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The glass cups are depressurized by providing some fire in the cup to heat up the air within just prior to placement. For example, hold a cotton ball dipped in alcohol with a pincer, ignite it, hold it in the cup, then rapidly apply to the skin; this is called shanhuofa (flash-fire cupping; see Figure 2). Sometimes, a small amount alcohol is put in the cup and lit; this method is called dijiufa (alcohol-fire cupping).
At the end of the 20th century, another method of suction was developed in which a valve was constructed at the top of the jar and a small hand-operated pump is attached so that the practitioner could suction out air without relying on fire (thus avoiding some hazards and having greater control over the amount of suction). Both glass and plastic cups were developed, though the plastic ones are not very well suited to moving along the skin once in place, as the edges are not entirely smooth and the strength of the cups is limited. The modern name for cupping is baguanfa (suction cup therapy).
In order to allow easy movement of the glass cups along the skin, some oil is applied. Medicated massage oils (with extracts of herbs) are particularly useful for this purpose. Since the cups are applied at room temperature, the indication of removing cold from the channels is no longer as applicable, at least to stationary cups. There is some friction generated with moving cups, so that there is a small but significant amount of heat applied by that method, especially if a warming oil is used as lubricant.
Generally, the cup is left in place for about 10 minutes (typical range is 5¨C15 minutes). The skin becomes reddened due to the congestion of blood flow. The cup is removed by pressing the skin along side it to allow some outside air to leak into it, thus equalizing the pressure and releasing it. Some bruising along the site of the rim of the cup is expected.
Today, cupping is mainly recommended for the treatment of pain, gastro-intestinal disorders, lung diseases (especially chronic cough and asthma), and paralysis, though it can be used for other disorders as well. The areas of the body that are fleshy are preferred sites for cupping. Contraindications for cupping include: areas of skin that are inflamed; cases of high fever, convulsions or cramping, or easy bleeding (i.e., pathological level of low platelets); or the abdominal area or lower back during pregnancy. Movement of the cups is limited to fleshy areas: the movement should not cross bony ridges, such as the spine. Following are some of the recommended treatment sites for various disorders.







