Farming Hirudo Leeches

Information about medicinal leeches, methodology for their application, how to buy leeches and case histories: Leeches - Pricing and Shipping Information (bout Leeches

Medicinal Leech (Hirudo Medicinalis)

Roughly 600 leech species ha e been identified to date, but only about !" are used in medicine# Leeches classified as medicinal leeches, $irudo %edicinalis, in the narrower sense ha e been used to treat patients for centuries#

&he first documented accounts of the use of $irudo medicinalis for medicinal purposes date bac' to the time of $ippocrates# (ccording to Sans'rit writings, )ha antari, the father of Indian medicine, held $ow to ta'e care of leeches nectar in one hand and a leech in the other# Leech therapy is also used in traditional *hinese medicine# Paintings of medicinal leeches ha e been found in pharaohs tombs# &he Solomon Parables also Leech &herapy describe leech treatment use in ancient medicine# Leech therapy in +ree' medicine can be found in the poem (le,ipharmacia by -icandros# Roman physician +alen classified leech terapy as a method for achie ing healthy balance# ( icenna also used leeches for healing aids# In the past leeches ha e Safety and (d erse .ffects of Leech &herapy pro ed to be the most effecti e treatment in many cases# Leeches were especially useful in battle 2loodsuc'ers hit the medical comebac' trail - 22* -ews wound treatment# .uropean countries in the !/th and !0th centuries imported o er !00 million leeches e ery year to satisfy high demand# 3hen modern medicine needs some help### 4#S# appro es leeches for therapy $irudotherapy Leeches and a $istory of %edicine &herapeutic properties &oday, doctors use leeches for treating abscesses, painful 1oints, glaucoma, myasthenia, and to heal enous diseases and thrombosis# %edical leeches are used in plastic surgery, for impro ing brain circulation and for curing infertility# &he general indications for leech therapy are: Inflammatory Reactions Heart Diseases Rheumatic Diseases Tendovaginitis and Tendinitis

Leech 7acts

Venous Disease and Varicose Veins Arthrosis Arthritis Muscle Tension Antidyscratic therapy ( lood purification and regeneration! of to"icoses and mental illnesses Throm osis and em olism #assive congestions and spastic conditions Verte rogenic #ain $yndromes Transudates and e"udates ( simple principle lies at the heart of all hirudo-miracles# )uring the process of feeding, leeches secrete a comple, mi,ture of different biologically and pharmacologically acti e substances into the wound# $irudin is the best 'nown component of leech sali a# $irudin is sometimes used to describe all acti e substance in leech sali a# In reality, $irudin refers only to one specific acti e substance in leech sali e# *omponents of medicinal leech sali a that e,ert effects in the host5s body are: Hirudin Calin Medicinal Links Destabilase Inhibits blood coagulation by binding to thrombin Inhibits blood coagulation by bloc'ing the binding of on 3illebrand factor to collagen# Inhibits collagen- mediated platelet aggregation %onomeri6ing acti ity# )issol es fibrin# &hrombolytic effects

About Leeches
Leeches are 'worms' with suckers on each end. Leeches can range in size from from a half of inch to ten inches long. They are brown or black in colour. Some feed on decaying plant material. Others are parasites, feeding on blood and tissue of other animals. lood!sucking leeches suck your blood using two ways" they use a proboscis to puncture your skin, or they use their three #aws and millions of little teeth. They li$e #ust about anywhere where is water. Leeches find you by detecting skin oils, blood, heat, or e$en the carbon dio%ide you breathe out. Leeches do not feed often. This is because they take in a big amount of blood when they feed. &octors often used leeches in the past to draw blood. Some barbers used leeches to do surgery as well as cutting hair. 'hen a barber finished surgery, he would take the bloody bandage and wrapped it around a pole to show he did surgery, too. Thats how the the white and red swirled barber pole came into use. Today, maggots and leeches are being used for different reasons. Scientists are studying leech sali$a. They belie$e the substance that stops or pre$ents blood clots will one day be able to be used on humans. (esearchers ha$e also identified se$eral medical compounds which can be de$eloped from leech sali$a. The anticoagulant and clot!digesting properties of these substances make them potentially useful as drugs for the treatment of cardio$ascular diseases such as heart attacks and strokes. Leeches can be )milked) for their secretions without being harmed, and research is continuing into the possibility of synthetically engineering leech sali$a. ut leeches are still being used to suck blood* &octors are now turning to leeches to help restore blood circulation to grafted tissue and reattached fingers and toes. +or e%ample" microsurgeons in a oston hospital used leeches to sa$e the ear of a , year old boy that had been bitten off by a dog. The leech can remo$e any congested blood to allow normal circulation to return to the tissues, thus pre$enting gangrene from starting. Today, hundreds of thousands of leeches are sold in -S. to hospitals,clinics and indi$iduals.The /uropean market is much bigger" millions of leeches are sold e$ery year.
Medicinal Leeches ! 0ome 1age Leeches and a 0istory of Medicine Leech +acts Leeches in Medicine -S. appro$ed leeches for therapy 0irudotherapy Therapeutic properties uy Leeches ! 1ricing 2nformation Medicinal Links

(c)2005-2006 Niagara 1487367 Ontario Inc.

Fre%uently As&ed 'uestions In which water should the leeches be kept in?
*lear water that is free from chlorine is necessary for maintaining leeches# ( oid placing leeches in chlorinated water# Leeches are sensiti e to substances such as chlorine,

copper, and other chemicals# -on-chlorinated tap water in most areas is suitable for leeches# )o not use distilled water alone since its e,treme purity can be harmful to the leeches5 metabolic balance# 8eep the water clean# 9nce the water shows signs of becoming dirty or polluted, it should be changed#

How can I get rid of the chlorine taste and smell in my drinking water ?
It can be as simple as letting a 1ug of water sit open to the air for a period of time gi ing the chlorine in the water time lea e the water# 9ther possible solution could be to install a faucetmounted filter#

How often do I need to change water for leeches?

. ery :-6 days, depends on ;uantity of leeches in a 1ar

How to change water for leeches?

*o er the 1ar opening by gau6e and dump the old water# &he gau6e will absorb the grease from the 1ar <pieces of the old leech s'in, etc#= &hen pour some fresh water in the 1ar# Sudden temperature changes could harm the leeches, so 'eep your containers with fresh water in the same room where you 'eep the leeches#

How many leeches can I keep in a jar?

4p to "0 leeches per gallon <> liters=

What temperature is ideal for leeches?

(ny temperature in a range of >07 to /0 7 <"-?@ *=

How long can I keep the leeches in the thermos/plastic container that you sent them in?
)on5t 'eep leeches in a thermos# &he thermos is too small and we use it for transportation purposes only#

Do I need to feed leeches?

Leeches can li e up to one year without food so you don5t need to feed them#

How fast does a leech become hungry and ready to suck again?
In "0-@0 days# &his doesn5t mean that you can use the leech again in "0-@0 days# Please remember, hospitals and clinics use the leeches only once and then must dispose them# Some indi iduals use their own leeches in :-> months

What is leeches lifespan?

4p to !0 years# $owe er, we can5t guarantee that the leeches will be ali e many wee's after they ha e arri ed# It depends on many factors that are out of our control : ;uality of water, smells, ;uality of entilation, sharp temperature or pressure changes, etc# Leeches can die after a meal 1ust because they ha e eaten too much # Some customers e,ecute mista'es what we cant imagine, for e,ample, mi, fed and hungry leeches, lea e detergent on the walls of the 1ar when they use a dishwasher, etc # &hat5s why we guarantee that the leeches will be ali e only upon arri al# %ost of our customers order the leeches and use them immediately or in a few days, and then dispose the leeches#

Are you still able to safely ship leeches during the cold winter months?
3e can deli er the leeches safely if the temperature in your area is in a range of "7 to 007 This information is only correct for the leeches that we supply. 2f you buy the leeches somewhere else you must ask your supplier how to take care of them Leeches ! 0ome 1age Leeches ! 1ricing 2nformation

(c)2005-2011 Niagara Leeches

Leech Therapy:
Questions and Answers

Ho( much lood does a patient lose during the treatment)

Leeches 3/uropean specie Hirudo Medicinalis4 can consume between , and 5, ml of blood 6!7 times their body weight in a single feeding. .n .merican specie Macrobdella Decora can consume 58 times less blood than Hirudo Medicinalis. That's why only the /uropean specie is used in medicine. 9enerally leech therapists use up to 58 leeches so the patient can lose up to 5,8 ml of blood during the treatment 'ith : leeches the blut$erlust for the patient is including to the ;achbluten with appro%. <88 to =,8 ml blood. )a small leech sucks <g ! the >uantity doubles itself = g, more largely to =8 g, on a$erage by the postoperati$e hemorrhage. 9enerally one counts on an a$erage $alue of <8 ! is limited =8 g total blood loss per leech and to setting 6 ! 5< copies in a meeting ) The bite of a leech is felt by the patients like <!= mos>uito bites.So the bite of the leech is not painful. The leech sali$a is filled with a chemical that contains a painkiller, which stops you from feeling the bite. The sali$a also has a chemical, which keeps the blood from clotting.

Does a leech ite cause pain)

In (hich diseases can leeches help)

Thanks to its blood!diluting and container!e%tending effect the leech is the ideal therapist for blood circulation disturbances.-sually unsatisfactory blood circulation is connected with diseases such as" Thrombose, cramp $eins, 0aemorrhoiden, cardiac infarct, impact accumulations, calcifying the containers, Tinnitus. 1ositi$e effects could be determined with rheumatism, .rthrose, $olume disk problems, pulling, bruises, muscular pains or muscle in#uries.

Ho( can I accomplish the leech therapy)

5. 'ash hands. <. Select appropriate personal protecti$e e>uipment 3glo$es4. =. ?leanse area with normal saline soaked sterile gauze. 6. .pply leeches with glo$ed hand on tweezers. ,. .llow leech to attach large posterior end first and direct smaller head end to the desired site. 3 Leeches can be loaded into an empty syringe without a plunger rear end first and the open end of syringe is placed o$er the desired site to ensure proper placement. 4 7. .pply the other leeches if neseseary. @. Monitor leeches until they fill with blood 358!<8 minutes4. -sually the leech falls off itself 3if not use salt. Leeches do not like salt and will drop off4 'ith certain site conditions leech bite more badly"

*hy does a leech sometimes not (ant to ite)

with cold skin with smokers with perfume!pure with older humans

(emedy is possible through warming up and cleaning the skin. +urther measures those are helpful the skin soften and the blood circulation promote. 2f the leech does not want to bite at all, there is the possibility the skin with a needle to puncture still.

Are there side effects)

'ith the right e%ecution of leech therapy and attention of all contraindications hea$y side effects arise $ery rarely. Local reactions are possible in the pro%imity of the point of the bite..lso, cycle weakness occurs relati$ely more fre>uently. Leeches can relie$e blood pooling around a muscle or skin flap better than drugs or other treatments. They are used to keep the blood flow in muscle, skin and fat tissue that has been surgically mo$ed from one part of your body to another. These tissues are also called flaps 2n some cases, leeches do a better #ob by remo$ing pooled blood than any other medical therapy.

