Types of raktamokshna

Raktamokshan  ( Therapeutic Blood Letting )  –

Part 4 on 4 Dec 15, Friday

•      Types of raktamokshna

•      By Shastra prayoga ( Sharp Instruments)

1.  Siravedhana  &  2. Prachchana

1.  Siravedhana (Venupuncture)

This procedure , proper training & practice .

As this is invasive training , prior written consent of patient is required.

This procedure should be done with delicate people ,low weight people ,alcoholic, small children, old people ,alcoholic ,debilated ,patient of Asthama ,Kasa,Hiccough

•      It includes removal of blood through vein by using syringe with the needle.

•      Venupuncture is done ,when there is not too cold,too hot,sky is clean .In rainy season,when there is clear sky,In summer in morning time,& in winter at  noon

•      Pretreatment

•      Snehan – Medicated Ghees like Tiktak Ghruta,Mahataktak Gruta or Khadiradi Ghruta are commonly used .For external Oiling Bala Taila or Seasame oil is used .Rakta dushtijanya Twak cikar – Use Vrana shodhan taila,Marichydi or Bruhan marichydi oil or paribhadra oil are also useful

•      Swedan – Water vapor ( Bashpa sweda) is useful .For local fomentation use Tapa sweda like with hot towel

•      Before Venu puncture at least 4 hour before do not do local Snehan .Full body oil application & fomentation is done 1 day prior Venupuncture

•      Liquid  ,snigdha ,sweet Diet is given .( Because Blood letting can cause Vata Prakop

Main Procedure

•      Vein in front of elbow joint is more commonly subjected to the procedure. Tourniquet is tied above the elbow joint. Patient is asked to  keep fist closed, by which this veins get dilated, predominant  and can be seen easily. Area is sterilized with the spirit & needle is inserted horizontally to the blood vessel.

•      This method of bloodletting is used in conditions in which impure blood circulates  throughout the body.

•      Remove blood very slowly and in proper quantity, depending upon the extent of impurity (dosha bala) and strength of the patient. Otherwise, adverse effects may be produced.

•      In day today practice 50 to 100 ml blood is removed in one time.

•      Blood can be removed by disposable Syringe & needle of 20 number

•      Scalp vein set can also be used ,instead of syringe & needle

After treatment

•      Shamana chikitsa

•      If any complications are observed, then those are treated on priority basis .

•      Prachhana ( Synonym –Shastrapad or pad )

•      In this procedure, bloodletting is done by very light superficial incisions taken on the skin with the help of scalpel. It is used to drain the accumulated blood from a particular point of the body.

•      Prachhana is done on the body. Silky cloth is applied on that surface and a syringe is pressed at that point. The piston should be pulled very slowly. It creates vacuum and blood is collected in the syringe.

•      Pracchan should be avoided at snyayu ,Sandhi i.e bony joints,Asthi or bone & Marma or vital points

•      Pracchan should be done in Pratilom direction & should be in parallel way

Shringa karma (Sringavacharanam)

•      Shringa means horn. In ancient times, horns were used to aspirate the vitiated blood from the body, hence named so. Small incision used to be made at the spot selected for aspiration and blood aspirated from the tip of horn with mouth.

•      Now days, the procedure can be carried out by a syringe cut at its mouth.

•      Shrunga is unctuous,slimy ,ushna & sweet in properties .So used for removing rakta ,vitiated by Vata

Alabu karma

•      Blood vitiated by Kapha dosha can be removed by Alabu karma.

•       For this, Alabu (tumbi / bitter dudhi / bottle gourd) is used hence named so.Alabu is Ruksha & Bitter .It is used for Kapha Dushit Rakta

•      Fresh gourd is taken .Pulp is removed .It is applied ,after doing Pracchan karma .Keeping burning candle ,gourd is covered on it .By sucking action ,blood is drained out from cuts & raktamokshan takes place .

•      Jatyadi taila or Ghruta is used for dressing & bandaging the wound.

•      Now a days ,Shrunga ,Alabu are rarely used for Blood letting

•      Prof.Dr.R.R.Deshpande --- 9226810630

•      Dr.Sachin Sarpotdar -------- 9822795363

•      Dr,Mayura Shinde ---------- 7276866831

Leech Application

Raktamokshan  ( Therapeutic Blood Letting )  –

Part 3 on 3 Dec 15, Thursday

Leech Application

•      Leech (Herudo medicinalis) is a blood- sucker.

