19 11-18 raktamokshana kolakata

Dr. K. Shiva Rama Prasad,
@ http://www.technoayurveda.com / http://www.slideshare.net/technoayurveda/
Standard Procedures of
RaktamokshanaRaktamokshana
6 days CME, Rashtriya Ayurveda Vidyapeeth, New Delhi
Institute of Post Graduate Ayurveda Education & ResearchInstitute of Post Graduate Ayurveda Education & Research,
Kolkata, West Bengal
18th November 2019
Dr. K. Shiva Rama Prasad, Prof, Panchakarma, LN Ayurved College, Bhopal/

Introduction
Standard Procedures of Raktamokshana
Introduction
• “Rakta” is “blood” and “mokshana” is “to letRakta is blood and mokshana is to let
out” ‐ is a para‐surgical procedure, included in
Panchakarma healing treatments by all three
Charaka, Sushruta and Vagbhata
• Raktamokshana therapy is the blood cleansing
& purification therapy in Ancient India that
purifies the body 4th humor “Rakta”.
• The process of Raktamokshana, oldest human
effort can be traced back to/from Vedic period
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

Importance of Rakta
Importance of Rakta
• Blood is the fore most and important cause of
Body sustenance.
• It is Jeeva (life) and should be protectedIt is Jeeva (life) and should be protected
always.
• The pure blood resemble Indragopa Red and• The pure blood resemble Indragopa Red and
non coagulated
स तसंिहता स थानम १४ शोिणतवणनीया ायःसु ुतसिहता सू थानम् - १४. शोिणतवणनीया ायः
1) देह िधरं मूलं िधरेणैव धायते | त ा ेन संर ं र ं जीव इित थितः ||४४||
ो ी ं ि ि ं ी
2) इ गोपक तीकाशमसंहतमिववण च कृ ित थं जानीयात् ||२२||

What is Rakta?
What is Rakta?
• Blood (Rakta) is the red homogeneous liquid that
circulates in the arteries and veins of humans andcirculates in the arteries and veins of humans and
other vertebrate animals, carrying oxygen to and
carbon dioxide from the tissues of the body
• Tejo tapa converts the Rasa in to red color Rakta• Tejo tapa converts the Rasa in to red color Rakta
• Rajas in females is also Rakta that appears from 12 yrs
(menarche) till 52 yrs (menopause)
• The Rakta follow Rasa Gati (3 sides) – like sound
horizontal, like fire upwards and like water downwards
रि ता ेजसा ापः शरीर थेन देिहनाम् | अ ाप ाः स ेन र िम िभधीयते ||५||
रसादेव या र ं रजःस ं वतते | त षा ् वादशादू याित प ाशतः यम् ||६||
स श ािचजलस ानवदणुना िवशेषेणानुधाव ेवं शरीरं के वलम् ||१६||
ु ु ् || ||
सु ुतसंिहता सू थानम् - १४. शोिणतवणनीया ायः

Classification of Raktamokshana
Classification of Raktamokshana
• 1 Shastra Visravana1. Shastra Visravana
– a) Pracchana is several incisions or pricks
b) Siravyadha is vene puncture– b) Siravyadha is vene puncture
• 2. Anushastra Visravana
) ( )– a) Jalaukavacharana is leeches (Pitta dosha)
– b) Alabu is extracting blood through vacuum
(K h d h )(Kapha dosha)
– c) Shrunga is cow’s horn (Vatadosha)

Raktamokshana
Raktamokshana
Visravana (Active) Passive
Superficial Deep Flow
(Siravyadha)
Jaluka
(leech Application)Vacuum
created
( Prachhanna)
(Siravyadha)
Cupping
(Dry & Wet)
Cut
(Viddha)
Needle
(Srunga /Suchi)
(Dry & Wet)
(Viddha) (Srunga /Suchi)

Indications of Raktamokshan
Indications of Raktamokshan
• Charaka refer Raktamokshana in JwaraCharaka refer Raktamokshana in Jwara,
Gulma, Kushta, Yakshma, Unmada, Udara,
Swwayathu Arsha Visarpa Grahani VishaSwwayathu, Arsha, Visarpa, Grahani, Visha,
Vatarakta, Yonivyapad, etc.
• Skin disorders like allergic dermatitis eczema• Skin disorders like allergic dermatitis, eczema,
sciatica, abscess, edema, swelling and
inflammations uremia dullness pericarditisinflammations, uremia, dullness, pericarditis,
tonsillitis are also included

Selection of Raktamokshana
Selection of Raktamokshana
• Vata = [Go] Srunga (as it is snigdha)[ ] g ( g )
• Pitta = Jaluka (as it is sheeta)
• Kapha = Alabu (as it is teekshna)
Contraindications of Raktamokshana
Ksheena Sarvanga sopha generated with AmlaKsheena, Sarvanga sopha generated with Amla
bhojana, Pandu, Arsha, Mahodara, Sosha and
Garbhini
अथािव ा ाः-
सवा शोफः, ीण चा भोजनिनिम ः, पा ुरो शसोद रशोिषगिभणीनां च यथवः ||२४||
स तसंिहता स थानम १४ शोिणतवणनीया ायः
सु ुतसिहता सू थानम् - १४. शोिणतवणनीया ायः

CONTRA INDICATED VEINS FOR VEIN PUNCTURE
CONTRA‐INDICATED VEINS FOR VEIN PUNCTURE
• There are 602 Vedhya siras and 98 Avedhya siras
• The Avedhya are divided in three regions –
– Shakhagat‐16, Kosthgat‐32, and Urdhavjatrugat‐50.
H f l l i i d b i• Harmful results are anticipated by puncturing
Avedhya sira
अत ऊ व ािम न िव े ाः [१] िसरा िभषक् |
वैक ं मरणं चािप [२] धा ासां ुवं भवेत् ||१९||
िसराशतािन च ा र िव ा ाखासु बु मान् |ु ु ् |
षट्ि ंश शतं को े चतुःष ं च मूधिन ||२०||
शाखासु षोडश िसराः को े ाि ंशदेव तु |
प ाश ुण ो म ाः [३] प रकीितताः ||२१||
ंि ी ि ि ी
सु ुतसिहता शारीर थानम् - ७. िसरावणिवभ शारीरम् 19‐21

Precise time for Raktamokshana
Precise time for Raktamokshana
• Pitta Dosha provoked and vitiate Rakta in the tta os a p o o ed a d t ate a ta t e
Sharad (autumn) season, So the autumn is best
for Rakta Mokshana
• Sushruta has further specified that blood‐letting
should be performed on a patient not in an
t l h t ldextremely hot or cold seasons
• Conditional timings for Raktamokshana –
I i b t i l k– a. In rainy season, but in clear sky
– b. In summer season, but in cool time
– c In Hemant Ritu (autumn) but in the noonc. In Hemant Ritu (autumn), but in the noon.

Sathish HS et al / Int. J. Res. Ayurveda Pharm. 4(5), Sep – Oct 2013
• In India, 143 research works are reported
• from various Ayurvedic Institutions. Majority of research works
were on Vicharchika (Eczema) (30 works) followed by Vrana (8
works). 75 research works were reported on Leech application,
followed by 28 works on (Sira Vedhana) venesectionfollowed by 28 works on (Sira Vedhana) venesection
• Raktamokshana (Bloodletting ), a parasurgical procedure removes
vitiated doshas
• As prophylactic (Blood Donation) measure if a person regularlyAs prophylactic (Blood Donation) measure if a person regularly
undergoes bloodletting therapy will not get afflicted by Shopha,
Twak dosha, Visarpa, Granthi etc disorders.

