Chikitsaa Prakaara: Siraavedha (Puncture of vein)

Prakaara Paribhaashaa:

• Blood letting by venous puncture.

Poorvakarma (Prerequisites):

Patient preparation:

• Internal and external oleation and whole body fomentationshould bedone.
• According to Vaagbhat`a meat soup added with Sneha or unctuous food should be consumed on the previous night.
• The patient should be given Yavaagu to drink.
• The procedure should not be done immediately after food intake.
• Svastivaachana.

Pradhaanakarma:

• Aasana – The position of the patient should be according to the site of Siraavedha.

• Position for Siraavedha at head – patient should sit on a knee high stool comfortably. The patient should sit in following position – legs flexed, elbows resting on knee joints, hands with closed fist, placed over carotid region. An assistant standing behind should put a stabilizing cloth on neck and fist while catching hold of the two ends of the cloth by supinated left hand, then he should be asked to tie it, neither too tight nor too loose, with the right hand for elevating the vein and to press on the centre of the back of the bandage in order to induce the blood flow, meanwhile the patient should blow his cheeks.
• Venouspuncture at leg – The leg should be slightly flexed and raised. The leg to be venouspunctured should be bandaged with cloth below the knee joint, the ankle should be pressed with hands and tourniquet should be applied four fingers above the point of puncture (S.Sha.6 / 8.)
• Venouspuncture at hand – Hand raised above, fist closed with thumb inside and tourniquet should be applied four fingers above the point of puncture.
• For Gridhrasi and Vis`hvaachee – Knee or elbow flexed.
• Venouspuncture at hip, back and shoulder – Back raised and extended head lowered.
• Venouspuncture at abdomen and thorax – Chest expanded, head raised and body expanded.
• Venouspuncture at Paars`hava (sides) – Arms hanging downwards.
• Venouspuncture at penis – Penis should be bent.
• Venouspuncture at lower surface of tongue – Raised tongue and kept steadfast with teeth.
• Venouspuncture at palate and gums – Mouth opened wide.
• It is important that the physician should be competent, confident and adept to the procedure and should have a steady hand.

Following is the chart for the site of venous puncture for specific disease.

Disease	Site
1. S`hiroroga and Netraroga	Lalaat`a, Apaanga, Upanaasaa
2. Karn`a Roga	Karn`jaa Siraa
3. Naasaa Roga	Naasaagra
4. Peenasa	Naasaa Sameepa, Lalaat`a
5. Mukharoga	Jihvaa, Osht`ha, Hanu, Taalu
6. Urdhva Jatrugata Granthi	Greevaa, Kant`ha, S`hankha, S`hira
7. Unmaada	Ura, Apaanga, Lalaat`a, Hanusandhi Madhya (TM joint)
8. Apasmaara	Hanusandhi Madhya (TM joint), Hanu, Bhroomadhya
10. Triteeyaka Jvara	Amsa Madhya
11. Chaturthika Jvara	Skandha Adha
12. Pravaahikaa with S`hoola	2 Angula above S`hron`i
13. S`hukraroga and Med`hraroga	Med`hra
14. Gridhrasi	4 Angula above or below Jaanu
15. Galagan`d`a and Gan`d`amaalaa	Uru
16. Apachi	2 Angula below Indrabasti
17. Sakthi S`hoola	4 Angula above Gulpha
18. Paadadaaha, Khud`a, Harsha, Vipaadi, Vaatakan`t`aka, Chippa	2 Angula above Kshipra Marma
19. Vis`hvaachi
20. Krosht`ukas`heersha, Khanja, Pangutva, Vaataja S`hoola	4 Angula above the Gulpha
21. Pleehaa Roga	Vaama Baahu at Koorpara Sandhi
22. Yakriddalyudara, Kaphodara, Kaasa, S`hvaasa	Dakshin`a Baahu at Koorpara Sandhi
25. Antar Vidradhi, Paars`hvas`hoola	Paars`hva, Kakshaa or between the breasts
26. Jihvaaroga, Dantaroga	Below the tongue
27.Mukhadooshikaa	Lalaat`a

Pas`hchaatkarma:

• Complications arising due to inadequate venous puncture and excessive blood loss should be treated immediatly.

• Following things should be avoided immediately after the procedure –

• Excessive hot or cold food.
• Krodha (anger)
• Maithuna (sexual act)
• Divaasvaapa (sleeping during daytime)
• Asaatmya Aahaara

• Laghu (light) and Agneedeepana diet should be consumed.
• Raktavardhaka diet should be consumed.
• Measures should be adopted to conserve digestive power.
• Parisheka with cold ghee or water.

Other description:

·        Sarvaangavyaapaka Raktadusht`i i.e. for vitiation of Rakta Dhaatu all over body   – Siraavedha should be done.

·        Particularly for Granthi situated in Urdhva Jatrugata region Siraavyadha should be done.

Last updated on April 30th, 2021 at 07:13 am