Abstract
Siraj Granthi, described in Ayurvedic classics as a disorder involving vitiation of Vata, Rakta, and associated structural
derangement of Sira, closely resembles the modern clinical entity of varicose veins. Varicose veins are a common chronic venous
disorder characterized by dilated, elongated, and tortuous superficial veins of the lower limbs, often associated with pain,
swelling, discoloration, and reduced quality of life. Despite advances in modern vascular interventions, recurrence, cost, and
procedural limitations continue to challenge long-term management. Ayurveda offers a holistic understanding of this condition
through the concepts of Siragata Vata and Siraj Granthi, emphasizing Dosha-Dushya involvement, impaired Rakta Pravaha,
and structural vascular changes. Among the therapeutic modalities described, Raktamokshana holds significant importance,
particularly Jalaukavacharana (leech therapy) and Siravyadha (venesection), which are traditionally indicated for vitiated Rakta
and vascular disorders. This review integrates classical Ayurvedic literature with contemporary medical understanding to
explore the etiopathogenesis, clinical correlation, and management of Siraj Granthi with special emphasis on Raktamokshana.
Classical references from major Ayurvedic texts are critically correlated with current concepts of chronic venous insufficiency,
vascular pathology, and non-surgical management strategies. The review highlights that Ayurvedic approaches, especially
bloodletting procedures, may provide a cost-effective, symptom-relieving, and clinically relevant complementary strategy in
managing varicose veins. Integrating traditional wisdom with modern understanding may broaden therapeutic possibilities and
encourage further evidence-based research in vascular care.