Sunday, October 12, 2008

Leeches For Migraines, Anyone?

When Demi Moore recently revealed that she undergoes leech treatments for her overall health “in this woman’s apartment”, it raised more than a few late-snacks from the bottom of people’s stomachs. Just how often are medicinal leeches used nowadays? And are they used for migraine treatment?

They’re Used For Migraines

Instead of having Big Pharma leech all of the money from your savings account, you can get real leeches to suck your blood. Does it hurt? Oh, yeah — patients say the first bite is incredibly sharp, but them subsides as their slimy doctors feed.

Practitioners are using medicinal leeches for a variety of ailments, including migraines, rhuematoid arthritis, gout, skin ulcers, wound cleaning and vasulitits. You usually need a few treatments in order to find any relief with the leeches.

Quite frankly, I haven’t been able to find any statistics on just how many migraineurs are turning to leeches for help or how effective they are. I have only found one reference that a clinical trial was performed, but have not found the results.

Not News

Using leeches for migraines isn’t a revolutionary new idea. Hippocrates, as well as writing oaths, recommended leeches for migraine treatment around 400 BC. It is thought he learned about medicinal leeches from Babylonian healers. Before Hippocrates, one of the only migraine treatments available was to get a hole drilled into your head (called trepaning).

Before You Get Stuck

You can’t just plop any old leech on your head and expect relief. There are only certain strains of leeches that are considered medicinal leeches. Although Demi Moore claims she goes to a private home to get her leech treatment, you usually have to go to a doctor.

Demand for medicinal leeches is rising as demand for alternative therapies rises. And you really can’t get more natural than a blood-sucking leech. The FDA even recognizes that they can have positive qualities.

If you have an infected wound or are threatened with gangrene from diabetes, then medicinal leeches and maggots can clean your wound better than a room full of doctors with various diplomas. But the jury is still out for the use of leeches for migraines.

Personally, I’d rather just have the migraine.

http://www.dealingwithheadaches.com/leeches-for-migraines-anyone/

Uses of Leech Therapy in Patients with Skin Grafts

Leeches, as we all know, can be viewed by many as quite disgusting creatures to look at, especially when they are full and bloated after gorging themselves on blood. Many people fear leeches and most stay away from them. Just the thought of having a leech attach themselves to a part of the body is enough to scare anybody. But remember, there are leeches that serve many purposes, especially when it comes to the medicine world. These medicinal leeches have long been used in the treatment of illnesses and diseases, and they have also been used in the healing process of skin grafts.

What is a Skin Graft?

When a patch of skin is taken from the same individual and transplanted to another part of their body, it is called skin grafting or skin transplant. The patch of skin taken from an individual is removed from an area of the body that has good circulation to increase the chance of healing quickly and properly. Common areas where skin grafts are taken are those that are hidden underneath clothes, usually from the buttocks or inner thighs. After skin harvesting, the donor site is covered with sterile and non-adhesive dressing so as to prevent the occurrence of infection.

After the patch of healthy skin is harvested, it is carefully spread over the required area. To keep it in place so as to promote good healing and good revascularization, well-padded dressings that exert gentle pressure are placed over the skin graft. Stitches can also be used to keep the skin graft in place to allow growth of new blood vessels, supplying the transplanted skin with blood, thus, increasing the healing process.

Skin grafts, although taken from the same individual, can still present a lot of risks. Infection of the recipient site can occur and delay healing and complications can also arise such as poor venous drainage leading to skin graft tissue death, and this is most especially true for patients whose vascular system is compromised.

If this occurs, skin grafting can be repeated in the hope that the graft will be successful the next time, but nowadays, many surgeons use leeches to avoid the above from happening.

Why Use Leech Therapy?

Leech therapy has been used for many years as a treatment for many conditions, especially when it comes to infection, so studies were done and it has been found, tested, and proven that leech therapy can really aid in the healing process of skin grafts.

How does leech therapy promote healing and recovery of patients who have undergone skin grafting?

As soon as the leeches attach themselves to the skin graft site, they begin to suck blood. While sucking, they also release a component called hirudin from their saliva. This component is very important in the inhibition of platelet aggregation (the process where the platelets clump or stick together) and coagulation cascade (a series of processes that ends with fibrin clot formation).

If these two detrimental complications are present in a skin graft, there will be marked venous congestion, which slows down the healing process of the skin graft. When the skin graft receives poor circulation, the site becomes cyanotic [a condition in which the skin and mucous membranes take on a bluish colour because there is not enough oxygen in the blood], then it hardens and cools until the transplanted tissue dies. Now, because of the hirudin and the Factor Xa inhibitor present in the leech’s saliva, these processes are inhibited. Since there is a vasodilator component in their saliva too, venous congestion is further reduced, promoting good blood flow into the skin graft. After continuous medicinal leech therapy, the skin graft will soon turn warm and pinkish, a good sign that there is an adequate blood supply.

Frequency of Leech Therapy in Patients with Skin Grafts

Medicinal Leeches suck on the area for up to an hour or more, where they can consume one to two teaspoons of blood. Two days after leech therapy, the skin graft site will show a noticeable increased blood supply to the area.

The frequency of leech therapy in patients with skin replants is about four days to five days, while the frequency in patients whose skin grafts became compromised is about six to ten days.

Leech Therapy Contraindications

Not all patients who undergo skin grafts are a candidate for leech therapy. Those who have AIDS or HIV are not recommended to undertake medicinal leech therapy because it could put them at risk of bacterial sepsis. Likewise, patients who take immunosuppressive drugs are also not advised to undergo leech therapy due to the same reason.

Skin Diseases

The skin is the body’s primary line of defense against infection. There are three common layers to the skin - Epidermis, Dermis and Hypodermis, composed of skin cells, capillaries, sweat glands, and hair follicles.

Common skin diseases often occur in the two uppermost layers, the epidermis and the dermis. Uncomplicated skin diseases are easily cured because the skin generally sheds after a couple of days, but more complicated skin diseases are rooted at the hypodermis level and these are more difficult to cure. Some skin diseases are rendered incurable and only subject to remission and exacerbation; that is, they remain idle on occasions and flare up from time to time.

Hirudotherapy to Treat Boils

Boils are infections deep in the skin. A boil begins as a red area and gradually becomes tender and firm. An ‘eye’ forms at the center and contains yellow fluid called pus, which is composed of white blood cells, dead bacteria and proteins.

During leech therapy, leeches are placed directly over the eye of the boil, so they can feed directly on the pus and at the same time, other leeches will be placed around the area to rid the body of pooled blood. This is important, because pooled blood causes pressure, leading to tenderness and will relieve the patient of pain.

Hirudotherapy to Treat Shingles


Shingles [Herpes Zoster] is a viral skin disease in adults and occurs due to reactivation in adulthood of dormant viral matter leftover from a bout of chickenpox in childhood. Although lifelong immunity to chickenpox is commonly spoken about, the viruses that cause it may lie dormant for years in sensory nerve cells, reactivating themselves and causing an attack of shingles at times when the immune system is weak, resulting in inflammation, pain, and a rash of small skin blisters.

The skin manifestation of herpes zoster is not serious, but the pain caused by the inflammation of the underlying nerve can be severe, lasting for weeks.

Treatment for Shingles is designed merely to limit the severity and duration of pain because there are usually post infection complications like neuralgia [chronic severe pain around a nerve path]. Leeches saliva contains a substance that has analgesic [pain killing] effects. Pain relief is known to be more powerful and longer lasting than general pain relieving tablets.

Hirudotherapy for Psoriasis

There are many skin diseases that can be treated with Hirudotherapy and one disease worth mentioning is Psoriasis.

Psoriasis is a common skin condition that occurs when the skin cells replace themselves too quickly. There are many different types, but the most common is chronic plaque psoriasis.

What are the symptoms?

The extent of the disease can vary from a few tiny lesions here and there on the body, but are most commonly seen on knees, elbows, the chest and scalp, appearing as red, scaly patches that reveal fine silvery scales when scraped or scratched and often itch and feel uncomfortable. This condition can cause sufferers to become withdrawn and uncomfortable in forming relationships because of the way people react to the appearance of their skin.

What causes it?

Why psoriasis occurs is unknown, which makes it quite impossible to prevent. However, many things are thought to trigger the condition, including skin injury, sore throats/chest infections, some drug treatments, sunburn and even stress. As hopeless as it all may sound, ancient doctors have been using Hirudotherapy to improve the outcome of skin diseases like psoriasis. Not only are leeches useful for sucking pooled blood, their saliva also contains active substances that are bactericidal [fights off bacteria that proliferates over thick layers of excess skin cells]. Other substances in the leech’s saliva also cause gradual slowing of skin cell production, giving noticeable relief for patients.

Hirudotherapy for Alopecia (Baldness)

Hirudotherapy for Alopecia

Alopecia is more commonly known as baldness. We are not talking about the normal age-related baldness, but the gradual and radical hair loss due to a fungal infection or dandruff.

About 100 hairs are naturally lost from the head every day, though the average human scalp contains between 100,000 and 150,000 hairs. Genetic baldness is caused by the body's failure to produce sufficient new hairs, not by excessive hair loss. It affects men more than women, although women also can develop a characteristic pattern of hair loss. About one quarter of men have started balding by the time they are thirty, and about two thirds are either bald or are balding by 60.

One of the advantages of Hirudotherapy is improvement of blood circulation. Bald spots in your head have less hair density because they have less blood circulation compared to other parts. The proliferation of fungi in the area can be one of the factors that cause the reduced blood flow.

Leech therapy is not generally associated with treating alopecia, but is very effective nonetheless. Blood circulation improves as a result and the body’s natural defense against fungal infection can once again be delivered to the affected areas, thereby promoting healing.

