UG Module 8 - Lesson 4

INDICATIONS 

प्रच्छानेनैकदेशस्थं —————————–| 

प्रच्छानं पिण्डिते वा स्यात्—————————–|i 

[स०-पिण्डिते रक्ते प्रच्छानं वा स्यात्|] 

[आ० र०-प्रच्छानस्य विषयान्तरमाह-प्रच्छानमिति| पिण्डिते-घने|] 

According to Ācārya Vāgbhaṭa, Pracchāna is the method of Raktamokṣaṇa used for the management of Ekadeśasthita doṣa and Piṇḍitadoṣas. 

बलदोषप्रमाणाद्वा विशुद्ध्या रुधिरस्य वा| 

रुधिरं स्रावयेज्जन्तोराशयं प्रसमीक्ष्य वा||१९||ii 

It is also mentioned by Ācārya Caraka that, the bloodletting should be done by considering the strength of the person, Doṣa, location of the disease, and has to be done until pure blood starts to flow out. 

CONTRA INDICATIONS 

Patients with bleeding disorders 

Pūrva karma 

After local abhyanga followed by nāḍī svedana, the area is properly cleaned by anti-septic preparations. Then the patient is allowed to be seated in comfortable posture and torniquet is tied 4inch above the area for Pracchāna. 

Pradhāna karma 

गात्रं बध्वोपरिदृढं रज्ज्वा पट्टेन वा समम्| 

स्नायुसन्ध्यस्थिमर्माणि त्यजन् प्रच्छानमाचरेत्| 

अधोदेशप्रविसृतैः पदैरुपरिगामिभिः| 

न गाढग़नतिर्यग्भिर्न पदे पदमाचरेत्|७|iii 

According to vāgbhaṭa ācārya the incisions are made after binding the above site with cloth or torniquet and made the area clearly visible. The area should be away from snāyu, sandhi, asthi and marma. The incisions should not be too deep.   

तत्र, ऋज्वसङ्कीर्णं सूक्ष्मं सममनवगाढमनुत्तानमाशु च शस्त्रं पातयेन्मर्मसिरास्नायुसन्धीनां चानुपघाति ||२६||iv 

Suśruta Ācārya also opines similarly. It is advised to do in areas devoid of marma, sirā, snāyu and sandhi. The incisions should be made after torniquet is bind and it should be small, linear, quick and not too deep. 

Paścāt karma 

After cleaning the area with proper antiseptic solution, proper bandaging has to be done. Medicines like Jātyādi ghṛta and Yaṣṭimadhu cūrṇa can also be applied. 

SAMYAK LAKṢAṆA 

लाघवं वेदनाशान्तिर्व्याघेर्वेगपरिक्षयः | 

सम्यग्विस्राविते लिङ्गं प्रसादो मनसस्तथा ||३३||v 

Samyak lakṣaṇa of any type of Raktamokṣaṇa  may include Lāghava (lightness), Vedana Śānti (reduction in pain), Vyādhivega Parikṣaya (reduction in recurrent attacks of disease) and Mana Prasāda (clarity of mind). 

COMPLICATIONS OF PRACCHĀNA

• Excessive bleeding 
• Increase in redness and swelling 
• Increased pain 
• Infection of wound and fever 

Before starting it should be confirmed that the patient is not affected with any bleeding disorders.  

Clean the wound with antiseptic solutions 

Arresting the blood by proper banding and immobilise the area as much as possible. 

Antibiotics in the form of ointments like Neosporin, bacitracin etc. as well as internally can be given to avoid infection like amoxicillin-clavulanate, cephalexin, doxycycline, dicloxacillin etc.  

Āyurveda medicines that can be used externally include Triphala kwath, panchavalkala kwath, murivenna, etc. and internal medications include Aragwadadhi Kashaya, Guggulu tiktakam Kashaya, tripala guggulu, etc.