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Correspondence |

Alternative Therapy: Cupping for Asthma FREE TO VIEW

Jodi Goodwin, MD; R. Andrew McIvor, MD, FCCP
Author and Funding Information

From the McMaster University, Firestone Institute for Respiratory Health, St Joseph’s Healthcare.

Correspondence to: R. Andrew McIvor, MD, FCCP, McMaster University, Firestone Institute for Respiratory Health, St Joseph’s Healthcare, T2127, 50 Charlton Ave E, Hamilton, ON L8N 4A6, Canada; e-mail: amcivor@stjosham.on.ca


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(2):475-476. doi:10.1378/chest.10-2220
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To the Editor:

A 35-year-old white man with severe, poorly controlled asthma was seen in the ED at the Firestone Institute (Hamilton, Ontario, Canada) with an acute exacerbation of his condition. He is a current smoker of 1 pack/d with a 20-pack-year history. He had no family physician and was noncompliant with visits to his respirologist. His asthma required prednisone for exacerbations a few times annually, and he had required intubation within the past 2 years. The patient had been prescribed numerous asthma inhalers but found only salbutamol to be effective. During his current exacerbation, he supplemented 30 to 40 puffs of salbutamol per day with alternative therapy, with no improvement in his symptoms. When the patient presented, he exhibited unusual lesions on his back from this alternative therapy known as cupping (Fig 1). An evidence-based approach to the patient’s care with corticosteroids and maximal bronchodilation produced rapid improvement in this case of near-fatal asthma.1

Figure Jump LinkFigure 1. Lesions caused by cupping. The patient provided written consent for the use of this photograph.Grahic Jump Location

Cupping refers to an ancient Chinese practice in which cups are applied to the skin to suck out noxious materials. The technique today involves the use of small glass cups in which a small amount of alcohol is put into the cup and ignited followed by pressing the cup against the skin to create a vacuum.2

This therapy was used widely in the United States in the 18th and 19th centuries. In fact, as late as 1931, Osler indicated cupping for the treatment of bronchopneumonia and acute myelitis.3 The therapy is still used today in many cultures. A study of Vietnamese refugees living in San Diego, California, showed that although the signs and symptoms of asthma were well recognized, traditional health beliefs and practices such as herbal ingestion, oil inhalation, bleeding, and cupping were found to be more frequently used in asthma subjects in the refugee population.4

Many patients turn to alternative therapies for asthma, with approaches ranging from chiropractic to breathing exercises. There remains a paucity of studies of these treatments, but to date, the evidence indicates that none, including cupping, is efficacious.5 Physicians must be sensitive to patients’ therapeutic preferences because Western medicine is practiced in a continually diversifying cultural climate. However, in asthma, anything more than an individual psychologic benefit is lacking.

Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA. Management of acute asthma in adults in the emergency department: nonventilatory management. CMAJ. 2010;1822:E55-E67. [CrossRef] [PubMed]
 
Kaptchuk TJ. Consequences of cupping. N Engl J Med. 1997;33615:1109-1110. [CrossRef] [PubMed]
 
Osler W. The Principles and Practice of Medicine. 1931;11211th rev. ed New York, NY Appleton:981
 
Ries AL, Picchi MA, Nguyen LH, Moser RJ, Molgaard CA, Wasserman SI. Asthma in a Vietnamese refugee population. Am J Respir Crit Care Med. 1997;1556:1895-1901. [PubMed]
 
Chapman KR, McIvor A. Asthma that is unresponsive to usual care. CMAJ. 2010;1821:45-52. [CrossRef] [PubMed]
 

Figures

Figure Jump LinkFigure 1. Lesions caused by cupping. The patient provided written consent for the use of this photograph.Grahic Jump Location

Tables

References

Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA. Management of acute asthma in adults in the emergency department: nonventilatory management. CMAJ. 2010;1822:E55-E67. [CrossRef] [PubMed]
 
Kaptchuk TJ. Consequences of cupping. N Engl J Med. 1997;33615:1109-1110. [CrossRef] [PubMed]
 
Osler W. The Principles and Practice of Medicine. 1931;11211th rev. ed New York, NY Appleton:981
 
Ries AL, Picchi MA, Nguyen LH, Moser RJ, Molgaard CA, Wasserman SI. Asthma in a Vietnamese refugee population. Am J Respir Crit Care Med. 1997;1556:1895-1901. [PubMed]
 
Chapman KR, McIvor A. Asthma that is unresponsive to usual care. CMAJ. 2010;1821:45-52. [CrossRef] [PubMed]
 
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