Complete healing of a Dooshivishajanya non-healing wound with Jalaukavacharana - A case report

A 35-year-old male patient, who is non-diabetic, non-dyslipidemic, normotensive, and euthyroid, and works as a hotel manager, visited our outpatient department with complaints of two ulcers on the inner side of his right lower leg, which developed rapidly after intense itching for about a week due to scratching. The ulcers were clean, had granulation tissue, caused mild pain, showed no discharge, and were surrounded by dark discolouration. The patient's history indicated that he had experienced severe itching in that area for four to five years, along with recurrent fevers, which began after being bitten by an unidentified type of black ant. The Bates Jensen wound assessment tool scored 33 for the larger wound and 27 for the smaller wound. Initially, the patient received some Ayurvedic treatments aimed at promoting healing for approximately 40 days, but these did not improve. A venous Doppler ultrasound of his right leg indicated chronic venous insufficiency. Given the persistent nature of the ulcers despite medical treatment, the condition was diagnosed as Dooshi Vishajanya Vrana over chronic venous insufficiency. Therefore, a single session of Jalaukavacharana was performed using three Jalaukas on the ulcer site, which healed within one week of the treatment. After the treatment, the Bates Jensen wound assessment scores improved to 18 for the larger wound and 17 for the smaller wound. Follow-up evaluations conducted after four months and one year revealed no recurrence of the ulcers. The dark discolouration of the leg began to diminish from the fourth month of the follow-up period.