We will now expound the chapter called as Jalauka vidhi – procedure of application of leeches to the body; thus said atreya and other great sages. (1)
अथातो जलौकोविधिं नामाध्यायं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ॥ १ ॥
नृपाढ्यभीरुसुकुमारबालस्थविरनारीणामसृग्विस्त्रावणाय जलौकसो योजयेत् ॥ २ ॥
To let out the blood from the body of the persons such as the kings, the wealthy, the frightful, the tender, the children, the aged and the women, leeches should be used. (2)
Jalauka bhedas – types of leeches
तास्तु द्विविधाः सविषा निर्विषाश्च । तत्र दुष्टाम्बुसर्पमण्डूकमत्स्यादिशवकोथमूत्रपुरीषजा रक्तश्वेतातिकृष्णतनुस्थूलचपलपिच्छिलाः स्थूलमध्यरोमशाः शक्रायुधवद्विचित्रोर्ध्वराजीचिता वा सविषाः । तद्दंशाद्दाहशोफपाककण्डूपिटकाविसर्पज्वरमूर्छाश्वित्रोत्पत्तिः । तत्र विषपित्तर क्तहरां क्रियां कुर्वीत। पद्मोत्पलसौगन्धिकादिसुगन्धिविमलविपुलसलिलशैवालजाः शैवाल श्यावा नीलोर्ध्वराजयो वृत्ताश्च निर्विषाः ॥३॥
They are of two kinds – poisonous and non-poisonous. Those which live in water polluted by decomposing dead bodies, urine and excreta of snakes, frogs, fish and other animals; which are red, white or very black in colour; thin or thick, very active and slimy, with thick hairs in moderate quantity, and different kinds of coloured lines resembling the rainbow on their body are poisonous. Their bite will produce burning sensation, swelling, ulcers, itching, eruptions, herpes, fever, fainting and leucoderma.
These conditions are to be treated with drugs which are antipoisonous, and which mitigate pitta and rakta.
Those which live in water which has lotus, lily and other fragrant flowers, large reservoirs having pure water and algae; which are like the algae, blackishgreen, have blue lines over their body and which are round are non-poisonous. (3)
सर्वासां च परं प्रमाणमष्टादशाङ्गुलानि । तत्र चतुष्पञ्चषडङ्गुला नृषु योजयेत् । गजवाजिष्वपराः । तासु सुकुमारास्तनुत्वचोऽल्पशिरस्का बृहदधरकायाश्च स्त्रियः । विपरीताः पुमांसोऽर्धचन्द्रकृतिपुरोवृत्ताश्च । तत्र बहुदोषेषु चिरोत्थितेषु चामयेषु पुमांसो योजयितव्याः । स्त्रियो विपरीतेषु । जलौकसस्त्वार्द्रचर्माद्युपायैर्गृहीत्वा सुरभिपङ्कगर्भे नवे घटे स्थापयेत् । शृङ्गाटककशेरुकशालूकशैवालमृणालवल्लूरमृत्स्नापुष्करबीजचूर्णं स्वादुशीतं स्वच्छं च तोयमन्नपानार्थे ताभ्यो दद्यात् । लालादिकोथपरिहारार्थमेवं च त्र्यहात् त्र्यहादूर्ध्वं पूर्वमन्नपानमपनीयान्यद्दद्यात् । पञ्चाहाच्च तद्विध एव घटान्तरे ताः सञ्चारयेत् । तासां तु दुष्टशेणितासम्यगग्वमनात् प्रततपातनाच्च मूर्च्छा भवति । तासामम्भोभिः पूर्णभाजनस्थानामचेष्टयाहारानभिलाषेण च ज्ञात्वा ता विवर्जयेत् । इतरास्तु हरिद्रासर्षपकल्काम्भसि मुक्तपुरीषा अवन्तिसोमे तक्रे वा पुनराश्वासिता जले सुखोपविष्टस्य संविष्टस्य वा मृद्गोमयचूर्णाभ्यामनुसुखं विरुक्ष्य दंशदेशं योजयेत् । अलगन्तीषु क्षीरघृतनवनीतरुधिरान्यतमबिन्दून् न्यसेत् प्रच्छेद्वा । अश्वखुरवच्च वक्त्रं निवेश्योन्नतस्कन्धा दशन्ति । यदा च शिशुवच्छ्वसन्त्यो शिरःस्पन्दोर्मिवेगैः पिबन्ति तदार्द्रवाससावच्छादयेत् । सेचयेच्चाम्भसाल्पाल्पम् । यथा च हंसः क्षीरोदकात् क्षीरमादत्ते तद्वदुत्क्लिष्टे रक्ते जलौकाः प्राग् दुष्टमसृक् । यदा च तद्दंशे तोदः कण्डूर्वा तदा शुद्धरक्तरक्षर्णांर्थमपनयेत् । लौल्याच्च दंशममुञ्चन्त्याः क्षौद्रं लवणचूर्णं वा मुखे दद्यात् ॥४॥
The maximum length of all kinds (of leeches) is eighteen angulis (fingers breadth); of them, those which are four, five or six angulas should be used for men and others for elephants and horses. Those which are slender, of thin skin, small head and large lower part (hind part) are females; those of opposite features, and which have their mouth part shaped like half-moon are males.
