HUSAIN ALKHALDY · ESSAYS  —  ESSAY

Cupping between History and Prophetic Medicine

On the birth of a practice and the root of an idea

History of medicineProphetic medicine≈ 15 min readTranslated from the Arabic

Prologue: Cupping through History

Rarely do we find a medical practice that accompanied humankind at home and on the road, and crossed civilizations, religions, and languages, the way cupping and bloodletting did — that is, drawing blood from the body for the purpose of treatment. It is among the oldest forms of healing known to humanity, and among the longest-lived; for it remained at the very heart of “official” medicine for thousands of years, from Pharaonic Egypt to nineteenth-century Europe, before modern science displaced it from its place.

References to drawing blood appear in the Egyptian Ebers Papyrus (around the sixteenth century BCE); it was known to the civilization of Mesopotamia, and practiced by China and India (where bloodletting in Ayurvedic medicine was called raktamokṣa). It then became, among the Greeks, a pillar of medicine when Hippocrates and Galen built upon it a complete physiological theory (the theory of the four humours). From them it passed to the Arabs before Islam, so that it was part of their inherited folk medicine when the Prophet (peace be upon him) was sent.

The aim of this essay is to trace this long journey, then to pause at a question that gently occupies many today: is cupping “prophetic medicine” in a sense that places it above criticism, or is it an ancient human treatment that the Prophet endorsed because it was the most effective option available in his time? The difference between the two answers is not merely theoretical; it determines how we read these texts: do we subject them to the scale of experiment and evidence, or do we raise them above that as revelation?

A historical aside — how bloodletting killed a president

In December 1799, George Washington, the first president of the United States, fell ill with an acute throat infection (today thought most likely to have been acute epiglottitis). He summoned his physicians — among the finest of their age — and himself asked to be bled, convinced of its benefit. Over roughly twelve hours, about 80 ounces of blood were drawn from him — nearly 40% of his entire blood volume — on the very same humoral logic: “inflammation is repletion, so let out the excess.” He died that night. The lesson is that bloodletting was no marginal quackery; it was the established, mainstream medicine right up to the threshold of the twentieth century — which helps us understand why it was a self-evidently acceptable treatment in the age of prophethood.

Part One: A Historical Review — Cupping, Bloodletting, and Their Origin in the Theory of the Four Humours

The theoretical framework that made it a “science”

We have seen that cupping and bloodletting are a human practice that transcends civilizations, with nothing peculiarly Arab or Islamic about them. But what raised them from a mere folk custom to a therapeutic system with a theoretical basis — by the standards of its time — was the Greek humoral theory. Hippocrates (fifth century BCE), and Galen after him (second century CE), articulated a conception whereby the human body rests on four humours:

Health, in their view, was the balance of these humours, and disease the disturbance of their proportion. So when the body became “full,” or one of its humours “corrupted,” the logical treatment — within this framework — was to expel the excess: by bloodletting, cupping, purging, or vomiting. Here lies the key to understanding the whole phenomenon: cupping was neither a “secret” nor a “miracle,” but rather the practical conclusion consistent with the best physiological theory available at the time. It was mainstream medicine, in the full sense of the word — exactly as removing an inflamed appendix is mainstream medicine today.

Cupping in Arabia and the age of prophethood

These practices passed into the Arabian Peninsula through trade routes and contact with the Persian and Byzantine civilizations. The Arabs practiced cupping, cauterization, and bloodletting within an inherited folk medicine. In this context the name of al-Ḥārith ibn Kalada al-Thaqafī stands out (some copyists and sources write it “al-Ḥarth ibn Kalada,” dropping the alif), nicknamed “the physician of the Arabs,” who is reported to have travelled to the land of Persia and studied medicine in its regions (the school of Jundishapur is usually mentioned) before returning to Ṭāʾif. And although much of the detail of his Persian journey carries a legendary character that calls for critical reservation, his existence and fame among the Arabs are an indication that medicine was a recognized craft with its own specialists in that society — a point whose significance will become clear in Part Three. What is established is that al-Ḥārith lived long enough to reach the caliphate of Muʿāwiya ibn Abī Sufyān; it is reported that Muʿāwiya asked him, “What is medicine, O Ḥārith?” and he answered, “al-azm” — meaning dieting and hunger.

