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Medicinal Leech Therapy Protocol

AI-generated illustration: gloved hand beside turmeric water and a jar of medicinal leeches, headline Medicinal Leech Therapy Protocol
Each leech is used once, for one patient, at Ghorpadi, Manjri Bk Hadapsar and Wagholi.
AMRUT AYU CARE™ · Panchakarma Therapy

Medicinal Leech Therapy Protocol: The Three Phases of Jalaukavacharana

How a leech therapy sitting is run at AMRUT AYU CARE™, step by step, following the classical Purvakarma, Pradhanakarma and Paschatkarma sequence.

Key Takeaways
Every sitting follows three phases: Purvakarma (screening and preparation), Pradhanakarma (application and monitoring) and Paschatkarma (wound care and aftercare).
Screening comes first. Leech therapy is not done for people on blood thinners, with bleeding disorders, severe anaemia, fever or infection, low immunity, or in pregnancy.
The skin is cleaned with plain water only, because leeches do not attach to skin that smells of soap, spirit or perfume. Leeches are activated in turmeric water before use.
Each leech draws roughly 5 ml of blood over 30 to 70 minutes and detaches by itself. Turmeric or rock salt is used if it needs help to let go. It is never pulled off.
At AMRUT AYU CARE each leech is used once, for one patient, and then disposed of as medical waste. Classical texts describe purging and reusing a leech; we do not do this.
Read this first. This page describes a clinical procedure performed by qualified Ayurvedic doctors. It is not a home method, and leeches from ponds or aquarium shops are never to be used on the body. Leech therapy is not done for people with haemophilia or another bleeding disorder, leukaemia, severe anaemia, low blood pressure, on anticoagulant (blood thinner) therapy, in pregnancy or while breastfeeding, or in frail or debilitated patients. There is no fixed age limit: the doctor assesses each patient, and a parent or guardian consents for a minor.
4.9 ★
from 52 Google reviews, Ghorpadi and Hadapsar (checked Sep 2026)
15+ years
Dr. Prashant Amrutkar, M.D., PhD Scholar (Panchakarma)
12+ years
Dr. Amruta Amrutkar, M.D. Ayurveda
2 clinics
with full Panchakarma: Ghorpadi and Manjri Bk, Hadapsar

The medicinal leech therapy protocol followed at AMRUT AYU CARE™, Pune. Jalaukavacharana (जलौकावचरण) is the leech-application form of Raktamokshana, which Ayurveda uses to remove vitiated Rakta from a local site. Classical texts describe the procedure in three phases: preparation (Purvakarma), the main procedure (Pradhanakarma) and aftercare (Paschatkarma). This page explains each phase as our M.D. Ayurveda doctors carry it out, so you know what happens and why. Call 8698282507.

Phase I

Phase I. Purvakarma: Preparation

Screening and consent
The doctor examines the site, reviews every current medicine and report, and checks the contraindications above. A haemoglobin or clotting test is asked for where needed. The procedure, the expected oozing and the bite marks are explained, and written consent is taken.
Systemic preparation, where advised
For some conditions the classical texts advise Snehana (oleation) and Swedana (fomentation) beforehand, to soften the tissues and bring the vitiated Doshas toward the surface. The doctor decides whether your case calls for it.
Preparing the site
The area is cleaned with plain water only. No soap, antiseptic, spirit or perfume, because the leech will refuse to attach. You are settled in a stable, comfortable position, lying or sitting, with the site fully exposed.
Selecting and activating the leeches
Only medicinal, non-poisonous leeches (Nirvisha Jalauka) from a certified supplier are used, and only active ones are selected. They are placed in turmeric (Haridra) water, which cleans them and makes them lively, then moved to fresh water shortly before application.
Timing: morning sittings are preferred, when the leeches are most active and the patient is rested. Classical texts favour Sharad (autumn), the season in which Pitta naturally rises, for planned Raktamokshana.
Phase II

