Jaloukavacharana - The Leech Therapy
Jaloukavacharana, or leech therapy, is one of the methods of Raktamokshana (bloodletting) mentioned in Ayurveda Shastra. It is a highly effective and gentle form of treatment, used especially for patients who require a delicate approach. The term "Jalouka" is derived from the Sanskrit words:
Nirukti/Etymology of Jalouka
जलमेव ओको वसतिस्थानं यस्याः जलौका । इति भरतः
That means, for whom water (Jala) itself is the abode or home is known as Jalouka (leech).
Reference in the Mahabharata
In the Mahabharata, the following shloka offers a profound analogy between human behavior and the nature of leeches:
Shloka:
गृह्णाति साधुरपरस्य गुणं न दोषं
दोषान्वितो गुणिगुणं परिहाय दोषम्।
बालस्तनात् पिबति दुग्धमसृग्विहाय
त्यक्त्रा पयो रुधिरमेव न किं जलौकाः॥
Translation and Explanation:
"A righteous person accepts the virtues of others, not their faults, while those who are flawed themselves focus on others' shortcomings and ignore their virtues. Just as a child drinks milk and leaves the blood behind, wise individuals choose virtues over flaws, unlike leeches that drink only blood, ignoring water."
This shloka critiques individuals who fail to distinguish between good and bad qualities, drawing a metaphor to the nature of leeches, which feed only on blood.
Indications for Jaloukavacharana
Leech therapy is particularly beneficial for:
Nrupa (Kings), Aadya (Wealthy Persons)
Baala (Children)
Sthavira (Elderly People)
Bheeru (Timid People)
Durbala (Weak Individuals)
Naari (Women)
Sukumara (Delicate and Sensitive Persons)
It is considered an ideal treatment for those who cannot tolerate more invasive bloodletting procedures due to its gentle and controlled approach.
Sloka:
नृपाढ्य-बाल-स्थविर-भीरु-दुर्ब्बल-नारीसुकुमाराणामनुग्रहार्थं
परमसुकुमारोऽयं शोणितावसेचनोपायोऽभिहितो जलौकसः॥
Types of Leeches (Jalouka)
According to Ayurveda, there are 12 types of leeches classified into two categories:
Poisonous Leeches (Savisha Jalouka)
These are to be avoided in therapeutic practices:
Krishna
Karbura
Alagardha
Indraudha
Samudrika
Gochandana
Sloka:
तत्र सविषाः कृष्णा कर्व्वुरा अलगर्द्दा इन्द्रायुधा सामुद्रिका गोचन्दना चेति
Non-Poisonous Leeches (Nirvisha Jalouka)
These are suitable for medical treatment:
Kapila
Pingala
Shankhamukhi
Mooshika
Pundarikamukhi
Savarika
Sloka:
अथ निर्विषाः। कपिला पिङ्गला शङ्कुमुखी मूषिका पुण्डरीकमुखी सावरिका चेति॥
Procedure for Jaloukavacharana
1. Pradhana Karma (Main Procedure)
The patient is positioned comfortably to expose the affected area.
If the affected part has no wounds, the area is scraped with Mritika (soil) or Gomaya Churna (cow dung powder) to encourage blood flow.
Purified leeches are applied to the affected site. The Vaidya (physician) observes whether the leech begins to suck blood.
If the leech does not begin feeding, a drop of milk or blood is applied to the site, or a small incision is made to encourage blood flow.
Once the leech starts sucking blood, it first consumes impure blood, indicated by the elevation of its neck, resembling the shape of a horse's hoof.
Depending on the case, 5-10 leeches may be applied at once, and the leeches are covered with wet gauze.
If the patient feels pricking pain or itching, it indicates that the leeches are sucking healthy blood, and they should be removed immediately by applying rock salt (Saindhava Lavana) to the leech’s mouth.
Sloka:
सूक्ष्मशुक्लार्द्रपिचुप्लोतावच्छन्नां कृत्वा मुखमपावृणुयादगृह्णन्त्यै क्षीरबिन्दुं शोणितबिन्दुं वा दद्याच्छस्त्रपदानि वा कुर्व्वीत यद्येवमपि न गृह्णीयात्तदन्यां ग्राहयेत्। यदा च निविशतेऽश्वखुरवदाननं कृत्वोन्नम्य च स्कन्धं तदा जानीयाद् गृह्णातीति गृह्णन्तीञ्चार्द्रवस्त्रावच्छन्नां धारयेत् सेचयेच्च। दंशे तोदकण्डूप्रादुर्भावैर्ज्जानीयाच्छुद्धमियमादत्त इति शुद्धमाददानामपनयेत्। अथ शोणितगन्धन न मुञ्चेन्मुखमस्याः सैन्धवचूर्णेनावकिरेत्॥
2. Paschat Karma (Post Procedure)
After the leech is removed, attention is paid to the wound and the leech itself.
Patient Care:
The triangular wound created by the leech’s mouth is allowed to bleed for a few minutes. The bleeding is controlled using a bandage with Yashtimadhu, Turmeric, Manjishta, and Lodhra Churna. The wound is then dressed with gauze smeared with Madhu (honey) and Ghritha (ghee).Leech Care:
After removal, the leech undergoes a vamana (emesis) procedure to expel the consumed blood. Saindhava Lavana is applied to the leech’s mouth, and rice water is poured over its body. The leech is pressed gently from its tail to its head to induce vomiting of the blood. If the leech does not move freely in water, indicating incomplete vomiting, the process is repeated. Failure to expel all blood may cause a disease known as “Indramada” in the leech.
Once purified, the leeches are placed in fresh water, ready for future use.
Sloka:
अथ पतितां तण्डुलकण्डनप्रदिग्धगात्रीं तैल-लवणाभ्यक्तमुखीं वामहस्ताङ्गुष्ठाङ्गुलीभ्यां गृहीतपुच्छां दक्षिणहस्ताङ्गुष्ठाङ्गुलीभ्यां शनैः शनैरनुलोमानुमार्ज्जयेदामुखाद्वामयेत्तावद् यावत् सम्यग्वान्तलिङ्गानीति। सम्यग्वान्ता सलिलसरकन्यस्ता भोक्तुकामा सती चरेत्। या सीदति न चेष्टते सा दुर्व्वान्ता तां पुनः सम्यग्वामयेत्। दुर्व्वान्ताया व्याधिरसाध्य इन्द्रमदो नाम भवति। अथ सुवान्तां पूर्ब्बवत् सन्निदध्यात् शोणितस्य च योगायोगानवेक्ष्य जलौको व्रणान्मधुनावघट्टयेच्छीताभिरद्भिश्च परिषेचयेद्बध्नीत वा व्रणं कषायमधुर-सिग्धशीतैश्च प्रदेहैः प्रदिह्यादिति॥
Conclusion
Jaloukavacharana, an ancient Ayurvedic bloodletting therapy using leeches, remains a gentle, effective, and highly controlled treatment for a variety of conditions. Its deep roots in Ayurveda, reinforced by its extensive mention in classical texts, make it an essential part of Ayurvedic therapeutic practices at Ayurveda Ayatanam.