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Traditional and Complementary

Medicine Practice Guideline on

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Bekam

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Ministry of Health Malaysia.

Traditional And Complementary Medicine Division

Copyright 2011, Ministry of Health Malaysia.

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All rights reserved. No part of this book may be reproduced,

stored, or transmitted in any form or by any means, electronic
or otherwise, including photocopying, recording, internet or any
storage and retrieval system without prior written permission
from the publisher.

First edition 2011

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Published by:
Traditional and Complementary Medicine Division
Ministry of Health Malaysia

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ISBN 978-967-10715-2-6

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Cover design by:

Mohd Afendy Baharuddin
Traditional and Complementary Medicine Division
Ministry of Health Malaysia

Contents
1
2

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3
4
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5
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Acknowledgements
1. Introduction
2. Definition
3. Types of Bekam and Treatment Concept
3.1 Bekam Kering/Bekam Angin (Dry Cupping)
3.2 Bekam Basah (Wet Cupping)
4. Treatment Criteria
4.1 Accepted Age
4.2 Indications
4.3 Contraindications
4.4 Recommended Time
4.5 Precautions
4.6 Side Effects and Complications
5. Treatment Procedures
5.1 Apparatus
5.2 Points of Application
5.3 Standard Precautions
5.4 Duration
5.5 Monitoring
5.6 Referral
6. Documentations
7. Practice Facilities
8. Conclusion
9. Appendices
Appendix 1: Sterilization and Disinfection Techniques
Appendix 2: Standard Precautions in Health Care
Appendix 3: Disposal of Infectious Clinical Waste
Appendix 4: Environmental Quality Act 1974
Appendix 5: Bekam Clerking Form
Appendix 6: Consent Form
Appendix 7: Bekam Apparatus
10. References
Editorial Board

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Acknowledgements

Special thanks to every individual and organizations that have in

one way or another contributed materials, comments and advices

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during the preparation of this practice guideline on Bekam.

Traditional and Complementary Medicine Practice Guideline on Bekam

1. Introduction
Bekam (or cupping) is a form of traditional medicine practice found in many cultures worldwide.
It involves placing cups containing reduced air or pressure (creating suction or a relative vacuum)
on the skin. It is known in other languages as badkesh, bahnkes, nuhang, bantusa, kuyukaku, gak hoi,
hijamah and many other names [20].

Bekam practices is thought to date back as early as 3000 B.C., the earliest record is from the Ebers
Papyrus, one of the oldest medical textbooks in the world. The book describes the systematic use
of cupping by the early Egyptians, as far back as 1500 B.C. In China, archeologists found evidence
of cupping dating back 1000 B.C. Cupping was mentioned in the writing of Hippocrates and was
practiced by the Greeks in 400 B.C [8,21,25].

Prominent historical persons advocating cupping as one of the treatment methods includes Galen
(a prominent Roman physician and philosopher of Greek origin) [21,25], Avicenna (or also known as
Ibn Sinna, preferred wet cupping), Matre de Monderville (surgeon to King Philippe of France who
wrote a textbook on surgery, including a long section on cupping, detailing the points in cupping),
and The Prophet Muhammad (Peace be Upon Him), who said, Healing is in three things: A gulp
of honey, cupping and branding with fire (cauterizing). But I forbid my followers to use branding
with fire. [2,3,22,23,24] . Imam Ahmad recorded in his Musnad that the Prophet Muhammad (Peace be
Upon Him) said, Verily, cupping is among your best remedies. [2] During The Prophet Muhammads
(Peace be Upon Him) time, cupping is a common practice.

The aim of bekam is to extract blood that is believed to be harmful from the body which in turn
rids the body of potential harm from symptoms that leads to a reduction in well being [23]. It is
reputed to:

Bekam is claimed to work via a range of mechanisms from counter-irritation to detoxification,

but these are mere theories that have not been tested or investigated. Results of several studies
appear to be encouraging and the authors conclude that cupping therapy effectively relieves
symptoms and pain... [16].

