Therapeutic efficacy of Jalaukavacharanam with Internal Ayurvedic regimen in Dhatugata Kushta: A Clinical Case Report based on Acharya Sushruta’s principles

Dhatugata Kushta, as described by Acharya Sushruta, represents a pathological advancement wherein vitiated Doshas infiltrate deeper structural components of the body (Dhatus), surpassing the superficial dermatological layers. The manifestation of Lakshanas (clinical features) depends on the Dhatu affected, demanding a treatment protocol customized to the Dosha – Dhatu involvement. This case report highlights a 27-year-old female patient presenting with Vaivarnya (discolouration), Kandu (itching) and Pidika (eruptions), managed through internal medications and Jalaukavacharnam (leech therapy) over a 15-day treatment course. Internal medication facilitated dosha pacification, Rakta Shodhana (blood purification) and detoxification, while Jalaukavacharnam effectively cleared localized dosha accumulation and enhanced microcirculation. Marked symptomatic improvement was observed within the first week. By the second leech therapy session, eruptions ceased and pigmentation visibly reduced. Follow up after one-month indicated sustained remission with no recurrence. This outcome supports the utility of Jalaukavacharnam as a first-line approach in patients for whom classical Vamana (therapeutic emesis) and Virechana (therapeutic purgation) are contraindicated.