CHP Hijama Techniques & Procedures 2 — Questions and Answers
Question 1: During the scarification (shurut) step, how deep should incisions typically be made in dry cupping conversion to wet hijama?
- Deep enough to reach the muscle fascia
- Superficial scratches penetrating only the epidermis (0.1–0.2 mm) (Correct answer)
- Through the dermis into subcutaneous fat
- Deep enough to produce brisk arterial bleeding
Correct answer: Superficial scratches penetrating only the epidermis (0.1–0.2 mm)
Incisions in wet hijama should be superficial, penetrating only the epidermis to a depth of about 0.1–0.2 mm to allow controlled blood and fluid extraction without damaging deeper structures.
Question 2: What is the recommended duration for the FIRST cup application (pre-scarification phase) in standard wet hijama?
- 30 seconds to 1 minute
- 3 to 5 minutes (Correct answer)
- 10 to 15 minutes
- 20 minutes
Correct answer: 3 to 5 minutes
The initial cup placement before scarification is typically held for 3–5 minutes to create hyperemia and draw blood to the surface, making the subsequent incisions more effective.
Question 3: Which of the following anatomical landmarks is a contraindicated cupping site due to proximity to major vasculature?
- Upper back (between scapulae)
- Posterior neck (C7 area)
- Anterior neck over the carotid artery (Correct answer)
- Lumbar region (L3–L5)
Correct answer: Anterior neck over the carotid artery
The anterior neck over the carotid artery and jugular vein is a contraindicated site because cupping there risks injury to major blood vessels and nerves.
Question 4: When applying cups using the flash (moving) cupping technique, the practitioner should:
- Apply suction, hold for 10 minutes, then slide
- Apply light suction and repeatedly place and remove the cup in quick succession (Correct answer)
- Use maximum negative pressure and leave stationary for 5 minutes
- Scarify the skin before applying the sliding cup
Correct answer: Apply light suction and repeatedly place and remove the cup in quick succession
Flash cupping involves repeatedly applying and quickly removing the cup with light suction to stimulate local circulation without prolonged pressure.
Question 5: A patient presents with keloid scarring on their upper back. The BEST course of action before performing hijama is to:
- Proceed normally since keloids do not affect cupping outcomes
- Avoid all cupping on or around keloid tissue due to risk of worsening scarring (Correct answer)
- Apply stronger suction to break down the keloid collagen
- Use wet hijama directly on the keloid to soften it
Correct answer: Avoid all cupping on or around keloid tissue due to risk of worsening scarring
Keloid tissue is a contraindication for hijama because the inflammatory response triggered by cupping can stimulate further keloid growth or worsen existing scarring.
Question 6: In the traditional sequence of wet hijama, which order is correct?
- Scarification → Dry cup → Second cup with suction → Removal
- Dry cup → Scarification → Re-cup with suction → Removal and cleanse (Correct answer)
- Re-cup with suction → Scarification → Dry cup → Removal
- Scarification → Re-cup → Dry cup → Removal
Correct answer: Dry cup → Scarification → Re-cup with suction → Removal and cleanse
The correct sequence is: dry cupping first to engorge the area, then scarification (shurut), then re-cupping to draw out blood and fluids, then removal and wound cleansing.
Question 7: What is the primary purpose of applying an oil (such as olive oil) to the skin before sliding/massage cupping?
- To sterilize the skin surface
- To reduce friction and allow smooth movement of the cup (Correct answer)
- To increase suction strength
- To promote deeper scarification
Correct answer: To reduce friction and allow smooth movement of the cup
Oil is applied as a lubricant to reduce friction between the cup rim and skin, allowing the practitioner to glide the cup smoothly during massage cupping without causing abrasions.
CHP Hijama Techniques & Procedures 2
During the scarification (shurut) step, how deep should incisions typically be made in dry cupping conversion to wet hijama?