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Ayurvedic panchakarma procedures mainly focus on throwing the vitiated dosha out of the body and thus checks the reoccurrence of the disease. And raktamokshana is one procedure among panchakarma which aims at excreting vitiated blood (Dushta rakta ) from our body.

The word Raktamokshan is derived from 2 words mainly Rakta (blood) and Mokshan (let out, to relieve).

These procedures explained thousands of years ago still holds and important place in ayurvedic treatment in curing many diseases, and have become a necessity in todays world due to changing food habits and lifestyle, for curing ailments and also to maintain health.

So before learning about this procedure let’s briefly go through an ayurvedic prespective about Rakta (blood)

Formation(Utpatti) of Rakta:

The first liquid principle known as Rasa,formed from the ahara (diet) while circulating in the body, when reaches yakrut(liver), pleeha(spleen), attains red colour due to ranjak pitta and will be known as Rakta.
Though rakta is circulating continuously in our body its main seats are yakrut(liver)and pleeha(spleen), and from here it governs the other seats of rakta (rakta sthna).

Functions of Rakta:

The prakrut (non vitiated) rakta improves complextion and nourishes mamsa dhatu and does the most important function of Jeevan (life maintainence).

Properties of Rakta:

It is Panchabautik (constituting all five Basic Principles) and is Anushna shita (for touch), Madhura (sweet), Ishat lavana( little salty),Guru(heavy) , Visra (having peculiar odour).
A person who possesses non vitiated and excellence quality Rakta is called Rakta Sara Purusha and he exhibits the following characters:- unctuous, red colour, beautiful dazzling appearance of the ears, eyes, face, tongue, nose, lips, sole of the hands and feet, nails, forehead and genital organs.

Such individuals are endowed with happiness great genius, enthusiasm, tenderness, moderate strength and inability to face difficulties and cannot tolerate hot food and environment such as travelling at noon.

Rakta vitiating factors

Alcohol consumption, excessive intake of salt, sour , pungent ,unctuous and heavy food items, stale food, and over eating, sleeping immediately after food,exposure to sun of hot environment, stress and not performing Raktamokshana. rakta is naturally vitiated in sharad (autumn)
Raktapradoshaja Vyadhi(Diseases cause by vitiated blood)

The following diseases occur due to the vitiation of blood, mukhapaka(oral ulcers), akshiraga(redness of eyes), asyagandhika(foul odour from mouth), gulma, upakusa,(bleeding from gums) visarpa(herpes Zoster), raktapitta(epistaxis), pramilika, vidhradhi, pradara(excessive menstrual flow), vatashonita, vaivarnya(discoloration of skin), agnisada, pipasa(frequent thirst), gurugatrata(heaviness of body), daha(burning sensation), tiktamla udgara(burps with sour and bitter taste), specially of the diet and drink that are not properly digested, krodha(anger), salt taste in mouth, sweda(excessive sweating), shareeradaurgandhya(body odour), kampa(tremours), atinidra(excessive desire to sleep), tamodarshana(blackouts), kandu(itching), kota, pidaka, kushta(skin diseases).


Depending on various factors, the media used for bloodletting varies. In absence of specific media any one of said procedure can be used for the purpose.

In case of bloodletting being vitiated by Vata, Pitta and Kapha dosha, the blood should be let out by Shringa, Jalauka and Alabu respectively. In cases of vitiation by two/all the three doshas together, Siravyadha or Pracchanna are to be adopted for letting out the blood.

Application of Shringa can bring out blood from an area of ten angulis around; Jalauka can suck from an area of one hasta(palm), the Alabu from an area of twelve anguli( 1finger breadth), Pracchanna from an area of one anguli, while Siravyadha(venous puncture) can purify the entire body.

In deep seated pathology, Jalauka(leech application) is preferable, in case of generalized vitiation of rakta – Siravyadha is advised and Shringa(horn), Alabu if pathology is superficial/utthana.

