Types of Raktamokshana

The presentation helps in understanding the methodology of Shringa,alabhu,pracchana and Ghati yantra and its applications.

1. Types of RAKTAMOKSHANA Dr Akshay Shetty Asst Professor Dept of Panchakarma SSRAMCH Inchal

2. Contents 12/06/2020 Raktamokshana (Dr Akshay Shetty) 2

3. Objectives By the end of the presentation the students must be able to----- Select Raktamokshana kaksha List Upakarana of Raktamokshana Enumerate Medicines used in Raktamokshana Predict the type of Raktamokshana as per dosha Demonstrate the Procedure of Prachchhana Demonstrate the Procedure of Shringavacharana Demonstrate the Procedure of Alabhu avacharana Demonstrate the Procedure of Ghati yantra 12/06/2020 Raktamokshana (Dr Akshay Shetty) 3

4. Raktamokshana kaksha The room should be free from direct air and have pleasant ambience It is contraindicated in excessive hot and cold so the room may be enabled with Air condition system It should have all necessary equipment's as well as medicines made available for combating emergencies during procedures 12/06/2020 Raktamokshana (Dr Akshay Shetty) 4

5. Upakarana of Raktamokshana Water container Hot water Cold water Sterile Gauze pieces Sterile swabs Sterile cotton Bandages Sira bandana materials (tourniquet, crepe bandage) BP apparatus Kidney trays Measuring glass Scalp vein (no 16/18/20) Surgical balade no 12 Taila for abhyanga Nadi sveda yantra Washing materials ( spirit,panchavalkala Kashaya) Chair Disposable syringe Sandhana,skandhana,pachana,dahana upakrana etc 12/06/2020 Raktamokshana (Dr Akshay Shetty) 5

6. Cont … The qualities of shastra should be---- Hriju Asamkirana Sukshma Sama Anavagadha – anuttana (S.Su.14/26) Kutharika shastra Vrihimukha shastra Trikurcha 12/06/2020 Raktamokshana (Dr Akshay Shetty) 6

7. Medicines used in Raktamokshana अथ खल्वप्रवर्तमाने रक्ते एलाशीतशिवकुष्ठतगरपाठाभद्रदारुविडङ्गचित्रकत्रिकटुकागारधूमहरिद्रार्काङ्कुरनक्तमालफलैर्यथालाभं त्रिभिश्चतुर्भिः समस्तैर्वा चूर्णीकृतैर्लवणतैलप्रगाढैर्व्रणमुखमवघर्षयेत्, एवं सम्यक् प्रवर्तते||३५|| S.Su14 12/06/2020 Raktamokshana (Dr Akshay Shetty) 7

8. Cont … Ela,sitashiva,kushta,tagara,patha,bhadradharu,vidanga,chitraka,trikatu,agaradhuma,haridra,arkankura,naktamala,phala. Rodhra,madhuka,priyangu,patanga,gairika,sarjarasa,shalmali,puspha,shanka,shukti,masha,yava,godhuma etc (S.Su.14/25) kakoladi gana,jatyadi ghrita,shatavari ghrita , madhu,ghrita List of emergency medicines Bolaparpati Bolabanda rasa Shonitaragal rasa Moti pishti Durva patra swarasa 12/06/2020 Raktamokshana (Dr Akshay Shetty) 8

9. Predict the type of Raktamokshana as per dosha तत्र  वातपित्तकफदुष्टशोणितं यथासङ्ख्यं शृङ्गजलौकालाबुभिरवसेचयेत्, सर्वाणि  सर्वैर्वा (विशेषस्तु विस्राव्यं शृङ्गजलौकालाबुभिर्गृह्णीयात्) ||४|| S.Su . 13 उष्णं समधुरं स्निग्धं गवां शृङ्गं प्रकीर्तितम् | तस्माद्वातोपसृष्टे तु हितं तदवसेचने ||५|| शीताधिवासा मधुरा  जलौका वारिसम्भवा | तस्मात् पित्तोपसृष्टे तु हिता सा त्ववसेचने ||६|| अलाबु कटुकं रूक्षं तीक्ष्णं च परिकीर्तितम् | तस्माच्छ्लेष्मोपसृष्टे तु हितं तदवसेचने ||७|| S.Su . 13 12/06/2020 Raktamokshana (Dr Akshay Shetty) 9

