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Leeches are close relatives of earthworms that feed on animal or human blood. The medical leech (Hirudo medicinalis) is used for leech therapy. The animals are placed on the skin of the person to be treated. There the leech cuts a small wound in the skin with its sharp teeth, from which it then draws blood. The ingredients of his saliva get into the blood of humans.
The effect of this therapy is made up of various factors: For some diseases, it results from the fact that certain harmful substances leave the body as a result of the blood that is taken, or excessive blood levels are eliminated. For this reason, leech therapy has long been assigned exclusively to the so-called elimination procedures (also elimination procedures). In addition, however, the saliva of the leeches contains various active substances that penetrate the human body through the bite and become active there. Among other things, they have anticoagulant, blood circulation, antispasmodic, anti-inflammatory and analgesic properties.
Naturopathy uses leech therapy for, among other things, inflammatory or venous diseases, joint diseases, local infections and certain eye diseases. Conventional medicine is now counting on the help of leeches in plastic surgery and pain therapy.
Leech therapy - a brief overview
In the following section you will find the most important information about leech therapy in brief.
- description: Leeches are placed on a person's skin and suck their blood, while at the same time they release their saliva into the wound, which then enters the human bloodstream.
- effect: Leech saliva contains pain relieving and anti-inflammatory agents as well as substances that stimulate blood circulation and lymph flow, prevent the formation of blood clots or can dissolve existing clots. The blood loss during use also acts as a small bloodletting.
- application areas: Among other things, inflammatory and venous diseases, joint diseases, local infections, eye diseases, plastic surgery, pain therapy.
- possible side effects: Slight, burning pain at the start of treatment, discoloration of the edges of the bite for up to two weeks, itching in the first three days after therapy, bruising (hematoma) at the bite site, circulatory problems, swelling of the lymph nodes, scarring, prolonged bleeding, delayed wound healing, drop in blood pressure, allergic Reactions, local inflammation, infections.
- Contraindications: Physical weakness, anemia (anemia), blood clotting disorders, diseases in the arterial system, known allergy to the secretion of leeches, diabetes, autoimmune diseases, pregnancy. The therapy should also only be used in adults.
- Note: Leech therapy should only be carried out by experienced, trained therapists and only after prior medical advice. As part of the therapy, particular attention must be paid to compliance with the hygienic regulations.
History of leech therapy
There is various information about the origin of leech therapy. Some sources locate him in Mesopotamia around three thousand years before the birth of Christ, others name ancient Egypt as the country of origin or consider writings from India around 500 BC as the first documentation of this form of therapy. In any case, it can be assumed that the leech therapy is several thousand years old.
How healers originally came up with the use of leeches on humans is not documented. However, it is known that animals such as horses, water buffalos, cattle and sheep seek out puddles with leeches wherever possible and have them "treated" by them. It would be possible for people to observe the animals and draw conclusions about the healing properties of the leeches.
Around two hundred years before Christ, the Greeks Nikander and Colophon reported leech treatments in Europe for the first time. In the eighteenth century, leech therapy was very fashionable in France: around a hundred million leeches were used for treatments each year. At the time, this therapy method fell into disrepute because it was carried out frequently without taking the patient's initial situation into account; In addition, a much too large number of leeches was used, so that the blood loss was sometimes life-threatening. At the time, this method was also called "vampirism".
But since leech therapy has had many successes over the centuries, some researchers have tried to find out what the leeches might do. In fact, in 1884, John Berry Haycraft, a British physiologist, was able to prove that leech saliva contains medicinally effective ingredients. One of the most important is hirudin. This chemical compound has an anticoagulant effect on the blood, relieves vascular spasms and thus improves the flow properties of blood and lymph. Other substances were later detected, including Eglin and Bdellin. Both have an analgesic and anti-inflammatory effect.
It is now known that a total of around twenty active ingredients in leech saliva, all of them protein compounds, find their way into human blood when leech bites occur. So far, only a few of them have researched what these are and how they work.