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Drain excess fluids and toxins

Loosens adhesions
Lift connective tissue
Enhance circulation in stagnant musculature and fascia
Stimulate the peripheral nervous system

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Bekam helps in the treatment of various ailments. However, it does not cure diseases. Rather, it
helps to alleviate or reduce the effects/symptoms and helps in controlling the disease and acts as

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Traditional and Complementary Medicine Practice Guideline on Bekam

a complementary medicine. Bekam is usually done as a complement to other practices such as

massage, and commonly, an herb preparation is prescribed to be taken after bekam.
Currently, any person can claim themselves as a bekam practitioner. However, due to its invasive
nature, there is a need to regulate the practice. Ideally, a bekam practitioner should have a proper
training and adequate working experience. For practitioners with a Diploma, they should have at
least six months of work, under supervision, or equivalent to 40 case presentations. In future, the
practice can only be performed by a practitioner with either a Diploma or Bachelors Degree in
the relevant studies.

The emphasis on training is appropriate in this current world and age due to the emergence
of various blood borne infectious diseases such as HIV/AIDS, Hepatitis B and Hepatitis C. It is
therefore important that a proper guideline, which focuses on proper handling of patients and
clinical wastes, be developed for implementation to ensure the safety of both practitioners and
patients alike.

* The American Heritage Dictionary of the English Language

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is the Malay word for cupping.

is a treatment in which evacuated glass cups are applied to intact/scarified skin in
order to draw blood toward/through the surface. It is used for disorders associated
with an excess of blood, one of the four humors of medieval physiology.

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Bekam
Cupping

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2. Definition

3. Types of Bekam and Treatment Concept

There are generally two types of bekam;
3.1

Bekam kering/bekam angin (dry cupping/wind cupping)

Evacuated cups are applied to the intact skin. There is no bleeding or scarification of the
skin.
Bekam basah (wet cupping)
In this method, evacuated cups are applied to the scarified skin and blood is drawn
through the wound to be evacuated.

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Table 1:
Types of bekam, treatment concept and purpose of treatment.

[1,4]

Bekam Kering (Dry Cupping)

Bekam Basah (Wet Cupping)

Treatment concept

Wellness

Therapeutic

Purpose of treatment

To draw inflammation away from deep parts toward the

surface, to make more accessible to medicine
To divert an inflammatory process to neighbouring and less
important organ
To infuse warmth and blood into an affected organ and disperse
vapour from it.
To alleviate pain.

Type

4. Treatment Criteria

Accepted age [1,2,4]:

Patients who wish to receive bekam therapy should be between 10 to 65 years old. For
those who are above 65 years old, bekam may be performed on him/her if he/she is in a
good state of health.

4.2

Indications [1,2,4,5,9,10,11,12,13,14,15]:
Bekam is indicated in the treatment of a number of musculo-skeletal conditions as well
as a general measure to maintain and promote well-being. It is used in conditions such as
listed below;
a. For pain relief (chronic and acute)
b. In inflammatory conditions (e.g. in rheumatoid arthritis)
c. For mental and physical relaxation
d. As a means of deep tissue massage
e. For menstrual pain, amenorrhoea or irregular menses
f. In gastrointestinal disorder such as gastritis and indigestion
g. In lung disorders such as chronic cough and asthma
h. To relieve insomnia
i. In cases of paralysis

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4.1

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Traditional and Complementary Medicine Practice Guideline on Bekam

4.3

Contraindications:
Contraindications for bekam are as listed in the table below.
Table 2:
Contraindications for bekam therapy
Bekam Kering

[1,2,4,5]

Bekam Basah

In pregnant and menstruating women

Over the breast in women
Over any bony prominences
In areas of inflammation and skin disorders
In areas with cut skin
Communicable diseases
In HIV and Hepatitis infections bekam may only be performed
if the apparatus used are disposable ones, and if the practitioner
observes a strict infectious disease control measures
Other infections bekam may be performed once the infection
has cleared up (especially fever)

Absolute
contraindications

Cancer patients
Over varicose veins and lymph
nodes
In patients with bone fracture
or muscle spasms
At sites of deep vein
thrombosis (DVT)
At sites of ulcers, over arteries
or where pulses can be felt
In patients with bleeding
disorders (e.g haemophilia,
thrombocytopaenia)

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Relative
contraindications

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Cancer patients
Over varicose veins and lymph
nodes
Haemophilia patients
Patients with low platelet
count (e.g. in immune
thrombocytopaenia)
Patients on anticoagulation or
antiplatelet treatment (e.g on
aspirin, warfarin or heparin)
In patients with bone fracture
or muscle spasms
At sites of deep vein thrombosis
(DVT)
At sites of ulcers, over arteries
or where pulses can be felt

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Precautions [2,4]:
a. Precautions should be undertaken when performing bekam therapy in these
conditions;
b. If done over the neck may induce amnesia
c. Patients with diabetes mellitus
d. Patients with cardiovascular diseases
e. Patients with infectious diseases
Requires the use of disposable equipments and proper disposal of clinical waste
(blood/body fluid soiled linens, cotton wool etc.) and contaminated items
(Appendix 2 and 3).
Develop and implement control measures, to eliminate or minimize the risks of
exposure or transmission.
Supply, maintain and use protective equipment to reduce the risk of infection
(gloves, goggles, aprons).

