Leech Therapy in Ayurveda - A unique modality of treatment in Ayurveda - Insights into Scientific Aspects, Mode of Usage and its scope in treatment of Various Diseases.

1. By,
Dr. Adithya J V
Assistant Professor
JSS Ayurveda Medical College and Hospital
Mysuru-08
1

2. Index
INTRODUCTION
HISTORICAL ASPECTS OF LEECH
DEFINITION OF JALAUKA
HABITAT AND COLLECTION OF LEECHES
TYPES OF JALAUKA
PRACTICAL APPLICATION OF JALAUKA
ANATOMY AND PHYSIOLOGY OF LEECHES
LATEST ADVANCEMENTS IN THE FIELD OF LEECHES
BIBLIOGRAPHY
2

3. Importance of Jaloukavacharana
3

4. 4

5.  Sushruta Samhita, the oldest available manual on surgery has
devoted an entire chapter for the description of Jalaukas in the
chapter Jalaukavacharaniya adhyaya for the purpose of blood
letting.
 Jalaukavacharana is claimed to be the supreme therapy
because of its safety and high efficacy in the disorders
involving the vitiation of blood.
5

6.  They were used as a surgical agents to extract the blood of
patients in a painless manner.
 For this reason, leeches were extensively used, in the past, in
surgery for blood letting (Phlebotomy).
 From the time of early Greek medicine, there are records of
leeches for blood letting.
6

7. Reference in Unani Medicine
 Unani medicine has also described the surgery – Ilaj-bil-
Yad. In this, they had mentioned leeching as a Taleeq.
According to them, leech application is a unique method
for removal of toxic matter from the blood.
 It is useful in Slun diseases i.e. baldness and ring worm.
7

8. References made by Eminent Scholars
 Blood letting tools have been dated to the Stone Age.
 There is evidence of therapeutic bloodletting among
Ancient Egyptians, Aztecs, Babylonians, although the first
written record of the practice is found in the Corpus
Hippocraticum.
 Avicenna, in his book “ Cannon of Medicine”, has described
utility of leech therapy in various diseases.
8

9.  Hirudo medicinalis, was commonly used for phlebotomy in
Europe in olden times and the practice, at one time spoken as
“leechery”, was so common that doctors themselves were often
called “Leeches”.
 The medicinal leech of America is Macrobdella decoraso, so great
was the demand for leeches for medicinal use that suitable
species were even cultured in huge leech farms.
 Nachtrieb (1912) states that about in year 1850, one American
leech farm disposed of as many as 1000 or more leeches daily.
About 7 million leeches were used in London hospitals and 5 to 6
million in Paris hospitals in 1863.
9

10. रक्थ मोक्षणा
अशस्त्र कृ ता
शृृंग जलौक अलाबु
शस्त्र कृ ता
प्रच्छान सिराव्यधन
10

11. 11

12. JALAUKA – ETYMOLOGY:
 जलमािामायुररतत जलायुका:, जलमािामॊक
ृं इतत जलौकि: ॥
िु.िू.१३/९
 जलौकिस्त्तु िुखिनाृं रक्तस्रावाय योजयेत् ॥
अ.हृ.२६/३५
 The word Jalauka is a compound word with two components
Jala + Ayu;
The animals having water as the life.
 The term Jalauka can be split into
Jala + Oka ;
The water dwelling animals.
12

13.  Shabdakalpadruma has considered Jalauka in feminine
gender and defined it as an aquatic creature employed to
expel out the vitiated blood.
 Bhagavadgomandalam defines Jalauka as an animal
living either in water or in mud with distended abdomen.
13

14. SYNONYMS
 Jalayuka, Jalaua, Jaluka, Jalaluka, Jaalalauka, Jalita, Jaloka,
 Jalauga, Jalatani, Jalaukas, Jalasuchi, Jalaukasu, Jalasarpini,
 Raktapata, Ruktapa, Raktapayini, Vanini, Vedhini, Venika.
14

15. ता द्वादश: , तािाृं िववष षट् , तावत्य एव तनवविष
॥
िु.िू.१३/१०
15

16. SAVISHA JALAUKA
 The Savisha Jalauka originates in ponds of stagnant and
turbid water containing the decomposed bodies of
poisonous insects, toads and poisonous fishes .
 General characters of Savisha Jalauka:
स्थूलमध्या: परिक्ललष्टा: प्रुथ्व्यो मन्दविचेक्ष्टता:।
अग्राहिण्यो अल्पपाहिन्य: सविषाश्चा न पूक्िता : ॥ (सु.सू.१८/१३)
16