The Benefits of Leech Therapy and its Effects

Yes, leeches can be thought of as slimy and unattractive creatures, but ugly or not, they do serve a lot of medical purposes when it comes to us, humans.

Since ancient times, leeches were used to treat many illnesses and disease through bloodletting, a method where blood was drawn out in the hope that removing impure blood would heal the body. Believe it or not, leech therapy is sometimes the best alternative in treating illnesses, and even surpasses pharmacological treatments. Because of its healing effects to the human body, this traditional method of curing diseases is still thriving today.

The Benefits of Leech Therapy

There are more than 600 species of leeches that have been identified, but only 15 of the species are used medically, so they are given a class of their own. They are classified as Hirudo Medicinalis or medicinal leeches.

Leech therapy has been used and is still in use for many diseases of the body. They are used to treat arthritis and other inflammatory processes. It is perfect for those with vascular (arterial and venous diseases), heart (ischemic diseases and hypertension), and lung problems (bronchitis and bronchial asthma). The medicinal leeches can also help in patients with pneumonia. The GI or gastrointestinal tract can also benefit from leech therapy, especially those who suffer from hepatitis, stomach ulcers, and pancreatitis, among others. Likewise, individuals with problems in their genitourinary system and gynecological disorders will also benefit greatly from leech therapy. Skin diseases like psoriasis, herpes, and eczema can also be treated with leech therapy. Other problems known to benefit from leech therapy are the eyes (example is glaucoma) and the brain (for infantile cerebral palsy).

But how exactly do leeches treat these many illnesses and diseases?

Anticoagulating Effects of Leeches

The leech’s saliva contains enzymes and compounds that act as an anticoagulation agent. The most prominent of these anticoagulation agents is hirudin, which binds itself to thrombins, thus, effectively inhibiting coagulation of the blood.

Another compound that prevents coagulation is calin. This, on the other hand, works as an anticoagulant by prohibiting the von Willebrand factor to bind itself to collagen, and it is also an effective inhibitor of platelet aggregation caused by collagen.

The saliva of the leeches also contains Factor Xa inhibitor which also blocks the action of the coagulation factor Xa.

Clot Dissolving Effects of Leeches

The action of destabilase is to break up any fibrins that have formed. It also has a thrombolytic effect, which can also dissolve clots of blood that have formed.
Anti-inflammatory Effects of Leeches

Bdellins is a compound in the leech’s saliva that acts as an anti-inflammatory agent by inhibiting trypsin as well as plasmin. It also inhibits the action of the acrosin. Another anti-inflammatory agent is the eglins.

Vasodilating Effects of Leeches

There are three compounds in the leeches’ saliva that act as a vasodilator agent, and they are the histamine-like substances, the acetylcholine, and the carboxypeptidase A inhibitors. All these act to widen the vessels, thus, causing inflow of blood to the site.

Bacteriostatic and Anesthetic Effects of Leeches

The saliva of leeches also contains anesthetic substances which deaden pain on the site and also bacteria-inhibiting substances which inhibit the growth of bacteria.

Overall Effects to the Human Body

Once the leeches attach themselves to the skin of the patient and start sucking blood, the saliva enters the puncture site and along with it the enzymes and compounds responsible for all these positive effects. Working together, they act to cure the disease present in the individual. Because of anticoagulation agents, the blood becomes thinner, allowing it to flow freely through the vessels. The anti-clotting agents also dissolve clots found in the vessels, eliminating the risk of them traveling to other parts of the body and blocking an artery or vein. The vasodilating agents help widen the vessel walls by dilating them, and this causes the blood to flow unimpeded, too.

Patients who suffer from pain and inflammation will feel relief from the anti-inflammatory and anesthetic effects of the leech’s saliva.

In the long run, leech therapy also helps to normalize the blood pressure of hypertensive individuals as well as lessen their risk of suffering from stroke and heart attacks. Blood circulation is also improved with leech therapy and it helps with the healing process of wounds, as well as wounds and lesions caused by diabetes. There is also a noticeable boost in the immune system’s function due to bacteriostatic agents.

Contraindication to Leech Therapy

Leech therapy is contraindicated to patients with HIV and AIDS. It is also not recommended to patients who are on immunosuppressive drugs. Leech therapy puts these patients at risk for bacterial sepsis, thus, worsening their conditions

Leeches: What Do They Do?

What exactly do leeches do? I mean, aside from swimming around murky pools and sticking to people’s legs, what do they really do? Well, to answer this question, perhaps it’s best if we find out what exactly leeches are first.

What Are Leeches?

Leeches are what we call annelids. They comprise the subclass Hirudinea. There are three types of leeches, fresh water leeches, terrestrial leeches, and marine leeches. Most of them live in fresh water, but there are also those that prefer to live on land, particularly in low foliage or in rain forests. There are also some leeches that can be found in dry forests, but only in places where there is a bit of moisture. During the dry season, these leeches often burrow themselves in the ground, where they hibernate even without water. They simply shrivel up and become rigid and their bodies become very dry. If you sprinkle them with water, they recover completely within ten minutes.

Those that live in the water usually prefer bodies of water that are relatively slow moving and calm. A lot of leeches may also be found in murky waters, which makes them harder to spot.

Leeches, quite interestingly are hermaphrodites – meaning they’re both male and female. When they reproduce, one of them merely chooses to play the role of female and another chooses to play the role of male.

They Bite and They Suck Blood

Contrary to popular belief, most leeches don’t really rely solely on drinking blood. Some of them actually eat other invertebrates that are smaller than them, swallowing them whole. Some leeches can’t bite and are content to feed off decomposing bodies.

Leeches that suck blood are called Haemophagic leeches, “Haemo” meaning blood and “Phago” meaning ‘to eat’. They attach themselves to their hosts only until they become full, after which, they will simply fall off and start digesting the blood they sucked out. These leeches suck blood through the anterior sucker which is composed of the first six segments of the invertebrate’s thirty four segments. It uses this ‘mouth’ to attach to the host. They also release some sort of anesthetic, which is the reason why you don’t feel the leeches when they bite. They then use suction and mucus to stay on their host. Once they open up a bite wound, they secrete an anti-clotting enzyme called Hirudin into the bloodstream so that blood will keep flowing. Sometimes, blood will continue to seep for hours after the leech has been removed, which is due to the anti-clotting enzyme in their saliva. While this may sound terrifying, being bitten by a leech isn’t deadly or dangerous.

They’re not really the villains that popular media often portrays them to be. In fact, leeches are actually very harmless. The amount of blood lost due to a leech’s bite isn’t really significant and when they’re full (which doesn’t take long), they simply fall off and go on with their lives.

People who bushwalk and don’t want leeches to attach, despite being relatively harmless are known to touch them with a cigarette end or a lighted match to release their grip, or they pour carbonated drinks over the leech. However, doing this can cause the leech to vomit its stomach’s contents into the opening wound, thereby increasing the risk of infection. So, it’s best if possible to disable their suckers by using a fingernail under the narrower end of the leech and flick them off. Never try to tear them off or it’ll worsen the wound, cause the leech to regurgitate its stomach contents, and possibly leave a portion of the leech’s mouth on the skin.

They Also Heal

Some of the popular leeches are the European Medical Leech or the Hirudo Medicinalis and some congeners. These are the ones used in the field of Medicine for microsurgery, grafting, and for reconstructive surgery. In the past, these leeches were used to cure infections and for bloodletting. They were quite popular during the medieval ages because they were known to cure infections; in fact, they remained great options for treating infections until antibiotics were discovered.

Doctors use leeches for microsurgery due to their ability of removing blood that has coagulated. They relieve venous congestion and muscle flaps. Leeches are also known to treat black eyes! Hirudin can be used to treat infections of the middle ear and is being tested as a systemic coagulant.

When used for medical purposes, a leech is NEVER used to treat more than one person, as bacteria and viruses present in their former host can transfer to the new host.

Leech Therapy: Is It Safe For You?

Present a random stranger with a leech and he’ll most likely have disgust written all over his face. Tell him that you’re going to let the leech bite him and he’ll look at you as if you’ve given him a death threat. Indeed, people’s reactions to leeches today are quite exaggerated and it’s almost funny to see how people over react to this poor and simple creature with no backbone to speak of. All people would usually remember are blotched camping trips where skinny-dipping led to lots of screaming and thrashing around because their legs suddenly got decorated with little black bloodsuckers. But, really, leeches are relatively harmless – not only that, they’re also very useful.

As you may have heard, the use of leeches in the field of medicine is widespread and very much accepted. They’re popular in the field of plastic surgery, especially for cases where grafting is quite difficult and also for reconstructive surgery. They’re also quite popular in microsurgery because of their ability to liquefy blood clots, thereby keeping the blood flowing and encouraging circulation.

But the idea of willingly letting a leech bite would be enough to make someone turn tail and run to the nearest exit. But really, leech therapy, aside from the minor inconveniences, is relatively harmless.

Pain

Of course, bites usually equate to pain and a leech’s bite is no exception, however, the pain that stems from a leech’s bite is slight. Some people say that it’s hardly noticeable and others say that it hurts as much as a wasp’s sting – but this is rather rare. The slight stinging sensation of a leech’s bite usually lasts for only about one to five minutes and after that, their natural local anesthetic effect kicks in. Usually, a patient’s pain is connected to their anxiety before the procedure, so simply put, the more you dread it, the more it hurts! So, the best thing is to try and distract yourself whenever leeches are applied and you probably won’t feel a thing.

Pruritus [Itchiness]

Itching on the site of the bite for the first few days is a common side effect of leech therapy. It’s not an allergic reaction, though people often mistake it to be so and it’s advised that the patient should be advised to avoid scratching the area because it delays wound healing. Local natural remedies for itching can be used, like cold moist wraps or vinegar wraps and if the itching is intense, antipruritic drugs like Fenistil ointment or an oral antihistamine can be used.