4.5

Side Effects and Complications :

a. Discomfort at site of application
b. Light-headedness or syncope [10,11]
c. Excessive bleeding
d. Anaemia [17,18]
e. Blisters and burns (if using fire to heat up the air inside the cups) [19]
f. Infections at scarified areas which may arise later after therapy
g. Visible marks at the cupping site

Apparatus :
a. Cups;
The cups used in bekam may be made from various materials. Traditionally it is made
from buffalo horn, bamboo, copper or porcelain. Modern cups are made from glass. It
has a valve at the top of the cup in which a pump is attached to remove the air inside
the cups obviating the need to heat the air inside the cups prior to application. These
cups should be sterilized after each treatment session. The used cups should not be
applied at different sites or on different patients. Be sure to choose a cup size that is
suitable for the area to be applied.
b. Sterile lancets;
Only sterile, single use, disposable lancets are to be used to puncture the skin in
bekam basah.

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5.1

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5. Treatment Procedures

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4.4

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Traditional and Complementary Medicine Practice Guideline on Bekam

5.2

Points of Application [1,2,4,5]:

The table below provides a list of common sites of application and its indications.
Indications

Nape of neck

Heaviness of eyelids, eye itchiness, bad breath

Over the two posterior neck veins

Head tremor, and other conditions of the head (face,

teeth, ears, eyes, throat, nose)

Between the shoulder blades

Pain in upper arms and throat, to relax cardiac sphincter

Site

of the stomach
Teeth, throat, cleanses head and jaws

Legs

Cleanses the blood, provokes menstrual flow

Inner thighs

Inflammatory masses in upper part of thigh, pustules,

Under the chin

podagra, piles, bladder, uterus, renal congestion

Inflammation of testicles, leg ulcers

Behind hips

Inflammatory conditions and ulcers of buttocks

Behind knee (popliteal space)

Chronic abscesses, septic ulcer of leg and foot

Over ankle bone (maleoli)

Suppressed menses, sciatica, podagra

Over outer side of hips

Sciatica, podagra, piles, inguinal hernia, tissues within hip

Over the buttocks, towards anus

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joints

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Front of thighs

Draws humor from all over the body, from head, benefits

Standard precautions:
a. Practitioners are required to observe standard precautions in health care (Appendix
2) at all times and all waste management have to adhere to clinical waste management
(refer to Guidelines on Handling and Management of Clinical Wastes in Malaysia,
Department of Environment, 2009, and Appendix 3).
b. To maintain sterility and prevent infection, disposable lancets should be used for all
bekam basah procedures.
c. The skin at the area to be treated with bekam basah should be cleansed with 70%
isopropyl alcohol and allowed to dry before scarification.
d. All instruments used should be disinfected and sterilized according to the recommended
methods of sterilization and disinfection (Appendix 1) prior to use on individual
patients.
e. Practitioners are required to use personal protective equipments, especially gloves
during treatment procedure and must always observe good personal hygiene.

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5.3

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the intestines, cures suppressed menses

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Traditional and Complementary Medicine Practice Guideline on Bekam

Duration [2,4]:
a. Each cup should only be applied for 10 to 15 minutes, or until the site under the cups
begins to appear reddish.
b. An average of 10 cups should be applied per procedure.
c. The same site can only be cupped 3 times, at which a new bleeding point is made each
time. The maximum application per site is 7 times.

