Raktamokshana: An Ancient Ayurvedic Parasurgical Practice and Its Applicability in Contemporary Clinical Practice: A Review

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Rajguru et al. European Journal of Pharmaceutical and Medical Research
634
RAKTAMOKSHAN- AN ANCIENT AYURVEDIC PARASURGICAL PRACTICE AND
ITS APPLICABILITY IN CONTEMPORARY CLINICAL PRACTICE: A REVIEW
Vartika Kashyap*1, M. B. Gaur2, Yogesh Kumar Pandey3 and Pooja Sabharwal4
1Post Graduate Scholar, Kriya Sharir Department, Ch. Brahm Prakash Ayurved Charak Sansthan, IPU, Khera Dabar,
New Delhi.
2Head of Department, Kriya Sharir Department, Ch. Brahm Prakash Ayurved Charak Sansthan, IPU, Khera Dabar,
New Delhi.
3Associate Professor, Kaya Chikitsa Department, Ch. Brahm Prakash Ayurved Charak Sansthan, IPU, Khera Dabar,
New Delhi.
4Assistant Professor, Rachna Sharir Department, Ch. Brahm Prakash Ayurved Charak Sansthan, IPU, Khera Dabar,
New Delhi.
Article Received on 19/02/2019 Article Revised on 11/03/2019 Article Accepted on 31/03/2019
INTRODUCTION
Acharya Sushrut, father of Indian surgery mentioned
several surgical and parasurgical procedures at various
contexts. Raktamokshan (bloodletting) being one of
them. Dhatus (tissues) are the entities that retain body,
mind and prana (life).[1] Rakta is second dhatu formed in
sequence. Few acharyas consider rakta as a fourth dosha
(physiological humour necessary for life) keeping in
mind its significance in sustaining life.[2] According to
our ancient literature, the kshaya (depletion) and
vriddhi(restoration) of dhatus depend upon rakta.[3] It is
the pillar of entire body.[4] Doshadhatuasraya-
ashrayibhava (Mutual Interdependence of doshaand
dhatu) accredited to Acharya Vagbhata says that vata
resides in asthi(bones), pitta resides in rakta (blood) &
sweda (sweat), kapharesides in rest of the dhatus.[5]
Raktadhatu (Blood) in untainted or healthy status looks
like fiery gold which turns red after putting in fire;
Indragopa (red colored insect), red lotus or like
AbrusPrecatorius (Gunja).[6] Raktadhatu(Blood) is
anushansheeta(neither very cool nor very warm). It is
sweet; unctuous, red in colour, heavy and has a
characteristic smell.[7] Rakta is a teja and jalamahabhuta
predominant dhatu. Acharyas dictate maintenance of life
processes & supporting the body as the main functions
ofrakta. To further emphasize the importance of rakta, it
is considered one of the pranayatna (seat of life) by
acharyas.[8] It means something essential for sustaining
life.
Raktavahastrotas play an important role in metabolism
of raktadhatu. The principle organs are yakrita (liver) &
pleeha(spleen).[9] Patency of strotas (conduits) are
obligatory for unrestricted circulation of blood. Any
vitiation inbetween leads to strotodushti (aberration in
channels) in form of atipravritii (undue excess
formation), sang (obstruction), siragranthi (growth
inside conduits) and/or vimarg-gaman (leaving its own
channel and entering unusual channel).[10] It leads to
varying diseases as summarised in Table 1. The
coagulation factors essential for clot formation are
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Review Article
ISSN 2394-3211
EJPMR
EUROPEAN JOURNAL OF PHARMACEUTICAL
AND MEDICAL RESEARCH
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ejpmr, 2019,6(4), 634-640
ABSTRACT
Ayurveda is about ten thousand year old science. There are several surgical and parasurgical procedures mentioned
in ancient ayurvedic texts which are applicable today by making few technologic modifications to traditional use of
them. One such parasurgical procedure is raktamokshan (bloodletting). Acharya Sushruta, father of Indian surgery,
considered rakta (blood) as a fourth dosha (bodily humour necessary to carry out physiological functions) as it is
responsible for nourishment of body and our efforts should be towards maintaining its health. Vitiation of rakta
leads to varying pathologies. Raktaj (blood borne) and pittaj (bodily humour responsible for metabolism and
transformation) diseases that cannot be cured by medication are treated by bloodletting. It is very ancient yet less
accredited application of ayurveda. Leech therapy, venesection, cupping therapy which are gaining name today are
all described as a subtype of raktamokshan in ayurveda thousands of years back. Nowadays, a lot of trained
ayurvedic practitioners are practising raktamokshan (bloodletting) therapy. The present study enlightens the
scientific practice of these procedures by acharyas as well as modern technologic advances applied for their use.