Since it has been proven that leech therapy is based on scientifically plausible relationships, it has been making a "comeback" in recent decades and is now used not only in naturopathic practices, but also increasingly in various areas of conventional medicine.
What are leeches?
The word leech comes from the Greek word "echis" and means "little snake". There are more than six hundred flukes worldwide. The medical leech comes for leech therapy (Hirudo medicinalis) used, which is native to Europe, North Africa and Asia Minor. It usually has a brownish to olive-green color, a black-spotted belly and red stripes on the back. A full-grown specimen can reach a length of about fifteen centimeters and can live around thirty years in the wild.
The leech habitat is fresh water. Tactile organs on their skin surface tell them at a distance of several meters whether there is prey nearby. Once you've identified a prey, swim to it and suck yourself tight. They have three jaws, all of which have sharp teeth. Accordingly, their bite resembles a three-pointed star. A meal takes about thirty to sixty minutes. During this time, the leech can take up an amount of blood that is five times its own body weight. When saturation is reached, the leech falls off its prey. He can then survive for a year or two without eating again.
Due to the widespread use of leech therapy, the occurrence of wild leeches became smaller and smaller in the first half of the nineteenth century. Because the leeches were collected to always have enough supplies for the treatments. Since then, you can hardly find them in their natural habitat in Europe. Instead, they are bred for medical use in special farms. In order not to further decimate the wild occurrences, the leech in Germany and other European countries is protected and may only be collected with a special permit.
For medical needs, leeches can be ordered or purchased directly from breeders or from pharmacies. Strict requirements of the Medicinal Products Act stipulate that only leeches from regularly checked breeding institutions may be used. Certain rules must be followed when storing until the animals are used. These are usually supplied by the manufacturer or the pharmacy.
The leeches may only be used once for hygienic reasons and must then either be killed in a precisely prescribed manner (with the help of high-proof medical alcohol or by freezing) or returned to the breeding farms for a fee. There, after an eight-month quarantine period, they are converted into special "pensioners' ponds", where they can live until their natural death occurs.
At this point, we would like to urge all users of medical leeches to pay the slightly higher costs for returning the leeches so that these useful animals are thanked for their service to human health and they can continue to live! After all, the leech is a living being that should not be considered a one-off or disposable item. Killing the leeches after a single use to save costs is not ethically correct and should be avoided if possible. You can make an active contribution to animal welfare by ordering leeches only from breeding establishments that allow returns, always returning used leeches and, as a patient, only have your leech therapy carried out where you are certain that the animals will receive the treatment after treatment Find your way into a "pensioner's pond".
Effect of leech therapy
For a long time, the effect of leech therapy was only explained by the fact that the blood loss had a cleansing effect because the body had to replace the lost blood with freshly formed blood. Due to the blood loss during such therapy, toxins that are actually present in the blood are excreted in small amounts and the use acts like a “mini-bloodletting” (more information on the method of bloodletting can be found in the link collection at the end of this article). This mode of action also applies to some diseases, but that's not all.
Later research has shown that the saliva of the leeches contains a veritable cocktail of medically effective substances. These alone or as a mixture can have a positive effect on various complaints. Among other things, leech saliva contains pain relieving and anti-inflammatory agents, as well as substances that stimulate blood circulation and lymph flow, prevent the formation of blood clots or can dissolve existing clots. The following important active substances have been identified in leech saliva:
Hirudin inhibits blood clotting and thus counteracts the formation of thrombosis prophylactically. Thrombosis (also called thrombus or "blood clot") is a blood clot that can occur in all blood vessels in the body.
Factor Xa inhibitor also counteracts the formation of thrombosis. It inhibits plasma coagulation in the blood by binding to the blood coagulation factor Xa.
Calin inhibits wound closure, so it keeps a wound open longer than the body would naturally do. Calin is the reason why the bite marks bleed for a long time after leech therapy.
