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Year : 2018  |  Volume : 39  |  Issue : 3  |  Page : 195-196  

“Chheam:” Classical Indochina phlebotomy wisdom

1 KMT Primary Care Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Web Publication29-Mar-2019

Correspondence Address:
Sora Yasri
KMT Primary Care Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ayu.AYU_11_18

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How to cite this article:
Yasri S, Wiwanitkit V. “Chheam:” Classical Indochina phlebotomy wisdom. AYU 2018;39:195-6

How to cite this URL:
Yasri S, Wiwanitkit V. “Chheam:” Classical Indochina phlebotomy wisdom. AYU [serial online] 2018 [cited 2023 Jun 3];39:195-6. Available from: https://www.ayujournal.org/text.asp?2018/39/3/195/255247

Dear Editor,

The classical health-care management is an interesting medical science. In tropical Asia, local health-care wisdom has been practiced for several thousand years. In Indochina, the Khmer or Cambodian classical medicine is interesting. It comprises the specific alternative medical science originated from both Ayurveda and classical Chinese medicine. Here, the author would like to discuss and present the specific practice, namely, “chheam.” The chheam is a classical health-care management using minute sharp needles for shallow piercing at skin allowing bloodletting. One needle is used for one piercing, and there are about 20–30 piercings per practice. This is an actual classical way for phlebotomy practice used in Cambodia and nearby Indochina countries. Focusing on this classical practice, the main indication is for relieving of local pain by promoting local blood flow. There is no contraindication.[1]

At present, this practice is widely used in Indochina. The classical chheam has already been integrated with another classical Chinese medicine health care, namely, baguan (cupping). The combined chheam with cupping [Figure 1] is done to promote the local blood circulation of the patients. The basic mechanism of cupping for health management is described by Cui and Cui as cupping-induced negative pressure can dilate local blood vessels to improve microcirculation, promote capillary endothelial cells repair, and accelerate granulation and angiogenesis.[2] This can be accompanied with basic mechanism of chheam, which is similar to therapeutic phlebotomy,[3] to promote the advantage of the combined practice.
Figure 1: Procedure for combined chheam with baguan

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Now, the improved safety standards of the practice have become the important issue[4] that can increase the utility of this classical Indochina health-care wisdom.

Indeed, the Cambodian technique has a similarity with the well-known Ayurvedic treatment of Raktamokshana (bloodletting). This is not surprising since the Cambodian culture has its root from Indian Hinduism combing with Buddhism. To allow bloodletting to decrease blood thickness and toxin is the basic concept for chheam, which is concordant with the concept of Raktamokshana. Nevertheless, the Cambodian technique uses only needle for puncturing to start bloodletting. This is different from the Raktamokshana, where either vein puncturing (Siravedhana Karma) or Jalauka (Hirudinea medicinalis) (Jalaukavacharana Karma) is used.[5] Furthermore, Raktamokshana has a clear indication and proof for several disorders such as eczema[5] and sciatica.[6] Focusing on the technique, there is a specific site of the body for performing Raktamokshana for each disease, but the chheam is usually done at lower back and used for counteracting the pain symptoms, the main focus is to promote circulation in the body. There is no specific knowledge for the direction of blood flow in specific organs as described in Raktamokshana.

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   References Top

Wannawiboon W. Bloodletting for medical treatment. Folk Dr 1999;22:22-4.  Back to cited text no. 1
Cui S, Cui J. Progress of researches on the mechanism of cupping therapy. Zhen Ci Yan Jiu 2012;37:506-10.  Back to cited text no. 2
Power D. The decay of blood letting 1909. Practitioner 2009;253:20.  Back to cited text no. 3
Nielsen A, Kligler B, Koll BS. Safety protocols for Gua Sha (press-stroking) and baguan (cupping). Complement Ther Med 2012;20:340-4.  Back to cited text no. 4
Raval HN, Thakar AB. Role of raktamokshana by jalaukavacharana and siravedhana in the management of vicharchika (Eczema). Ayu 2012;33:68-72.  Back to cited text no. 5
[PUBMED]  [Full text]  
Kumbhare-Patil M, Gahukar DB, Patil SN. Role of raktamokshana by ghati yantra in treatment of Gridhrasi (sciatica): A pilot study. Ayu 2016;37:26-31.  Back to cited text no. 6
[PUBMED]  [Full text]  


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