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ISSN (Print): 2789-0317

ISSN (online): 2789-0325

School of Religious and Social Studies,
Faisalabad (38000), Pakistan.

Muslim Friendly Traditional and Complementary Medicine
Guidelines: A Study on Wet Cupping Treatment and Practices
in Malaysia

Mohamad Afiq ibn Razali, and Betania Kartika

To cite this article:

Ibn Razali, Mohamad Afiq, and Betania Kartika. “Muslim Friendly Traditional
and Complementary Medicine Guidelines: A Study on Wet Cupping Treatment
and Practices in Malaysia.” Journal of Religious and Social Studies 1, no. 1 (2021):
85-100.

DOI: https:// doi.org/10.53583/jrss06.01.2021

Published online: 13 Jul 2021

iv Submit your article to JRSS

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Journal of Religious and Social Studies
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MUSLIM FRIENDLY TRADITIONAL AND
COMPLEMENTARY MEDICINE GUIDELINES:
A STUDY ON WET CUPPING TREATMENT AND
PRACTICES IN MALAYSIA

Mohamad Afig Ibn Razali', and Betania Kartika?

Abstract: Ministry of Health Malaysia (MOH) has established the
Traditional and Complementary Medicines Division (TCM) in
February 2004. The ministry has recognised wet cupping therapy
as one of the traditional and complementary medicines practices
under this division. Under TCM Act 2016, the MOH is the only
authority to govern the policy and to impose the ethical practice’s
cuidelines to be enforced on wet cupping practitioners in
providing services that are safe and clinically proven as the best.
It is expected that wet cupping will be one of the drivers in the
global halal treatment industry in Malaysia. This article attempts
to provide the basis for future study on the perception and
expectations of wet cupping service delivery in the rapidly
erowing Muslim-friendly medical care sector. On the whole,
practitioners must adhere to these guidelines to ensure that the
Magasid al-Shari’ah, which are the protection of a patient's life,
intellect, and property are safeguarded. All of this is under the
basic purpose of a Muslim’s life, and that is to obtain Allah's
blessings in all circumstances.

Keywords: Wet Cupping, Hyamah, Medicine, Muslim-Friendly,
Medical Services, Prophetic Medicine, Magasid al-Shari‘ah.

INTRODUCTION

Over many decades, traditional medicine has devoted particular attention to the

health and well-being of our society as a whole. To cure ailments and promote health,

International Institute for Halal Research and Training, Kuala Lumpur, Malaysia. bd)
International Institute for Halal Research and Training, Kuala Lumpur, Malaysia.

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alternative medicine is still practised by the world today. Additionally, the World Health
Organization describes that market for Traditional and Complementary Medicine (TCM)
methods and practitioners is considerable and growing globally. Even the Malaysian
Ministry of Health has long known the relevance of TCM from a health, economic, and
social, and cultural point of view in Malaysia. TCM is promoted as a complementary
treatment to modern medicine by the Ministry, which sought to make safe and high-
quality TCM services publicly accessible while also incorporating them into the public

healthcare system to provide effective healthcare coverage for all Malaysians.

In 1998, Malaysia spent roughly US$ 500 million on TCM treatments and facilities,
resulting in approximately US$ 300 million on conventional medicine.’ Malaysia has
become one of the several nations that supervise the varying degrees of TCM and the
practitioners who employ it. The TCM Act’s enforcement has already begun and is being
carried out in phases. Examples include the Traditional and Complementary Medicine
(TCM) Act 2016 (Act 775) in Malaysia, which oversees TCM practice and practitioners
on the 10th of March 2016 and went into effect on the 1st of August 2016. According to
the Traditional and Complementary Medicine (TCM) Act 2013, the government
recognises traditional medicine; nevertheless, practitioners must be registered with

organisations recognised by the MOH to practice.

Among the entire TCM around the world and one of the alternative medications is
the Hijamah practice. Alternatively, wet-cupping treatment, blood leaching therapy, or
blood-letting rehab are terms used to describe it. It is a component of traditional Islamic
therapy advocated by the Prophet Muhammad (PBUH) and is referred to as Al-Tibb al-
Nabawi (the Way of the Prophet).

He asserted in a hadith narrated by Anas ibn Malik that “Indeed the best of remedies you
have is Hijamah...”*

World Health Organization, Traditional medicine: growing needs and potential (Geneva:
WHO Policy Perspectives on Medicine, 2002), 1.
https://apps.who.int/iris/handle/10665/67294.

