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It was hypothesized that specific changes in the local tissue structures occur as a result of local negative pressure in the cups used which stretches the nerve and muscle, thereby increasing blood and lymphatic circulation and causing autohemolysis and relieving painful muscle tension (16).
According to the family history and positive findings on physical examination (jaundice and splenomegaly), a work-up for hemolytic anemias, including Hb electrophoresis, osmotic fragility, and autohemolysis test was performed for each patient.
The latter also broke cell membranes and an increase in autohemolysis was accompanied by the increase in the osmotic resistance.