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Let The Leeches Loose
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Tried ‘rakta mokshan’ (leech therapy) for chronic ailments? Dr Anil Patil explains this aspect of Panchakarma therapy

‘Rakta mokshan’ or artificial bloodletting was included in the Panchakarma therapy by Aacharya Sushrut (800 BC) who is also known as the world’s first plastic surgeon. It involves extracting blood from specific veins that correspond to certain chronic diseases. Earlier, it was done by either using sterilised horns of animals, gourd, or by applying leeches, or by puncturing veins (Phlebotomy). Sounds rather unpleasant, doesn’t it? Well, it isn’t all that bad! But it IS an invasive procedure and only a licensed physician should perform it.

Is Leech Therapy For You?
Patients suffering from chronic oedema and inflammations, skin disorders, gout, tumours, boils, abscesses, disorders of liver and spleen, herpes, inflammations, etc are advised to undergo bloodletting therapy. According to the Ayurvedic lingo, all the diseases caused by a vitiated ‘pitta dosha’ or impurities of blood are advised treatment of bloodletting. But remember, you can’t take leech therapy if you are pregnant, anaemic, or malnourished, or suffer from piles, tuberculosis, excessive weakness, cachexia, etc.

Ideal Time For ‘Rakta Mokshan’
Leech therapy works mostly on diseases occurring due to impure blood. The main ‘dosha’, which is responsible for affecting the blood, is ‘pitta’ and October is the time (Sharad Ritu) when pitta usually goes out of balance. So this is an ideal time for ‘Rakta Mokshan’. But if it has to be done on any other day, then it should be done on a day when the temperature is moderate and sky is not clouded.

Suck It Out
‘Jallowka Avacharan’ is one of the most important forms of ‘Rakta mokshan’ where leeches are placed to suck the impure blood. A non-poisonous leech is selected of moderate size (10 to 12 cm). Jallowka (leeches) are refrigerant in nature and therefore very useful against ‘pitta’ imbalances. This is also less invasive than any other form of ‘rakta mokshan’. Four or five days of ‘Snehan’ and ‘Swedan’ should be performed before the therapy in the form of external application.

But stop two days before the therapy begins. The area where the leech has to be applied should be thoroughly cleaned with plain water only. Then the leech is held with help of a gloved hand on the affected region. It will attach itself and start sucking blood. If it doesn’t, a small incision is made and the leech is held over it. After sucking impure blood, the leech becomes turgid, heavy and falls off on its own. Once this happens, the part should be washed and tightly wrapped since saliva of a leech contains an anticoagulant and hence bleeding takes some time to stop, which actually helps for the toxin removal.

In Siravedh, another form of ‘rakta mokshan’, a cut is made in a small vein, and blood is allowed to flow out. Siravedh also requires you to undergo ‘snehan’ and ‘swedan’.

Monitoring ‘Rakta Mokshan’
The area around the bite wounds created by the leech should be assessed routinely for local infection and treated accordingly. The patient’s hemoglobin level should be assessed. Blood clots should be removed gently at regular intervals (approximately every 20 minutes for the first few hours). It is very important that the leech is not disturbed during feeding. This may result in premature detachment or regurgitation of fluids and gut contents of the leech into the affected site.

The goal of leech therapy is to produce adequate venous outflow from the tissue by adjusting the number of leeches per application and the number of applications.
Be wary of signs of incomplete bloodletting like itching, inflammation, cellulitis and pain at the site of blood-letting. When done in excess, one could experience headaches and weakness. To stop excessive bleeding in such cases, ice or astringent medicines should be applied on the area of bleeding.

Leechy Benefits
The main therapeutic benefit of the leech is not the 5 milliliters of blood removed per leech during tissue attachment. It is the salivary secretions released during this event that account for the mode of action of leech therapy. The leech produces a number of diverse salivary secretions that include an anaesthetic, anticoagulant, local vasodilator (histamine), and an enzyme (hyaluronidase). The combined action of these secretions, permit the affected area to ‘ooze’ up to 150 ml of blood for up to 48 hours. On average, leech bites bleed for six hours.

Successful Cases
When J Patel (73) first came to the clinic, he was unable to walk due to a highly swollen left leg caused by varicose veins and covered with infected boils. His doctors feared Septicaemia and had advised amputation. We tried leech therapy once every week for six weeks along with other alternative treatments. To the astonishment of everyone, he was cured and became almost normal after three months of therapy.

Sheila Raichand (53) had come to us with extremely painful knees due to severe osteoarthritis and was not even in a position to stand. Leech therapy administered once a week for four weeks along with acupuncture helped her come back to normal. Apart from this, leech therapy has also helped patients with thyroid problems and chronic aches.

The leech produces a number of diverse salivary secretions that include an anaesthetic, anticoagulant, local vasodilator (histamine), and an enzyme (hyaluronidase).

So, ready to let out impure blood?

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