Blood Loss

Leeches are blood suckers, meaning that whenever they attach to your skin, they ingest some of your blood. Now, in the wild imaginations of people who abhor creepy crawly things, leeches can suck a person’s blood until the person shrivels up and dies, but of course, we know that this is really not the case! Leeches only suck about a teaspoon of blood and when they’re full, they naturally fall off. Of course leeches also have an enzyme called Hirudin in their saliva, which is an anticoagulant that is injected into a person’s bloodstream. However, blood may keep seeping several hours after the bite, which may cause some anxiety for the patient, but is nothing to worry about.

Infection

A leech’s body contains bacteria that may cause infection, but these microorganisms are easily killed by antibiotics, therefore it’s quite safe to use leech therapy.

Therapeutic Benefits for Diabetics

Diabetes

Today, Diabetes is one of the most prevalent chronic diseases in the world. Millions of people have been diagnosed with Diabetes and everyday, thousands more become part of this statistic.

Diabetes: A Quick Overview

Diabetes is a condition caused by the pancreas’s failure to produce enough insulin. The difference between type 1 and type 2 is the degree of insulin depletion. In type 1 diabetes, the onset is usually early in childhood, where there is absolute depletion of insulin. In type 2 diabetes, the onset is usually in adulthood around the age of 45 or older; where insulin production occurs, but an insufficient amount of insulin is produced.

When we eat, sugar turns into glucose and enters our bloodstream and is distributed to our body cells. Glucose is the “food” that gives our cells energy to function and insulin is crucial for breaking down glucose into the form that our cells can use. Without insulin or with too little insulin, glucose will not be absorbed by our cells, and they in turn will have no or little energy.

In the above situation, glucose remains in the blood causing it to thicken, which can create complications in the body. Transporting blood from one
organ to another requires more effort, resulting in the vessel walls thickening and becoming less flexible. The heart also becomes overworked with the effort required to pump blood around the body and of course, thickened blood struggles to pass through capillaries, let alone the smaller blood vessels. This alone compromises the blood supply to distal organs, let alone the fact that viscous blood can predispose a patient to develop blood clots, which can travel to major organs like the brain, heart and lungs causing a stroke, heart attack or lung embolism.

Leech Therapy: An Ancient Science

Leech Therapy, also known as Hirudotherapy, is the treatment using medical leeches to assist various diseases. It is a therapy known since ancient times and remains very much in use today.

Hirudo Medicinalis is a species of leech used for medical applications, which are able to consume up to 15 ml of blood, therefore, therapists can use up to 12 leeches simultaneously or more, depending on the type of disease treated. When leeches bite, they inject their saliva into the wound. Their saliva contains enzymes, different chemicals and substances that bring about diverse therapeutic benefits for the patient.

Therapeutic Benefits for Diabetics

One of the most important substances recognised in leech salivary glands is Hirudin, a substance that suppresses the blood clotting mechanism. If you remember, it was mentioned earlier that Diabetes patients have viscous [thick] blood, which creates a higher risk of developing blood clots. Development and dislodgment of clots into the general circulation poses serious threats to anyone and can cause instant death, so the suppression of blood clotting is essential.

Hirudin also has a blood diluting effect, so apart from preventing blood clots; it also thins the blood, allowing the blood to circulate more easily, relieving pressure on the heart and blood vessels.

All These and More

Aside from Hirudin, there are many other active substances found in the saliva of leeches, which contribute to the improvement and normalization of capillary circulation. There are also other substances which produce a natural analgesic, provide antibacterial properties, lower blood pressure and have an anti-inflammatory effect.

In Diabetes and other diseases, the microcirculation restoration effect of Hirudotherapy is essential in preventing amputation of fingers and toes. As we know, the care of the fingers and toes are crucial and since a diabetic’s blood circulation can be sluggish, where blood is sometimes unable to fully penetrate capillaries, the body cannot heal the smallest of wounds, or worse, necrosis [tissue death] can result and sometimes amputation of a finger, toe or limb is necessary to stop the spread of this condition to other parts of the body and Leech Therapy is known to improve circulation in distal parts of the body (i.e. extremities).

Today, hospitals worldwide use leeches to assist a number of areas, including restoration of circulation in reattaching parts of the body, such as fingers, toes, ears or hands which have been accidentally amputated and good blood supply and nerve connection is essential for recovery. These reattachment procedures are often complemented with leech therapy so that circulation is restored more easily and safely.

Little Research

Scientific research is ongoing regarding the use of leeches in assisting countless diseases in the medical arena. Leeches are without doubt, miraculous creatures; their obvious advantage is the fact they have survived for several centuries, therefore allowing us to acknowledge that some mysteries of nature, for the time being, may remain unmeasured.

Leeches have and will always be thought of as the “wonder doctors” of science.

http://toolsforlife-dvd.com.au/diabetes.html

Leech Therapy: Migraines

Millions of people suffer from Migraines each year, in fact, eleven out of a hundred are said to have suffered or are suffering from Migraine headaches. Migraines are also said to be one of the leading causes of unproductivity in workplaces. Indeed, migraines can easily become the bane of a person’s existence, especially since the pain is usually so intense that one can hardly do anything else but complain and hope the pain goes away as soon as possible. The exact causes of migraine headaches are still unclear, although a number of years ago, it was thought to be a change in the state of the blood vessels supplying the brain. Now, however, the belief about migraine is due to the disturbance stems from the brain itself rather than in the vessels supplying it. One thing that’s sure is that the pain is somewhat relieved when circulation to the particular painful area is improved and the same principle holds true with migraines and this is where leeches come in handy.

Leeches are wonderful creatures, despite their reputation of being slightly – okay, overly disgusting to many people, they still prove to be helpful creatures! These remarkable invertebrates have found a way to keep us happy and at the same time keep themselves happy. It’s a relationship that’s mutually beneficial, so you really have to wonder why most people abhor them so much.

There is a theory that suggests migraines are caused by tiny blood clots that are formed in the heart, which then travel to the brain and these blood clots disrupt the flow of blood to the brain and thus cause the typical symptoms of migraine like the one-sided head-ache, photophobia, and nausea. As you may already know, there is a substance found in leeches called Hirudin. This substance is an anticoagulant, causing blood to become more diluted, thus allowing it to flow easier and faster. Hirudin can dissolve those little clots that have formed by converting fibrinogen to fibrin.

It’s also known that leeches can increase the circulation in the body, even on the head, because its sucks just enough blood to get the blood stream flowing. Leeches can also cause vasodilation, meaning the vessels are widened, thus lowering the pressure on the walls of these vessels, improving blood flow.

Good blood circulation is vital! In a painful area, it’s absolutely necessary, especially in places like the brain and using leeches instead of medications for migraines is healthier. For one thing, medications can have serious side effects unlike leeches which, if handled properly, are relatively safe and have no prolonged adverse effects. Drugs, especially strong pain relievers like narcotics, can be addictive, so they’re not advisable if possible. Frequent use of certain drugs may also cause dependence and an increase in tolerance, meaning the next time you’re in pain, you may need a higher dose and as you may be aware, higher dosages of drugs can be toxic for your body.

Another substance in leech saliva that is known to help relive migraines is a natural anesthetic that is released after attaching itself and can greatly relieve discomfort. If you’d rather have a leech on your head rather than a splitting headache, then perhaps leech therapy is the thing for you.

(http://toolsforlife-dvd.com.au/migraines.html)

Migraine Headaches and Leeches

Leeches are making a comeback, it seems.

Medicinal leeches are used to improve blood circulation, get rid of poisons in the blood, rejuvenate the respiratory and the excretory system and help with migraines.

They are used widely in Malaysia and other Southeast Asian countries. In India, just the last week Unani medicine experts finalized the standard operating procedures (SOP) that specifies rules that will have to be followed by all leech therapists in India.

And, in case you are wondering, the Food and Drug Administration of the United States classifies leeches as medical devices.

"Surgeons who do plastic and reconstructive surgery find leeches especially valuable when regrafting amputated appendages, such as fingers or toes. Severed blood vessels in such cases often are so damaged that they lack the ability to clear the area of blood. In these cases, it is difficult for the surgeon to make a route for blood to leave the affected part and return to circulation."

Leeches apply just enough amount of suction to get the blood flowing.

However, there is another aspect to using leeches that could possibly be of a benefit to migraine patients.

The parasite's saliva contains a powerful anti-clotting agent hirudin. At the same time, leeches emit a natural anesthetic that minimizes pain.

Anti-clotting medication has shown some promise as a migraine preventive. We've talked about it in the recent article Clopidogrel (Plavix) - Migraine Cure or a Death Trap?

The conclusion here is - it doesn't seem to be detrimental to one's health. Whether it really helps with migraines, the question for now remains open.

(http://www.raingem.com/2008/08/migraine-headaches-and-leeches.html)

Leech therapy makes a revival in Kashmir

Srinagar, April 24 : Doctors at various hospitals in Kashmir have adapted traditional leech therapy for patients suffering from various ailments like surgical reattachments of fingers, toes, ears for its ability to prevent venous congestion.

Leech therapy is considered quite effective, as when blood-sucking leeches bite a person, their saliva that contains several bioactive substances, causes blood flow to increase to the damaged tissue and prevents clotting.

Once bitten, a person can bleed for hours, allowing oxygenated blood to enter the wound area until veins re-grow and regain circulation.

Hospitals in Kashmir are using the leech therapy on patients suffering from arthritis, gout, chronic vertigo and sinusitis.