In (hich other cases can leeches e used)

*hy is leech therapy used instead of other medical treatment)

*hat are the enefits of leech therapy)

*hy do some people re+ect using leeches )

The benefits of leech therapy are not only the amount of blood that the leech remo$es" 2t is the anti!blood clotting enzymes in their sali$a that allow blood flow from the area where they ha$e been. Many people are afraid of these creatures crawling on their body and biting them.
uying Leeches ! 1ricing

Leeches Sale ! Main page Leech +acts .bout Leeches Leeches are appro$ed for therapy in the -S. 0irudotherapy Therapeutic properties Leeches and a 0istory of Medicine
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$afety and Adverse ,ffects of Leech Therapy

Leech therapy rarely e er leads to serious complications# &he local pain of treatment and short-term itching are regular side effects# Prior to treatment, the patient should be ad ised accordingly and as'ed to sign a consent form describing the rele ant side effects <see (ppendi,=# Pre alence data from systematic and prospecti e studies are only a ailable for some of the different side effects of leech therapy# &he following analysis was compiled using the data from published efficacy studies and case reports, as well as from personal obser ations# Auality control data on ad erse e ents documented in more than !000 cases treated at .ssen-%itte $ospital, mostly for treatment of degenerati e 1oint disease, were also included in the analysis# Local #ain During Treatment Perceptions of the local pain of leeching ary# %ost patients describe a local dragging pain that occurs immediately after the leech bites and persists for around one to fi e minutes# (s more and more sali a is introduced into the tissues, the anesthetic effect of leech sali a begins to ta'e effect# &he intensity of the pain of the leech bite and the first phase of feeding is generally described as mild or negligible <depending on the indi idual5s pain threshold=, but some patients find the pain more intense, similar to that of a wasp sting# &he percei ed intensity of the leech bite aries from one indi idual to another# Sub1ecti e pain ratings range from Bhardly noticeableB to BmildB <similar to the pain of stinging nettle= to Bsimilar to a wasp stingB < ery rare=# ( slight <or sometimes somewhat stronger= rhythmic pulling sensation is usually noticed for the first one to three minutes after the start of feeding# 3hether stimuli of e,actly the same intensity are percei ed as painful or are not percei ed at all is certainly dependent on the indi idual5s personality, but also depends on that person5s concentration on the leech or attitude toward leech therapy# &he si6e of the indi idual leech5s 1aw, the strength of the bite, the intensity of suction, and the olume and composition of the leech sali a also play a role# %any people ne er e en notice the leech bite, for e,ample when they are bitten under water while their attention is focused on something else# 7re;uently, the more an,iously the patient focuses on the leech preparing to bite, the higher the pain perception# &he leech therapist should 'eep this in mind during the preparation phase and during treatment# ( di ersion can sometimes be helpful# It is also helpful to allow the patient to Bget to 'nowB BhisB or BherB leech and to reassure the patient by handling the leech in a confident manner# If late, glo es must be worn for hygienic reasons, the leech therapist should ne er use forceps on the leech# %any patients lose their a ersion to leeches

.ll about the leeches" +orum Leeches in Medicine -.S. appro$es leeches for therapy 0irudotherapy Therapeutic properties uy Leeches ! 1ricing 2nformation Leeches and a 0istory of Medicine ack to Leeches for sale -S.

when they are shown how elegantly they swim and the beautiful colored pattern on their bac' is pointed out# %any people report that the patient5s attitude toward the leeches changes from negati e to positi e after a positi e treatment e,perience# %ost of the apprehensions pro1ected onto the leech are based on archaic fears rather than on ob1ecti e facts# 3e also ad ise against 'illing leeches in front of the patients# If the leech is to be 'illed after treatment, the animal should be fro6en and placed in a 00C alcohol solution a few days later# Local Itching &ransient itching at the site of the leech bite in the first few days after treatment is ery common and should not be mista'en for an allergic reaction# In the study of the efficacy of leech therapy in patients with osteoarthritis of the 'nee, roughly @0C of patients treated with leeches de eloped local itching that lasted a mean of two days# &ransient itching occurs at a comparable fre;uency, but stronger intensity le els in many cases where leeches were applied to more peripheral 1oints, for e,ample the thumb, but at lower le els after treatment of large 1oints and ertebrogenic 6ones, according to empirical assessments# &he patient could be ad ised of these side effects prior to treatment# &he patient should ne er scratch the leech bite, especially after initial wound closure, because this fre;uently delays wound healing# 3e recommend local cooling remedies <curd wraps, cold moist wraps, inegar wraps=# 7or more se ere itching, commercial antipruritic products <e#g#, 7enistil ointment= or oral antihistamines may be used# Some leech therapists prescribe concurrent oral antihistamines for patients with a 'nown history of se ere reactions <itching and s'in reddening= to leech therapy# Isolated reports describe brief recurrences of moderate itching in certain situations <e#g#, high temperatures= o er the course of se eral months after an otherwise une entful course of leech therapy# Hypotension and Vasovagal Attac&s Patients with a history of de eloping aso agal attac's or syncope <fainting= before other in asi e treatment methods may also de elop such a reaction at the start of or during leech therapy# 9ne sur ey showed that aso agal attac' occurred in one out of !000 leech treatments performed at our hospital# &herefore, the leech therapist should always as' about the patient5s prior history of aso agal attac' or fainting before procedures such as blood sample collection or acupuncture# &o guard against aso agal attac', the patient should drin' plenty of fluids before and during treatment, and treatment should always be performed in a calming en ironment while the patient is lying down# &wo outpatient cases of hypotension and asodepressor syncope following leech therapy were also obser ed# 2oth patients had 'nown arterial hypertension and were on triple antihypertensi e medication, which they continued ta'ing as usual# ( few hours after leech therapy, both patients de eloped a brief attac' of benign syncope# It is important to remember that leeching has a 'nown antihypertensi e effect when treating patients on antihypertensi e medications# Patients should drin' plenty of fluids# If there is a strong flow of blood from the leech bite, the patient5s blood pressure should be monitored and antihypertensi e medications should be ad1usted as needed# -lood Loss Leech therapy is always associated with a certain degree of blood loss, which is clinically irrele ant in most cases# In the clinical trial by %ichalsen, the mean hemoglobin loss was 0#@ mgDdL, and clinically rele ant blood loss did not occur in any of the patients studied# $owe er, there ha e been isolated obser ations of stronger afterbleeding with a corresponding decrease in hemoglobin, particularly in cases where a leech was inad ertently applied directly to a superficial ein# (ccording to the records of .ssen-%itte $ospital, a clinically rele ant decrease in hemoglobin <E : mgDdL= occurred after leech therapy in two patients, one of whom re;uired a blood transfusion <after being treated with si, leeches for osteoarthritis of the 'nee=# (s'ed retrospecti ely, one of the patients stated that she had, in her opinion, e,perienced prolonged wound bleeding in the past# In another case, afterbleeding from the leech bite lasted o er :6 hours and had to be stopped with a cutaneous suture# .,tensi e coagulation tests were then performed but did not re eal any specific

coagulation disorder# Prior occurrences of abnormal bleeding seem to be anamnestically important, and patients should be specifically as'ed about such e ents# (nticoagulants are important concurrent medications to watch for# If low-dose aspirin is prescribed in combination with other platelet aggregation inhibitors <clopidogrel, Isco er, Pla i,= or high-dose fish oil <9macor=, a smaller number of leeches <three to four= should initially be used# 2lood counts should always be obtained before starting leech therapy# &o reliably pre ent the loss of rele ant ;uantities of blood, the leech therapist should ne er use more than !? leeches in a single treatment session# Impaired *ound Healing. $uperinfection. and Allergies (fter the leech drops off, the edges of the three-pronged wound generally swell for !?->/ hours accompanied by a feeling of local tension, heat, and reddening# Small blood spots <ecchymoses= de elop below the s'in around the leech bite# Larger collections of blood rarely de elop# (s with superficial bruising, the blood spots are initially reddish iolet, then turn yellowish, and finally disappear within around two wee's# Locali6ed inflammation, sometimes with papulous ele ation of the bite sites, is a relati ely common problem that is often accompanied by itching # &hese inflammations usually subside ;uic'ly when iced and left undisturbed# &he cause of this wound-healing disorder is un'nown# Improper handling, especially early stoppage of afterbleeding from the wound, s;uee6ing the head of the leech with forceps, forceful remo al of the leech before it has finished feeding, and failure to 'eep the animals in fresh water, ha e fre;uently been implicated as potential causes# $owe er, this has also been obser ed to occur after proper leech handling in isolated cases# &heoretically, local infection with (eromonas hydrophila is a potential cause, but there has been no microbiological e idence so far of the presence of (eromonas hydrophila in the wound secretions from the affected patients# %ore se ere local inflammations are most commonly caused by secondary wound contamination or irritation due to mechanical irritation, such as scratching and rubbing# &he patient should be thoroughly ad ised of the importance of protecting the wound from mechanical irritation# (ccording to the hospital sur ey, more se ere locali6ed inflammations occurred in three isolated cases: 9ne patient de eloped erysipelas and two de eloped moderate lymphangitis# (ll cases resol ed ;uic'ly in response to antibiotic treatment with cephalosporins andDor gyrase inhibitors# Strict adherence to contraindications and locali6ation recommendations minimi6es the ris' of locali6ed inflammation# In unclear cases where progressi e and painful s'in reddening de elops, especially if associated with increased temperature, the leech therapist should 'now to administer antibiotics immediately# Pseudolymphomas may occur in rare casesF these papulous efflorescences are caused by an arthropod reaction to the leech bite# *urrently, there is no data by which to assess the precise fre;uency of this ad erse effect# &o our 'nowledge, a total of three documented and confirmed cases ha e been reported# It is difficult to distinguish secondary wound-healing disorders from potential allergic reactions# Precise data on the fre;uency of allergic reactions to leech bites are not a ailable# Local itching, a common side effect of leeching, should not be interpreted as an allergic reaction# 4ne;ui ocal allergic reactions such as transient urticaria and locodistant swelling ha e been reported in a few isolated cases# $owe er, locali6ed symptoms, refle, erythema, and urticarial dermographism in psycho egetati ely labile indi iduals ha e been obser ed more often# (n older case report describes the occurrence of a short-term anaphylactic shoc' after application of si, leeches to the temple region# Some leech therapists administer systemic antihistamines for treatment of local allergic reactions with <empirically= good success# $owe er, the good response rate to antihistamines is not proof per se of an allergic cause: ( certain rate of placebo response to antihistamines must also be ta'en into account# &he possible boosting of an e,isting antibiotic allergy by leech therapy was also proposed in a case report# 3hen interpreting local reactions that occur following leech therapy, it is important to remember that the proteases in leech sali a release arious types of nonimmunological mediators# 7urthermore, such reactions can be aggra ated by psycho egetati e factors# (ll in all, there are only a few cases in which an association between leech therapy and the occurrence of allergic reactions has been pro ed with sufficient certainty# $owe er, allergic reactions may potentially occur after e,posure to any foreign proteins# *ontact dermatitis has also been obser ed after use of leech ointment# Short-term reacti e swelling andDor tenderness of pro,imal lymph nodes has occasionally been reported, but most