17.  तत्र सविष : - कृ ष्ण कर्ुुि अलगदाु इन्रायुधा सामुहरका गोचन्दना ॥
िु.िू.१३/११
TYPES OF SAVISHA JALAUKA
17

18. 1. KRISHNA:
अन्िनचूणुिणाु
पृथुशिि: कृ ष्णा: ॥
िु.िू.१३/११
18

19. 2.KARBURA
िशमुमत्सस्यिदायता
चचन्नॊन्नत क
ु क्षि : कर्ुुिा
||
िु.िू.१३/११
19

20. 3.ALAGARDA
िॊमिा मिापाश्िाु
कृ ष्णामुखि अलगदाु ||
िु.िू.१३/११
20

21. 4.INDRAYUDHA
इन्रायुधिद् ऊध्िु
िाक्िशिक्स्चत्र इन्न्रायुधा
||
िु.िू.१३/११
21

22. 5.SAMUDRIKA
ईषदशसवपततका
विचचत्रपुष्पाकृ ततचचत्र
सामुहरक : ||
िु.िू.१३/११
22

23. 6.GOCHANDANA
गोिृषणित् अधोिागे
द्विधािुताकृ तति्
अणुमुखि गोचन्दन इतत
:॥
िु.िू.१३/११
23

24. FEATURES OF SAVISHA JALAUKA BITE:
 श््यतु अततमात्रं कण्डु मूर्च्ाु ज्िि दाि ्हदु मदा सदन ||
िु.िू.१३/११
24

25. NIRVISHA JALAUKA
 पद्मोत्सपल नशलन क
ु मुद सौगक्न्धक क
ु िलय पुन्डिीक
िैिालकोथिात विमलेष्िम्िसः च तनविुष ॥ िु.िू.१३/११
 Nirvisha Jalauka originates in decomposed vegetable
matter, as the putrified stems of the several aquatic plants
known as Padma, Utpala, Nalina, Kumuda, Pundarika and
common zoophytes, which live in clear water.
25

26. General characters of Nirvisha Jalauka:
 मिाशिि र्लित्सयः िीघ्रपातयन्योः मिािन ॥
िु.िू.१३/१३
 अथ तनविुषा : कवपला – वपन्गल - िंिमुखि – मूवषका –
पुन्डरिकमुखि – सािरिका ।
िु.िू.१३/१२
26

27. 1.KAPILA
मन:िीलािक्न्ितः
पाश्िाुभयां प्रुष्टे क्स्नग्धा
मुद्ग िणाुः ।
िु.िू.१३/१२
27

28. 2.PINGALA
िलता व्रुत्त्काया आिुगा: ॥
िु.िू.१३/१२
28

29. 3.SHANKAMUKHI
यक्र
ु द्िणाु िीघ्रपातयन्योः
दीर्ुतीक्ष्णमुिी ।
िु.िू.१३/१२
29

30. 4.MUSHIKA
मूवषकाक्र
ु ततिणाुः अतनष्ट
गन्धाः ।
िु.िू.१३/१२
30

31. 5.PUNDIRAKAMUKI
मुद्गिणाुः तुल्यिलत्र
पुन्डिीकमुिीः ।
िु.िू.१३/१२
31

32. 6.SAAVARIKA
क्स्नग्ध पद्मापत्रिणाु
अष्टादि अन्गुल प्रमाणा
।
िु.िू.१३/१२
32

33. 33

34. •Habitat of leech
•Methods of collection
•Time of collection
•Preservation of leeches after collection
34

35. Habitat of Non Poisonous leeches
तािाृं यवन पान्ड्या िह्या पौथनादीतन क्षेराखण
।िु.िू.१३/१२
Yavana
Region spawning from
afghanishthan ,turkmenistan and
parts of the european lands
Pandya
South India
Sahya
Western Ghats
Pouthana
Assam, west bengal,
meghalaya etc
35

