Raktamokshana

Raktamokshana-An important procedure among the Panchakarma

Ayurvedic panchakarma procedures mainly focus on throwing the vitiated dosha out of the body and thus checks the reoccurrence of the disease. And raktamokshana is one procedure among panchakarma which aims at excreting vitiated blood (Dushta rakta ) from our body.

The word Raktamokshan is derived from 2 words mainly Rakta (blood) and Mokshan (let out, to relieve).

These procedures explained thousands of years ago still holds and important place in ayurvedic treatment in curing many diseases, and have become a necessity in todays world due to changing food habits and lifestyle, for curing ailments and also to maintain health.

So before learning about this procedure let’s briefly go through an ayurvedic prespective about Rakta (blood)

Formation(Utpatti) of rakta:
            The first liquid principle known as Rasa,formed from the ahara (diet) while circulating in the body, when reaches yakrut(liver), pleeha(spleen), attains red colour due to ranjak pitta and will be known as Rakta.
Though rakta is circulating continuously in our body its main seats are yakrut(liver)and pleeha(spleen), and from here it governs the other seats of rakta (rakta sthna).
Functions of  Rakta:
The prakrut (non vitiated) rakta improves complextion and nourishes mamsa dhatu and does the most important function of Jeevan (life maintainence).
Properties of Rakta:
It is Panchabautik (constituting all five Basic Principles) and is Anushna shita (for touch), Madhura (sweet), Ishat lavana( little salty),Guru(heavy) , Visra (having peculiar odour).
A person who possesses non vitiated and excellence quality Rakta is called Rakta Sara Purusha and he exhibits the following characters:- unctuous, red colour, beautiful dazzling appearance of the ears, eyes, face, tongue, nose, lips, sole of the hands and feet, nails, forehead and genital organs. Such individuals are endowed with happiness great genius, enthusiasm, tenderness, moderate strength and inability to face difficulties and cannot tolerate hot food and environment such as travelling at noon.
Rakta vitiating factors
Alcohol consumption, excessive intake of salt, sour , pungent ,unctuous and heavy food items, stale food, and over eating, sleeping immediately after food,exposure to sun of hot environment, stress and not performing Raktamokshana. rakta is naturally vitiated in sharad (autumn)
Raktapradoshaja Vyadhi(Diseases cause by vitiated blood)
            The following diseases occur due to the vitiation of blood, mukhapaka(oral ulcers), akshiraga(redness of eyes),  asyagandhika(foul odour from mouth), gulma, upakusa,(bleeding from gums) visarpa(herpes Zoster), raktapitta(epistaxis), pramilika, vidhradhi, pradara(excessive menstrual flow), vatashonita, vaivarnya(discoloration of skin), agnisada, pipasa(frequent thirst), gurugatrata(heaviness of body), daha(burning sensation), tiktamla udgara(burps with sour and bitter taste), specially of the diet and drink that are not properly digested, krodha(anger), salt taste in mouth, sweda(excessive sweating), shareeradaurgandhya(body odour),  kampa(tremours), atinidra(excessive desire to sleep), tamodarshana(blackouts), kandu(itching), kota, pidaka, kushta(skin diseases).
CLASSIFICATION OF RAKTAMOKSHANA:
 Depending on various factors, the media used for bloodletting varies. In absence of specific media any one of said procedure can be used for the purpose.
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(palm), the Alabu from an area of twelve anguli( 1finger breadth), Pracchanna from an area of one anguli, while Siravyadha(venous puncture) can purify the entire body.
 In deep seated pathology, Jalauka(leech application) is preferable, in case of generalized vitiation of rakta – Siravyadha is advised and Shringa(horn), Alabu if pathology is superficial/utthana.

Indications for Raktamokshana:

Bloodletting as a method of treatment is indicated in skin disorders, Sotha(swelling), daha(burning sensation),  Vatarakta(gout), kushta(skin disorders), vata diseases having severe pain, slipada(elephantiasis), blood vitiated with poisons, granthi,Vidradhi, arbuda(cancer),  heaviness of the body, raktabhishyanda(conjunctivitis), yakrutpliha roga, visarpa(herpes),  pidaka(boils), paka. In all diseases, bloodletting can be done either by Shringa, Jalauka or by Siravyadha.

Contraindications of Raktamokshana:
 Generalised swelling, swelling in debilitated persons, caused by sour diet and that in those suffering from Pandu(anemia), Arshas(bleeding piles), Udara(ascites),  and in Garbhini(pregnancy).
Procedure
The procedure is divided into 3 parts
1.Purva karma (pre operative procedure)
 In the preoperative procedure. Snehana (oleation) internal and external, swedana(hot fomentation with steam to whole body)
2.Pradhan Karma(operative procedure)
a) By using jalauka(leeach)
The patient is made to lie on bed comfortably. The leach is applied over the affected part. The leech starts to suck blood when its mouth becomes raised and appears like horses hoof.
If the leech does not suck blood a drop of milk is put at the spot or a small prick with sterilized needle is taken. A wet cotton is kept over the body of leech to keep it moist  and alive. The leech leaves the spot after a while or is deliberately removed when the patient experiences pricking pain at the site. (This pain indicates that the Leach is sucking pure blood)
b) siravedha (venous puncture)
The patient is asked to lie comfortably over a bed. The air cuff of sphygmomanometer is tied over the bicep muscle of hand. The patient is asked to clench his fist tightly. The cuff is inflated and the desired vein(medial cubital is preferred) is punctured with a sterilized scalp vein(butterfly) needle. Cuff is removed and the blood is collected in a kidney tray. When the sufficient quantity of blood is drawn the needle is withdrawn and patient is asked to loosen his fist. A cotton swab is pressed over the wound.
3.Paschat karma (post operative procedure)
If bleeding continues from the diseased site fine powders of lodhra (Symplocos racemosa), yastimadhu(Glycyrrhiza glabra),raktachandana (Pterocarpus Santalinus)etc. are applied. The area is covered is wet cloth or a thin paste of cooling dravya like chandan is applied.
The patient is advice to take rest and can be given light diet or milk later in the evening.
Rice flour is applied to whole body of jalauka and little siandhava lavana (rock salt) and oil is applied to its mouth. And it is squeezed gently from tail to mouth in order to remove the sucked blood. Now jalauka is immersed in water and can be used after a span of seven days.

Regimen to be followed by the patient:
After the procedure patient must strictly avoid anger, stressful work, excessive indulgence in sex, sleeping at day time(especially after meals), exercise, travelling, exposure to wind and sunlight.
Benefits of Raktamokshana
One who timely performs Raktamokshana never suffers from skin diseases ,and other Raktaja vyadis mentioned above.