EFFECT OF JALAUKAVCHARANA IN BUERGER'S DISEASE-A CASE STUDY

Abstract

Background: A non-atherosclerotic, segmental inflammatory illness of small and medium-sized arteries and veins, Buerger's disease (also known as thromboangiitis obliterans) primarily affects young male smokers and increases the risk of limb loss, ischaemia, and ulcers.  An Ayurvedic bloodletting technique called jalaukavcharana (therapeutic leech therapy) has long been utilised to promote local circulation and eliminate polluted blood.  The possible clinical effects and safety of jalaukavcharana in a patient with Buerger's illness are investigated in this case study. Case presentation: A 45-year-old man with a clinical diagnosis of Buerger's disease complained of rest pain and an 8-week-old, non-healing ulcer on the lateral surface of his right foot.  Conservative treatments (vasodilator therapy, analgesics, wound dressing, smoking cessation counselling) only slightly improved the situation.  In accordance with conventional aseptic technique, jalaukavcharana was given in three sessions over the course of two weeks at locations close to the ulcer and along distal limbs. Results: The patient reported a progressive decrease in rest pain (VAS from 8/10 to 2/10 at 4 weeks) following three sessions of jalaukavcharana.  The ulcer showed decreased exudate, granulation tissue development, and a reduction in area (baseline: 4.2 cm²; 4 weeks: 1.1 cm²).  Doppler readings revealed a partial restoration of distal artery flow patterns, and limb skin temperature and capillary refill time improved.  Minor localised bleeding and temporary erythema at the bite locations disappeared without any long-term consequences. No systemic side effects were noted. Conclusion: In this one instance, jalaukavcharana seems to be linked to better local wound healing and symptomatic alleviation in a Buerger's disease patient.  Enhanced microcirculation, leech saliva's anticoagulant and anti-inflammatory properties (such as hirudin and calin), and local decongestion are all potential explanations.  These results are preliminary and suggestive; controlled studies are needed to assess safety, appropriate methodology, and efficacy.