Raktamokshana - A Systemic Review

Raktamokshana is the important para surgical method of bloodletting incorporated by Acharya Sushruta in the basic plan of detoxification therapy. Though the broad utility of this therapy is extensively elaborated in Ancient Text of Ayurveda, it has limited use in the clinical practices of Panchakarma that may occur due to apprehension about the procedure to develop any surgical or systemic complication; lack of skill for practical demonstration or knowledge regarding its efficacy. The meta-analysis of various techniques of the Raktamokshana, is primarily planned to study their effectiveness & safety for managing multiple disorders. On an extensive review of the literature regarding this topic, 16 studies are conducted with 469 participants at different places or states from India. A narrative synthesis of all included studies & their critical analysis was demonstrated concisely using tables. It was found that only two modes of Raktamokshana, i.e., Siravedha & Jaoukavacharana, which are widely used in practice for different skin and musculoskeletal disorders, while only two trials study the modified Shringa method. No clinical study was carried out to demonstrate the effect of other methods of Raktamokshana or modifications in various clinical entities. The efficacy of three modes of Raktamokshana, i.e., Siravedha, Jalouka & Shringa, can be justified based on the basic principles of Ayurveda & physiological actions. This study demands to conduct scientific multi-centric research studies with a large sample size in the future to embark on these conclusions & to enhance their acceptance globally.