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Dr. K. Shiva Rama Prasad,
@ http://www.technoayurveda.com / http://www.slideshare.net/technoayurveda/
Standard Procedures ...
Introduction
Standard Procedures of Raktamokshana
Introduction 
• “Rakta” is “blood” and “mokshana” is “to letRakta  is  b...
Importance of Rakta
Standard Procedures of Raktamokshana
Importance of Rakta
• Blood is the fore most and important cause ...
What is Rakta?
Standard Procedures of Raktamokshana
What is Rakta?
• Blood (Rakta) is the red homogeneous liquid that 
cir...
Classification of Raktamokshana
Standard Procedures of Raktamokshana
Classification of Raktamokshana 
• 1 Shastra Visravan...
Standard Procedures of Raktamokshana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Raktamokshana
Standard Procedures of Raktamokshana
Raktamokshana 
Visravana (Active) Passive
Superficial Deep Flow
(Siravy...
Indications of Raktamokshan
Standard Procedures of Raktamokshana
Indications of Raktamokshan
• Charaka refer Raktamokshana...
Selection of Raktamokshana
Standard Procedures of Raktamokshana
Selection of Raktamokshana
• Vata = [Go] Srunga (as it is ...
CONTRA INDICATED VEINS FOR VEIN PUNCTURE
Standard Procedures of Raktamokshana
CONTRA‐INDICATED VEINS FOR VEIN PUNCTURE
• T...
Precise time for Raktamokshana
Standard Procedures of Raktamokshana
Precise time for Raktamokshana 
• Pitta Dosha provoked...
Standard Procedures of Raktamokshana
Sathish HS et al / Int. J. Res. Ayurveda Pharm. 4(5), Sep – Oct 2013
• In India, 143 ...
Standard Procedures of Raktamokshana
R. Vidyanath et al / IJRAP 2011, 2 (1)
• There are 19 conditions told in Vangasena fo...
Vangasena … ctd
Standard Procedures of Raktamokshana
g
• 8. Gandamala: Siravedhana on the lower surface of the 
tongue 12 ...
Vangasena … ctd
Standard Procedures of Raktamokshana
g
• 12. Slipada ‐ Siravedhana ‐ Incise the vein below the 
ankle in P...
Leech therapy
Standard Procedures of Raktamokshana
Leech therapy 
• Jaluka is aquatic sucking animal q g
• They are two va...
Standard Procedures of Raktamokshana
• Itrat M, Zarnigar, 
Haque N. Historical 
aspects of leech 
therapy: a critical 
rev...
Leach Application method
Standard Procedures of Raktamokshana
Leach Application method 
• Make a small puncture at the sit...
Wound care after Leach application
Standard Procedures of Raktamokshana
Wound care after Leach application
• When bleeding...
Leach history
Standard Procedures of Raktamokshana
Leach history 
• Sushruta was the first person to contribute an exclusi...
Leach history
Standard Procedures of Raktamokshana
Leach history 
• Leeching reached the height of its popularity in the m...
Leach history
Standard Procedures of Raktamokshana
Leach history 
• The leeches was brought back into the medical g
domain...
Scientometric analysis of medicinal leech therapy
Standard Procedures of Raktamokshana
S¸ enel E et al., Scientometric ana...
Leach Saliva
Standard Procedures of Raktamokshana
Leach Saliva 
• In a study, the hirudin was tested for thrombin 
inhibit...
Salivary Gland Secretions of Leech
Standard Procedures of Raktamokshana
Salivary Gland Secretions of Leech
• Hirudin: An a...
• Hirustasin Inhibits kallikrein tr psin
Standard Procedures of Raktamokshana
• Hirustasin: Inhibits kallikrein, trypsin, ...
• Factor Xa inhibitor: Inhibits the activity of coagulation factor
Standard Procedures of Raktamokshana
• Factor Xa inhibi...
The saliva of leech contains
Standard Procedures of Raktamokshana
The saliva of leech contains
• Anesthetic ‐ which makes ...
Standard Procedures of Raktamokshana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Sunil G. Ilag et.al, Rece...
Leach Farming
Standard Procedures of Raktamokshana
Leach Farming
• Leeches breeds once during an 
annual season in the mon...
