Jaloka Avcharaniya Adhyaya - 13th Chapter of Sushruta Samhita
Acharya Sushruta has written Sushruta Samhita in the Sanskrit language which is the oldest Ayurvedic text on surgery. Worldwide known as"The Father of Surgery" Acharya Sushruta was a scholar in ayurvedic medicine and surgery. Also known as "The Father of Plastic Surgery" he was the first one who did forehead flap rhinoplasty. In this article, we will learn about the 13th chapter of Sushruta Samhita (Sutra sthana) which is Jaloka Avcharniya Adhyaya.
Jaloka avcharan (leech therapy) is the application of leeches on the skin in order to remove impure/ contaminated blood from the body. It is mostly done for skin diseases and in order to purify the blood. It is considered the most natural and easiest method of removing impure blood. In this chapter, we will learn about leech therapy and various methods to remove blood by using leeches, horns and gourds. You will also get to know the ideal leech that is used in leech therapy by medical practitioners.
Bloodletting Through Different Methods
- The blood vitiated by various doshas like Vata, Pitta and Kapha is removed from the body by using shringa (horns of animals), jalauka (leeches) and alabu (pitcher gourd) respectively.
- Shringa being unctuous in nature pacifies vata whereas Jaloka is cold in potency and pacifies Pitta. The dryness of Alabu pacifies Kapha.
- The blood contaminated by the aggravation of Vata, Pitta and Kapha is eliminated using all 3 methods.
Properties of Shringra, Jaloka and Alabu
- Shring (Horn): The horn of a cow is hot in potency, sweet in taste and unctuous in nature. That's why it is used for the elimination of blood vitiated by Vata.
- Jaloka (Leeches): Jaloka lives in cold places and originates in water. It is sweet in taste and therefore it is used to eliminate blood vitiated by Pitta.
- Alabu (Gourd): Alabu is bitter in taste, dry and sharp in nature. That's why it is used to eliminate blood vitiated by Kapha.
Elimination Of Blood By Shringa And Alabu
First of all, the site from where the blood is about to be drawn should be incised. Then a thin cloth should be covered over the narrow orifice of the horn. The Shriga should be covered over that site and blood is removed by sucking. In a similar way, blood is eliminated using Alabu by keeping burning a lamp or cotton inside the Alabu.
Jaloka Nirukti (Etymology Of Jaloka)
As Jala (water) is the ayu (life) for leeches, therefore, they are called Jalayuka and Jala (water) is their oka (habitat) hence they are called Jaloka.
Types Of Jaloka
There are total 12 types of Jaloka. Six Jalokas are poisonous whereas the other six are non-poisonous.
Given below are the names of Poisonous Jalokas:
- Krishana Jaloka: The Jaloka which resembles the color of the powder of Black Anjana (black soot) and has a big head is Krishna.
- Karbura Jaloka: Jaloka which resembles the length of Varmi Matasya (a type of fish) and it has stripes on the abdomen.
- Algarda Jaloka: Algarda Jaloka has hairs on the body. It is characterized by big flanks and has a black mouth.
- Indrayudha Jaloka: Indrayudha Jaloka has colorful stripes resembling a rainbow.
- Samudrika Jaloka: The Jaloka has black and yellow dots with shapes of various flowers.
- Gochandana Jaloka: The lower part of Jaloka resembles the scrotum of a bull and its lower part is divided into two parts. It has a small mouth.
Symptoms After Being Bitten By Poisonous Jaloka
If a person is bitten by 6 types of Poisonous Jaloka then the following symptoms are seen in a person:
- Pruritis (Severe itching)
- Burning sensation
Places Where Poisonous Jaloka Are Found
Poisonous Jaloka is present in river bodies where poisonous fishes, urine, excreta and decayed bodies of poisonous fishes, insects, worms, and frogs are present. Those Jaloka which live in poisonous water are poisonous in nature.
Non Poisonous Jaloka
Given below are the names of Non-Poisonous Jaloka:
- Kapila Jaloka: These Jalokas have yellow-colored flanks. Its color resembles Manashila (realgar) and monga (green gram).
- Pingula Jaloka: These Jalokas are slightly red or brown in color with round bodies and move quickly.
- Shankhamukhi Jaloka: These Jalokas are dark in color like liver and suck blood very quickly. They have long and sharp mouths.
- Mushika Jaloka: It resembles the shape and color of mice. Mushika Jaloka has an unpleasant smell.
- Pundarika Mukhi Jaloka: These Jalokas resemble the green-colored moong dal (green gram) and its mouth resembles the shape of a lotus.