"Sinusitis results in mucous collection that leads to various ailments like headache, cough and cold. In order to get rid of it, surgical methods are adopted to drain the exodus. But leech therapy is easier than draining because leeches have certain enzymes that help to liquify and dissolve the substances and also have anti-biotic, anti-microbial and anti-inflammatory substances that relieve the person from sinusitis," said Dr Nasir Hakeem, program incharge of leech therapy.

The hospitals using leeches for treatment follow the traditional Unani system of medicine.

The application of medicinal leech 'Hirudo medicinalis' for clearing poison from body has been practiced for long. In fact they have been used in medicine for thousands of years and is believed to have been in fashion in Egypt around 2,500 years ago.

Leech therapy was commonly used in traditional medicine for treating localized pain.

According to medical experts, more than 100 bioactive substances are present in the saliva of a leech that goes into the body of a patient while impure blood is extracted.

Earlier, people used to practice the traditional method on roadside or near shrines. And, traditional leech workers used leaches on multiple patients, thus, increasing the risk of transferable diseases.

But to avoid transmittable diseases, hospitals have adopted the single usage of a leech during the treatment. After a leech is used on any human, it is then killed as a part of the measures to prevent it from passing the infection from one patient to another.

A growing number of patients are showing interest, as they find the treatment in hospitals effective, hygienic and clean.

"I had a lot of pimples on my face but they have reduced now after I started undergoing leech therapy. It's very safe here in the hospitals. It is a kind of therapy where leeches purify the blood and we don't need any medicines for the treatment," said Faizaan Bhat, one patient.

"The leeches are found more during winters. It is a traditional form of therapy. Earlier people used to go to places like Hazrat Bal where they used to collect leaches in a pot. But here in the hospitals, everything is more hygienic," said Ajaz Ahmed, patient.

The medicinal leeches are brown, red striped and olive coloured. The creatures have two suckers, one at each end and have three jaws.

Leech species are carnivorous and the ones, which are predatory, feed on invertebrates like worms and snails. But a few of them are blood sucking and feed on vertebrates like reptiles and mammals.

Patients who have not been cured through conventional medicine are the ones who mostly come forward for the therapy.

It costs rupees 50 per leech used for treatment apart from other charges at the hospitals in Kashmir. (ANI)

Korea: Some Docs Latching Onto Leeches

By JOOHEE CHO
March 4, 2008


SEOUL — For seven years, Duck-Im Kim and her family tried everything they could to cure a rare skin disease called purpura — a red or purple discoloration that some doctors believe is caused by bleeding underneath the skin.

"My legs started to swell one day," Kim, 48, recalls. "And then it got red, really red … all over, and lasted for weeks, sometimes months."

Besides the pain, Kim says she was too embarrassed to go out in public. It eventually led her into serious depression.

There is no definitive cause or cure known in modern medicine for purpura. Combined with inflammation, the hemorrhagic area begins with red spots, becomes darker into purple, and later fades away to a brownish-yellow color.

But now Kim is looking to another, less conventional method that she hopes will help treat her condition.

"When I was just about to give up, I learned through the Internet that making leeches to suck my blood could help," says Kim, as she sits in a waiting room in Handongha Traditional Korean Medical Clinic, in Seoul. "Disgusting, yes, but being desperate I had no other options left."

Dr. Dong-Ha Han — nicknamed "doctor leech" for his eight years of research on medical leeches — says he can treat patients with vasculitis, skin ulcer, atopic dermatitis, rheumatic arthritis, migraine and gout. His toolbox includes leeches that are starved for six months.

"The theory is you make them bite and suck clotted blood vessels, allowing fresh blood to circulate," Han explains, while holding a plastic container filled with inch-long leeches. The secret, he says, is in an enzyme known as Hirudin, a very powerful anti-coagulant in leech saliva.

The leeches are taken out of the container into a glass tube with which they can be slid onto the area of infection. Kim is now undergoing her fifth session of the treatment, which costs $220 per visit.

She flinches for a moment as the leech bites in.

"It feels like a needle poking, but the pain soon goes away," she sighs in relief. That's because leeches secrete local anesthetic enzymes naturally to avoid detection by the host.

Once attached, the leeches will suck blood from 30 to 50 minutes. From about an inch long, they will become more than three times that size. After completely feeding itself, the leech falls off and fresh blood continues to drip from that spot for a minute or two.

In this session, Kim has a total of 19 leeches attached on both her legs. During the therapy, swelling has been visibly reduced.

"The healing process allows fresh and oxygenated blood to stream into her infected area," Han explains. "That way, it would restore normal circulation."

Kim nods in approval. "It's gruesome at first. But I couldn't believe it when I saw the results."

Ancient Therapy Meets Modern Medicine

Leech therapy dates back 2,500 years to ancient Egypt, where bloodletting was practiced in the belief that it would bring balance to the human body.

Bloodletting continued on to medieval Europe, where doctors used leeches to treat tonsillitis by hanging a leech on a string and inserting it down the patient's throat. The treatment was so popular that commercial leech trading became an industry.

But supply could not keep up with extremely high demand, which led to near-extinction of the leeches used in the practice.

In Korea, leech therapy began 500 years ago. But according to Han, up until now modern medicine had largely disregarded treatments using the creatures. Now, however, he says the technique is slowly making a comeback. Indeed, many doctors are now using leeches to help restore circulation after microsurgery on ears or fingers.

"In Europe, especially in Germany, the leech therapy is widely used in modern western medical practice," said Dr. Byung-Kee Han, a plastic surgeon at Bundang Cha Hospital. But he adds that the fact that the therapy is not covered by insurance in Korea makes it a pricey option.

"There's a big market out there, but the therapy is not cost-effective, at least in Korea," he says.

(http://abcnews.go.com/Health/PainManagement/story?id=4379952&page=1)

Saturday, October 11, 2008

Leech saliva drug could cut heart attacks by a third

By Celia Hall, Medical Editor
Last Updated: 9:55PM BST 02 Sep 2001


A DRUG derived from the saliva of leeches can reduce the risk of a repeat heart attack by a third, according to the results of an international study released yesterday.

Two centuries after the medical leech had its heyday in Western medicine, blood-thinning properties of the leech's saliva have been found to be more effective than another drug commonly used for heart attack patients.

Bivalirudin, a new, genetically engineered form of hirudin, the substance in the leech's saliva that stops blood clotting, was used in an international trial involving 17,000 patients, including 225 patients from Nottingham. It was compared with heparin, another blood-thinning agent.

Prof Harvey White, of Green Lane Hospital, Aukland, New Zealand, who led the study, told a briefing at the European Society of Cardiology meeting in Stockholm yesterday that the results confirmed the effectiveness of a new range of heart drugs.

Heart attacks are caused when a blood clot blocks the supply of blood to the heart. Untreated, the heart muscle is starved of oxygen and muscle cells begin to die. Heart attack patients are now routinely treated with a blood-thinning drug - in Britain this is usually aspirin - and clot-dissolving drugs.

About one patient in every 20 who has a heart attack has another shortly afterwards. Researchers are constantly seeking better drugs to stop repeat attacks which weaken the heart further, risk death and reduce the chances of a good recovery.

Prof White said they had found that bivalirudin was 30 per cent more effective than heparin in preventing a repeat attack. For every 1,000 patients treated with bivalirudin within 30 days of their heart attack, eight fewer subsequent heart attacks were recorded than among those treated with heparin.

Prof Sir Charles George, of the British Heart Foundation, said yesterday that studies had increasingly shown that combined therapy after a heart attack was better than a single drug in preventing another attack.

Dr Eric Topol, chairman of cardiovascular medicine at the Cleveland Clinic, Ohio, said: "The results of this trial are momentous. This is an important drug in the treatment of heart attacks."

Leeches were widely used in the 19th century to let blood, though belief in their ability to purge unhealthy "humours" goes back to medieval medicine.

During blood letting, dozens of leeches were sometimes applied to a patient resulting in blood loss of up to 80 per cent. More recently leeches have been used to drain blood from bruising and inflammation. They are also sometimes used in plastic surgery.

Tuesday, October 7, 2008

Leech Therapy

They bite, slither, and slide -- and they save fingers and lives.

While the sight of a wriggling, blood-sucking leech may make many people feel queasy, the spineless worms can also help people feel better -- as NATURE's BLOODY SUCKERS shows. The ancient physician's art of using leeches has made a modern medical comeback: the worms help doctors do everything from reattach severed fingers to treat potentially fatal circulation disorders.

Leeches -- which are found all over the world, living mostly in fresh water -- have long had a place in the doctor's medical kit. Five thousand years ago, Egyptian medics believed that letting a leech sip a sick patient's blood could help cure everything from fevers to flatulence. And in medieval Europe, leeches were so closely associated with doctors that physicians were called "leeches" -- and they used millions of the parasites annually to treat patients.

In the 20th century, however, most doctors turned away from the worms, which in nature feed on everything from frogs to alligators. A few physicians, however, saw that leeches might play a special role in certain kinds of surgery, by helping promote blood flow to damaged tissue. That's because when leeches bite a victim, their unique saliva causes blood flow to increase and prevents clotting. As a result, once bitten, victims can bleed for hours, allowing oxygenated blood to enter the wound area until veins re-grow and regain circulation.

The leech is invaluable in microsurgery when faced with the difficulties of reattaching minute veins. Ears have such tiny veins that, in the past, no one was able to successfully reattach them. Then, in 1985, a Harvard physician was having great difficulty in reattaching the ear of a five-year-old child; the tiny veins kept clotting. He decided to use leeches and the ear was saved. This success established leeches in the modern medical world. Since then, leeches have saved lives and limbs, reducing severe and dangerous venous engorgement post-surgery in fingers, toes, ear, and scalp reattachments; limb transplants; skin flap surgery; and breast reconstruction.