Destabilase and Apyrase cause thrombolysis, i.e. a dissolution of thromboses that have already arisen in the blood.
Hirustasin has an anti-inflammatory and circulation-promoting effect.
Bdellin, Eglin and LDTI (Leech Derived Triptase Inhibitor) have anti-inflammatory effects.
Research into the beneficial ingredients of leech saliva continues and it will be interesting to see what results it will produce!
After leech therapy in conventional medicine was long considered ineffective and even dangerous charlatanism, leeches are now used in plastic surgery, among other things. The often persistent hematomas (“bruises”) are treated with leeches; For example, leech therapy after skin transplants can resolve venous congestion and prevent thrombosis. Leeches are also occasionally used to decongest the lymph after breast reconstructions (restoration of the breast after an operation).
Pain therapy is another field of application for the helpful little bloodsuckers in conventional medicine. Among other things, pain relief caused by osteoarthritis, rheumatism or other joint diseases has been successful with leech therapy. According to some experts, the substances in the leech saliva are so effective that leech therapy is even superior to therapy with non-steroidal anti-inflammatory drugs (NSAIDs). These are drugs that have an analgesic and anti-inflammatory, sometimes anti-coagulant effect and are often used to treat symptoms such as back pain, arthritis or toothache. These include, for example, the drugs aspirin and ibuprofen.
Chronic back pain and stubborn tension are sometimes already treated with leeches in conventional medicine. In addition to the analgesic, the circulation-promoting aspect of the saliva active ingredients also comes into play here.
In many naturopathic practices, leech therapy is used for various diseases; this includes
- High blood pressure (hypertension),
- Spider veins,
- Buzzing in the ears or other ringing in the ears (tinnitus),
- acute gout attacks,
- chronic inflammation of the sinuses (inflammation of the sinuses) and the middle ear,
- Testicular inflammation,
- Gallbladder inflammation,
- Inflammation of the mammary gland
- and tendonitis.
A desired detoxification and elimination can also be supported with leeches. The main areas of application are:
- venous congestion,
- Varicose veins
- and thrombophlebitis (superficial phlebitis).
Leech therapy should not be used in people who are severely physically weak and / or suffer from anemia (anemia). Children and pregnant women should also refrain from using leeches. Other contraindications are blood clotting disorders, diseases in the arterial vascular system, a known allergy to the secretion of leeches, diabetes and autoimmune diseases.
Carrying out leech treatment
As mentioned above, it is essential to only use leeches that come from certified leech breeding companies or from pharmacies.
The skin should not be washed with soap or applied to the selected areas three days before the treatment. Since the leeches are extremely sensitive to odors, the skin may only be cleaned with water beforehand. People who smoke, take certain medications (such as beta blockers) or are very stressed may find that the leeches do not get stuck so easily. Scoring the skin before putting on the leeches can help here.
The patient should take a comfortable and comfortable posture during treatment, as therapy can take up to two hours. The therapist has the necessary accessories ready before the start. Everything should be done in peace as the leeches are extremely sensitive to stress.
To stimulate the blood circulation, the affected skin areas are rubbed with a damp, warm cloth before treatment. In the case of locally limited diseases, the leeches are also applied to the diseased area, for example in the area of a joint. If it is a systemic disease that affects the whole body, such as hypertension (high blood pressure), the leeches are placed in places where experience has shown that a good effect can be expected. A leech is never placed directly on an inflammation focus or on a vein. In this case, a location nearby is chosen.
The leech is removed from its storage container using tweezers and placed on the selected skin area. At the first bite, the leech exudes a secretion that opens the pores of the skin. The bite is no more painful than a small spike with a needle. Some patients also compare it to touching a nettle. Approximately two to ten leeches are used at the same time during a session. In the course of the suction process, they release the healing substances described above through their saliva.
A leech stays on the body for about sixty to ninety minutes until it falls off on its own. The animals should never be removed by force. The amount of blood withdrawn is approximately ten to twenty milliliters per leech. This is why this therapy is often referred to as "mini-bloodletting".