- Savarika Jaloka: It is unctuous, and resembles the color of a lotus petal. It is 18 angula (31.73 cm) in length. It is mostly used to remove impure blood from cattle.
Places Where Non-Poisonous Jaloka Are Found
- These Non-Poisonous Jaloka are found in Arab countries, South India, Central India and places around Mathura (U.P). In these places, leeches with big bodies that are strong and those who suck blood very fast are found. These leeches are voracious and non-poisonous.
- The leeches that are born in water bodies where decayed lotus, water lily, red lotus, lily, red lily, white lotus and algae are found. These leaches are found in clean water.
- These leeches are found in deep and fragrant water bodies. Non- Poisonous Jalokas are not present in narrow water bodies and in mud sludge. It does not eat poisonous substances.
Rearing Of Leeches
These Jalokas should be collected with the help of moist leather. Then these leeches should be kept in a new big pot containing the water and mud of the same water body. The leeches should be fed with powder of algae, dry meat of aquatic animals, Indian water chestnut and stalk of a lotus. Grass and lotus are added to the pot filled with water so that leeches can sleep properly. Old water should be removed and new water should be added after every 3 days and the pot should be changed every week.
Leeches That Are Unsuitable For Use
Leeches that have the following features are not suitable for use:
- Leeches that are big from the middle and thin from the sides
- Leeches which have an ugly appearance
- Jalokas which are very flat
- Leeches which are less active
- Jalokas which do not stick to the site of the application
- Leeches that sucks very less quantity of blood
- Poisonous leeches
Procedure Of Application Of Jaloka On The Body
The patient suffering from the disease is made to sit or lie down. The site on which Jaloka is to be applied is made rough by rubbing the site with mud or cow dung powder. It should be rubbed in such a way that it does not cause any pain or discomfort. The body of the leech should be covered with a mixture of mustard and turmeric. Then, leeches should be kept in a water pot for at least 28 minutes. After observing that leeches have become fatigue-free physicians should select the leech for bloodletting. The selected leech is applied at the diseased site and the leech is allowed to bite the site. After that leech is covered with a smooth, white and moist cotton cloth. But its mouth should remain uncovered. If Jaloka does not fix its mouth to the affected site then a few drops of milk or blood are kept in that region or that region should be incised with an instrument. If all the attempts of the Jaloka application are failed then another Jaloka should be applied in that region.
If the leech makes its mouth like a horse loof and lifts its neck it means that the leech has bitten the selected site. Then the leech starts to suck the impure blood. The body of the leech which is covered with cotton cloth should be sprinkled with water at a span of few intervals. If the patient feels pricking pain and itching at the site of the application of the leech it means that the leech has started sucking pure blood. At this point, the leech should be removed. Attracted by the smell of blood if the leech does not stop sucking blood and does not detach from the applied site then powder of rock salt should be sprinkled over its mouth. After sucking impure blood the leech falls apart from the site and that diseased site should be sprinkled with rice flour. The mouth of the leech should be rubbed with the solution of oil and salt.
Now physician should hold the leech with the thumb and finger of the left hand and should knead the body of the leech slowly in the downward direction with the help of the thumb and finger of the right hand. In this way, the leech is allowed to vomit out all the sucked blood till all the signs of satisfactory vomiting appear. If the leech sinks in the water and is inactive it means that the leech hasn't vomited completely. So, the leech should be made to vomit out. If the leech does not vomit out that impure blood it develops an incurable disease called Indramada. If the leech has completed vomiting then it should be kept in the water pot.
After looking at the proper or improper quantity of blood sucked by the leech. Shatadauta ghrita (type of ghee) or a swab dipped with Shatdauta ghrita should be applied at the site. The wound caused by leech should be massaged with honey and cold water should be sprinkled in that region. Then, it should be bandaged. Alternatively, a paste of astringent, sweet, unctuous herbs which are cold in potency should be applied to that site.
Suitable Physician For Leech Therapy
The physician who has knowledge of Jalokas and knows the method of application of Jalokas on the diseases or desired site is capable of treating Jalokasadhya diseases (diseases cured by leech therapy).
The blood vitiated by various doshas like Vata, Pitta and Kapha is eliminated from the body by using Shringa, Leeches and Alabu respectively. In this chapter, we have discussed Leech therapy in detail. Leech therapy is used to eliminate impure blood from the body. There are total 12 types of leeches mentioned by Acharya Sushruta. Depending upon their feature one can get to know either they are Poisonous or Non-Poisnous leeches. One should select Non-Poisonous leeches for leech therapy and it should be done by a physician who has the full knowledge about leeches.