•      Leech lives in water hence named Jalauka, but can survive out of water if proper moisture is provided.

•      It has following body parts

•      Mouth – contains suckers with the help of which it sucks the blood

•      Body – it is shiny with transverse line on the body surface

•      Base – it is a circular part which sticks to the surface for the support

•      Length of the leech is variable (from 1 and half cm to 45 cm) but 6 -10 cm length is the best for Raktamokshna.

•      Skin is shiny and moist due to secretion secreted by the skin.

•      This moistness is necessary for the respiration. Respiration of leech takes place through the skin.

•      Difference between male and female

•      Female leech – narrow mouth, broad body, skin soft shiny

•      Male leech – half circular shape, broad mouth, narrow body

•      Types of leech

•      Leech is of two types

1.  Poisonous (Savisha)

2.  Non-poisonous (Nirvisha)

•      Always use non-poisonous leach for bloodletting. If poisonous leech is applied on the body, it will cause oedema, itching, fever, vomiting, body ache, fainting etc.

•      Now days, leaches are available in the market for raktamokshana.

The cost is about 40-60 Rs per leech

•      Storage of leech

•      Leeches are stored in glass jar filled with water or fish ponds or aquarium.

•       Water should be changed after every 2-3 days for proper oxygen supply.

•      Water should not be chlorinated, this can be harmful to leeches.

•      They can live without any food material for 4-6 months.

•      Benefits of leech application

•      Painless method of Raktamokshna

•      Very easy to apply, cheap and short

•      Pre-surgery processes like anesthesia are not necessary prior to leech application

•      Do not result in any harmful effects.

•      It shows result instantly. So it is counted as a emergency treatment also.

•      Leech application

•      Clean the body surface at which leach should be applied.

•      But do not use an aromatic substance for cleaning like soap, dettol, spirit etc. because of this smell leech will not suck blood from that surface.

•      Apply honey at that surface or do the Prachhana karma (Scraping) so as some drops of blood collect at that surface.

•      Leech quickly sticks to that surface and start sucking.

•      Keep the leach always moist by placing cotton mesh pierced in water. Water should be poured on the cotton mesh at regular intervals.

•      After sucking (as much as it can), the leech itself leaves the body surface

•      It sucks impure blood first.

•      While sucking of blood leech discharges certain chemicals through saliva.

•      Hirudin : anticoagulant, prohibits blood clotting

•      Prasaran :which destructs minute bacilli

•      Himatin : disolves the clots in the blood

•      Sandnyahar

•      While sucking impure blood, there will be no feeling like pain.

•      But when it begins to suck the pure blood, it will cause pain, itching etc. in that case, one should make efforts to remove the leech from the body surface.

•      For that turmeric powder is applied at the mouth of leech, or any aromatic substance like spirit, dettol can be used.

•      After removal of leech, turmeric powder is applied at the mouth of leech. It causes the leech to vomit the sucked blood. All the impure blood should be removed; otherwise the leech will not survive for longer time.

•      The wound of the body surface at which the leech was applied, contains anticoagulant hirudin. It causes bloodletting for longer time. Hence do not apply bandage.

•      Firstly clean the wound by cotton swab repeatedly. This causes decrease in hirudin level.

•      Afterwards turmeric powder should be applied on the wound. It causes clotting. Then apply pressure bandage on the wound.

•      Kindly note ,even before Leech application BT ,CT ,PT test must be done to rule out Blood Dyscrasias

•      Some modern Doctors recommend Inj TT ,to the patient ,before applying Leeches

•      Prof.Dr.R.R.Deshpande --- 9226810630

•      Dr.Sachin Sarpotdar -------- 9822795363

•      Dr,Mayura Shinde ---------- 7276866831

Raktamokshan ( Therapeutic Blood Letting ) -Indications & Contraindications

Raktamokshan  ( Therapeutic Blood Letting )  –

Part 2 on 2 Dec 15, Wednesday

Indications for blood letting

•      All disease which are caused by impure blood e.g. skin diseases

•      Acne, rash, urticaria, eczema ,specially wet Eczema, scabies ,leucoderma, chronic itching, baldness ( Indralupta) ,Abscess

•      Musculo Skeletal problems ,having Pitta vitiation & Rakta is Dushya like Vatarakta ( gout & Rhrumatoid Arthritis also )

•      Digestive complaints ,where Pitta is vitiated Dosha & Rakta is Dushya Hepato & splenomegaly ( Both are Raktasyaya) ,Cirrhosis of Liver ,Repeated Apthous ulcers, piles, Dacrocystitis.

