VENESECTION

DEPARTMENT OF ILAJ BIT TADBEER

(REGEMINAL THERAPY)
‫شعبہ عالج بالتدبیر‬
Dr. G. Venkateshwarlu (HOD and Professor)
Dr. Md. Lutf Ali Siddiqui (Associate Professor)
Dr. Zehra Begum (Assistant Professor)
Under the Guidance of
Dr. Md. Lutf Ali Siddiqui (Associate Professor)

Presented by:
Syed Mahmood ul Hasan
Mohd Noor ul Haq
Mohd Musheer Ahmed
Ayesha Firdous
Ayesha Tarannum
What is Venesection?
➢Venesection is the act of drawing or removing
blood from the circulatory system through a
cut (incision) or puncture to any of the
superficial blood vessels.
➢The purpose is evacuation of waste material
(madda-e-fasida) from the body.
➢It is also known as Phlebotomy or
Venepuncture.
History
➢ Venesection or Phlebotomy is the longest-running
tradition in medicine.

➢ Originated in the ancient civilizations of Egypt and

Greece, persisted through the Medieval, Renaissance,
and enlightenment periods, flourished in Arabic and
Indian medicine and lasted through the second
industrial revolution.

➢ The practice continued for 2,500 years until it was

replaced by the techniques of modern medicine.
Types of BLOOD LETTING
General Local
Wet
Venesection
cupping

Leech
Arteriotomy
therapy
PRINCIPLES OF BLOOD LETTING
If the morbid
matter is below • Cupping
dermis
If the matter is
• Leech
below
hypodermis therapy
If the morbid
matter is deep in • venesection
the blood
Objectives of Venesection
➢To maintain normal volume of blood in people
who are predisposed to develop the disease due
to excess of blood.
➢To stimulate istehala (metabolism).
➢To check kasrat-e-tams (menorrhagia) and ru’af
(epistaxis).
➢To cure humma-e-ajaamia (malaria) and splenic
disorders, bawaser-e-damvi (haemorrhoid), warm-
e-khusiya (orchitis), Iltehab-e-rahem (metritis),
jarbohikka (scabies and pruritus), Khuraj (boils),
Iltehab-e-kabid (hepatitis)
Methods of Venepuncture
There are the following three methods for venepuncture:
1. Syringe method
2. Vacuum tube method
3. Butterfly method
Types of Incisions
Narrow incision (Fasd e Zeeq/Tang
fasd)

Wide incision (Fasd e Waseeh/kushada

fasd)

Longitudinal incision(Toolani Shigaaf/

fasd e tool)

Transverse incision (Fasd e Mauraz)

Oblique incision(Fasd e Maurab)

TERMS AND CONDITION
FOR VENESECTION
➢ When the blood is scattered in all vessels and
consistency is liquefied then without Nuzj
venesection should be done.

➢ If blood is restricted in a particular organ like in

cases of arthritis and gout or blood is thick, viscous
and mired with humour then venesection should
never be performed before Nuzj.
Pre Venesection Investigations

• Complete blood picture: CBP

• Clotting Time: CT
• Bleeding Time: BT
• Random Blood Sugar: RBS
• HbsAg
• ECG
• Liver Function Test: LFT
• Renal Function Test: RFT
INSTRUMENTS

LANCETS ANTECUBITAL VEIN

SYRINGE METHOD, VACUM TUBE, BUTTERFLY

 PROCEDURE

Assemble Select the Perform Draw

Prepare hand
equipment the patient site hygiene blood
Modern Application of
Venesection
➢ Phlebotomy was used for the treatment of various disorders,
but in addition to its therapeutic benefits, phlebotomy also
had a preventive role.
➢ Currently, therapeutic phlebotomy is approved for three main
indications:
▪ Haemochromatosis
▪ Polycythaemia vera
▪ Porphyra cutanea tarda.
The Amount of Blood to be Removed
➢ The proper time between the stoppage of blood and bandaging the
wound varies from case to case.
➢ Some people can stand blood loss of even more than five or six rattal
(2000/2400 ml), Even though they might be suffering from fever;
other seemingly fit and healthy are unable to bear even a fraction of
this loss.
➢ Three things should be noted during draining of blood-
❖ Flow of blood
❖ Color of blood
❖ Condition of pulse
➢ Bloodletting should be stopped when speed of bloodletting becomes
slow or when color of blood changes from blackish to bright red or
pulse becomes shorter and particularly when pulse becomes weaker.
➢ If the patient has nausetic feeling, yawn’s or hiccup after the onset of
bloodletting then if should be stopped immediately.
Post Venesection Procedure
➢ Advice bed rest for a period of 4 to 5 hours.
➢ Check pulse, blood pressure, temperature and
respiration.
➢ The diversion of morbid matter after fasd may lead to a
rise in the normal body temperature resulting in mild to
severe fever, In such cases venepuncture should be
repeated or symptomatic Regims can be followed.
➢ If the blood pressure falls severely and the pulse
become weak, and the patient experiences respiratory
distress & cyanosis, he/she should be admitted in the
hospital.
• Artificial respiration/ oxygen inhalation
• Inj. Atropin IV
• Blood transfusion if needed
• Check temperature, pulse and blood pressure
frequently.
Vessels for Blood Letting
➢ Blood letting may be carried out from a vein or an artery.
➢ However it is, rare that it is carried out from an artery as there is
risk of haemorrhage, and sometimes even developing an
aneurysm especially when the incision is minimal.
➢ If proper steps are taken to prevent haemorrhage, blood letting
from an artery can be of great value in case where it is really
indicated.
➢ Thus it is particularly beneficial when some light and agitated
humor has led to a serious disturbance in the area supplied by
the artery.
➢ In such cases blood letting is carried out from the artery of the
affected area with considerable benefit and without any fear of
complications.
Sites of Venesection
SN Blood vessels Drains Part of Body Prevent of Disease
1. Cephalic vein (Qeefal) Head, Neck , upper part of liver Otolagia, Meningitis

