Shockingly, it was almost 3 weeks ago when I started this series by demonstrating how acupuncture is nothing but a cultural hang-up.

What was most interesting is that in my first post on the matter, I explored the history of acupuncture and how even traditionally, the Chinese mostly saw it as a bunk, silly superstition. It was only when Mao Zedong needed it for political purposes because there were too many people to provide real healthcare to, he pushed fake medicine to keep people quiet and working.

Even so, I got replies saying 'nope. It's real because I did it once and felt good! And everybody else does too!'

Well, this is an ongoing theme in this whole series so I'll try to avoid repetition in countering that retort. Another common theme you will hear from me is the very real effect of placebo.

Most of Chinese medicine is built on placebo (aside from the heavy doses of propaganda) and the fact that this actually does have positive effects in many ways is fine.

However, just because a treatment is seemingly benign with an unintentional placebo benefit, does not make it harmless, and this is something we will dig deeper into today, because this pseudoscience can leave some ugly marks on your body and society:

Cupping

I've seen this phenomenon for years, having lived in Asia since 2010, and it instantly hit me as bizarre and stupid. It hit me again in 2016 when all those Olympic swimmers started doing it. Superstitious fools.

Essentially, cupping is where you put a cup on your body and create a vacuum between your skin and it. This can be done by suction or more traditionally, heating the cup up which would heat the air within.

This in turn pulls at the skin and brings the blood to the surface. Basically, you're giving yourself a bruise, multiple times all over your body. Then, if 'wet' cupping, a person slices your skin open and lets out the 'toxins' or 'bad blood'.

The belief - and it is precisely that, a belief - is that the qi (yes, that again) is disrupted, and by doing this, it re-establishes the equilibrium between body and qi or whatever. Interestingly, 'dry' cupping appears to be more popular, and it's not even clear what that's for. One source claims that dry cupping:

...causes organ blood absorption, organ warming, and loss of organ humidity

But doesn't state how that benefits anybody.

Basically, what it all boils down to is bloodletting, and similar versions of this superstitious crap can be found all over the world.

Bloodletting

This is a real daft idea, but it has survived for 2,000 years until recent times. In Europe, it was still around until the late 1800's! In fairness, bloodletting as a practice was probably the best thing people had at the time and it sounds kind of plausible enough when talking about balancing the body, and even more so when you think of things like 'lowering blood pressure'; hypertension.

But just because the Romans and Egyptians and Chinese thought something was cool thousands of years ago, doesn't make it so.

In fact, it may be the case that more people have been killed by bloodletting than saved, including George Washington, who was drained of up to 7 pints of blood for a chest infection.

In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients

It seems logical that if you have high blood pressure, letting some out would lower it, like opening a can of coke. But this is a misunderstanding of what hypertension is. It's not about having too much blood, it's actually far more complex and far less understood. There are cases of blood vessels narrowing, too much salt in the diet, high blood volume in the centre of the body and so on.

Donating blood does have a blood pressure-dropping effect, but small and temporary.

A comparison of 655 blood donors with 3,200 nondonors showed average blood pressure between the two groups was almost the same.

There are other very specific reasons to do professional bloodletting, or phlebotomy, for things like hemoglobin build up in higher altitudes leading to chronic mountain sickness, and polycythemia, which is a disease the creates too many red blood cells.

But what bloodletting isn't good for, is 'balancing you body' by creating brruises and slicing them a little, which is the crux of Cupping.

What does Cupping claim to fix?

Well, it's a bit like the God of the Gaps argument. Where things are largely subjective or unknown to science, God reigned supreme. But while science and medicine improves, God stays static, and so his position and responsibility continually taking smaller and smaller place in our world, left only with the things we cannot explain... until we can.

The same goes for cupping. By keeping its claims to subjective matters, like join, back, muscle pains, fatigue, depression, they can forever remain 'unfalsifiable' and thus 'valid'.

Another form of this is keeping with what the culture deem acceptable. In the West, we are currently going through a 'detox' movement, where every health business is telling you your body is full of toxins and this product or that product can remove it, even though the human body is a fantastic, self-cleansing device.

