Thursday, November 6, 2014

Leech therapy in Ayurveda

Definition of ‘Jaloka’

As the very basis of life for ‘Leeches’ is water, since their site of dwelling is ‘Jal’ i.e.
water, the ‘Leeches’ are known as ‘Jaloka’.
Jaloka Avacharan(Leech therapy )
· In this method, Raktamokshan is done with the help of ‘Leeches’ i.e. Leeches are
applied on the desired site for blood letting.
· It is considered most unique & most effective method of blood letting. Here, the
vitiated ‘Doshas’ are removed from the body without using any cutting
instruments, hence Raktamokshan by means of ‘Leech’ comes under ‘Ashastra’

Types of Jaloka

Broadly Jalokas’ are divided into two types:
- Poisonous (Savish Jaloka)
- Non- poisonous (Nirvish Jaloka ).
Six different types of Leeches are found in both poisonous & non- poisonous category.
Basically, these Jalokas are named according to their appearance i.e. their external look
or colour.
Poisonous Non- poisonous
Krishna Kapila
Karbura Pingala
Alagarda Shankh- mukhi
Saamudrika Mushika
Indra- yudha Pundarik- mukhi
Go chandana Saa varika

Identification of Non- poisonous Leech

The Non- poisonous or ‘Nirvish Jalokas’ can be safely identified by their
1. Yellowish- Manhshila-like colour,
2. their swift activity or
3. by their glitter like or copper like colour,
4. by their wide lotus- bud like mouth &
5. by their glistening appearance.
· Generally, these Leeches are grown in pure flowing water, ponds with clean water
& the lakes in which there are lotus flowers & greenery.
· Note: The poisonous Leeches are found in Muddy water, Gutters or in water
which is contaminated by urine, stool, fish, frog & other water animals. They are
comparatively bigger in size & dark in colour. After the application they produce
severe pain, itching or allergic reaction at the site, giddiness, fever, burning
sensation, vomiting. Also few patient may develop signs of intoxication &

About Leeches

· Scientific name: Hirudo medicinalis
· Country: Albania, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bulgaria,
Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece,
Hungary, Ireland, Italy, Kazakhstan, Latvia, Lithuania, Luxembourg, Moldova,
Netherlands, Norway, Poland, Portugal, Romania, Russia, Spain, Sweden,
Switzerland, Turkey, Ukraine, United Kingdom, Yugoslavia
· Continent: Europe, Asia
· Diet: Blood of birds, fish, frogs, mammals
· Food & feeding: Carnivore
· Habitats: Freshwater
· Conservation Status: Near Threatened
· Relatives: Earthworm, lugworm
· Description: Leeches have segmented bodies like an earthworm, but unlike
earthworms they are slightly flattened rather than round. They have a sucker at the
head and the tail end and the one at the head surrounds the mouth. The mouth
contains three jaws that can break the skin of their hosts to suck their blood.
Medicinal leeches are greenish brown on their backs with thin red stripes running
along the body and paler below. They grow up to 20 cm in length.
· Lifestyle: Leeches live in shallow muddy pools and ponds with plenty of
waterweeds. When hungry, they attach themselves to a passing animal, break the
skin with their jaws, and inject special chemicals that prevent the blood from
clotting and reduces any pain. They then suck the blood of the host until they are
full, when they withdraw their jaws and drop off into the water. They can
consume 15 grams of blood - ten times their own body weight, before they are
full, but they only need to feed every six months.
· Family & friends: Like slugs, leeches are hermaphrodite, having both male and
female parts, but they still need to come together to mate with each other.
· Growing up: After mating, 15-50 eggs are laid in a spongy case or cocoon, above
the waterline often under stones. The eggs hatch in 3-5 weeks and the young
leeches need two seasons of feeding before they are ready to breed themselves.
Materials and equipments for leech therapy
· Ideally a separate Leech therapy room is preferred.
· This room should be well equipped with
· patient bed,
· Separate tanks for storage of leech,
· The dressing trolley having gloves, gauze pieces, Normal saline , blood pressure
instrument, emergency medicines
· Adequate number of sterile tray for cleansing of leech, cleansing material like
turmeric powder etc. dressing materials