5.5

Monitoring :
a. Patients who underwent bekam therapy should be monitored for development of
complications or adverse events.
b. The blood loss/drawn in bekam basah is to be observed and treatment should be
abandoned if there is excessive bleeding. Each procedure should not draw more than
10 ml/kg of blood (e.g. in a person weighing 45 kg, blood loss should be 450 ml or
less). A maximum of 450 ml blood loss is allowed per procedure.
c. Post-procedure, the bleeding time should not exceed 15 minutes. Patients with
suspected prolonged bleeding time should be referred to the medical professional as
soon as possible after undertaking appropriate measures to control the bleeding (e.g.
pressure bandage).
d. All patients who underwent bekam basah should be monitored for at least 15 minutes
post-procedure and should be questioned about their occupation. Patients in whom
fainting would be especially hazardous to themselves or to others (e.g. pilots, surgeons,
bus drivers) should probably refrain from work for up to 12 hours post-procedure,
especially if the total amount of blood drawn is the maximum allowed.

5.6

Referral:
a. Emergency medical services must be contacted immediately in the event of
cardiorespiratory collapse (e.g. 999, St. Johns Ambulance).
b. Patients should be referred to the nearest available healthcare facility in event of
occurrence of complications or adverse events with adequate information or account
of events and procedures done.
c. Appropriate measures should be taken whilst awaiting the arrival of medical help (e.g.
provision of basic life support or first aid, or call for help).

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5.4

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6. Documentations
6.1
6.2
6.3

6.4

The number and type of cups used and its placement sites must be recorded.
The estimated blood loss/drawn in bekam basah is to be documented clearly.
Patients who underwent bekam therapy should be monitored for development of
complications or adverse events and recorded accordingly. Measures taken should be
documented clearly.
Consent must be obtained prior to commencement of therapy. Patients should be
competent to give consent of care. In case of minors (aged 18 years and below) and
mentally impaired adults, practitioners requires the consent of a guardian.

7. Practice Facilities

7.4

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8. Conclusion

Bekam is an invasive procedure with potential for transmission of communicable diseases. Due to
this invasive nature, there is a need for the development of a guideline to assist bekam practitioners
on the proper practices and practice facility set up to prevent or minimize risk of transmission of
communicable diseases. This guideline also encourages all practitioners to adhere to the code of
ethics and code of practice, and maintains a high level of medical professionalism. It is also hoped
that with the birth of this guideline, the safety and well-being of both patients and health personnel
are protected.

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7.2
7.3

Each practice facility should have a dedicated room for treatment which is equipped with
a treatment bed, equipment tray/trolley, and proper waste bins (refer Appendix 3: Figures
3, 4, 5 and 6). Segregation of clinical wastes shall be done using the standard waste bag
with appropriate colour coding (refer to Guidelines on Handling and Management of
Clinical Wastes in Malaysia, Department of Environment, 2009).
Treatment rooms should be well lighted and ventilated.
There should be a regular cleaning schedule which is diligently adhered to keep the
environment clean and safe.
There should be proper management of spillage, soiled/contaminated linen, and disposal
of sharps and clinical waste (refer Appendix 2).

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7.1

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Appendices

Traditional and Complementary Medicine Practice Guideline on Bekam

Appendix 1:
Sterilization and Disinfection Methods
Methods of sterilization

Steam sterilization is the most widely used method for instruments made of metal. It is nontoxic,
inexpensive, sporicidal and rapid if used in accordance with the manufacturers instructions (e.g. time,
temperature, pressure, wraps, load size and load placement). Steam sterilization is only fully effective
when free from air, ideally at 100% saturated steam. Pressure itself has no influence on sterilization, but
serves as a means of obtaining the high temperatures required.

Recommended methods of sterilization

* Steam under pressure (e.g. autoclave, pressure cooker)

Recommended sterilizing temperatures and times for steam under pressure, and for dry heat, are shown
in the table below.

Required pressure: => 15 pounds per square inch (101 kilopascals)

Time

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Temperature
115C

126C
134C

15 minutes

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121C

30 minutes

10 minutes
3 minutes

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* Dry heat (e.g. electric oven)

Time

160C

120 minutes

170C

60 minutes

180C

30 minutes

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Temperature

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(Source: WHO - GPA/TCO/HCS/95/16 p.15.)

Instruments made of rubber or plastic which are unable to stand the high temperature of an autoclave
can be sterilized chemically, at appropriate concentrations and ensuring adequate immersion times (e.g.
6% stabilized hydrogen peroxide for six hours).
It should be noted that boiling needles in water is not sufficient for sterilization, nor is soaking in alcohol,
since these methods do not destroy resistant bacterial spores or certain viruses.
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Methods of Disinfection
A high level of disinfection is achieved when instruments are boiled for 20 minutes. This is the simplest
and most reliable method of inactivating most pathogenic microbes, including HIV, when sterilization
equipment is not available. Boiling should be used only when sterilization by steam of dry heat is not
available. Hepatitis B virus is inactivated by boiling for several minutes; HIV, which is very sensitive to
heat, is also inactivated by boiling for several minutes. However, in order to be sure, boiling should be
continued for 20 minutes.

