It describes about a bitter experience of a patient of Gouty arthritis with Leech application that I had treated during my higher studies

1. A BITTER EXPERIENCE
0N LEECH APPLICATION
Dr. N.Prasad, MD (AYU), PhD
PROFESSOR AND HOD,
DEPT. OF KAYA CHIKITSA
DR. ANAR SINGH AYURVEDIC
COLLEGE AND HOSPITAL,
FARRUKHABAD, U.P.

2. INTRODUCTION
 Jalaukavacharana ( Leech application) is
considered as the safest method of Rakta
Mokshana described under Anushastra
Vishravana, usually used for blood letting in pitta
predominant rakta dushti janya disorders.
 In the present paper I am going to share one of my
bitter experience on leech application, where we
had applied leech on a female patient of 35 years
age suffering from Krostruka sirsa (Gouty arthritis),
one of the eighty nanatmaja vatavikaras, caused
due to vitiation of rakta along with vata.

3. Aim & objective :-
 To provide sudden relief from pain &
swelling in a patient of krostrukasirsha .
 To evaluate the efficacy of
Jalaukavacharana in krostrukasirsha .

4. MATERIALS & METHODS :-
Materials:-
 Jalauka (Leech).
 Haridra churna (Turmeric powder).
 Karpas (cotton).
 Clean tape water of room temperature.
Methods:-
 Number of patient – 1
 Place of trial – IPD of Gopabandhu Ayurved Mahavidyalaya,
Puri.
 Duration of leech application – 15 minutes

5. Case Report :-
Name:- Mrs. Savita Sahu
Age:- 35 Yrs.
Sex:- Female
Address:- At/P.O.- Brahmagiri
Dist - Puri
Date:- 15/02/2003
Complaints:-
 Pain in right knee joint since 15 days
 Swelling of the right knee joint since 10 days
 Unable to walk due to pain since 7 days

6. Selected therapy :-
Shaman:-
1. Kaishar guggul – 250mg. twice a day with
honey.
2. Rasna saptak kwath – 30ml. twice a day.
3. Prasarani tail for external application.
Shodhan:-
Raktamokshana through Jalaukavacharana
(Leech application).

7. Observation & Result :-
SIGNS AND
SYMPTOMS
SEVERITY GRADES BEFORE
AND AFTER TREATMENT
B.T. A.T.30 A.T.6 A.T.24
Minutes Hours Hours
Pain G3 G1 G2 G3
Swelling G3 G2 G1 G2
Tenderness G3 G2 G2 G3
Bleeding G0 G1 G2 G3

8. Discussion :-
 The results obtained after 30 minutes of leech application
indicates that, all the signs and symptoms of the patient were
decreased except bleeding, which was due to leech
application.
 After 6 hours, there was increase in pain and bleeding,
decrease in swelling, but no change in severity of tenderness
as compare to previous observation (after 30 minutes).
 After 24 hours of leech application, it was observed that all
the signs and symptoms were severely increased except mild
decrease in swelling.
 The above results indicate towards some complications,
appeared after leech application.

9. Probable causes of complication :-
 Faulty patient selection.
 Faulty disease selection.
 Improper leech selection.
 Faulty leech preparation.
 Faulty leech application.
 Lack of proper investigation.
 Improper post – operative management.

10. Suggested preventions :-
 Accurate diagnosis.
 Perfect patient selection.
 Proper investigation (B.T, C.T. etc.)
 Adequate patient preparation.
 Proper leech selection
 Same leech should not be reused minimum for
seven days.
 Proper preparation of leech before application.
 Proper leech application.
 Proper post – operative management.

11. Conclusion :-
 Krostruka sirsa is a severely painful disease described
under eighty-nanatmaja vata vyadhi.
 Complications may arise after leech application.
 But it is not wise to declare jalaukavacharana as a harmful
therapy for Krostruka sirsa with only one clinical data.
 Trial should be taken in a large sample.
 Complications may arise due to several factors.
 We should not ignore the probable complications.
 Appropriate preventive majors should be taken before,
during and after leech application, so that it will be widely
acceptable.