Evaluation of organisms present in the gut of Hirudinaria granulosa or Indian cattle
Standard Procedures of Raktamokshana
...
Siravyadha
Standard Procedures of Raktamokshana
Siravyadha
• Venesection or phlebotomy is the surgicalVenesection or phleb...
Size of puncture
Standard Procedures of Raktamokshana
Size of puncture
• The size should be that of 1 Vrihi or half barley...
Quantity of Rakta Visravana
Standard Procedures of Raktamokshana
Quantity of Rakta Visravana
• A Prastha (approximate 54 t...
Remedy for Atipravritti of Blood
Standard Procedures of Raktamokshana
Remedy for Atipravritti of Blood 
• 1) Sandhana (pro...
Cupping therapy
Standard Procedures of Raktamokshana
Cupping therapy
• Wet and dry Cupping therapy since 400 BC for 
treat...
Standard Procedures of Raktamokshana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Standard Procedures of Raktamokshana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Different Types of Cupping Sets
Standard Procedures of Raktamokshana
Different Types of Cupping Sets
Dr. K. Shiva Rama Pra...
5 step Wet cupping treatment procedure
Standard Procedures of Raktamokshana
5 step Wet cupping treatment procedure
• Prima...
CUPPING THERAPY POINTS
Standard Procedures of Raktamokshana
CUPPING THERAPY POINTS 
Dr. K. Shiva Rama Prasad, at http://ww...
CUPPING THERAPY POINTS
Standard Procedures of Raktamokshana
CUPPING THERAPY POINTS 
Dr. K. Shiva Rama Prasad, at http://ww...
Dry Cupping application
Standard Procedures of Raktamokshana
Dry Cupping application 
Method ‐1
Creating vacuum through he...
Standard Procedures of Raktamokshana
Evaluation of the Effects 
of Traditional Cupping 
on the Biochemical, 
Hematological...
Mechanism of Cupping therapy
Standard Procedures of Raktamokshana
Mechanism of Cupping therapy
• Cupping is thought 
to ac...
Cupping Adverse events
Standard Procedures of Raktamokshana
Cupping Adverse events
Related to site Generalized
• Scar form...
Standard Procedures of Raktamokshana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Standard Procedures of Raktamokshana
RaktamokshanaRaktamokshana 
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Skin & H...
A Clinical Study of Jalaukavacharana in Varicose Eczema (Vicharchika)
Standard Procedures of Raktamokshana
y ( )
Dr. Vinay...
Standard Procedures of Raktamokshana
Indian Journal of Ancient Medicine and Yoga (IJAMY) 2009, 2(3): 165‐174
• Total 54 pa...
Standard Procedures of Raktamokshana
Sonaje Manoj et al / IJRAP 2011, 2 (6) 1659‐1663
• Out of 75 patients; in Group A (Ja...
Standard Procedures of Raktamokshana
International Journal of Ayurvedic and Herbal Medicine 6:6 (2016) 2402 –2407
• 38 yr ...
Standard Procedures of Raktamokshana
www.wjpr.net Vol 6, Issue 8, 2017. 941 ‐959 *** www.wjpr.net Vol 6, Issue 6, 2017. 13...
Comparative assessment of Jalaukavacharana (Leech Application) and
( )
Standard Procedures of Raktamokshana
Shringavachara...
Role of Raktamokshana by Jalaukavacharana and Siravedhana in the
Standard Procedures of Raktamokshana
y
management of Vich...
To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in
Standard Procedures of Raktamokshana
To evalua...
EFFICACY OF JALAUKAVACHARANA IN VISARPA W.S.R TO HERPES ZOSTER – AN 
Standard Procedures of Raktamokshana
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Role of Pracchana in Indralupa
Standard Procedures of Raktamokshana
Role of Pracchana in Indralupa
Mahesh P. Savalagimath*...
Standard Procedures of Raktamokshana
Role of 
Pracchana in 
Indralupa
Mahesh P. 
Savalagimath*, 
Shweta S. 
M b ddi**Mumba...
MANAGEMENT OF INDRALUPTA WITH LOCAL PRACHCHHANA AND 
Standard Procedures of Raktamokshana
APPLICATION OF ARAGVADHADI LEPA:...
MANAGEMENT OF INDRALUPTA ‐ A CASE STUDY.