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Chemical disinfection is used for heat-sensitive equipment that may be damaged by high temperatures.
Most disinfectants are effective against a limited range of microorganisms only and vary in the rate at
which they destroy microorganisms. Items must be dismantled and fully immersed in the disinfectant. Care
must be taken to rinse disinfected items with clean water so that they do not become recontaminated.
Chemical disinfectants are unstable and chemical breakdown can occur. They may also be corrosive and
irritating to skin. Protective clothing may be required. Chemical disinfection is not as reliable as boiling
or sterilization. The agents include:
chlorine-based agents, e.g., bleach
aqueous solution of 2% glutaraldehyde
70% ethyl or isopropyl alcohol.

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(Source: WHO - GPA/TCO/HSC/95/16 p.16 and WHO AIDS Series 2, 2nd edition, p.3, 1989.)

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Appendix 2:
Standard Precautions in Health Care
* Standard Precautions. AIDS/STI Section, Ministry of Health, 2002.

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STANDARD PRECAUTIONS PRACTICES

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Standard Precautions involve work practices which avoid direct contact with blood and all body fluids
and guard against needle-stick injuries and exposures to mucous membranes. The infection control
practices should include:
1. Hand washing.

Hand washing is a process of removing of transient, potentially pathogenic micro-organisms
from the hands and it is a critical factor in the management of patients with HIV/AIDS. Hands
should be washed routinely;
Before and after coming into contact with patient
When they are contaminated with blood and body fluids
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After removing gloves

Before and after each patient-care procedure,

Hands should be properly washed following the effective hand-washing technique as shown
in Figure 1.

Rotational rubbing of right

thumb clasped in left palm and
vice versa.

Rotational rubbing, with

clasped fingers of right hand in
left palm and vice versa.

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Back of finger to opposing

palms with fingers interlocked.

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Palm to palm, fingers

interlaced.

Right palm over left hand and

vice versa.

Palm to palm.

2.

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Figure 1:
Hand Washing Technique.

Appropriate use of personal protective equipment (PPE) including gloves, mask, eye goggles,
face shield and gown.
Gloves
Sterile surgical gloves should be worn for all surgical and invasive procedures
Disposable latex/rubber gloves should be worn when touching blood, body fluids,
secretions, mucous membranes, non-intact skin, excretions, and contaminated
items.
Gloves should be promptly removed after touching these materials.
Change gloves in between procedures and between patient contact.
Gloves should be discarded after a procedure.
Hands should be washed immediately after removing gloves.

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a.

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b. Mask, eye goggles or face shields

Mask, eye goggles or a face shield should be worn to protect mucous membranes of
the eyes; nose; and mouth only when performing patient-care procedures that are likely
to generate splashes of blood, body fluids, secretions and excretions. Examples of such
procedures are irrigation and suction procedures, delivery and dental procedures etc.
Plastic aprons/gowns

A separate disposable apron/gown should be worn for each patient. It is worn to

prevent soiling of clothing when performing patient-care procedures that are likely to
generate splashes of blood, body fluids, secretions or excretions.

c.

Use of disposables and proper cleaning, disinfection and sterilization of patient-care

equipment.

4.

Proper housekeeping and management of spillage.

Proper housekeeping
There should be a regular cleaning schedule which is diligently adhered to keep the
environment clean and safe.
b. Management of spillage
The spillage should be dealt with as soon as possible.
Disposable latex/rubber gloves should be worn throughout the procedure.
Rubber boots and plastic disposable overshoes may be worn if a large area is
grossly contaminated with the spillage.
Chloride granules to cover the spillage and left for 5-10 minutes. If it is a large
spillage, it may be covered with suitable absorbent material.
The spillage should be wiped up using paper towels or suitable absorbent material.
Avoid direct contact between gloved hands and the spillage.
The area should be mopped with Sodium hypochlorite (Chlorox)* 1 : 100.
For a large spill, a mop can be used to wipe instead, but the mop needs to be
disinfected with sodium hypochlorite and rinsed thoroughly.
Broken glass pieces should be carefully swept with a broom and discarded into a
sharps container.
Equipments used for management of spillage should be decontaminated.