KEYWORDS: Raktamokshan, jalauka, Siravedha, ghatiyantra, bloodletting.
*Corresponding Author: Dr. Vartika Kashyap
Post Graduate Scholar, Kriya Sharir Department, Ch. Brahm Prakash Ayurved Charak Sansthan, IPU, Khera Dabar, New Delhi.

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Rajguru et al. European Journal of Pharmaceutical and Medical Research
635
synthesized in liver. Spleen filters & cleanses blood,
creates new blood cells in fetal life and stores platelets
which are released in case of severe bleeding. The
endothelial layers of blood vessels are considered as
raktadharakala. It plays significant role in formation and
storage of raktadhatu. The normal endothelium degrades
adenosine diphosphate and inhibits platelet aggregation.
Injury to endothelium leads to expression of adhesive
molecules & procoagulant activities leading to formation
of clot.[11]
Raktamokshan (bloodletting) is considered best therapy
in blood borne and pittaj diseases as pitta has similitude
with rakta because of sansargata (close relation between
two), pradushanata (vitiated by pitta) and gandhavarna-
anuvidhanata (acquires its odour and colour).[12]
Bloodletting can be done by several procedures
depending upon the pathology. Siravedha (venesection)
is done in deep seated or generalised vitiation of rakta.
Shringa (animal horn), alaabu (dried gourd), ghati (bell
shaped earthen pot) are applied for numbness or tactile
loss. Jalauka (leech) is applied if disease is in sub-
cutaneous region. If disease is in skin or in form of
localised swelling, pracchan (scrapping) is done.[13]
Various procedures of bloodletting are mentioned in
ayurveda alongwith indications and contraindications for
each. Every procedure has detailed description which can
be divided in to pre-, during- and post procedure do’s
and don’ts. The need of the hour is to make it accessible
to masses by opting modern techniques and parameters.
METHODOLOGY
The present study is conducted after thoroughly
undergoing
1. Critical reference of ayurvedic texts especially
brihattrayee in relation to rakta and raktamokshan as a
modality.
2. Recent advancements in procedures by which
bloodletting can be done.
3. Relevant internet search like ncbi, researchgate,
google using keywords Raktamoshan, jalauka,
Siravedha, ghatiyantra.
4. Various articles concerned with bloodletting therapy
and its applicability in today’s world.
A correlation is made between ayurvedic and
contemporary concept of bloodletting. And a compilation
of particulars is made in light of modern view of
raktamokshan. Role of bloodletting therapy as adjuvant
to present line of management of blood borne diseases is
appreciated.
DISCUSSION
Three basic physiological entities considered to be pillars
of life are vata, pitta and kapha. All have different
functions in body. Kaphadosha is responsible for growth
and maintenance marking its anabolic or synthetic
activity. Pitta dosha is responsible for all type of
metabolic activity at the GI tract as well as cellular level.
Vatadosha is responsible for movement at muscular as
well as nervous system level. Sushruta being the father
of surgery gives much importance to rakta. Pure blood is
considered as pillar for life. Amount of raktadhatu in
body is 8 anjali (the maximum volume one can bear in
both hands brought together).[14] Because impure blood
can cause diseases it should be removed from body time
to time.
Pitta resides as ashrayi (dependent) in rakta (blood) and
sweda (sweat).[15] When pitta is vitiated and cannot be
treated by pitta alleviating medicines, bloodletting is
helpful. It is therapy for both vitiated rakta and pitta as
both are acquaintances. Vata and kapha doshas are also
responsible for raktadushti. Properties of vitiated rakta
by three doshas are given in Table 2.[16]
Bloodlettingremoves impure blood vitiated by
imbalanced doshas from the body.
Acharyas classify several methods of bloodletting as
Siravedha(venesection), shringa(horn of animal),
alaabu(dried gourd or long fruit of cucurbitaceae
family), ghati(a medium sized bell like instrument with
one end open), pracchan (superficial phlebotomy) as per
severity and depth of conditions.
