PRACHCHHANA AND JALAUKAVACHARANA IN SHALAKYATANTRA

PRACHCHHANA AND JALAUKAVACHARANA

• Prachchhana and Jalaukavacharana are classical Raktamokshana (bloodletting) procedures mentioned in Ayurveda, specifically under Shalyatantra and Shalakya Tantra, used for treating localized blood vitiation and inflammatory conditions.

• These methods are especially indicated in Netra (Eye), Karna (Ear), Nasa (Nose), Mukha (Oral cavity), and Shira (Head) regions in Shalakya.

• The aim is to reduce Dushta Rakta (vitiated blood) and relieve symptoms such as Sopha (swelling), Daha (burning), Raga (redness), Ruja (pain), etc.

PRACHCHHANA (SCRATCHING/BLOODLETTING WITH MULTIPLE INCISIONS)

DEFINITION

• Prachchhana is a method of Raktamokshana involving multiple superficial linear incisions made using a sharp instrument.

SANSKRIT REFERENCE
स्रावेच्छो रक्तदुष्ट्यक्तुं प्रच्छनं विधिना वदेत्।
छेदैर्मृदुभिरालाभैरधोमुखगतान्यपि॥
— Sushruta Samhita, Sutrasthana 13/9

INDICATIONS (YOGYA ROGAS)

• Netra abhishyanda (Conjunctivitis)

• Karna shula (Earache)

• Ardita (Facial paralysis with blood stagnation)

• Vranashotha (Inflamed wounds)

• Raktaja rogas (Blood-borne disorders in ENT)

CONTRAINDICATIONS (AYOGYA ROGAS)

• Pandu (Anemia)

• Arsha (Piles)

• Garbhini (Pregnancy)

• Bal, Vriddha, Durbala (Children, Elderly, Weak patients)

PRACHCHHANA KARMA – STEP-BY-STEP PROCEDURE

PURVA KARMA (PRE-OPERATIVE MEASURES)

• Sthanika Snigdha Swedana – local oleation and sudation to facilitate easier blood flow.

• Prayoga of Rakta-prakopaka Ahara-Vihara to vitiate and localize Rakta if required.

• Patient is advised to lie in a comfortable position.

PRADHANA KARMA (OPERATIVE MEASURES)

• Sterilized sharp knife or blade is used.

• Multiple superficial incisions (linear or crisscross) are made over the swollen/inflamed area, avoiding deeper tissues.

• Direction of incisions is made downward (adhomukha) to facilitate gravity-assisted drainage.

• Let the vitiated blood ooze out till bright red blood appears.

• Procedure is done gently and with sterile precautions.

PASCHAT KARMA (POST-OPERATIVE MEASURES)

• After satisfactory bloodletting, the area is washed with medicated decoction (Triphala, Panchavalkala).

• Apply antiseptic or healing herbal pastes (like Jatyadi lepa or Haridra)

• Bandage with sterile gauze.

• Observe for signs of excessive blood loss or infection.

MODERN CORRELATION

• Superficial scarification and wet cupping (Hijama) are comparable methods in modern alternative therapy.

• Used to relieve congestive inflammatory ENT conditions like furuncles, cellulitis, and chronic inflammatory otitis externa.

JALAUKAVACHARANA (HIRUDOTHERAPY / LEECH THERAPY)

DEFINITION

• A method of Raktamokshana using medicinal leeches (Jalaukā) for painless and safe bloodletting, ideal for delicate body parts like the eye, ear, and face.

SANSKRIT REFERENCE
जालूकाः शमयेयुस्तु रक्तदुष्टिं न संशयः।
— Ashtanga Hridaya, Sutrasthana 26/41

INDICATIONS (YOGYA ROGAS)

• Netra roga – e.g. Abhishyanda, Adhimantha (Conjunctivitis, Glaucoma)

• Twak vikara – Kushtha (skin diseases)

• Raktaja shotha – Inflammatory swellings of ENT regions

• Karna roga – Karna nada (tinnitus), Karna srava (discharge)

• Siroroga – Painful conditions of head and face

CONTRAINDICATIONS

• Pregnancy

• Immunocompromised patients

• Anemia

• Uncontrolled diabetes

• Excessively dry or oedematous areas

JALAUKAVACHARANA KARMA – STEP-BY-STEP PROCEDURE

PURVA KARMA

• Selection of non-poisonous (nontoxic) leeches – classified as Savisha (toxic) and Nirvisha (non-toxic).

• Wash the leeches in clean water and smear with turmeric powder to remove external slime and parasites.

• Local area is cleaned and massaged with milk or ghee to attract the leech.

PRADHANA KARMA

• Leech is applied on the desired site.

• It starts to suck blood and gradually swells.

• Signs that bloodletting is happening: Slight burning or pricking sensation, mild pain, and leech detaches once full.

• If it doesn’t leave on its own, apply a pinch of rock salt or turmeric near its mouth.

PASCHAT KARMA

• Application of healing herbal paste (like Haridra or Jatyadi) over the site.

• Leech is induced to vomit the ingested blood by rubbing turmeric or mustard on its mouth.

• Keep leech in clean water with regular monitoring.

• Avoid scratching or manipulating the bite area.

• Observe for signs of allergy or excessive bleeding.

SANSKRIT SHLOKA ON MANAGEMENT
दंशान्मुक्तां जले स्थाप्य पुनर्मार्जय भेषजैः।
स्नेहस्वेदैः प्रदातव्यं दोषाकृष्टिं विचक्षणैः॥
— Sushruta Samhita, Sutrasthana 13/15

MODERN CORRELATION

• Leech therapy (Hirudotherapy) is scientifically accepted.

• Leeches secrete Hirudin, an anticoagulant, and local anesthetic, which improves blood circulation and pain relief.

• Used in plastic surgery, ENT inflammatory conditions, venous congestion, hematoma, and post-traumatic inflammation.

BENEFITS

• Minimally invasive

• Ideal for highly vascular and delicate regions

• Anti-inflammatory and decongestive

• Painless and safe when performed properly