A COMBINED APPROACH IN THE MANAGEMENT OF DUSHTA VRANA (VARICOSE ULCER) WITH JALAUKAVACHARANA AND VIRECHANA KARMA: A CASE STUDY

A 59-year-old male patient presented to the Shalya Tantra OPD with a 15-year history of chronic non-healing ulcers over the bilateral lower limbs, compounded by severe pain, burning sensation, serous exudation, and localized hyperpigmentation over the past 2 months. Conventional allopathic management provided only temporary symptomatic relief. A venous color Doppler study confirmed bilateral saphenofemoral junction (SFJ) incompetence and superficial varicosities with incompetent perforators. The patient was managed through a strategic combination of Abhyantara Shodhana (Virechana Karma), Sthanika Shodhana (Vrana Pariseka), bio-purification via Jalaukavacharana (Leech Therapy), and subsequent structured Shamana Chikitsa. This integrative approach led to complete wound epithelialization, a 95% reduction in pain indices, and a substantial improvement in the patient's holistic quality of life over a 45-day clinical window.