Jalaukaas in coronary block (Bypass to Bypass Surgery)

- Prof. Dr. Muralidhar P. Prabhudesai
M.F.A.M., A.V.P.
Ex- In-charge, Panchakarma Dept.,
Bhaisaheb Sawant Ayurvedic Medical College,
Sawantwadi, Dist. - Sindhudurga, Pin - 416510.

Case report of a pt. with IHD with TVD

Date - 9 March 1995
Name of the pt. – xyz
Age – 65yrs.
Sex – M
Chief Complaints – Dyspnoea on exertion (on walking a few steps, even after talking few words)
- Constipation, passes hard stools after 5-6 days interval
- Poor appetite
- Weakness
- Chest-pain
- Oedema over feet
- Hypertension
- Tingling in Lt. palm
- He used to get up in midnight due to chocking sensation in chest
- Feeling of some swelling (heaviness) in Lt. side of chest
- Consumes lots of Angised / Sorbitrate tabs. per day while walking or talking (20-22 tabs. in a day)
O/E – B. P. 220/110, Pulse – 102/min., Wt.- 59.5 Kgs., Jeevhaa – Saam, Koshtha- Krur, Agni- Manda, Nidra- Khandita, Bala- alpa, Ubhaya Paad-shotha- ++, Twak-sparsha - rookshata ++
Psychologically he was so depressed; he thought that he will never come out.
Past History – This pt. was serving in State Transport (Maharashtra) as Stand –in charge. Due to tight schedule of duties, he was not able to pass urine, whenever mootra-vega was there. As a result of which he developed urinary stones. He had heart-attack in 1980. His CST revealed ischemia. For investigation, he had undergone angiography in Feb. 1982, in Bombay Hospital & he was found to have 12 coronary artery-blocks (five in Rt. Coronary & seven in Lt. Coronary). Due to so many blocks, he was not allowed to undergo bypass-surgery. He was kept on conservative treatment (11 types of tabs. per day) and was admitted in the hospital for 4 mths. & was advised Tab. Angised and/or Tab. Sorbitrate SOS. He resumed his duties as he got little relief.
Due to chronic constipation he used to take Tab. Dulcolax 4 + Patankar Kadha (Laxative) ½ a cup + Kayam Churna (laxative) 1 tsf, very often. Even then he was not satisfied with his bowels (He got relieved temporarily).
After retirement (during 1992 - 1995) again the symptoms got aggravated for which he consulted many physicians but every time there was addition of medicines, without much relief.
He also was detected to have Diabetes mellitus.
Samprapti – Sedentary work (no shareerayas) – malavarodh & waramwar mootravarodh – apaan vaigunya – pratilom gatitah samaan vikruti – aama nirmiti – due to constant mental strain “Kha-vaigunya" in heart (which is moolasthana of Rasavaha & Manovaha srotas) – sthaan-sanshray of aama there – resulting in blocks – again malavarodh due to the medicines given for the ailment & the vicious circle went on. At the same time, Vyana Vayu-dushti (vyano hrudi sthitah…) & Udan-dushti (urah sthanam udanasya) - resulting in bal-hani - shram-shwas & vikruti in vak-pravrutti, prayatna, bal, warna and as mind was involved, due to various tensions (Hrudayam manasah sthanam), he lost his confidence & urja.
Diagnosis - He was diagnosed to have IHD with triple vessel disease + diabetes
With all the medications above, he was not satisfied with the treatment; as he had no much relief.
After retirement again the dose of Tab. Angised & Tab. Sorbitrate was increased since last four years.
After going through his huge file we thought to put him on Shaman (conservatory) treatment, along with the treatment he was advised, initially.
Initial treatment: Abhyantara Chikitsa-
1) Gandharva Haritaki 500 mg. twice a day before meals (apaane)
2) Arogyavardhini Vati 500 mg. twice a day after half of meal (samaan kale – as Munchan karya of Samana vayu was affected) thinking that Kutaki in the formula will do Bhedan of the hard stool. This drug is also Deepak & Pachak, which was expected in this patient.
3) Arjun & Punarnava-mool Quath, 4 tsf after meals (Vyaanodaane) with madhu (which is yogavahi), as anupan. Arjuna is well known for its specific role in Hrudroga. Punarnava is Shothghni & is useful in Hrudroga also (- Dhanwantari Nighantu). Hruday is awasthit sthan of vyana-vayu & this vayu is responsible for Ras-Rakta Samvahan. Vak-pravrutti, bal, urja (which were affected in this pt.) are under control of Udana-vayu, which has its awasthit sthan in Uroguha. So this medicine was given in vyaanodan kale)
4) Shankh Vati SOS ( as the pt. had aadhmaan due to malavarodha)
5) Snehan – As the Pt. was Vata-prakruti according to his age & he had Krura Koshtha & the rutu that time was with vat-prakop (kaalatah) -
1. Abhyantar – Ghrut Sevan (As usual, I had to spend about 15 minutes to convince the pt. about this concept)
2. Bahya - Mahamaash Taila
6) Siddha Jalapaan - Vidang-jeerak-siddha agnisanskaarit Jala (Vidang is Krimighna, which is needed in our area, where people used to drink water from well or river & Jeerak is deepak – Pachak & grahi, so dravashoshak, as the pt. had pedal oedema (udakavah srotovikruti)
7) 4 tsf of Castor Oil at every night, with lukewarm water.
