heat (this is sometimes called fire cupping), or there are plastic cups that use a manual pump to suck out the air while they are sitting on the skin. The cups can also be moved, with the application of oil to the skin, along meridians or large muscle groups which have a distinct "massage-like" feel for the patient.
Cupping is used to relieve pain, remove heat, increase circulation and pull toxins out of the body. It is also excellent for digestive problems like stomach aches, vomiting, and diarrhea as well as respiratory problems like coughing and asthma. Cupping is an amazing modality for warming, dredging the meridians (where there is often blocked or "stagnant" Qi) and moving Qi and blood. Despite how the results may look, it happens to be incredibly relaxing and is like having a warming massage. The effect, in fact, is like having a reverse massage with the cups pulling up on skin and muscles, instead of applying pressure downwards. The red marks left are often used to diagnose the severity of the stagnation of Qi and blood or toxicity, and although they can look severe, they are painless and go away in a day or two.
Glass "Fire" Cupping
this helpful image from hoylasnoticias.com
Contraindications
There are several things that you want to look out for before you try cupping. You do not want to do cupping over areas of broken skin or rashes, edema (swelling), areas where there are large blood vessels, or if you have a high fever with convulsions. Also, pregnant women should never have cupping on the abdominal and sacral area. Cupping is also not appropriate if you have a bleeding disorder.
In conclusion, cupping is a wonderfully therapeutic treatment and one that patients always really love. It is warming to the muscles, and the sensation of the skin and muscles being pulled up into the cup is unique and relaxing as well as detoxifying. Cupping keeps Qi and blood flowing smoothly inside the body, which is the key to ultimate health. If you have never tried it, you definitely should. The marks it leaves behind are also always a great conversation starter!
What is Qi?
By Emma Suttie, D.Ac, AP
Qi is a huge and complex subject and one that is central to Chinese medicine theory. Qi is a difficult concept to explain because it is difficult to measure and impossible to see. To the Chinese, it is a given. It is the very force that governs life and all of its processes, but for us in the West, it is a little more difficult to wrap our minds around. In the West, we live in a culture that is largely ruled by science, and science is all about things that we can see and prove. Although science is now able to prove the efficacy of things like acupuncture, the HOW is still largely under debate. Qi is at the core of why all of the modalities in Chinese medicine - Acupuncture, Chinese herbs, gua sha, tuina, moxibustion, cupping, auricular, it is one of the main reasons that they are so effective, and have been for more than 5000 years.
Qi is a subtle energy that can be loosely translated as vital energy or life force. In India, it is called Prana. In Japan, Ki. Many of the Eastern cultures know and understand this concept and its role in keeping the body healthy. In Chinese medicine, Qi is the force that animates all living things. Qi flows through energy pathways throughout the body called meridians or channels. There are 12 main meridians that correspond to specific organs and run bilaterally, mirroring each other. There are also extra pathways that run deeper in the body, but all are the channels through which Qi travels. Qi must move freely throughout the body for health to be maintained. A blockage of the Qi in the body usually results in pain (a main symptom of Qi stagnation) and if left untreated can cause a whole host of other, more serious problems. In addition to Qi running through the meridians, each organ also has its own unique Qi. Each organs’ Qi can become deficient, excess, or stuck, or stagnated. Stagnation of Qi starts energetically, but if left untreated, can manifest physically as things like tumours and other masses. This is why it is important to keep Qi flowing freely.
This image from Acupuncture Media Works
The Qi in the body also flows in two-hour intervals through each of the organ systems. This is used as a diagnostic tool by TCM (traditional Chinese medicine) practitioners. If, for example, you are waking up consistently at a specific hour every night, it points to an imbalance in that specific organ. If there is a certain hour of the day when you feel particularly productive, then it would suggest that the organ that corresponds to that hour is strong. You can see the chart below for the organs and the corresponding times.
Because of the importance of Qi and its ability to flow freely through the body, the Chinese have developed many exercises to help build Qi, as well as keep it moving freely. The external martial arts, like Kung Fu are excellent for cultivating Qi and keeping it moving, and the internal martial arts like Tai Chi and Qi Gong are excellent ways of cultivating and strengthening Qi and keeping it flowing throughout the body so that health can be maintained.
