LEECH THERAPY AS AN ADJUNCT TO AYURVEDIC MANAGEMENT OF PERIPHERAL VASCULAR DISEASE (GAMBHIRA VATARAKTA) AND GANGRENOUS FOOT: A CASE REPORT

Introduction: Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerotic vascular disease in which impaired arterial perfusion of the lower extremities may progress to ischemic tissue injury, ulceration, and gangrene. In the Ayurvedic framework, the clinical phenotype of peripheral vascular disease may be interpreted within the spectrum of Vatarakta, particularly when the manifestations suggest involvement of both Vata and Rakta with obstruction of normal vascular pathways. Case Presentation: The present case report describes a 67-year-old woman with hypertension who presented with blackish discolouration of both lower limbs, blister formation followed by ulceration of the left foot, and progressive gangrenous changes over the plantar aspect of the foot. The case was clinically diagnosed as peripheral vascular disease with ischemic gangrenous changes and correlated with Gambhira Vatarakta. Intervention: Jalaukavacharana was administered locally over the affected limb as an adjunct to Ayurvedic internal and local therapies. According to the case record, treatment was performed once weekly for three months, comprising 12 sittings, with regular wound assessment and continuation of the prescribed Ayurvedic medicines. Outcome: During the treatment period, progressive development of healthy granulation tissue, reduction in unhealthy tissue, improved local tissue viability, and clinical improvement in peripheral circulation were observed, without further progression of gangrenous changes. Conclusion: These findings suggest a potentially useful adjunctive role for Jalaukavacharana in selected patients; however, they do not establish reversal of arterial obstruction or efficacy attributable to Jalaukavacharana alone. Objective post-treatment vascular assessment, standardized wound measures, and controlled clinical studies are required to clarify its therapeutic role.