: Muhammad ibn Ismail Al-Bukhari, The English Translation of Sahih Al Bukhari With the
Arabic Text, trans. Muhammad Muhsin Khan, (Cairo: Al-Saadawi Publications, 1996),
Hadith no# 5696.

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Furthermore, recorded Ibn ‘Abbas that the Prophet (PBUH) said; "Healing is in three
things: A gulp of honey, Hyamah and branding with fire (cauterizing). But I forbid my followers
to use (cauterization) branding with fire”?

The Quran states: “And whatsoever the Messenger gives you, take it. And whatsoever he
forbids, abstains...”° It is said in this verse that Muslims should follow in the footsteps of
the Prophet Muhammad (PBUH) and he advocated Hyjamah and urged people to use it.

DEFINITION OF TCM

A variety of definitions for TCM are available from a variety of writers and
organisations. Noticeably, the definitions differ from one country to the next. The World
Health Organization’s (2002) and MOH’s (2007) definitions of TCM serve as the

foundation for this research.

TCM is defined by the WHO as the “summary of all knowledge, skills and practises
based on theories, beliefs and experiences indigenous to various cultures, whether or not
they are explanatory, used for maintaining health and for preventing, diagnosing,
improving, and eliminating or treating physical, mental or social imbalances”.’ Here,
practical experience and observation are passed down verbally or in writing from one
family member to the next, and nothing else is taken into consideration. In particular,
traditional medicine may be regarded to be the fusion of numerous things into a single

kind of ancestral experience that has been acquired or acquired from ancestors.

As defined by the World Health Organization*, traditional medicine includes “various
methods, attitudes, knowledge and beliefs integrating plant, animal and/or mineral
medicinal products, spiritual treatments, manually applied techniques and exercises
used alone or in combination to preserve the well-being and treat, diagnose or
prevention of sickness.” To be certain, the World Health Organization (WHO) also

defined alternative medicines as "a broad collection of health-care practises which were

: Muhammad ibn Ismail Al-Bukhari, The English Translation of Sahih Al Bukhari With the
Arabic Text, Hadith No: 5680.
: Al-Qur’an 59:7.

World Health Organization, Traditional medicine : growing needs and potential, 2.
8
Ibid., 2.

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not the core of a country’s own culture and are not incorporated into the mainstream
national health service” in 2005. Other words, such as natural medicine, non-
conventional medicine, and holistic medicine, are occasionally used to refer to these

health care methods.

The Malaysian Medical Council classifies TCM practice as “a practise other than
medicine or surgery by licensed physicians as specified in the Medical Act 1971.”° The
definition of traditional medicine in Malaysia, as defined by ASEAN Consultative Board
Standards and Quality (ACCSQ) in 2006, is “any product used in indigenous medicine
practises where the drug consists of a single or one or more naturally occurring
substances and a single plant, animal or mineral, or a part of extracted or crude extract,

and a homeopathic medicine.”

Traditional and complementary medicine, according to the TCM Division of the
Ministry of Health Malaysia, is “a type of health-related practice designed to prevent,
treat, manage, and preserve mental and physical well-being of individuals, including
Traditional Malay Medicine, Traditional Chinese Medicine, Traditional Indian
Medicine, Homeopathy, and Complementary Therapies.”'’ For the World Health
Organization (2002), TCM practitioners are defined as “any people that provide

complementary and alternative practices to cure, assess, or avoid any ailment or illness.”

TCM PRACTICES IN MALAYSIA

There are three distinguishing characteristics of TCM in Malaysia. As a starting point,
TCM in Malaysia is very diverse in terms of legacy and history; language; philosophy;
ethnic origin; geographical distribution; and the stage at which each practice is now
developing. In the second place, TCM is inextricably connected to each racial community
in Malaysia’s history and tradition. Lastly, the private sector dominates the supply of

TCM services in Malaysia, with the public sector playing a supporting role.

Ministry of Health, The national policy of traditional and complementary medicine (Kuala
Lumpur: Ministry of Health Malaysia, 2007), 5.

Traditional and Complementary Medicine Division, Introductory of The Traditional and
Complementary Medicine (Kuala Lumpur: Ministry of Health Malaysia, 2007), 9.