It can be done using sharp or blunt instruments as
mentioned in flowchart 1.[17]
A.Using sharp instrumens: It includes prachhana and
Siravedha
1. Prachhana: literal meaning ‘quick sharp incisions’.
2. Siravedha: directly puncturing a vein with a needle.
B.Using blunt instruments: Shringa (horn of animal),
alaabu (dried gourd or long fruit of cucurbitaceae
family), ghatiyantra (a medium sized bell like instrument
with one end open); all three instruments are used after
pracchan(superficial phlebotomy). The principle of
action is generation of negative pressure and increase in
blood circulation to that localised area. Application of
jalauka (Leech therapy) is one of the procedures
included under ashastrakrita(without using sharp
instruments) raktamokshan.
Certain specified conditions are also mentioned where
bloodletting needs to be done.
Indications of bloodletting: Diseases occurring due to
vitiation of blood and pitta shall be dealt with
bloodletting. These include abscess, pain because of
vata, skin diseases, inflammation, filariasis, poisoning,
all types of growths/tumors, erysipelas, sexually
transmitted diseases, breast diseases, odontitis,
uvulitis.[18] These disorders include vitiated raktain their
pathogenesis which is to be removed by bloodletting.
Contraindications of bloodletting: Pregnancy, fasting,
generalised oedema, chest injury, severe malnutrition,
dehydration, anaemia, acute asthma, immediately after
vamana, virechan and basti.[19]

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Leech therapy
Ancient perspective of leech therapy: Leech therapy is
very ancient yet less accredited concept of Ayurveda. It
requires proper selection of patient and leeches,
purification, maintenance of leeches in earthen pots as
mentioned in ancient texts. Acharya Sushruta has defined
two types of leeches- poisonous and non-poisonous with
each having six subtypes. Hirudo medicinalis is used
most commonly for therapeutic purposes nowadays.[20]
Non-poisonous types are used for bloodletting.
Application of poisonous leeches causes, oedema,
itching, fainting, fever, burning, vomiting and
intoxication. He has mentioned use of leech in children,
women, elderly, princely and other subtle patients as it is
the mildest form of bloodletting.[21]
Technique of Jalauka Application[22]
A. Purva Karma (Pre-Procedure)
1. Proper snehana (oleation) and swedana (sudation) of
the patient.
2. Cleansing of Leech by pouring the Leech in water
mixed with turmeric powder.
3. Site of application preparation: Cleaning of part of
the body to which leech is going to be applied.
B. Pradhana Karma (Chief Procedure): Prick the skin
with a sharp and sterile needle before application of
leech so that drop of blood comes out and then apply
the Leech through. It is to be covered by wet cotton
cloth. Apply madhu (honey), ghrit (ghee), or butter
if leech is not sucking blood from the site.
C. Paschata Karma (Post Procedure):After sucking
sufficient blood, they separate from the area on their
own. 3-4 leeches are applied at effected area usually.
If the patient feels pricking, itching or discomfort at
the site of leech application it means leech has
started sucking fresh blood. It is when leech should
be removed from the site.
1. Patient care: There is oozing of blood from wound
created by the mouth of leech after detachment.It is
checked by use of Yastimadhu(Glycirrhizaglabra)or
turmeric powder or application of digital pressure or
tight bandaging with the cotton cloth.
2. Leech care: Vamana(Stimulation of emesis) of the
leech also has to be done so that it can be applied to
the same patient for subsequent procedure. Leech is
pressed from hind to front end for emesis or
turmeric powder is applied over leech’s mouth.
After vamana, leech is put in fresh water in clean
jar.
One leech usually sucks 5-10 ml of blood.[23] Feeling of
lightness in body, alleviation of pain, lessening in
severity of the disease and joyful mind are the symptoms
of proper vishravan (bloodletting).[24]
According to a study done to establish efficacy of leech
therapy in management of osteoarthritis (Sandhivata), it
was observed that there is a significant decrease in
symptoms including pain, stiffness, and tenderness on
application of leech therapy in sandhivata.[25] Recent
advances in leech therapy have led some researchers to
believe that purified extract obtained from especially
salivary glands of leech show an antimicrobial activity
against many Gram-negative/positive pathogens. They
reported that leech extract had a high antibacterial
activity against Shewanella and Aerococcus viridans
while a lower activity was observed against Escherichia
coli, Salmonella typhi and Staphylococcus aureus. They
concluded that leech extract could be used in the
treatment of bacteria-induced illnesses including
arthritis, foodborne disorders, and nosocomial
infection.[26]
Mode of action of leech therapy and its modern day
application: Leeches have biologically active
compounds in their secretions especially saliva. Recent
researches unveil the presence of bioactive peptides and
proteins in its saliva. These include antithrombin
(hirudin, bufrudin), antiplatelet (calin, saratin), factor Xa
inhibitor (lefaxin), antibacterial (theromacin,
theromyzin). During feeding on blood, leeches secrete a
complex mixture of different biologically and
pharmacologically active substances into the wounds.