36. Method of collection of leeches
 Acharya Sushruta, has told that the leeches can be caught with a piece
of wet leather - in tanks, streams and water bodies where there are
lotus.
 There is another method to collect the leeches i.e. the fresh meat of
dead animals, fish or milk must be applied on the thigh of an animal or
the human himself, then tie it around his thigh (Jangha) and immerse
tied part i.e. the Jangha in the water for some time. Due to attraction
towards these diet, Jalauka will come and start biting.
 Then they are made to leave dead meat/skin with the application of
Saindhava lavana (rock salt) and collected.
36

37. 37

38. Time of Collection
Sharad Ritu (Autumn)
OCTOBER TO NOVEMBER
38

39. Preservation of leeches
 It is put into a large sized new pitcher filled with water and
slime of the pool.
 Shaivala and powder of dried meat and aquatic bulbs
should be put into the pitcher for feeding.
 Blades of grass and leaves of aquatic plants should be put
into it for them to lie upon
 The water and edibles should be changed every two or three
days
 The pitcher should be changed every one week.
39

40. 40

41.  तत्र िात वपत्त कफ दुष्टिॊखणत यथा संखयां
श्ुंग िलौकालर्ुशिि् अिसेचयेत्॥ Su.Su.13/4
Blood vitiated by Vata – Pitta – Kapha should be let out by means of
Shrunga – Jalauka – Alaabu respectively.
 िीताचधिासा मधुिा िलौक िारिसंििा ।
तस्मात् वपत्तोप्सृष्टे तु हिता सा त्सििसेचने ॥ Su.Su.13/6
Leech emerges from water , Lives in Cold climate and is sweet and as such
is useful in blood letting in those diseases vitiated by Pitta.
41

42. PARAMA-SUKUMARO-AYAM
 नृप आड्य र्ाल स्थविि िीरु दुर्ुल नािी सुक
ु मािाणाम ् अनुग्रिाथुम्
पिमसुक
ु मािो अयं िोखणतािसेचन उपायो अशिहितो िलौकसः ॥
सु.सू.१३/३
 Application of leech is the most delicate method of blood
letting prescribed particularly for the benefit of
 Kings
 Wealthy persons
 Children
 Timid
 Debilitated
 Women
 Most Delicate persons
42

43. 43
गुल्मा अशिि्

44. 44
वात रक्त
क
ु ष्ट दुष्टा व्रणा

45. 45
श्वयतु
स्स्त्कन् ग्राफ़्टट्

46. 46
चमि रोगा चमाि रोगा

47. 47

48. 48

49. Classical method of application of leech
49

50. PURVA KARMA
Patient :
1. Examination of the patient who
is fit for Jalaukavacharana.
2. Preparation of the patient:
Snehana and Swedana Karma is
to be instituted to the affected site
where leech will be applied.
The affected part is to be rubbed
(Vigharshan) by the rough powder
of mrt or gomaya churna.
It is contraindicated if the part is
ulcerated.
Jalauka :
1. Selection of the leech
2. Activation of the leech
Before the application of
leech, it should be kept in the
Haridra mixed water till they
become active and then
cleaned with the help of pure
water.
50

51. ACTIVATION OF LEECH
 Acc. To Acharya Sushrutha :
ग्रहिताश्च िषिप-रजनीकल्कॊदक प्रहदग्ध गारे: िसललिरकमध्ये
मुिूति स्स्त्थता ववगतक्लमा ज्नात्व तास ृं रोगृं ग्राियेत् ॥
िु.िू.१३/१९
 Acc. To Acharya Vagbhatta :
Suitable jalauka must be selected and kept in water containing तनशा
कल्क, िोम (water in which grains are washed) or तक्र and it should be
made comfotable by putting back in pure water
51

52. 52

53. SCIENTIFIC REASON BEHIND THE
ACTIVATION OF LEECH
The digestive tract of the medicinal leeches has been
found out to contain two types of Bacteria’s namely :
* Aeromonas Veronii ;
* Aeromonas Rikenella ;
* Aeromonas Hydrophilla ;
If these enters into the blood circulation , it may cause
wound infections .
53

54. 54

55. PRADHANA KARMA
 The patient must be prepared as stated above. The leech will
be too much unctuous and soft and as a result it slips off from
the hand.
 It is better to catch leech either with the gauze or after wearing
the rubber gloves. Then the leeches should be taken out of
their receptacles and put over the selected place.
 Leeches attach to the skin by two muscular suckers before
biting with three jaws inside their anterior suckers and takes
the shape of horse shoe shape i.e
55

