Raktamokshana

Rakta moksha (bloodletting) is one of the most important treatments in Ayurveda, an ancient method for the purification of blood. It is the specific form of panchakarma that targets rakta dhatu. Lord Dhanvantari, the mythological figure who gave Ayurveda to Sushruta, is depicted holding a leech—symbolizing the importance of this therapy.

Bloodletting is indicated for increased rakta (rakta vruddhi) and many rakta dushti conditions. Leeches continue to be used therapeutically in Western medicine in over 2,000 cases annually, especially for reattaching digits. Panchakarma including rakta moksha helps kindle dhatu agni and improves the quality of both sthayi and asthayi dhatu.

Asra-visruti – Raktamokshana – blood letting .

— Astanga Hridaya Sutrasthan, Dvividha Upakramaneeya

Vamana (Therapeutic Vomiting, Emesis) Virechana (purgation therapy) Niruha (decoction enema) Nasya (Nasal administration) Raktamokshana (Blood letting) 1.

— Astanga Hridaya Sutrasthan, Dvividha Upakramaneeya

With the due analysis of the pathogenesis, plihodara should be treated by measures like oral medication of sneha (medicated unctuous substance), sudation, virechana (therapeutic purgation), niruha (decoction enema) and anuvasana basti (oil enema) and raktamokshana (blood-letting) by sectioning the vein located in the left arm [77].

— Charaka Samhita, Chikitsa Sthana — Therapeutic Principles, Chapter 13: Abdominal Diseases Treatment (Udara Chikitsa / उदरचिकित्सा)

In such condition raktamokshana (bloodletting) procedure should be administered.

— Charaka Samhita, Chikitsa Sthana — Therapeutic Principles, Chapter 14: Hemorrhoids Treatment (Arsha Chikitsa / अर्शचिकित्सा)

In addition, raktamokshana (blood letting) and virechana (purgation therapy) are specially indicated.

— Charaka Samhita, Chikitsa Sthana — Therapeutic Principles, Chapter 21: Erysipelas Treatment (Visarpa Chikitsa / विसर्पचिकित्सा)

Hence in visarpa, virechana followed by raktamokshana is recommended because the disorder is located in blood.

— Charaka Samhita, Chikitsa Sthana — Therapeutic Principles, Chapter 21: Erysipelas Treatment (Visarpa Chikitsa / विसर्पचिकित्सा)

vinirharet| If dosha in shakha (body elements) vitiate the blood then raktamokshana should be administered at first.

— Charaka Samhita, Chikitsa Sthana — Therapeutic Principles, Chapter 21: Erysipelas Treatment (Visarpa Chikitsa / विसर्पचिकित्सा)

Goiter (Galaganda) treatment emphasizes Kapha-reducing diet and procedures like Vamana (emesis) and Raktamokshana (bloodletting).

— Sharangadhara Samhita, Parishishtam, Chapter 46: Diet for Goiter and Cervical Swelling (Galaganda Pathyapathyam)

Goiter (Galaganda) treatment emphasizes Kapha-reducing diet and procedures like Vamana (emesis) and Raktamokshana (bloodletting).

— Sharangadhara Samhita, Parishishtam, Chapter 35: Diet for Goiter and Cervical Swelling (Galaganda Pathyapathyam)

In emesis, purgation, and bloodletting, one Prastha is defined as 13.

— Sharangadhara Samhita, Uttara Khanda, Chapter 3: Vamana Vidhi (Emesis Therapy)

second, bloodletting (Rakta Sechana);

— Sharangadhara Samhita, Uttara Khanda, Chapter 11: Lepa Vidhi (Topical Paste Application)

Blood should be extracted with leeches (jalaukabhih), or bloodletting (chara) should be performed there.

— Sharangadhara Samhita, Parishishtam, Chapter 1: Diseases of the Liver (Yakrit Roga Adhikara)

Leech therapy (Jalaukavacharana) is the gentlest form of Raktamokshana (bloodletting) — reserved for patients who cannot tolerate surgical bloodletting (venesection).

— Sushruta Samhita, Sutra Sthana, Chapter 13: Jalaukavacharaniya Adhyaya - Leech Therapy

Sharira Sthana continued: (6) Pratyeka Marma-nirdesha (Individual Description of Vital Points), (7) Sira-varnana (Description of Veins/Vessels), (8) Sira-vyadha (Venesection/Bloodletting from Veins), (9) Dhamani (Description of Arteries), (10) Garbhini-vyakriti (Description of the Pregnant Woman).

— Sushruta Samhita, Sutra Sthana, Chapter 3: Adhyayana Sampradaniya Adhyaya - Method of Study and Teaching

Substitute instruments (anu-shastra) include: bark strips (tvaksara), crystal (sphatika), glass (kacha), ruby/garnet (kuruvinda), leeches (jalauka), fire (agni), caustics (kshara), nails (nakha), gourd shell (goji), lily stalks (shephalika), and the edges of certain plant leaves — these may be used for bloodletting and scarification (15).

— Sushruta Samhita, Sutra Sthana, Chapter 8: Shastravacharaniya Adhyaya - Sharp Surgical Instruments

For royalty, children, the elderly, the fearful, the weak, women, and the delicate — for their benefit, this supremely gentle method of bloodletting through leeches has been prescribed (3).

— Sushruta Samhita, Sutra Sthana, Chapter 13: Jalaukavacharaniya Adhyaya - Leech Therapy

Leech therapy (Jalaukavacharana) is the gentlest form of Raktamokshana (bloodletting) — reserved for patients who cannot tolerate surgical bloodletting (venesection).

— Sushruta Samhita, Sutra Sthana, Chapter 13: Jalaukavacharaniya Adhyaya - Leech Therapy