R. Vidyanath et al / IJRAP 2011, 2 (1)
• There are 19 conditions told in Vangasena for Rakta mokshana
• 1. Arshas ‐ Siravedhana, Jaloukavacharana (30, 76, 313)
• 2. Daha ‐ Siravedhana of the vein named Rohini (19)
• 3. Unmada ‐ Siravedhana (42)
4 Plih d V B h M dh Si dh (129)• 4. Plihodara‐ Vama Bahu Madhya Siravedhana (129)
• Yakritodara Dakshina Bahu Madhya Siravedhana (221)
• 5. Vatavyadhi ‐ Siravedhana (579), Sringavacharana (90)5. Vatavyadhi Siravedhana (579), Sringavacharana (90)
• 6. Vatarakta ‐ Pracchana (23) Sringi (22), Alabu prayoga (22),
• 7. Andavriddhi = Jaloukavacharana (16,29), Siravedhana – above
the temporal region at the end of the ear (33)

Vangasena … ctd
g
• 8. Gandamala: Siravedhana on the lower surface of the
tongue 12 veins are present. Among those, the 2
prominent, black ones should be incised slowly with
Kusa patra Sastra by holding the tongue with Badisa
Yantra. After the blood is drained apply the paste ofYantra. After the blood is drained apply the paste of
Guda and Ardraka on the wound. Kuluttha Yusha and
other Anabhishyandi substances are wholesome during
the treatment (22 23)the treatment. (22, 23)
• 9. Galaganda ‐ Siravedhana ‐ 3 veins located nearer to
the outer joint of both ears (22)j ( )
• 10. Grandhi: Jaloukavacharana (13)
• 11. Arbuda: Pracchana (10) Sringavacharana (12)

Vangasena … ctd
g
• 12. Slipada ‐ Siravedhana ‐ Incise the vein below the
ankle in Pittaja Slipada (12) &Incise the vein in the
thumb in Kaphaja Slipada (14)thumb in Kaphaja Slipada (14)
• 13. Vidradhi ‐ Jaloukavacharana (28) Siravedhana (40)
• 14. Agantuja Vrana ‐ Sringavacharana (35)g j g ( )
• 15. Upadamsa ‐ Siravedhana (8)
• 16. Kushta ‐ Pracchana, Sringa, Alabu,
Jaloukavacharana Siravedhana (48)Jaloukavacharana, Siravedhana (48)
• 17. Padadari ‐ Siravedhana ‐ Vein traversing the sole of
the foot should be punctured (81)
• 18. Balaroga ‐ Jaloukavacharana (113,117)
• 19. Visha roga ‐ Raktamokshana (40)

Leech therapy
Leech therapy
• Jaluka is aquatic sucking animal q g
• They are two varieties –
– 6 Savisha (Krushna, Karbura, Alagarda, Indrayudha,
S d ik G h d )Samudrika, Gochandana)
– 6 Nirvisha (Kapila, Pingala, Shankhumukhi, Mooshika,
Pundarikamukhi, Savarika)
• They are cultured/harvested in pots and water is
changed in every 3 days and pots are changed in
every 7 daysevery 7 days
े ािण हणं जातीः पोषणं सावचारणम् |
जलौकसां च यो वेि त ा ान् स जये दान् ||२४||
ंि ौ ी
सु ुतसंिहता सू थानम् - १३. जलौकावचारणीया ायः

• Itrat M, Zarnigar,
Haque N. Historical
aspects of leech
therapy: a critical
review. Int J Health
Sci Res. 2013;3(7):78‐
83.

Leach Application method
Leach Application method
• Make a small puncture at the sitep
• Apply leach on the area
• Keep cold cloth over leach
• When pain and itching is observed by patient, we
anticipate the leach is sucking the good blood
R th l h b l i i dh l• Remove the leach by applying saindhava lavana
• Cover Jaluka with rice and apply oil /salt or
turmeric before squeezing the leach for vomitingturmeric before squeezing the leach for vomiting
• Once the blood is vomited place the leach in to a
water container

Wound care after Leach application
Wound care after Leach application
• When bleeding stops apply cold water orWhen bleeding stops apply cold water or
honey.
• Kashaya Madhura Snigdha Sheeta pralepa is• Kashaya, Madhura, Snigdha, Sheeta pralepa is
applied over the leach wound.
A l b d h i• Apply bandage over the site.

Leach history
Leach history
• Sushruta was the first person to contribute an exclusive
chapter and farming on Jaluka in 2nd BC
• Leech can ingest an amount of blood close to that of
eight times of their own weight.eight times of their own weight.
• The leeches can be primarily found in the freshwater
lakes, ponds or rivers ranging from 5cm to nearly 25
cmcm.
• Varying sources date the leech to 2500 years ago, when
it was used for bloodletting in ancient Egypt.
• In India Jaluka usage is documented between 500 BC
and 200 AD by the name of “Jalaukavacharan” in
Ayurveda i.e. Hirudotherapyy py

Leach history
Leach history
• Leeching reached the height of its popularity in the middle
19th century, when it was exposed by the French physicians
Francois Broussais (1722‐1838).
• A record of 57 millions leeches was used in 1854. Between
the years of 1829 and 1836, five to six millions leeches
were used annually in the hospitals of Paris.
• Broussais treated diseases such as typhoid fever, Syphilis,
T.B, and even mental illness by applying leeches to
abdomen.
• He continue to discuss the use of leeches as treatment for
myocarditis, peritonitis, pleuritis, hepatitis, gastritis,
tonsillitis, nephritis, pneumonia, whopping cough,
dysentery, hemorrhoids, acne and pimples.

Leach history
Leach history
• The leeches was brought back into the medical g
domain in the middle of the 20th century, its use
was called as hirudotherapy.
• The main reason why leeches are employed in• The main reason why leeches are employed in
microsurgeries is to reduce venous congestion.
• Venous congestion may lead to edema, capillaryVenous congestion may lead to edema, capillary
and arterial slowing, arterial thrombosis, flap
ischemia and eventual necrosis.
I 1983 H d l d h• In 1983, Handerson et al. reported a case where
leeches were used in the post operative
treatment of a scalp avulsion case. p

Scientometric analysis of medicinal leech therapy
S¸ enel E et al., Scientometric analysis of medicinal leech therapy, J Ayurveda Integr Med,
https://doi.org/10.1016/j.jaim.2018.11.006

Leach Saliva
Leach Saliva
• In a study, the hirudin was tested for thrombin
inhibition in synovial inflammation in Antigen
I d d A th iti (AIA)Induced Arthritis (AIA).
• The intra‐articular fibrin staining was reduced by
hirudin treatment.hirudin treatment.

Salivary Gland Secretions of Leech
Salivary Gland Secretions of Leech
• Hirudin: An active principle in the salivary gland secretion
of leeches, which acts as a potent anticoagulant (blood
thinner). It inhibits blood coagulation by binding to
thrombin
• Hyaluronidase (spreading factor): Facilitates the
penetration and diffusion of pharmacologically active
substances into the tissues, especially in joint pain and has
tibi ti tiantibiotic properties
• Calin: Inhibits blood coagulation by blocking the binding of
the Von Willebrand factor to collagen. It inhibits collagen‐
di t d l t l t ti [16 19]mediated platelet aggregation [16,19].
• Destabilase: Dissolves fibrin and has thrombolytic effects.