10. Procedure of Prachchhana Prachchhana is a special technique of blood letting by pricking of needle or superficial incisions by any sharp ended instruments in a specific manner in a localised area Indication : Pindita rakta Materials required --- Triphala or panchavalkala Kashaya Nadi sveda yantra Surgical blade or needle Tourniquet Cotton Bandage Jatyadi ghrita Surgical gloves 12/06/2020 Raktamokshana (Dr Akshay Shetty) 10

11. Cont … Poorva karma: Stanika abhyanga Svedana Part is cleaned and dried The patient is advised to sit or lie down in comfortable position Tourniquet is tied four inches above the affected part to facilitate bleeding 12/06/2020 Raktamokshana (Dr Akshay Shetty) 11

12. Cont … Pradhana karma Several moderate uniform and visible pricks or incision are made by sterilised blade or needle The incision or pricks is to be made very quickly and steadily and many in number Marks are to be made from below upwards and side by side Patient is asked to release and apply pressure on the area alternatively Tourniquet is to be released when the blood flow is stopped automatically or required amount of blood is let Paschat karma : after soaking and proper cleaning by triphala or Panchavalkala Kashaya,jatyadi ghrita or other medicine are to be applied 12/06/2020 Raktamokshana (Dr Akshay Shetty) 12

13. Shringavacharana Horn of cow is to be collected first and the it is to be cleaned It should be round in shape and seven angula in length The hole of the base be like thumb where as the upper part should be size of mudga (S.Su.13/8) Procedure Physcian should make incision over the affected area as prachchhana After oozing of some blood,the wider edge of the the horn which is covered by a thin cloth is to be kept over the affected area Physician should suck the narrower side of the horn to facilitate the oozing 12/06/2020 Raktamokshana (Dr Akshay Shetty) 13

14. Alabhu avacharana Alabu commonly known as bottle gourd. Types : Dhirga and vritta Madhura and tikta Tikta alabhu is used for vamana and raktamokshana It should have circumference of eight anguli and length of four anguli 12/06/2020 Raktamokshana (Dr Akshay Shetty) 14

15. Cont … Preparation of Alabu : First of all ,a Dirgha alabu is to be selected which is white in colour ,fresh and of appropriate size. Then its pulp is removed by cutting its narrower portion An accommodation for keeping a lamp or source of fire is to be made inside it. 12/06/2020 Raktamokshana (Dr Akshay Shetty) 15

16. Cont … Procedure After abhyanga and svedana . Patient is asked to sit or lie in a suitable posture. Prachchhana is to be made on the desired site. A source of fire is to be kept inside alabu and the cut end of it is to be placed to the affected part in such away that the inner portion of alabu becomes air tight. After sometimes when the inner oxygen will be consumed a negative pressure will be created to facilitate the oozing of blood After ten to fifteen minutes ,the alabu is to be removed forcefully from the body 12/06/2020 Raktamokshana (Dr Akshay Shetty) 16

17. Cont … Paschat karma : Soaking properly by sterile gauze piece ,the area is to be washed by triphala or panchavalkala kvatha . Any ointment is to be applied 12/06/2020 Raktamokshana (Dr Akshay Shetty) 17

18. Ghati yantra The mechanism of ghati yantra is same as alabu , the only difference is that ghati yantra is made of metal . It is also used to elevate the root of Gulma prior to surgery. 12/06/2020 Raktamokshana (Dr Akshay Shetty) 18

19. Summary 12/06/2020 Raktamokshana (Dr Akshay Shetty) 19

20. References Sushruta Samhita Principles and Practice of Panchakarma,Dr Pulak kanti Kar 12/06/2020 Raktamokshana (Dr Akshay Shetty) 20

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