An aside on distinguishing two men who were confused for one another

Some sources confuse the matter and make al-Naḍr ibn al-Ḥārith — who was killed as a disbeliever at Badr — a son of the physician of the Arabs, al-Ḥārith ibn Kalada al-Thaqafī. Curiously, this very confusion was made by the great medical historian Ibn Abī Uṣaybiʿa himself in ʿUyūn al-Anbāʾ — our primary source for the physician's biography — for he counted al-Naḍr as his son and as “the Prophet's maternal cousin.” This is an error corrected by the genealogists and hadith scholars (such as al-Zubayr ibn Bakkār and Ibn al-Kalbī, and rebutted at length by Ibn al-Athīr and al-Nawawī): the al-Naḍr killed at Badr was a Qurashī of the ʿAbd al-Dār clan; his lineage is al-Naḍr ibn al-Ḥārith ibn ʿAlqama ibn Kalada ibn ʿAbd Manāf — so “Kalada” here is a higher ancestor in a different Qurashī lineage, with no connection to the Thaqafī physician. What exposes this confusion is a decisive chronological clue: the physician lived into the time of Muʿāwiya — so how could his son have been killed in the second year of the Hijra? The two names simply resembled one another (“al-Ḥārith… Kalada”), and so the confusion arose; in reality there is no link between them.

In sum: when Islam came, cupping was a common and accepted treatment — not because it was necessarily correct, but because it was consistent with the science of that age.

Part Two: A Gentle Critique of the Idea of “Prophetic Medicine” — from the Hadith to Ibn al-Qayyim's Book

When was “prophetic medicine” born?

Among the ironies that escape many is that the term “prophetic medicine” as an independent literary genre did not exist in the early centuries. The Prophet (peace be upon him) did not dictate a book on medicine, nor did the Companions gather his medical reports into a dedicated compilation. Rather, this kind of writing arose later, when a group of scholars — after Greek medicine had become firmly established in Islamic civilization through Ibn Sīnā (Avicenna) and al-Rāzī — set about gathering the hadiths with medical content and commenting on them.

Among the most famous of these compilations: the chapter that Ibn al-Qayyim al-Jawziyya (d. 751 AH) composed in his book Zād al-Maʿād, known independently as “Prophetic Medicine”; the book Prophetic Medicine by al-Dhahabī (d. 748 AH); and what al-Suyūṭī wrote afterward. It is noteworthy that these authors — being jurists and hadith scholars rather than physicians first and foremost — generally blended the hadith reports with the Galenic medicine prevailing in their time, explaining the hadith on cupping, for example, on the basis of humoral theory itself. That is, “prophetic medicine” in its written form is, in large part, Greek medicine dressed in prophetic garb.

Where does the problem lie?

The problem is not in the writing of these books; gathering hadiths and commenting on them is a legitimate scholarly work. The problem lies in what the idea came to mean in people's minds: that a “medicine mentioned in the Sunnah” turns into a “medicine sent down from heaven that never errs,” so that it is raised above criticism, and with it the rule of experiment and evidence — which is the very soul of medicine — is suspended.

Fairness requires us to note that the great scholars themselves were not heedless of this. Qāḍī ʿIyāḍ pointed out that whatever proceeds from the Prophet in matters of medicine and custom “involves no diminishment or deficiency, for these are ordinary matters known to those who have tried them.” The point is that an error in a purely medical question — if it occurs — does not touch the station of prophethood, because prophethood was not sent to establish medical facts in the first place.

The gentle critique: dismantling, not demolition

Here it is well to put the matter in its proper place, gently and clearly: whoever performed cupping with the intention of following an act reported of the Prophet has, in that, the reward of intention and emulation, and this is a respected matter of faith. But to say that cupping is an effective treatment for particular illnesses because it is “prophetic medicine” — this confuses the station of devotion with the station of experience. Medical benefit is established by clinical evidence, not by the mere fact of its being mentioned. Ibn Khaldūn noted that some of what is reported may benefit “by way of blessing through the sincerity of belief,” such that its effect returns to faith and psychological reassurance — which is what we today call, in the language of medical research, the placebo effect — and not to any direct pharmacological action.