Perhaps the best known advocate of medical leeches is Roy Sawyer, an American researcher. Several decades ago, he recognized the potential benefits of "leech therapy" and started one of the world's first modern leech farms. Today, the company -- Biopharm, based in Britain -- provides tens of thousands of leeches every year to hospitals in dozens of countries. Two species are commonly used in leech therapy, which can last for up to 10 days.

Leeches can help promote blood flow to damaged tissue.

Leeches do have their downsides. Sometimes, they slip off patients and reattach themselves in unwanted places. And no matter how helpful, some patients simply can't stomach the thought of a blood-sucking parasite burrowing into their skin. So some scientists have developed a "mechanical leech" that can perform some of the same duties -- without the gross-out factor.

"In the case of the leech in medicine, we think we can improve on nature," says Nadine Connor, a University of Wisconsin at Madison scientist who in 2001 helped develop the mechanical leech. The device, which looks a little like a small bottle attached to a suction cup, delivers an anti-clotting drug to damaged tissue and then gently sucks out as much blood as needed. And, unlike real leeches, the mechanical version is insatiable and can remove as much blood as doctors think is necessary (real leeches drop off when engorged with blood).

"But perhaps the mechanical device's biggest advantage is that it is not a leech," says Connor. "People don't want this disgusting organism hanging on their body. This added psychological stress for both patient and family members compounds an already difficult situation."

Other physicians, however, still swear by the natural wrigglers. Leeches, they say, are a nearly perfect -- and self-reproducing -- surgical tool. And the leech's bite, they add, isn't nearly as bad as its reputation.

Friday, October 3, 2008

Leeches offer vein hope

Thursday, 24 September, 1998

Leeches have been used successfully to treat varicose veins. New Scientist reports that doctors in India have used the blood-sucking worms to cure the leg ulcers and swelling that result from the condition. The doctors, at the KEM Hospital and Seth Medical College in Bombay, used the treatment on 20 patients.

Clinical trial success

They said it cured ulcers in all the patients and reduced serious swelling in 18 of them. The researchers said that the treatment works because blood in veins has had the oxygen removed. Leeches prefer this venous blood to the oxygen-rich blood carried in arteries, they said. Varicose veins are veins that have been stretched and grow out of proportion to the blood they have to carry.

Malfunctioning veins

The condition, which affects about two-thirds of adults in the UK, occurs when valves in the veins malfunction. Conventional treatment involves surgery to remove the problematic vein or else injections of a substance that causes the vein to scar and close. Sometimes both treatments will be used. Leeches have been making a comeback in the medical world of late. Research in the US recently showed that a chemical derived from the creatures could help reduce deaths and heart attacks in people suffering coronary heart disease.

Multipurpose bloodsuckers

Leeches are particularly useful in plastic surgery, such as breast reconstruction and where a part of the body has become severed and had to be sewn back on. Sometimes, the patient's veins are too weak to carry blood and it builds up, causing "venous congestion". Attaching leeches to the body draws the blood away gradually and painlessly since leech saliva contains an anaesthetic. Leeches were widely used up until this century for many medical conditions, including tonsillitis and piles.

Doctors say they fell out of use because they were being applied too much and in the wrong way.
But leeches are becoming big business as doctors go back to their roots. Biopharm, a leech farm in Wales, provides the NHS with 15,000 leeches a year and ships another 15,000 around the world. Marian Bower, the farm's manager said business is booming. "We started as a small company in Wales. Now we have distribution offices around the world and are about to open another in South Africa," she said.

(http://news.bbc.co.uk/1/hi/health/179227.stm)

Leech Therapy

Thursday January 22, 2004

A study published in the Annals of Internal Medicine journal suggests that leeches may relieve pain better than topical anti-inflammatory treatments. Patients in the study were required to allow the blood sucking leeches to be attached to the ailing area 70 minutes a day for up to 90 days.

http://biology.about.com/b/2004/01/22/leech-therapy.htm

Leech Treatment: MOUTH

Clinical Policy Bulletin: Medicinal Leech Therapy

Policy Number: 0556

Aetna considers medicinal leech (Hirudo medicinalis) therapy medically necessary for any of the following conditions:
  • Poor venous drainage (venous congestion/venous outflow obstruction); or
  • Salvage of vascularly compromised flaps (muscle, skin, and fat tissue surgically removed from one part of body to another); or
  • Salvage of vascularly compromised replants (limbs or other body parts re-attached after traumatic amputation).
Aetna considers medicinal leech therapy experimental and investigational for treating knee osteoarthritis, inadequate arterial supply or tissue ischemia, and for all other indications.


Background

The medicinal leech, Hirudo medicinalis, has been used increasingly for relief of venous congestion, especially for salvage of compromised pedicled flaps and microvascular free-tissue transfer, digital re-implantation, and breast reconstruction. Leech therapy for compromised flaps is best used early since flaps demonstrate significantly decreased survival after 3 hours if venous congestion is not relieved. If venous pooling occurs around a flap or replant, the skin becomes cyanotic, cool, and hard. If capillary refill time (CRT) remains more than 3 seconds the flap or replant will not survive. The objective of leech therapy is for the affected area to become pink and warm, with a CRT of less than 2 seconds.

When leeches begin feeding, they inject salivary components (e.g., hirudin) that inhibit both platelet aggregation and the coagulation cascade. This results in a marked relief of venous congestion. The anti-coagulant causes the bite to ooze for up to 48 hours following detachment, further relieving venous congestion. By feeding for 10 to 60 minutes, leeches consume from 1 to 2 teaspoons of blood. Results from clinical studies showed that the success rate of salvaging tissue with medicinal leech therapy is 70 to 80%. On June 28, 2004, the Food and Drug Administration (FDA) had for the first time cleared the commercial marketing of leeches for medicinal purposes (in skin grafts and reattachment surgery).

Recently, leech therapy has also been suggested to be an effective treatment for rapid reduction of pain associated with osteoarthritis of the knee (Michalsen, et al., 2002). However, its effectiveness in treating osteoarthritis (OA) of the knee needs to be validated in larger randomized controlled studies. In a follow-up randomized controlled study, Michalsen, et al. (2003) evaluated the effectiveness of leech therapy for symptomatic relief of patients with OA of the knee (n = 51). Patients received a single treatment with 4 to 6 locally applied leeches (leech therapy group) or a 28-day topical diclofenac regimen (control group). The primary end point, pain at day 7, was reduced from a mean (+/-SD) of 53.5 +/- 13.7 to 19.3 +/- 12.2 after leech therapy compared with 51.5 +/- 16.8 to 42.4 +/- 19.7 with topical diclofenac. Although the difference between group pain scores was no longer significant after day 7, differences for function, stiffness, and total symptoms remained significant in favor of leech therapy until the end of study and for quality of life until day 28. The authors concluded that leech therapy helps relieve symptoms in patients with OA of the knee. The potential of leech therapy for treating OA and the pharmacological properties of leech saliva remain to be clarified.

In an editorial that accompanied the article by Michalsen, et al., Hochberg (2003) discussed some of the drawbacks of this paper. A lack of blinding of the patients as well as the researchers is a major pitfall because it raises concerns regarding measurement bias, especially since the outcome measures were all subjective. Also, 7 days is a short time frame for measuring the primary outcome measure since OA is a chronic condition. Furthermore, patients in both groups seldom used rescue therapy, suggesting that, despite the observed significant differences in pain scores at day 7, both groups may have been satisfied with their responses to study interventions. Thus, it is still unclear whether leech therapy is effective in treating knee pain in patients with OA.

Medicinal leech therapy is usually carried out for 4 to 5 days for patients with replant; it may be performed for 6 to 10 days for patients with compromised flaps.

A complication of leech therapy is the risk of infection; thus, it is recommended that therapy not be used in the presence of non-viable tissue.

Patients with HIV infection, or individuals taking immunosuppressive medications should not undergo leech therapy because of the risk of overwhelming bacterial sepsis.

The above policy is based on the following references:
  • Voge C, Lehnherr SM. Leeches. Nursing. 1999;29(11):46-47.
  • Utley DS, Koch RJ, Goode RL. The failing flap in facial plastic and reconstructive surgery: Role of the medicinal leech. Laryngoscope. 1998;108(8 Pt 1):1129-1135.
  • de Chalain TM. Exploring the use of the medicinal leech: A clinical risk-benefit analysis. J Reconstr Microsurg. 1996;12(3):165-172.
  • Haycox C, Odland PB, Coltrera MD, Raugi GJ. Indications and complications of medicinal leech therapy. J Am Acad Dermatol. 1995;33(6):1053-1055.
  • Michalsen A, Moebus S, Spahn G, et al. Leech therapy for symptomatic treatment of knee osteoarthritis: Results and implications of a pilot study. Altern Ther Health Med. 2002;8(5):84-88.
  • Michalsen A, Klotz S, Ludtke R, et al. Effectiveness of leech therapy in osteoarthritis of the knee: A randomized, controlled trial. Ann Intern Med. 2003;139(9):724-730.
  • Hochberg MC. Multidisciplinary integrative approach to treating knee pain in patients with osteoarthritis. Ann Intern Med. 2003;139(9):781-783.
  • U.S. Food and Drug Administration (FDA). FDA clears medicinal leeches for marketing. FDA Talk Paper. T04-19. Rockville, MD: FDA; June 28, 2004. Available at: http://www.fda.gov/bbs/topics/answers/2004/ANS01294.html. Accessed June 30, 2004.
  • Frodel JL Jr, Barth P, Wagner J. Salvage of partial facial soft tissue avulsions with medicinal leeches. Otolaryngol Head Neck Surg. 2004;131(6):934-939.
  • Whitaker IS, Cheung CK, Chahal CA, et al. By what mechanism do leeches help to salvage ischaemic tissues? A review. Br J Oral Maxillofac Surg. 2005;43(2):155-160.
  • Durrant C, Townley WA, Ramkumar S, Khoo CT. Forgotten digital tourniquet: Salvage of an ischaemic finger by application of medicinal leeches. Ann R Coll Surg Engl. 2006;88(5):462-464.
  • Knobloch K, Gohritz A, Busch K, et al. Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review. Handchir Mikrochir Plast Chir. 2007;39(2):103-107.
(Source: http://www.aetna.com/cpb/medical/data/500_599/0556.html)

Sunday, September 28, 2008

Isolation of thrombin inhibitor from the leech Hirudinaria Manillensis (Asian Leech)

Division of Biotechnology,
PHLS Centre for Applied Microbiology and Research,
Porton Down, Salisbury, UK.