Standard Procedures of Raktamokshana
G O U C S S U
Snehal A. Ingle, Minal Khode1,...
Management of Alopecia by bloodletting and certain 
Standard Procedures of Raktamokshana
g p y g
Ayurveda medicine: A case...
A STUDY ON EFFICACY OF PRACHANNA AND BHRINGARAJA LEPA IN THE
Standard Procedures of Raktamokshana
MANAGEMENT OF KHALITYA (...
A Case Study of Leech Therapy (Jalaukavacharana) in Khalitya
Standard Procedures of Raktamokshana
W.S.R. Alopecia 
Yadav C...
EFFECT OF AYURVEDIC SHAMAN (PACIFICATION) & SHODHAN (PURIFICATION) TREATMENT IN 
( )
Standard Procedures of Raktamokshana
...
EFFICACY OF JALUKAVACHARANA IN THE MANAGEMENT OF
Standard Procedures of Raktamokshana
YUVANAPIDAKA W.S.R. TO ACNE VULGARIS...
Standard Procedures of Raktamokshana
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inin 
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Standard Procedures of Raktamokshana
Ayu. 2014 Jul‐Sep; 35(3): 270–276.
doi: 10 4103/0974 8520 153743: 10 4103/0974 8520 1...
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http://www ayurlog com Volume 6th | Issue: 3rd April 2018http://www.ayurlog.com Volum...
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g g ( ) g
and raktamokshana: A revi...
Pain management in Gridhrasi through Ayurveda ‐An 
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g g y
Observational Study
Dr. Rang...
Critical analysis of Siravyadhana in pain management of 
Standard Procedures of Raktamokshana
Raktavrutavataja Gridhrasi –...
Standard Procedures of Raktamokshana
Ayu. 2016 Jan‐Mar; 37(1): 26–31. PMCID: PMC5541463
• Ghatiyantra (cupping) 
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Effect of Cupping Therapy in Gridhrasi (Sciatica)
Standard Procedures of Raktamokshana
Effect of Cupping Therapy in Gridhr...
Modified Raktamokshna as Chinese cupping therapy in acute 
Standard Procedures of Raktamokshana
pain management of Lumbar ...
The Cumulative anti‐inflammatory effect of bloodletting by Leech 
(J ll k h ) i i f A h i i (A ) i fl
Standard Procedures ...
Case Study of Frequent Leech application in Diabetes mellitus 
Standard Procedures of Raktamokshana
with special reference...
MANAGEMENT OF JANU SANDHISHULA BY RAKTAMOKSHANA THROUGH 
Standard Procedures of Raktamokshana
JALAUKAVACHARANA
Kad Ujwala ...
Role of Leech application in Vatarakta: A pilot study
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pp p y
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A Comparative Study of Siravyadha and Kokilakshadi Kshayama
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A CASE STUDY – AYURVEDIC APPROACH IN THE MANAGEMENT 
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OF DEEP VEIN THROMBOSIS (DVT)
Vd...
Standard Procedures of Raktamokshana
Kaur Rimpaljeet et al. Journal of Biological & Scientific Opinion ∙ Volume 3 (2). 201...
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Management of Deep Vein Thrombosis 
D...
A CASE REPORT ON THE EFFECTIVENESS OF JALAUKAVACHARAN IN THE 
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MANAGEMENT OF VARICOSE ...
Clinical assessment of jalaukavcharan (leech therapy) in 
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• Leeches activated in Haridra water ...
Standard Procedures of Raktamokshana
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oc...
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A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana)
Standard Procedures of Raktamokshana
A Co...
Pain management and wound bed preparation of a chronic 
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non healing wound over heel b...
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A Case Report on Siraja Granthi
Standard Procedures of Raktamokshana
A Case Report on Siraja Granthi
Shetty Kishor Kumar, ...
Effect of Rakthamokshana (blood letting therapy) and Sri Lankan traditional 
di i i j hi ( i i ) d
Standard Procedures of ...
Standard Procedures of Raktamokshana
RaktamokshanaRaktamokshana 
Researches ExperiencesResearches Experiences
inin 
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A CONCEPTUAL REVIEW OF RAKTAMOKSHANA AS AN 
Standard Procedures of Raktamokshana
A CONC PTUA R VI W OF RAKTAMOKSHANA AS AN...
