Rakta Mokshana - Blood Letting Therapy

Rakta Mokshana - Blood Letting

Blood letting / Raktamokshana is an invasive procedure, hence it should only be administered by a licensed physician.

Sushruta, being the father of Surgery has given much importance to the blood. He considered blood to be a fourth dosha in the body. Pure blood has life giving value, while impure blood can create or spread disease. Hence impure blood should be removed from the body.

Pitta dosha has an affinity with the blood. Hence when it is vitiated and cannot be treated by the usual medicines, bloodletting can be helpful. Hence it is the therapy for the diseases due to both vitiated blood and pitta. The purpose of blood letting is to remove toxic blood with vitiated doshas like Pitta from the body. Therefore it is the main form of therapy for both blood related and pitta related diseases.

Types of therapeutic blood-letting
1. With sharp instruments:
Prachana – taking quick sharp incisions. A tourniquet or tight bandage is placed on the proximal portion of arm or a leg of the patient. Distal to the tourniquet, a sharp scalpel is used to make superficial, parallel, vertical incisions. Care is taken NOT to incise over local marma points, veins, arteries, joints or nerves.

2. Siravyadha – Venesection. This is performed directly puncturing a vein with a needle, scalp vein needle preferably 18 or 19 no. or other sharp objects. The amount of blood removed should not exceed one pint (350 ml) Therefore, when this procedure is warranted patients can be instructed to donate a pint of blood at local blood bank.

3. With blunt instruments.
· Shringa - Horn of cow to withdraw superficial blood after scraping, taking the advantage of its hollowness.

· Alabu - A fruit of cucurbita lagnaria or vulgaris is dried and internal part is taken off, the hollow part is used for evacuation of blood by sucking method.

· Jalauka (Leeches) - The most renowned method of blood letting and the mildest of all types, is jalauka. It is still used today for children, women, the elderly, wealthy, princely, and other delicate patients. It is a safe, painless, and effective form of treatment.

How to apply leeches – (Jalauka)

• Of the many varieties of leeches existing, six non-poisonous are in clinical use. They are kept in glass jar with water or in earthen pot for ready use.
  

• When leeches are used, the particular part of the body where leeches are to be applied should be thoroughly washed with water (disinfectant drugs should not be applied to the skin), cleaned and dried.
  

• Leeches are first put in the water containing turmeric for purification. Then they should be kept in ordinary water. They are covered with damp gauze piece.
  

• If they are not catching, then a scratch should be made or a drop of milk should be put on the skin where a leech is to be applied.
  

• No. of leeches to be applied, depend upon the skin surface affected. One leech for one square cm. is to be applied. Usually 3 to 6 and maximum 35 leeches are applied. One leech usually sucks 8 to 10 c.c. of blood.
  

• After sucking sufficient blood, the leech automatically separates from the skin. Otherwise one can apply little salt water drop on their mouth, so that they leave the skin. Put them to salt or turmeric water to vomit blood and then keep them in the clean water.
  

• The small wound made by the leech should be dressed with medicated oil such as jatyadi or padmakadi taila and then firmly bandaged.
  

• These leeches can be used again to same patient after 15 days.
  

Indications of Blood-letting

Chronic Skin Diseases, Eye diseases, Headache, Chronic anger, Excessive sweating, Eczema, Spleenomegaly, Tumors, Skin pigmentations. Mental confusion, Psoriasis, Hepatomegaly, Bodyache, Pruritis, Vitiligo, Acne, Gingivitis, Jaundice, Tremors, Acid reflux, Urticaria. Anxiety, Gout, Alcoholism, Metrorrhagia, Boils, Stomatitis, Snake bite, Foul body odour, Erysipelas, Haemorrhoids, Anorexia, Allergies, and Pittaja rogas.

Contra Indications of Blood-letting
Pregnancy, Angina, Impotency, Fasting.General anasarca, Chest injury, Severe cachexia, Dehydration, Anaemia, Fear of the procedure,Acute asthma, and immediately after vamana, virechana, and Vasti.
Post Blood-letting regimen
· Avoid excess cold or heat, and refrain from sex for one week
· Avoid aggravation and anger, and avoid day time sleep.