The leech Hirudinaria manillensis belongs to the same family as the medicinal leech Hirudo medicinalis, which has been widely used for the study of hirudin, a specific thrombin inhibitor. A similar inhibitor has now been isolated from the heads of the Hirudinaria leech by acetone/acid extraction and further purified to near homogeneity by ion exchange chromatography followed by affinity chromatography on thrombin-agarose and reverse phase HPLC. The purified material was recovered at about 10-15% yield and had a specific activity of about 12,000-14,000 ATU/mg, similar to other hirudin variants. The inhibitor was shown to be homogenous by sodium dodecyl sulphate/polyacrylamide gel electrophoresis in the presence of 8 M urea with an apparent molecular mass of about 7000 daltons under reducing conditions. Comparison of the anticoagulant effect on human plasma by partial thromboplastin time assay have shown that the inhibitor from Hirudinaria has similar potency as hirudin variant 1 at equivalent dosage. However, it does not cross-react with monoclonal antibodies towards recombinant hirudin variant 1. Comparison of the N-terminal amino acid sequence up to residue 25 also indicates differences at positions 2, 13, 17 and 24 between the two thrombin inhibitors. These findings indicate that the primary anticoagulant present in the leech Hirudinaria is a potent thrombin inhibitor (Bufrudin) with biological activity similar to hirudin, but differs in its structural and immunological properties.

(http://www.ncbi.nlm.nih.gov/pubmed/1773002)

Leech Documentary : Malaysia

Majalah 3 - Documentary



Lain Dari Yang Lain - Documentary



Malaysia Hari Ini - Documentary



Saturday, September 27, 2008

Leeches: The Fact Sheet

Biology

Leeches are annelids or segmented worms, and although closely related to the earthworms, are anatomically and behaviourally more specialised.

The bodies of all leeches are divided into the same number of segments (34), with a powerful clinging sucker at each end (although the anterior, or front sucker can be very small). Body shape is variable, but to some extent depends on the degree to which their highly muscular bodies are contracted. The mouth is in the anterior sucker and the anus is on the dorsal surface (top) just in front of the rear sucker.

Leeches usually have three jaws and make a Y-shaped incision. The Australian land leech has only two jaws and makes a V-shaped incision. Australian leeches can vary in size from about 7 mm long to as much as 200 mm when extended.

Different Types

Leeches are grouped according to the different ways they feed. One group (the jawed leeches or Gnatbobdellida) have jaws armed with teeth with which they bite the host. The blood is prevented from clotting by production of a non-enzymatic secretion called hirudin. The land leech commonly encountered by bushwalkers is included in this group.

A second group (the jawless leeches or Rhyncobdellida) insert a needle-like protrusion called a proboscis into the body of the host and secrete an enzyme, hemetin which dissolves clots once they have formed. Leeches which live on body fluids of worms and small freshwater snails possess such an apparatus.

A third group, (the worm leeches or Pharyngobdellida) have no jaws or teeth and swallow the prey whole. Its food consists of small invertebrates.

Respiration

Respiration takes place through the body wall, and a slow undulating movement observed in some leeches is said to assist gaseous exchange. Aquatic leeches tend to move to the surface when they find themselves in water of low oxygen content. As a fall in atmospheric pressure results in a small decrease in dissolved oxygen concentrations, rising leeches in a jar of water provided nineteenth century weather forecasters with a simple way of predicting bad weather.

Sense Organs

Sensory organs on the head and body surface enable a leech to detect changes in light intensity, temperature, and vibration. Chemical receptors on the head provide a sense of smell and there may be one or more pairs of eyes. The number of eyes and their arrangement can be of some use in Identification, however to properly identify a leech, dissection is required.

The Rhyncobdellids are capable of dramatic colour changes, and although not an attempt at camouflage, the significance of this behaviour is unknown.

Reproduction

As hermaphrodites, leeches have both male and female sex organs. Like the earthworms they also have a clitellum, a region of thickened skin which is only obvious during the reproductive period. Mating involves the intertwining of bodies where each deposits sperm in the others' clitellar area. Rhyncobdellids have no penis but produce sharp packages of sperm which are forced through the body wall.

The sperm then make their way to the ovaries where fertilisation takes place. The clitellum secretes a tough gelatinous cocoon which contains nutrients, and it is in this that the eggs are deposited.

The leech shrugs itself free of the cocoon, sealing it as it passes over the head.

The cocoon is either buried or attached to a rock, log or leaf and dries to a foamy crust. After several weeks or months, the young emerge as miniature adults. Studies show that the cocoons are capable of surviving the digestive system of a duck. Leeches die after one or two bouts of reproduction.

Feeding

Most leeches are sanguivorous, that is they feed as blood sucking parasites on preferred hosts. If the preferred food is not available most leeches will feed on other classes of host. Some feed on the blood of humans and other mammals, while others parasitise fish, frogs, turtles or birds. Some leeches will even take a meal from other sanguivorous leeches which may die after the attack.

Sanguivorous leeches can ingest several times their own weight in blood at one meal. After feeding the leech retires to a dark spot to digest its meal. Digestion is slow and this enables the leech to survive during very long fasting periods (up to several months).
Foraging - How does a leech go about searching for a blood meal?

A hungry leech is very responsive to light and mechanical stimuli. It tends to change position frequently, and explore by head movement and body waving. It also assumes an alert posture, extending to full length and remaining motionless. This is thought to maximise the function of the sensory structures in the skin.

In response to disturbances by an approaching host, the leech will commence "inchworm crawling", continuing in a trial and error way until the anterior sucker touches the host and attaches. Aquatic leeches are more likely to display this "pursuit" behaviour, while common land leeches often accidentally attach to a host.

The Bite

When a jawed leech bites it holds the sucker in place by making its body rigid. Using its semi circular and many toothed jaws like minute saws, it then makes an incision in the skin and excretes a mucous from the nephropores (external openings from the kidney-like organs). This helps the sucker to adhere. A salivary secretion containing the anticoagulant and a histamine floods the wound and the leech relaxes its body to allow the blood to be ingested. This mixture allows the blood to flow and also prevents clotting once inside the leech. A bacterium in the gut of the leech assists the digestion of the blood, and it has been shown that the type of bacterium varies with the type of host on which the leech feeds. The bacterium also prevents growth of other bacteria which may cause the ingested blood to putrefy.

Habitat

Most leeches are freshwater animals, but many terrestrial and marine species occur.

Land leeches are common on the ground or in low foliage in wet rain forests. In drier forests they may be found on the ground in seepage moistened places. Most do not enter water and cannot swim, but can survive periods of immersion.

In dry weather, some species burrow in the soil where they can survive for many months even in a total lack of environmental water. In these conditions the body is contracted dry and rigid, the suckers not distinguishable, and the skin completely dry. Within ten minutes of sprinkling with a few drops of water, these leeches emerge, fully active.

Freshwater leeches prefer to live in still or slowly flowing waters, but specimens have been collected from fast flowing streams.

Some species are considered amphibious as they have been observed in both terrestrial and aquatic habitats.

Uses in Medicine

For over 2000 years, leeches were needlessly applied for many ailments as an adjunct to blood letting. Their use in Europe peaked between 1830 and 1850, but subsequent shortages led to a decline in their use. Today there is a real clinical application in that they are of great value to plastic surgeons when venous congestion of skin and muscle flaps is a problem.

Leeches are treated in the same way as blood products and are reused only on the same patient.

Medical use of leeches also includes treatment of black eyes, and hirudin is used in the treatment of inflammation of the middle ear. Hirudin is also being developed for experimental use as a systemic anticoagulant, and may prove useful in invitro blood sampling.

Repellents

The most common enquiry regarding leeches concerns repellents. It is unknown whether a specific preparation is commercially available but there is a plethora of tried and tested, but unproven leech-protection ideas. These include a lather of bath soap smeared on exposed parts and left to dry, applications of eucalyptus oil, tropical strength insect repellent, lemon juice and impenetrable barriers of socks and pantyhose.

The Wound

The presence of hirudin in the wound following a leech bite may cause oozing to continue for several hours. Although inconvenient, blood loss is not significant.

Gut bacteria can cause wound infection. In the post-operative use of leeches this is closely monitored and dealt with by use of the appropriate antibiotic.

There may also be a delayed irritation and itching after a bite. There appears to be no support for the theory that mouthparts left behind after forced removal of the leech causes this reaction.

Can leeches transmit disease? There is no evidence to suggest that they do. The presence of trypanosomes, (malarial parasites), in the gut of jawless leeches has been noted, but jawed leeches do not appear to be hosts.

Allergy to leech bite has been reported. Medical opinion should be sought, depending on the severity of the reaction.