There are many ways to build Qi. Good food, clean air, and participating in positive activities all build Qi. And many things diminish Qi, like stress, not getting enough sleep and having an unhealthy lifestyle. It is almost impossible to stay away from stress and other things that can deplete Qi, but the good news is that we are always able to rebuild it by simply doing things that give us energy. Keeping Qi moving is extremely important and the best way to do this is simply by moving your body. The act of walking (preferably in nature) is a wonderful way to keep Qi moving and stay a healthy, happy human being.
This article also appears on the website Qi Encyclopedia at -
http://qi-encyclopedia.com/index.asp?article=WhatIsQi-3
Interview with Andrew Schlabach - Co-Founder & President of The Acupuncture Relief Project
By Emma Suttie, D.Ac, AP
Andrew Schlabach, who is co-founder and president of the Acupuncture Relief Project, kindly agreed to sit down and answer a few questions about his organization and all the good things they are doing with their clinic in Nepal.
For those who don’t know about your organization, could you tell us a little bit about it?
Acupuncture Relief Project (ARP), along with our local partners, operates a small primary care clinic in a rural village of Nepal. Founded in 2008, Acupuncture Relief Project provides healthcare practitioners of various disciplines an opportunity to gain valuable field experience while making a positive impact on the local community. Our efforts include the treatment of patients living with HIV and AIDs as well as people suffering from extreme poverty and social disenfranchisement. We are a completely volunteer-based project and rely on a grassroots approach to sustainability and community support.
Why did you choose Nepal? Did you have a personal connection to it, or did you think it would be the place that would most benefit from this type of clinic?
I had the privilege of working as a mountaineering instructor at the notorious Himalayan Mountain Institute in Darjeeling India and participated in several expeditions in Nepal, Tibet and Northern India. Through this experience I fell in love with Nepal and its people. Later when I trained as an acupuncturist I envisioned a program which would not only provide service to a community that had very little access to medical care but would also provide an opportunity for healthcare practitioners to experience the complexities and hardships of the developing world. Hopefully providing an experience which challenges practitioners to connect to a deeper understanding of their medicine and foster the growth of compassionate wisdom.
Were the local Nepalese people open and receptive to coming to the clinic to get acupuncture, or did it take some time for them to warm up to it?
We don't characterize ourselves as an "Acupuncture" clinic even though we are primarily staffed by acupuncture physicians. Mostly we are just a primary care clinic... a place where anyone can come to get medical care and advice. Like anywhere in the world, some people are very open-minded about acupuncture and some are very skeptical. Once we establish trust, it doesn't really matter whether we are using acupuncture or allopathic medicine, people know they can come in and we will do our best to help them. It is very difficult to describe to people in developed countries what it means to live without access to care. Many times our job is more about patient education, assessment and referral than it is about any particular treatment modality. Just the fact that we can assess whether a child's fever is manageable or an emergency provides the community with a priceless resource.
Did the locals have any prior knowledge of what acupuncture was?
Not really. We get asked many times a day "what kind of medicine is on the needle". We explain that there isn't any and that we are simply assisting their body in healing itself. That is probably a bit mystifying but then, after couple treatments, they start getting better. Then they bring their whole family.
You have a group of wonderful local interpreters who work with the practitioners. Is the language barrier still difficult?
Our interpreters are world class professionals and they continue to improve. Several of them have worked with us since the beginning. The difficulty for both us and the interpreters is the limitation of the language itself. There are three common languages in the area in which we operate. Nepali, Newari, and Tamang. Each language has it's own unique limitation. For example in Newari there is only one word for the torso which translates in English to "heart". A patient may come in complaining of "Heart Disease" which for us only narrows it down to the torso. They could be suffering from anything from indigestion to angina to hepatitis. They don't have specific words or an understanding of internal organs so our interpreters do the best they can and we rely on many non-verbal cues and diagnositics to direct our assessments.
What are some of the conditions that you treat most?
People in the village are mostly subsistence farmers and they work very hard throughout their lives. About 65% of patients that we see are coming in for chronic pain. Low back, neck and knees particularly. This is something acupuncture is quite good at addressing and we see very good results in getting people back to work so they can take care of their families. We also see a multitude of other conditions including digestive disorders, hypertension, diabetes, stroke, febrile stroke, uterine prolapse, asthma, tuberculosis and typhoid. We also sometimes deal with social issues like domestic violence and substance abuse.
Do you only use acupuncturists?
