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Cupping is form of alternative therapy that is widely practiced worldwide. It is known by many terms depending on where you are. In our local setting, it is referred to as ‘berbekam’ in Malay.


The principle behind cupping therapy is the creation of a low pressure vacuum inside the cup by two means: the heating of the air inside the cup or creating a low pressure inside the cup through a suction pump. Heating of the air inside the cup can be done through burning of cotton soaked in alcohol (usually 70% or above) for a brief second before application to the designated area. As the heat inside the cup dissipates, suction is created from the cooling action. Example of suction method is rubber pump or syringe among the examples.


Cupping can be broadly categorised to two types: dry cupping and wet or bleeding cupping. In dry cupping, the cups are usually applied to the designated area whereas in bleeding or wet cupping, a small scratch or incision is made with a needle or lancet prior to the application of the cup. This is a form of bloodletting therapy. In Chinese believe, cupping help to remove toxins from the blood. Generally, bleeding or wet cupping provides a more ‘curative-treatment approach’ whereas dry cupping is seen as the ‘therapeutic and relaxation approach.’ Wet cupping believed to be more widely practiced.


Cupping generally leaves markings ranging from a simple ring bruise to a circular bruise depending the suction applied and can range from singular to the more common multiple marks. As cupping is generally applied to soft part of the body, marking are usually found on the body.


Use of cupping or therapy using this principle is believed to date back to as early as 3000 BC. Up to now, cupping is used to treat a broad range of ailments ranging from blood disorders, numerous rheumatic disorders such as joint and musculoskeletal pain, gynaecological disorders and infertility, skin disorders and even for physical or psychological wellbeing. In some countries, cupping is widely available and accepted form of alternative therapy.


Image and text contributed and prepared by

Dr Vui Hengi Chong, Department of Internal Medicine, RIPAS Hospital, Brunei Darussalam.

All images are copyrighted and property of RIPAS Hospital.