Part Three: The Evidence and the Views — “Sent as a Prophet, not a Physician”

We arrive at the heart of the thesis: the Prophet (peace be upon him) was sent as a teacher of people's religion, their morals, and their bond with their Lord — not as an arbiter of worldly sciences and crafts. His instruction regarding cupping falls under the endorsement of a beneficial, widespread custom, not under intended devotional legislation sought for its own sake. We build this claim on three supports, ordered from strongest:

The first support: the hadith of pollinating the date palms — “You know better the affairs of your world”

This is the most solid foundational principle. The Prophet (peace be upon him) passed by a people pollinating date palms and advised them to abandon it; they did so, and the fruit came out poor. When he learned of it, he spoke his comprehensive words: “You know better the affairs of your world” (narrated by Muslim). This is an explicit text that establishes, in the very tongue of prophethood, that his speech in worldly, empirical affairs is not all binding revelation, and that the people of expertise know best in their field of expertise. If this is so in pollinating palms, then medicine is all the more so.

The second support: Ibn Khaldūn's text — prophetic medicine “is in no way part of revelation”

Ibn Khaldūn (d. 808 AH) comes to settle the matter in the clearest expression the heritage has known. In the Muqaddima he says that the desert-dwellers have a medicine built on a limited, inherited experience passed down from the elders and old women of the tribe, then he declares plainly:

“The Arabs had much of this medicine, and among them were well-known physicians such as al-Ḥārith ibn Kalada and others. The medicine transmitted in the religious tradition is of this kind, and is in no way part of revelation; it was merely something customary among the Arabs. It occurred in the mention of the Prophet's circumstances (peace be upon him) of the type that mentions his circumstances which are habit and natural disposition, not from the standpoint that it is legislated to be practiced in that manner.”

Ibn Khaldūn thus draws a decisive distinction between what is human habit and natural disposition (like eating, drinking, and treating illness) and what is intended legislation that is followed as an act of worship. He places prophetic medicine in the first category: that is, it was mentioned in the biography as one of the Prophet's human habits, not as binding legislation.

The third support: the story of al-Ḥārith ibn Kalada — referral to the specialist

Abū Dāwūd (no. 3875) narrated from Saʿd ibn Abī Waqqāṣ (may God be pleased with him) that he fell ill, and the Prophet (peace be upon him) visited him and placed his hand between his breasts until he felt its coolness upon his heart, then said: “You are a man suffering in the heart (mafʾūd); go to al-Ḥārith ibn Kalada, the brother of Thaqīf, for he is a man who practices medicine” (mafʾūd: one afflicted with an ailment of the heart/chest).

The point of evidence is that the Prophet (peace be upon him) referred the patient to a specialist physician and described him as one who “practices medicine,” and did not set himself up as a treating physician. This accords perfectly with Ibn Khaldūn's text: medicine is a craft with its own people, and prophethood is another matter.

An important scholarly note on the grading of this hadith (to preserve the rigour of the argument)

This hadith was graded weak by a number of scholars, among them al-Albānī and the editors of the Musnad of Aḥmad, and Ibn al-Qaṭṭān cast doubt on the continuity of its chain (because it comes by way of Mujāhid from Saʿd, and his hearing directly from him is not established). For this reason it should not be made an independent proof to be relied upon on its own, but rather a supporting witness to what the first two supports indicate — for they are stronger than it in both chain and import. A strong argument is built on its firmest evidence, not on its weakest.

Among the corroborating witnesses too is the incident of the ladūd (medicine placed in the side of the mouth): when the Prophet's illness grew severe (peace be upon him), his Companions administered medicine to the side of his mouth without his permission, and he disapproved of it. This indicates that they did not regard his conduct in treatment as binding religious revelation that must not be contravened, but dealt with it as a worldly matter open to independent judgment.

Doing justice to the opposing view

It is only fair to note that a party of scholars hold that in some hadiths of prophetic medicine there is a form of prophetic guidance and even inimitability worthy of attention, and that the hadiths of cupping, the ʿajwa date, and the like are not merely passing customs. The fair position — represented by the words of Qāḍī ʿIyāḍ cited above and by many verifying scholars — is to distinguish: what belongs to the category of devotion (such as ruqya, supplications, and seeking refuge) has its source in revelation and is taken as legislation; and what belongs to the category of treatment by foods, herbs, and medicines has its reference in experience and trial, and is tested by the scale of medicine. This distinction preserves for the texts their due worth, and preserves for science its independence.

Conclusion: How Do We Read Cupping Today?