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TCM is defined in the TCM Act 2016 [Act 775] as a “form of health-related practice
aimed at preventing, treating, or managing disease or illness or preserving an
individual’s mental and physical well-being, and includes practices such as traditional
Malay medicine (TMM), traditional Chinese medicine (TCM), traditional Indian
medicine (TIM), Islamic medical practice, homeopathy, and complementary therapy.”"!
Given the wide variety of TCM modalities that are practiced in Malaysia, it is not feasible
to develop a single strategic plan, system, or set of criteria that would apply consistently
across all of the modalities, as has been suggested. Designing an adequate policy basis
for TCM in Malaysia is therefore one of the MOH’s primary tasks in governing and

institutionalize the various TCM activities in Malaysia.

Malaysia is abundant in botanical medicinal plants and herbal resources, making it
an excellent source of raw materials for TCM. For generations, this characteristic has
tended to favor TCM techniques in Malaysia. Numerous modalities make a distinction
between Malaysian TCM approaches. Malaysia’s diverse population favors a variety of
TCM methods. Their oneness fosters acknowledgment of TCM’s varied modalities. TCM
techniques in Malaysia are primarily classified based on ethnicity. The practice of other
TCM modalities that do not correspond to their heritage is seen on a few occasions when

diverse ethnic groups coexist with one another.

TCM may be classed in Malaysia into 5 categories, as seen in the table below.’” In the
2011 TCM Division, MOH introduced Islamic Medicine into TCM.

Traditional and Complementary Medicine Division, The Traditional and Complementary

Medicine (TCM) Act 2016 (Kuala Lumpur: Ministry of Health Malaysia, 2016), 4.

M.S. Pillay, Traditional and Complementary Medicine in Malaysia (New Delhi: International
Conclave on Traditional Medicine, 2006), 14; Mohd Hadi, T&CM Practice towards
Standardization (Pulau Pinang: Kursus Asas Farmasi dalam Perubatan Tradisional dan
Komplementari, 2010), 18.

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Table 1: Type of TCM practices in Malaysia

Type Description Examples

Malay traditional Indonesian origin Traditional massage,

medicine herbal treatment, post-
natal treatment, bekam

Chinese Since the 18th century, it has been Tuinalogy, acupuncture,

traditional imported from China and Koreaand moxibustion, cupping,

medicine applied in Malaysia. herbal medicine

Indian traditional Originating in India, Pakistan, Ayurveda, Siddha,
medicine Bangladesh, and Sri Lanka, and Unani
having been practiced in Malaysia
from the nineteenth century
Complementary It was brought to Malaysia from Chiropractic,
medicine India, Sri Lanka, and the West, and naturopathy, reiki,
has been practiced around since the colour vibration, yoga,
19th century. tai chi
Homeopathy It was brought to Malaysia mostly Homeopathy
from Sri Lanka and has been
practiced there since the 19th century.
Islamic medical Malaysians have been practicing it Rugyah, Hijamah

practice

since the 15th century.

Source: TCM Division, /ntroductory of The Traditional and Complementary Medicine, 21

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The Ministry of Health (MOH) is responsible for the oversight of the healthcare
system offered to the general population in Malaysia. The ministry is in the authority of
the services and care used within Malaysia’s healthcare system. MOH’s efforts for the
expansion and formalization of TCM were bolstered by the diversity of TCM practices
in Malaysia, as well as public demand for safer, natural alternatives. During the June
2012 and September 2012 Parliamentary sessions, the draught TCM Bill was read several
times before being finally enacted as the TCM Bill on the 27th of September 2012.

TCM Division (2011) reports that there are officially seven TCM confederations
facilitating in the formalization and uniformity of TCM activities and serving as liaisons
between TCM Division and TCM practitioners. For instance, in 2010, the PUTRAMAS
was abolished and replaced by Gabungan Pertubuhan Perubatan Malaysia (GAPERA),
beginning on 28 June 2010.

There were around 11,691 TCM practitioners in Malaysia, as per the Health
Informatics Center (MOH, 2010). It is estimated that the number of TCM practitioners

has grown to around 15,000."