Purva karma:
Preparation of patient

· Selection of suitable patient
· Laghu Aahar (Light semi-solid diet) like Yavagu etc is advocated before the
· Coagulatory disorder like haemophilia should be rulled out. Similarly,
recautionary measures should be taken while handling the Anaemia, Diabetes,
Hepatitis, HIV patients.
· No Snehan i.e. oleation should be allowed. However,Mild Swedan (half hour
before) to the site of blood letting can be given.
· The desired site is properly washed with cold water.
(One should not apply Spirit gauze or turmeric to clean the area in any condition.)
Preparation of Jaloka
· Fresh Leech from the tank/ jar is chosen & dropped in a tray or bowl filled with
clean water.
· Fine turmeric & triphala powder is mixed in it. One can observe that an inactive
Leech becomes highly active & runs all around the tray immediately after
sprinkling of the powder which indicates its carving for food.
· After this, the active Leeches are selected & transferred in another tray having
clean water.
Pradhan karma/Main Procedure:
· The desired site is cleaned with wet gauze.
· Now, the Leech is held at its neck with fingers & applied directly to the skin, 5-
10 Leeches are applied at a time depending upon the necessity.
· Once Leeches start sucking the blood, they are covered with wet gauze & cold
water is poured on them from above time to time, so as to make Leech
comfortable during sucking.
· If Leech do not catch the site by its own, in such condition a small niche or prick
induced bleeding may be required so as to facilitate the sucking procedure.
· The Leech when once starts sucking the blood, elevates its neck, and fixes its
head to the supporting point of skin. One can observe wave like movements
indicating sucking of blood.
· When Leech becomes fully satisfied with its food, it leaves off the skin of he
patient & drops itself down.
· If not- then the patient may feel itching sensation which indicates impure blood
from that spot is no more available for the Leech.
· In such a case, a little turmeric powder is placed on the sucking point of the Leech
& immediately the Leech takes s away its mouth from that point.
· One should not apply Leeches to major veins like Femoral or Jugular veins and to
the delicate parts like Breast, Penis or Eye lids.
· Used Leeches should be kept in separate jars.
Amount of blood loss:
· Each Leech sucks around 15 to 20 ml of impure blood at one application.
Pashchat karma: (Post operative)
Post procedure Pateint’s care-
· Leech is removed from the site
· The site is cleaned with savlon or normal saline
· Turmeric powder is placed to the bleeding site
· Bandaging is done to arrest the bleeding. (sometimes the oozing from the site do
not stop, in such cases wound can be sealed with the help of tincture benzene )
· Sips of Lime water, Soup or Glucose water can be offered to the patient.
· Patient is allowed to sit for some time before leaving the place.
Post procedure Jaloka care-
· Leech after the use is kept in an empty tray.
· Turmeric powder is placed on its mouth so as to induce vomiting.
Immediately after this one may find jets of black coloured blood being emitted by the
· Some of the practitioners advocate to gently squeeze out the blood with fingers
from anus to mouth.
· After this the Leech is again washed in clean water.
· In the end Leech is transferred in the jar starving for seven days.

Specialty of Leech-

· A Leech has got an anti- coagulant chemical called Hirudin. While sucking the
blood this Hirudin prevent clotting of blood.
· Ayurveda believes that Leeches suck only the impure part of blood. We can
assume the sucking of blood from superficial veins which is deoxygenated or
impure one.
Hirudin Inhibits blood coagulation by binding to thrombin
Inhibits blood coagulation by blocking the binding of von
Willebrand factor to collagen. Inhibits collagen- mediated
platelet aggregation
Destabilase Monomerizing activity. Dissolves fibrin. Thrombolytic effects
Hirustasin Inhibits kallikrein, trypsin, chymotrypsin, neutropholic
cathepsin G
Bdellins Anti-inflammatory. Inhibits trypsin, plasmin, acrosin
Hyaluronidase Increases interstitial viscosity. Antibiotic
Tryptase inhibitor Inhibits proteolytic enzymes of host mast cells
Eglins Anti-inflammatory. Inhibit the activity of alpha-chymotrypsin,
chymase, substilisin, elastase, cathepsin G
Factor Xa inhibitor Inhibits the activity of coagulation factor xa by forming
equimolar complexes
Complement inhibitors May possibly replace natural complement inhibitors if they are
Carboxypeptidase A
inhibitors Increases the inflow of blood at the bite site
Histaminelike substances Vasodilator. Increases the inflow of blood at the bite site
Acetylcholine Vasodilator
Anesthetics subsctance Anesthetic

Indication & Utility of Leech Thearapy-

· It is used effectively in the management of non- healing ulcerative lesions like
Diabetic ulcer, Leprotic wound etc. as it helps to improve the local blood
circulation. Hence, healing is promoted.
· It relieves vascular congestion. So, can be effectively used in conditions like long
standing Varicose ulcers, Filariasis, post-op. skin grafting lesions.
· It is used in Arthritis, Sprain or spasm to relieve the pain, inflammation &
discomfort symptomatically.
· Used in Abscess, Cellulites, Thrombophlebitis and Varicose Veins
· Useful in third degree thrombosed prolapsed Piles.
· Useful in Atherosclerosis of the limb as it improves circulation.
· Jaloka siddha oil is used locally to treat hyper pigmentation.
· Useful in various skin disorders like Eczema, Pimples, and Psoriasis etc.
· Research is going on to study the efficacy of Leech in the management of MI
(where it is used around the pericardium) & stroke as it has got an anti- coagulant
chemical called Hirudin which resembles drugs like Heparin & Strepto- kinase.
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