Rakthamokshana means the procedure of blood letting for the therapeutic purpose for removing morbid doshas with blood. Rakthamokshana is practised in blood born diseases, in Pitta predominant diseases and also in a few vata disorders. Rakthamokshana is the fifth main karma of panchakarma therapy and has been listed by Susrutha and Vagbhata. Charaka has not included rakthamokshana in panchakarma.
Acharya Susrutha considers raktha as the fourth dosha.
In the treatment of rakthaja roga the following measures are indicated viz;
1) Rakthamokshana
2) Virechana
3) Upavasa
4) All other therapies suggested for the treatment of rathapitta.
SUITABLE TIME FOR RAKTHAMOKSHANA
Rakthamokshana is best indicated when
1) Day is neither too cold
2) Day is neither too hot
3) Nor the day is bad
4) It is not cloudy
SEASONVISE SHEDULE OF RAKTHAMOKSHANA
1) Rainy season – on a clear day
2) Summer season – when it is cold
3) Early winter – mid day
RAKTHAMOKSHANA IS OF TWO TYPES
- Sasthra visravana
- Anushasthra visravana
Anushasthra visravana is used to let blood from sukumara persons.
VAGHBATA CONSIDERED THE FOLLOWING AS ANUSHASTHRA
1) Leech
2) Alkali
3) Cauterisation
4) Nails, glass, stone piece, non metallic substances.
JALOOKAVACHARANA
Leeches are of 2 types
1) Poisonous – 6 types
2) Non poisonous – 6 types
The patient have a disorder to be treated with leech should be asked to sit or lie down.Then the shodhita leech should be applied to the diseased spot.Their mouth should be covered with smooth white and moistened cotton swab. When the leech starts opening its mouth like horses hoof and raising the shoulders it is the sign that the leech is sucking the blood.If the leech does not start sucking blood then ksheera or a drop of blood should be kept over the affected part and the leech will start sucking the blood. If at the bitting site needling pain and itching appear it indicates that the leech is sucking pure blood, by pouring rock salt at its mouth.
As soon as the leech is removed it should be dipped in dilute saline water, turmeric water and plain water one after the other. By this process the leech vomits out the blood immediately. Once used the leech is not fit to be used again for atleast seven days.
TREATMENT OF THE PATIENT
After the leech has detached blood from the sucked area should be allowed to flow for 1-3 minutes and then dressing should be done with jathyadi ghritham.
Starting of pruritis and subsiding of redness and pain are indications of removal of vitiated blood.
PRAECHANA
Praechana is a type of raktamokshana. Superficial incisions are made over the skin with the help of a scalpel, fine needles or instruments. It is applied over the elevated portion of the skin locally where few superficial incisions should be made. The part proximal to the incision should not be made in marmasthalas, snayus, sandhis and asthis.
Blood letting with this method is commonly used in localised blood disorders and in certain skin disorders. Praechana must be done after taking aseptic measures. Antiseptic dressing should be applied over the mankind.
BENEFITS OF BLOOD PURIFICATION
When the blood is purified, the colour of the individual will be bright and shining and his sense organs will act powerfully and quickly. Thus the mind will be full of continentness and the body will get strength and happiness. Siravyadha which we do not practice here gives total purification of blood.