commonly in patients with delayed wound healing# &hese symptoms ha e most fre;uently de eloped in the groin region after application of leeches for treatment of the 'nee 1oint, hip 1oint, or aricose eins# Rapid and une entful disappearance of lymph node swelling is described in all of the case reports# $epsis Sepsis due to systemic infection with (eromonas hydrophila has been repeatedly obser ed after leech application in reconstructi e surgery indications, but not in any of the other rele ant fields of use# &his supports the conclusion that the ris' of (eromonas hydrophila sepsis is increased only in patients with se ere underlying diseases or immunosuppression, which is often the case in surgical candidates for leech therapy# 3e therefore recommend concurrent antibiotic treatment for all surgical patients recei ing leech therapy # In the remaining fields of use, primary antibiotic therapy does not appear to be necessary according to the current state of 'nowledge, but rele ant contraindications must be obser ed# Transmission of Infectious Diseases &oday, medicinal leeches are generally only used once# &herefore, there is no ris' of the indirect transfer of infectious diseases from one patient to another# Primary infection with (eromonas hydrophila is clinically rele ant only when leeches are applied to surgical transplants# *oncurrent antibiotic treatment is therefore recommended for infection prophyla,is in these cases <see abo e=# &he transmission of other bacterial or iral pathogens to humans within the conte,t of leech therapy has not been obser ed so far# $carring 3hen left undisturbed, leech scars usually ;uic'ly shrin' to hardly isible or in isible tiny three-pronged mar's that disappear completely within one to three wee's# $owe er, if wound healing is impaired due to scratching or secondary wound infection, the scars may remain isible for significantly longer periods of time# Papulous s'in changes persisting for se eral months ha e also been reported in isolated cases# In one case, a permanent Barthropod reactionB was also reported to occur after leech treatment# Significant scarring may occur particularly when leeches are applied to areas with thin s'in and thin layers of subcutaneous tissue or 1oint regions where the s'in is in constant motion# &he wearing of restricti e clothing after treatment, for e,ample around the 'nees, can also result in scar formation# 7or esthetic reasons, restraint is ad ised when using leeches in the facial region or in other clearly isible and cosmetically rele ant parts of the body# $ere, we again stress that it is necessary to thoroughly inform the patient about the potential ris's of treatment, including scarring, and to obtain written informed consent from the patient before going ahead with the treatment#

--/ 0e(s1 -loodsuc&ers hit the medical come ac& trail

Leeches were widely used up until this century for many medical conditions, including tonsillitis and piles. )They went too far, o$erusing them and using them in the wrong way with little benefit, ) said Mr 'einko$e, a fifth!year medical student at the -nited Medical and &ental Schools of 9uy's and St Thomas' 0ospitals in London. . few doctors were still using leeches in the 5A=8s and 68s, mainly on stroke patients, but their use died out until the 5A78s when interest in the creature was reignited. ut it is only in the last 58 to 5, years that they ha$e really caught on and their use has taken off in the last fi$e years. Mr 'einko$e belie$es it has taken so long for them to come back because they ha$e an image problem. 1eople donate blood for medicinal purposesB leeches take it away... )&octors ha$e been reluctant to use them because of their image, but now it has been pro$en that they can be useful in certain cases,) he said. Leeches are particularly useful in plastic surgery, such as breast reconstruction and where a part of the body has become se$ered and had to be sewn back on. Sometimes, the patient's $eins are too weak to take the blood away from the body part and the blood builds up, causing )$enous congestion). .ttaching leeches to the body can draw the blood away gradually and painlessly since leech sali$a contains an anaesthetic. This allows the re!attached body part to sur$i$e until the $eins are strong enough to work normally. One man who cut off his penis had to ha$e leeches attached to drain the blood. The leeches suck the blood until they become totally engorged. They can take in up to 58 times their bodyweight in blood. 'hen they are full they fall off and can be replaced with another leech. . patient may need up to =8 leeches to drain blood away. Mr 'einko$e says most patients are willing to ha$e leeches on their bodies if it is a choice between leeches, more operations or losing a part of the body. 0e says children often gi$e them names. ut their family and friends are not so keen to see the creatures

Leeches $ale 2 Main page Leech Therapy Leech Facts A out Leeches Leeches are approved for therapy in the 3$A Hirudotherapy Therapeutic properties -uy Leeches 2 #ricing Information Leeches and a History of Medicine

at work. This has led some doctors to hide the leeches, using dressings. .nother consideration is to ensure the leech feeds on the right part of the body. &octors in 1hilidelphia ha$e de$eloped a plastic shield to hide the leech and keep it in place. 2t in$ol$es a dinner plate!like ob#ect with a hole in it. This is used on se$ered fingers. The patient's arm is co$ered in plaster of paris to keep it raised in the air so the blood can be drained. The dinner plate is put on top and the leech is attached and co$ered in fabric. One of the doctors in$ol$ed is called &r ?allegari, con#uring up images of the famous 9erman film. Most hospitals in the -C which use leeches do not keep them on site when there is no specific need for them. There are a handful of pharmacies up and down the country which ha$e storage room for them. They can send leeches o$er to hospitals on re>uest. Leech sali$a also has medicinal uses of its own. 2t pre$ents clotting and is being used in se$eral new drugs, for e%ample, to treat patients who ha$e had a stroke, often due to blood clots in the brain. . new one, hirudin, is being used in the -S and may ha$e less side effects than other anti!clotting drugs.
(c)2005-2006 Niagara 1487367 Ontario Inc.

When modern medicine needs some help, surgeons call in mother nature's little helper - the leech
)2 was scalped by a bo%!making machine,) says ?hristine Lippincott. She was working in a factory in 9reensboro, ;orth ?arolina, and her attention wandered. )2t caught my hair from behind and ripped it right off in a second, from the back of my neck to my eyebrows.) 9ushing blood, Lippincott fainted. ?oworkers carefully e%tricated her scalp from the bo% machine, packed it in ice, and rushed it and her to the local hospital. . helicopter took her to &uke -ni$ersity Medical ?enter in &urham, where plastic surgeon L. Scott Le$in sewed her scalp back on, meticulously reconnecting its blood

supply in a si%!hour operation. ut the crisis wasn't o$er. Le$in could see that blood was flowing through the reattached arteries into Lippincott's replanted scalp. ut it wasn't flowing out $ery well through her $eins, which are $ulnerable to clots and increased pressure. So Le$in did what many up!to!date surgeons would do" 0e applied leeches.

)2 had them on my neck and the back of my head,) says Lippincott, who is <,. )There was a bucket of them in the room with me. lood was pouring out of my scalp <6 hours a day for a week.) ut that was the point. loodsucking worms maintained her circulation and probably sa$ed her scalp. )2t's a time!honored method that works e%tremely well in the right patients, the right clinical situation, the right application. 2t's a li$ing drug therapy,) says Le$in, chief of plastic surgery and professor of orthopedic and plastic surgery at &uke's medical center. Leeches aren't a surgeon's first option, of course. Other methods are tried firsttrying to connect as many small $eins as possible, redoing the surgery and,

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when a finger or toe is in$ol$ed, remo$ing the nail, scoring the nail bed with a scalpel, and putting the patient on heparin, an anticoagulant. ut sometimes only a leech will do. That was the case with Lippincott. )2f we hadn't done it,) Le$in says, )her replant might well ha$e failed for lack of $enous outflow.) The leech's peculiar talent is to create a wound that bleeds for hours. Substances in its sali$a anesthetize the wound, pre$ent clotting, and dilate $essels to increase blood flow. -sing them in surgery is simple" 1oke the warm, blue, swollen, congested skin with a needle to start the flow of in$iting, clot!dark blood. .pply a leech, and the $oracious worm, ha$ing been stored unfed, will saw through the skin with the =88 teeth in its tripartite #aws. 2ts sucking mouth will draw out congested blood and maintain circulation until the patient's body creates new blood!flow channels. .nd when the leech has fed for <8 minutes to an hour, taken 5, to =8 milliliters of blood, and dropped off sated, its anticoagulant assures that the wound will ooze for 58 hours more. 2n Lippincott's case, Le$in applied =8 to 68 leeches o$er si% days. Hirudo medicinalis, the /uropean medicinal leech, is a four!inch!long carni$orous, hermaphroditic, segmented worm with a sucker on each end, fi$e pairs of eyes, and =< ner$e bundles, or )brains,) in the middle. 2t is one of 7,8 leech species and is found mostly in ponds and bogs. Some species are highly specializedone, in fact, feeds only on earthworms. .nother feeds on fish in freezing polar seas. One dwells in the nostrils of Saharan camels, another inside the rectum of the .frican hippopotamus. .nother li$es in ;ew 9uinea ca$es and sucks the blood of bats. Still another, the anaconda of leeches, inhabits the .mazon basin and grows up to 5: inches long. +or well o$er <,888 years, humans ha$e employed 0irudo for bloodletting, a practice thought to restore balance to the body's humors and heal e$erything from headaches to hemorrhoids. Leeches were so entwined with medicine that the words leech and doctor were synonymous in .nglo!Sa%on /nglish, and by the mid!5Ath century they had become the aspirin of their dayapply two leeches and call me in the morning. . +rench physician working in the early 5Ath century, +ranDois!Eoseph!Fictor roussais, is said to ha$e prescribed as many as =8 leeches at a time before he e$en saw his patients. .s medical science ad$anced, leeching died out, but with the ad$ent of micro$ascular surgery and tissue transfer, surgeons redisco$ered the creature's $alue. Two Slo$enian surgeons pioneered modern medical leeching in the 5A78s, describing how the worms assisted them in a tissue!flap transplantation. Then, in 5A:,, 0ar$ard plastic surgeon Eoseph -pton was called to care for a ,!year!old boy whose ear had been bitten off by a dog. /ars, which ha$e $ery small blood $essels, had ne$er been successfully replanted. -pton had no trouble with the boy's arteries, but as he worked through the night reconnecting the $eins, clots began to form. -pton had used maggots to clean se$ere infections while ser$ing in the .rmy, so the idea of a natural remedy came easily to him. 0e phoned iopharm, a company in Swansea, 'ales, owned by zoologist (oy T. Sawyer, who breeds 0irudo on the world's only leech farm. . bo% of leeches arri$ed