2. Basilic vein (Bazleeq) Hepato-spleenomegaly

3. Median vein (Akhal) Abdomen Pneumothorax, Headache

4. Salvatella (Usailim) Liver & Spleen Diseases of Liver & Spleen

5. Sciatic vein (Arqun-Nisha) Leg Sciatic, Varicose, Elephantiasis

6. Popliteal vein (Mabij-rkbah) Lower Abdomen Menstruation, Obstructed piles

7. Frontal vein Head Headache, Conjuctivitis

8. Parietal vein Head Migraine, Eczema of Scalp

9. Temporal vein Head Leukoma, Cataract, Night blindness

10. Jugular vein Chest Asthma, pneumonia, pleurisy

11. Labial vein Mouth Mouth Ulcers, Stomatitis

12. Inferior Lingual Chin, Throat Angina, Tonsilitis

13. Temporal Artery Eye’s Eye’s Diseases

14. Post Auricular Eye’s Glaucoma, Leukoma

Blood letting is generally carried out from the following
six veins in Upper Limb:
❖ Cephalic (keefal)
❖ Median cubital (akhal)
❖ Basilic (bazleeq)
❖ Accessory cephalic (habluzzirra)
❖ Third dorsal metacarpal (usailim)
❖ Axillary (ibti)
Blood letting is generally carried out from the following
Four veins in Lower Limb:

❖ Poplitial vein (Mabij rkbah)

❖ Great saphenous vein (Shafin)
❖ Sciatic vein (Arqun Nisha)
❖ Tendocalcanum vein (Mustkadam)
Indications
1. Venesection (Fasd) is carried out when there is excess of blood in the
body.
2. It is also carried out when the patient is either exposed to the risk of
developing a disease or has actually developed one.
In both cases, the idea is to remove the general excess of humors, or the
abnormal humor or both and to divert the blood to the opposite side.
1. Sciatica, gout and rheumatism.
2. Recurrence of haemoptysis from excess of the blood rupturing
partially healed blood vessels.
3. Convulsions, coma, and melancholia.
4. Swelling of throat and internal organs.
5. Hot (inflammatory) type of conjunctivitis.
6. Excessive heat or weakness in the internal organs.
7. When an abscess is threatening to rupture before maturation.
8. Fevers for no other reason than to reduce the excess of morbid matter.
9. For stopping haemorrhage, as in epistaxis, haemoptysis, menorrhagia,
bleeding piles, and bleeding from a ruptured abscess.
10.In wounds and contusions as a prophylactic against inflammation.
Contraindications
Venesection (Fasd) is contraindicated in:
1. Excessively cold temperament.
2. Extremely cold climate.
3. Severe pain.
4. After resolving baths.
5. After coitus.
6. In children under fourteen years of age.
7. Those who are flabby and have pale puffy complexion.
8. In elderly persons.
9. Chronic invalids unless their disability is due to abnormal
blood.
10.With a full stomach.
11.Incase of some prolonged diseases.
12.Not suitable in colic.
13.During pregnancy or menstruation.
14.In case of acute infective fevers.
Complications
Complications associated with having blood drawn are slight but may
include:
➢ Sometimes a blunt lancet is unsuitable for venesection as it fails to cut the
vessel and causes unnecessary pain and swelling.
➢ Constipation.
➢ Haematoma.
➢ Infection [cellulitis and phlebitis].
➢ Petechiae.
➢ Air embolism.
➢ Produces weakness.
➢ Unconsciousness.
➢ Polydipsia.
Conclusion
➢ It is evident that venesection (Fasd) is one of the most effective types of
regimental therapy performed for centuries.
➢ In Unani literature various modes of management are discussed but
Fasd is proving effective in various disorders..
➢ Fasd is a classical regime practised by Unani physicians since
centuries. In the current scenario, venesection is cast aside chiefly on
the basis of some modern pathology-based studies.
➢ The concept of conventional medicine is different from Unani
medicine. The thousand years of meticulous observations of Unani
physicians cannot be denied just on the basis of the studies that have
been undertaken on small sample sizes.
➢ Besides, this classic regimen is also found effective in some studies of
this modern time. Thus, in the present era, further studies have to be
carried out on a large sample size for scientific justification of
venesection.
REFERENCES:
1. Ilaj Bit Tadbeer by Jamal Akhtar
2. Usool e Tibb
3. Research paper
4. Ilaj Bit Tadbeer by Javeed Ahmed Khan