Fp 31-leech therapy-dr mahesh kumar-pdf
Leech therapy or Jalaukavacharan is a bloodletting procedure described in Ayurveda. It is a very useful procedure in the treatment of various medical and surgical diseases.
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Leech and Leech therapy :scientific overview and its application
1. 1
Dr. Mahesh Kumar
M.S.(Ay),
Department of Shalya Tantra
Ch. Brahm Prakash Ayurved Charak Sansthan,
Under Govt. of NCT of Delhi
Najafgarh, New Delhi-73
drmkguptabhu@gmail.com
Leech Therapy:
“A Marvellous Bloodletting Practice in Ayurveda”
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
2. Aim
2
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
To submit an overview of
Leech
Therapy, an
ancient Ayurvedic
treatment method
3. 3
Background
Leeches are lower animal of Phylum
Annelida./ sanguivorous in nature.
Leeches can survive in water without food
for a long time but they can’t without water
even there is abundance food.
Jalaukavacharana=leech therapy- a type of
bloodletting
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
4. 4
SOME FACTS ABOUT LEECHES-
The leech is a freshwater annelida worm, usually black
or brown and about 5 -15 cm in length.
Of the more than 650 known species in Hirudo
genus, 15 are mostly used for medicinal
purposes, Hirudo medicinalis being one of them.
Indian medicinal leech known as Hirudinaria
granulosa
It’s body is divided into 33 parts.
It has two suckers – anterior and posterior.
With anterior sucker it sucks the blood while the
posterior one provides stability to leech.
The scars produced due to bite of the leeches are
of ‘Y’ shape.
Phylum -
Annelida
Class -
Hirudinia
Order -
Gnathobdellida
Genus -
Hirudineria
Species -
Medicinalis
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
10. 10
Pre – op preparation
Preparation
of patient
Preparation
of Leech
Method of Leech therapy
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
Main procedure
Close
observation
and care
Bloodletting
Post-therapy care
Haemostasis
and
precautions
for patient.
Vomiting and
care of Leech
11. ASHWAKHURAVADANANAM UNNATASKANDAM
After knowing that it has started to suck the blood it should be
covered with wet gauge and the gauge should be kept wet by
continuously pouring water on it.
11
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
12. 12
Post application management
Care of Leech
Vomiting out blood
Put in fresh water
Then squeezed by opposite hand slowly and gently.
Don’t reuse same leech before 7days.
Care of patient
Stop bleeding
Care of wound bite
bandaged properly.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
14. 14
?? LEECH SUCKS IMPURE BLOOD
The reference came
from A.H.Su.26/43, As
a swan sucks only milk out
of the mixture of milk and
water, leech sucks impure
blood only.
What is impure blood
–
Clotted blood
Stagnant blood
Deoxygenated blood
Nutrient less blood and
Contaminated blood (with
micro-organisms, allergens ,
poisons etc.)
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
15. 15
?? WHEN AND HOW TO REMOVE THE LEECH FROM THE
SITE
Mostly detached spontaneously
When pricking pain and itching
at the site of bite,
Don’t pull the leech forcefully.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
16. ?? Common problem in leech therapy
16
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
. Availability of fresh
leech
. Delayed leech
attachment
. Patient’s fear
17. ?? Problem in adopting…..to say
yes…..solution
Proper education reduces fear of patient
If patient. still reluctant ; arrange a pt. who has had
similar disease.
17
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
18. ?? Mode of action of Leech
.
18
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
A. By sucking blood
B – By injecting bio
active substances
19. 19
By sucking blood – local effects
It decrease blood congestion
That lowers pressure in
diseased area
That facilitate inflow of
oxygenated and nutrient blood
Finally improved health status
of regional tissue
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
20. 20
By injecting bioactive agents – It act
localiy & distally.
Bioactive agents
Anti coagulating
1.Hirudin
2.Calin
3.Factor Xa inhibitor
Thrombolytics
1. Distabilase
Anti-inflammatory
1.Bdelin
2.Hyluronidase
3. Eglin
Vasodilators
1.Histamine like
substances
2.Acetylcholine
3.Carboxypeptidase
A inhibitor
Bacteriostatics
And anaesthetic
agents
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
21. 21
Contraindication of leech therapy
Patient refusal, non interesting
Arterial insufficiency diseases
Bleeding disorders, so asses it before therapy
Immunocompromised pt.
Anemic patient.
Patients taking medicines like- Large dose of
vitamin E, Aspirin, heparin, warferin, NSAID, Garlic,
ginger, Ginkgo biloba etc
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
22. 22
?? Whats are Adverse effects
Local pain - according to the pain threshold of the patient
Local itching
Hypotension and vasovagal attack (1 in 1000 patients)- very
rare
To avoid it proper history should be taken, Should take plenty of
water before application, close observation in first visit.
Blood loss/ haemorrhage – generally insignificant.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
23. 23
?? Transmission of infectious diseases
like- AIDS, hepatitis-B
Precaution- Proper aseptic conditions should be taken.
Prior screening of the patient . Avoid the re-application of
the leech in another patient.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
24. The Leech therapy, a para-surgical procedure, have
rich ancient reference, indicated in pittaja and raktaja
diseases.
Leech application as an adjuvant with drugs
are found very effective in inflammatory
conditions, Inflammed piles, Herpes Zoster,
Pimples & Thrombophlebitis, Eczema.
No severe side effect/ no need of supportive drugs.
Needs less infrastructure/ Day care procedure.
Bioactive chemicals and bloodsucking nature make it
unique.
To find out mode of action of leech therapy requires
more study
Aseptic precaution and proper care is requisite.
Conclusion
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 24