From this review it becomes clear that:

  1. Cupping is an ancient human practice that transcends civilizations, its theoretical basis being the theory of the four humours, with nothing peculiarly Arab or Islamic about it.
  2. The Prophet (peace be upon him) endorsed it because it was the sound treatment available in his age, not because he founded a new medicine; and “prophetic medicine” as a literary genre is a later description, not a prior one.
  3. The evidence and the views — from the hadith of pollinating the palms, to Ibn Khaldūn's declaration, to his referral of patients to specialists — converge to show that his mission (peace be upon him) was for religion, not for medicine: he was sent as a prophet, not a physician.

In this there is no disparagement of the Sunnah; rather it is putting everything in its place: devotion where devotion belongs, and experience where experience belongs. As for the question “Does cupping benefit today?” — its answer is not to be sought in the texts of hadith, but in the scale of clinical evidence alone — and that is another door, deserving of a separate essay that subjects the published reviews to the rigorous frameworks of methodological appraisal.

The Station of Prophethood Is Too Exalted to Be Reduced to a Profession or a Remedy

It remains for us to affirm what is more important than all of this: the station of prophethood is loftier and nobler than every station, and too sublime to be measured against the station of physicians and sages. The Prophet (peace be upon him) was not sent to teach people how to perform cupping or bloodletting; rather he was sent to bring them out of darkness into light, and to connect their hearts with their Lord. When we insist that the medical details of his time were “sent-down revelation,” we — without intending it — bring this highest station down into the arena of dispute over worldly particulars, instead of keeping it in its loftiness.

Indeed, in this insistence there is a gap through which the critic slips: for if it is said that cupping is a “prophetic science” from revelation, while it is a practice known in the civilizations preceding Islam by centuries, then the detractor can say, “Then he learned it from human beings who came before him” — and far be it from the Messenger of God. Safer for the argument, and truer to the reality, is to say: this is a common human custom that the Prophet endorsed as beneficial in its time, not as a science by which he was singled out above all people; and thus the objection collapses at its root.

This meaning grows stronger through the greatest proof of his truthfulness (peace be upon him): his being unlettered. He is the Prophet who neither reads nor writes, who grew up among an unlettered people and never sat with a teacher or a sage. For one whose condition was such, the guidance and beneficial knowledge he brought are all the more indicative that it was revelation from God, not acquired from human beings. Illiteracy here is not a deficiency to be excused; it is the very proof that severs the claim of “learning from others.” Hence the one most eager to magnify prophethood is the one who returns worldly knowledge to its human door, and keeps revelation pure for that for which it came — religion and guidance.

God the Exalted said:

﴿الَّذِينَ يَتَّبِعُونَ الرَّسُولَ النَّبِيَّ الْأُمِّيَّ الَّذِي يَجِدُونَهُ مَكْتُوبًا عِندَهُمْ فِي التَّوْرَاةِ وَالْإِنجِيلِ يَأْمُرُهُم بِالْمَعْرُوفِ وَيَنْهَاهُمْ عَنِ الْمُنكَرِ وَيُحِلُّ لَهُمُ الطَّيِّبَاتِ وَيُحَرِّمُ عَلَيْهِمُ الْخَبَائِثَ وَيَضَعُ عَنْهُمْ إِصْرَهُمْ وَالْأَغْلَالَ الَّتِي كَانَتْ عَلَيْهِمْ ۚ فَالَّذِينَ آمَنُوا بِهِ وَعَزَّرُوهُ وَنَصَرُوهُ وَاتَّبَعُوا النُّورَ الَّذِي أُنزِلَ مَعَهُ ۙ أُولَٰئِكَ هُمُ الْمُفْلِحُونَ﴾

“Those who follow the Messenger, the unlettered prophet, whom they find written in what they have of the Torah and the Gospel, who enjoins upon them what is right and forbids them what is wrong, and makes lawful for them the good things and prohibits for them the evil, and relieves them of their burden and the shackles which were upon them. So they who have believed in him, honoured him, supported him, and followed the light which was sent down with him — it is those who will be the successful.”

[al-Aʿrāf: 157]

May God's peace, blessings, and benedictions be upon the most noble unlettered Prophet, who conveyed the message, discharged the trust, counselled the community, and through whom God guided people from misguidance — and upon his family, his Companions, and all who follow his guidance until the Day of Judgment.

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© 2026 Husain Alkhaldy — published in the site's Essays. Original in Arabic: الحجامة بين التاريخ والطبّ النبوي.