Leech therapy is an ancient Ayurvedic treatment that involves applying medicinal leeches to the skin to remove impure blood. It is indicated for various vascular, inflammatory, and skin diseases. Leeches secrete substances that help remove stagnant blood locally and systemically while their blood-sucking action also provides local effects. The therapy requires proper application and care of leeches, and has few side effects when done aseptically. It provides an effective and low-cost treatment option without major supportive drugs.

1. 1
Dr. Mahesh KumarDr. Mahesh Kumar
M.S.(Ay)-IMS,BHUM.S.(Ay)-IMS,BHU
Assistant ProfessorAssistant Professor
Department of Shalya TantraDepartment of Shalya Tantra
Ch. Brahm Prakash Ayurved Charak Sansthan,Ch. Brahm Prakash Ayurved Charak Sansthan,
Under Govt. of NCT of DelhiUnder Govt. of NCT of Delhi
Najafgarh, New Delhi-73Najafgarh, New Delhi-73
drmkguptabhu@gmail.comdrmkguptabhu@gmail.com
Leech Therapy:Leech Therapy:
““A Marvellous Bloodletting Practice in Ayurveda”A Marvellous Bloodletting Practice in Ayurveda”
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

2. AimAim
2
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
To submit an overview
of Leech
Therapy, an
ancient Ayurvedic
treatment method

3. 3
BackgroundBackground
Leeches are lower animal of Phylum
Annelida./ sanguivorous in nature.
Leeches can survive in water without food
for a long time but they can’t without water
even there is abundance food.
Jalaukavacharana=leech therapy- a
type of bloodletting
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

4. 4
SOME FACTS ABOUT LEECHES-SOME FACTS ABOUT LEECHES-
 The leech is a freshwaterThe leech is a freshwater annelidaannelida worm, usually blackworm, usually black
or brown and about 5 -15 cm in length.or brown and about 5 -15 cm in length.
Of the more than 650 known species in Hirudo
genus, 15 are mostly used for medicinal
purposes, Hirudo medicinalis being one of them.
Indian medicinal leech known as Hirudinaria
granulosa
It’s body is divided into 33 parts.
It has two suckers – anterior and posterior.
With anterior sucker it sucks the blood while the
posterior one provides stability to leech.
The scars produced due to bite of the leeches are
of ‘Y’ shape.
Phylum -
Annelida
Class -
Hirudinia
Order -
Gnathobdellida
Genus -
Hirudineria
Species -
MedicinalisENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

5. 5
IndicationIndication (A.H.Su.26/43 )
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

6. Peripheral Vascular Diseases
Dry Gangrene, Wet gangrene)
Atherosclerosis
Buerger’s Diseases
Reynauds Diseases
Varicose Vein
Deep Vein thrombosis
Arterial blockage
Venous obstruction
Other Diseases
Diseases of blood, , ,
Acne
Thrombosed pile mass
Thrombosis
Plastic surgery –skin grafting rejection
Inflammatory Diseases
•Abscess- Vidradhi
•Cellulitis
•Thrombophelebitis
•Chronic Epididymitis-orchits, Carbuncle,
Paronychia
•Inflammatory arthritis
•LymphadenitisLymphadenitis
Wound/ UlcerWound/ Ulcer
Wound, ulcer(simple)Wound, ulcer(simple)
Non Healing ulcer,Non Healing ulcer,
Chronic Multiple woundChronic Multiple wound
Osteomyelitic woundOsteomyelitic wound
Diabetic foot ulcerDiabetic foot ulcer
Venous ulcerVenous ulcer
Skin Diseases –
Dermatitis, eczema, Psoriasis,
Pruritis, Discoloured skin

7. ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019 7
Wound
Non healing ulcer
Venous ulcer

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Osteomyelitic
wound
Reynods D.
Buerger,s Diseases Deep vein Thrombosis

9. ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March
2019 9
Thromosed pile mass
Non-specific nasal
inflammation
Varicosevein

10. 10
Method of Leech therapyMethod of Leech therapy
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

11. ASHWAKHURAVADANANAM UNNATASKANDAM
AAfter knowing that it has started to suck the blood it should befter knowing that it has started to suck the blood it should be
covered with wet gauge and the gauge should be kept wet bycovered with wet gauge and the gauge should be kept wet by
continuously pouring water on it.continuously pouring water on it.
11ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

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Post application management
Care of Leech
Vomiting out blood
Put in fresh water
Then squeezed by opposite hand slowly and gently.
Don’t reuse same leech before 7days.
Care of patientCare of patient
Stop bleeding
Care of wound bite
bandaged properly.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