CONCEPT OF RAKTAMOKSHANA IN NETRAROGA
Standard Procedures of Raktamokshana
Jayesh R. Katrodiya et,al. WJPR,  Volume 6, Iss...
To study the Efficacy of Jalaukavacharan and Shadanga
Standard Procedures of Raktamokshana
g
Guggulu in Puyalasa w.s.r. to...
Standard Procedures of Raktamokshana
A REVIEW ARTICLE ON ROLE OF JALAUAKAVACHARANA AS 
ADJUVANT THERAPY IN OPEN ANGLE GLAU...
Jalukavacharan (Leech) in (External Hordeolum)
Standard Procedures of Raktamokshana
Jalukavacharan (Leech) in (External Ho...
EFFECTS OF JALOUKAVACHARAN IN STYE & CONJUNCTIVITIS 
Standard Procedures of Raktamokshana
FF CTS OF JA OUKAVACHARAN IN STY...
AN OPEN CLINICAL STUDY OF JALOUKAVACHARANA WITH
Standard Procedures of Raktamokshana
ABHYANTARA PRAYOGA OF GUDUCHYADI GHRI...
The Concept of Raktamokshana in the
Standard Procedures of Raktamokshana
The Concept of Raktamokshana in the 
management o...
Conclusion
Standard Procedures of Raktamokshana
Conclusion 
• Raktamokshana even though not included in a ta o s a a e e t...
Recommendations
Standard Procedures of Raktamokshana
Recommendations
• Periodical blood donation is a prophylacticPeriodic...
Standard Procedures of Raktamokshana
Thanks from 
D KSR P dDr KSR Prasad
Author of Ayurveda
Dr. K. Shiva Rama Prasad, at h...
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19 11-18 raktamokshana kolakata

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LN Ayurved College & Hospital, Kolar Road, Bhopal professor of Panchakarma and Head of the department Dr K Shiva Rama Prasad has delivered a Guest lecture on the Importance and Standard procedures of Raktamokshana at Institute of Post Graduate Ayurvedic Education & Research under Dept. of Health & Family Welfare, Government of West Bengal on 18th November 2019.

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19 11-18 raktamokshana kolakata

  1. 1. 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/
  2. 2. 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/
  3. 3. Importance of Rakta Standard Procedures of Raktamokshana 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|| ो ी ं ि ि ं ी Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ 2) इ गोपक तीकाशमसंहतमिववण च कृ ित थं जानीयात् ||२२||
  4. 4. What is Rakta? Standard Procedures of Raktamokshana 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|| Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ ु ु ् || || सु ुतसंिहता सू थानम् - १४. शोिणतवणनीया ायः
  5. 5. Classification of Raktamokshana Standard Procedures 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  6. 6. Standard Procedures of Raktamokshana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  7. 7. Raktamokshana Standard Procedures of 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ (Viddha) (Srunga /Suchi)
  8. 8. Indications of Raktamokshan Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  9. 9. Selection of Raktamokshana Standard Procedures 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ सु ुतसिहता सू थानम् - १४. शोिणतवणनीया ायः
  10. 10. CONTRA INDICATED VEINS FOR VEIN PUNCTURE Standard Procedures of Raktamokshana 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|| ंि ी ि ि ी Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ सु ुतसिहता शारीर थानम् - ७. िसरावणिवभ शारीरम् 19‐21
  11. 11. Precise time for Raktamokshana Standard Procedures of 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  12. 12. Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  13. 13. Standard Procedures of Raktamokshana 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  14. 14. Vangasena … ctd Standard Procedures of Raktamokshana 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  15. 15. Vangasena … ctd Standard Procedures of Raktamokshana 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)  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  16. 16. Leech therapy Standard Procedures of Raktamokshana 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|| ंि ौ ी Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ सु ुतसंिहता सू थानम् - १३. जलौकावचारणीया ायः
  17. 17. Standard Procedures of Raktamokshana • Itrat M, Zarnigar,  Haque N. Historical  aspects of leech  therapy: a critical  review. Int J Health  Sci Res. 2013;3(7):78‐ 83.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  18. 18. Leach Application method Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  19. 19. Wound care after Leach application Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  20. 20. Leach history Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  21. 21. Leach history Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  22. 22. Leach history Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  23. 23. Scientometric analysis of medicinal leech therapy Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  24. 24. Leach Saliva Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  25. 25. Salivary Gland Secretions of Leech Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  26. 26. • Hirustasin Inhibits kallikrein tr psin Standard Procedures of Raktamokshana • 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  27. 27. • Factor Xa inhibitor: Inhibits the activity of coagulation factor Standard Procedures of Raktamokshana • 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  28. 28. The saliva of leech contains Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  29. 29. Standard Procedures of Raktamokshana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Sunil G. Ilag et.al, Recent Updates in Leech Therapy, ADJIM, July ‐ Sept 2018; Vol. 3 Issue 3, 26‐30