Leeches are appro$ed for therapy in the -S. 0irudotherapy Therapeutic properties uy Leeches ! 1ricing 2nformation

o$ernight, and the boy's ear was sa$ed. 'hen -pton published his results in the #ournal 1lastic and (econstructi$e Surgery, leech sales soared. ;ine years later, in a memorably bizarre case, leeches sa$ed a life. &uring an operation for congenital facial abnormalities, an :!year!old &utch boy de$eloped swelling so se$ere that his tongue filled with blood and protruded from his mouth, blocking his airway. Steroids and antibiotics didn't help. ut si% hours and <@ leeches later, the boy was out of danger, and leeches had been firmly reestablished as good medical science. ;obody knows how many li$es, limbs, and appendages they ha$e sa$ed, but medical literature describes leeches being used to relie$e se$ere postsurgical $enous congestion after finger, toe, ear, and scalp replantation and penile surgery, after skin!flap plastic surgery, and to relie$e engorgement of the nipple following breast augmentation or reduction surgery. .nd the creatures ha$e turned out to be miniature pharmaceutical factoriesresearchers ha$e isolated a dozen compounds from leech sali$a to pre$ent blood clots, treat inflammation, dilate blood $essels, kill bacteria, and relie$e pain. ?arl 1eters, the leech!growth technician at iopharm, remo$es the muslin co$er from a plastic bucket, and leeches crawl out. 0e pokes one. 2t creeps across a $isitor's hand, humping along with the suckers at its head and foot and arching its back like a 0alloween cat. The creature feels wet and cool, like a chilled strand of fettuccine. /$ery few seconds, it stands on its rear sucker and wa$es its head around ominously, as if searching for something, which is #ust what it's doing. 2t's out for blood. )2t's like a cross between a slimy slug and a Felcro barracuda,) 1eters says with a grin and a glance toward the mo$ie poster on the wall for The .frican Gueen. 2n the mo$ie, 0umphrey ogart's character says" )2f there's anything in the world 2 hate, it's leeches. Oh, the filthy little de$ils*) 1eters has worked with them for nine years and has been bitten fi$e times. 0e says it doesn't hurt, )but 2 don't think 2'd like to be plastered until a hospital re>uests a batch of hungry ones with leeches.) 2n nature, the medicinal leech inhabits the wetter en$ironments of western and southern /urope. Sensing the warmth, motion, or shadow of possible prey, the leech cozies up, attaches itself with its suckers, in#ects an anesthetic so that its presence is not detected, and goes to work. The three #aws of its head sucker stiffen, protrude, and slice into the prey's skin with a sawing motion. 2mmature leeches feed on the thin!skinned bodies of amphibians and young fishB mature leeches can mo$e on to larger prey, such as cattle, horses, ducks, and humans. The leech's natural anticoagulant, hirudin, keeps blood flowing for the <8 to 68 minutes it takes to feed, during which time the leech's body weight may increase 58 times, reaching up to 78 grams 3about two ounces4. The secretions of one leech can pre$ent up to half a cup of blood from coagulating. lood sucked into its crop can take 5: months to digest. &uring 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. 'ithin two to four weeks, about 5, to <, leeches hatch. -nder the right conditions, a leech can produce up to 5,<88 young in a fi$e!year lifetime. .t iopharm, leeches

feed on pig blood poured into an artificial membrane that simulates the skin of natural prey. .fter rearing the leeches for si% months at :8 degrees +ahrenheit, 1eters transfers them to a room chilled to a growth! slowing 6, degrees. They can li$e there for a year without food. 'hen leeches lea$e iopharmthousands a yearthey are packed like ?hinese takeout in little cardboard bo%es. They go to such places as ?arolina iological Supply, in urlington, ;orth ?arolina, where workers store them in buckets of icy spring water until a surgeon like Le$in calls. )'e maintain them so that when surgeons get one, it's a nice, clean, hungry leech,) says Lawrence 'allace, the firm's director for li$e biological products. 0ungry they areB sterile they are not. 2n the gut of e$ery one, e$en those raised in sterile conditions, li$es Aeromonas hydrophila, a bacterium that pre$ents putrefaction of the leech's blood meal and supplies enzymes crucial to its digestion. Studies ha$e found that as many as <8 percent of leeched patients become infected by this bacterium, which increases the risk of serious wound infections. So pre$enti$e antibiotics are gi$en to patients with weakened immune systems. Aeromonas also kills other bacteria. Eoerg 9raf of the 2nstitute for 2nfectious &iseases at the -ni$ersity of ern, Switzerland, belie$es that a better understanding of Aeromonas could help researchers find a way to fight such bacteria as Staphylococcus aureus, which are becoming lood doesn't flow easily in an in#ured and inflamed ear. ecause leeches release enzymes that promote blood flow, they can help difficult wounds heal resistant to antibiotics. +or some reason, staph cannot grow inside a leech. This may be the result of inhospitable conditions within the leech, says 9raf, but it's also possible that .eromonas produces something that inhibits staph growth. +inding such a substance could lead to a way of controlling staph growth in humans. ut leeches themsel$es may pro$e a direct source of antibiotics. Michel Salzet of the -ni$ersity of Science and Technology in Lille, +rance, has found infection!fighting peptides in leeches akin to those that ha$e already been disco$ered in insects and other in$ertebrates. 2n leeches, these peptides are produced within 5, minutes of a bacterial infection. )These antimicrobial peptides diffuse >uicker and easier than antibodies,) he says, suggesting that such speed and potency might add up to a defense that can outbreed and outrun pathogens. ).ntibacterial peptides from leeches may cure human diseases,) Salzet says. That wouldn't surprise (oy T. Sawyer. ?ourtly and soft!spoken, the ;orth ?arolinian escorts a $isitor through his leech museum. 2t's a tidy room, bright and cheerful despite its display of bowls and kni$es for bleeding, leech #ars with perforated lids, and oil paintings of patients with leeches stuck on their necks. 0e speaks of a )$eritable pharmacy) of leech products, referring to potentially useful compounds he and his researchers ha$e turned up. There's the enzyme orgelase, a )spreading factor) that >uickly distributes chemicals in leech sali$a around the wound. Sawyer belie$es it could help carry local anesthetic deep into tissues before surgery. .nd there's calin, which neutralizes the effects of collagen, a natural blood clotter. 0e calls it a )collagen!coating paint) that could help pre$ent blood clots following $ascular surgery. Sawyer and others ha$e isolated a dozen more acti$e substances from 0irudo and nine

other leech species. .mong these is a local anesthetic that renders a leech bite painless. 0ow it works is still not understood, and Sawyer has been unable to isolate the analgesic. )?ommon sense is telling me something is there. This is a potentially rich area,) he says. Salzet, who recently found a morphinelike compound in 0irudo, agrees. The anticoagulant e%tracted from leech sali$a highlights the difficulties of de$eloping drugs from the animal. 2n the marketplace, hirudin competes against heparin, which is easily deri$ed from $ertebrate immune cells and works with certain cofactors to inhibit thrombin, a clot!producing enzyme. 0irudin works more simply than heparin, binding directly to thrombin alone, but its dosage must be carefully measured to pre$ent e%cessi$e bleeding. Long!term studies of hirudin in humans ha$e not been carried out, but a series of small studies suggests it may boost short!term heart attack sur$i$al by as much as =8 percent o$er heparin. Other studies suggest it may be more effecti$e than heparin in reducing deep!$ein clotting after hip surgery. ut to make enough hirudin from leeches for economical production, )you'd need a swimming pool of blood,) says Maurice Moloney, professor of plant biotechnology at the -ni$ersity of ?algary in .lberta, ?anada. So he tried another approach, altering /thiopian brassica, a type of mustard, to contain the gene for hirudin. 0e planted fi$e acres of the plant and produced 58 tons of seed, from which he e%tracted the drug. .nother candidate drug from leeches is hementin, deri$ed from the 5:!inch!long .mazon leech 0aementaria ghilianii, which Sawyer brought back from +rench 9uiana in 5A@@. 0e wondered if this leech, which lances large mammals with a si%!inch!long proboscis, also produced anticoagulants to prolong its dinner. 2t did. ut while hirudin pre$ents clot formation, hementin dissol$es a particular kind of platelet!rich clot that can cause stroke and heart attack and against which clot busters like streptokinase and urokinase are ineffecti$e. . 9erman firm, says Sawyer, may decide to to clone the compound. Other scientists are studying the leech's large, easily $isible ner$es. +iguring out how they work could help in promoting ner$e regeneration in humans with spinal cord in#uries. ut the leech's future in science, like its past, will most likely stick close to its main interest" blood. )Secretions from bloodsucking animals could be to cardio$ascular diseases what penicillin was to infectious disease in the past,) Sawyer says. )Leeches are preadapted to human physiology. The secretions from their sali$a cross the entire spectrum of physiology" blood clotting, digestion, connecti$e tissue, disease, pain, inhibition of enzymes, anti! inflammation. Hou name it, the leech has it.)
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U.S. approves leeches for therapy

lood!sucking leeches ! used for thousands of years in medicine ! now ha$e the -.S. go$ernments appro$al as a tool for healing skin grafts or restoring circulation, regulators said on Monday.
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The +ood and &rug .dministration appro$ed an application from +rench firm (icarimpe% S.S to market leeches for medicinal purposes. The company has been breeding leeches for 5,8 years, the +&. said. &octors ha$e used the small a>uatic worms for se$eral thousand years in the belief that bloodletting helps to cure a wide range of complaints from headaches to gout. They reached their height of medicinal use in the mid!5:88s. Today, doctors around the world use leeches to remo$e blood pooled under skin grafts for burn patients, or to restore circulation in blocked $eins by remo$ing pooled blood, the +&. said in a statement. Leeches are particularly useful in surgeries to reattach body parts such as fingers or ears, (icarimpe% said on its 'eb site. The leeches can help restore blood flow to reconnected $eins. The +&. said it considered the leeches a medical de$ice. The agency appro$ed their sale after re$iewing medical literature and safety data pro$ided by (icarimpe%. The +&. also e%amined information about how the leeches are fed, their en$ironment, and the employees who handle them.

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Hirudotherapy
0irudotherapy is a treatment using medical leeches. This kind of therapy is known from the time of e%treme anti>uity and is still ali$e nowadays. This fact testifies its efficiency in healing $arious kinds of illnesses and diseases. The method of hirudotherapy is appro$ed by many countries.

The enormous e%perience of using medicinal leeches in medical purposes is sa$ed up during many centuries. 'ith the de$elopment of science the mechanism of action of a secret of sali$ary glands of leeches was deciphered, biologically acti$e substances which are included in it were opened,their influence on the certain structures of an ali$e organism is in$estigated. Some medical forms are created on a basis of biologically acti$e substances of sali$ary glands of leeches and work on creation of new substances is conducting. Modern hirudotherapy differs from the ancient one because now we do not use wild leeches" instead we use leeches grown at special biofactories where they are in a se$ere >uarantine. esides, nowadays we use a leech only once. This fact completely e%cludes the chance of infecting a patient.

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The ob$ious ad$antage and absolute safety of hirudotherapy is checked up by thousands of years of e%perience of mankind and does not cause any doubts. One of the first substances found in sali$ary glands of medicinal leech is hirudin!the substance oppressing the process of blood clotting. Then such anticoagulating substances as ferment destabilaza,ingibitors of plazmine,callecrein of plasmine and others were opened. +actors of diffusion!ferments of gialuronidaza,collagenaza,the factors appressing the mediators of pain!cininaza,antisclerous factors were in$estigated as well. .gain opened substances are studied. Thus,a medicinal leech is a small factory manufacturing biologically acti$e substances. The result of action of biologically acti$e substances on an ali$e organism are"

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!normalization and impro$ement of capillary circulationB !e%pressed antiinflammation effectB !antistressful and adaptogene effectsB !immunostimulating and immunomodulating effectsB !anesthesiaB !anticoagulationB !antibacterial effectB !impro$ement of an endocellular e%hange and the realization of these mechanisms has both local and general character.

The e%istence of skin!$isceral connections with the definite organs is well known. iologically acti$e substances act to organs during the blood!sucking work of medicinal leeches through $iens. 2t promotes the impro$ement of blood circulation in the certain organ,renders trombolitic,antiinflammatory,immunostimulating action,raises nutrition of tissues, strengthens tissues immunity. 2ts impossible to name all diseases which can be treated by using hirudotherapy. 2ts easier to name contra!indications here " absolute!hemophilia, relati$e!pregnancy,anemia,hypotonia.