56. * अश्ििुििदानानं
*उन्नम्य च स्कन्धं
The leeches having stuck
to the affected part may
be inferred from the
mouths of the leeches
assuming the shape of
horseshoe and raised
and arched position of
their necks after they
had attached to the seat
of the disease.
56
यदा च तनववशते अश्विुरवदानानृं क्र
ु थ्वे उन्डनम्य च स्त्कन्डधृं तदााः
जानीयाद्ग्रुह्णातीतत: ||

57. 57

58. If the leech doesn’t bite the desired part:
अग्रह्णान्डत्यॆ क्षीर बबन्डदु शोणीत बबन्डदु वा दध्यात ् शस्त्रपदातन
वा क
ु वीत: यध्येवमवप न ग्रस्ह्णयात्त तदाअन्डयाृं ग्राियेत ् ॥
िु.िू.१३/१९
After leech starts sucking the blood ,
ग्रह्णास्न्डत चार्द्िवस्रावच्नन्डनृं क्र
ु त्व धारयेत ् ॥
िु.िू.१३/१९
58

59. Indicating signs for removing leech
 दृंशे तोद कण्डु प्रादु ािवै जानीयात ् च शुद्द्समयष्मदत्त ् इतत:
शुद्दमानामपनयेत ्|| िु.िू.१३/
- A sensation of itching at the seat of application.(लण्डु प्रादुिाुि)
- A drawing pain at the seat of application.(तोद)
59

60. िलौकास्त्सिात्सम प्रिािेण प्राग्दुष्टेमेि िलतं वपर्क्न्त ।
यथा दुग्धशमचश्त उदकां िंसो दुग्ध्मेि वपर्तीत्सयथुः॥
अ.ह्रु.सू २६/४२
60
Prabhava

61. Directions to remove the leech:
 अथ: शॊखणत गन्डधेन न मुन्डचेत ् मुिाम ् आस्त्या: िैन्डधव
चूणेनावककरेत ॥
िु.िू.१३/३४
 Sometimes leeches refuse to fall even after the appearance of the
desired signs, due to their fondness for the smell of blood.
 They should be sprinkled with the dust of powdered Saindhava
(Sushruta) or Haridra churna(Vagbhatta) upon their mouth.
61

62. PASCHATH KARMA
62

63. 1. Care of the patient
Samyak yoga
 िॊखणतस्य योगा-अयॊगान् िक्ष्य
ितधौतघ्र्ताभयन्ग: तक्त्सपचुधािणं िा:॥
 As soon as the leech is removed
from the body an application
with Shatadhauta Ghrita should
be applied on the wound; or
Pichu dipped in Shatadhauta
Ghrita should be kept on it.
 Heena Yoga
 िलौकव्रणान् मधुना अिर्ट्टट्टयेत्
िीताशििद्शि॥
 Ati Yoga
 परिषेचयेत् िध्नीयात् िा कषाय-
मधुि-क्स्नग्ध िीतैस्च प्रदेिै: ।
Asamyak Yoga
63

64. 2.Care of the leech :
 अथ पतततां तन्डुल कन्डन प्रहदग्धगात्रीं तैल लिणाभयुलतमुखिं िामिस्त अन्गुष्ट
अन्गुशलबयां ग्रिीत पुर्च्ा दक्षिणिस्तांगुष्टान्गुशलभयां िनैः िनेि्-अनुलोमम ्
अनुमािुयेत् मुिात् िामयेत् तािध्याित् सम््क िान्ताशलन्गातनतत॥
िु.िू.१३/३५
 After falling of, the leech body should be anointed with तन्डडुल्and mouth should be
massaged with oil and salt.
 Then they should be caught by the tail end with the thumb and the forefinger of the
left hand and their backs should be gently rubbed with the same fingers of the right
hand from tail upward to the mouth with a view to make them eject the full quantity
of blood.
 Then leeches should be kept in a separate pot containing pure water. 64

65. 65

66. Samyak Vantha Lakshana/Finding of proper vomitting
 िम्यग्वान्डता िसललिरक
े न्डयस्त्ता ोक्तु कामा िती चरेत॥
िु.िू.१३/२४
 अथृं िुवान्डता पूविवत ् िस्न्डनदध्यात ् ॥ िु.िू.१३/२७
 Leeches that had vomited the full quantity of blood sucked
would move very actively in quest of food when placed in water
on the contrary if there is no complete vomiting of blood they
would be lying dull and inactive.
66

