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Response to VanillaRhapsody (Reply #6)

Sun Apr 20, 2014, 11:39 AM

93. Medicinal use of leeches

Medicinal leeches are any of several species of leeches, but most commonly Hirudo medicinalis, the European medicinal leech.

The European medical leech Hirudo medicinalis and some congeners, as well as some other species, have been used for clinical bloodletting for thousands of years. The use of leeches in medicine dates as far back as 2,500 years ago, when they were used for bloodletting in ancient India. Leech therapy is explained in ancient Ayurvedic texts. Many ancient civilizations practiced bloodletting, including Indian and Greek civilizations. In ancient Greek history, bloodletting was practiced according to the humoral theory, which proposed that, when the four humors, blood, phlegm, black and yellow bile in the human body were in balance, good health was guaranteed. An imbalance in the proportions of these humors was believed to be the cause of ill health. Records of this theory were found in the Greek philosopher Hippocrates' collection in the fifth century BC. Bloodletting using leeches was one method used by physicians to balance the humors and to rid the body of the plethora.

The use of leeches in modern medicine made a small-scale comeback in the 1980s after years of decline, with the advent of microsurgeries, such as plastic and reconstructive surgeries. In operations such as these, problematic venous congestion can arise due to inefficient venous drainage. Sometimes, because of the technical difficulties in forming an anastomosis of a vein, no attempt is made to reattach a venous supply to a flap at all. This condition is known as venous insufficiency. If this congestion is not cleared up quickly, the blood will clot, arteries that bring the tissues their necessary nourishment will become plugged, and the tissues will die. To prevent this, leeches are applied to a congested flap, and a certain amount of excess blood is consumed before the leech falls away. The wound will also continue to bleed for a while due to the anticoagulant hirudin in the leeches' saliva. The combined effect is to reduce the swelling in the tissues and to promote healing by allowing fresh, oxygenated blood to reach the area.[36]

The active anticoagulant component of leech saliva is a small protein, hirudin. Discovery and isolation of this protein led to a method of producing it by recombinant technology. Recombinant hirudin is available to physicians as an intravenous anticoagulant preparation for injection, particularly useful for patients who are allergic to or cannot tolerate heparin.


Today
Medicinal leech therapy made an international comeback in the 1970s in microsurgery,[6][7] used to stimulate circulation to salvage skin grafts and other tissue threatened by postoperative venous congestion,[6][8] particularly in finger reattachment and reconstructive surgery of the ear, nose, lip, and eyelid.[7][9] Other clinical applications of medicinal leech therapy include varicose veins, muscle cramps, thrombophlebitis, and osteoarthritis, among many varied conditions.[10] The therapeutic effect is not from the blood taken in the meal, but from the continued and steady bleeding from the wound left after the leech has detached, as well as the anesthetizing, anti-inflammatory, and vasodilating properties of the secreted leech saliva.[2] The most common complication from leech treatment is prolonged bleeding, which can easily be treated, although allergic reactions and bacterial infections may also occur.[2]

Because of the minuscule amounts of hirudin present in leeches, it is impractical to harvest the substance for widespread medical use. Hirudin (and related substances) are synthesised using recombinant techniques. Devices called "mechanical leeches" that dispense heparin and perform the same function as medicinal leeches have been developed, but they are not yet commercially available.


more at link:
http://en.wikipedia.org/wiki/Hirudotherapy#Medicinal_use



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