CONCEPT OF WET CUPPING TREATMENT

Sucking cups are used to provide negative pressure to the skin during cupping
treatment, which is a simple technique that anybody may do.'* There are several
different kinds of cupping treatment reported in the literature, namely dry cupping
therapy, wet cupping therapy, medicinal cupping therapy, moving cupping therapy,
and others.'° It seems that wet cupping is the most prominent kind of wet cupping
treatment and that it is the technique of wet cupping therapy that has been used in
Prophetic medicine. In contrast to conventional treatment procedures, wet cupping
therapy represents an excretive form of therapy, not an introductory one. Wet cupping

treatment, for example, utilizes negative pressure suction and skin pricking to breach

Loh Foon Fong, “Regulating Traditional Medicine,” The Star Online, July 3, 2011, 12.

https: //www.pressreader.com/ malaysia /the-star-malaysia /20110703 /285185829828885.
" Al- Shamma Yaser MH and Ali Abdil Razzaq, “Al-Hijamah Cupping Therapy,” Kufa

Medical Journal 12, no.1 (2009): 51.
Chirali IZ. The Cupping Procedure: Traditional Chinese Medicine Cupping Therapy
(London: Churchill Livingstone, 1999), 73-86.

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the skin's barrier and excrete a blood fluid mix containing soluble waste and pathological
causative chemicals (CPS). The second negative pressure suction completes the waste
excretion procedure. Worse still, the significance of medical research on cupping

treatment is not addressed.

Medical problems such as herpes zoster’®, vitiligo'’, high blood pressure”,
rheumatoid arthritis’’, headache, and migraine*® have been treated with cupping. A
dysmenorrhoea”', acute trigeminal neuralgia’, and acute gouty arthritis also were found

to alleviate pain.”

Taibah’s wet cupping treatment is solidly based on science and medicine.”. It is used
as a mechanical clinical excretory technique to remove the blood and interstitial fluids
from the CPS. It opens up the skin barrier, improves the skin’s natural excretion
activities, and increases immunity and filtering at both capillaries ends to remove the

CPS blood to promote physiology and equilibrium. The development of reactive

“ Huijuan Cao, Chenjun Zhu and Jianping Liu, “Wet cupping therapy for treatment of
herpes zoster: a systematic review of randomized controlled trials.” Altern Ther Health
Med 16, no.6 (2010): 48-54.

_ Sherif Shoukry Awad, “Chinese cupping: a simple method to obtain epithelial grafts for
the management of resistant localized vitiligo.” Dermatol Surg 34, no. 9 (2008): 1186-1192.

18

Lee MS, Kim JI, Ernst E, “Is cupping an effective treatment? An overview of systematic
reviews. J Acupunct Meridian Stud 4 (2011): 1-4.

Mohamed M. Reslan Hssanien, Abbas F. Ahmed and Mansoura Fawaz S.. Al Emadi S,
Hammoudeh M, “Effect of cupping therapy in treating chronic headache and chronic
back pain at Al heijamah.” World Family Medicine Journal 8, no. 3 (2010): 30-36.

= Peter J Koehler and Christoper J. Boes “A history of non-drug treatment in headache,
particularly migraine.” Brain 133 (2010): 2489-2500.

= Sultana Arshiya, Khaleeq Ur Rahman, Muzn Farzana and Azad Lone, “Efficacy of
hijamat bila shurt (dry cupping) on intensity of pain in dysmenorrhoea-a preliminary
study.” Ancient Science of Life 30, no.2 (2010): 47-50.

oe Zhang Z., “Observation on therapeutic effects of blood-letting puncture with cupping in
acute trigeminal neuralgia.” Journal of traditional Chinese medicine 17, no.4 (1997): 272-274.

2

Zhang, Shi-Jun, Jian-Ping Liu and Ke-Qiang He. “Treatment of acute gouty arthritis by
blood-letting cupping plus herbal medicine.” Journal of traditional Chinese medicine 30, on.1
(2010): 18-20.

o El Sayed SM, Mahmoud HS and Nabo MMH, “Methods of Wet Cupping Therapy (AI-
Hijamah): In Light of Modern Medicine and Prophetic Medicine.” Alternative &
Integrative Medicine 2, no. 3 (2013): 4-5.

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hyperemia, which is caused by the compressive pressure applied on the skin for a while
more than a few seconds, has also been found to be beneficial to patients applying for
wet cupping, as has been documented before. Within minutes of vascular compression
occurring, the skin’s blood supply is reduced, causing a build-up of vasodilator
chemicals in the skin’s blood vessels. Hyperaemia occurs when blood flow to the skin
rises significantly as a result of vascular compression being relieved.” As a result, more
blood may be drawn into the skin circulation, where it may be filtered and cleaned

during the next stages of wet cupping.