• Hirustasin Inhibits kallikrein tr psin
• Hirustasin: Inhibits kallikrein, trypsin,
chymotrypsin, and neutropholic cathepsin G
[21,22].
• Bdellins: Anti‐inflammatory effect and inhibits
trypsin, plasmin and acrocin [15].
Chl P ibi i [23]• Chloromycetyn: Potent antibiotic [23].
• Tryptase inhibitor: Inhibits proteolytic enzyme
• Eglins: Anti inflammatory They inhibit the• Eglins: Anti‐inflammatory. They inhibit the
activity of alphachymotrypsin, chymase,
substilisin, elastase, and cathepsin G
• Anesthetic‐like substances: Reduce pain during
biting by a leech

• Factor Xa inhibitor: Inhibits the activity of coagulation factor
• Factor Xa inhibitor: Inhibits the activity of coagulation factor
Xa (very important role during the treatment of Osteo‐
arthritis and Rheumatoid arthritis)
• Histamine‐like substances: A vasodilator increases the
inflow of blood at the bite site
• Complement inhibitors: Replace natural complement
inhibitors if they are deficient.
• Carboxy‐peptidase‐A inhibitors: Increase the inflow of blood• Carboxy‐peptidase‐A inhibitors: Increase the inflow of blood
• Acetylcholine: Vasodilator
• Collagenase: Reduces collagen
LEECH THERAPY: COHERENT REVIEW OF HISTORY, FUNCTIONAL COMPONENTS IN SALIVA AND
THERAPEUTIC APPLICATIONS IN SURGICAL DISEASES
Collagenase: Reduces collagen
Sheetal G. Asutkar et.al., INDIAN JOURNAL OF APPLIED RESEARCH, Volume‐9 | Issue‐4 | April‐2019 |6‐9

The saliva of leech contains
The saliva of leech contains
• Anesthetic ‐ which makes the bite of the leech
painless to its host;
• histamine like vasodilator which increases the blood
flow to the feeding areas by increasing the diameter offlow to the feeding areas by increasing the diameter of
the blood vessels; and a
• Hyaluronidase a chemical enzyme, which facilitates the
degradation of the connective tissues around the bitedegradation of the connective tissues around the bite
site allowing the vasodilator substance, wider access to
the area.
Th i l i l Hi di hi h i• There is also an anticoagulant Hirudin, which is
responsible for inhibiting blood coagulation and is
employed as an anticoagulant

Sunil G. Ilag et.al, Recent Updates in Leech Therapy, ADJIM, July ‐ Sept 2018; Vol. 3 Issue 3, 26‐30

Leach Farming
Leach Farming
• Leeches breeds once during an
annual season in the month ofannual season in the month of
March‐ April
• Soil is provided as mud inside the
pots The inner planter having thepots. The inner planter having the
capacity of 2 liter.
• The pH of pure water is 7 (25 0C) being neither an acid nor
a base.
• water TDS – 1396 (av.)
• water pH‐ 9 (av.)
• Water specific gravity – 1011(av.),
N f N l d f h
• Nature of water – Natural ground water, fresh water

Evaluation of organisms present in the gut of Hirudinaria granulosa or Indian cattle
g p g g
leech used for the purpose of Hirudotherapy (Jalukavacharana) in Ayurveda – A
Metagenomic study
Rajneesh V. Giri, J Ayurveda Integr Med Sci 2018;6:56-61.
• One survey on circulatory obstruction analyzed 277 case
reports to quantify the efficacy of leech therapy and found
that 78% of the cases resulted in successthat 78% of the cases resulted in success
• The presence of phylum Proteobacteria in GB5, GB9, LB5,
LB14 organisms has been identified in the gut of leech. g g
• GB5 and GB9 samples showed presence of species
belonging to Aeromonadaceae family.
• these organisms can be neutralized by adopting the
Poorvakarma of keeping leeches in Haridra before
JalukavacharanaJalukavacharana

Siravyadha
Siravyadha
• Venesection or phlebotomy is the surgicalVenesection or phlebotomy is the surgical
opening or puncture of a vein in order to
withdraw blood, to introduce a fluid, or , ,
(historically) when letting blood
• Siravyedha: Charaka explained Siravyedha at theSiravyedha: Charaka explained Siravyedha at the
site of AntaraKandara‐Gulpha (C.Chi.28/101).
• Acharya Sushruta and Vagbhatta indicatedAcharya Sushruta and Vagbhatta indicated
Siravyedha four Angula above and four Angula
below at the site of knee joint.j

Size of puncture
Size of puncture
• The size should be that of 1 Vrihi or half barley
• In muscular areas, it should be the size of yava.
• The puncture should be …
– Ruju = straight, Sukshma = minute, sama = equal,
Anavagadha = not deep, anuttana = not superficial,
avoiding the Marma Nadi Snayu & Sandhiavoiding the Marma, Nadi, Snayu & Sandhi
सु ुतसंिहता सू थानम् - १४. शोिणतवणनीया ायः
श िव ावणं ि िवधं- ानं [१] , िसरा धनं च ||२५||
त , ऋ स ीण सू ं सममनवगाढमनु ानमाशु [१] च श ं पातये मिसरा ायुस ी
ं ि
ना चानुपघाित ||२६||

Quantity of Rakta Visravana
Quantity of Rakta Visravana
• A Prastha (approximate 54 tola) measureA Prastha (approximate 54 tola) measure
seemed to be sufficient for a strong and adult
patient
• Dalhana said that one Prastha is equal to 13
Pala for bloodletting.
– Uttam(maximum) one Prastha,
– Madhyama(medium) half of the Prastha
– Adham(minimum) one‐fourth of the Prastha
(Kudava)

Remedy for Atipravritti of Blood
Remedy for Atipravritti of Blood
• 1) Sandhana (process by contracting the affected part): The
drugs of astringent are possessed of the property of bringing
about an adhesion of the wound i.e. Sandhana.
• 2) Skandana (thickening or congealing the local blood):
Cooling measure such as application of ice spray of cold waterCooling measure such as application of ice, spray of cold water
etc. tend to thicken the local blood, i.e. Skandana.
• 3) Pachana (process of setting up suppuration in the wound):
Alkalis and Alkaline preparations produce suppuration in such a
wound called as Pachana.
• 4) Dahana (process of cauterization): Cauterization has the• 4) Dahana (process of cauterization): Cauterization has the
property of contracting a vein.
चतिवधं यदेत िधर िनवारणम | स ानं नं चैव पाचनं दहनं तथा ||३९||
चतुिवध यदत िधर िनवारणम् | स ान न चव पाचन दहन तथा ||३९||
णं कषायः स े र ं यते िहमम् | तथा स ाचये दाहः स ोचयेत् िसराः ||४०||

Cupping therapy
Cupping therapy
• Wet and dry Cupping therapy since 400 BC for
treatment of headaches, lack of appetite, indigestion,
fainting, abscess evacuation, narcolepsy, etc observed.fainting, abscess evacuation, narcolepsy, etc observed.
• There is a mention of Cupping in the famous Egyptian
Papyrus Ebers (1550 BC)
• There are 10 types of different cupping methods viz.
Dry Cupping– weak/light cupping,
– medium cupping,
– strong cupping,
– moving cupping,
– needle cupping,
– moxa/hot needle cupping,
empty/flash cupping
Wet Cupping
– empty/flash cupping,
– full/bleeding cupping,
– Herbal cupping, and
– water cupping
Wet Cuppingwater cupping.

Different Types of Cupping Sets
Different Types of Cupping Sets

5 step Wet cupping treatment procedure
5 step Wet cupping treatment procedure
• Primary sucking: cup was placed on the selected site y g p p
and the air inside the cup rarified via manual suction.
The cup clings to the skin and was left for a period of 5
minmin.
• Scarification: multiple superficial incisions are given
• Bloodletting: cup was placed until it is filled with bloodBloodletting: cup was placed until it is filled with blood
from the capillary vessels.
• Removal: The cup was removed after 3 ‐ 5 min or as
the blood oozing stops
• Dressing: Local dressing is done with aseptic antiseptic
measuresmeasures

CUPPING THERAPY POINTS
CUPPING THERAPY POINTS

Dry Cupping application
Dry Cupping application
Method ‐1
Creating vacuum through heat
Method ‐2
Creating vacuum through PressureCreating vacuum through heat Creating vacuum through Pressure

Evaluation of the Effects
of Traditional Cupping
on the Biochemical,
Hematological and
Immunological FactorsImmunological Factors
of Human Venous Blood
A Compendium of Essays
on Alternative Therapyon Alternative Therapy
by Mohammad Reza
Vaez Mahdavi, Shahed
University, Irany,

Mechanism of Cupping therapy
Mechanism of Cupping therapy
• Cupping is thought
to act mainly by
increasing local
blood circulation
d li i thand relieving the
painful muscle
tension by
generatinggenerating
vacuum by
mechanical
withdrawal orwithdrawal or
thermal cooling of
the entrapped air
under the cup.
p

