Hemapheresis from the Ayurvedic Point of View

ABSTRACT

Hemapheresis is a medical term defined as the withdrawal of blood from the body and separating the one or more blood components and returning the blood by a transfusion of remaining blood to the donor, it can also be referred to as hemapheresis is a therapeutic way of elimination of some components of blood like cells or particular parts of plasma from the patient's blood to improve his or her condition. This is done by a centrifugation method, the collected blood is mixed with anticoagulant, and then those components that are requested to be separated are done and the rest of the blood is returned to the owner's body. In this article, we are going to discuss hemapheresis, its need as well as significance, and its correlation with rakta shodhana in Ayurveda.

INTRODUCTION

Hemapheresis is useful in those patients who need acute management and temporary reduction of blood components in an emergency situation. It is used widely to remove whole blood from a donor, and separates the blood components that help to remove the particular component from the bloodstream and then re-introduced it. This procedure is basically used for the collection of platelets or plasma as well as in particular medical conditions in which disease-provoking components are needed to be removed.

Some common components that are needed to be removed from the blood in certain conditions such as:-

1. Plasmapheresis - In this procedure, plasma is removed from the bloodstream.
2. Plateletpheresis - In this method, platelets are removed from the bloodstream.
3. Leukapheresis - Where the leukocytes are being removed from the bloodstream.
4. Erythropheresis - Red blood cells are removed from the bloodstream called erythropheresis.
5. Lymphopheresis - This method is used for the removal of lymphocytes.

The apheresis procedure is not only used for the removal of blood components, but in this procedure, we can also add some of the blood components as required by the patient's disease.

PROCESS OF HEMAPHERESIS

The apheresis procedure is done by collecting the blood from the patient or donor through the tube system and storing it in a centrifuge machine where the components are separated. After this filtration process, the needed element is differentiated from the blood, and the rest of the blood is reinfused back into the patient. This procedure doesn’t cause any pain or takes up to two hours depending on the conventional blood donation system.

In Which Conditions This Procedure Is Needed?

Following are some basic indications for which apheresis procedure is being used or is very beneficial:-

• Myasthenia Gravis - Weakness, fatigue in the muscles due to some issue between the nerves and the muscles.
• Waldenstrom’s Macroglobulinemia – It is a rare type of cancer that happens in white blood cells. In this disease bone marrow produces too many abnormal white blood cells that affect the healthy blood cell components.
• Familial Hypercholesterolemia - In this condition, bad or LDL cholesterols are at a high level.
• Leukostasis - Elevated white blood cells may cause Leukaemia and lead to clogging of blood vessels.
• Myeloproliferative Disorders - This condition causes severe elevation of platelets in the bloodstream.
• In Severe Vasculitis
• Severe Rheumatoid Arthritis
• Lupus Erythematosus
• Chronic Autoimmune Polyneuropathy

AYURVEDIC OVERVIEW

In Ayurveda, this procedure can be correlated with Rakta shodhana. The blood is detoxified, with various health-beneficial procedures that Ayurvedic physicians can only do. Many herbs are used to detoxify the blood within the body and some procedures are used to eliminate the impurified blood from the body. These are considered under the raktamokshana therapy.

Raktamokshana Therapy

Raktamokshana Therapy is one of the panchakarma procedures which helps to detoxify the blood with the help of various means like Jalauka, alabu, shringi, and siravedhan.

Leech Therapy

Leech Therapy is referred to as Jalauka avacharan, and is said to be a wonderful procedure for the elimination of pitta and rakta dosha. This procedure is very helpful in detoxifying the blood. (Hirudo medicinalis) is a parasitic worm that comes under the subclass of Hirudinea and is taking place under Phylum Annelida. This is a bloodsucker organism that sucks the impure blood from the body. Its saliva consists of an enzyme called hirudin which is very helpful in blood coagulation. . Our holy Acharyas, has described this procedure under the category of anushastra that are also named as parasurgical procedures.

Types - Leeches are of two types like Savisha or Nirvisha. These are of six-six types. Savisha jalaukas are poisonous in nature found in dirty lakes or ponds fed up with dead animals. Nirvisha jalaukas are non-poisonous in nature, are found in freshwater lakes or ponds and these are bluish-black  in colour and are of yellowish belly.

