Raktamokshana- When Purification Involves Blood

Raktamokshana is probably the Panchakarma procedure most strongly associated with the surgical tradition of Acharya Sushruta.

Literally, the term refers to the controlled letting or removal of blood.

Different classical techniques existed, including venesection and scarification, but one of the most remarkable is Jalaukavacharana—the application of medicinal leeches.

The Sushruta Samhita devotes an entire chapter, Sutra Sthana Chapter 13, to leeches: their selection, application, observation and aftercare. Sushruta regarded leech application as a comparatively gentle method of bloodletting for selected individuals.

To a modern reader it may sound like medicine from a distant world. And then one discovers that medicinal leeches never entirely disappeared from modern medicine.

The U.S. FDA currently recognizes medicinal leeches as a medical product for a very specific modern indication: helping tissues affected by venous congestion, particularly where prolonged localized bleeding may assist graft or tissue healing.