Cupping Adverse events
Cupping Adverse events
Related to site Generalized
• Scar formations
• Burns
• Headache
• Pruritus
• muscle tension
• Bullae formation
• Dizziness
• Tiredness
• Small hematoma
• Pain at cupping site
• Anemia
• Nausea
• Abscess formation
• Skin infection
• Insomnia ,
• Vasovagal attack
• Hyper pigmentation
Vasovagal attack

Researches ExperiencesResearches Experiences
in
Skin & Hair

A Clinical Study of Jalaukavacharana in Varicose Eczema (Vicharchika)
y ( )
Dr. Vinayak A. Mali, Journal of Ayurveda and Integrated Medical Sciences | May ‐ June 2018 | Vol. 3 | Issue 3
• 30 patients with varicose eczema 30 pat e ts t a cose ec e a
(Vicharchika) in 2 groups – (A)
Jalaukavacharana (4 sittings at 7 days
l) h l dinterval) with internal medication &
(B) only medicine (Kaishoraguggulu
1tds Arogyavardini rasa 1tds1tds, Arogyavardini rasa 1tds,
Manjistadikashaya 4 tsp bd)
• Overall study showed thatOverall study showed that
Jalaukavacharana was clinically and
statistically effective

Indian Journal of Ancient Medicine and Yoga (IJAMY) 2009, 2(3): 165‐174
• Total 54 patients in which Raktamokshana by Jalauka (34) and Siravyadha• Total 54 patients, in which Raktamokshana by Jalauka (34) and Siravyadha
(20) patients.
• Jalauka had 82.35 % cure rate where as Siravyadha brings 70% cure rate.
J l k / Si dh b li d i h t l t f th b d i l di• Jalauka / Siravyadha can be applied in each external part of the body including
the vital part (Marma) and also in aged, debilitated patients. It can taken out
easily even deep seated impure blood
J l k li d t th it f l i ft l i d f ilk bl d• Jaluka applied at the site of lesion after applying drop of milk or blood.
• In Siravyadha tourniquet - Punctured with 16 no. wide bore needle -tourniquet
was released - ooze for 5 minutes – needle withdrawn and Dressing was done
ith h t dh t h itwith shatadhauta ghrita
• Hb% increased in both groups & ESR and TLC reduced in both groups
• An extra ordinary close observation of 80 patients of blood donor (average 5
times) revealed that they were free from skin disorders.

Sonaje Manoj et al / IJRAP 2011, 2 (6) 1659‐1663
• Out of 75 patients; in Group A (Jalaukavacharana) 37, and
Group B (Siravyadha) 38 patients were regi
• Modality Jalaukavacharana & Siravyadha were done One
sitting per week for 4 weeks after localized external oil
massage and steam sudation at affected part before
procedure.
• In group A the pacification of the symptoms was statistically
similar to Group B but percentage change showed better
results in group A.
• In the management of Vicharchika but Siravyadha found most
efficient with least complications in comparison with
Jalukavacharana

International Journal of Ayurvedic and Herbal Medicine 6:6 (2016) 2402 –2407
• 38 yr Male Atopic dermatitis patient with
symptoms – Kandu,Twakdaran & Daha since 1 y p ,
month got applied Jalauka for consecutive 4
weeks
• Jalaukavacharana shows improvement in skin
texture luster decrease in lesion size & relieftexture ,luster, decrease in lesion size & relief
in itching

www.wjpr.net Vol 6, Issue 8, 2017. 941 ‐959 *** www.wjpr.net Vol 6, Issue 6, 2017. 1307 ‐1321
• Siravedha karma will be find effective in the
symptoms of Vicharchika and also in holistic
health effect.
• No data of disease concern
• After Siravedha vitiated Kapha Vata, Pitta get
expelled out it leads to reduce in Raja and Tama
Guna of Mana it means Indriya Shudhhi andGuna of Mana it means Indriya Shudhhi and
Mana Prasadana resulted after Siravedh karma
(Raktmokshana). [doubtful](Raktmokshana). [doubtful]

Comparative assessment of Jalaukavacharana (Leech Application) and
( )
Shringavacharana (Horn Application) in Vicharchika
Manoj L. Sonaje1, Dhiman K. S2, Bhuyan C3, Gupta S. K4, Dudhamal T. S5
International Journal of Ayurvedic Medicine, 2011, 2(4), 220‐232
O t f 62 ti t 30 J l k• Out of 62 patients; 30 Jalauka
acharana, 32 Shringavacharana
patients were treated
• Both sittings were at 7 days interval
for 4 weeks
• Jaluka reduced Kandu, Vaivarnyata,Jaluka reduced Kandu, Vaivarnyata,
Raji, Rukshata, Size of patches,
Pidaka relived and show significant p
value <0.001value <0.001
• Srunga pacification reduced all
cardinal symptoms and notify HS
with p value <0 001with p value <0.001.

Role of Raktamokshana by Jalaukavacharana and Siravedhana in the
y
management of Vicharchika (Eczema)
Hiren N. Rava and A. B. Thakar (Ayu. 2012 Jan‐Mar; 33(1): 68–72.)
• 29 patients of Vicharchika (eczema) were distributed in 229 patients of Vicharchika (eczema) were distributed in 2
groups – Jalaukavacharana (4 sittings in 30days) &
Siravedhana (2 sittings in 30 days)
• At Siravedhana the blood drawn is standardized with water• At Siravedhana, the blood drawn is standardized with water
measured by patient's Anjali (63.75 ml aprox).
• Number of Jalauka applied was decided on the basis of the
size of lesion (example 1 cm = 1 leech)size of lesion (example, 1 cm = 1 leech).
• No patient was completely cured

To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in
To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in
Vicharchika w.s.r. to Eczema
Kulkarni Sharad, Syeda Ather Fathima, Naveen BS
Journal of Ayurveda and Integrated Medical Sciences | July ‐ Aug 2017 | Vol. 2 | Issue 4
• 40 patients in 2 groups, Jalauka followed by
Khadira Kashaya Parisheka and Paana (30 ml)
das one group and only Jalauka in 2nd group
• Jalaukavacharana followed by Khadira
prayoga fared better results than
Jalaukavacharana alone in the management
of Vicharchika (eczema)

EFFICACY OF JALAUKAVACHARANA IN VISARPA W.S.R TO HERPES ZOSTER – AN
OBSERVATIONAL STUDY
Dr. P. N. Shilpa and Dr. T. D. Ksheerasagar
World Journal of Pharmaceutical Research, Volume 7, Issue 14, 800‐813.
• 40 Patients of Visarpa were subjected for
Raktamokshana using Jalouka for 15 days.
• Jaloukavacharana has a vital role in the
t ti li f f h l d id th f tsymptomatic relief of shoola and aids the faster
healing of lesions.
• Post Herpetic neuralgia can be prevented by early
interventionintervention

Role of Pracchana in Indralupa
Role of Pracchana in Indralupa
Mahesh P. Savalagimath*, Shweta S. Mumbaraddi**, Manohar S. Sarangi**
• A female patient of 35 yrs age complained Patchy hair p y g p y
loss since 1 year. Associated with acidity and hair fall.
• Advised for Pracchanna and Scalpel pricks are made
th ff t d lover the affected scalp area
• Triphala choorna 1tsf at bed time
• Haridra (30gm)+ Vidanga(20gm) + Amalaki• Haridra (30gm)+ Vidanga(20gm) + Amalaki
Choorna(30gm) ½ stf tid B/F with Jaggery Asaneladi
taila – for external application on Scalp.
• Guduchi choorna (60gm)+ Mustha choorna
(30gms)+Amalaki choorna (40gms) – 1tsf BD A/F and
continuedcontinued.