In the East, Qi is still going strong, so instead, the focus is on that.

Whatever makes the most money, basically.

Research

As I mentioned previously with acupuncture, there is extensive research on the matter; out of 3,000 studies, none have been able to confirm the benefits of acupuncture, and it has led to much frustration that there is even a need to waste money on such things, and a demand for it to stop, 3,000 papers later. But then again, all papers from China come up 100% positive, so that likely statistical phenomenon keeps the studies coming.

The same can be said for Cupping. So let's see if there's any ground for validity. The first thing I came across before I even started writing this, was from NCBI. Generally fairly reputable, I was disappointed to find a rather 'safe', tiny post that informs you of the Iranian practice of cupping, Hijama, and concludes with this:

Dry cupping and wet cupping can be introduced as the complementary treatment methods beside other treatment methods.

This is almost as if to say 'I don't want to say what I think, at risk of being professionally castrated'. It neither confirms nor denies the relevance of cupping. This, I suppose, is unsurprising given that it comes from the 'Iranian Journal of Medical Sciences'.

But let's dig deeper.

False positive results

A false positive is simply a result that says something is positive, when really it isn't. This is typically found in small, biased studies. An ongoing theme I've noticed when looking at these trials is that any positive results appear to indeed be small groups, typically headed by somebody called 'Jiang' or some Iranian name. Another theme I find with these studies is along the lines of this:

Lack of a sham therapeutic arm may be the most important limitation of this study.

The limitation of generalizability of the results to children with non-functional constipation is another considerable point

These come from a study looking at 'functional constipation' in children.

None of the 16 included trials blinded participants or practitioners, most likely resulting in performance bias.

However, due to the fact that only trials with small sample sizes were available and that there were potential risks of bias (based on methodological quality assessment) within the included studies, combination of cupping therapy and other treatments compared with other treatments alone showed “low” evidence of benefit.

...one half of the included trials were retrieved from the Chinese literature, which may have introduced potential selection bias

Due to the limited number of included trials, subgroup analysis could not be conducted for further assessment. (explaining the issue that those being studied were suffering different ailments)

These are from studies based on pain relief via cupping.

Of the 135 RCTs included in this review, 84.44% were high risk of bias.

...there is high potential that our review may have publication bias.

These are from a study on the therapeutic effects of cupping.

Do you see the theme? I had a bunch more tabs open but I gotta go out to dinner in 28 minutes.

So it seems there's an ongoing issue that all the studies showing positive results have critical flaws in their design, leading to false positives all over the shop, whereby larger and higher quality studies tend to come out negative.

But of course, the media doesn't care about THAT.

Is it harmful?

I'd argue yes. Totally. When I was in Korea, a friend asked me to try some traditional Korean thing and I was like 'sure whatever'. So she put this thing on my hand and lit it. I felt a bit of a burn as it happened and when she took it off, a big red mark was on my hand.

The next day, that turned into a giant, pus-filled blister and following that, a much larger red area. Following that, a scar. One that still sits there today 6 years later.

My point is, the likelihood of things going wrong seems to be quite high. Last year, a man was left with SEVEN, disgusting black holes in his back, and a fever, after trying to treat shoulder pain. Sorry but the picture has to be posted!

In other, less extreme cases, psoriasis was spread around their body - a disease of the skin that leaves red, scaly patches. furthermore, infection is not uncommon, and bruises are, well, guaranteed. Burns are also highly common.

Wet cupping can be even worse, causing anemia if slicing the skin open is done excessively.

Generally, it's not going to be life threatening, but by taking part, you risk scarring your body for life for what is, evidently, a pseudoscience.

Stick to what works; Pain medicine, laxatives, a glass of water and a good rest. You'll be fine.

And no, it doesn't help you swim faster in the Olympics.

Image Sources:

_{Cupping lady | Back hole man | Washington
| Olympic Cupping}

Sources:

_{Bloodletting | Bloodletting for hypertension
| Harmful bloodletting | Hijama | Constipation | Pain relief | Therapy review}