Indications for Raktamokshana:

Bloodletting as a method of treatment is indicated in skin disorders, Sotha(swelling), daha(burning sensation), Vatarakta(gout), kushta(skin disorders), vata diseases having severe pain, slipada(elephantiasis), blood vitiated with poisons, granthi,Vidradhi, arbuda(cancer), heaviness of the body, raktabhishyanda(conjunctivitis), yakrutpliha roga, visarpa(herpes), pidaka(boils), paka. In all diseases, bloodletting can be done either by Shringa, Jalauka or by Siravyadha.

Contraindications of Raktamokshana:

Generalised swelling, swelling in debilitated persons, caused by sour diet and that in those suffering from Pandu(anemia), Arshas(bleeding piles), Udara(ascites), and in Garbhini(pregnancy).


The procedure is divided into 3 parts

1.Purva karma (pre operative procedure)
In the preoperative procedure. Snehana (oleation) internal and external, swedana(hot fomentation with steam to whole body)

2.Pradhan Karma(operative procedure)
a) By using jalauka(leeach)
The patient is made to lie on bed comfortably. The leach is applied over the affected part. The leech starts to suck blood when its mouth becomes raised and appears like horses hoof.

If the leech does not suck blood a drop of milk is put at the spot or a small prick with sterilized needle is taken. A wet cotton is kept over the body of leech to keep it moist and alive. The leech leaves the spot after a while or is deliberately removed when the patient experiences pricking pain at the site. (This pain indicates that the Leach is sucking pure blood)
b) siravedha (venous puncture)

The patient is asked to lie comfortably over a bed. The air cuff of sphygmomanometer is tied over the bicep muscle of hand. The patient is asked to clench his fist tightly. The cuff is inflated and the desired vein(medial cubital is preferred) is punctured with a sterilized scalp vein(butterfly) needle. Cuff is removed and the blood is collected in a kidney tray. When the sufficient quantity of blood is drawn the needle is withdrawn and patient is asked to loosen his fist. A cotton swab is pressed over the wound.

3.Paschat karma (post operative procedure)
If bleeding continues from the diseased site fine powders of lodhra (Symplocos racemosa), yastimadhu(Glycyrrhiza glabra),raktachandana (Pterocarpus Santalinus)etc. are applied. The area is covered is wet cloth or a thin paste of cooling dravya like chandan is applied.

The patient is advice to take rest and can be given light diet or milk later in the evening.

Rice flour is applied to whole body of jalauka and little siandhava lavana (rock salt) and oil is applied to its mouth. And it is squeezed gently from tail to mouth in order to remove the sucked blood. Now jalauka is immersed in water and can be used after a span of seven days.

Regimen to be followed by the patient:

After the procedure patient must strictly avoid anger, stressful work, excessive indulgence in sex, sleeping at day time(especially after meals), exercise, travelling, exposure to wind and sunlight.

Benefits of Raktamokshana

One who timely performs Raktamokshana never suffers from skin diseases ,and other Raktaja vyadis mentioned above.

One of the major pitfalls of modern professional as well as personal life is stress. With obesity and bad diet, stress completes the unholy trinity of the three pronged problems which contributes to many modern lifestyle related disorders. Even if you control obesity and diet through lifestyle changes, stress is inherent in our everyday life and mostly is not in your control.

However, Ayurveda has some great methods through, which you can limit or minimize stress and limits its effect on your mind, body and soul.

Ayurveda - The holistic approach to stress
Ayurveda has been around for thousands of years and is thus, a great tool to fight or reduce many of the physical and mental ailments that afflict you. Ayurveda’s approach at busting stress is thus, very well rounded. These methods help keep your mind still to reduce stress and also reduce the ill effects of stress on your body. Some of the elements of this holistic diet are mentioned below:

1. Change your diet: Stress creates craving for unhealthy food, which is either very spicy or has a lot of processed sugar or fat. It is a temporary fix, which is again required when the next bout of stress hits, resulting in a pattern akin to addiction. One of the first steps is to break the cycle by changing eating habits. Stress occurs as a reaction to adversities in the world and rather than food aggravating the vata, pitta and kapha doshas, it should pacify and balance them. Whole and healthy food is what you need in such a case and it can comprise of


Root vegetables


Simple foods such as rice or roti

Green vegetables among others

2. Drink herbs in form of beverages to reduce stress: There are many forms of Ayurvedic herbs, which can help combat stress. One natural response among many people when stressed is to consume coffee or tea in large quantities, which may actually aggravate the problem. Try drinking Ayurvedic herbs as tea, which have been specially formulated to combat stress and correct the unbalanced doshas within the body.

