Raktamokshana is one among the Panchakarma therapies which is exclusively indicated in Raktaja and Pittaja vyadhi’s
Rakta mokshana is a process of letting the vitiated blood out of the body as a treatment procedure which are caused due to the imbalance of Rakta and Pitta(one among the three basic elements and the body and one among the body component).
This procedure is carried out by using a sharp surgical instrument or by using any Para-surgical methods or by the use of Jaloukavacharana (Leech therapy)
The main Classification of Raktamokshana are
Shastra visravana—use of surgical instruments
Anushastra vidhi—mainly the use of jalouka’s

Treatment procedure.
The treatment procedure is divided in to three parts…

Purva karma(pre procedure)
Pradhana Karma(main Procedure)
Pashyat Karma(Post Procedure)

PURVA KARMA (PRE PROCEDURE)
Selection of the patient:-
Selection of the patient for this procedure is depend up on the diagnosis which is done with
Astha vidha pareeksha’s(eight fold examination)and Dashavidha Pareeksha’s(ten fold examination) which is done by a qualified physician.

Selection of the Jalouka

JALOUKA
It is an aquatic creature which is employed to expel out the vitiated blood from the body. There are more than 600 species of leeches that have been identified, but only 15 of the species are used medically, so they are given a class of their own. They are classified as Hirudo Medicinalis or medicinal leeches.

There are two types of Jalouka’s:-

• Savisha with poision
• Nirvisha without poision

Nirvisha jalouka’s are the medicinal leeches and based on the purpose of treatment medicated leeches are selected The selection of the leeches depends on their habitat, color, food etc. Habitat of Nirvisha Jalouka—the medicated leech is amphibious, needing both land and water, generally they are found in watery region, swim in sweet water, take shelter under, stones, plants and other objects in shallow water, also in pond, lakes some times in still water in rice fields.
Preservation of jalouka-After collecting the jalouka they are kept in a wide earthen pot and on every third day the water should be changed and after 5 to 6 days the pot should be changed. Nutrition for jalouka-aquatic plants, grass which are made as a bed for the jalouka.
In Healing earth multi specialty ayurveda hospitals the doctor’s are well versed in indentifying the habitat, their method of collection, varieties, storage and method of application, because of this they are successful in treating the indicated diseases with the help of jalouka’s.

PRADHANA KARMA(MAIN PROCEDURE)
After explaining to the patient about the procedure patient is made to lie down on the droni, the affected part is cleaned properly and the selected leech is applied on the affected part. A prick is made on the skin, if the leech is not pricking by itself ,then we have to apply milk on the affected part or we can give a prick with the help of a sterile needle, then immediately the leech will start sucking the impaired blood.

The leech is covered with wet cotton when they start sucking the blood just to cool the body of leech.

Duration of the treatment: Till the patient feels itching sensation at the site of bite or till the leech takes off its sucker from the bite area by itself.

PASHYAT KARMA (POST PROCEDURE)
When patient experiences burning sensation remove the leech from the affected area by applying haridra(turmeric) or saindhava (medicates salt ) on the affected area.

INDICATION FOR LEECH THERAPY

• Non healing ulcer
• Diabetic ulcer
• Skin disorders
• Varicose vein
• Leucoderma
• Warts
• Foot Corn

MODE OF ACTION OF JALOUKAVACHANA

Once the leeches are applied on the affected part of the body of the patient they start sucking blood, the saliva enters the puncture site and along with it the enzymes and compounds responsible for all these positive effects starts working together.
Anticoagulating Effects of Leeches.
The leech’s saliva contains enzymes and compounds that act as an anticoagulation agent. The most prominent of these anticoagulation agents is hirudin, which binds itself to thrombins, thus, effectively inhibiting coagulation of the blood.
Anti-inflammatory Effects of Leeches
Bdellins is a compound in the leech’s saliva that acts as an anti-inflammatory agent by inhibiting trypsin as well as plasmin. It also inhibits the action of the acrosin. Another anti-inflammatory agent is the eglins.
Vasodilating Effects of Leeches
There are three compounds in the leeches’ saliva that act as a vasodilator agent, and they are the histamine-like substances, the acetylcholine, and the carboxypeptidase A inhibitors. All these act to widen the vessels, thus, causing inflow of blood to the site.
Bacteriostatic and Anesthetic Effects of Leeches
The saliva of leeches also contains anesthetic substances which deaden pain on the site and also bacteria-inhibiting substances which inhibit the growth of bacteria.
The action of destabilase is to break up any fibrins that have formed. It also has a thrombolytic effect, which can also dissolve clots of blood that have formed.
All these effects act to cure the disease present in the individual. Because of anticoagulation agents, the blood becomes thinner, allowing it to flow freely through the vessels. The anti-clotting agents also dissolve clots found in the vessels, eliminating the risk of them traveling to other parts of the body and blocking an artery or vein. The vasodilating agents help to widen the vessel walls by dilating them, and this causes the blood to flow unimpeded, too.
Patients who suffer from pain and inflammation will feel relief from the anti-inflammatory and anaesthetic effects of the leech’s saliva.
In the long run, leech therapy also helps to normalize the blood pressure of hypertensive individuals as well as lessen their risk of suffering from stroke and heart attacks. Blood circulation is also improved with leech therapy and it helps with the healing process of wounds, as well as wounds and lesions caused by diabetes. There is also a noticeable boost in the immune system’s function due to bacteriostatic agents.