Indications -

• This procedure is specially used in vitiated pitta dosha and rakta dhatu.
• This bloodletting procedure is very effective in varicose veins, gout, sciatica, osteo-artheritis, chronic skin conditions like kushtha , pama, dadru, or abscess, arsh (haemorrhoids), ascitic conditions, hair fall etc.
• This procedure is very effective in the management of ulcers, relieves hyperpigmentation, postphlebitic syndrome and edema.
• Beneficial in peripheral vascular diseases, or other spasmodic conditions.
• This procedure helps the diabetic patients to stabilise their state and helps in healing the diabetic ulcers commonly seen in feet, and is considered to control all the complications that may arise from diabetes.
• This procedure is very useful in vatarakta condition, which is said to be a very complex form of disease, consisting of pain in joints, redness, swelling and tenderness (with all inflammatory signs). So we can say that this procedure is very beneficial in arthritis patients.

Alabu

Alabu is said to be a variety of bottle gourd. It is of two types one is Cucurbita lagenaria which is used as a vegetable, it is of sweet taste. One alabu is of bitter taste, Lagenaria vulgaris, and is used as a bloodletting procedure. This procedure is mainly used for kapha dushit rakta. Alabu is 12 fingers ong in length, its circumference is 18 fingers round, its mouth part is a little bit curved and its circumference is about 3 to 4 anguls. Half gourd is placed on the skin with a lighted lamp (deepak) in it.

Shringi

When the rakta dhatu is dushit by vata dosha then shringi is used for bloodletting. Cow’s horn is used for this procedure because it is hollow from inside. Shringi is ushna in potency, and it consists of madhur (sweet), snigadh (moist) properties. It is 18 angul long and its first part is like mustard seed. Its broad opened mouth is covered with thin cloth so that it can cover the lacerated part of the body and the other end must be used for suctioning the blood connected with the physician's mouth. It will be helpful in reducing the pain.

Sira Prcchaan

Lacerations made by physicians that must not meet each other, are straight in shape, are small in size, not very deep, and not superficial. These are used to extract the impure blood from the body. Sira prachan is done on the affected part by effectively protecting the marma (vital points), sira (venous system), snayu (tendons) and sandhi’s (joints).

This procedure should be done in not so cold or hot climates , not in an excessive sweating state. This procedure should not be done in bad atmospheres, must protect the cautious areas like venous system, or on any joint, just after eating the food.

If this procedure is done in a stable condition with needed precautions then it will result in lightness in the body, reduce the pain from the affected parts, decrease the fasting process  of spreading the diseases, and when impure blood is excreted out from the body the bleeding stops automatically.

Some Important Herbs That Help In Purifying The Blood

Some herbs are very effective in pitta shaman and in nourishing the rakta dhatu. Some of them are:-

1. Manjistha - Rubia Cordifolia, this herb is very helpful in pacifying kapha and pitta dosha, this has great rakta shodhak properties, so is very beneficial in reducing blood disorders. This medicinal herb is very effective in kushtha rogas (skin disorders), like eczema (dadru), psoriasis, visarp, having anti- inflammatory properties, increases the healing process etc.
2. Sariva - Hemidesmus indicus, this herb is well known for its blood purification properties, this is consisting of sweet and moist properties that helps to pacify the vata guna, with its cold potency it alleviates the pitta dosha and due to its bitter rasa it helps in reducing the kapha dosha. This is anti-inflammatory in nature, reduces daha, fever, and detoxifies the body.
3. Haridra - Curcuma longa, this herb is very beneficial in kapha-Vata shamak, pitta rechak and is of  bitter taste so that it reduces the pitta dosha. This is helpful in reducing the pain, inflammation, any infectious disease, and can kill the microorganism that can result in any severe disease.
4. Neem - Azadirachta indica, this medicinal herb is very effective in purification of Blood, it helps in nourishing all the dhatus and increases immunity to fight up all the diseases, its tikta (bitter) rasa helps to purify the blood and pacifies the pitta dosha.
5. Guduchi - Tinospora cordifolia, this herb is very effective in detoxification of blood and can be used in any type of dosha predominance disease. When this herb is used with ghrita it pacifies vata dosha, and when used with sharkara (jaggery) it pacifies pitta dosha and when Guduchi is used with madhu it can pacify the kapha dosha.

CONCLUSION

Hemapheresis is a therapeutic way of elimination of some components of blood like cells or particular parts of plasma from the patient’s blood to improve his or her condition. In short this condition can be correlated with the purification process of the body, this will help to recover the patient effectively and can manage various diseases. As per Ayurveda, hemapheresis can be relate with rakta shodhak and various procedures are included in the raktashodhak therapy like raktamokshana, via jalauka, alabu, shringi and siravedhen procedures and this also have some effective herbs that purifies the blood effectively like Manjishtha, sariva, haridra and many more are mentioned by Acharyas in classical textbooks.