8) Aashwasan Chikitsa - This is very important to support pt.'s positive attitude, especially when dealing with chronic pts. Vaidya should always create confidence in pt.'s mind that he will definitely come out. This helps to modify the state of mind from 'heen' to 'pravar' Satwa. (This is little easier for senior, bald headed Vaidyas).
He was advised to have light meals till his appetite was improved.
After a fortnight when he came for follow-up he was little happy to have bit easy evacuation of his bowels. His appetite was also improved a little more. He was able to reduce the no. of Angised & Sorbitrate by about 12-15 per day.
The same treatment was continued for another fortnight. His symptoms got aggravated in May 1995 after eating Jambu-fal (which is madhur-kashaya rasa pradhan & kashay-ras is known to cause dhamani-sankoch), so he had to increase the dose of Angised & Sorbitrate & as he had a little choking sensation due to ‘Durdin” in June 1995, (because of which he had to increase dose of Angised & Sorbitrate) he was advised to fumigate his bedroom with Vacha & Dhoop.
Then he was admitted in our hospital for Basti-treatment. He was given snehan, swedan & matra-basti of ground-nut oil 60 ml. (in those days Siddha tailas were not available in our area, as nobody was practicing Panchakarma, so we decided to use this oil, as it was freshly prepared in our farms), while going to bed every night for five consecutive nights. (This matra-basti yojana was advised to his on the basis of his 'vat-pradhan age' & malavarodhajanya (i. e. margavarodhajanya) samprapti.) Then after a gap of 2 days (to avoid sneh-saatmya) again matra-basti was repeated for another five nights. After these two courses of matra-basti there was remarkable improvement in his complaints & could get confidence that he will come out of it, soon. But till May 1995, he was not relieved of his chest-pain & he still had to wake up in midnight due to uneasiness in chest & tingling in Lt. palm.
By that time, one of my friend sent me an article from Reader’s Digest (Aug. 1995) titled “Welcome back little blood-sucker” by Alan Road. My friend knew that we were applying leeches for various ailments, in our practice. The article said that “Even though, the leech will suck for only 20-30 minutes bleeding may continue for several hours or so; clearing the most challenging blockage ” – on page no. 82. "Their saliva contains a powerful enzyme capable of rapidly dissolving blood-clots", - on page no. 83. After going through these lines we remembered that our texts, Ashtanga-Hrudaya & Sushrut-Samhita mention the same –
1) Avagadhe Jalaukasaa…………. - A. H., Sutra. 26/54
2) Grathitam Jalajanmabhi: ………..- A. H., Sutra. 26/53
3) Awagadhe Jalauka syaat…… - Sushrut., Shareer., 8/26
Meaning that, leeches are indicated in cases of blood-clots or thrombus.
And then an idea struck my mind – to apply leeches directly over the chest. We discussed our idea with many, but nobody had tried this type of application.
On 07/09/1995 - Pt. told that he was satisfied with his bowel-motions, even after consuming four tsf of Castor Oil, on alternate days. His B. P. was 150/80 mm of Hg.(in spite of stopping all his anti-hypertensive drugs; as he showed signs of hypotension on continuation of the drugs. May be because main cause of hypertension, i. e. tension about his own health, was reduced to a marked extent), Pulse-rate - 78/min. Wt. - 57 Kgs. (as he had no pedal oedema, any more)
We shared the above idea with the patient & after his written consent we decided to implement this novel idea.
On 25/09/1995 - Pt. was admitted in evening. We gave matra-basti of 50 ml. of groundnut-oil, at bed-time.
Next day, on 26/09/1995 we applied five leeches. The leeches left him after about 6 hours. But to our astonishment he had sound & undisturbed sleep that night.
Having encouraged by this result we applied leeches repeatedly after a gap of about a week or two and sometimes after a month even, & day by day the patient showed marked improvement.
Jalauka-application was repeated in Jan. 1996, Feb. 1996 & in April 1996. During all this period he was very happy with Shankh Vati. (It is very easy to know the 'Karmukatwa' of this Vati, as it created 'Vatanuloman' in this pt. so he got relieved with it.) He used to call it - 'a magic pill'.
Again his symptoms were aggravated in June 1996, when he went to meet his only son in Mumbai, so again dose of Angised/Sorbitrate was increased a little. This might be due to the atmospherically polluted conditions in Mumbai. This time we advised him to do Asanas like Pavanamuktasana, Shawasan, & Pranayamas.
By September 1996, his confidence & especially stamina was regained. Tingling sensation in his Lt. palm was stopped, he was able to enjoy undisturbed sleep at night and he was able to walk 5 kms. non-stop & he was able to climb about five stair-cases, initially after resting a while & then many a times without Angised or Sorbitrate. The intake of Angised & Sorbitrate was reduced to maximum two tabs. daily.