0irudotherapy may be applied at any diseases known nowadays. 2t can be used as an independent method of treating and in comple% with the others. &octors know perfectly well how it is difficult to struggle with chronic inflammatory diseases. The matter is that at all $arieties of clinical displays of illnesses mechanisms of protection of an organism are uni$ersal!emission mediators of inflammation,$azoconstrictors,apireties and some other biologically acti$e substances into blood. /$erything comes to aspiration of a li$e organism to delimit the nidus of inflammation by deterioration of blood circulation and capillary!tissue permeability,creation of an inflammatory shaft by cellular and con#uncti$e tissue structure and a temperature mode in the gi$en area..s a result of it the concentration of drugs for e%ample an antibiotic in the nidus of inflammation is much lower than in blood. The increase of a dose of a chemical drug doesnt sol$e a problem because leads to e%cessi$e allergy and strikes a blow on other organs!3on li$er,kidneys,spinal cord,endocrin glands4. .s a result we ha$e a lot of problems" disbacteriosis,hepatitis,nephropathy,immune deficiency conditions,but the problem of chronic inflammation for a gi$en patient is not sol$ed. 0ere its a time to recollect about hirudotherapy. iologically acti$e substances containing in sali$a glands of medicinal leeches can restore blood circulation in the nidus of inflammation, remo$e an ischemia of organs, pro$ide capillary tissue e%change and due to it can carry out the transport of chemical drugs into the nidus of inflammation, impro$e

immune protection and regeneration of tissues. 2n such conditions the using of the same chemical drugs is possible in smaller doses. These factors do not limit the abilities of hirudotherapy to influence the nidus of inflammation. The matter is that in sali$ary glands of medicinal leeches there are some substances capable to detain the growth of bacterias.One of the most in$estigated substances is hirudin. 2n e%periments at animals a bacteriastatic and bactericidal action of hirudin has been pro$ed. The main reason of medicinal action of hirudin for e%ample at thrombophlebitis is in its bactericidal property. Thats why it becomes clear that the using of leeches both at aseptic inflammation and at inflammation caused by the bacterial agent helps the organism. The property of a secret of sali$ary glands of a medicinal leech to penetrate throughdemarcacional shaft of inflammation is deternimed by the action of the factor of penetration!the enzime gialuronidaza. This enzime is capable to unacti$ate the action of gialuron acid which is the cementing substance for con#uncti$e tissues.

Such feaeture of hirudotherapy essentially distin>uishes it from the other methods of treatment. esides the mentioned abo$e effects of hirudotherapy its necessary to remember about one such as the irritation of biologically acti$e points influence on refle% zones.2t was noticed long ago that leeches prefer to sit on the certain areas of skin which correspond to points of ancient ?hinese methods of treatment! needleacupuncture. 2n result of hirudotherapy we recei$e the effect in treatment not only due to action of biologically acti$e substances of leeches' secret,but also by means of influence on refle% zones. +or e%ample at the treatment of hypertonic disease biologically acti$e points of occipital and cer$ical area are used and the influence of these points gi$es anaesthetic,$asodilating and hipotenzi$e effects.The other action of leeches is blood taking.One leech e%hausts from , to 58 ml of blood.. leeding lasts for some hours3about 5<!<6 hours4 and the patient loses about <8!=8 ml of blood.Thus due to influence of , leeches simulteneously the patient loses 588!<,8 ml of blood and this way of blood taking has un>uestionable ad$antages before taking blood from $eins. Taking blood from the area connecting with the ill organ lasts for about an hour. Thus, it is creating conditions of a stable and lasting many hours drainage and $enous unloading of the gi$en area,in the certain area there usually is an impro$ement of microcirculation,the nutrition of tissues,cellular e%change, $enous stagnation is usually li>uidated and the ischemia of organ is usually eliminated..fter a treatment course consisting of ,!58 procedures using from 6 to 58 leeches a good clinical effect is marked..t the cardio$ascular pathology leading to decompensation of blood circulation3ishemic heart disease, intimate defect4 the leeches appointing to the area of a li$er authentically reduce increased arterial pressure, leads to reducing the stagnation in the li$er,to impro$ement of lung $entilation and unloading of heart. The effect comes in a result of a direct hipotenzi$e and anticoagulating action of hirudin and in not a smaller degree due to reducing of peripheral resistance. .t diseases of cardio$ascular system hirudotherapy plays a special role.2t is easy to find an e%planation for this taking into account its abo$e mentioned properties. esides it is necessary to note the ability of hirudin to influence on blood clotting. The li>uid condition of blood and its clotting is pro$ided by functional interation of two systems of the organism"clotting and anticlotting.The anticlotting

system supports blood in li>uid condition,protecting it from clotting,the second one pro$ides protection from bleeding at infringement of integrity of blood $essels. +or the patients with ischemic heart disease, hypertension,for old people,for patients with diabetes the main problem is atherosclerosis of $essels and as a result!angiopathyBatherosclerosis is nothing that infringement of integrety of blood $essels.which pro$ide and acti$ate the system of clotting.2n a result one of the most terrible displays of diseases of heart and $essels is the thrombosis of arteries in the $ital important organs. The output of thrombosis are the infarction of heart,brain,lungs brinding sometimes to lethal outcomes. Stimulation of fibrinolitic acti$ity and anticlotting system of blood at such diseases,oppression of formation of trombs,and reducing of $iscosity of blood are necessary both with medical purpose and for pre$enti$e maintanance of ischemic conditions. The mechanism of oppressing acti$ity of hirudin on thrombin is in$estigated. 0irudin blocks the action of thrombin and the last one losing its properties,doesnt promote the transition of fibrinogen into fibrin. esides the secret of sali$a of a medicinal leech blocks an anitial attachement of thrombocytes and completely supresses their aggregetion on a surface of collagenus. Thus,the secret of sali$ary of a medicinal leech influences on cellular and plasma factors of blood clotting.2n researches of many authors it is marked that after the assignment of leeches there is a normalization of separate parameters of coagulogramme!at anitial combination of hyper coagulations the anticoagulating system is acti$ating and on the contrary becomes more acti$e. Similar effect was not recei$ed e$en when we use such widely known anticoagulants as heparin and aspirin. 'e should add the lipotropal effect of enzymes of sali$ary glands of medicinal leeches which consists in the ability to influence on blood lipids. .t the beginning of the century some scientists e%pressed the assumption that the de$elopment of atherosclerosis can be pre$ented by applying medicinal leeches. 2n 5A:6!5A:A it was e%perimentally pro$ed that at long intro$enous introduction of a secret of sali$ary glands of medicinal leeches to the rats which were in the condition of a strongly e%pressed atherosclerosis the last ones had reduction of lipids in abdominal and lung arteries. 2ts well known that the lipoproteids of low density and lipoproteids of $ery low density promote the de$elopment of atherosclerosis,but the lipoproteids of high density play the role of the protecti$e antisclerous factor. .t ishemic heard disease there is a redistribution of cholesterol in different classes of lipoproteids. The >uantity of it raises in lipoproteids of low density and in lipoproteids of $ery low density being reduced thus in lipoproteids of high density. The patients of this group ha$e authentic increase of the le$el of common lipids,triglicerids,cholesterol in arterial walls. Many authors engaged in this problem mark the authentic reduction of triglicerids and cholesterol in blood after se$eral session of hirudotherapy. 2t allows to draw a conclusion that lipotropic ensymes secret of sali$ary of medicinal leeches may be used at atherosclerotic defect of $essels irrespecti$e of primary localization of atherosclerosis. 1robably the effect of re#u$enation which may be noticed after hirudotherapy!the appearance of shine in eyes, the impro$ement of skin elasticity,the appearance of flush,the disappearance of the mask of tiredness on patients faces,a $igorous kind of patients. 2t's possible because in this case we

deal with the mechanism of increasing of $ascularization of skin and internal organs. 1robably, due to the action of girudin and gialuronidaze3the factor of penetration4it is impro$ing not only blood circulation is organs!targets,but in other organs and tissues due to the best capacity of cappilary!tissues e%changing and so on. 2t promotes the reduction of swelling,the dissolution of the organized blood!clots,cosmetic effect. The using of leeches promotes the increasing of local immunity as well.

&iseases of $essels, heart, chronic nonspecific diseases of lungs leading to heart and li$er incompetence may be treated with hirudotherapy. .t heart incompetence and chronic lung s heart the stagnation in a big circle of blood circulation takes place and this fact leads to functional li$er incompetence. The unloading of a big circle of blood circulation at hirudotherapy3the impro$ement of blood circulation in region4,the action of lipotropic enzymes,the reduction of a hypostasis of li$er!all these factors promote the impro$ement of patients health due to the comple% influence of leeches secrets on organism.

0irudotherapy as we see should be regarded not only as a pre$enti$e maintenance,but also as a method of treatment at ishemic heart disease, insult and other $ascular pathologies,at diseases of e%change,at endocrine diseases,ner$ous diseases, at all inflammatory diseases and so on. .s a result it s necessary to note that the succers of hirudotherapy depends not only on biological properties of leeches secret but also from the e%perience of a doctor and #oint actions of a patient and a doctor.
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Leeches and a History of Medicine

+or o$er 6888 years, the leech has been a familiar remedy, with 9reek and (oman physicians praising the application of this cle$er in$ertebrate. 2n the 5Ath century leeches were en#oying a golden age. Millions were raised for medical use as their fame as a cure!all ensued. The mid 5:88s saw their constant use for local bloodletting. &ruggists administered thousands of leeches to patients with anything from gumboils to facial discolouration. Leeches were applied to the mouth and inside of the throat using a leech!glass, although patients fre>uently swallowed them. 1atients were relie$ed only with a salty drink of water or perhaps the most popular cure!all of the day, a couple of glasses of wine. Sometimes the leech would not drink and then had to be encouraged by some blood or cream smeared at the puncture site or bathed in a warm glass of beer until ready. Once sucking, an a$erage leech would drink blood weighing as much as itself in about 5, minutes and consume between <.,! ,., grams of blood 3half a teaspoon4. 2f the bite failed to stop bleeding after the leech was remo$ed then $inegar, sil$er nitrate and hot wires were applied.

.part from using the /nglish and Scottish leeches, huge numbers were imported from +rance, 0ungary, the -kraine, Turkey, (umania, (ussia, /gypt and .lgeria. 2n 5:67 in +rance alone, =8 million leeches were used. 0ospitals in both London and 1aris re>uired 5= million between them for that single year. .merica produced their own leeches and one farm sold o$er a thousand per day. Leeches were also caught from the wild by many interesting ways, including men bathing a muddy ditch or in a stream with a glass of pig blood, rolling their trousers up and wading into the water. 0ere they would wait patiently for leeches to adhere themsel$es to their legs. .fter a while, back on land the feeding leeches would be stripped off and sold to leech dealers. The leech industry began its decline due to the o$er collection of the animal and its discredit by the medical profession. y the end of the 5Ath century the golden age of the leech had passed.

