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Rakta Mokshana – therapeutically reducing Pitta Dosha

Rakta Mokshana, as it is called in Ayurvedic texts, can be translated as liberation of the blood, and refers to applications in which blood is extracted to relieve the body, either through bloodletting or by means of leeches. It is one of the five applications traditionally included in Panchakarma, along with Nasya (nasal treatment), Vamana (therapeutic vomiting), Virechana (purging) and Basti (medicinal enema). If you’ve had a Panchakarma cure, you are already familiar with some of these. In classical Ayurveda, Rakta Mokshana plays an important role, but in Europe it is practiced in only a few clinics.

A brief history of bloodletting

Bloodletting is one of the oldest purifying procedures and is known worldwide among many indigenous peoples. Hippocrates founded the humoral pathology, also called the four-fluid system, around 460 B.C., describing the development of disease based on the body fluids, including the blood. At that time, bloodletting was used especially to remedy inflammations and persistent pain. Bloodletting became more widespread throughout Europe through Hildegard von Bingen, who recommended bloodletting once a year for regular cleansing and stimulation of the organism. From the Middle Ages until the 19th century, this therapeutic procedure was used for numerous diseases and ailments. As modern medicine flourished, bloodletting faded into the background, but with the growing interest in integrative healing methods, it has experienced a renaissance within naturopathy for several years now. In Ayurveda, bloodletting has been a common therapeutic procedure for over 5000 years and is counted among the Shodana therapies, i.e. the procedures for purification and cleansing.

How it works

The purpose of Rakta Mokshana is to relieve the body by withdrawing blood as a therapeutic measure. Metabolic residues (Ama), which can accumulate in the blood just like in the tissues, are drained out, allowing the organism to regenerate more easily. Withdrawal of blood opens up space for tissue fluid to flow in, thereby changing the qualitative composition of the blood. The flow properties of the blood are improved and at the same time a hematopoietic (blood-forming) stimulus is given to the bone marrow. Another effect is an increase in the number of white blood cells, which play a central role in the immune system. Bloodletting thus removes old blood containing toxins and promotes the formation of new blood and cells. Simultaneously, a stimulus is set in the body tissues to dissolve and release metabolic waste products.

Indications for Rakta Mokshana

Charaka Samhita, the traditional scripture of Ayurveda, lists the following diseases and symptoms that can be relieved by bloodletting:
  • Cardiovascular diseases, such as high blood pressure, lightheadedness, stroke.
  • Skin diseases involving itching and rashes, such as atopic dermatitis or psoriasis
  • Gout and hyperacidity
  • Inflammation of mucous membranes, conjunctivitis and sinusitis
  • Tendency to heavy nosebleeds and heavy menstrual bleeding
  • Headaches
  • Tendency to thrombosis
  • Other symptoms associated with increased Pitta Dosha, such as profuse sweating or gastritis.


Practical implementation of Rakta Mokshana

As with all Ayurvedic treatments, bloodletting is performed according to very specific criteria and in a prescribed order. Whether there is an indication for bloodletting can be quickly determined on the basis of the anamnesis and pulse diagnosis. Laboratory findings also provide important information about the composition of the blood ( the numbers of the various blood cells, the ratio of the solid to the liquid components of the blood, the hematocrit value and the iron status) and are naturally taken into account when determining the indication. The purifying effect can be increased considerably by a suitable pre-treatment, such as a light diet over several days and the use of herbal preparations or by performing the bloodletting as part of a Panchakarma course of treatment. The actual bloodletting has maximum benefit if the following aspects are observed – as already described by Hildegard von Bingen:
  • Correct time
  • Fasting for at least 12 hours
  • Selection of a suitable vein on the basis of palpation
  • Correct insertion technique – we use a laminar needle according to Dr. Töth
  • Observation of the transition from dark to light blood
  • Withdrawing the correct amount of blood, depending on constitution, disease profile, and the color transition
  • Number of bloodletting sessions per year


The change in the color of the blood during bloodletting is an interesting phenomenon. At a certain point, the impure, rather thick blood changes to lighter, thinner blood, which indicates the individually determined end of the bloodletting. Usually, the amount drawn is between 50 and 200 ml. Unlike when donating blood, where 400–500 ml are withdrawn, bloodletting does not require a fixed amount, but goes by the change of color, so that the physiology’s vital force is preserved and the immune system is not weakened. Thus, bloodletting is typically experienced as non-impairing; the body completely replenishes the extracted blood within a few days. Following Rakta Mokshana, the cleansing effect can be further enhanced by continuing a light, plant-based diet and abstaining from alcohol and coffee for at least 3 days. By combining Ayurveda, traditional European naturopathy and modern medicine, bloodletting can be a very effective tool in eliminating disorders related to Pitta Dosha. However, it is never the sole therapy and always requires individual care with an overarching therapeutic concept to achieve lasting change. The team of doctors at the Maharishi Health Centre Bad Ems is available for advice.
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