3. Try Aromatherapy: Incense sticks and other specially formulated aroma candles can be used to create a relaxing atmosphere in your home where you can sit and meditate while the pleasant aromas and the herbs within them can lower your stress level and act as a release point.

4. Abhyanga: This is a form of self-massage with the help of specially medicated herbal Ayurvedic oils. It helps the body by relaxing the muscles, lubricating connective tissues and also improving circulation. Abhyanga reduces stress within the body and keeps you calm and relaxed. This will help you to reduce stress and also handle it better on a daily basis.

5. Pranayama, yoga and exercise: One of the most effective tools to combat stress and improve your physiological condition is through yoga and pranayama. Pranayama in particular is one of the most effective methods to regulate multiple functions of the body and to ensure your mind stays still and calm. Certain yoga poses can also be emphasized on to ensure better stress relief. Also ensure that you diligently follow your exercise routine daily as it is proven to be one of the most effective ways of combatting stress.

6. Herbs: Certain herbs can be used as medications, which can restore the balance of doshas. Sometimes, stress is caused due to internal problems rather than incitement from the outside world. Some of the herbs that can be used in medicated combinations in such cases are triphala, ashwagandha and brahmi. However, it is best to consult with an Ayurvedic practitioner who can prescribe tailor made medications for you.

Diabetes is a condition wherein the sugar levels in your blood increases significantly. This happens when the sugar you consume from food is not efficiently processed by the body thus, raising your blood sugar levels. An excess concentration of sugar in the blood can make you prone to various health complications.


The symptoms of diabetes include frequent urge to urinate, increased thirst, increased hunger and rapid weight loss, combined with fatigue and irritability. Diabetes can also cause problems in the eyes, such as blurred vision as well as make you prone to cataracts and even glaucoma (in very rare cases). With diabetes, any injury or body sore tends to take a lot of time to heal.


Diabetes is a disorder that occurs due to impaired insulin functioning. Insulin is a hormone that is produced by pancreas, which is located right below the stomach. Diabetes, when occurs as a result of insufficient production of insulin by the pancreas, is known as Type 1 Diabetes. In this type, the immune cells in the body attack the cells in the pancreas, which produce insulin, thus discouraging insulin secretion.

Another kind is the Type 2 diabetes, which occurs when the cells in the body become insulin resistant. Most cases of diabetes are of this particular type, as one of the major reasons behind this is following an erratic lifestyle devoid of healthy habits.

Gestational diabetes is the third type, although it isn’t very common. During pregnancy, the various hormones that are secreted in the body can play spoilsport with the functioning of the pancreas, thus the production of insulin. This leads to a drastic rise in blood sugar levels.

Ayurvedic treatment

1. Eat healthy: Eating healthy assumes the maximum importance; you need to eat healthy in order to control diabetes effectively. Include plenty of fruits and vegetables in the diet, but make sure to pick foods that contain little sugar. Fruits such as bananas and grapes are not the best options for a diabetic. Rather, one should consider cucumber and bitter gourd in such circumstances.

2. Exercise regularly: Regular exercise can keep your body weight at optimal levels which goes a long way in preventing and controlling symptoms of diabetes. Besides being good for your heart, cardiovascular exercises such as running bring down the excess glucose levels in the blood.

3. Limit stress: Stress is very harmful for the body as it reduces your immunity against diseases and infections. Leading a stressful life can make you prone to a variety of disorders, diabetes being one of them. Relaxation techniques such as meditation and yoga can help one deal with stress effectively.

As nature transitions seasons and exhibits change, Ayurveda recommends cleansing and rejuvenation to help the body adapt. Of particular focus at this time of the year is balancing vata. As discussed in the last newsletter, there is no system in the body that is not touched by vata, and according to Ayurvedic tradition, vata alone is responsible for more that 55% of the diseases encountered by humans.