Males are to be used in conditions of profound increase of doshas and in diseases which are long-standing; females, in the opposite conditions.
Leeches are to be collected by holding them with a wet leather or by other methods and preserved in a fresh, mud pot containing good smelling slush (mud).
They should be fed with plants like srngataka kaseruka, saluka, saivala, mrnala, vallura (dried meat), mrtsna, puskarbija curna (fine powder of seeds of lotus) and sweet, cold and clean water. The feeds and water which are stale should be removed once in three days, to get rid of saliva and decomposing matters and fresh ones added.
The leeches are to be transferred to new pots once in five days.
They get into the condition of coma by incomplete vomitting of impure blood and also by applying them to such blood very often. This condition can be recognised by their lying idle without movement inside the water and by lack of desire for food. So they should be removed.
The others should be kept for some time in a solution of haridra and sarsapa or in Avantisoma (sour gruel prepared with rice wash) or in buttermilk, to help them void their excreta; next they should be put into clean water to regain their activity.
Jalauka vidhi – procedure of application of leeches
The patient who is to be treated should be made to sit comfortably, the part of the body selected for the application (of leech) should be made a little rough by rubbing it with mud or powder of cowdung and the leech applied to the spot. If it does not stick on, one or two drops of milk, ghee, butter or blood should be put on the spot or a small incision made (on the body of the patient) to get a drop of blood. After holding (adhering) to the spot with their mouth and raising their shoulders they assume the shape of a horse’s hoof.
When they breathe like children (very fast) and drink the blood quickly, by moving (shaking) their head rapidly then they should be wrapped with wet cloth and cold water sprinkled over them slowly little by little. Just as the swan drinks only the milk from a diluted milk, similarly the leeches drink only the bad blood first from the pool of (vitiated) blood.
When the patient experiences pricking pain or itching at the site of the bite, the leeches are to be removed, to protect the pure blood. If they do not leave their bite by the greed of blood, a drop of honey or a pinch of salt should be put on their mouth. (4)
पतितां तु तण्डुलकण्डनोपदिग्धगात्रां तैललवणाभ्यक्तमुखीं आपुच्छादामुखमनुलोमं शनैः पीडयन् सम्यग्वामयेत् । ततः पूर्ववत् सन्निध्यात् । सप्तरात्रं च ताः पुनर्न पातयेत् । अशुद्धे तु रक्ते मधुना गुडेन वा दंशात् किञ्चिदवघट्टयन् स्त्रावयेत् । स्रुतरक्तस्य च सद्यो दंश शीता – भिरद्धिः प्रक्षाल्य सर्पिः पिचुनावगुण्ठयेत् । स्थितरक्तं चोत्क्लिष्टशोणितशेषप्रसादनाय कषायमधुरशिशिरैः सघृतैः प्रदेहैः प्रदिह्यात् ॥५॥
After they fall off they should be covered with powder of broken rice, their mouth smeared with oil and salt; they should be slowly massaged from their tail portion towards their mouth in the downward direction and made to vomit all the blood they have sucked. Afterwards, they should be transferred to their dwelling pot and should not be used again within seven days.