No. We primarily use acupuncturists because this treatment modality allows us to treat a large number of people for very little money or overhead. The clinic also hosts herbalists, Tibetan traditional practitioners, homeopaths and massage therapists. We have also had several allopathic and naturopathic physicians work with us. We try to provide as much care as possible and we find that we do very well without the overhead of a pharmaceutical dispensary. We do utilize a small stock of antibiotics and other drugs when we need to but we will try to get a patient to an appropriate facility a patient has a serious or emergency condition.
What were some of the things that surprised you about running the clinic in Nepal?
I think what continues to amaze me is how much impact a small clinic can have on so many people. Not only our patients who of course benefit from our care but also our interpreters who have meaningful jobs supporting their own communities. Additionally our volunteer practitioners continuously report to us the effects of their experience in Nepal. Many have shared how they have gained a new appreciation for patient care and that has carried forward into their own practices and communities.
About how many people do you treat a day?
The clinic sees about 80-120 people per day. We also conduct several outreach clinics in outlaying villages each week.
Do you have any idea how many patients you have treated since the clinic began?
Well over 100,000 patient visits.
Is the clinic operational full time, or only at certain times of the year when you can bring volunteers?
Yes. There are practitioners at the clinic year round, however the clinic runs at varied capacity depending on the availability of volunteers and other resources. Organizationally, we focus particularly on our training program which operated from September to March every year. During this time the clinic opperates is at it's maximum capacity. The availability of healthcare in the winter months is particularly critical to the village so we prioritize our efforts for this time of the year.
Acupuncture is very cost effective compared to Western medicine. How much does it cost to run the clinic?
Again, we characterize ourselves as a primary care clinic and not an "acupuncture" clinic. We utilize a variety of modalities (including Western medicine) and attempt to determine the "best" care for a particular patient. In many cases, acupuncture is the "best" care. The total cost of operation including all of our herbal and western dispensary, we provide primary care year round for about $4.80 USD per patient visit. I don't wish to take anything away from other types of service projects but for sake of comparison, you can compare us to a visiting medical/dental camp which operates in Nepal for a few weeks each year which costs $24-30 USD per visit. I will say that the dental services that they provide are worth every penny to the communities they serve.
What is the most difficult thing about running the clinic?
I think with any service project there are constant stresses around resources. There is never enough money, time or volunteers to accomplish everything you might envision. Also, as a US based non-profit there are many logistical complexities of operating a clinic half way around the world. All of these are relatively minor in the grand scheme but they must be constantly addressed in order to insure our long term sustainability.
What would you like to see the Acupuncture Relief Project do in the future?
Training local practitioners is our ultimate goal and one that we are actively trying to solve. In 2011, we fully funded a scholarship for one student only to be setback as the only Oriental Medicine school in Nepal became defunct. We have now adopted an apprenticeship program for two students and we are also exploring the possibility of sponsoring a student to study in the US, Canada, Australia or China. Our major obstacle is a lack of legitimate accreditation and licensure in Nepal so obviously this issue will be on our list for awhile.
Here is some more information about Andrew from the Acupuncture Relief Project website...
Andrew Schlabach MAcOM EAMP
Andrew Schlabach is the co-founder and President of the Acupuncture Relief Project having received his Masters in Acupuncture and Oriental Medicine from the Oregon College of Oriental Medicine in 2008. His master’s research project founded a Practice Based Research Network for Oriental medicine practitioners and researchers in Oregon and Southwest Washington in collaboration with the Helfgott Research Institute. Now practicing at Healthwerks - Acupuncture Wellness Clinic, Vancouver Washington he is the author and publisher of the Acupuncture and Chinese Herbal Medicine - Clinic Survival Guide. Mr. Schlabach also served as President and Creative Director of Split Diamond Media, Inc. of Portland Oregon for 15 years. Specializing in business-to-business advertising, Split Diamond Media pioneered digital publishing technologies and internet services for a variety of regional and national companies. Mr. Schlabach is also an accomplished mountaineer with expedition experience in the Himalayas, distinguishing himself as an instructor at the prestigious Himalayan Mountain Institute in Darjeeling India. Having travel extensively in central Asia, Mr. Schlabach has become a student of world theology, Tai Ji and yoga. As a veteran of the U.S. Army, he received an Army Commendation Medal for distinguished service to his unit.
To learn more about The Acupuncture Relief Project and the wonderful work they are doing, please visit their website at www.acupuncturereliefproject.org
And be sure to watch the 30 minute documentary, Compassion Connects about their clinic in Nepal. It is incredibly inspiring!