Phase II. Pradhanakarma: The Main Procedure

Application
The leech's mouth is guided to the exact spot. For a small lesion a piece of gauze or paper with a hole keeps it on target. If a leech is slow to attach, a drop of milk or ghee on the skin, or a tiny sterile prick to produce a drop of blood, encourages it.
Monitoring
The leech is covered lightly with moist cotton and kept wet throughout. Effective feeding shows as a swelling of the mid-body and visible rhythmic pulsations. Feeding usually lasts 30 to 70 minutes, and each leech draws roughly 5 ml of blood.
The endpoint
Classical texts give a clear sign: the patient begins to feel itching or a pricking, burning sensation at the site, taken to mean the leech has reached pure blood (Shuddha Rakta). The principle is to remove the local excess and stop before depleting the patient.
Detachment
Most leeches drop off once full. If one does not, a pinch of turmeric or rock salt (Saindhava) at its mouth makes it release. It is never pulled off, because that tears the skin.
Phase III

Phase III. Paschatkarma: Aftercare

Wound care at the clinic
The bites are allowed to bleed briefly, then cleaned and dressed with turmeric (Haridra) or Shatadhauta Ghrita, a classical washed ghee, under a light pressure bandage. Leech saliva keeps the blood from clotting, so oozing for several hours afterwards is expected.
Disposal of the leeches
Each leech is used once, for one patient, and is then disposed of as medical waste. Classical texts describe making the leech vomit the blood, resting it and using it again. We do not reuse leeches, on the same patient or any other.
Diet that day
Light, warm, freshly cooked food, and warm water to drink. Avoid chilli-hot, sour, fermented and heavy food for a few days, so that Agni, the digestive fire, stays steady while the site heals.
Rest and restrictions
Rest for the day, in body and mind. Avoid strenuous work, sun, wind and long travel, keep the dressing dry, and do not scratch the bites when they itch over the next few days.
When to call
Call the clinic or see a physician the same day for bleeding that soaks through dressings after several hours, spreading redness, pus, fever or dizziness.
Leech therapy is performed at Ghorpadi (Main), BT Kawade Road, Manjri Bk, Hadapsar and Wagholi. Kharadi and Viman Nagar consult online.

Related reading: Leech Therapy in Pune: Cost, Procedure and Safety and Leech Therapy FAQs, 28 questions on pain, preparation, bleeding and aftercare.

Reviewed by Dr. Prashant Amrutkar
M.D., PhD Scholar (Panchakarma) · 15+ years · AMRUT AYU CARE™, Pune
This page describes our procedure for information. It is not a guide for self-treatment. Responses differ by condition and by person, and no result is promised. It is not a substitute for a consultation.
Questions patients ask

Frequently Asked Questions

What are the three phases of leech therapy in Ayurveda?

Purvakarma, preparation and screening; Pradhanakarma, application and monitoring of the leeches; and Paschatkarma, wound care, diet and rest afterwards.

Why is the skin cleaned with plain water only?

Leeches are sensitive to smell and taste. Soap, antiseptic, spirit or perfume on the skin makes them refuse to attach, so only plain water is used.

Why are leeches put in turmeric water?

Turmeric (Haridra) water cleans the leech and makes it active before application. It is the classical method of activation.

How long does a leech stay attached?

Usually 30 to 70 minutes. It detaches by itself once full. If it does not, turmeric or rock salt makes it release, and it is never pulled off.

Are leeches reused after being purged?

Not at AMRUT AYU CARE. Classical texts describe purging and reusing a leech, but we use each leech once, for one patient, and dispose of it as medical waste.

Is leech therapy done at home?

No. It needs screening, medicinal leeches from a certified supplier, clean technique and someone trained to manage bleeding. Pond or aquarium leeches are never to be used on the body.

4.9 ★
from 52 Google reviews, Ghorpadi and Hadapsar (checked Sep 2026)
15+ years
Dr. Prashant Amrutkar, M.D., PhD Scholar (Panchakarma)
12+ years
Dr. Amruta Amrutkar, M.D. Ayurveda
2 clinics
with full Panchakarma: Ghorpadi and Manjri Bk, Hadapsar
Book a Leech Therapy Consultation
Sittings at Ghorpadi (Main), Manjri Bk Hadapsar and Wagholi · Online for Kharadi and Viman Nagar
 2025-11-23T15:43:26

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