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a.

3.

5.

Management of soiled/contaminated laundry

a. Staff handling ward linen should wear disposable latex/rubber gloves and masks at all
times. Handling should be done only when necessary and no sorting is allowed.
b. Used linen should be placed into laundry bags at site.
c. Soiled linen soaked with blood or body fluid should be placed into appropriate laundry
bags with biohazard label.
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6.

Disposal of sharps and infectious wastes

Disposal of sharps
Sharps containers must be placed at the work sites.
Needles should not be removed from disposable syringes, recapped, bent or
broken by hands.
Sharps (loose needles, scalpels, blades, razors, IV administration sets, glass pieces
and ampoules) should be picked up with forceps and discarded into sharps
containers.
Sharps containers should not be more than two-thirds full before disposal.

a.

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b. Disposal of infectious wastes

Wastes contaminated with blood and blood products (including blood packs) and
soiled dressings should be discarded into yellow-coloured bags, ensuring that no
leaking of fluid from the bag.
Excreta and other body fluids should be discarded directly into the toilet or into
the sluice that is directly connected to the sewage system.

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Appendix 3:
Disposal of Infectious Clinical Wastes
* Standard Precautions. AIDS/STI Section, Ministry of Health, 2002.

Start

Infectious Clinical Waste

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Yellow Waste bag

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Sharps

Non-sharps

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Sharps

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Central Collection Area

Incineration

End

Figure 2:
Flow Chart Disposal of Infectious Clinical Wastes
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Figure 4 :
Example of sharps bin.

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Figure 3 :
Example of clinical waste bin with yellow bag (for incineration only).

Traditional and Complementary Medicine Practice Guideline on Bekam

Figure 5 :
Example of black general waste bag.

Figure 6 :
Example of blue waste bag (wastes for
autoclaving or equivalent treatment).

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Appendix 4:
Environmental Quality Act 1974
Section 24 - Restrictions on pollution of the soil.
(1) No person shall, unless licensed, pollute or cause or permit to be polluted any soil or surface of
any land in contravention of the acceptable conditions specified under section 21.

(2) Notwithstanding the generality of subsection (1), a person shall be deemed to pollute any soil or
surface of any land if

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(a) he places in or on any soil or in any place where it may gain access to any soil any matter
whether liquid, solid or gaseous; or
(b) he establishes on any land a refuse damp, garbage tip, soil and rock disposal site, sludge
deposit site, waste-injection well or otherwise used land for the disposal of or a repository
for solid or liquid wastes so as to be obnoxious or offensive to human beings or interfere
with underground water or be detrimental to any beneficial use of the soil or the surface of
the land.

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(3) Any person who contravenes subsection (1) shall be guilty of an offence and shall be liable to a
fine not exceeding one hundred thousand ringgit or to imprisonment for a period not exceeding
five years or to both and to a further fine not exceeding one thousand ringgit a day for every day
that the offence is continued after a notice by the Director General requiring him to cease the act
specified therein has been served upon him.
[Am. Act A953:s.12]

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Appendix 5:
Bekam Clerking Form

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Appendix 6:
Consent Form

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Figure 7:
Example of a modern bekam apparatus.

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Appendix 7:
Bekam Apparatus

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Figure 8:
Example of a commonly prescribed herb preparation to be used after bekam.

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Figure 10:
Traditional bekam set.

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Figure 13:
Horns used in bekam.

Figure 11:
Traditional glass cups and scarificator.

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Figure 12:
Glass cup with built in sucking tube.

Figure 9:
Bamboo bekam set.

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Figure 14:
Traditional cupping set.