References
Mann, K.H. 1962. Leeches (Hirudinea) Their structure, Physiology, Ecology and Embryology. Pergamon Press Ltd
Williams, W.D.Australian Freshwater Life. Globe Press
Sawe, R.T. Leech Biology & Behaviour (reprint). Neurobiology of the Leech, 1981. Cola Spring Harbour Laboratory
Seliznev, K.G. et al. Use of the medicinal Leech in the treatment of ear diseases. Relat. Spec. (Switz) 1992 54 (1) 1-4
Wills, M.D. et al. The Medicinal Leech: an old treatment revisited. Microsurgery (US) 1993 14 (3) 183-6
Richardson, L.R. Observations on the Australian Land Leech, Chtonobdella Libbata (Grube, 1866). Aust. Zoologist V. XIV (3) 1968
Davies, R.W., Linton, L.R., Wrona, F.J. Passive dispersal of Four Species of Freshwater Leeches (Hirudinoidea) by ducks. Freshwater Invertebrate Biol. 1982 1(4) 40-44
Richardson, L.R. Trypanosomes in the crop of an Haemadipsid leech. 1968 Aust. Journal of Sci. vol 30 (9)

http://www.amonline.net.au/factsheets/leeches.htm

When modern medicine needs some help, surgeons call in mother nature's little helper - the leech

by Jack McClintock, Photography by Elinor Carucci
published online December 1, 2001
http://discovermagazine.com/2001/dec/featblood

"I was scalped by a box-making machine," says Christine Lippincott. She was working in a factory in Greensboro, North Carolina, and her attention wandered. "It caught my hair from behind and ripped it right off in a second, from the back of my neck to my eyebrows." Gushing blood, Lippincott fainted. Coworkers carefully extricated her scalp from the box machine, packed it in ice, and rushed it and her to the local hospital. A helicopter took her to Duke University Medical Center in Durham, where plastic surgeon L. Scott Levin sewed her scalp back on, meticulously reconnecting its blood supply in a six-hour operation.

But the crisis wasn't over. Levin could see that blood was flowing through the reattached arteries into Lippincott's replanted scalp. But it wasn't flowing out very well through her veins, which are vulnerable to clots and increased pressure. So Levin did what many up-to-date surgeons would do: He applied leeches.

"I had them on my neck and the back of my head," says Lippincott, who is 25. "There was a bucket of them in the room with me. Blood was pouring out of my scalp 24 hours a day for a week."

But that was the point. Bloodsucking worms maintained her circulation and probably saved her scalp. "It's a time-honored method that works extremely well in the right patients, the right clinical situation, the right application. It's a living drug therapy," says Levin, chief of plastic surgery and professor of orthopedic and plastic surgery at Duke's medical center.

Leeches aren't a surgeon's first option, of course. Other methods are tried first—trying to connect as many small veins as possible, redoing the surgery and, when a finger or toe is involved, removing the nail, scoring the nail bed with a scalpel, and putting the patient on heparin, an anticoagulant. But sometimes only a leech will do. That was the case with Lippincott. "If we hadn't done it," Levin says, "her replant might well have failed for lack of venous outflow."

The leech's peculiar talent is to create a wound that bleeds for hours. Substances in its saliva anesthetize the wound, prevent clotting, and dilate vessels to increase blood flow. Using them in surgery is simple: Poke the warm, blue, swollen, congested skin with a needle to start the flow of inviting, clot-dark blood. Apply a leech, and the voracious worm, having been stored unfed, will saw through the skin with the 300 teeth in its tripartite jaws. Its sucking mouth will draw out congested blood and maintain circulation until the patient's body creates new blood-flow channels. And when the leech has fed for 20 minutes to an hour, taken 15 to 30 milliliters of blood, and dropped off sated, its anticoagulant assures that the wound will ooze for 10 hours more. In Lippincott's case, Levin applied 30 to 40 leeches over six days.

Hirudo medicinalis, the European medicinal leech, is a four-inch-long carnivorous, hermaphroditic, segmented worm with a sucker on each end, five pairs of eyes, and 32 nerve bundles, or "brains," in the middle. It is one of 650 leech species and is found mostly in ponds and bogs. Some species are highly specialized—one, in fact, feeds only on earthworms. Another feeds on fish in freezing polar seas. One dwells in the nostrils of Saharan camels, another inside the rectum of the African hippopotamus. Another lives in New Guinea caves and sucks the blood of bats. Still another, the anaconda of leeches, inhabits the Amazon basin and grows up to 18 inches long.

For well over 2,000 years, humans have employed Hirudo for bloodletting, a practice thought to restore balance to the body's humors and heal everything from headaches to hemorrhoids. Leeches were so entwined with medicine that the words leech and doctor were synonymous in Anglo-Saxon English, and by the mid-19th century they had become the aspirin of their day—apply two leeches and call me in the morning. A French physician working in the early 19th century, François-Joseph-Victor Broussais, is said to have prescribed as many as 30 leeches at a time before he even saw his patients.

As medical science advanced, leeching died out, but with the advent of microvascular surgery and tissue transfer, surgeons rediscovered the creature's value. Two Slovenian surgeons pioneered modern medical leeching in the 1960s, describing how the worms assisted them in a tissue-flap transplantation. Then, in 1985, Harvard plastic surgeon Joseph Upton was called to care for a 5-year-old boy whose ear had been bitten off by a dog. Ears, which have very small blood vessels, had never been successfully replanted. Upton had no trouble with the boy's arteries, but as he worked through the night reconnecting the veins, clots began to form.

Upton had used maggots to clean severe infections while serving in the Army, so the idea of a natural remedy came easily to him. He phoned Biopharm, a company in Swansea, Wales, owned by zoologist Roy T. Sawyer, who breeds Hirudo on the world's only leech farm. A box of leeches arrived overnight, and the boy's ear was saved. When Upton published his results in the journal Plastic and Reconstructive Surgery, leech sales soared. Nine years later, in a memorably bizarre case, leeches saved a life. During an operation for congenital facial abnormalities, an 8-year-old Dutch boy developed swelling so severe that his tongue filled with blood and protruded from his mouth, blocking his airway. Steroids and antibiotics didn't help. But six hours and 27 leeches later, the boy was out of danger, and leeches had been firmly reestablished as good medical science.

Nobody knows how many lives, limbs, and appendages they have saved, but medical literature describes leeches being used to relieve severe postsurgical venous congestion after finger, toe, ear, and scalp replantation and penile surgery, after skin-flap plastic surgery, and to relieve engorgement of the nipple following breast augmentation or reduction surgery. And the creatures have turned out to be miniature pharmaceutical factories—researchers have isolated a dozen compounds from leech saliva to prevent blood clots, treat inflammation, dilate blood vessels, kill bacteria, and relieve pain.

Carl Peters, the leech-growth technician at Biopharm, removes the muslin cover from a plastic bucket, and leeches crawl out. He pokes one. It creeps across a visitor's hand, humping along with the suckers at its head and foot and arching its back like a Halloween cat. The creature feels wet and cool, like a chilled strand of fettuccine. Every few seconds, it stands on its rear sucker and waves its head around ominously, as if searching for something, which is just what it's doing. It's out for blood.

"It's like a cross between a slimy slug and a Velcro barracuda," Peters says with a grin and a glance toward the movie poster on the wall for The African Queen. In the movie, Humphrey Bogart's character says: "If there's anything in the world I hate, it's leeches. Oh, the filthy little devils!" Peters has worked with them for nine years and has been bitten five times. He says it doesn't hurt, "but I don't think I'd like to be plastered with leeches."

n nature, the medicinal leech inhabits the wetter environments of western and southern Europe. Sensing the warmth, motion, or shadow of possible prey, the leech cozies up, attaches itself with its suckers, injects an anesthetic so that its presence is not detected, and goes to work. The three jaws of its head sucker stiffen, protrude, and slice into the prey's skin with a sawing motion. Immature leeches feed on the thin-skinned bodies of amphibians and young fish; mature leeches can move on to larger prey, such as cattle, horses, ducks, and humans. The leech's natural anticoagulant, hirudin, keeps blood flowing for the 20 to 40 minutes it takes to feed, during which time the leech's body weight may increase 10 times, reaching up to 60 grams (about two ounces). The secretions of one leech can prevent up to half a cup of blood from coagulating. Blood sucked into its crop can take 18 months to digest. During this time, the leech does little but lie around in a stupor, rousing itself only to reproduce. The hermaphroditic leech copulates on land, wrapping around its partner using a kind of mucus, and later secretes a cocoon, which it deposits in damp soil near the shoreline. Within two to four weeks, about 15 to 25 leeches hatch. Under the right conditions, a leech can produce up to 1,200 young in a five-year lifetime. At Biopharm, leeches feed on pig blood poured into an artificial membrane that simulates the skin of natural prey. After rearing the leeches for six months at 80 degrees Fahrenheit, Peters transfers them to a room chilled to a growth-slowing 45 degrees. They can live there for a year without food.

When leeches leave Biopharm—thousands a year—they are packed like Chinese takeout in little cardboard boxes. They go to such places as Carolina Biological Supply, in Burlington, North Carolina, where workers store them in buckets of icy spring water until a surgeon like Levin calls. "We maintain them so that when surgeons get one, it's a nice, clean, hungry leech," says Lawrence Wallace, the firm's director for live biological products. Hungry they are; sterile they are not. In the gut of every one, even those raised in sterile conditions, lives Aeromonas hydrophila, a bacterium that prevents putrefaction of the leech's blood meal and supplies enzymes crucial to its digestion. Studies have found that as many as 20 percent of leeched patients become infected by this bacterium, which increases the risk of serious wound infections. So preventive antibiotics are given to patients with weakened immune systems.