Role of
Pracchana in
Indralupa
Mahesh P.
Savalagimath*,
Shweta S.
M b ddi**Mumbaraddi**,
Manohar S.
Sarangi**

MANAGEMENT OF INDRALUPTA WITH LOCAL PRACHCHHANA AND
APPLICATION OF ARAGVADHADI LEPA: A SINGLE CASE STUDY
Nileshkumar Chabhadiya et.al.
World Journal of Pharmaceutical Research , Vol 6, Issue 05, 2017. 1 5 3 3 ‐1538
• 25 year female patient with bald
spot on scalp since 2 monthsspot on scalp since 2 months
• Prachchhana at an interval of 15
days 3 times done and Aragvadhadidays 3 times done and Aragvadhadi
lepa application done daily.
• Local Aragvadhadi lep applicationLocal Aragvadhadi lep application
with Prachchhana in indralupta
helps to re‐growth of hair

MANAGEMENT OF INDRALUPTA ‐ A CASE STUDY.
G O U C S S U
Snehal A. Ingle, Minal Khode1, Ashish A. Thatere, Jayant D. Gulhane, Prakash R. Kabra
World Journal of Pharmaceutical Research, Vol 6, Issue 8, 2017. 2104‐2110
• Female aging 50 yrs with• Female aging 50 yrs with
Indralupta since 1 year
K/c/o HTN
J l k li d i 2• Jalauka was applied in 2
sittings at an intervel of 7
days followed by local
li ti f J l iapplication of Jaypal in
Dhanyak Svaras for seven
days and later advised to
G t i N ik l T iluse Gomutra in Narikel Tail
• Enthusiastic results were
achieved within two months

Management of Alopecia by bloodletting and certain
g p y g
Ayurveda medicine: A case study
by Nirmal Bhusal, Gopesh Mangal, Journal of Ayurvedic and Herbal Medicine 2017; 3(3): 108‐110
• A male patient aged 23 years with
complaint of excessive hair fall more
than 150 hairs in a day resulting in
b ld i f h d d d ff dbaldness in forehead, dandruff and
Itching all over head was managed by
Abhyanga with Dhurdhurpatradi Taila
followed by modified bloodlettingfollowed by modified bloodletting
technique
• Fine 26 × ½ (0.45× 13 mm) number
insulin needle was taken and fineinsulin needle was taken and fine
superficial pricking was done to let the
blood ooze out from the area. The whole
targeted area was prickedtargeted area was pricked.

A STUDY ON EFFICACY OF PRACHANNA AND BHRINGARAJA LEPA IN THE
MANAGEMENT OF KHALITYA (HAIRFALL)
Bhavya B M, IAMJ (Dec, 2016‐ Jan, 2017) 1(2) 166‐174
• 60 patients with the classical p
features of khalitya in 2
groups only prachanna as 1st
group and prachannagroup and prachanna
followed by Bhringarajalepa
in 2nd group.
• 8 sittings in 60 days at an
interval of 7 days
• Prachanna with Lepa is more• Prachanna with Lepa is more
effective than Prachanna
alone

A Case Study of Leech Therapy (Jalaukavacharana) in Khalitya
W.S.R. Alopecia
Yadav CR* and Guguloth R
International Journal of Pharmacognosy and Chinese Medicine, Volume 1 Issue 3 , 1‐4International Journal of Pharmacognosy and Chinese Medicine, Volume 1 Issue 3 , 1 4
• A 28 yrs old female, with complaints of hair
fall, thinning of hairs with recession of
hairline in temporal and frontal regionhairline in temporal and frontal region,
dandruff, itching scalp, and roughness since 6
yrs
• Two leeches are applied over to fronto• Two leeches are applied over to fronto‐
temporal region of both sides at the intervel
of 15 days for 5 times.
• Oral administration of drug was Saptamrita• Oral administration of drug was Saptamrita
Loha, Manjista Churna, Bringaraja Churna,
Nimbhadi Churna, Abhraloha and
Asthiposhaka VatiAsthiposhaka Vati.

EFFECT OF AYURVEDIC SHAMAN (PACIFICATION) & SHODHAN (PURIFICATION) TREATMENT IN
( )
ACNE VULGARIS GRADE III (MUKHADUSHIKA) ‐ A CASE STUDY
Lad Meenal et.al. World Journal of Pharmaceutical Research, Volume 5, Issue 4, 841‐850.
• 23 years female painful, burning 3 yea s e a e pa u , bu g
and nodular diagnosed as acne
applied Jalauka locally once in 7
d f ddays for 21 days.
• Medication ‐ Arogyavardhini‐ 2 BD,
Ji i Sh di ti 2 BDJingi ‐ Sharadi vati – 2 BD,
Chandraprabha vati‐ 2 BD,
Paripathadi kwath‐ 10ml in theParipathadi kwath 10ml in the
morning, and Gandharva haritaki‐ 1
Tsf BT given

EFFICACY OF JALUKAVACHARANA IN THE MANAGEMENT OF
YUVANAPIDAKA W.S.R. TO ACNE VULGARIS‐ A PILOT STUDY
Kumarvipin Et Al: www.iamj.in IAMJ: Volume 4; Issue 10; October‐ 2016, 2933‐2938
• 15 patients of acne applied with jaluka• 15 patients of acne applied with jaluka
• Jalaukavacharana alone is very significant in relieving the
associated complaints like Kandu, Daha and Vedana etcp

inin
Musculoskeletal Care

Ayu. 2014 Jul‐Sep; 35(3): 270–276.
doi: 10 4103/0974 8520 153743: 10 4103/0974 8520 153743doi: 10.4103/0974‐8520.153743: 10.4103/0974‐8520.153743
• Out of 30 patients, 19 treated by Agnikarma in and
Siravedha in 11 patients for Gridhrasi
• Siravedha with no. 20 disposable scalp vein set drawn a
volume of 30‐60 ml at 4 Angula below Janu Sandhi
(Knee joint) at 7 days interval for 4 times.( j ) y
• 68.42% patients showed marked improvement and
21.05% had complete relief after Agnikarma.
• In Siravedha 72 73% patients had moderate• In Siravedha, 72.73% patients had moderate
improvement whereas 27.27% patient had marked
improvement.

http://www ayurlog com Volume 6th | Issue: 3rd April 2018http://www.ayurlog.com Volume 6th | Issue: 3rd April 2018
• At selected area superficially 4– 5 incisions
were given with 22 number surgical blade andwere given with 22 number surgical blade and
the glass cups were placed. Creating vacume
the blood was drawn till the blood flow stops p
and blood clots.
• Cupping imparts measurable reduction in the pp g p
intensity of Ruja, Toda, and Stambha which
are the major symptoms of Gridhrasi.

Management of gridhrasi (sciatica) with agnikarma
g g ( ) g
and raktamokshana: A review
Brijesh R Mishra et.al, International Journal of Research in Indian Medicine, January‐ March 2019 | Vol. 03rd | Issue:1st, 1‐5
• Agnikarma and Siravedhana are considered as
instant healer of pain. The sites are ‐f p
–Charaka : Antara Kandara Gulpha
Harita : Four angula above the gulpha in–Harita : Four angula above the gulpha in
tiryak gati
Ch k d P d k i h hik A li (–Chakradatta : Pada kanishthika Anguli (
little toe of the affected leg)

Pain management in Gridhrasi through Ayurveda ‐An
g g y
Observational Study
Dr. Rangarajan B, Journal of Ayurveda and Integrated Medical Sciences | July ‐ Aug 2018 | Vol. 3 | Issue 4, 40‐
43
• 10 patients diagnosed as• 10 patients diagnosed as
Gridhrasi presenting with
severe pain unilateral or p
bilateral given Siravedhana with
20 no scalp vein set and fixed
ll k dhtill Samyak Siravyadha
Lakshanas appeared.
Si dh i ff ti i th• Siravydha is effective in the
management of pain in
Gridhrasi.Gridhrasi.

