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Raktamokshana, when taken in a literal sense, means the art of letting the blood out of the body for therapeutic purposes. It removes the removes the morbid Doshas from the blood. It may include the procedure of applying leeches to specific areas of the body or performing the delicate art of phlebotomy or venesection, the ancient Ayurvedic scriptures have provided detailed yet useful procedures of Raktamokshana.

Raktamokshana is practiced in blood-borne diseases, in Pitta predominant diseases and also in few Vata diseases. It is one of the five “Panchakarma” procedures; as listed by Susruta and Vagbhatta. However, Acharya Charaka has not listed Raktamokshana as Panchakarma. The procedure that Susruta has described as a comprehensive basis, the other Panchakarma measures are designated to eliminate vitiated Dosha, but Raktamokshana aims to eliminate vitiated blood as a therapeutic measure. However, since Pitta and blood are axiomatically associated with each other, some pitta also gets eliminated during the procedure.

The working mechanism of this type of therapeutic bloodletting contributes to the general health in five ways. It is thrombolytic – it breaks down bad clots that form in the bloodstream. It is anti-inflammatory – thus can be used in a various inflammatory condition of the body. It stimulates the immune system – thus protecting the body against further infection. It raises the nutrition of the tissue by increasing blood flow to specific areas. Finally, it strengthens tissue immunity. These fivefold actions invariably help in creating more vital and disease free life.

Despite all the promises, this procedure is being applied to the general practice of Ayurveda lesser and lesser. In some countries, a professional license is required in order to practice this therapy. Bloodletting is useful when wishing for immediate results with Pitta disorders such as skin, liver, spleen, and conditions like gout, headaches, varicose vein, and hypertension. The therapeutic application of the bloodletting also depends on which type of procedure is used. Siravedha (venepuncture) is used specifically for pain due to bulging disk, frozen shoulder, sciatica. Leeches are used for Pitta disorders. The incision at a localized area and then vacuum suctioning is done for Vata disorders and loss of sensation. Cupping is done for Kapha disorders.

In some people, certain precaution is required in doing Raktamokshana. Rakta mokçha is not used on babies, the elderly, during pregnancy or menstruation, or with anemia, edema, leukemia, bleeding, or cirrhosis. It is also best to be avoided in conditions like jaundice, vomiting, paralysis, ascites and convulsive states.

Leeching is usually done in early fall. But diseased condition may warrant the therapy at other seasons as well. It involves an initial bite with leeches, which is usually a painless bite, followed by sucking of 5 to 15 ml blood. At first, blood should be dark or purplish. When it turns bright

red, therapy is complete. Sometimes various sensitive sites require only a prick to relieve problems. For example, at the eyebrow, a prick relieves headaches and eye inflammation. Hirudin, a substance present

in the saliva of leech prevents the blood from clotting. The alimentary canal expands during the sucking of blood to accommodate the same in the alimentary system.

Of course, general precautions should be taken when applying the leeches. The digestive tract of medicinal leeches is colonized by two bacteria: Aeromonas and Rickenella. Aeromonas causes wound infection. The infection can be prevented by treating the leech prior to application with turmeric (Curcuma longa). Certain conditions like itching and increased pain are treated medically. Hemophobia, hypovolemic shock, a blown vein is to be avoided.

In conclusion, if there is no significant improvement even after panchakarma treatment, the underlying pathology lies in blood. Here the importance of Raktamokshana comes around, which helps in fast relief from symptoms. The Raktamokshana being a simple yet effective procedure can be done easily and even on a first visit basis.

All the procedures of panchakarma should be performed under the proper guidance of an expert Ayurveda practitioner.