•      Cardiovascular System problems due to Pitta & Rakta like Hypertension ,In CCF ,to reduce preload

•      Neurological problems like Migraine,  Headache of other types

•      Psychological problems like Hot Temper ( Of course it will need other Pschological management like Councelling,Yoga methods like Pranayam practice,Meditation )

•      In Ayurveda Rakta Pradoshaja Diseases are described at Cha Sutra 24 /11 to 16 ,Ashtang Hrudaya Sutra 27/2,3;Cha Sutra 28/24 to 27 ,Su Sutra 25/ 12 to 15 ;Harit Chaturtha Cha 5

Contraindication for blood letting ( Ref Su Sutra 14/19 & Su Sharir 8/2)

•      As blood is eliminated in this procedure, it should not be children, old age, in very weak patients ,pregnant women ,Exhausted due to heavy physical work like excess exercise or walking ,after Vaman, Virechan, Asthapana and Anuvasana, rainy season, cough, asthma, and High fever, Hemiplegia, Impotency, Low weight ,Giddiness, undernourished ,Oedema all over body i.e Anasarca  are the contraindicated situations.

•      As this is Invasive procedure ,it should be done after written consent only.BT CT & Prothrombin time of each patient before Raktamokshan ,to avoid Medicolegal complications

•      Disorder related with bleeding time, clotting time, prothrombin time should be very carefully handled. Prolonged B.T., C.T., P.T. are contraindicated. Diases like Haemophilia ,Thalassemia ,Severe Anaemia are contraindications

•      Patients on anti platelet, anticoagulant ( Post stroke or MI) are the high risk cases. So better should be avoided

Suitable Time for Raktmokshan

•      Summer-Morning / Evening

•      Rainy-In absence of cloud

•      Autumn-Suitable for both diseased and healthy persons

•      Winter-Midday

•      Prof.Dr.R.R.Deshpande --- 9226810630

•      Dr.Sachin Sarpotdar -------- 9822795363

•      Dr,Mayura Shinde ---------- 7276866831

Raktamokshan ( Therapeutic Blood Letting ) – Introduction

Raktamokshan  ( Therapeutic Blood Letting )  –

Part 1 on 1 Dec 15, Tuesday

Introduction

•      Synonyms – Asravisruti, Raktanirharan, Shonitnirharan, Raktaharan, Raktasrawan, Shonitmokshan

•      ‘Rakta’ means the blood and ‘moksha’ means to eliminate.

•      The word simply means bloodletting. In this procedure, the impure or vitiated blood is removed from the body

Importance of Raktamokshna

•      As Basti is the important part of therapy in Kaya chikitsa,

 Raktamokshna is the important part of therapy in shalya tantra (surgery).

•       It is called half of the treatment. Hence, Sushruta included Raktamokshna in Panchakarma.

Specialty of Raktamokshna  or Difference from other karmas

•      In other Panchkarmas, impure or vitiated doshas are eliminated.

•       Vaman,  Virechana and Basti are used for the treatment of mainly Kapha, Pitta and Vata respectively.

•       In these procedures, actually doshas are eliminated through the body.

•      Nasya karma is used to treat diseases above clavicle. In these karmas, doshas and their seats are important.

•      But in bloodletting, there is no actual removal of doshas. There is removal of dhatu – blood. But, as Pitta and Blood live in symbiosis ( Ashraya Ashrayi Sambandha), it is used to treat diseases caused by impure Pitta and impure Blood.

How it works?

•      Pitta dosha and blood live in symbiosis form. Any impurity of Pitta makes the blood impure and vice versa.

•      In bloodletting, impure blood is removed from the body. This automatically pacifies Pitta Dosha

•      Also Raktamokshan  helps in formation of pure blood in the body. Thus, relieve from diseased symptoms

•       Blood Donation ,process is very parallel to Ayurvedic Raktamokshan .So Blood Donation is helpful to the needy person ,but simultaneously Blood Donor can also get some benefits of Ayurvedic Raktamokshan .But main difference is Ayurvedic Raktamokshan is done to remove vitiated Rakta & Pitta from the body

•      Prof.Dr.R.R.Deshpande --- 9226810630

•      Dr.Sachin Sarpotdar -------- 9822795363

•      Dr,Mayura Shinde ---------- 7276866831