Critical analysis of Siravyadhana in pain management of
Raktavrutavataja Gridhrasi – A Case Study
Yadu Gopan et.al. Journal of Ayurveda and Integrated Medical Sciences | Mar ‐ Apr 2018 | Vol. 3 | Issue 2, 105‐108
• 40 year old male complaints of pain in40 year old male complaints of pain in
low back radiating to right leg till right
foot since 3 months diagnosed as
Grudhrasi.Grudhrasi.
• Sarvanga Abhyanga with Nirgundi Taila
and Bashpa Sweda, Snigdha Yavagu
Pana with 200 ml Sthanika AbhyangaPana with 200 ml, Sthanika Abhyanga
and Swedana for 10 mins and
Siravyadhana with at dorsum of foot
for 10 mins till the bleedings stoppedfor 10 mins till the bleedings stopped
by itself and almost 25ml of venous
blood has been drawn.

Ayu. 2016 Jan‐Mar; 37(1): 26–31. PMCID: PMC5541463
• Ghatiyantra (cupping)
Raktamokshana was done on Sphik
(gluteal region) or Kati (low back)(gluteal region) or Kati (low back)
region with the help of 18 no.
needle and Ghatiyantra
(K h t ) i f tti(Kanchapatra) in four settings

Effect of Cupping Therapy in Gridhrasi (Sciatica)
Effect of Cupping Therapy in Gridhrasi (Sciatica)
Durgesh Nandini, Tukaram Dudhamal, Indian Journal of Ancient Medicine and Yoga, Volume 9
Number 3, July ‐ September 2016, 115‐118
• 44 years‐old female with low back y
pain radiating to left leg, severe
morning stiffness, burning
sensation in left foot reducedsensation in left foot, reduced
appetite since 7 years
• Wet cupping was done in two pp g
sittings at 15 days interval
• Pain was decreased more efficiently
• Study concluded that sciatic pain
can be managed with cupping
therapytherapy

Modified Raktamokshna as Chinese cupping therapy in acute
pain management of Lumbar spondylosis ‐ A Rare Case Report
Madhuri Rai, Tukaram Dudhamal, Int. J. of AYUSH Case Reports April‐June 2018; 2(2)
• 54 years Male having sever low back
pain which radiating in to both legs
since 1 year with painful restricted
movement of lumbar joints
• Raktamokshana by wet type of
Chinese cupping therapy in 2 sittingsChinese cupping therapy in 2 sittings
at 15 days interval is done
• Raktamokshana by Chinese cupping is
an office procedure effective simplean office procedure, effective, simple,
and safe for pain management of
patients having lumbar spondylosis

The Cumulative anti‐inflammatory effect of bloodletting by Leech
(J ll k h ) i i f A h i i (A ) i fl
(Jallaukavacharana) in patients of Arthritis (Aamvata) w. s. r. inflammatory
markers‐a Research Realm
Sheetal G. Asutkar, Subhashchandra Varshney
International Journal of Research in Indian Medicine June 2018 | Vol 02 | Issue :5th pp 1‐17International Journal of Research in Indian Medicine, June 2018 | Vol. 02 | Issue :5 , pp 1 17
• For 30 patients application of Leeches were done
alternate day for 20 days. y y
• 15 had knee joints involved, 8 had ankle joints
involved, 4 patients had wrist joint involved, 2 patients
h d lb j i t i l thad elbow joint involvement.
• CRP was found to reduce by 5 mg to 10mg as average
in 30 patients after raktamokshana by leechin 30 patients after raktamokshana by leech
• The mean percentage relief in pain is found to be
69.99%.

Case Study of Frequent Leech application in Diabetes mellitus
with special reference to Frozen Shoulder.
Chetan Agrawal, Rashmi Kale
Ayurlog: National Journal of Research in Ayurved Science Volume 6th | Issue: 2nd March 2018y g y |
• A female aged 60 years K/C/O
DM diagnosed as frozenDM, diagnosed as frozen
shoulder.
L h li ti d d• Leech application decreased
pain and increased range of
h ld j i t tishoulder joint motion

MANAGEMENT OF JANU SANDHISHULA BY RAKTAMOKSHANA THROUGH
JALAUKAVACHARANA
Kad Ujwala Vilas et.al., World Journal of Pharmaceutical Research, Volume 8, Issue 5, 992‐995.
• Total 7 Jalauka applied all around on VamaTotal 7 Jalauka applied all around on Vama
Janu sandhi in 3 sittings at the interval of 7
days relieved inflammation and paindays relieved inflammation and pain.

Role of Leech application in Vatarakta: A pilot study
pp p y
Shashank Jha, Londhe PD
International Journal of Ayurvedic Medicine, 2014, 5(1), 129‐132
• For 10 patients of Vatarakta, Leech application is done
3 times at interval of 1 week.
• After leech application shatdhaut ghrit is used• After leech application shatdhaut ghrit is used
• Non significant in Serum Uric acid levels

Shrimali D. Jayantkumar & Vikash Bhatnagar. Journal of Biological & Scientific Opinion ∙ Volume 4 (4). 2016
• Sushruta in Padadaha Padaharsha ChippaSushruta in Padadaha, Padaharsha, Chippa,
Visarpa, Vatashonita, Vatakantaka, icharchika
and Padadari Roga Siravedhana should beand Padadari Roga Siravedhana should be
done two Angula (approx 4cm) above the
Kshipra MarmaKshipra Marma.

A Comparative Study of Siravyadha and Kokilakshadi Kshayama
in Vaatarakta W.S.R to GOUT
Mehta Chetan1,*, Bhardwaj Anil2, Bhatia Yogesh3, Tripathy B. P4 RRJoUSH (2017) 6‐10
• Siravyadha on the dorsum of hand/foot 2 AngulaSiravyadha on the dorsum of hand/foot, 2 Angula
(Fingers‐approx. 4 cm) above the kṣipramarma is
planned. Approx. 100 ml of bloodletting made in p pp f g
each sitting for 2 sittings at an interval of 15 days.
• Only 10% moderate relief was observedOnly 10% moderate relief was observed

inin
Circulatory Carey

A CASE STUDY – AYURVEDIC APPROACH IN THE MANAGEMENT
OF DEEP VEIN THROMBOSIS (DVT)
Vd. Santosh Pathak1, Vd. V. R. Sonambekar2, Vd. Pankaj Dixit3, Vd. Kanchan Padwal4
IRJIMS, Jul‐Sep 2018, Volume:1(Issue:1):61‐67 p ( )
• A female patient of 63 yrs age, complaints of Both leg
swelling, pain, & redness since 2‐3 yrs having H/O
Thromolysis diagnosed as DVT.Thromolysis diagnosed as DVT.
• 1‐2 Jalaukavacharana done at both lower limb on
alternate day for 5 times. Approximately 15‐20 ml blood
sucked by 1 Jalauka every time.sucked by 1 Jalauka every time.
• Mahamanjishthadi Kwatha 20ml, Sarivadyasava 20ml
Punarnawadi Kwatha 20ml Kaishor Guggulu 500mg
Gandhaka Rasayana 250mg Laghumalini Vasanta 250mgGandhaka Rasayana 250mg Laghumalini Vasanta 250mg
Punarnava Mandur 250mg (all twice a day For 20 days)
• Local application done with Punarnava Musta
Duruharidra Devdaru Patha & Kankshi (Alum) pasted inDuruharidra Devdaru Patha & Kankshi (Alum) pasted in
water and applied gently for 15 days

Kaur Rimpaljeet et al. Journal of Biological & Scientific Opinion ∙ Volume 3 (2). 2015
A 47 M l d l d i i th l ft l l• A 47 years Male, developed pain in the left leg. color
Doppler suggestive of Ac. hrombosis in left femoral
vein and partial recanalization of thrombus in right
f l ifemoral vein
• Vishgarbh Tail Abhyanga, Nadi Sawedana with
Rasanasaptak Kawath followed by Jalauka repeated
after every 7th day for 4 times.
• Ekangaveer Rasa 150 mg 1 Tab. BD, ∙ Mahayograjj
guggulu 325 mg 1 Tab. BD, & ∙ Maharasnaadi Kwathaguggulu 325 mg 1 Tab. BD, & Maharasnaadi Kwatha
60 ml. BD.
• Leech therapy is beneficial in reduction of pain,
swelling tenderness in the patient of DVTswelling, tenderness in the patient of DVT.