TYPES AND METHODS OF WET CUPPING APPLICATION

Cupping treatment may be practiced in a variety of ways; however, appropriate
selection and selection of the best techniques of cupping therapy for curing illness seems
to be essential. Puncturing and cupping (PC) is the first technique, which consists of the
following steps: skin marking, sterilisation, puncturing, cupping, and sterilisation. The
second approach is the cupping, puncturing, and cupping (CPC) method, which
contains six stages: demarcation of the skin, sterilisation, first cupping, puncturing,

second cupping, and sterilising.

Table 2: Differences between Dry Cupping Therapy and Wet Cupping Therapy
Dry Cupping Therapy Wet Cupping Therapy

Distribution The most frequent kind of In the Arabic or Islamic world, the
cupping treatment is practiced in most prevalent form of capping
China. Available in various treatment is the CPC technique in
regions of the world. Saudi Arabia, while in China and
many areas of the globe the PC

approach dominates.

= Kenneth Saladin, Anatomy & Physiology: The Unity of Form and Function (New York: The

McGraw Hill companies, 2003), 262.

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https: / /doi.or

10.53583 /jrss06.01.2021

Types

Dry cupping
therapy

Skin puncturing

Number of

technical steps

Excretion of excess

fluids and wastes

As a Prophetic
medicine

recommendation

Treating
pathological

causes

One type

It is possible to complete the

procedure in a single session.

Not done

One stage that consists only of

cupping

Not done, such fluid and waste
retention. Apart from pain
receptors and pain-sensitive
tissues, just diluting and
redistribution of hazardous

soluble chemicals may happen.

- Dry cupping therapy in the
prophetic period was not used
as a single therapy.

- Done in prophetic medicine as
the first phase of prescribed
wet cupping treatment.

Excess fluids containing soluble

CPS, whether palliative or causal,

are not eliminated.

94

Two types: CPC method and PC

method.

The CPC method includes the initial
stage of wet cupping therapy that is
not included in the approach of the
PC method.

Done

The PC technique has two stages,
while the CPC method has three

steps.

Excrete fluids and waste after
dilution and redistribution into
collected fluids in the skin after
elevating. In the CPC this is better

than in the PC approach

The CPC technique, also known as
Hiyamah, was advocated and used
throughout the Prophetic period, and
it is being practiced today in Saudi

Arabia and other Islamic nations.

When done correctly, particularly
with the CPC technique, it may be
healing.

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Source: El Sayed SM, Methods of Wet Cupping Therapy (Al-Hijamah): In Light of Modern Medicine and
Prophetic Medicine, 3

TCM GUIDELINES ON WET CUPPING TREATMENT

Some wet cupping practitioners have acknowledged the existence of the laws and
euidelines provided by the Ministry of Health Malaysia through the Traditional and
Complementary Medicine division. Examples of laws and guidelines are the Act 775; the
Traditional and Complementary Medicine Act 2016 and Garis Panduan Amalan Perubatan
Tradisional & Komplementari: Bekam (MOH, 2013). These rules and guidelines showed
proper uses of alternative medications that have been proved to be scientifically safe.
The practitioners have either implemented or are effectively working adjustments to
their practices to comply with the integration policy effort, or they are either ready for
adaptation or will be prepared to amend their practices in the future. The overwhelming
majority of practitioners, on the other hand, are not willing to make the transition to
formal-institutional learning, which is needed under the interconnected learning

programme.”

Among the code of ethics for wet cupping practitioners adhered all the times as

below:?7’

1. Practitioners are expected to behave themselves ethically in all of their
interactions with their clients, the general public, and other practitioners;

2. Practitioners are required to adhere to the advertising rules at all times;

3. Practitioners are not authorized to perform any TCM education training courses
without the prior consent of the MOH;

4. Practitioners are expected to adhere to the aforementioned code of conduct in the

course of their professional duties; and

Muhammad Ismail, The Paradigm Shift of TCM into Integrated Medicine (Selangor: 4th
International Traditional/Complementary Medicine Conference and Exhibition, 2002), 8.
i TCM Division, The Traditional and Complementary Medicine (TCM) Act 2016, 11.