If the blood coming out from the place of the bite is found to be bad, the wound of the bite should be touched with honey or molasses, squeezed slightly to let out some more blood. Afterwards, the place is to be washed with cold water and covered with a cloth dipped in ghee. When the bleeding has stopped, a thin paste of drugs having astringent and sweet taste and cold potency, mixed with ghee should be applied over the place to conserve the residue of good blood. (5)
Anya Raktamoksana krama
तत्र योगादीन् सिराव्यधवदुपलक्षयेत् प्रतिकुर्वीत च । दुष्टरक्तापगमात् श्वयथुशैथिल्यं दाहरागशूलोपशमश्च । रक्तपित्तेन दुष्टमलाबुघटिकाभ्यां न निर्हरेदग्निसंयोगाद्वातकफाभ्यां च दुष्टं निर्हरेत् । तथा कफेन न शृङ्गेण स्कन्नत्वात् । वातपित्ताभ्यां तु दुष्टं निर्हरेत् । अथ प्रच्छाद्याङ्गं तनुवस्त्रपटलावनद्धप्रान्तेन श्रृङ्गेणाचूषेत् । तथा प्रदीप्तपिचुगर्भाभ्यामलाबुघटि काभ्यामिति । भवन्ति चात्र श्लोकाः ॥६॥
The adequate, inadequate and excessive condition of this therapy as well as the management of complications are similar to those of venesection.
By the removal of impure blood there will be decrease in the swelling, burning sensation, redness and pain.
The blood which is vitiated by increase of pitta (as in haemorrhagic disease) should not be taken out of the body by using either a gourd or a sucking pot, because of contact with fire inside them but only that blood which is vitiated by increase of vata and kapha should be brought out by those methods;
That which is vitiated by increased kapha should not be brought out by using the horn as the blood will have been coagulated; but the blood vitiated by increase of vata and pitta can be brought out by this method.
The blood can be sucked through the horn after making incision on the body and applying the wide mouth of the horn covered with a thin cloth.
The gourd or a pot may be used for sucking the blood by keeping lighted wick inside them and applying their mouths to the affected portion of the body (of course, after making an incision there). (6)
गात्रं बध्वोपरिदृढं रज्ज्वा पट्टेन वा समम् । स्नायुसन्ध्यस्थिमर्माणि त्यजन्प्रच्छानमाचरेत् ॥७॥
Some more verses here :
The incision should be done in a place devoid of tendons, joints, bones and vital spots and after tieing a thread or tape, firmly above the site of the incision. (7)
अधोदेशप्रविसृतैः पदैरुपरिगामिभिः । न गाढघनतिर्यग्भिर्न पदे पदमाचरेत् ॥८॥
The incisions should be made from above downwards but not from below upwards; it should not be very deep, wide or one over the other. (8)
प्रच्छानेनैकदेशस्थं सुप्तं शृङ्गादिभिहरेत् । ग्रथितं तु जलौकोभिरसृग्व्यापि सिराव्यधैः ॥९॥
The blood which has got localised in a place should be removed by incising, that which has slept (not moving or circulating) by means of horn etc., that which has become solid by the use of leeches and that which has spread all over the body by cutting the veins. (9)
प्रच्छानं पिण्डिते वास्यादवगाढे जलौकसः । त्वक्स्थेऽलाबुघटी शृङ्गं सिरैव व्यापके उसृजि ॥ वातादिधाम वा शृङ्गजलौकोऽलाबुभिः क्रमात् ॥१०॥
The incision may be used when the blood has become clotted,
Leeches when it has become thick,
when it has collected in the skin by use of gourd, sucking pot or horn and
when it is prevading the whole body by cutting the vein;
(use of) the horn, leeches, and gourd are ideal for the seats of vata, pitta and kapha respectively. (10)
स्रुतासृजः प्रदेहाद्यः शीतैः स्याद्वायुकोपतः। सतोदकण्डूः शोफस्तं सर्पिषोष्णेन सेचयेत् ॥११॥
The person who has been bled will have increase of vata, by (actions such as) cold applications etc., and develops pricking pain, itching and swelling (at the site of bleeding). So he should be treated by pouring warm ghee over the place of bleeding. (11)
॥ इति पञ्चत्रिंशोऽध्यायः ॥
Thus ends the thirty-fifth chapter.
