Foot note Bahrain

Diabetes and “Traditional” medicine.

Recently the “Showbiz” columns of Western newspapers were showing photographs of the film star Gwyneth Paltrow’s back! Across her upper back were signs of “cupping” the alternative health treatment which involves having heated glass cups placed on areas of the body for its presumed therapeutic value. The results on the skin (for some time before the effect fades) are red circular marks.

In the Middle East , traditional medicine has long been part of the local scene and recently for the first time I witnessed a “cupping” session. This variation on the theme involved puncturing the back with a device which caused a series of large pin-pricks in a rectangular pattern over which the heated cup was placed. The effect over a period of 10 minutes or so was to draw blood from the wounds into the cups. More than one cup was used and the treatment was for back pain. Patients were told the “black” blood was bad and needed to be drained from the body. For anyone unfamiliar with the colour of blood once it has left the body, very dark red or “black” is an alarming sight, and perceived as something unhealthy which should be removed from the body.

More commonly in the Middle East are other techniques which I have never witnessed, only seen the results.

  • Homeopathy, common to most countries using region specific plants.
  • Bone-setting, which is not so commonly seen now and was the way in which fractures were manipulated and set by the local healer.

By far the most common treatment seen is:

  • Cautery or Al-Kowie. This is the treatment whereby various parts of the body are burned in areas which ‘relate’ to the area of pain/disease in a similar way to which acupuncture needles are placed on the ear to “cure” smoking.

The technique involves heating a metal rod (similar to a bicycle spoke) in a fire and placing it on a site. With children a heated stick is used. In the disease leishmaniasis a smouldering rag is placed over the skin lesions.

The problem with this technique in its relationship to podiatry is that the foot is used as a site for a number of ailments and unfortunately the resulting burn, particularly if the patient happens to have diabetes, can cause more problems than the condition for which they are seeking treatment. The foot is used to “cure” jaundice, sciatica, polio and localized cellulitis, tumours and cysts.

This gentleman in the photograph (Photo 1) was a Type 1 diabetic who received this treatment for stomach ache and the photo was taken 3 weeks after the cautery treatment and after he had spent 10 days in hospital because of the burn and oedema. With regular podiatry care as an out patient this gentleman did heal but not everyone who undergoes this procedure is so lucky. (Photo 2 at 3 month post-burn stage). From a podiatry point of view we try to discourage this practice, but often patients who have undergone this type of treatment and seen the effects are so frightened by the results that it is not so hard to convince them that there are better ways to treat common ailments.

It is of interest to note that acupuncture, acupressure and reflexology all use the heel area as sites to resolve stomach ailments.

Sue Tulley


Joslin Diabetes Center Affiliate at Bahrain

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