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5. Practitioners who violate the ethical code may be subjected to a disciplinary

investigation.

The post-treatment is also very vital for wet cupping practitioners to adhere with
patients, especially with the oxidant drainage. Below is the flow chart for clinical waste

management after treatment.

Infectious Clinical Waste

——_—

Sharps Non-sharps
Yellow
Sharps waste bag

Central Collection Area }

t

Incineration

Source: Ministry of Health, The national policy of traditional
and complementary medicine, 18

PROPHETIC MEDICINE RECOMMENDATIONS ON WET CUPPING
MEDICATION

Prophetic medicine is a phrase that refers to all of the Prophet Muhammad SAW’s
ahadith (sayings), recommendations, behaviors, and teachings about health and illness.
Cupping therapy is strongly recommended in even more just one hadith in Prophetic

medicine:

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“The best remedy is al-Hijamah (CPC method of wet cupping therapy)””° and;

“Tf there is a benefit in any of your treatment modalities: benefit will be in the blade puncture
in cupping therapy, a gulp of honey and cauterizing, but I do not like cauterization”~’

Although Prophet Muhammad (PBUH) was not a physician, he was a wonderful
teacher and leader to his companions and country. All areas of life, including social and
healthcare issues, were covered by his counsel and guidance.” There is evidence that
the process for wet cupping treatment in the Prophetic period of history, which was
more than 1400 years ago, was similar to those employed today in the CPC approach.
Prophet Muhammad SAW was said to have requested Hijamah, after which the physician
began by placing horns, which were equivalent to sucking cups in modern times, on his
body for the first cupping step, which after he punctured the skin with something like a

lancet, and then performed the second cupping step;

“A man asked the Prophet (PBUH) about that procedure. The Prophet SAW replied, “This 1s
al-hijamah (wet cupping therapy)”. The man asked: “What is al-hyjamah?” The Prophet
answered:” It is one of the best remedies used by people’””

In Prophetic medicine, it is recommended that you undertake wet cupping treatment
before you consume anything. Prophet Muhammad (PBUH) said: “Al-Hijamah on an empty
stomach 1s better, and in tt, there is healing and blessing, and it increases one’s intellect and

memory”

It is possible to glean important scientific truths from this hadith, which are consistent
with current medical understanding. Cupping treatment during an empty stomach will
prevent the shifting of a large part of circulatory blood into the gastrointestinal tract

(GIT), thereby ensuring that blood circulation in the skin does not diminish. Blood

= Al-Bukhari, The English Translation of Sahih Al Bukhari With the Arabic Text, Hadith no#
5696.

si Ibid., Hadith no# 5680.

30

Ibn al-Qayyim Al-Jauziyah, Healing with the Medicine of the Prophet (Peace be upon Him),
trans. Jalal Abual Rub, (Fordham University: Darussalam Publishers & Distributors,

1999) ,.41;

= Ahmad ibn Muhammad Ibn Hanbal, English Translation of Musnad Imam Ahmad Bin Hanbal
(KSA: Dar al-Salam Publications, 2012), Hadith no# 20108.

Ss Muhammad ibn Yazid ibn e Majah, Al-Sunan (Cairo: Dar Ihya’ al-Kutub, 1953), Hadith
no# 3616.

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supplies to the GIT consume a substantial part of blood supplies at the cost of skin
circulation during food digestion. An empty stomach, therefore, allows huge blood to
filter from the skin’s circulation during cupping treatment. As a result, cupping therapy
is believed to filtrate circulating blood by filtering pumping blood in skin capillaries,
which supports the contemporary finding. This confirms the current notion that cupping
treatments filter the blood flowing in skin capillaries via the filtering of blood.’ As a
result, after meals, redistribution of blood happens as a result of the movement of
significant quantities of blood into the GIT at the cost of other tissues such as the skin

and kidneys.**

THE PRESERVATION OF LIFE AND THEIR ESSENTIAL (DARURI)
ASPECTS ON WET CUPPING PRACTITIONERS

As regards the Magasid al-Shari’ah, this simply means that any health intervention
programme in the field of medicine and healthcare should contribute to a healthy and
moral right, to avoid sudden and improper fatalities, to safeguard against intellectual
and social incapacity, to publicise the safe reproductive success and emergence of human
descendants. Allah says:

“And if anyone saved one life, it would be as if he had saved mankind entirely.”””

