External therapies: The cup

What holds the cup on

拔罐 Bá Guàn

In fire cupping the flame goes in and out in an instant: it consumes the oxygen inside and, as the air cools, it contracts and creates a pressure lower than atmospheric. That is what holds the cup. The flame does not heat the cup or “transmit warmth”.

Fire cupping

The flame creates the vacuum; the rim arrives barely warm

Valve cup

The same vacuum, pumped: adjustable and repeatable

Silicone cup

The flexible body is compressed before it is set down

In all three

The stimulus is mechanical, never thermal

Common mistake: Believing the flame is there to heat the cup. If the cup arrives hot at the skin, the technique was done badly.

A student says their fire cup “doesn't heat enough” and leaves the flame inside longer. What is happening?

1. Nothing: more flame is more vacuum
2. They are losing vacuum because the hot air escapes
3. They will get a thermal effect on top of the mechanical one
4. They are heating the rim, which is the only part that can burn

Each cup with what characterizes it

In flash cupping, what do you watch between repetitions?

1. That the cup stays hot
2. The color of the skin every few repetitions
3. That the vacuum gets stronger each time
4. That the patient does not talk during the series

Put the placing of a fire cup in order

1. Inspect the skin and agree what they will feel↑↓
2. Light the swab, away from the alcohol bottle↑↓
3. Take the flame in and out in an instant↑↓
4. Set the cup down immediately, rim barely warm↑↓
5. Check the skin color before leaving it in place↑↓

A patient asks whether dark marks mean they were “very congested”. What do you answer?

1. Yes: the darker, the more stagnation there was
2. Yes, but only if the mark lasts more than a week
3. No: the color depends on how long it was left on, and nothing else
4. Color depends on several things — vacuum, time, area, skin — and does not measure how much they had