Leeches saliva is rich in antithrombotic agent hirudin. So
it is effective in management of cardiovascular diseases
which effect heart, veins and arteries. Leech’s saliva has
inhibitory action on thrombin. It also increases blood
flow to the localised area temporarily. It also has
inhibitory action on Xa coagulating factor. Thus it blocks
the coagulation cascade and proves to be a fibrinolytic
agent.[27]
Microsurgery is carried out under microscope to
anastomose small blood vessels, veins and arteries
during reconstruction or replantation of tissues or
amputated parts. Leech biting of the part induces blood
oozing, secretion of bioactive enzymes, anticoagulants
and vasodilators thus preventing venous congestion of
that part. The duration of leech therapy post-surgery is
variable and depends upon the recovery of patient.
Besides this, leech saliva is known to have analgesic,
anti-diabetic, anti-microbial and antimetastatic activity in
favour of which several researches have been conducted.
Siravedha (Venesection): Acharya Sushruta has
described 700 sira in the body. 400 sira are in
appendages, 136 in trunk region, 164 in head and neck
region. Out of these 98 sira are avedhya (not suitable for
venesection).[28] While in rest of sira, blood can be drawn
as per pathology. Certain diseases in relation to site of
vedhan (venesection) are described as given in Table
3.[29] It is contraindicated in weak, pregnant, infants, old
age and patients suffering from diseases like anaemia,
immediately after panchkarma(detoxifying therapies),
emaciation, high fever, epilepsy, paralysis, fasting and

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Rajguru et al. European Journal of Pharmaceutical and Medical Research
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syncope as patient’s bala (strength) is already
compromised. Bloodletting will further aggravate vata
and lessen strength in such patients as the fate of rakta is
unstable after raktamokshan and special attention has to
be given to strength of agni (basic metabolism).[30]
Kutharika (axe shaped blade), vrihimukha (trocar), aara
(awl), vetaspatra (scalpel) are some of the instruments
mentioned in ancient texts used for suchivedhan karma
(puncturing or cutting vein).[31] These are replaced by
accessible bored needles in contemporary practice.
Application of Siravedha in modern day: Venesection
shall be performed by trained ayurvedic physician only
as it can have complications if not done suitably.
Procedure includes internal and external snehana
(oleation) by medicated ghee or oil. After that
generalised or localised swedana (sudation) depending
upon condition is done. Liquid or light semi-solid diet
having rice and water in proportion 1:6 is given to
patient before procedure.[32]
For main procedure, a day is selected when weather is
favourable neither too hot nor too cold as it may interfere
with vasoconstriction or dilatation. The patient is asked
to lie down. After selecting the proper vein, area is
sterilised by spirit swab, tourniquet is applied so the vein
becomes prominent. No. 18 needle or scalp needle is
used to puncture the vein and blood is allowed to flow. If
venesection is done in proper way the patient will feel
generalised or localised lightness, pain will be
diminished, symptoms of disease will be minimised and
he would feel blissful.