Aeromonas also kills other bacteria. Joerg Graf of the Institute for Infectious Diseases at the University of Bern, Switzerland, believes that a better understanding of Aeromonas could help researchers find a way to fight such bacteria as Staphylococcus aureus, which are becoming resistant to antibiotics. For some reason, staph cannot grow inside a leech. This may be the result of inhospitable conditions within the leech, says Graf, but it's also possible that Aeromonas produces something that inhibits staph growth. Finding such a substance could lead to a way of controlling staph growth in humans.

But leeches themselves may prove a direct source of antibiotics. Michel Salzet of the University of Science and Technology in Lille, France, has found infection-fighting peptides in leeches akin to those that have already been discovered in insects and other invertebrates. In leeches, these peptides are produced within 15 minutes of a bacterial infection. "These antimicrobial peptides diffuse quicker and easier than antibodies," he says, suggesting that such speed and potency might add up to a defense that can outbreed and outrun pathogens. "Antibacterial peptides from leeches may cure human diseases," Salzet says.

That wouldn't surprise Roy T. Sawyer. Courtly and soft-spoken, the North Carolinian escorts a visitor through his leech museum. It's a tidy room, bright and cheerful despite its display of bowls and knives for bleeding, leech jars with perforated lids, and oil paintings of patients with leeches stuck on their necks. He speaks of a "veritable pharmacy" of leech products, referring to potentially useful compounds he and his researchers have turned up. There's the enzyme orgelase, a "spreading factor" that quickly distributes chemicals in leech saliva around the wound. Sawyer believes it could help carry local anesthetic deep into tissues before surgery. And there's calin, which neutralizes the effects of collagen, a natural blood clotter. He calls it a "collagen-coating paint" that could help prevent blood clots following vascular surgery. Sawyer and others have isolated a dozen more active substances from Hirudo and nine other leech species. Among these is a local anesthetic that renders a leech bite painless. How it works is still not understood, and Sawyer has been unable to isolate the analgesic. "Common sense is telling me something is there. This is a potentially rich area," he says. Salzet, who recently found a morphinelike compound in Hirudo, agrees.

The anticoagulant extracted from leech saliva highlights the difficulties of developing drugs from the animal. In the marketplace, hirudin competes against heparin, which is easily derived from vertebrate immune cells and works with certain cofactors to inhibit thrombin, a clot-producing enzyme. Hirudin works more simply than heparin, binding directly to thrombin alone, but its dosage must be carefully measured to prevent excessive bleeding. Long-term studies of hirudin in humans have not been carried out, but a series of small studies suggests it may boost short-term heart attack survival by as much as 30 percent over heparin. Other studies suggest it may be more effective than heparin in reducing deep-vein clotting after hip surgery.

But to make enough hirudin from leeches for economical production, "you'd need a swimming pool of blood," says Maurice Moloney, professor of plant biotechnology at the University of Calgary in Alberta, Canada. So he tried another approach, altering Ethiopian brassica, a type of mustard, to contain the gene for hirudin. He planted five acres of the plant and produced 10 tons of seed, from which he extracted the drug.

Another candidate drug from leeches is hementin, derived from the 18-inch-long Amazon leech Haementaria ghilianii, which Sawyer brought back from French Guiana in 1977. He wondered if this leech, which lances large mammals with a six-inch-long proboscis, also produced anticoagulants to prolong its dinner. It did. But while hirudin prevents clot formation, hementin dissolves a particular kind of platelet-rich clot that can cause stroke and heart attack and against which clot busters like streptokinase and urokinase are ineffective. A German firm, says Sawyer, may decide to to clone the compound.

Other scientists are studying the leech's large, easily visible nerves. Figuring out how they work could help in promoting nerve regeneration in humans with spinal cord injuries. But the leech's future in science, like its past, will most likely stick close to its main interest: blood. "Secretions from bloodsucking animals could be to cardiovascular diseases what penicillin was to infectious disease in the past," Sawyer says. "Leeches are preadapted to human physiology. The secretions from their saliva cross the entire spectrum of physiology: blood clotting, digestion, connective tissue, disease, pain, inhibition of enzymes, anti-inflammation. You name it, the leech has it."

Leech Therapy

Leeches have been used in medicine for thousands of years. Leeches remove blood ("phlebotomize") from their host, and they release pain-killing (anesthetic) and blood-thining (anticoaggulant) substances with their saliva. Live leeches are currently used to treat blood-congested limbs, which otherwise might die or require amputation, if the pooling blood cannot be removed any other way. They are also sometimes used to provide pain relief, and for many other therapeutic effects.

History of Leech Therapy

Leech therapy has a long history. Records indicate that Egyptians used leech therapy 3,500 years ago. Leech treatments were very popular during the Middle Ages. Again leech therapy became was commonly practiced in the 1800's by American physicians treating a variety of diseases.

In the 1980, medicinal leech therapy got a big boost by plastic surgeons who used leeches to relieve venous congenstion, especially in transplant surgery. This use of leech therapy ("hirudotherapy") provides a good example of its current status. When appendages are re-attached following traumatic amputation, it is often possible to reconnect the largfer arterial blood vessels, but not the thinner, more delicate venous vessels. The body will eventually develop the necessary venous connections to drain the area of oxygen-depleted blood; but if this does not occur rapidly enough, the pooling venous blood can produce enough swelling and pressure that fresh arterial blood may no longer be able to enter the re-connected limb. In this situation, leeches are used to drain the local blood and decompress the pressure within the grafted limb, otherwise at risk of necrosis (death).

Today, Medicinal leeches are also used in the treatment of other veinous deseases such as thrombophlebitis, as well as angina pectoris, arthritis, hematomas, and even tinnitus.

Natural History of Leeches

The medicinal leech (Hirudo medicinalis) is a segmented worm (Phylum: Annelida). This phylum includes the Polychaetes, the Oligochaetes (earthworms) and the Hirudinea (leeches).

Leeches have two "suckers," one at each end. The caudal (back end) suction cup helps the leech to ambulate on dry surfaces, and to attach to its host; the rostral (front end) suction cup also contains the mouth with three sharp jaws that leave a Y-shaped bite.

The medicinal leech lives in clean waters. Leeches swim free in the water, with an undulating motion. When attached to its host for feeding, the leech remains in place for 30 minutes to 6 hours or more, as it fills with blood. During feeding, H. medicinalis can suck 5 - 15 mL of blood --- several times its own body weight.

Leech saliva contains several bioactive substances, including anti-cooaggulants, vaso-dilators, and anesthetics. Hirudin, a potent anticoagulant in leech saliva, inhibits the conversion of fibrinogen to fibrin, preventing blood from clotting. Indeed, a wound may continue to bleed for many hours after the leech has already detached.

The benefits of leech therapy are due, in large part, to the anti-coaggulant effects, vasodilatory effects, and anesthetic effects of these biochemicals, as well as the physical effects of blood letting (phlebotomy).

Like a snake, the leech periodically must shed its skin. The leech is hermaphtroditic, having both male and female elements. Fertilization and egg-laying usually occur during the spring, summer, and winter months. Young leeches feed on the blood of small water animals (frogs, toads or fish). Leeches may not be ready for medical application until they are several years old.

Clinical Practice of Leech Therapy

The application of leech therapy is simple: leeches are gently placed in the area needed, and allowed to attach and engorge for the next 6-12 hours, after which they will release. The entire course of treatment may require one to 6 treatments or more, depending upon the goals and rate of response.

For more details about the specific application procedures, readers are referred to the manufacturer's directions. A list of manufacturers can be found elsewhere on this site.

Leeches (Hirudo Medicinalis) have been used medically for more than 1500 years. Originally used to remove “bad blood,” the leech is now used extensively by reconstructive surgeons needing to remove stagnant blood from a flap or reattached limb. When the venous blood does not return to the heart, it pools in the wounded area, increasing pressure and preventing fresh arterial blood from entering the area with oxygen and nutrients. The venous blood must be removed and the pressure must be reduced in order to save the flap or limb. The leech is able to do this exceptionally well, because its saliva contains important biochemicals, including vasodilators, anticoagulants, and anesthetics.

The leech will withdraw approximately 5 ml (one teaspoon) of blood. Further therapeutic benefit of leech therapy comes after the leech is removed, during which up to 50 mls of blood will continue to ooze, for up to 48 hours. More leeches attached to the site mean more blood will be removed. After 3-7 days, the veins have usually reconnected themselves such that the blood is no longer pooling in the limb. Normal color and pressure should return to the area, as arterial blood circulates easily in the damaged zone. By that time, the wound will be able to heal, without further phlebotomy (leech therapy).

The application of leeches to the patient is relatively simple, but does require care. As few as one, or as many as 6 or more leeches may be required for a wound, depending upon its size and its clinical response. The greatest number of leeches should be applied to the area of maximal venous congestion.

The patient’s skin must be cleaned thoroughly with soap and water, and then rinsed with distilled, non-chlorinated water. A gauze barrier around the area intended for the leech will help prevent the leech from wandering away from the site where it’s attachment is desired. It can be carried to the site by hand, or it can be placed within a 5 cc plastic syringe (plunger removed) and then applied to the wound site, containing the leech until it is attached.

If the leech is reluctant to bite, it might be necessary to entice it with a tiny droplet of blood, drawn from the wound site with a needle prick.

Once the leech is attached, it will likely remain safely in place until fully distended. The gauze square can be removed and used elsewhere without disturbing the animal;however, it is important that the site be checked continuously to insure that the leech hasn't moved. The leech will let go of the patient (host) when it is finished (usually within an hour).

What's New in Leech Therapy

In June, 2004, the U.S. Food and Drug Administration cleared for medical leeches for marketting by Ricarimpex SAS, based in France.

http://www.bterfoundation.org/indexfiles/leechrx.htm