If dosha in shakha (body elements) vitiate the blood then raktamokshana should be administered at first. The physician should use vishana (deer horn) in vata dominance, jalauka (Hirudinea medicinalis) in pitta dominance and alabu (lagenaria siceraria) in kapha dominance for blood letting or physician should perform siravyadha (blood letting through vein) promptly from the adjacent vein to the affected part, without which rakta kleda (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. (68-70)
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If ''dosha'' in ''shakha'' (body elements) vitiate the blood then ''raktamokshana'' should be administered at first. The physician should use ''vishana'' (deer horn) in ''vata'' dominance, ''jalauka'' (Hirudinea medicinalis) in ''pitta'' dominance and ''alabu'' (lagenaria siceraria) in ''kapha'' dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. [68-70]