According to Shari’ah, the encouragement of the Jalb al-Masalih (general welfare and
benefits), as well as the Dhar al-Mafasid (protection and safeguarding from suffering), are
the ultimate goals to be achieved. In all areas of their life, Muslims are required to follow
the Shari'ah. Aiming to offer Muslim patients with medical service that complies with
Islamic standards, which includes the use of halal medicine, Muslim-friendly healthcare
services are being established. According to what can be deduced, in the event of
delivering health care services that are compliant with Shari’ah, the prime objective of
the healthcare professionals would be to offer medical services that guarantee the

= C. Norryd, H. Denker, A. Lunderquist, T. Olin and U. Tylén, “Superior mesenteric blood

flow during digestion in man.” Acta chirurgica Scandinavica 141, no. 3 (1975): 197-202.
= Vijayaraghava Ambarish, Pradip Barde, Avni Vyas and Kishore Kumar Deepak,
“Comparison between preprandial and _ post-prandial heart rate variability
(HRV).” Indian Journal Physiol Pharmacol 49, no. 4 (2005): 436-442.

ee Al-Our’an 5:32.

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principal necessities (Daruriyyat) for all human beings, and in particular for the life of the
patient. As part of this process, practitioners must pay careful regard to the requirements
of the general public, which must take precedence above any business interests or
benefits. The goal of establishing Muslim-friendly medical services is indeed to

cuarantee that practicers focus on the lives and livelihoods of Muslims in Malaysia.

Allah mentions: “...And do not kill the soul which Allah has forbidden [to be killed] except by
[legal] right.””°

Consequently, Hijamah professionals’ main services would involve the duty of
practicing to give honest and authentic medical diagnoses, treatments, and care for
patients to save their lives. Practitioners must endeavor, following Islamic health ethical
standards, to ensure they do their homework to prevent any failure which may endanger
a patient’s cause serious injury. Having said that, it is their responsibility to follow the
rules and policies set by the MOH which are clinically safe. The responsibility of medical
professionals is to give their patients the finest therapy available to relieve their pain and

suffering.

According to Yacoub, who cited Imam Ghazali’s perspective on medical treatment,
ailments may be classified into three categories: those that are curable, those that are
anticipated to be treated, and those for which a remedy has not yet been discovered.”
Refusal to get medical care when the illness may be cured is strictly prohibited in Islam.
Even in cases where the disease may be curable but the treatment may have a harmful
risk factor and so there is no assurance that the medication will be possible to treat the
illness, treating is not deemed to be against Islamic teachings because it is not considered
to be contrary to relying on Allah; therefore, patients are compelled to seek treatment.
The treatment of the third type may include dangerous side-effects like cauterization, in
such situations the illness may remain alone but therapy is allowed owing to
advancement of research and medicine as Holy Prophet (PBUH) mentioned in a hadith

which is reported by Jabir as he says:

ae Al-Qur’an 6:151.
es Ahamd Abdel Aziz Yacoub, The Figh of Medicine (Turkey: 5S. Afsar Ed, 2013), 86.

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“There is a remedy for every malady, and when the remedy 1s applied to the disease it 1s
cured with the permission of Allah, the Exalted and Glorious.””°

CONCLUSION

Wet cupping is a prospective subject that needs the Islamic essence to deal with its
theories and practices. Integrating TCM into the national health care system and
Muslim-friendly medical services is vital, but these changes involve and implicate many
parties, especially the practitioners. This consideration will identify if they are making
improvements, whether they are ready to change, or whether they will be keen to take

forth shifts in their practices in compliance with the policy effort on integration.

In a country in which the development of the global halal industry has become one
of the primary focuses, practitioners who comply with the rules and guidelines for
proper use of Hijamah practice authorized by the MOH can improve and ensure the long-
term survivability of the Shari'ah-compliant medical service market by providing
services that meet the needs and expectations of Muslim patients seeking medical
treatment in a safe and halal environment. This research not only highlights continuing
improvements and the creation of Muslim-friendly hospitality services but also fills the
gap in awareness concerning alternative medicines for Muslims in particular and the
broader public. In summary, this research will serve as a basis for future research on the
perceived service quality of wet cupping service delivery in the rapidly growing

Muslim-looking medical care sector.

Al-Bukhari, The English Translation of Sahih Al Bukhari With the Arabic Text, Hadith no# 95.

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