During the Eastern Jin Dynasty, Ge Hong, in his work Zhouhou Beiji Fang, mentioned the use of horn therapy for treating swelling; the horns used were from oxen. Given the popularity of this method at the time, improper application could easily lead to accidents. Therefore, Ge Hong specifically warned to carefully select the appropriate indications, emphasizing in the book: "Yongju, tumors, stone abscesses, tendon knots, scrofula, none of these should be treated with horn acupuncture. Those who use horn acupuncture rarely escape misfortune" (Zhouhou Beiji Fang‧Volume 2). This is clearly reasonable, as even from today's perspective, most of the listed conditions are indeed not suitable for cupping.

By the Sui and Tang periods, there was a breakthrough improvement in the tools used for cupping, with the introduction of processed bamboo cups to replace animal horns. Bamboo cups were widely available, inexpensive, and easy to obtain, greatly aiding the dissemination and promotion of this therapy; at the same time, bamboo cups were lightweight and had strong suction, which to some extent enhanced the effectiveness of the treatment. Among the medical texts of the Sui and Tang periods, Wang Tao's Waitai Miyao contains extensive records on this subject. For example, Waitai Miyao‧Volume 40 provides a detailed description of using bamboo cups for suction: "Following the horn method, bamboo was used to make small horns, leaving a section three to four inches long, with a diameter of four to five fen. For fingers, fine bamboo can be used. When it cools, it can be applied to the sting area, using a large horn for the fingers. If the qi fistula disease does not respond, the horn should not be too small; larger horns provide quicker relief. Quickly make four or five pieces, boil them thoroughly in a pot, and apply them to the sting area, replacing them when they cool." It points out that bamboo cups of different sizes should be used according to different body parts. The suction method used at that time is the same as the cup-boiling method still in use today, also known as the boiling tube method. It is worth noting that Waitai Miyao provides detailed introductions to this method in several places. In Volume 13, it mentions that before cupping, "mark the spot with ink. Take a bamboo tube of Dyers Woad, one and a half inches long, with one end left with a node, and the node-less end thinned to resemble a sword. Boil this tube several times until hot, then remove the tube and press it onto the ink-marked spot." The improvements in suction tools and methods had a significant impact on later generations.