Introduction

Jalaukaavacharana  is one of the most effective therapy blood letting therapy in ayurveda .  The process of blood letting in which leeches are been used is known as jalaukavacharana.

Word meaning

                                          Jalaukavacharana  = jalauka + avacharana

Jalauka – the one which is having their abode is water - leech

Leeches are also named as jalayukah as the water is its life. As leeches emerges from water , lives in cold and is sweet due to which it is being used for  blood letting when pitta is vitiated.

It is been  included under  raktamokshana ,which is considered to be one among the purificatory therapies ( shodhana ).according to acharya susruta , the purificatory therapies are divided into a group of 5 which are been named as panchakarmas. The 5 purificatory therapies are vamana ( emesis ) , virecana ( purgation therapy ) , vasti ( enema) , nasyam ( nasal drops) , raktamokshana ( blood letting )).acharya susruta had given more importance to rakta ( blood ) as it is considered to be life and its loss from the body can lead to death of a person . As susruta was well versed in surgical thechniques , he had a viewpoint that   blood played a important role in the body and its loss can create harm to patient  , therefore it should be  termed as the 4^th dosa and included raktamokshana under the panchakrama.

Word meaning of raktamokshana-   raktamokshana= rakta + mokshana

                                                                                     Rakta – blood

                                                                            Mokshana – letting it to flow

 Rakta ( blood )- according to ayurveda

According to ayurveda the main function of blood is jeevanam( maintainance of life ). Rakta is considered to be the root of life and it is the one which sustains the life .due to this reason , with all the efforts we should protect it.

Rakta is formed from the first dhatu i.e rasa dhatu ( plasma ) and due to action of ranjaka pitta  , blood is attaining the red colour.the transformation into red colour happens when it goes to liver and spleen.

Blood is composed of all panchamahabhuta ( 5 elements of universe ) and qualities of them are seen in the blood such as :-fishy odour, liquidity, redness , pulsation  & lightness

Characteristics of normal blood :

• Not too thick
• Free from discolouration
• Stimulates indragopaka ( a red coloured insect which come out of earth in rainy season)

Types of blood letting therapy

According to materials used –

1. Shastra krita ( using sharp instruments )

Word shastra means anything which is sharp in nature ( sharp instruments )  . Word krita means which is being done.the process  in which sharp instruments are being used is known as shastrakrita. The therapies included under it are :

1. Prachannam - the process in which series of pricking which is been done using sharp instruments over superficial layers of skin.it is being used when vitiated blood is is accumulated over superficial layers of skin which is concentrated to  one place
2. Sira vyadhanam -  a superior grade of blood letting procedure in which vitiated blood is being taken out from the body using vein puncture.it is been done when the vitiated blood is present all over the body.

 

2. Ashastrakrita ( without using sharp instruments )

1. Shringa ( horn )- horn of animals such as cow are used in this procedure ,  mainly if  twak (layers of skin ) are effected with vata dosha.
2. Alabu (gourd ) -if  twak (layers of skin ) are effected blood letting with gourd can be done.
3. Jalauka (leech ) – non poisonous leechs are used for blood letting when blood is vitiated by pitta dosha

More about leech :-

Jalauka are of 12 varieties , which can be subdivided  into  2 types ie poisonous and non poisonous . There are 6 poisonous varieties and 6 non poisonous varieties .

Poisonous varieties are seen mostly in arab countries (yavana ) , south india (pandiya ), central india (sahya) and region in and around uttarpradesh.poisonous ones are born in water which is rich in urine , faeces , putrified or decaying blood bodies of fish , animals etc .  For therapeutic procedures non poisonous leeches are being used as it is not harmful to patient.usage of poisonous varieties can lead to huge swelling , itching , swelling , loss of consciousness , fever , burning sensation , vomiting , malaise , intoxication.

Non poisonous are found in clean water bodies which is devoid of decaying animals and which is rich with flowers like lotus , lilly etc .the one which move round in clean and fragrant water , abstaining from eating unwholesome food are wholesome  for therapeutic usage.

Leeches which is having blotting in the middle part of the body ,  ugly in nature , having large body size , which are slow in movement , sucks only little amount of blood ,  not holding on the body , are not recommended for therapeutic procedures.