While explaining the significance of raktamokshan,
acharyas say that bloodletting done at regular intervals
prevent occurence of several skin disorders (like leprosy,
urticaria, dermatitis, eczema), apachi
(lymphadenopathy), gandamala (inflammed cervical
lymph nodes), galganda (goitre) and several types of
swelling, oedema all diseases caused by impure blood.[33]
Ghatiyantra (Application of bell like earthen pot)
Acharya vagbhat mentions use of alaabu and ghatiyantra
in the area of numbness or loss of tactile stimulation. In
treatment of gulma (abdominal growth/swelling/tumour),
he says that after oleation and sudation when gulma
becomes flaccid, apply ghatiyantra over it. Once the
affected area gets raised within ghatiyantra, remove it
and hold the area using cloth. Incise the area and then
using special type of instruments vimarg, ajpad and
adarsh, press the affected area. This is the ancient
ayurvedic description of application of ghatiyantra.[34]
Markedly effective use of ghatiyantra is seen in
Gridhrasi (sciatica). It is characterized by the onset of
Ruja (pain), Toda (pricking), and Stambha (stiffness),
initially in Sphika (gluteal region) and then radiating
distally to Kati-Prishtha (low back), Janu (knee), Jangha
(thigh) till Pada (feet). The patients suffering from
Gridhrasi have restricted movements due to painful
limb, affecting the daily routine activities. Marked
reduction in severity of mean scores of Ruja, Toda,
Stambha, and Spandana was seen in the patients after the
use of Ghatiyantra for Raktamokshana, which was
statistically significant. Ghatiyantra is found to be the
simple and effective treatment (in adjunct to other
treatment) for reducing Ruka, Toda, Stambha, and
Spandana in Gridhrasi.[35]
Application of ghatiyantra (cupping) in modern day
Application of cupping can be done by various methods
like dry cupping, wet cupping, moving cupping, flash
cupping, neddle cupping.[36] In dry cupping, only
negative pressure is created using air suction pump
inside pot so as to raise the area of applicaton. No prick
is done over skin. In flash cupping, alcohol dipped cotton
or simple matchstick is burnt inside pot/jar which heats
the inside of the cup. It is then quickly inverted over area
of application. Suction is created and area rises when air
cools down. In wet cupping, the area of pain is cleaned
with spirit swab. 3-4 skin pricks are given using no. 18
needle or small incisions are made, cup/jar after heating
from inside is placed over that area, blood is collected in
cups spontaneously.[37] The basic principle of
ghatiyantra is increasing the flow of blood in the
affected area. This will wash out the accumulated
metabolites in that area and pain is relieved. Cupping
therapy is accredited to several other ancient sciences
whereas the basic principle or mode of its action was
mentioned thousands of years ago in ayurvedic classic
texts.
Raktamokshan as best treatment modality in certain
diseases: Acharya Charak has mentioned certain
disorders where raktamokshan has to be done. In
vatarakta (gout), bloodletting is indicated using shringa,
jalauka, suchi, alabu, pracchanand/or siravedha. If vata
is aggravated, bloodletting is contraindicated as it causes
rakta kshaya.[38] Bloodletting is considered paramount
treatment in visarpa(erysipals) as it can’t occur without
vitiation of rakta and pitta.[39] Gulma roga (abdominal
tumors) that don’t respond to any treatment is curable by
bloodletting.[40] In treatment of unmada (psychosis),
vishamjwar (fever irregular in onset, symptoms and
duration), apasmara (epilepsy), bloodletting is indicated
in temporal region or border of hairline.[41]
These are some of the procedures mentioned in thousand
years old Ayurveda which can be done for prophylactic
as well as therapeutic purposes. Prior to procedure
bleeding time and clotting time of patient shall be
assessed to exclude any bleeding disorder. Special
measures should be kept in mind in case bleeding does
not stop. The patient might need rest, proper fluid
balance and maintenance of intravenous fluid
intervention in such case.
CONCLUSION
Bloodletting is based on an ancient system of
medicine in which blood and other bodily fluids were

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Rajguru et al. European Journal of Pharmaceutical and Medical Research
638
regarded as humours that had to remain in proper balance
to maintain health. Pittadosha and raktadhatu hold
similitude with each other. Hence vitiation of one leads
to vitiation of other. And when excess toxicity of rakta
and pitta has occurred so much so that it cannot be cured
by herbs or any other procedure, raktamokshan comes to
rescue.
Bloodletting can prove to be highly effective in
conditions like hypertension, skin diseases like acne,
urticarial, dermatitis, eczema; abscess, boils etc.
therapeutic phlebotomy is done in specific conditions
like hemochromatosis and polycythemiavera where
excess red blood cells are removed out of body.[42] This
is thousand years old principle of Ayurveda although less
accredited to it. In modern day, a lot of trained ayurvedic
practitioners are practising bloodletting therapy
successfully across the country. But still its access to
masses is lacking. The need of the hour is to grow
awareness among practitioners as well as patients
towards the fruitfulness of this therapy. It can be used as
a prophylactic procedure to prevent occurrence of blood
borne diseases as well as therapeutic procedures in
various conditions mentioned in this study. Yoga and
meditation are well embraced by western world which
are the two key aspects of ayurveda. Likewise it holds in
itself several other enigmas like raktamokshan that need
to be explored for the wellbeing of entire human race.
Table 1: Types of raktavahastrotodushti and associated diseases.
Table 2: Properties of raktadushtias a result of three doshas.
S. No.
Dosha
Properties of raktadushti
1.