Leeches Sale ! Main page Leech +acts .bout Leeches Leeches are appro$ed for therapy in the -S. 0irudotherapy Therapeutic properties

Today leeches are bred in capti$ity in many institutions including ristol Ioo 9ardens. Leeches ha$e found new fame in microsurgery, where doctors re>uire the precision of the leech to drain congested blood from wounded sites. 1lastic surgeons are particularly grateful for the contribution made by the leech, due to their use in the treatment of difficult grafts and reconstructi$e surgery.
<88,!<855 .ll (ights (eser$ed. ;iagara Leeches

uy Leeches ! 1ricing 2nformation

Therapeutic properties of hirudotherapy1

general reflexogenic hypotensive bloodletting immunopotentiating internal decongestion bacteriostatic anticoagulant anti-inflammatory protective antithrombotic local anti-edematous thrombolytic analgesic removal of microcirculation disorders antiatherosclerotic removal of abnormal intersystem interactions

anti-ischemic

Wonder-doctor called leech. The applied medicine has hundreds years e%perience in the struggle against the human diseases. &ozens thousands of different mi%tures, tablets, $accines, drugs, etc. ha$e been created and all of them effect the human treatment. .nd why do the professional doctors again and again apply to the traditional methods of treatment preferring old remedies tested by our ancestorsJ There is no secret in that .ll these methods are grounded on the natural roots. That is why our medical center applied to the ancient method of )treatment for hundreds diseases) ! Hirudotherapy. Hirudotherapy 3from Latin hirudo!leech4 is known since ancient times. .long with the general bloodletting, it has been considered as a necessary remedy in treatment for different diseases. Secret of salivary lands of !edical leech contains more than 588 bioacti$e substances and has anti!edematous, bacteriostatic, analgesic, resol$ing actions, it eliminates microcirculation disorders, restores damaged $ascular permeability of tissues and organs, eliminates hypo%ia 3o%ygen star$ation4, reduces blood pressure, increases immune system acti$ity, deto%ifies the organism, releases it from the threatening complications, such as infarct, stroke, impro$es bioenergetic status of the organism. The way of leech secret in"ection is $ery simple" being placed on the skin it bites the skin, then the secret of the leech sali$a falls into the blood channel and goes to the disease focus through $essels. 2n the treatment we use hirudorefle%otherapy placing the leeches on the refle%ogenic points as a )Life needle). #ndications for treat!ent with !edicinal leeches: ! cardio$ascular diseases, including essential hypertension and ischemia disease, phlebogene diseases of the lower e%tremitiesB ! chronic bronchitis, pneumonia, bronchial asthmaB ! gastrointestinal tract diseases 3hepatitis, cholecystitis, pancreatitis, stomach ulcer4B ! /;T diseasesB ! paradontosis and other teeth diseasesB ! urological diseasesB ! male sterilityB ! skin diseases 3neurodermatitis, psoriasis, eczema, herpes4B ! gynaecological disorders 3commissural processes in the small pel$is, female sterility, chronic adne%itis, parametritis, endometriosis, fibromastopathy4B ! systemic diseases 3rheumatic arthritis, systemic lupus erythematosus, scleroderma4B ! osteochondrosis and radiculitisB

0ome Leeches and a 0istory of Medicine Leech +acts Leeches in Medicine -.S. appro$es leeches for therapy 0irudotherapy .bout Leeches uy Leeches ! 1ricing 2nformation

! eyes diseases, including glaucomaB ! infantile cerebral paralysis 32?14 and other diseases. $ioactive substances of the !edicinal leeches: %. &. '. ). +. ,. -. /. 1. %3. %%. %&. %'. %). %+. %,. %-. %/. Hirudin Hyaluronidase (seudohirudin *estabilase Apyrase $dellines . lines 0ininases Hista!ine-li2e substances 4olla enase Leech prostanoids #nhibitor of 2alli2rein of the blood plas!a (roteases Lipolytic en5y!es #ntibitor of 6a factor of the blood coa ulation Tri lyceridase 4holesterol esterase Lipase

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(c)2005-2006 Niagara Medica Leeches

Leech 7acts
5. There are 7,8 known species of leeches. <. The largest leech disco$ered measured 5: inches. =. .bout one fifth of leech species li$e in the sea, where they feed on fish. 6. The leech has =< brains. ,. The 0irudo leech lays its babies within a cocoonB whereas the .mazon leech carries its babies on its stomach ! sometimes as many as =88. 7. ;ot all leeches are bloodsuckers. Many are predators which eat earthworms, etc. @. The .mazon leech uses a different method of sucking blood. 2t inserts a long proboscis into the $ictim, as opposed to biting. :. The bite of a leech is painless, due to its own anaesthetic. A. The 0irudo leech in#ects an anti!coagulant serum into the $ictim to pre$ent the blood clotting. 58. The leech will gorge itself until it has had its fill and then #ust fall off. 55. The leech will gorge itself up to fi$e times its body weight. 5<. The first leech was used in medicine about 5888 .?., probably in ancient 2ndia. 5=. 2n the past, people would stand in the lakes and pools dotted around the country and when the leeches attached to their legs they would put them in baskets and sell them. Today the 0irudo leech is an endangered species. 56. The original surgeons were barbers and they used leeches to cure anything from headaches to gout* 5,. The ner$ous system of the leech is $ery similar to the human ner$ous system and is an enormous benefit to researchers in their >uest for the answers to human problems. 57. The nearest relati$es of leeches are earthworms. 5@. Leeches can bite through a hippo's hide*
(c)2005-2006 Niagara 1487367 Ontario Inc.

.bout Leeches Leeches in Medicine -.S. appro$es leeches for therapy 0irudotherapy Therapeutic properties uy Leeches ! 1ricing 2nformation Leeches and a 0istory of Medicine ack to Leeches for sale -S.

Hirudo medicinalis
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Hirudo medicinalis

4onservation status

;ear Threatened 32-?; <.=4 L5M Scientific classification Cingdom" .nimalia 1hylum" .nnelida ?lass" ?litellata Order" 0irudinida +amily" 0irudinidae 9enus" Hirudo Species" H. medicinalis $ino!ial na!e Hirudo medicinalis
Linnaeus, 5@,:

8edicinal leeches are any of se$eral species of leeches, but most commonly Hirudo medicinalis, the .uropean !edicinal leech. Other Hirudo species sometimes used as medicinal leeches include 3but are not limited to4 Hirudo orientalis, Hirudo troctina, and Hirudo verbana. The Me%ican medical leech is Hirudinaria manillensis, and the ;orth .merican medical leech is Macrobdella decora.

4ontents

5 Morphology

< (ange and ecology = Medicinal use o =.5 2n the past o =.< Today 6 See also , (eferences 7 /%ternal links

8orpholo y
The general morphology of medicinal leeches follows that of most other leeches. +ully mature adults can be up to <8 cm in length, and are green, brown, or greenish!brown with a darker tone on the dorsal side and a lighter $entral side. The dorsal side also has a thin red stripe. These organisms ha$e two suckers, one at each end, called the anterior and posterior suckers. The posterior is used mainly for le$erage, whereas the anterior sucker, consisting of the #aw and teeth, is where the feeding takes place. Medicinal leeches ha$e three #aws 3tripartite4 that look like little saws, and on them are about 588 sharp teeth used to incise the host. The incision lea$es a mark that is an in$erted H inside of a circle. .fter piercing the skin and in#ecting anticoagulants 3hirudin4 and anaesthetics, they suck out blood. Large adults can consume up to ten times their body weight in a single meal, with ,!5, ml being the a$erage $olume taken.L<M These leeches can li$e for up to a year between feeding. Medicinal leeches are hermaphrodites that reproduce by se%ual mating, laying eggs in clutches of up to ,8 near 3but not under4 water, and in shaded, humid places.

9an e and ecolo y

Typical habitat with a large population of Hirudo medicinalis, in 9ermany Their range e%tends o$er almost the whole of /urope and into .sia as far as Cazakhstan and -zbekistan. The preferred habitat for this species is muddy freshwater pools and ditches with plentiful weed growth in temperate climates.

O$er!e%ploitation by leech collectors in the 5Ath century has left only scattered populations, and reduction in natural habitat though drainage has also contributed to their decline. .nother factor has been the replacement of horses in farming 3horses were medicinal leeches' preferred food source4 and pro$ision of artificial water supplies for cattle. .s a result, this species is now considered $ulnerable by the 2-?;, and /uropean medicinal leeches are legally protected through nearly all of their natural range. They are particularly sparsely distributed in +rance and elgium, and in the -C there may be as few as <8 remaining isolated populations 3all widely scattered4. The largest 3at Lydd4 is estimated to contain se$eral thousand indi$idualsB 5< of these areas ha$e been designated Sites of Special Scientific 2nterest. There are small, transplanted populations in se$eral countries outside their natural range, including the -S..

8edicinal use
#n the past

/arthenware #ar for holding medicinal leeches The first description of leech therapy, classified as blood letting, was found in the te%t of Sushruta samhita 3dating :88 .?.4 written by Sushruta, who was also considered the father of plastic surgery. 0e described about 7 types of leeches 3poisonous and non!poisonous4. &iseases where leech therapy was indicated were skin diseases, sciatica, and musculoskeletal pains. 2n medie$al and early modern medicine, the medicinal leech 3Hirudo medicinalis and its congeners Hirudo verbana, Hirudo troctina, and Hirudo orientalis4 was used to remo$e blood from a patient as part of a process to )balance) the )humors) that, according to 9alen, must be kept in balance for the human body to function properly. 3The four humors of ancient medical philosophy were blood, phlegm, black bile, and yellow bile.4 .ny sickness that caused the sub#ect's skin to become red 3e.g. fe$er and inflammation4, so the theory went, must ha$e arisen from too much blood in the body.

Similarly, any person whose beha$ior was strident and )sanguine) was thought to be suffering from an e%cess of blood. Leeches were often gathered by leech collectors and were e$entually farmed in large numbers. . recorded use of leeches in medicine was also found during <88 .?. by the 9reek physician ;icander in ?olophon.L<M Medical use of leeches was discussed by .$icenna in The Canon of Medicine 358<8s4, and by .bd!el!latif al! aghdadi in the 5<th century.Lcitation neededM The use of leeches began to become less widespread towards the end of the 5Ath century.L<M 'ikimedia ?ommons has media related to" Medical leeches

Today
Medicinal leeches are now making a comeback in microsurgery. They pro$ide an effecti$e means to reduce blood coagulation, to relie$e $enous pressure from pooling blood 3$enous insufficiency4, and in reconstructi$e surgery to stimulate circulation in reattachment operations for organs with critical blood flow, such as eyelids, fingers, and ears.L=ML6ML,M The therapeutic effect is not from the blood taken in the meal, but from the continued and steady bleeding from the wound left after the leech has detached.L<M The most common complication from leech treatment is prolonged bleeding, which can easily be treated, although allergic reactions and bacterial infections may also occur.L<M ecause of the minuscule amounts of hirudin present in leeches, it is impractical to har$est the substance for widespread medical use. 0irudin 3and related substances4 are synthesised using recombinant techni>ues. &e$ices called )mechanical leeches) that dispense heparin and perform the same function as medicinal leeches ha$e been de$eloped, but they are not yet commercially a$ailable.L7ML@ML:M

See also

0elminthic therapy N other medical use of parasites 2chthyotherapy N medical use of fish

9eferences
5. <. =. 6. ,. 7. : 'orld ?onser$ation Monitoring ?entre 35AA74. )Hirudo medicinalis). I C! "ed #ist of Threatened $pecies. %ersion &''(.&. 2nternational -nion for ?onser$ation of ;ature. (etrie$ed .pril <6, <858. O a b c d e 'ells M&, Manktelow (T, oyd E , owen F 35AA=4. )The medical leech" an old treatment re$isited). Microsurgery %) 3=4" 5:=N7. 1M2& :6@A=57. : .bdelgabar .M, howmick C 3March <88=4. )The return of the leech). Int. ). Clin. *ract. +- 3<4" 58=N,. 1M2& 5<775@A<. : /rnst / 3Euly <88:4. ) orn to suck!!the return of the leechJ). *ain %'- 3<4" <=,N7. doi"58.5857P#.pain.<88:.8<.857. 1M2& 5:=7@==,. : )Shark!bite surfer gi$es leeches a go). The Australian. <88A!8<!<,. (etrie$ed <88A!8<!<,. : Salleh, .nna. . mechanical medicinal leechJ A+C $cience ,nline. <885!5<!56. (etrie$ed on <88@!8@!<A.