Benefits of blood letting by using leech

• Most delicate therapy
• Can be used for those who are delicate in nature
• Can be used for old , children , women , timid etc . As these persons are physically and mentally tender , no higher grade of therapies can be done on them. In such cases jalaukavacharana is highly effective.
• Acts on deeper layers of body
• Its much easier to do the procedure
• Much faster result
• Greater reduction in the symptoms
• Complications are rare
• Cost effective in nature

Process of collection and storage of leeches

• Caught from fresh water pound by dipping a fresh skin ( or a piece of flesh )/ a piece of leather.
• Later they are detached from skin and is been trasfered to a pot containing water from same pound ( or any water which is not chemically treated can be taken. Presence of chemicals inside the water can lead to death of the leech. Containers which is having small small opening in their lids can be used if the earthern pots are not available. The presence of minute openings on lid will help in air circulation ).
• The water in the pot should be changed every 3^rd day and the pot should be changed every 7^th day.
• The leeches can be fed with little pieces of dried meat / aquatic tubers (powder )as food.
• Collection of leeches can be done in autum season

Materials required for jalaukavacharana

• Leech
• Turmeric
• Cotton piece
• Water
• Vessels
• Jatyadi ghritam ( if needed)

Preparation of jalauka for therapy

Leech should be transferred from the pot to a vessel containing fresh water. The leech should be cleaned well. Then leech is being transferred into a vessel containing water added with a pinch of turmeric. By this process the leech get activated .after leeches get activated, the leeches should be transferred from the water containing turmeric into another vessel containing fresh water.

Procedure of jalaukavacharana

Person on which jalaukavacharana is to be done is made to sit / lie comfortably depending upon site over which leech is to be kept.the site should be cleaned with warm water using a cotton piece. Then leech is taken out of the water and it is been kept over the site . The leech will attach to the site by itself within a few minutes. If the leech didn’t get attached by itself over the site , then a small drop of blood of the same patient can be dropped over the site. Otherwise a pick over the site can be done using the sharp instrument.when the blood start coming out  of the site, the mouth part of leech can be kept near to the blood. The leeches being attracted towards blood will attach to the area by itself. When the leech get attached to the area , the leech will attain a horse shoe shape over the neck region. Then a thin cotton piece which is dipped in water is made to spread over the body of leech. The leech should not be disturbed till  it detaches from the site by itself . Leech should be allowed to stay over the site for 45 min. If it didn’t detach by itself within 45 minutes / if any pain is created while sucking blood , then leech should be detached by putting a small pinch of  turmeric over its mouth end.as it is irritant towards turmeric , it will detach from the area within few seconds. After the detachment of the leech , person who had undergone the therapy as well as the leech should be taken care well.the site of leech bite should be cleaned well and the site should be packed with turmeric / jatyadhi ghritam and a mild bandaging should be done . The leech should be transferred to a vessel as soon as possible after the leech had detached from the site. Then leech should be made to vomit by adding a small pinch of turmeric over the mouth of leech. Due to the irritation , the leeches will start vomiting out the blood. A mild massage with 1 finger over the leech can be done from tail end till the mouth end . This will help the leech to vomit out the blood. As soon as the vomiting process is completed , the leech can be transferred to a vessel containing fresh water.then the body of leech should be cleaned well with cotton piece dipped in water , so that it will be devoid of turmeric .later the leech can be transferred back to the pot. The same leech should not be used for another person. Therefore the leech which is used for a particular person should be kept separated from other leeches . its better to name the pot and the date of usage should be noted over it . This will help us to prevent the diseases which are transmittable in nature .

Ideal time for raktamokshana- moderate season ( not too cold / not too hot)

Benefits of cleansing the blood of its vitiations

• Increases the lusture
• Sence oragans become clear
• Person will be able to recognize things in a balanced  or ideal manner
• Improves the function digestive fire ( without any obstacles)

• Lightness of body
• Cessation of pain
• Decrease in intensity of disorder
• Cheerfulness of mind

Precautions

• The proper vomiting should be done for leech till it returns back to the normal size.
• No residue of turmeric should be there on the leech
• If there is pain during the course of therapy , just stop the treatment at once.
• Proper naming of pots ( name of person and date of last therapy )should be done to prevent the mixing up of  leeches of one person with other person.