Vol. 2, Issue 1, Part A (2025)

Varicose ulcers, often resulting from chronic venous insufficiency, present a significant therapeutic challenge due to their recurrent and non-healing nature. In Ayurveda, Jalaukavacharana (leech therapy) is advocated as a Raktamokshana (bloodletting) method with both curative and palliative properties for Dushta Vrana (chronic wounds). In modern medicine, Hirudotherapy has gained renewed attention as a minimally invasive intervention employing leeches for microcirculatory improvement and decongestion. This paper provides a comparative clinical and theoretical evaluation of Jalaukavacharana and Hirudotherapy, drawing from classical Ayurvedic texts and recent biomedical evidence. While both modalities utilize the medicinal leech (Hirudo medicinalis), their methodologies, underlying philosophies, and outcome metrics differ. Integrative analysis reveals that both therapies show promise in ulcer healing, pain reduction, and local circulation enhancement. However, Ayurvedic Jalaukavacharana, when combined with internal Shodhana and Ropana therapies, may offer a more holistic and sustainable management approach for chronic varicose ulcers.