If the leech has fallen off, the wound can bleed for a long time. The expected blood loss is again about the same amount of blood that was absorbed during sucking, i.e. about ten to twenty milliliters per animal. Overall, the blood loss per leech is 20 to 40 milliliters. The wound is then closed loosely with an absorbent bandage. Bleeding is part of the treatment and should not be interrupted as it supports the effectiveness of leech therapy. The wound is also freed of any germs by the bleeding. Bleeding may take up to twenty-four hours. Therefore, in some practices, the patient is asked to stay in the practice for a few hours after the treatment. The dressing must be changed the next day at the latest.
Leeches should never be torn off because parts of the jaw may remain in the wound. There is also a risk that the leech will vomit and release digestive residues and digestive bacteria into the wound. Sprinkling salt on the leech, as often mentioned, should also be avoided.
If the treatment has to be stopped prematurely for important reasons, a wooden spatula is used to carefully lift the head of the leech from various sides in order to remove the animal very carefully. Sometimes a swab soaked in alcohol placed near the bite also helps.
Depending on the type of disease and individual response to therapy, leech treatment only needs to be carried out once or several times. Repeated use over a longer period is rarely required.
A mild, burning pain is often felt at the start of treatment. However, this usually only lasts about five minutes. The edges of the bite site can change color, which can remain visible for up to two weeks. Itching often occurs in the first three days after leech therapy. Other possible side effects include bruising (hematoma) at the bite site, circulatory problems and swelling of the lymph nodes. Scarring is also possible, which must be pointed out to the patient before treatment.
Side effects that occasionally or rarely occur include prolonged bleeding, delayed wound healing, a drop in blood pressure, allergic reactions, severe local inflammation and infections.
Leech therapies should therefore only be carried out by experienced, trained therapists. As part of the therapy, particular attention must be paid to compliance with the hygienic regulations.
In many practices, the patient has to stay a few hours after the treatment. Since the bleeding starts after the leeches fall off, the wound is covered with a loose but thick bandage. The bleeding time is four to twenty-four hours. It is part of the treatment, is important for healing and contributes to self-cleaning of the wound. It is important that the association is changed regularly. Most therapists therefore order the patient for the next day to change the dressing.
On the day of leech therapy, you should rest and, above all, make sure you have sufficient fluids, ideally with still water or unsweetened herbal tea. Itching may occur after treatment. This should not be given in by scratching, otherwise the wound could become infected. In particular, if the leeches are attached to or near joints, the areas in question should not be exposed to stress or only slightly for a while.
You should discuss with your family doctor in advance whether leech therapy is suitable for you. It is also important to consult about the medication you are currently taking. Certain medications must not be taken during leech therapy and in principle this special therapy should only be in the hands of experienced and trained practitioners (doctor, doctor, alternative practitioner, alternative practitioner). You can find a detailed checklist of what to look out for in terms of prevention, treatment and aftercare with our tips for reading on. (kh, sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Magistra Artium (M.A.) Katja Helbig, Barbara Schindewolf-Lensch
- Bierbach, Elvira (ed.): Naturopathic practice today. Textbook and atlas. Elsevier GmbH, Urban & Fischer Verlag, Munich, 4th edition 2009
- What leech therapy does, Deutsches Ärzteblatt, online edition (accessed: October 9, 2019), aerzteblatt.de
- HBB - Heilpraktiker Berufs-Bund: Rejection procedure: leech therapy (accessed: 09.10.2019), heilpraktiker-berufs-bund.de
- Hohmann, Christoph-Daniel; Stange, Rainer; Steckhan, Nico; Robens, Sibylle; Ostermann, Thomas; Paetow, Arion; Michalsen, Andreas: Effectiveness of leech therapy in chronic lower back pain, a randomized controlled study, Ärzteblatt 2018, aerzteblatt.de