Summary
Justin and Dr. Sydnee McElroy of Sawbones deliver an entertaining and thoroughly researched history of cupping therapy, prompted by seeing Michael Phelps' cupping marks at the Olympics. Dr. Sydnee, a practicing physician, traces cupping from its earliest mentions in the Chinese Boshu (Han Dynasty) through ancient Egypt's Ebers papyrus, Greek medicine with Hippocrates and Galen, Roman bathhouses (with remnants found at Pompeii), and forward through centuries of European medical practice. The episode explains dry cupping, wet cupping (hijama, involving small skin cuts), fire cupping, and the combination with moxibustion (burning mugwort). Dr. Sydnee contextualizes cupping within the humoral theory of medicine, where practitioners believed illness stemmed from imbalanced humors (blood, yellow bile, black bile, phlegm) and cupping could rebalance them. She covers historical uses including boil drainage, snake bite treatment, tuberculosis, skull depression repair, and even hysteria treatment. The hosts take a skeptical stance on modern claims, noting that a large 2012 meta-analysis found most studies showed no harm but also no clear benefit. They point out that modern proponents still list cupping for everything from arthritis to weight loss to depression, and that some websites still reference "removing humors," which is settled science that humoral theory is not valid.
Key Points
- Earliest written mentions of cupping appear in the Chinese Boshu (Han Dynasty) and the Egyptian Ebers papyrus
- Types include dry cupping, wet cupping (hijama with skin cuts), fire cupping, and cupping with moxibustion
- Historical context rooted in humoral medicine: rebalancing blood, yellow bile, black bile, and phlegm
- Hippocrates, Galen, Celsus, and Paracelsus all advocated for cupping for various conditions
- Originally used for specific purposes like draining boils and treating snake bites before expanding to cure-all claims
- A 2012 meta-analysis found most studies showed no harm but no clear benefit from cupping
- Modern claims range from arthritis and pain to weight loss, depression, and cancer treatment
- Modern silicone cups exist that won't leave marks, and facial cupping has become popular
Key Moments
What cupping actually is and how suction is created
Dr. Sydney McElroy explains the cupping procedure for newcomers: cups (usually glass) are placed on the body, suction is created by lighting a small flame inside to burn the oxygen, and the cup is left on for 5-15 minutes. She distinguishes dry cupping from wet cupping and describes how it can be combined with acupuncture.
"And you're going to apply suction somehow. Now, how you apply suction to that cup, it just depends on what kind of machine you're using. Traditionally, the way you would do that is to create negative pressure inside the cup by lighting a little flame inside of it. Creates a vacuum."
Ancient origins from boil drainage to Hippocrates and Galen
Sydney traces cupping's history from ancient China where it was originally used to draw pus from boils, through mentions in Egyptian papyri, Greek medicine where Hippocrates and Galen were advocates, to Roman bathhouses where remnants of cups were found at Pompeii.
"the reason being was it was to try to like draw it to a head and draw the pus out"
No good evidence cupping works but the placebo effect may give athletes an edge
Sydney reviews the 2012 meta-analysis finding no harm but no proven benefit from cupping, with small biased studies suggesting possible effects. She argues that for elite athletes like Michael Phelps, even a placebo-driven psychological edge of hundredths of a second could make a difference.
"There have been small studies that have shown that it helped with certain conditions, not with athletic performance. So that has never been proven. So what Michael Phelps is doing, I can't vouch for unless he just likes it."