Role of Jalaukavacharan (Leech Therapy) In The
Management of Deep Vein Thrombosis
Dr. Shubhada Lonikar and Dr. Bhagyashri Tathe
Aayushi International Interdisciplinary Research Journal (AIIRJ) Vol VI Issue II FEBRUARY 2019Aayushi International Interdisciplinary Research Journal (AIIRJ) ‐ Vol ‐ VI Issue ‐ II FEBRUARY 2019
• 38 yrs male, diagnosed through color Doppler suggestive of Ac.
Thrombosis in left femoral vein and partial re‐canalization of
th b i i ht f l ithrombus in right femoral vein.
• Internal medications were Ekangaveer Rasa 150 mg 1 Tab. BD, ∙
Mahayograjjguggulu 325 mg 1 Tab. BD ∙ MaharasnaadiKwatha60 ml.
B.
• External treatment is Abhyanga with Vishgarbh Tail. Nadi Sawedana
with RasanasaptakKawathwith RasanasaptakKawath.
• Jalaukaavcharana‐ repeated after every 7th day for 4 weeks
• With the help of leech therapy we can improve the quality of life of
the DVT patients.

A CASE REPORT ON THE EFFECTIVENESS OF JALAUKAVACHARAN IN THE
MANAGEMENT OF VARICOSE VEINS
Siddhi R. Nachankar and Mukund D. Bamnikar
World Journal of Pharmaceutical Research, Volume 7, Issue 19, 898‐902.
• 55 years old female with the
complaints of muscle cramps, pain
and swelling in both legsand swelling in both legs
• Jalaukavacharan was done as shown
• Kachanar Guggul 250 mg TDS,
Triphala Guggul 250 mg TDS alongTriphala Guggul 250 mg TDS along
with Maharasnadi Kwath 40 ml BD
was given

Clinical assessment of jalaukavcharan (leech therapy) in
Management of varicose veins– a case report
Khurana Pooja et.al. IAMJ: Volume 2; Issue 2; Mar ‐ Apr 2014
• A 27 year old female had complaints of pain in both legs since one• A 27 year old female, had complaints of pain in both legs since one
year, muscle cramps in both legs, swelling over the lower legs,
unable to walk
• She got Mahayograjj Guggul 325mg 1 tab BD, Maharasnaadi Kwath
60 ml BD,
• Vishgarbh Tail for abhyang and Rasnasaptak kwath for nadi swedanVishgarbh Tail for abhyang and Rasnasaptak kwath for nadi swedan
• Jalaukaavcharana karma 4 times

Jalaukavacharan (Leech Application): Para‐Surgical Approach to Shlipada
(Fileriasis): A Pilot Study
Chatrubhuja Bhuyan et.al., Indian Journal of Ancient Medicine and Yoga, Volume 5 Number 3, July ‐ September 2012, 15‐21
• 13 patients of Shlipada got leech• 13 patients of Shlipada got leech
application for 20 sittings in 6 weeks in 2
groups
1st (it hi littl d• 1st group (itching, little redness,
inflammation; non pitting oedema)
patients reduced local inflammation after
3 4 itti B t ti i 10 t3‐4 sitting. Become asymptomatic in 10 to
15 sittings.
• 2nd group (residual hard swelling, g p ( g
Hrariness, nodules occurred on the
lesions) got 40% relief in even 20 sitting
within 6 weeks.

inin
Ulcer & Ano‐rectal care

Int. J. Ayur. Pharma Research, 2015;3(2):60‐65
• Leeches activated in Haridra water for 15 – 20 minutes before
application.
• In lithotomy or lateral (left or right) position of patient leach was
placed at the site of applicationplaced at the site of application.
• With the symptoms like burning, itching, pain etc; leeches were
removed by sprinkling Haridra powder or Saindhava.
• Patients were given a “T” bandagePatients were given a T bandage.
• The treatment Jalaukavacharana is more effective in reducing the
size and symptoms of thrombosed piles than surgical excision.

www.wjpr.net Vol 8, Issue 5, 2019. 1227‐ 1234
• Perianal hematoma is a small clot
occurring in the perianal subcutaneous
connective tissue, usually superficial to , y p
the corrugator’s cutis ani muscele.
• A 20 year male patient with Severe
pain Difficult in passing stool and apain, Difficult in passing stool and a
Mass felt at anal region since 2 days
• Jaluka (leech) was applied locally on
i l h tperianal hematoma
• Leech sucks the blood from the site of
application and reduces pain and
swelling.

http://www.ayurlog.com Volume 6th | Issue: 3rd April 2018
• A 42 year old male complained y p
of severe pain, discomfort and
swelling at perianal region since
3 days3 days.
• Leach applied for 30‐70 minutes
till Leech falls off from the site
than the site was cleaned with
Triphala Churna.
• The entire procedure done for 2• The entire procedure done for 2
days and repeated after 1
month for another 2 days

A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana)
A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana)
In Patients of DushtaVrana w. s. r. Chronic Non‐Healing Wound
Sheetal Asutkar, Balika Bhatbhage
International Journal of Research in Indian Medicine, Oct‐Dec 2018 | Vol. 02nd | Issue :6th p 1‐14
• 60 patients in 2 groups Control & Trial
(Jalaukavacharana) for 7 days daily followed(Jalaukavacharana) for 7 days daily followed
by Triphala kwatha dhavana once a day
• Jalauka has Capability of improving• Jalauka has Capability of improving
microcirculation
N d t id• No data or no evidences

Pain management and wound bed preparation of a chronic
non healing wound over heel by Leech Therapy‐A Case Study“
Sheetal Asutkar, Yogesh Badwe, Balika Bhatbhage
International Journal of Research in Indian Medicine, June 2018 | Vol. 02 | Issue : 04 , | |
• A 65 years female, complain wound over right
heel with unpleasant smell, Pain burning and
pricking in character and swelling aroundpricking in character and swelling around
wound since 2 months.
• Surgical wound debridement under local
anesthesia done nder antibiotic co erageanesthesia done under antibiotic coverage
• 2 jalaukas (leeches) daily were applied for 10
days
• ‘Leech therapy’ proves as a cost effective, time
saving, affordable and acceptable treatment in
wound carewound care

Management of Chronic Venous Leg Ulcer (traumatic) – A Case Report
Kulkarni Oorvi, Prashanth A.S. Management of Chronic Venous Leg Ulcer (traumatic)
– A Case Report. J Ayurveda Integr Med Sci 2016;4:152‐158
• 45yrs, male with chronic wound near
left ankle approximately between knee
and ankle swelling in the left foot,
dragging type of pain
• 42 sittings of Jaloukacharana was
carried out
• Kankayana Vati 2BD, Prabhakara Vati
2BD, Kaishora Guggulu DS 1BD, Nimbadi
Guggulu 2 TDS, Lohasava 5ml BD
• Kokilaksha Kashaya + Panchatiktakay
Kashaya + Manjishtadi Kashaya. 4tsp tid
with hot water
• Varicogel (Fagus sylvatica) ointment ext. g ( g y )

A Case Report on Siraja Granthi
A Case Report on Siraja Granthi
Shetty Kishor Kumar, Rao, Shreedhar SM, Fathima SA. A Case Report on Siraja
Granthi. J Ayurveda Integr Med Sci 2017;4:332‐336
• A 39 year old male with engorged veins overA 39 year old male with engorged veins over
right lower limb since 2 years developed
mild edema around the right ankle,
discoloration and itching for last 4 monthsdiscoloration and itching for last 4 months
• Above 2 Angula of Kshipra Marma was
cleaned and Siravyadha 4 sittings at an
interval of 7 days done with disposableinterval of 7 days done with disposable
needle no 18 to draw 200ml of blood every
time
– Patient was prepared with 120 ml of Tilap p
Yavagu before undergoing Siravyadhana.
• Sahacharadi Kashaya 15 ml Bid given
internally for 28 days.y f y

