control trial should be undertaken to study the safety and efficacy of leech therapy in acute gout. *Corresponding author: Ashok Kumar panda, Department of Ayurveda Research, Ayurveda Regional Research Institute - A unit of CCRAS, Department of AYUSH, Government of India, Gangtok, Sikkim, India, Tel: 03592-231494; E-mail: akpanda_06@yahoo.co.in Received January 23, 2012; Accepted March 05, 2012; Published March 08, 2012 Citation: Panda AK, Debnath SK (2012) Effectiveness of Leech Therapy in Gambhira Vata-Rakta (Acute Gout): A Pilot Study. J Homeop Ayurv Med 1:108. doi:10.4172/2167-1206.1000108 Copyright: © 2012 Panda AK, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Leech; Bloodletting; Ayurveda; Acute; Gout; Patients Introduction Rakamokshyana (Bloodletting) is an ancient procedure that was utilized in Ayurveda in the setting of a humoral and pathological concept as a general treatment for all ailments, as well as during the middle ages primarily as a remedy for the treatment of inflammatory and infectious diseases by other traditional medicines of world. The general population was convinced of the efficacy of this treatment for centuries, even requesting it on occasion on a prophylactic basis. Leech has been used from ancient days in Grace, Roma and Arabian countries. Susruta (1000 BC) and Charak (600-200 BC) are two sages from India to describe about leech therapy whereas western literature mentioned about Themison (80-40 BC) – a pupil of Asclepiads is the first person to describe about leech therapy [1]. Leech is an Anglo-Saxon word derived from “Loece” meaning “to heal” and the oldest therapeutic book about leech is leechdom [2]. Leech is an: “aquatic worm with a flattened body, tapering toward each end, and terminating in circular flattened discs, the hinder one being the larger of the two. It swims with a vertical undulating motion, and moves when out of water by means of these discs or suckers, fastening itself first by one and then by the other, and alternately stretching out and contracting its body. The mouth is placed in the center of the anterior disc, and furnished with three cartilaginous lens-shaped jaws at the entrance of the alimentary canal. These jaws are lined at their edges with fine, sharp teeth, and meet so as to make a triangular incision in the flesh. The head is furnished with small, raised points, supposed by some to be eyes. Leech belongs to the Phylum Annelida family of fresh-water parasitic invertebrates [3]. It was noticed that leech bites continued to bleed after the leech was withdrawn. This phenomenon was finally explained in 1884 when John Berry Hay croft, a Birmingham chemist, discovered an anticoagulant, called “hirudin”, that the leech injected into the blood, which kept the capillaries flowing [4]. The resurgence of Leech therapy in treatment of hypertension, migraines, phlebitis, varicose veins, arthritis, hemorrhoids, and ovarian cysts were introduced in Russia after 1990’s [5,6]. In the United States, plastic surgeons use them to drain blood from wounds after limb or tissue reattachment [7,8]. Some Indian clinical trials of leech therapy in Osteoarthritis, Frostbite, Hypertension, Migraine are in Progress from Unani Research Council [9]. Recent research also supports leech use in relieving pain in patients with osteoarthritis of the knee, as well as in treating purpura fulminans, periorbital hematoma, sublingual hematoma, systemic lupus erythematous, and ear infection [10]. The prevalence of Gout is now as high as 12.6% may due to increased frequency of obesity and hypertension. Monosodium urate crystal is the active constituent for acute inflammatory reaction in Gout [11]. Colchine, corticosteroid and NSAID are the choices of drugs in acute gout with their proven adverse effect [12]. Leech therapy has been indicated as means of bloodletting for both types of Vata-rakta where pain, burning and redness found as per Charaka chikitsa [13,14]. Some Chinese evidences of Bloodletting in Gout with Cupping and herbal