Introduction
In Iranian medicine, clearing the waste products from the human body is one of the important principles of maintaining and promoting health. Cupping therapy has two types; dry and wet. The different effects of wet cupping on the human body and some of the mechanisms of its effect have been shown in various studies. The general conditions of this treatment are determined based on the patient’s physical and spiritual conditions, age, habits, and environmental conditions. There are some restrictions for this treatment that must be observed; therefore, it is necessary to assess the  people’s needs for cupping, which are achieved after a complete recording of history and precise examination. 
One of the strongest recommendations about cupping is to pay attention to its time (season, month, day or even hour). Haziran is the 6th month of the Gregorian calendar, and the name of the first day of summer in the solar calendar, which is the recommended time for cupping. Due to the necessity and importance of cupping and the public acceptance of this intervention, the present study aims to investigate the reasons for cupping in Haziran and the people’s knowledge of the cupping principles.
Methods
This descriptive cross-sectional study was conducted in 2019. The study population consisted of people referred to the selected cupping clinics in Mashhad and Birjand cities. The required sample size was calculated separately for each city according to the two main variables (reasons for referral and the knowledge level) and based on similar studies. Finally, 400 people were selected as the study samples. The last days of June (Haziran) was considered as the study period due to the high number of people who referred for cupping in this month. Inclusion criteria were willingness to participate in the study and signing the consent form. Exclusion criteria were the return of incomplete questionnaires or unwillingness to continue participation. The samples were selected using a convenience method. A questionnaire was completed by them, after obtaining their informed consent. Its validity and reliability were measured and confirmed in a previous study. Data analysis was performed in SPSS v. 16 software.
Results
Of 400 participants, 392 completed the questionnaires; 62.8% (n=246) were male, 75.1% (n=292) were married. 40.3% (n=154) had a university education, and 77.7% (n=289) had moderate socio-economic status. 82.2% (n=53) of the women were housewives; 6.6% (n=26) of participants had an underlying disease, 40.8% (n=119) had a history of cupping two times or more in a year, and 42.7% (n=132) had moderate satisfaction with cupping therapy. The most common reason for cupping was the “maintenance of health” (73.9%, n= 272), followed by “disease treatment”. Regarding the people’s knowledge of the principles of cupping (Table 1), it was found that more than half of participants had correct information about the best season (spring) for cupping (81.5%, n=255), satiety during cupping (74.4%, n=210), the best time for having bath after cupping (after 24 hours) (79.7%, n=240), what to eat after cupping (Honey syrup) (64.7%, n=189) and complications of cupping (69.3%, n=185), but their knowledge was not desirable in other areas such as the best hours of day for cupping (Early morning) (46.9%, n=130), the best day of the week for cupping (Thursday) (21.3%, n=62), and the best days of month for cupping (middle of the month) (35.6%, n=86).




Discussion
Due to the high popularity of cupping therapy in Iran, which is done mainly to maintain the health, and considering the poor knowledge of people about the correct principles and conditions of cupping, especially in the Haziran days, the monitoring of cupping clinics is needed for performing educational interventions and developing the cupping knowledge of people. Therefore, it is necessary to inform the people through the media about the correct cupping and its principles in Haziran.
Ethical Considerations
Compliance with ethical guidelines
This article has been approved by the ethics committee of Mashhad University of Medical Sciences (code: IR.MUMS.REC.1399.529). Entering the samples into the study was fully informed and voluntary and accompanied by the completion of the consent form.
Funding
This article is in the form of a research project number 980786 belonging to Mashhad University of Medical Sciences, and the costs of the project were provided by the research assistantship of Mashhad University of Medical Sciences.
Authors' contributions
All authors equally contributed to preparing this article.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The researchers thank and appreciate the cooperation of Mr. Seyed Mohammad Vahid Ghazanfari.

 

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