Cupping

An acute exacerbation of asthma brought this 52-year-old Russian emigr to the emergency department (ED). Examination revealed the well-demarcated round erythema and ecchymosis on the patient's back. This circular pattern was created by cupping performed 2 days earlier by the patient's wife in an effort to treat her husband's asthma.

Cupping (or bahnkes, as it is known in Yiddish) is still used as a folk remedy for asthma, bronchitis, and musculoskeletal pain in China, Russia, Korea, and many other countries. Drs Sultan S. Khan and Jahon Soltani of Coney Island Hospital in Brooklyn, NY, note that cupping also has a long history of use in the West and has been employed as a treatment for bronchopneumonia and acute myelitis.¹

The cupping technique requires igniting alcohol in a small glass that immediately is pressed tightly against the skin. A vacuum is produced by the combustion of the alcohol and the consequent loss of oxygen from the cup. The theory is that the created vacuum sucks out noxious materials from the body.

This patient was unconcerned about these lesions caused by cupping and requested no intervention for the skin condition. He was discharged from the ED following therapy for the asthma exacerbation.

REFERENCE:
1. Osler W Sr, McCrae T. The Principles and practice of Medicine. 11th ed. rev. New York: Appleton; 1930:981.

FOR MORE INFORMATION:

• Ackerknecht EH. Therapeutics From the Primitives to the 20th Century. New York: Hafner Press; 1973.
• Dearlove J, Verguei AP, Birkin N, et al. An anachronistic treatment for asthma. Br Med J (Clin Res Ed). 1981:283:1684-1685.
• Gillespie WA. Remakrs on the operation of cupping and the instruments best adapted to country practice. Boston Med Surg J. 1834;10:27-30.
• Hills M. A treatise on the operation of cupping. Boston Med Surg J. 1833;9:261-273.
• Manber H, Kanzer M. Images in clinical medicine. Consequences of cupping. N Engl J Med. 1996;335:1281.