  30. 30. Leach Farming Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ • Nature of water – Natural ground water, fresh water
  31. 31. Evaluation of organisms present in the gut of Hirudinaria granulosa or Indian cattle Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  32. 32. Siravyadha Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  33. 33. Size of puncture Standard Procedures of Raktamokshana 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 ी ं ि Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ ना चानुपघाित ||२६||
  34. 34. Quantity of Rakta Visravana Standard Procedures of Raktamokshana 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  35. 35. Remedy for Atipravritti of Blood Standard Procedures of Raktamokshana 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|| Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ 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||
  36. 36. Cupping therapy Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Wet Cuppingwater cupping.
  37. 37. Standard Procedures of Raktamokshana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  38. 38. Standard Procedures of Raktamokshana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  39. 39. Different Types of Cupping Sets Standard Procedures of Raktamokshana Different Types of Cupping Sets Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  40. 40. 5 step Wet cupping treatment procedure Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  41. 41. CUPPING THERAPY POINTS Standard Procedures of Raktamokshana CUPPING THERAPY POINTS  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  42. 42. CUPPING THERAPY POINTS Standard Procedures of Raktamokshana CUPPING THERAPY POINTS  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  43. 43. Dry Cupping application Standard Procedures of Raktamokshana Dry Cupping application  Method ‐1 Creating vacuum through heat Method ‐2 Creating vacuum through PressureCreating vacuum through heat  Creating vacuum through Pressure Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  44. 44. Standard Procedures of Raktamokshana 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, Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  45. 45. Mechanism of Cupping therapy Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ p
  46. 46. Cupping Adverse events Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  47. 47. Standard Procedures of Raktamokshana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  48. 48. Standard Procedures of Raktamokshana RaktamokshanaRaktamokshana  Researches ExperiencesResearches Experiences in  Skin & Hair Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  49. 49. A Clinical Study of Jalaukavacharana in Varicose Eczema (Vicharchika) Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  50. 50. Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  51. 51. Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  52. 52. Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  53. 53. Standard Procedures of Raktamokshana 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] Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  54. 54. Comparative assessment of Jalaukavacharana (Leech Application) and ( ) Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  55. 55. Role of Raktamokshana by Jalaukavacharana and Siravedhana in the Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  56. 56. To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in Standard Procedures of Raktamokshana 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) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  57. 57. EFFICACY OF JALAUKAVACHARANA IN VISARPA W.S.R TO HERPES ZOSTER – AN  Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  58. 58. Role of Pracchana in Indralupa Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  59. 59. Standard Procedures of Raktamokshana Role of  Pracchana in  Indralupa Mahesh P.  Savalagimath*,  Shweta S.  M b ddi**Mumbaraddi**,  Manohar S.  Sarangi** Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  60. 60. MANAGEMENT OF INDRALUPTA WITH LOCAL PRACHCHHANA AND  Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  61. 61. MANAGEMENT OF INDRALUPTA ‐ A CASE STUDY. Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  62. 62. Management of Alopecia by bloodletting and certain  Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  63. 63. A STUDY ON EFFICACY OF PRACHANNA AND BHRINGARAJA LEPA IN THE Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  64. 64. A Case Study of Leech Therapy (Jalaukavacharana) in Khalitya Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  65. 65. EFFECT OF AYURVEDIC SHAMAN (PACIFICATION) & SHODHAN (PURIFICATION) TREATMENT IN  ( ) Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  66. 66. EFFICACY OF JALUKAVACHARANA IN THE MANAGEMENT OF Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  67. 67. Standard Procedures of Raktamokshana RaktamokshanaRaktamokshana  Researches ExperiencesResearches Experiences inin  Musculoskeletal Care Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  68. 68. Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  69. 69. Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  70. 70. Management of gridhrasi (sciatica) with agnikarma Standard Procedures of Raktamokshana 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)  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  71. 71. Pain management in Gridhrasi through Ayurveda ‐An  Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  72. 72. Critical analysis of Siravyadhana in pain management of  Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  73. 73. Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  74. 74. Effect of Cupping Therapy in Gridhrasi (Sciatica) Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  75. 75. Modified Raktamokshna as Chinese cupping therapy in acute  Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  76. 76. The Cumulative anti‐inflammatory effect of bloodletting by Leech  (J ll k h ) i i f A h i i (A ) i fl Standard Procedures of Raktamokshana (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%. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  77. 77. Case Study of Frequent Leech application in Diabetes mellitus  Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  78. 78. MANAGEMENT OF JANU SANDHISHULA BY RAKTAMOKSHANA THROUGH  Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  79. 79. Role of Leech application in Vatarakta: A pilot study Standard Procedures of Raktamokshana 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   Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  80. 80. Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  81. 81. A Comparative Study of Siravyadha and Kokilakshadi Kshayama Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  82. 82. Standard Procedures of Raktamokshana RaktamokshanaRaktamokshana  Researches ExperiencesResearches Experiences inin  Circulatory Carey Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  83. 83. A CASE STUDY – AYURVEDIC APPROACH IN THE MANAGEMENT  Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  84. 84. Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  85. 85. Role of Jalaukavacharan (Leech Therapy) In The  Standard Procedures of Raktamokshana 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.   Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  86. 86. A CASE REPORT ON THE EFFECTIVENESS OF JALAUKAVACHARAN IN THE  Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  87. 87. Clinical assessment of jalaukavcharan (leech therapy) in  Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  88. 88. Jalaukavacharan (Leech Application): Para‐Surgical Approach to Shlipada Standard Procedures of Raktamokshana (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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  89. 89. Standard Procedures of Raktamokshana RaktamokshanaRaktamokshana  Researches ExperiencesResearches Experiences inin  Ulcer & Ano‐rectal care  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  90. 90. Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  91. 91. Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  92. 92. Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  93. 93. A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana) Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  94. 94. Pain management and wound bed preparation of a chronic  Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  95. 95. Management of Chronic Venous Leg Ulcer (traumatic) – A Case Report Standard Procedures of Raktamokshana 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 ) Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  96. 96. A Case Report on Siraja Granthi Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  97. 97. Effect of Rakthamokshana (blood letting therapy) and Sri Lankan traditional  di i i j hi ( i i ) d Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ walking were completely relieved on Day 21 
  98. 98. Standard Procedures of Raktamokshana RaktamokshanaRaktamokshana  Researches ExperiencesResearches Experiences inin  Shalakya careShalakya care  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  99. 99. A CONCEPTUAL REVIEW OF RAKTAMOKSHANA AS AN  Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  100. 100. CONCEPT OF RAKTAMOKSHANA IN NETRAROGA Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  101. 101. To study the Efficacy of Jalaukavacharan and Shadanga Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  102. 102. Standard Procedures of Raktamokshana 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.  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  103. 103. Jalukavacharan (Leech) in (External Hordeolum) Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  104. 104. EFFECTS OF JALOUKAVACHARAN IN STYE & CONJUNCTIVITIS  Standard Procedures of Raktamokshana 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  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  105. 105. AN OPEN CLINICAL STUDY OF JALOUKAVACHARANA WITH Standard Procedures of Raktamokshana 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. Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  106. 106. The Concept of Raktamokshana in the Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  107. 107. Conclusion Standard Procedures of Raktamokshana 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 .  Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  108. 108. Recommendations Standard Procedures of Raktamokshana 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 Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
  109. 109. Standard Procedures of Raktamokshana Thanks from  D KSR P dDr KSR Prasad Author of Ayurveda Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
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LN Ayurved College & Hospital, Kolar Road, Bhopal professor of Panchakarma and Head of the department Dr K Shiva Rama Prasad has delivered a Guest lecture on the Importance and Standard procedures of Raktamokshana at Institute of Post Graduate Ayurvedic Education & Research under Dept. of Health & Family Welfare, Government of West Bengal on 18th November 2019.

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