@.

: ?rystal, ?harlotte. iomedical /ngineering Student 2n$ents Mechanical Leech niversity of %irginia !e-s. <888!5<!56. (etrie$ed on <88@!8@!<A. :. : +o%, Maggie. /;T (esearch 9roup (ecognized for Mechanical Leech 1ro#ect ,to-eb. -ni$ersity of 'isconsin, Madison, &i$ision of Otolaryngology. (etrie$ed on <88@!8@!<A.

.;ternal lin2s

Ta%onomy page in 1ubmed with many e%cellent references &ocumentary about alternati$e medicine with leeches and maggots &ocument concerning the history of loodletting

Leech
+rom 'ikipedia, the free encyclopedia Eump to" na$igation, search +or other uses, see Leech 3disambiguation4. Leech

Hirudo medicinalis

Scientific classification Cingdom" .nimalia 1hylum" .nnelida ?lass" ?litellata Hirudinea Subclass"
Lamarck, 5:5:

#nfraclasses

.canthobdellidea /uhirudinea 3but see below4 Leeches are segmented worms that belong to the phylum .nnelida and comprise the subclass Hirudinea.L5M Like other oligochaetes, such as earthworms, leeches share a clitellum and are hermaphrodites. ;e$ertheless, they differ from other oligochaetes in significant ways. +or e%ample, leeches do not ha$e bristles and the e%ternal segmentation of their bodies does not correspond with the internal segmentation of their organs. Their bodies are much more solid as the spaces in their coelom are dense with connecti$e tissues. They also ha$e two suckers, one at each end. The ma#ority of leeches li$e in freshwater en$ironments, while some species can be found in terrestrialL<M and marine en$ironments, as well. Most leeches are hematophagous, as they are predominantly blood suckers that feed on blood from $ertebrate and in$ertebrate animals.L=M .lmost @88 species of leeches are currently recognized, of which some 588 are marine, A8 terrestrial and the remainder freshwater ta%a.L6M Leeches, such as the Hirudo medicinalis, ha$e been historically used in medicine to remo$e blood from patients.L,M The practice of leeching can be traced to ancient 2ndia and 9reece, and continued well into the 5:th and 5Ath centuries in both /urope and ;orth .merica. 2n modern times, the practice of leeching is much rarer and has been replaced by other contemporary uses of leeches, such as the reattachment of body parts and reconstructi$e and plastic surgeries L7M and, in 9ermany, treating osteoarthritis.L@ML:M

4ontents

5 Ta%onomy and systematics < .natomy and physiology o <.5 (eproduction and de$elopment o <.< &igestion = eha$ior o =.5 +eeding =.5.5 (emo$al and treatment 6 Medicinal use of leeches , (eferences 7 /%ternal links

Ta;ono!y and syste!atics

Haemadipsa .eylanica, a terrestrial leech found in the mountains of Eapan Leeches are presumed to ha$e e$ol$ed from certain Oligochaeta, most of which feed on detritus. 0owe$er, some species in the Lumbriculidae are predatory and ha$e similar adaptations as found in leeches. .s a conse>uence, the systematics and ta%onomy of leeches is in need of re$iew. 'hile leeches form a clade, the remaining oligochaetes are not their sister ta%on, but in a di$erse paraphyletic group containing some lineages that are closely related to leeches, and others that are far more distant. There is some dispute as to whether 0irudinea should be a class itself, or a subclass of the ?litellata. The resolution mainly depends on the e$entual fate of the oligochaetes, which as noted abo$e, do not form a natural group as traditionally circumscribed. .nother possibility would be to include the leeches in the ta%on Oligochaeta, which would then be ranked as a class and contain most of the clitellates. The ranchiobdellida are leechlike clitellates that were formerly included in the 0irudinea, but are #ust really close relati$es. The more primiti$e .canthobdellidea are often included with the leeches, but some authors treat them as a separate clitellate group. True leeches of the infraclass /uhirudinea ha$e both anterior and posterior suckers. They are di$ided into two groups" .rhynchobdellida and (hynchobdellida

(hynchobdellida are )#awless) leeches, armed with a muscular, straw!like proboscis puncturing organ in a retractable sheath. The (hynchobdellae consist of two families" o 9lossiphoniidae are flattened leeches with poorly defined anterior suckers. o 1iscicolida ha$e cylindrical bodies and usually well!marked, bell!shaped, anterior suckers. The 9lossiphoniidae li$e in freshwater habitatsB the 1isciolidae are found in seawater habitats. .rhynchobdellida lack a proboscis and may or may not ha$e #aws armed with teeth. .rhynchobellids are di$ided into two orders" o 9nathobdela" 2n this order of )#awed) leeches, armed with teeth, is found the >uintessential leech" the /uropean medical 3bloodsucking4 leech, Hirudo medicinalis. 2t has a tripartite #aw filled with hundreds of tiny, sharp teeth. The incision mark left on the skin by the /uropean medical leech is an in$erted H inside a circle. 2ts ;orth .merican counterpart is Macrobdela decora, a much less efficient medical leech.LAM 'ithin this order, the family 0irudidae is characterized by a>uatic leeches and the family 0aemadipsidae by terrestrial leeches. 2n the latter are Haemadipsa sylvestris, the 2ndian leech and Haemadipsa .eylanica 3yamabiru4, the Eapanese mountain or land leech.

1haryngobdella" These so!called worm!leeches consist of freshwater or amphibious leeches that ha$e lost the ability to penetrate a host's tissue and suck blood. They are carni$orous and e>uipped with a relati$ely large, toothless mouth to ingest worms or insect lar$ae, which are swallowed whole. The 1haryngobdella ha$e si% to eight pairs of eyes, as compared with fi$e pairs in 9nathobdelliform leeches, and include three related families. The /rpobdellidae are some species from freshwater habitats.

Anato!y and physiolo y

The leech and its ner$ous system

The number and position of eyes are essential for distinguishing the leech species. Like other annelids, the leech is a segmented animal. ut unlike other annelids, there is no correspondence between the e%ternal segmentation of a leech's body surface with the segmentation of its internal organs.L5M The body surface of the animal can be di$ided into 58< annuli, whereas its internal structures are di$ided into =< segments.L58M Of the =< segments within the body, the first four anterior segments are designated as head segments, which include an anterior brain and sucker. This is followed by <5 midbody segments, which include <5 neuronal ganglia, two reproducti$e organs, and A pairs of testes. +inally, the last se$en segments are fused to form the animal's tail sucker, as well as its posterior brain.

9eproduction and develop!ent

Leeches are hermaphrodites, meaning each has both female and male reproducti$e organs 3o$aries and testes, respecti$ely4. Leeches reproduce by reciprocal fertilization, and sperm transfer occurs during copulation. Similar to the earthworms, leeches also use a clitellum to hold their eggs and secrete the cocoon. &uring reproduction, leeches use hyperdermic in#ection of their sperm. They use a spermatophore, which is a structure containing the sperm. Once ne%t to each other, leeches will line up with one's anterior side opposite the other's posterior. The leech then shoots the spermatophore into the clitellur region of the opposing leech, where its sperm will make its way to the female reproducti$e parts. The embryonic de$elopment of the leech occurs as a series of stages. &uring stage 5, the first clea$age occurs, which gi$es rise to an . and a ?& blastomere, and is in the interphase of this cell di$ision when a yolk!free cytoplasm called teloplasm is formed.L55M The teloplasm is known to be a determinant for the specification of the & cell fate.L5<M 2n stage =, during the second clea$age, an une>ual di$ision occurs in the ?& blastomere. .s a conse>uence, it creates a large & cell on the left and a smaller ? cell to the right. This une>ual di$ision process is dependent on actinomycin,L5=M and by the end of stage = the . cell di$ides. On stage 6 of de$elopment, the micromeres and teloblast stem cells are formed and subse>uently, the & >uadrant di$ides to form the &M and the &;O1G teloblast precursor cells. y the end stage 7, the zygote contains a set of <, micromeres, = macromeres 3., and ?4 and 58 teloblasts deri$ed from the & >uadrant.L56M

The teloblasts are pairs of fi$e different types 3M, ;, O, 1, and G4 of embryonic stem cells that form segmented columns of cells 3germinal band4 in the surface of the embryo.L5,M The M!deri$ed cells make mesoderm and some small set of neurons, ; results in neural tissues and some $entral ectoderm, G contributes to the dorsal ectoderm and O and 1 in the leech are e>uipotent cells 3same de$elopmental potential4 that produce lateral ectodermB howe$er the difference between the two of them is that 1 creates bigger batches of dorsolateral epidermis than O.L5<M The sludgeworm Tubifex, unlike the leech, specifies the O and 1 lineages early in de$elopment and therefore, these two cells are not e>uipotent.L57M /ach segment of the body of the leech is generated from one M, O, 1 cell types and two ; and two G cells types.L5<M The ectoderm and mesoderm of the body trunk are e%clusi$ely deri$ed from the teloblast cells in a region called the posterior progress zone.L5@ML5:M The head of the leech that comes from an unsegmented region, is formed by the first set of micromeres deri$ed from ., , ? and & cells, keeping the bilateral symmetry between the .& and ? cells.L5:M

*i estion

Mouthparts and sucker 2n most blood!sucking leeches the digesti$e system starts with the so!called #aws, three blades set at an angle to each other. 2n feeding they slice their way through the skin of the host, lea$ing a H!shaped incision. ehind the blades is the mouth, located $entrally at the anterior end of the body. 2t leads successi$ely into the pharyn%, then the esophagus, the crop, the gizzard, and the intestinum, which ends at the posterior sucker. The crop is a distension of the alimentary canal that functions as an e%pandable storage compartment. 2n the crop, some blood!sucking species of leech can store up to fi$e times the body mass of blood. The leech produces an anticoagulant that pre$ents the stored blood from clotting, plus other agents that inhibit microbial decay of the blood. These measures are so effecti$e that a mature medicinal leech does not need to feed more than twice a year. 1ossibly as an adaptation, its digesti$e process is e%tremely slow. The bodies of predatory leeches are similar, though instead of #aws many ha$e a protrusible proboscis, which for most of the time they keep retracted into the mouth. Such leeches often are ambush predators that lie in wait till they can strike prey with the proboscises in a spear!like fashion.L5AM Some kinds that li$e on small in$ertebrates or detritus ha$e neither proboscis nor #aws, but simply engulf their food with the mouth.