Panchakarma is recommended at the change of seasons to help balance the shifts in doshas that can accumulate with the change in environment. The primary treatment in panchakarma that is geared towards vata is basti (Ayurvedic enema). Basti is so highly revered in the panchakarma process that it is said that the benefit received from basti is equal to the cumulative benefit of the other four processes in panchakarma. And that only makes sense, given the prevalence that vitiated vata plays in the disease process.

Basti works in the region of the colon, but its impact is so far reaching and deep that simply calling this process an enema does not do it justice. Recall that as the major seat of vata in the GI tract, the colon is critical in keeping vata balanced in the entire body. In the stages of samprapti (Ayurvedic pathogenesis), vata first accumulates in the colon, and then as it begins to “overflow”, it will spread and create imbalanced vata in other susceptible parts of the body. This systemic imbalanced vata can affect almost any system in the body, as vata is a necessary presence throughout the body; it is likely to affect the systems which have some weakness (a khavaigunya). Basti provides herbal cleansing and nourishment directly into the intestines and colon, without having to be digested by the stomach and upper GI tract, as would be the case with anything taken by mouth.

Traditional Ayurvedic teaching reminds us that basti can be used for a variety of reasons, including bowel regularity, joint support, excess vata in digestion causing occasional gas, nervous system support, and healthy sleep patterns.1 Clearing vata from the system also helps create energy and vitality as well as clarity in the mind.6 Basti promotes overall well-being, a graceful aging process, luster and a healthy glow. Multiple international studies have been done regarding the benefits of basti, and they also show benefits to joint, back, and bone health.2,3,4,5

Basti does have some general situations in which it is contraindicated, including pregnancy, menstruation, diarrhea, inflammation of the anal region or rectal bleeding, and extreme weakness or debility.1 Generally, basti is well tolerated in appropriate candidates, and a proper basti should result in 1-2 bowel movements with cleansing of the fecal matter as well as a feeling of lightness and a promotion of appetite and agni.1,6 If the basti was insufficient, one may be left with pain, incomplete fecal clearing, and/or swelling.6

Prior to doing basti, one can prepare by applying warm oil (such as sesame) to the abdomen and lower back in a clockwise direction following the flow of the intestines. If one is so inclined, one can even do a full body massage with warm oil to help with oleation and loosening of toxins. After massage with warm oil, one can place a warm pack, such as a hot water bottle) to the abdomen for a few minutes, allowing the intestines to be primed for the application of basti.

Basti can be classified in a variety of ways. While there are a number of treatments that can be referred to with the term basti, here we are speaking only of rectal basti, as this is the primary treatment for our dosha of choice, vata. Rectal basti is usually one of two major types: niruha basti, which is done with herbal decoctions and is purifying and cleansing in nature; and anuvasana basti, usually done with oil, which is nourishing, strengthening, and oleating in nature.

Niruha basti, which is best done in the morning on an empty stomach, can use an endless variety of hebal decoctions. Often dashamula is used as one of the ingredients, as it is a primary herbal remedy to dispel excess vata. Classical formulas add triphala, rock salt and honey to the dashamula.6 Modern variations will choose any number of cleansing or rasayana herbs depending on the desired outcome. Guduchi has a cooling, calming effect and can help balance pitta. Punarnava helps balance excess water in the system and can also balance kapha. Other nourishing rejuvenatives can include ashwagandha or shatavari. To help irritation in the system, licorice can provide a soothing nature. And for a cleansing effect, triphala is a solid choice. Niruha basti can be held for 15-20 minutes, or longer if comfortable, up to 48 minutes.6 Following the administration of niruha basti, one can have a light meal of easily digestible food.

Anuvasana basti is primarily oil based and is meant to be building and nourishing. Locally, providing oleation for any dryness caused by vata can support a healthy, supple colon. More broadly, the oil helps to ground vata and promotes energy and vitality. Anuvasana basti is usually based in sesame oil, which may be plain or herbalized with supportive Ayurvedic herbs. Anuvasana basti can be held for longer periods of time, even up to a full day, as long as it is comfortable for the client, as it continues to provide a supportive effect.

