DR. KAUSHAL SINHA 2 N D YEAR PG SCHOLAR

DEPT OF PANCHAKARMA

Raktamokshana in Gridhrasi

Introduction

Shodhana chikitsa is one of the most important treatment modality in ayurveda.

raktamokshana is one among the panchashodhana.

Gridhrasi

One of the Nanatmaja vikaras.Characterised by piercing pain,

stiffness,cramps beginning from the sphik radiates upto the pada through the posterior aspect of kati, prusta, janu ,jangha.

Leading disability in walking.

Types 1. Vataja Gidhrasi2. Vata-kaphaja Gridhrasi

Vataja Gridhrasi: Curved posture (altered gait) due to pain(pain during lateral bending), severe stiffness, pulsation in back, hip, thigh, knee and foreleg.

Vata-kaphaja Gridrasi: Along with the above features, indigestion, drowsiness, nausea, anorexia, heaviness of the leg and freezing sensation in the lower limbs are complained

Sciatica

Pain in the leg generally unilaterally caused by irritation of sciatic nerve.

There may be numbness, difficulty in moving or controlling the leg.

Pain, generally travel from back of thigh to back of calf and may also extends upwards to the hips and downwards to the foot.

so comparitively sciatica resembles with the Gridhrasi described in Ayurvedic science.

Hetu

Ruksha, Sita, Alpa, Laghu, Tikta,Katu, Kashaya Anna sevana.

Atimaithuna. Ativyayama .Excessive sitting on a chair for a longer timeExcessive standing for longer time.Amotpatti. Dhatukshaya etc.

Causes of sciatica according to the modern knowledge:Bulging disc or herniated disc.Degenerative disc disease.Piriformis syndrome.Pregnancy.Spinal stenosis.Spinal tumors and spinal infections.Spondylolisthesis.Trauma.

Disc bulge

Herniated Disc

Piriformis syndrome

Spinal Stenosis

Spondylolisthesis

Spinal Tumor

Definition of Raktamokshana

“Raktasya Mokshanam Raktasrava” letting out the impure blood from the body is known as Raktamokshana.

Types of Raktamokshana

Types of Raktamokshana Indications

shringa Vata Dushta Rakta, Avagada tama Dushta,Rakta in twak, Sukumara purusha,Kandu,Suptata,Sparshanasha

Jalouka Pitta Dushta Rakta,grathita Rakta, Avagada Dushta Rakta in twak, Sukumara purusha, Toda, Daha

Alabu Kapha Dushta Rakta, Avagada tara Dushta,Sukumara purusha, Kandu, Suptata

Siravyadha Tridoshaja Rakta Dushti, Sarvanga Gata Dushti

pracchana Uttana Rakta, Ekadesha Pindita Rakta

Ghati Yantra Kapha-Vata Dushta Rakta

Treatment stated by Acharya charaka in Gridhrasi areSiravedhaBastikarma Agnikarma Treatment stated by Acharya Sushrutha isSiravedha treatment stated by Acharya Bhela areSnehanaSwedanaBasti Raktamokshana

Sites of Raktamokshana

4 angula above or below from Janu Sandhi(sushrutha)

4 angula above from Gulf (haritha)In between the Kandara and Gulf (charaka)

Procedure of siravyadhaPurva karmaSambhara sangragaAtura cayanaAtura siddhataPradhana karmaSiravyadhanartha aasanaSiravyadha and NirikshanaPaschat karmaAtura paricharyaPariharya vishayaShamana chikitsa

Amount of blood to be collected

One Prastha is advocated as the maximum limit of blood letting with excessively vitiated doshas.

As per Dalhana1 Prastha- uttama matra½ Prastha- madhyama matra¼ Prastha- hina matra

Probable Mode of Action of Raktamokshana

Kandara is the upadhatu of Rakta and kandara is the Dusya in Gridhrasi.

Gridhrasi is the Rakta vata as stated by Harita.

Gridhrasi is due to Vyana Vayu Prakopa ant this Vyana Vayu is related to blood circulation.

Elimination of Ama by Siravyadha which obstructs the srotas or channels and vayu gets anoloma.

Discussion

Sciatica

How is TNF related ?

Whether chemicals in

the blood called

Cytokines influence

pain ? What is Chemical

Radiculitis?

Conclusion

Raktamokshana can cure the disease when other treatment do not have the effect on disease/ when other treatment fails.

It gives immediate relief in pain of Gridhrasi.

The symptoms of samyak siravedha are Laghavam, Vedanashanti , visravit rakta , it means the pain arising from a disease condition get subsided followed by decrease in the symptoms of the disease so siravedha can be used in pain predominant diseases.

Thankyou…