What is Medical Leech (Hirudotherapy)?
The history of leech therapy is considered to be as old as the pyramids. There are pictures of leeches in the tombs of the Pharaohs and information about the use of leeches for medical purposes in Roman and Greek texts.
Hippocrates (B. 460 BC, Kos – D. 370 BC, Larissa) was a Greek physician, considered the ‘father of medicine’ in western medicine, who was the first to state that superstitions were not the basis of diseases and that diseases developed within a certain logical framework. Aelius Galenus (200 AD – 129 AD) was a medical scientist who lived in the Roman period and influenced the modern medical world for 1000 years with his theories. Since these physicians, hirudo therapy has been used. The physiological mechanism underlying hirudo therapy has been revealed in recent years after the study of the oral secretion of living beings.
In the United States in the 17th century, Dr. Benjamin Rush found that leech therapy in the United States had more benefits than known in the treatment of blood circulation and vascular diseases. In 1840, Dr. Henry Clutterbuck described ‘Hirudo Medicinalis’ as “an excellent remedy which we know to be highly beneficial when leeches are used judiciously”.
Leech therapy gained popularity in Europe in the 18th and 19th centuries. For centuries it has been an important element in the treatment of diseases all over the world. In Europe, especially Germany, France and England discovered the miracle of leeches and imported millions of leeches every year. Not only Europe, but also Asian and Far Eastern countries have used leeches extensively and continue to do so. Russia ranks high among the countries exporting leeches in the world.
In the 20th century, with the discovery of antibiotics, the enzymes of ‘Hirudo Medicinalis’ were scientifically studied by Richard Truszkowski in 1928, although its popularity in the medical world partially decreased in Europe. With the widespread use of plastic surgery and orthopedic implant surgery, the miraculous effects of the oral secretion of the living creature were rediscovered and started to be used.
The use of ‘Hirudo Medicinalis’ has become widespread in our country in the last 30 years after successful surgeries in plastic surgery because we have been influenced by European medicine. In fact, leech treatment has been traditionally used in Anatolia for many years in our country and was seen as ‘husband-wife’ treatment by physicians and no interest was shown. By using idioms such as ‘sucking like a leech’, this creature has been humiliated in our subconscious. It is a fact known for centuries that it is beneficial to humanity in a way that does not deserve this humiliation. As in all our applications, as the use of leech treatment has become widespread in Europe, its use in our country has started to increase in the medical world. In fact, such treatments should be blended with modern medical knowledge and evaluated integratively and used for the treatment of humanity. Just as breast milk is and will continue to be number one in the development of children with its content and effects despite all our development. Likewise, the use of Hirudo medicinalis in treatments is and will continue to be important in terms of its effectiveness. As with leeches, herbal treatments have a higher degree of healing than synthetic ones because the source is natural. Leech therapy and phytotherapy (herbal treatment) deserve much more attention as a source of healing for diseases.
Mechanism of Action of Leech Therapy
The oral secretion of this creature contains over 100 bioactive substances that can be easily integrated with substances in human physiology. The basic logic is that when the creature sucks blood, like mosquitoes, it releases oral secretions into our body. These secretions make it easier for the leech to suck blood. While the creature is doing this process, it is a source of healing for our diseased areas thanks to the enzymes it gives to our vascular and lymphatic system. Due to the content of the oral secretion, it is a carefully prepared medicine. Hirudo medicinalis is a small factory with the bioactive substances it secretes.
Substances in Leech Secretion
Hirudin Prevents blood clotting (binds to thrombin).
Hyaluronidase: Increases tissue permeability and reduces its viscosity.
Apyrase: Inhibits host platelet aggregation.
Collagenase: Breaks down collagen peptide bonds.
Proteases: Cleaves protein bonds. Cleans damaged areas in wounds and burns by breaking them down.
Lipolytic enzymes: Breakdown of lipids; includes hydrolysis of triglycerides.
Destabilase: Dissolves fibrin (thrombolytic effects).
Bdellines: Anti-inflammatory inhibits trypsin, plasmin, acrosin.
