First stage in hijama therapy is diagnosis and it’s the most important stage of this therapy.


After listening to complaints of the patient, hijama points to be applied, number of sessions and time between each session should be decided according to science of modern hijamatology by master physician who is looking on diseases with paradigm of functional and holistic medicine.

For example, if some patient have pain in his feet, it needs a physician to diagnose the underlying cause of the pain and whether that pain is local or radiating from some vertebra, and locating that vertebra which is causing pain is specialty of a trained physician. There is some physicians listening to history of patients by hours before deciding points of hijama therapy to be applied.

After diagnosis we go to procedure part and hygiene is a must as in any surgical procedure including minor surgeries like hijama therapy. All materials should be sterilized or disposable for one use. The procedure of hijama therapy has 3 main steps.

  •  First step: First Suction Phase
  • Second step: Superficial Incisions Phase
  • Third step: Second Suction Phase

When we look on mechanism of hijama from perspective of ancient medical systems we can find many different interpretation all trying to address detoxing and balancing the body with different words. But if we want to focus on hijama therapy from perspective of modern literature then we can find amazing answers about mechanism of hijama therapy which collectively pushed to establish science of modern hijamatology.

Every step of Hijama Therapy procedure have different effects and mechanisms.

First step: First Suction Phase


Suction strength and duration varies from area to be applied and skin nature of the patient. This phase is better clarified with modern literature of our day, because pressure is the mechanism of microcirculation that carries oxygen and nutritients to cells and carries molecular and metabolic wastes and carbon dioxide from cells to circulation. The purpose of this first suction phase is to apply negative pressure on skin and to underlying tissues which changes many physiology and biology on skin and underlying tissues, which we can summarize as following:

1-Activating blood circulation to the cupped area which results in speeding oxygenating and feeding cells of the area with nutritients.
2-Supporting lymphatic circulation.
3-Increasing permeability of the capillaries.
4-Rupture of weak capillaries which results in secretion of histamine.
5-Suction of toxic and causative pathological substances and metabolic wastes from connective tissues (including muscular tissues) up to the skin barrier, including unnamed and undiscovered toxins. In the following picture you can see how a deep hematoma is sucked to the skin barrier by hijama sucking and disappearing after hijama therapy procedure.


Second step: Superficial Incisions Phase


After specific time of applying negative pressure by first suction phase, we apply the superficial incisions, and this phase of the procedure contains tremendously incredible benefits and effects. This phase is just a very tiny superficial incisions and not paining the patient with deep cuts or needling like in acupuncture. To give an example how much superficial incisions these should be, I can tell about one of practical exams given to physicians by applying incisions to some plastic balloon without exploding it or by applying incisions to some double layer of A4 papers without reaching with incisions to second paper. So it’s enough to reach beginning of dermis part of skin. We can call it micro incisions done by master hands.


We can summary effects of this phase as following:

1-Applying incisions to epidermis layer of skin in order to open epidermal barrier in order to excrete collected toxins, metabolic wastes and causative pathological substances during first step of suction.
2-Applying incisions to the beginning of dermis layer of skin in order to open blockage in capillaries of that area.
3-Secretion of Nitric Oxide.
4-Secretion of Beta Endorphin which works as natural morphine.
5-Secretion of Adrenocortical hormones.
6-Stimulating millions of nerve ends which results in billions of biological reactions.
7-Stimulating organ reflex zones which results in therapeutic reflexes commanded by brain which lasts for several days and triggering beginning of healing process.
8-Mysterious secrets which hijamatologists still working on revealing it, and some others waiting to be discovered by scientists.

Third step: Second Suction Phase


With this second suction phase that is applied to superficially incisioned zones we excrete toxins, metabolic wastes and causative pathological substances mixed with some amount of capillary blood out of the body and same first suction phased also continuing to process.

It is interesting that when hijama is applied correctly:

1-Amount of toxins, metabolic wastes and causative pathological substances mixed with capillary blood changes from cupping point to another.
2-Excreting toxins, metabolic wastes and causative pathological substances mixed with capillary blood stops after sometime automatically followed by drops of plasma (light yellow liquid), and it’s impossible to drain one more drop of blood any more no matter how strong the suction is applied.


We can face this effects only when hijama procedure is applied correctly.

These were the effects of hijama during the procedure. Other huge benefits of hijama therapy is starting after the procedure with comprehensive and holistic way of triggered biological healing mechanisms mainly as following:

1-As results of clearance of toxins, metabolic wastes and causative pathological substances in connective tissues under the skin, whole blood filtration is starting. It’s kind of holistic seroclearance triggered to cleanse and freshen the whole blood.

Surgeon Dr. Abdullah Nasrat has noticed that colour of venous blood in hepatitis B patients changing dramatically after 1 day of hijama therapy.

Venous Blood Colour in Hepatitis B patients before treatment
hijama012 Venous Blood Colour in Hepatitis B patients after 1 year of medications
hijama012 Venous Blood Colour in Hepatitis B patients after 1 day of hijama therapy

2-Regulation of microcirculation.
3-When it’s being applied on organ reflex zones, it triggers healing mechanism of internal organs through nerve stimulation.
4-Stimulation of immune system and raising it seriously.
5-Stimulation of production of red blood cells. So, when hijama is applied correctly it can never lower your red blood cells count but oppositely red blood cells count should be raised.
6-Increasing ability of skin in throwing toxins. Sometimes, we can observe new acne coming in and around sites of hijama which indicates to us that skin started to throw toxins easier.
7-Stimulating body’s known and unknown healing mechanisms which results in triggering beginning of healing process of chronic and acute diseases.

Finally, hijama therapy, may looks like simple therapy, but it has huge effects and impact on the whole systems of the body. Any scientist studying hijama therapy with sincerity, can be more than amazed on this interesting therapy.

There is a saying in China: “Acupuncture and cupping, more than half of the ills cured”.

Hijama therapy is the strongest cupping method and includes effect of acupuncture. So if it’s applied correctly with scientific hands then definitely you should be ready to be amazed !

With wishes of beneficial healings,

Jameel A. Sulami
Bio-Friendly Integrative Medicine Expert
Physician |  Consultant |  Researcher |  Writer

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