Jalaukavacharana is the procedure of letting out the impure blood from the affected area of skin by the application of non-poisonous leech (jalauka).

• Ref General Requirements SOP
• Lancet -1
• Ishtika churna-1 pinch.
• Leeches -4-5
• Vessel with water- 1
• Wet cotton-2-3
• Shatadoutha gritha-Q.S.
• Cotton pad -4-5
• Gauze -1 roll
• Kidney tray- 4-5             
• Haridra powder- Q.S.
• Saindhava – Q.S.

Manpower

• Therapist-1
• Physician-1

Preparation of tray

• Take a clean tray.
• Put lancet, ishtika churna, cotton pad, gauze, haridra powder, saindhava, shatadoutha gritha.

Preparation of patient

• Check vitals.
• Vegotsarga

• The jalaukas needed for the procedure are first placed in water infused with turmeric powder to make it active.
• Once the jalukas become active it is transferred into a vessel of fresh water and left for 48 minutes.

• Patient is asked to sit comfortably in a knee highchair.
• The site where the jalauka is to be applied is cleaned with a sterile cotton swab.
• Jalouka is held cautiously with moist cotton pad without covering its mouth.
• The Jalaukas are placed over the skin and are allowed to bite themselves.
• If the jaloukas are not biting themselves a drop of milk or blood can be dropped over the site to initiate the biting or a small incision is made over the site.
• If the jalaukas still do not bite, they are promptly replaced with fresh ones.
• Biting is ensured by the appearance of horseshoe shaped mouth and raised neck on the Jalaukas.
• At this moment, the jalaukas are covered with moist cotton and cold water is frequently poured, to provide cooling and soothing effect to the jalaukas.
• Once the patient feels the sensation of scratching and pricking pain at the bite site, signifies the jalaukas has started sucking the pure blood.
• If the jaloukas remain attached to the site despite these symptoms, then haridra or saindhava is dusted over the mouth of jalaukas.
• Once the jalaukas detaches from the site, they are gently shifted to a kidney tray.

For Jalauka

• Vomiting is induced in jaloukas by dusting pinch by pinch of haridra powder over its body.
• The tail end of the jalauka is held with the thumb and fingers of left hand.
• With thumb and fingers of right hand, the body of the jalauka is gently kneaded and pushed towards its face.
• This will induce vomiting of sucked blood completely.
• Complete vomiting of sucked blood is ensured by observing the to and fro motion of jalauka in search of food while keeping it in fresh water.
• If it sinks in water without any movements, suggests the sucked blood is not completely vomited.
• Thus, vomiting is to be induced once again.
• Thereafter, the jaloukas are cleansed with fresh water and kept in a separate jar labeled with patient’s name and date of procedure for seven days.

For patient

• The area is cleaned with cotton.
• A cotton pad soaked in shatadoutha gritha is applied over the site.
• Thereafter, bandage is wrapped over the site.
• The patient is advised to take rest.
• Till patient feels the sensation of scratching and pricking pain or till the jalauka detach itself from the site.

• Till patient feels the sensation of scratching and pricking pain or till the jalaukas detaches themselves from the site.

• Venous illness
• Acute phlebitis
• Varicose veins
• Otitis media
• Mastoiditis
• Diabetic ulcers
• Allergies
• Piles

• Anemia
• Arterial insufficiency
• Absolute hemophilia

• Jalauka should be handled very carefully.
• Jalauka should be covered with wet cotton throughout the procedure.
• Cold water should be poured frequently.
• Jalauka must be made to vomit the sucked blood completely.
• If the vomiting doesn’t take place properly, then a disease named indramada occurs in jalauka.
• The same jalauka cannot be reused for seven days.

• Soreness
• Allergic reactions
• In those conditions wash the area with triphala kashaya and apply shatadoutha gritha.