Vata
Frothy, reddish-black, parched and less viscous in appearance, fast flowing and
delay in clotting.
2.
Pitta
bluish yellow or greenish in color, pungent smelling, flies and ants revolting and
takes long to clot.
3.
Kapha
Red ochre like in color, greasy, cold, more viscous, slimy, sluggish in flow
Table 3: Diseases in relation to site of siravedhan.
S. No.
Disease / Condition
Modern corelate
Site of siravedhan
1.
Padadaha, padaharsha,
avbahuk, chippa, visarpa,
vatashonita, vatakantak,
vicharchika, padadari
Burning sensation in soles, tingling
in soles, whitlow, erysipelas, gout,
ankle sprain, eczema, fissures I sole
2 angula above kshipramarma (present in between
big toe and next toe) by using vrihimukhashastra
(trochar or thick needle)
2.
Koshtrushirshaka, khanjta,
panguta, vatavedna
Inflammation of knee joint, limping,
lameness, pain caused by vata
4 angula above gulfamarma (ankle joint)
3.
Apachi
Swellings, growths in neck
(lymphadenopathy)
2 angula below indrabastimarma (vital point in
centre of calf muscle)
4.
Gridhrasi
Sciatica
4 angula above or below janumarma (knee joint)
5.
Galaganda
Tumour in neck (goitre)
Urumula (base of the thigh)
6.
Pleeharoga
Spleen disorders
Medial ascpect of left arm near kurparsandhi
(elbow joint) or at junction ring finger and little
finger of left hand
7.
Yakritaroga, kaphodar, kasa,
shwasa
Abdominal enlargement because of
liver disorders, kaphadosha
Medial ascpect of right arm near kurparsandhi
(elbow joint)
8.
Vishvachi
Pain in arms (brachial neuritis)
4 angula above kurparsandhi (elbow joint)
9.
Shulayuktapravahika
Painful dysentery
Shronisamantada (around pelvis)
10.
Parivartika, updansha,
shukadosha, shukraroga
Diseases of penis
Medhra Madhya (middle of penis)
11.
Mutravriddhi
Hyrdrocoele
Sides of vrishna(scrotum)
12.
Dakodar
Ascites
Left side of raphae 4 angula below umblicus
S. No.
Type of strotodushti
Modern correlate
Diseases occurring as a result of strotodushti
1.
Atipravritii
Undue excessive action
Asrigdar(menorrhagia)
2.
Sang
Complete or partial
obstruction of strotas
(conduit)
Kushtha(skin diseases), pidika(Acne Vulgaris),
gudpaka(inflamed anal region), medhrapak(inflamed penis),
neelika (nevus), vyanga(melanosis), tilkalak(non-elevated
mole), dadru(tinea corporis), charamdal, shwitra (leprosy),
pama(scabies), kotha(urticarial), pleeharoga (spleen disease),
kamala (jaundice), vatarakta(gout)
3.
Siragranthi
Growth inside conduits
Arsha (piles), vidradhi (abscess), arbuda (growth or swelling)
4.
Vimarg-gaman
Entering some other conduit
after leaving its usual conduit
Kamala (jaundice), raktapitta (epistaxis), vatarakta (gout)

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Rajguru et al. European Journal of Pharmaceutical and Medical Research
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13.
Anta-vidraddhi, parshvashula
Internal abscess, pain in flanks
Left anterior axillary line
14.
Bahushosha, avbahuk
Wasting of arm, loss of movement
of the arm
Middle of two scapula
15.
Tritiyakajwar
Tertian fever
Middle of trika sandhi (upper back)
16.
Chaturthakjwar
Quartan fever
Below scapula on either side
17.
Apasmara
Epilepsy
Middle of hanu-sandhi (temporo-mandibular joint)
18.
Unmada
Insanity
Shankha(temple), keshant sandhi (border of
hairline), vaksha (chest), apanga (outer angle of
eye), lalaata (forehead)
19.
Jihva and dantroga
Diseases of tongue and teeth
Below tongue
20.
Taluroga
Diseases of uvula
Uvula
21.
Karna roga, karnashula
Ear disorders and ear ache
Above and around ear
22.
Timira, akshipaka , netraroga
Partial blindness, ulceration of eye,
diseases of eye
Near nose, lalaata (forehead), apanga(outer angle
of eye)
23.
Shiroroga, adhimantha
Diseases of head, diseases of eye
Same as above
Flowchart 1: Types of modalities of raktamokshan.
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