13. DiscussionDiscussion

14. 14
?? LEECH SUCKS IMPURE BLOOD
The reference came
from A.H.Su.26/43, As
a swan sucks only milk outswan sucks only milk out
of the mixture of milk andof the mixture of milk and
water, leech sucks impurewater, leech sucks impure
blood only.blood only.
What is impure blood –
Clotted blood
Stagnant blood
Deoxygenated blood
Nutrient less blood and
Contaminated blood (with micro-
organisms, allergens , poisons etc.)
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

15. 15
?? WHEN AND HOW TO REMOVE THE LEECH FROM
THE SITE
Mostly detached spontaneously
When pricking pain and itching
at the site of bite,
Don’t pull the leech forcefully.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

16. ?? Common problem in leech?? Common problem in leech
therapytherapy
16ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
 . Availability of fresh leech. Availability of fresh leech
 . Delayed leech attachment. Delayed leech attachment
 . Patient’s fear. Patient’s fear

17. ?? Problem in adopting…..to say?? Problem in adopting…..to say
yes…..solutionyes…..solution
17ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
 Proper education reduces fearProper education reduces fear
of patientof patient
 If patient. still reluctant ;If patient. still reluctant ;
arrange a pt. who has hadarrange a pt. who has had
similar disease.similar disease.

18. ?? Mode of action of Leech
.
18ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
A. By sucking blood
B – By injecting bio
active substances

19. 19
By sucking blood – local effectsBy sucking blood – local effects
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

20. 20
By injecting bioactive agents – It actBy injecting bioactive agents – It act
localiy & distally.localiy & distally.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

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Contraindication of leech therapy
Patient refusal, non interestingPatient refusal, non interesting
Arterial insufficiency diseasesArterial insufficiency diseases
Bleeding disorders, so asses it before therapyBleeding disorders, so asses it before therapy
Immunocompromised pt.Immunocompromised pt.
Anemic patient.Anemic patient.
Patients taking medicines like- Large dose ofPatients taking medicines like- Large dose of
vitamin E, Aspirin, heparin, warferin, NSAID, Garlic,vitamin E, Aspirin, heparin, warferin, NSAID, Garlic,
ginger, Ginkgo biloba etcginger, Ginkgo biloba etc
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019

22. 22
?? Whats are Adverse effects
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
 Local painLocal pain - according to the pain threshold of the- according to the pain threshold of the
patientpatient
 Local itchingLocal itching
 Hypotension and vasovagal attackHypotension and vasovagal attack (1 in 1000(1 in 1000
patients)- very rarepatients)- very rare
To avoid it proper history should be taken, Should takeTo avoid it proper history should be taken, Should take
plenty of water before application, close observation in firstplenty of water before application, close observation in first
visit.visit.
 Blood loss/ haemorrhage – generally insignificant.Blood loss/ haemorrhage – generally insignificant.

23. 23
?? Transmission of infectious
diseases like- AIDS, hepatitis-B
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 2019
Precaution- Proper aseptic conditions shouldPrecaution- Proper aseptic conditions should
be taken.be taken.
Prior screening of the patient . Avoid the re-Prior screening of the patient . Avoid the re-
application of the leech in another patient.application of the leech in another patient.

24.  The Leech therapy, a para-surgical procedure, have rich ancientThe Leech therapy, a para-surgical procedure, have rich ancient
reference, indicated in pittaja and raktaja diseases.reference, indicated in pittaja and raktaja diseases.
 Leech application as an adjuvant with drugs are foundLeech application as an adjuvant with drugs are found
very effective in inflammatory conditions, Inflammedvery effective in inflammatory conditions, Inflammed
piles, Herpes Zoster, Pimples & Thrombophlebitis,piles, Herpes Zoster, Pimples & Thrombophlebitis,
Eczema.Eczema.
 No severe side effect/ no need of supportive drugs.No severe side effect/ no need of supportive drugs.
 Needs less infrastructure/ Day care procedure.Needs less infrastructure/ Day care procedure.
 Bioactive chemicals and bloodsucking nature make it unique.Bioactive chemicals and bloodsucking nature make it unique.
 To find out mode of action of leech therapy requires more studyTo find out mode of action of leech therapy requires more study
 Aseptic precaution and proper care is requisite.Aseptic precaution and proper care is requisite.
ConclusionConclusion
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar 29-31 March 201924

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