Roktamokshana (Blood Letting therapy)

The term “Raktamokshana” comprises of two words, ie., ‘Rakta’ & ‘Mokshana’.
Rakta: The word ‘Rakta’ means: coloured, dyed, tinged, painted, Red, crimson, blood red.
Mokshana: The word ‘Mokshana’ is derived from the root ‘moksha’ means ‘to relieve’ or ‘to let out’. Therefore letting out of blood is known as Raktamokshana.
Raktamokshana is considered one among Shodhana procedures. It is the localized treatment not considering the vitiation of the doshas. It is an important therapy in shalya tantra (surgery) as is basti (medicated enema) in kayachikitsa (medicine).

Extraction of vitiated blood from the body by using Sastras and Anusastras is known as Raktamokshana. Kusta, Visarpa, Slipada etc. are some of the diseases caused due to the vitiation of blood. Therapeutic toxic blood letting involves releasing toxic blood from various body sites, although mainly from the back. At first blood should be dark or purplish. When it turns bright red, therapy is complete. Two to 8 ounces is the general amount of blood released.

Classification
In case of bloodletting being vitiated by Vata, Pitta and Kapha dosha, the blood should be let out by Shringa, Jalauka and Alabu respectively. In cases of vitiation by two/all the three doshas together, Siravyadha or Pracchanna are to be adopted for letting out the blood.
Application of Shringa can bring out blood from an area of ten angulis around; Jalauka can suck from an area of one hasta, the Alabu from an area of twelve anguli, Pracchanna from an area of one anguli, while Siravyadha can purify the entire body. In deep seated pathology, Jalauka is preferable, in pindita rakta – Pracchanna is useful, in case of generalized vitiation of rakta – Siravyadha is advised and Shringa, Alabu if pathology is superficial/utthana.

Types Of Raktamokshana

Raktamokshana is of two main types:

 1) Using surgical instruments

Pracchana: scratching with a sterile scalp is indicated to drain the accumulated blood from a particular point.

Sira vedhana: Venepuncture is devised whenever vitiated blood circulates in the body.

2) Other tools

Jalouka prayoga: Deep-seated blood can be extracted with the help of leech application.

Shringa: To extract the blood vitiated by Vata, shringa or deer horn is indicated.

Ghati yantra: To drain the vitiated blood, which has settled in different layers of the skin, cupping is useful.

Indications for Raktamokshana:

Bloodletting as a method of treatment is indicated in Sotha, daha, paka, raktavarna, asruksruti, Vatarakta, kushta, vata diseases having severe pain, pani roga, slipada, blood vitiated with poisons, granthi, arbuda, apachi, ksudraroga, raktadhimantha, vidari, stanaroga, debility and heaviness of the body, raktabhishyanda, tandra, putigraha, putiasya, putideha, yakrutpliha roga, visarpa, vidradhi, pidaka, paka of karna, oshta, ghrana, vaktra, siroruja, upadamsa and raktapitta. In all diseases, bloodletting can be done either by Shringa, Jalauka or by Siravyadha.

• Skin diseases
• Herpes
• Jaundice
• Ulcers
• Gout
• Piles
• Abscess
• Leucoderma
• Syncope
• Eczema
• Deep Venous thrombosis
• Varicose vein

Precaution

Rakta Mokshan is not used on babies, the elderly, during pregnancy or menstruation or with anemia, edema, leukemia, bleeding or cirrhosis. Generalised swelling, swelling in debilitated persons, caused by sour diet and that in those suffering from Pandu, Arshas, Udara, Shosha and in Garbhini.