Encouraged by the results we decided to investigate the patient by repeating his angiography. After trying a lot we found a source. Fortunately, the head of cardiology department of KEM hospital agreed to carry it out through the donations collected every day, as a special case of research.
After the due schedule of appointment etc. the angiography was carried out, in June 1997, but to our astonishment the reports mentioned that all the previous blocks were increased in size. And naturally the HOD of the department was very annoyed, even though the patient was feeling relieved a lot than before.
After thinking a lot over this case, we came to realize that the previous angiography was done about 13 yrs. ago, when the pt. came to us for the first time. By that time, during those 13 years., many changes must have taken place, which were not on record. This was the main reason why we were unable to present the case, in a conference before Modern Medical Experts, even though there was marked clinical improvement.
This improvement was realized by a Senior Cardiologist in our area, whose advice was sought by the pt. repeatedly, before coming to us. While consulting the case before him, the Cardiologist remarked - "if this is proved, we will have to change all our concepts regarding modern anatomy & physiology……".
The pt., who was told that his life span is not more than 6 months, was awarded a bonus life of 7 more years, that too a pleasant life without any physical or mental stress & he was able to enjoy marriage ceremony of his only son. All this was possible for him because of the Ayurvedic way of thinking. He passed away in 2002, peacefully and without any physical or mental strain.
Many a times it so happens that after Ayurvedic treatment the lab. reports remain unchanged, but the pt. is relieved symptomatically. So, the new entrants in Ayurvedic Stream should take a note of this.
Our Observations in this case -
1) We applied jalaukas for about 12 times, after a gap of at least 8 days.
2) We avoid to take pricks with needle, to apply jalaukas, as we do not like to interfere with their inherited wisdom ( of course, allotted to them, by the God) to seek the site to prick & surprisingly, all the jalaukas applied, sought left lateral part of sternum to suck the blood. Not a single pricked over the central or right lateral part of sternum.
3) The jalaukas took too much time to leave pricked area; many of them took even 7-8 hours, initially. The admitted pt. could move here & there, with one hand over the moist gauze-piece, used to cover the applied jalaukas. (We do not force the jalaukas to leave the site, by applying Haridra or similar………….)
4) Almost all the jalaukas applied initially, vomited dark, very thick, sticky, tantumay & shleshmala blood, while squeezing. It was very difficult to to squeeze them to drain the vitiated blood sucked by them, as a result of which many of the jalaukas, applied initially, were dead after the very first application.
5) The initially squeezed jalaukas got globular & multiple sacs like appearance, as those were not drained properly.
6) Though the pt. was known diabetic healing of the tiny prick wounds took the same time, as in a normal person. (During my professional experience, for last 41 years only, I have come to the conclusion that usually, diabetes cannot be in the list of contraindication for Jalaukawacharan, except in pts. with very high BSL level (above 500 mg/dl.)
7) Not a single Jalauka pricked the same site again for sucking blood.
While concluding -
Whatever relief we could give in this case, the credit goes to the
- Our Gurujan, who gave us inspiration & the 'vision' while thinking about a disease, through Ayurvedic way
- The Samhita-granthas, which guided us from time to time
- "Bhishak-vashyataa" of the pt. who obeyed honestly, each & everything we advised, ( like consuming Eranda-taila daily, preparing quath every day, taking medicines regularly, performing daily asanas and pranayamas, observing the pathya very strictly) and
- The well-wishers like you all.
Actually, we had taken lot of risk to admit the pt. in our clinic, where no major emergency measures were available, there was no 'official' Dr. available in the area of 10 kms. radius, except us two, primary health care center was about 16 Kms. away. So, any emergency situation could have created lot of problems for us. With the blessings of The God Dhanwantari we did not had to face any problem.
To be frank, 'the bye-pass surgery' is a bye-pass to treatment, as the surgeons don't treat the cause. They just give a way to the obstructed flow of blood. They never give guarantee that surgery will prevent further blocks. If this is so, then why not try some other ways like one described here? Perhaps, this, low cost effective remedy, may prove to be an alternative for bypass surgery.
This was possible to accept this kind of case, because the pt. showed full faith with us & he had no other alternative because of his poor financial status.
If this story inspires anybody to try such cases, we will definitely help him/her with our limited capacity. I wished to get attachment to some institute with a large no. of OPD pts., to show positive results in various cases, but I failed to do it. (Dant-Chanak Nyaya).
So friends, I conclude here & wish you all the best in your general practice with Ayurvedic vision.
|| Sarve atra sukhinah santu ||


Contact :
Prof. Vd. M. P. Prabhudesai
Sawantwadi, Dist. - Sindhudurga.
Maharashtra, India. Pin - 416510
Mobile - +919422435323
e-mails - vdmurali13@gmail,com . . . . . . . . . . . . . . . . . . . . . . . . . dr_murali13@yahoo.co.in