acteria in the gut were long thought to carry on digestion for the leech, instead of endogenous enzymes that are $ery low or absent in the intestine. .s disco$ered relati$ely recently, all leech species studied do produce endogenous intestinal e%opeptidases,L=M which can unlink free terminal!end amino acids, one monomer at a time from a gradually unwinding and degrading protein polymer. 0owe$er, unzipping of the protein can start from either the amino 3tail4 or carbo%yl 3head4 terminal!end of the protein molecule. The leech e%opeptidases 3arylamidases4, possibly aided by proteases from endosymbiotic bacteria in the intestine, starting from the tail or amino end, slowly but progressi$ely remo$ing many hundreds of indi$idual terminal amino acids for resynthesis into proteins that constitute the leech. Since leeches lack endopeptidases, the mechanism of protein digestion cannot follow the same se>uence as it would in all other animals in which e%opeptidases act se>uentially on peptides produced by the action of endopeptidases.L=M /%opeptidases are especially prominent in the common ;orth .merican worm!leech /rpobdella punctata. This e$olutionary choice of e%opeptic digestion in 0irudinea distinguishes these carni$orous clitellates from Oligochaeta. &eficiency of digesti$e enzymes 3e%cept e%opeptidases4, but, more importantly, deficiency of $itamins, comple% for e%ample, in leeches is compensated for by enzymes and $itamins produced by endosymbiotic microflora. 2n Hirudo medicinalis, these supplementary factors are produced by an obligatory symbiotic relationship with two bacterial species, Aeromonas veronii and a still!uncharacterized "i0enella species. ;onbloodsucking leeches, such as /rpobdella punctata, are host to three bacterial symbionts, *seudomonas, Aeromonas, and 1lebsiella spp. 3a slime producer4. The bacteria are passed from parent to offspring in the cocoon as it is formed.

$ehavior

Leech climbing a door by Lake Leake, Tasmania Leeches are able to display a $ariety of beha$iors that allow them to e%plore their en$ironments and feed on their hosts. /%ploratory beha$ior includes head mo$ements and body wa$ing.L=M

7eedin

Leech attacking a slug Most leech species do not feed on human blood, but instead prey on small in$ertebrates, which they eat whole. To feed on their hosts, leeches use their anterior suckers to connect to hosts for feeding, and also release an anesthetic to pre$ent the hosts from feeling them. Once attached, leeches use a combination of mucus and suction to stay attached and secrete an anticoagulant enzyme, hirudin, into the hosts' blood streams. Though certain species of leeches feed on blood, not all species can biteB A8Q of them feed solely on decomposing bodies and open wounds of amphibians, reptiles, waterfowl, fish, and mammals 3including humans4. . leech attaches itself when it bites, and it will stay attached until it becomes full, at which point it falls off to digest. &ue to the hirudin that leeches secrete, bites may bleed more than a normal wound after the leech is remo$ed. The effect of the anticoagulant will wear off se$eral hours after the leech is remo$ed and the wound is cleaned. Leeches normally carry parasites in their digesti$e tracts, which cannot sur$i$e in humans and do not pose a threat. 0owe$er, bacteria, $iruses, and parasites from pre$ious blood sources can sur$i$e within a leech for months, but only a few cases of leeches transmitting pathogens to humans ha$e been reported.L<8M . study found both 02F and hepatitis in .frican leeches from ?ameroon.L<5M

9e!oval and treat!ent

. land leech can be remo$ed by hand, since they do not burrow into the skin or lea$e the head in the wound.L<<M . sore de$elops and lasts for about a week.L<=M 9rande (onde (i$er, Oregon 3-.S.4

One recommended method of remo$al is using a fingernail or other flat, blunt ob#ect to break the seal of the oral sucker at the anterior end of the leech, repeating with the posterior end, then flicking the leech away. .s the fingernail is pushed along the person's skin against the leech, the suction of the sucker's seal is broken, at which point the leech will detach its #aws.L<6ML<,M ?ommon, but medically inad$isable, techni>ues to remo$e a leech are to apply a flame, a lit cigarette, salt, soap, or a chemical such as alcohol, $inegar, lemon #uice, insect repellent, heat rub, or certain carbonated drinks. These will cause the leech to >uickly detachB howe$er, it will also regurgitate its stomach contents into the wound. The $omit may carry disease, and thus increase the risk of infection.L<6ML<,ML<7M .n e%ternally attached leech will detach and fall off on its own when it is satiated on blood, which may be anywhere from <8 minutes to two hours or more. .fter feeding, the leech will detach and depart.L<7M 2nternal attachments, such as inside the nasal passage or $aginal attachments, are more likely to re>uire medical inter$ention.L<@ML<:M .fter remo$al or detachment, the wound should be cleaned with soap and water, and bandaged. leeding may continue for some time, due to the leech's hirudin. leeding time will $ary, with location, from a few hours to three days. This is a function of the hirudin and other compounds that reduce the surface tension of the blood. .nticlotting medications also affect the bleeding time. .pplying pressure can reduce bleeding, although blood loss from a single bite is not dangerous. The wound normally itches as it heals, but should not be scratched, as this may complicate healing and introduce other infections. .n antihistamine can reduce itching, and applying a cold pack can reduce pain or swelling. Some people suffer se$ere allergic or anaphylactic reactions from leech bites and re>uire urgent medical care. Symptoms include red blotches or an itchy rash o$er the body, swelling around the lips or eyes, feeling faint or dizzy, and difficulty breathing.L<7M

8edicinal use of leeches

+urther information" 0irudotherapy The /uropean medical leech Hirudo medicinalis and some congeners, as well as some other species, ha$e been used for clinical bloodletting for thousands of years. The use of leeches in medicine dates as far back as <,,88 years ago, when they were used for bloodletting in ancient 2ndia. Leech therapy is e%plained in ancient .yur$edic te%ts. Many ancient ci$ilizations practiced bloodletting, including 2ndian and 9reek ci$ilizations. 2n ancient 9reek 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. .n imbalance in the proportions of these humors was belie$ed to be the cause of ill health. (ecords of this theory were found in the 9reek philosopher 0ippocrates' collection in the fifth century ?. loodletting using leeches was one method used by physicians to balance the humors and to rid the body of the plethora. The use of leeches in modern medicine made its comeback in the 5A:8s after years of decline, with the ad$ent of microsurgeries, such as plastic and reconstructi$e surgeries. 2n operations such as these, problematic $enous congestion can arise due to inefficient $enous drainage. Sometimes, because of the technical difficulties in forming an anastomosis of a $ein, no attempt is made to reattach a $enous supply to a flap at all. This condition is known as $enous insufficiency. 2f this congestion is not cleared up >uickly, the blood will clot, arteries that bring the tissues their necessary nourishment will become plugged, and the tissues will die. To pre$ent this, leeches are applied to a congested flap, and a certain amount of e%cess 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' sali$a. The combined effect is to reduce the swelling in the tissues and to promote healing by allowing fresh, o%ygenated blood to reach the area.L<AM The acti$e anticoagulant component of leech sali$a is a small protein, hirudin. &isco$ery and isolation of this protein led to a method of producing it by recombinant technology. (ecombinant hirudin is a$ailable to physicians as an intra$enous anticoagulant preparation for in#ection, particularly useful for patients who are allergic to or cannot tolerate heparin.

9eferences
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5,.

: F. C. erezo$skii K M. Shankland 35AA74. )Segmental di$ersification of an identified leech neuron correlates with the segmental domain in which it e%presses Lo%<, a member of the 0o% gene family). )ournal of !eurobiology &1 3=4" =5AN=<A. doi"58.588<P3S2?2458A@! 67A,35AA78=4<A"=T=5A"".2&!;/-6U=.8.?OB<!?. 1M2& :A8@575. 57. : .. .rai, .. ;akamoto K T. Shimizu 3<8854. )Specification of ectodermal teloblast lineages in embryos of the oligochaete annelid Tubifex" in$ol$ement of no$el cell!cell interactions). Development %&/ 3@4" 5<55N5<5A. 1M2& 55<6,,:@. 5@. : &. ;ardelli!0aefliger K M. Shankland 35AA=4. )#ox9', a member of the !1-& homeobo% gene class, is e%pressed in a segmental pattern in the endoderm and in the cephalic ner$ous system of the leech Helobdella). Development %%/ 3=4" :@@N:A<. 1M2& @A5,7@5. 5:. O a b M. Shankland K .. /. ruce 35AA:4. ).%ial patterning in the leech" de$elopmental mechanisms and e$olutionary implications). +iological +ulletin %1+ 3=4" =@8N=@<. doi"58.<=8@P5,6=5,8. ESTO( 5,6=5,8. 1M2& AA<6@@@. 5A. : 9o$edich, +redric (.B ain, onnie .. 3March 56, <88,4. ).ll about leeches). (etrie$ed Eanuary 5A, <858. <8. : .hl!Chleif ., (oth M, Menge ?, 0euser E, al#er 9, 0erbst ' 3<8554. )Tenacity of mammalian $iruses in the gut of leeches fed with porcine blood). )ournal of Medical Microbiology ,3 374" @:@N@A<. doi"58.58AAP#mm.8.8<@<,8!8. <5. : ;ehili M, 2lk ?, Mehlhorn 0, (uhnau C, &ick ', ;#ayou M 35AA64. )/%periments on the possible role of leeches as $ectors of animal and human pathogens" a light and electron microscopy study). *arasitology "esearch /3 364" <@@NA8. doi"58.588@P +8<=,5:7@. 1M2& :8@=85=. <<. : urke, &on 3<88,4. The complete +ur0e:s bac0yard8 the ultimate boo0 of fact sheets. Murdoch ooks. 2S ; 5!@686,!@=A!8. (etrie$ed <88A!8A!55. <=. : +u#imoto, 9aryB Marc (obin and radford &essery 3<88=4. The Traveler:s Medical 3uide. 1rairie Smoke 1ress. 2S ; 8!A@866:<!,!<. (etrie$ed <88A!8A!55. <6. O a b )The Cnowledge" (emo$ing a leech). Times Online. October 5,, <887. (etrie$ed Euly <:, <88@. <,. O a b Scenario .rchi$e, Tra$el Sur$i$al" 0ow to (emo$e a Leech 'orst ?ase Scenarios. (etrie$ed on <88@!8@!<:. <7. O a b c Fictorian 1oisons 2nformation ?entre" Leeches Fictorian 1oisons 2nformation ?entre. (etrie$ed on <88@!8@!<:. <@. : 2brahim, .dibahB 9harib, 0akim ilalB idin, Mohd. ;izar 3<88=4. ).n -nusual ?ause Of Faginal leeding" . ?ase (eport). The Internet )ournal of 3ynecology and ,bstetrics & 3<4. 2SS; 5,<:!:6=A. <:. : lood!sucker gets up woman's nose (euters $ia . ? ;ews. <88,!86!55. (etrie$ed on <88@!8@!<:. <A. : ?alling &octors Leech and Maggot to the O.(. 2slamonline.net

.;ternal lin2s
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Leech fact sheet, .ustralian Museum ;orth .merican leeches 0ow to remo$e a leech