Al-hijamah did not decrease red cell mass or hemoglobin in polycythemia rubra vera (in agreement with Taibah theory): A case study and concise therapeutic note

Alayoubi, Abdelfattah; Albadawi, Emad A.; Alghabban, Hadel Mahroos; Aljaouni, Soad K.; Alharthi, Mohammed Turki Hussein; ElSawaf, Zeinab Moustafa; Elhassan, Yasir; Bahashwan, Abdulrahman Salem; Wasif, Ghada; Ibrahim, Sara M.H.; Ahmed, Kamal Taleb; Abdel-Mageed, Osama; Donkol, Abdel-Raheem; Fawzy, Ahmed; Saad, Alfarazdeg Ageed; Aly, Mohamed Abdelnaem; Albeihany, Amal; Al-Hussaini, Abdel-Rahman Mahmoud T.; Omran, Eman Khalaf; Elgohary, Ayman Abdelnaem M.; El Sayed, Salah Mohamed; Afifi, Tarik

doi:10.21608/svuijm.2025.358647.2109

Al-hijamah did not decrease red cell mass or hemoglobin in polycythemia rubra vera (in agreement with Taibah theory): A case study and concise therapeutic note

Document Type : Case reports.

Authors

¹ Division of Medical Biochemistry, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.

² Division of Anatomy and cell biology, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.

³ Division of Hematology, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.

⁴ Department of Pediatric Hematology/Oncology, King Abdulaziz University Hospital, Faculty of Medicine & Yousef Abdullatif Jameel Chair of Prophetic Medicine Application, King Abdulaziz University, Saudi Arabia.

⁵ Division of Pathology, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia & College of Medicine, Al-Azhar University for girls, Egypt.

⁶ Division of Medical Physiology, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.

⁷ Department of Anesthesia, Al-Hada Armed Forces Hospital, Al-Hada, Taif, Saudi Arabia.

⁸ Department of Anesthesia, Prince Mohamed Bin Abdul-Aziz Hospital for National Guards, Al-Madinah, Saudi Arabia.

⁹ General Surgery Department, Aswan University Hospital, Aswan, Egypt & King Fahd Hospital, Al-Madinah Health Cluster, Al-Madinah, Saudi Arabia.

¹⁰ General Surgery Department, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.

¹¹ Department of Hematology, King Faisal Specialist Hospital & Research Center, Al-Madinah, Saudi Arabia

¹² Division of Medical Microbiology & Immunology, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia

¹³ Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia.& Department of Medical Parasitology, Sohag Faculty of Medicine, Sohag University, Egypt.

¹⁴ Department of Cardiology, Al-Miqat Hospital, Al-Madinah Health Cluster, MOH, Al-Madinah, Saudi Arabia.

¹⁵ Division of Medical Biochemistry, Department of Basic Medical Sciences, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia. & Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt.

¹⁶ Department of cardiothoracic surgery, Sohag Faculty of Medicine, Sohag University, Egypt & Najran Health Cluster, Najran, Saudi Arabia

10.21608/svuijm.2025.358647.2109

Abstract

Background: Polycythemia rubra vera is characterized by increased RBCs, hemoglobin and hematocrit.
Case study: We report a 40 years patient having polycythemia vera with normal biochemical investigations. At Al-hijamah clinic of Taibah University Medical Center, Al-hijamah was performed in the sitting position at the known anatomical sites: kahel region (skin overlying the 7^th cervical vertebra), sub-kahel region, interscapular region, and lower back. The patient felt transient dizziness and lied down in left lateral position then completed Al-hijamah in the sitting position. Sharta mihjam (superficial skin scarifications) following 1^st suction step were performed and a generous bloody excretion (about 200 cc) was excreted.
Results: 3 weeks later (to exclude acute irrelevant events), complete blood count revealed that Al-hijamah caused increased red cell mass from 5.95 (X 106 cells/µL) before Al-hijamah to 6.11 (X 106 cells/µL) after Al-hijamah, increased hemoglobin from 17.76 g/dL before Al-hijamah to 18.63 g/dL after Al-hijamah and increased hematocrit value from 52% before Al-hijamah to 53.3% after Al-hijamah. Al-hijamah relieved the symptoms lack of energy (fatigue), tiredness, headaches, and dizziness.
Conclusion: No significant change occurred in hemoglobin, RBCs or hematocrit value after Al-hijamah. Interestingly, all increased after Al-hijamah, but symptoms of polycythemia rubra vera (as fatigue) were relieved. This agrees with Taibah theory where causative pathological substances are excreted through the fenestrated dermal capillaries in a size-dependent manner and the bloody excretions contain filtered vascular fluids, tissue fluids and some RBCs (due to skin scarifications). RBCs are larger in size than the dermal capillary fenestrations and can’t be excreted during Al-hijamah. Al-hijamah appears to be safe in anemia. Phlebotomy is recommended rather than Al-hijamah in treating polycythemia. Al-hijamah-induced bone marrow stimulation needs investigations.

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