There are a variety of traditional schedules which can use a combination of alternating niruha and anuvasana basti in order to achieve optimal effect. The usual protocol starts with an anuvasana basti to prime the colon, then alternates niruha and anuvasana basti to cleanse and nourish (so the colon does not become overly depleted), and ends with a number of anuvasana bastis in order to replenish and rejuvenate the colon and balance, ground, and nourish vata after the cleansing process. Caraka recommends schedules of yoga basti (8 bastis), kala basti (16 bastis), and karma basti (30 bastis), used based on the degree of vata vitiation.6 Another alternative can also be to mix the herbal decoction and oil together, blend to make a solution, and administer the basti.

After doing basti, one should take care to follow vata balancing recommendations. Eat light, grounding, warm, oleative food. Rest and avoid vata provoking activity, including excessive talking, extremely windy or cold weather, travel, and busy activity. In this way, basti can be used to keep vata balanced on a routine basis, cleanse vata during seasonal transitions, and manage more extreme vata imbalances that are causing issues in the deeper tissues.

You must have heard about the indispensible use of the effective tea tree oil in so many Ayurvedic preparations. The oil is effective for many reasons, and the six common uses are as follows.

Treating scars and wounds: Tea tree oil is effective in extremely small concentrations, and can cause miraculous effects. That is why only a small portion is enough to get promising results. When two drops of tea tree oil are combined with 15 drops of Jojoba oil, and this mixture is applied to the wounds, injuries and scars, they heal quickly and scars disappear faster.

Treating breathing and respiratory problems: A lot of medical conditions, which may be caused by a bacteria or virus, can result in respiratory problems as a direct effect or side effect. In all such cases like cough and cold, flu, asthma, bronchitis, pharyngitis, tuberculosis etc., tea tree oil is highly effective and hence used in Ayurvedic medicines to loosen the mucous inside and expel it out. A direct massage on the chest by adding it with the other oils, or adding a few drops to warm water for inhaling vapour can help.

Mind freshener and nerve treatment: Tea tree oil has found great usage in mind freshening and nervous disease treatments. That’s because of the soothing effect of the oil in boosting the mind and body. In fact, it is also used in fighting fatigue, tiredness, phobias, fear, stress etc. Therefore, a body massage with coconut oil and about five drops of tea tree oil added to it helps very much.

Clearing lice and dandruff: These two are the major problems of hair and scalp, and both have a common remedy, which is the tea tree oil. The oil has microbial and fungicidal properties, which prove it to be a useful ingredient in the making of concoction and Ayurvedic medicines for dandruff and lice problems. The oil can directly be blended with hair oil or shampoo for great effects.

Skin infections due to bacteria and fungus: Skin problems aggravated by fungus infection, bacteria etc. can be alleviated with application of tea tree oil. The antifungal properties of the oil helps fight worse conditions like athlete’s foot, jock itch etc. Equal proportions of tea tree oil and any other oil like coconut or almond oil can be applied on to the affected parts twice daily to clear off fungus and heal the skin.

Immunity and resistance booster: Tea tree oil can be used for massages and rubs by mixing just two drops to any other base oil like coconut oil, for treating and preventing several skin and body conditions. These include bed sores, fungal infections, nappy and diaper rashes, cuts and wounds, insect bites, rashes and a lot more.

Dr. Abhijit Shirude
Dr. Abhijit Shirude
MS - Allopathy, ENT Specialist, 5 yrs, Pune
Dr. Pradip Pandhare
Dr. Pradip Pandhare
DNYS, 9 yrs, Pune
Dr. Khushbu Kolte
Dr. Khushbu Kolte
BDS, Dentist Cosmetic and Aesthetic Dentist, 8 yrs, Pune
Dr. Sandeep Darunde
Dr. Sandeep Darunde
BAMS, Optician Ophthalmologist, 3 yrs, Pune
Dr. Dr.Monica Rathod
Dr. Dr.Monica Rathod
BDS, Cosmetic and Aesthetic Dentist Dental Surgeon, Thane