We have concluded the sections on making a diagnosis and by now you should be able to identify constitutions, root syndromes, branches and have a very good idea of what to do next ان شاء الله ﺗﻌﺎﻟﯽٰ

The following sections deal with the treatment methods to be applied in order to address the root syndrome. In this module I will be going through Hijama therapeutics and associated advanced methods of bleeding therapies.

I want you to keep in mind however that Hijama is not for every illness and it is not the primary modality in any case. In fact in order of importance these are the therapies you should be using:

1. Adjusting diet and lifestyle, including advising the patient on the adherence to the fardh and sunnah practices and any additional practices, adhkaar and duaas to be read

2. Identifying and addressing any environmental, social or other factors that are the cause of the illness

3. Using Herbal Medicines, Hijama and special diets to treat the illness.

When it comes the last category of treatment you need to decide between the following options:

1. Using all 3 together

2. Using only herbal medicines and a special diet

3. Using only herbal medicine

4. Using only a special diet

5. Using Hijama and a special diet

You will notice that Hijama is never used alone in order to treat illness.

The only case where It can be used on its own is in order to prevent illness in a patient who is living a good lifestyle and eating correctly which is rare, but to use Hijama alone in the majority of cases is not sufficient.

No hadeeth mentions that Hijama is to be used alone and the Sunnah displays that Nabi ﷺ himself used multiple methods of treatment and advised multiple methods of treatment as will be discussed in the modules still to come.

With regard to Hijama there are different methods and also the amount of blood drawn can be variated. Nowadays everyone thinks that Hijama is to use a lot of cups and the more blood the better it is. This is false, there are also no reports asserting that the Prophet ﷺ had so many cups and so much blood removed as is seen the videos on youtube and practiced by many therapists.

Hijama itself must be differentiated from cupping as there is a big difference. Nowadays people confuse cupping, even dry cupping with Hijama whereas only wet cupping where blood is removed can be considered one type of Hijama.

Hijama refers specifically to diminishing the blood volume through bloodletting. Traditionally in Hijaz and other cultures this was done from superficial areas but it can be applied to phlebotomy as well though this is specific for particular illnesses.

Types of Hijama

There are two broad types of Hijama, general zone based Hijama, also referred to as Hijama in strength - (more like in the absence of a specific illness that is not related to the persons constitution), this also can be referred to as health maintenance hijama.

It is done on specific days, normally 2 to 6 times a year depending on the constitution and the climate and specific points on the upper back & head (or alternatively a zone that corresponds to the patients constitution) are used.

General Hijama (Also referred to as "Sunnah" Hijama or Health maintenance Hijama)

• Best when done on the 17th, 19th, 21st but can be done between the 17th to 23rd
• Best during the hot seasons/climate
• Morning period
• Empty stomach
• Between the shoulder blades & on the vertex
• 2 to 6 times per year

Ahadeeth regarding general Hijama

• “The best thing by which you treat yourself is Hijama”
• “Whoever has hijama done on the 17th, 19th or 21st of the month, it will be for him a cure from every illness”
• Rasulullah (SAW) used to undergo cupping on the head and between the shoulders and say: “Whosoever removes this blood, it will not harm him that he does not take any other medical treatment”

Hijama in illness

• No restriction on days
• Less blood is removed (a few drops to 2 cups)
• can be done often, even daily in acute cases
• We also bleed veins, special points and areas besides the back and head

Ahadeeth regarding Hijama in illness

• “Rasul (SAW) was cupped on his foot for bruising” Ibn Majah
• “Whenever someone would complain of headache to the Rasul of Allah (SAW), He (SAW) would advise them to perform Hijama” - Abu Dawud
• Ibn Qayum mentions that Rasul (SAW) was cupped on his head when afflicted with Sihr

Jurisprudic issues

• Hijama is “a sunnah”, but jurisprudically it is mustahab
• Seeking treatment is sunnah
• Having Hijama done when it is contraindicated will be impermissible