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10. References

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The Canon of Medicine by Avicenna. Adapted by Laleh Bakhtiar. Great Books of the Islamic World, 1999.
Cupping: A Practice of The Prophet & A Miraculous Way of Treatment. Compiled by Shihab Al-Badry Yasin.
Minhaj An-Nubuwwah Bookstore, 2005.
Medicine of the Prophet. Translated by Penelope Johnstone. The Islamic Texts Society, 1998.
The Traditional Healers Handbook, a Classic Guide to the Medicine of Avicenna. Hakim G.M. Chisti.
Healing Arts Press, 1988.
Rawatan Umum Dalam Perubatan Ibn Sina. Dr. Mohd Hilmi B. Abdullah. Pustaka Hilmi, 2007.
Standard Precautions. AIDS/STI Section, Ministry of Health, 2002.
JL Turk, Elizabeth Allen. Bleeding and Cupping. Annals of the Royal College of Surgeons of England (1983).
Volume 65.
Dr. Nurdeen Deuraseh. Health and Medicine in the Islamic Tradition Based on the Book of Medicine
(Kitab Al-Tibb) of Sahih Al-Bukhari. JISHIM, 2006.
Jong-In Kim, Myeong Soo Lee, Dyong-Hyo Lee, Kate Boddy, Edzard Ernst. Cupping for Treating Pain: A
Systematic Review. Evidence-base Complementary and Alternative Medicine (eCAM) Advance Access
published online, May 2009.
Kallem Ullah, Ahmed Younis, Mohamed Wali. An investigation into the effect of Cupping Therapy as a
treatment for Anterior Knee Pain and its potential role in Health Promotion. The Internet Journal of
Alternative Medicine, 2007.Volume 4, number 1.
Khosro Farhadi, David C. Schwebe, Morteza Saeb, Mansour Choubsaz, Reza Mohammadi, Alireza Ahmadi.
The Effectiveness of wet cupping for nonspecific low back pain in Iran: A randomized controlled trial.
Complementary Therapies in Medicine, January 2009.Volume 17, issue 1.
Andreas Michalsen, Silke Bock, Rainer Ludtke, Thomas Rampp, Marcus Baecker, Jurgen Bachmann, Jost
Langhorst, Frauke Musial, Gustav J Dobos. Effects of Traditional Cupping Therapy in Patients with Carpal
Tunnel Syndrome: A Randomized Controlled Trial.
Wan Xue-wen. Clinical Observation on Treatment of Cervical Spondylosis with Combined Acupuncture
and Cupping Therapies. Shanghai Research Institute of Acupuncture and Meridian, 2007.
XY Zhang. Traditional Chinese Medicine (TCM) in the Management of General Gynaecological Disorders/
Conditions. www.womenshealthclinic.co.uk
John Koo, Sumaira Arain. Traditional Chinese Medicine for the Treatment of Dermatologic Disorders. Arch
Dermatol, Nov 1998.Volume 134.
Edzard Ernst. Editorial Testing Traditional Cupping Therapy. The Journal of Pain, 2009.Volume 10, No. 6.
Il-Suk Sohn, Eun-Sun Jin, Jin-Man Cho, Chong-Jin Kim, Jong-Hoa Bae, Ju-Young Moon, Sang-Ho Lee, MyungJae Kim. Bloodletting-induced cardiomyopathy: reversible cardiac hypertrophy in severe chronic anaemia
from long-term bloodletting with cupping. European Journal of Echocardiography, 2008.
Hyo Jin Lee, Nam Hwan Park, Huan Jung Yun, Samyong Kim, Deog Yean Jo. Cupping Therapy Induced Iron
Deficiency Anaemia in a Healthy Man. The American Journal of Medicine, 2008.Volume 121, No. 28.
Niklas Iblher, Bjoern Stark. Cupping Treatment and Associated Burn Risk: A Plastic Surgeons Perspective.
Journal of Burn Care and Research, 2007.
www.wikipedia.org
http://www.greekmedicine.net/therapies/Hijama_or_Cupping.html
http://www.itmonline.org/arts/cupping.htm
http://www.integrative-healthcare.org
http://www.unani.com/cupping.htm
http://www.ib3health.com
Guidelines on the Handling and Management of Clinical Wastes in Malaysia, third edition. Department of
Environment, Ministry of Natural Resources and Environment, 2009. http://www.doe.gov.my

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Editorial Board

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Dr. Shamsaini Shamsuddin

Senior Principal Assistant Director
Traditional and Complementary Division
Ministry of Health

Jaafar Lassa
Deputy Director
Traditional and Complementary Division
Ministry of Health

Dr. Ramli Abd. Ghani

Director
Traditional and Complementary Division
Ministry of Health

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Dr. Zalilah Abdullah

Senior Principal Assistant Director
Traditional and Complementary Division
Ministry of Health

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Dr. Nur Hidayati Abdul Halim

Principal Assistant Director
Traditional and Complementary Division
Ministry of Health

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