Eglines: Anti-inflammatory inhibits alpha-chymotrypsin, chymase, substilicin, elastase, cathepsin G activity.
Calin: Inhibits blood clotting by binding to collagen and Van Willebrand factor. Inhibits collagen-induced platelet aggregation.
Tryptase inhibitor: Inhibits proteolytic enzymes of host mast cells.
Acetylcholine: Has vasodilator effects.
Carboxypeptidase A inhibitors: Increases blood flow.
Factor Xa inhibitor: Inhibits clotting factor Xa activity by forming complexes.
Medical Leech application creates the following effects in our body thanks to these biocompounds:
- Decreased blood clotting
- Thrombolytic (clot destruction) effect
- Increasing blood flow to tissues and organs
- Antihypertensive effect (normotensive)
- Drainage of toxins and blood clots from the blood and lymph system
- Stimulation of the neuromuscular system
- Restoration of vascular permeability
- Bacteriostatic effect (stopping the proliferation of microorganisms and causing them to die)
- Immunostimulating effect
- Helping to balance organ physiology by applying to acupuncture points
- The most important effect is to prevent ischemia by increasing microciculation in end organs, which is currently not achieved with current medical treatments.
Usage Areas of Leech Therapy
Leech (Hirudo medisinalis) treatment has anticoagulant (prevents clot formation), vasodilation, bacteristatic and anesthetic effects. With this mechanism of action, it can be used in the treatment of many diseases. In this way, it ensures healthy circulation in the diseased organ by expanding the vessels leading to the organs with impaired circulation, dissolving the clots formed and stopping the growth of bacteria in the environment, if any. It can be applied after all kinds of microsurgical operations to ensure healthy circulation. Despite today’s technology, Hirudo medisinalis secretions are still the most excellent method to open the blockage especially in the veins feeding the end organs. It is also used to prevent stasis due to venous congestion and compression. It can be used in gynecological diseases, urological diseases, joint diseases, migraine and tension-type headaches, hypertension, abdominal pain, widespread body aches and skin diseases. It should not be forgotten that this treatment method can also be used to get rid of toxins and accelerate circulation (prophylactically).
Strictly Contraindicated Situations
Hemophilia, leukemia, multiple myeloma, lymphoma, hypotension (low blood pressure), anemia, HIV infection, AIDS, chemotherapy, liver cancer, pacemaker, pregnancy, menstruation, dialysis patients.
Patients taking the following medications must be notified (leech treatment is not possible for patients with chronic use):
Coumadin, Plavix and similar, Aspirin and similar, Dabigatran and similar
Medications that should be stopped 2-3 days before the procedure:
Fish Oil, Gingo biloba products, Acetylsalicylic acid, Sindenafil.
What not to do before the procedure:
Strong painkillers, herbal treatments, herbal creams, homeopathic remedies.
What not to do after the procedure:
Physical therapy, intensive massage, deep tissue massage, reflexo therapy, aromatherapy, acupressure, jogging, cycling, intense swimming, weight lifting, intense work
Is leech treatment painful?
The level of pain varies according to the person. The pain caused by the leech can be compared to a bee bite. However, with one difference; 1 to 5 minutes after the leech bite, the substances in the oral secretion of the living creature show an anesthetic effect and relieve the pain.
Does itching occur after the procedure in leech treatment?
The most common side effect after the procedure is itching. This is not an allergic reaction. It is an effect of oral secretion and disappears in 2-3 days. Our recommendation for this is vinegar water and cold compress. Protecting the application area against scratches and impacts can prevent subsequent complications not caused by leeches.
Is there a lot of blood loss in leech treatment?
No, it does not. The maximum amount of blood that a leech can absorb cannot exceed 10 cc. The total loss does not exceed one tea glass (approximately 100 cc). It is much less than a cupping.
What is the infection risk of leech treatment?
There is always this risk in unsafe hands. The most important risk of leeches used repeatedly or on many patients is infectious diseases (hepatitis B, C, HIV). There is a risk of infection by aeromonas spp. bacteria that can be found in the intestines of Hirudo medisinalis. We can get rid of this situation by having the procedure done in safe hands.