Effect of Rakthamokshana (blood letting therapy) and Sri Lankan traditional
di i i j hi ( i i ) d
medicine on Siraja Granthi (varicose veins) ‐ A case study
Wickramasingha M.M.A.I.P., Ediriweera E.R.H.S.S. Effect of Rakthamokshana (blood letting therapy) and SriLankan traditional
medicine on Siraja Granthi (varicose veins) ‐ A case study Int. J AYUSH CaRe. 2018; 2(1):6‐13.
• 35year old female patient with a 14year history35year old female patient with a 14year history
of varicose veins (Siraja Granthi) treated with
N h till 8 d d ti ll li d D• No change till 8 days and partially relieved on Day
15. Pain and heaviness in the leg and, pain in
walking were completely relieved on Day 21
walking were completely relieved on Day 21

inin
Shalakya careShalakya care

A CONCEPTUAL REVIEW OF RAKTAMOKSHANA AS AN
A CONC PTUA R VI W OF RAKTAMOKSHANA AS AN
ADJUVENT THERAPY IN NETRAROGAS
Rahul Raghunath Borade et.al. WJPR, Volume 7, Issue 12, 282‐290.
• Indications for Raktamokshana in Netraroga
– Abhishyanda, Adhimantha, Siraharsha, Sirotpata, Puyalasa,
Vatparyaya Vartmavbandh Klishtavartma BahalavartmaVatparyaya, Vartmavbandh, Klishtavartma, Bahalavartma,
Pothaki, Anyatovata, Sashofa Akshipaka, Ashofa Akshipaka,
Pittaja and Kaphaja Timira, Savrana Shukla, Anjananamika,
Pothaki Complications of Arma Pilla Roga and many morePothaki, Complications of Arma, Pilla Roga and many more
• Contra indications
– Very young, old, emaciated, exhausted, Suffering from high
fever, convulsions or unconscious patients, General
swelling of body, Wasting due to unhealthy diet, Anemia,
Piles, Pregnant women etc.

CONCEPT OF RAKTAMOKSHANA IN NETRAROGA
Jayesh R. Katrodiya et,al. WJPR, Volume 6, Issue 6, 564‐570
• Susruta considered the Raktamokshana asSusruta considered the Raktamokshana as
partial or complete treatment
• General Contra Indications for• General Contra‐Indications for
Raktamokshana (Sushruta & Vagbhata)
S h h K hi d G bhi i A h– Sarvangashopha, Kshina pandu, Garbhini, Arsha,
Shosha, Asvinna, Atisvinna, Bala, Vridhdha, Bhiru,
Dourbalya Kamala Chardi Murcha PakshaghataDourbalya, Kamala, Chardi, Murcha, Pakshaghata,
Svasa, Snehapita, Abhukta.

To study the Efficacy of Jalaukavacharan and Shadanga
g
Guggulu in Puyalasa w.s.r. to Acute Dacryocystitis
Chaudhari Devendra R. To study the Efficacy of Jalaukavacharan and Shadanga Guggulu in Puyalasa w.s.r. to
Acute Dacryocystitis. J Ayurveda Integr Med Sci 2016;4:39‐41..
• Puyalasa’ (Acute dacryocystitis) is an acute
suppurative inflammation of lacrimal sac
h i d b i f l lli i h i fcharacterized by painful swelling in the region of
sac associated with epiphora, fever and Malaise
• Group A received Jalaukavacharana (20 Patients• Group‐A received Jalaukavacharana (20 Patients
got on 1st, 3rd, 5th day) as a line of treatment,
patients of Group‐B received hadanga Guggulupatients of Group B received hadanga Guggulu
and Patients of Group‐C received both
Jalaukavacharana and Shadanga Guggula.

A REVIEW ARTICLE ON ROLE OF JALAUAKAVACHARANA AS
ADJUVANT THERAPY IN OPEN ANGLE GLAUCOM
Bhagyashri P. Mhetre et.al, ejpmr, 2017,4(03), 237‐240. gy , jp , , ( ),
• Jaluka is also helpful as adjuvant therapy in
Glaucoma.

Jalukavacharan (Leech) in (External Hordeolum)
Jalukavacharan (Leech) in (External Hordeolum)
Amol Kadu, Jalukavacharan (Leech) in Anjananamika (External Hordeolum), Joinsysmed vol 3(1), pp 44‐47
• Hordeolum or Stye (External y (
hordeolum) is common disease
manifested as lid swelling
O l h li d t th ff t d• One leech was applied to the affected
side only once. On third day, swelling,
reddening, pain and scar mark of leech g p
bite was also diminished
• Jaluka (Leech application) is a cost‐
effective and an easily accessibleeffective and an easily accessible
treatment that can be made use of in
managing stye successfully.

EFFECTS OF JALOUKAVACHARAN IN STYE & CONJUNCTIVITIS
FF CTS OF JA OUKAVACHARAN IN STY & CONJUNCTIVITIS
Shilpa Dhote, WJPR, Volume 3, Issue 9, 1379‐1389
• Anjananamika, (Stye & j , ( y
Conjunctivitis) with Acute pain &
swelling of the lid margin
• In mild (1‐3) moderate (3‐5) and
severe (5‐7) days gap has been
given.
• Jaloukavacharan shows full
( d) )recovery (cured) 68.18%)
patients

AN OPEN CLINICAL STUDY OF JALOUKAVACHARANA WITH
ABHYANTARA PRAYOGA OF GUDUCHYADI GHRITA IN
SIRAJAAL WITH SPECIAL REFERENCE TO EPISCLERITIS
Reshma A. Jadhav et.al. WJPR, Volume 6, Issue 2, 1470‐1475, , ,
• Episcleritis is an inflammatory condition
affecting the episcleral tissue that liesaffecting the episcleral tissue that lies
between the conjunctiva and the sclera
• 30 patients received Medium sized jalouka in30 patients received Medium sized jalouka in
10 settings at the interval of 3 days
• Guduchyadi ghrita was given orally 5ml twiceGuduchyadi ghrita was given orally 5ml twice
• Jaloukavacharana with abhyantara guduchyadi
ghrita has shown good results in sirajaalghrita has shown good results in sirajaal.

The Concept of Raktamokshana in the
The Concept of Raktamokshana in the
management of Badhirya
Nileshkumar C, Hemangi S, Ronakgiri G, Jayesh K, Varsha S, Jignesh V. The Concept of Raktamokshana in the
t f B dhi J A d I t M d S i 2017 4 127 129management of Badhirya. J Ayurveda Integr Med Sci 2017;4:127‐129.
• Treatment modalities mentioned for Badhirya
are Snehavirechana, Raktamokshana,
Bastikarma, Murdhabasti, Nasya and
Dhupana.
• In Badhirya, Raktamokshana is done from the y
Siras residing around the Karna and also from
Sira of Lalaata, Upnasika and Apaangaf p p g

Conclusion
Conclusion
• Raktamokshana even though not included in a ta o s a a e e t oug ot c uded
Shodhana therapy by Charaka, he accepted the
practices of contemporary
• Sushruta included Raktamokshana as Shodhana
by accepting Rakta as 4th Dosha
– He applied Siravedha and Jaluka specifically
• Vagbhata practiced Raktamokshana and brought
more advancements to itmore advancements to it
• The adaptation of Raktamokshana in
Panchakarma is minimal as it is “Asuri”Panchakarma is minimal as it is Asuri .

Recommendations
Recommendations
• Periodical blood donation is a prophylacticPeriodical blood donation is a prophylactic
Raktamokshana to be followed twice in a year,
must in every Sharad Rituy
• We need to evaluate methodically many aspects
of Raktamokshana with proper Biomarkers, asof Raktamokshana with proper Biomarkers, as
the scattered research evidences express the
positive resultsp
• We need to look forward for the new
instrumentation based on traditional principles p p

Thanks from
D KSR P dDr KSR Prasad
Author of Ayurveda

19 11-18 raktamokshana kolakata

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