During Siravyadha (venesection), what is the maximum amount of blood that can be removed?

Appeared in: Haryana CHO - 2022

Explanation

According to the classical Ayurvedic text Sushruta Samhita, the maximum quantity of blood that can be removed from a strong patient during a single session of Siravyadha (venesection) is one Prastha.
One Prastha is an ancient unit of volume, which translates to approximately 640 ml in modern measurement.
This procedure, known as Raktamokshana (bloodletting), was a therapeutic measure intended to treat diseases believed to be carried in the blood.

Option A: One Pala is a very small volume (approximately 48 ml) and does not represent the maximum limit for a therapeutic procedure in a strong patient.
Option B: Ten Pala equals approximately 480 ml. While this volume is close to modern blood donation units, it is not the specific maximum limit defined as one Prastha (which is about 13.3 Pala) in classical texts.
Option D: Two Prastha (approximately 1280 ml) is an excessive and dangerous volume of blood to remove at once. It would far exceed the safe limit and could lead to severe hypovolemic shock, Vata aggravation, and potentially fatal outcomes.

Clinical Relevance

Nursing practice connection: Knowing Maximum blood removal limit in Siravyadha (Ayurvedic venesection) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
For students of Ayurveda, knowing these classical limits is fundamental for patient safety during Raktamokshana procedures.
This knowledge provides a historical and comparative context to modern phlebotomy, where a standard blood donation is 350-450 ml and therapeutic phlebotomy is around 500 ml.
What if the patient has 'Madhyama Bala' (medium strength)? According to Ayurvedic principles, the amount of bloodletting would be reduced, typically to one Kudava (approximately 192 ml), demonstrating the importance of assessing patient strength before the procedure.

How to Approach the Question

Identify the core of the question, which asks for a specific quantitative limit ('maximum amount') for a traditional procedure ('Siravyadha').
Recognize that 'Siravyadha', 'Pala', and 'Prastha' are terms from Ayurveda, indicating the answer will be found in classical texts, not modern medical guidelines.
This is a factual recall question. Access your knowledge of Ayurvedic measurements and the specific guidelines for Raktamokshana as described by authorities like Sushruta.
Recall or deduce the relationship between the units. A 'Prastha' is a larger unit than a 'Pala'.
Select the option that matches the established classical limit, which is 1 Prastha.

Concept Tested & Keywords

Concept Tested: Maximum blood removal limit in Siravyadha (Ayurvedic venesection)
Stem keywords: Siravyadha, venesection, maximum amount of blood
Lead-in keywords: what is
Negative lead-in flag: false

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