Panchakarma is a globally known term today, and it has grown into a super specialty of Ayurveda. Panchakarma aims at the complete  cure of the disease  from its root so that any chance of reoccurrence does not occur.

According to Acharya Susrutha the 5 karmas are Vamana (Emetic), Virechanam (purgative),  Vasti (Enema), Nasyam (Instilling medicines through nose) and rakthamoshana (bloodletting).

Among these five, that involved with the renewal of dushta raktha (bad blood) ie. Rakthamoksha (Bloodletting).

Rakthamoksha is divided into two.

1)         Those using shastra (ie. Using surgical instruments)

2)         Those without using shastra (ie. Without surgical instruments)

According to the 3 doshas it is classified as

1. For vata dosha – Remove blood using horns of deer or bull
2. For pitta dosha – Remove blood using leeches
3. For kapha doshas – Remove blood using  ghatiyanthram (an instrument prepared using fruit of cucurbit variety)

The practice of Raktamoksha later back to ancient  time, and it is still practiced  today. The remarkable  outcome from this has actually  given a boost to the ayuvedic system of medicine.

Jaluka or Leech Therapy

Jaluka or leeches are found in cold and damp places. They are of cold potency organisms (Sheeta veerya), so used to pittaja vikara (diseases).

Types of leeches :  Devided in to two main groups.

Savisha – that with visha   and  Nirvisha – that without visha

Savisham is of 6 types  (Poisonous leeches)

1. Krishna: It is black with long head
2. Karbura: It is similar to rohita matsya
3. Alagarda: This has hair and small tumors all over the body
4. Indrayudha: Withmany colours, like a rainbow
5. Samudrika: It is yellow and black colour. Its body is covered with many spots.
6. Gochandana: Similar to cow’s male organ.

Savisha (poisonous) leeches have poison in them. They are not used. If these bites they cause raktha ashudhi (impurities to blood), itching and wounds which do not heal very fast.

Nirvisha (Non poisonous leeches)

It is of 6 types

1. Kapila: Brown colour
2. Pingala: Red colour of round shape
3. Shankamukhi: Similar to colour of liver. It can drink blood fast.
4. Mushika: Colour and smell of rats
5. Pundarikamukhi: face similar to lotus
6. Savarika : 18 finger breadth (18 angulam)

Specialty of leeches

Leeches  have the ability  to  suck blood  through  its special  orifices  present  in the front and back of its body.  Its mouth has 3 sharp teeth.  A leech  can  suck  blood  for about  30 minutes to 6 hrs.  And it  can  suck from  5ml. to 50 ml.  The sucked blood can  be stored in its digestive system for months and months.  To digest this sucked blood, it takes about 6 months to 1 year.

Process of blood digestion by leeches

Like all animals the saliva of leeches have many enzymes.  One such enzyme is hirudin.  The special quality  of hirudin  is that  it can  prevent blood coagulation, ie. Acts as an anti-coagulant.

Leech biting

The process of leech therapy  is done under 3 headings

1. Pre operative procedure (Poorvakarma)
2. Operative procedure (Pradhana karma)
3. Post-operative procedure (Paschat karma)

Pre operative procedure (Poorvakarma)

• Good leeches should be collected from fields and marshy areas.
• The leech should be  kept in water  containing paste of turmeric for a while.
• This cleanses the digestive tract of the leech.
• The place to be bitten by leach should also be washed with turmeric.

Operative procedure (Pradhana karma)

• Place the leech over the place to be bitten.
• If it is not biting that area – apply honey or butter or prick the area with a small sterilized needle.
• When the leech  has started sucking blood, place a wet cotton over its body.
• Simultaneously drop a few beads of water frequently  over its mouth.  This process  increases the blood sucking speed of the leech.
• Once the patient feels itching or pain at the site of bite, then the leech should be removed.
• This can help us understand that the bad blood is sucked fully and the leech  is sucking the good blood, so leeches removed from the area.

Post operative (Paschat karma)

• The leeches are made to vomit the drunken blood by dropping turmeric powder over its mouth.
• Sometimes it should be made to vomit manually by rubbing leeches body from its tail side to head side (ie. In opposite direction of sucking) this removes the sucked blood.

Care of site of bite

• The area bitten by the leech should be cleaned and washed.
• It should be bandaged with shatadhauta ghrita or with honey and turmeric.

Cure of leech after bite

• The leech should be checked if proper vomiting of blood is done, or else it will become weak or even may die.
• If proper vomiting by the leech, it regains its early mobility and strength.
• It should then be transferred to separate jars filled with good water (avoid chlorinated water) and stored for further use.

Disease where Leech therapy is done

1. Arthritis
2. Vascular and venous diseases
3. Varicose vein ulcer
4. Heart and lungs problems
5. Skin conditions like psoriasis, eczema etc.
6. Disease of the eye
7. Genitourinary diseases
8. Gynecological disorders