67. Durvantha Lakshana:-
 या िीदती न चेष्टते िा दुवािन्डता, ताृं पुना: िम्यग ् वामयेत॥
िु.िू.१३/२९
 दुवािन्डत्या व्याधधर िाध्या इन्डर्द्मदो नाम वतत ।
िु.िू.१३/३०
 It gives rise to an incurable disease particularly known as
Indramada means Raktamada or Raktamatta.
67

68. 68

69. 69

70. 70

71.  Basically there are around 650 species of leeches found all over the
world.
 Medicinal leeches commonly used is the Hirudo medicinalis or the
European Medical Leech.
 Other species sometimes referred to as Medical Leeches include (but
are not limited to):
71
Hirudo
Verbana
Macrobdella
Decora
Hirudo
Troctina
Hirudo
Orientalis
Hirudo
Manillensis

72. HIRUDINARIA
 The genus Hirudinaria comprises fresh water leeches,
which are sanguivorus (Blood sucking) in habit and attack
domestic animals and man.
 Four species of these are found in India, namely H.
javanica, H. manillensis, H. granulosa and H. viridis
occurring in the ponds and ditches.
 The account given here refers to Hirudinaria granulosa.
72

73. FEATURES OF H.GRANULOSA
73

74.  H.Granulosa on maturity measures about twelve inches in length.
 It is greatly elongated, appears more or less cylindrical in a state of
contraction, but is found to be dorso-ventrally flattened in
stretched condition.
 The dorsal surface is more or less plane, transverse section of the
body, is elliptical in shape.
 The dorsal surface is green and ventral orange.
 The external surface of the body is segmented into about one
hundred rings or annuli by a series of well-marked grooves, which
are striking enough in natural condition.
74

75.  These organisms have two suckers, one at each end, called the
anterior and posterior suckers.
 The posterior is used mainly for leverage, whereas the anterior sucker,
consisting of the jaw and teeth, is where the feeding takes place.
 Medicinal leeches have three jaws (tripartite) that look like little saws and
on them are about 100 sharp teeth used to incise the host.
 Large adults can consume up to ten times their body weight in a single
meal, with 5-15 ml being the average volume taken.
 These leeches can live for up to a year between feeding
 Medicinal leeches are hermophrodites that reproduce by sexual mating,
laying eggs in clutches of up to 50 near water and in shaded, humid places.
 After birth leeches can live up to 19 or 30 years.
75

76. 76

77. Leech Eggs
77

78. SENSES AND MOBILITY
 Medicinal leeches have 5 pairs of eyes, but they do not see the full
spectrum of a picture, although leeches can find their way almost
perfectly.
 Smell, taste and touch are well-developed, which help leeches to
survive. It is worth noticing that leeches wonderfully respond to smell
of items that are deep down the water.
 Few researches tell a leech has 32 brains !!!
 Anterior and Posterior Brain with 21 segmental ganglions in turn
branching into about 175 sensory neurons from each ganglion.
78

79. 79

80. 80

81. 81

82. Sl.
No
Enzymes/Chemicals Action
01 Hirudin Restrains the clotting of the blood, works as diuretic and an
antibiotic. It keeps the wound open for the approx. 30 minutes
after sucking act and keeps the blood fluid.
02 Calin Restrains the blood clotting.
03 Hyaluronidase is a spreading factor that ensures that the other active
substances which are effective at the bitten areas can spread.
04 •
Eglins Restrains digestive proteases.
05 Bdellin These substances have antiphlogistic , antibiotic and further
characteristics.
06 Destabilase Dissolves Fibrin and has thrombolytic effects
07 Eglins Factor XA
Inhibitor
Inhibits the activity of coagulation factor XA
08 Compliment Inhibitors Replace natural compliment inhibitors if they are deficient
09 Carboxy peptidase A
inhibitors
Increases the inflow of blood
10 Acetyl Choline Vasodialotor
11 Anaesthetic Like
Substances
Reduces pain during the biting of leech
82

83. 83

84. A medicinal leech is a small factory to manufacture biologically
active substances which has following actions
 Normalization and improvement of capillary circulation.
 Vaso dialator
 Corrects venous hypertension
 Anticoagulation effect.
 Anti-inflammatory effect.
 Blood purification effect by expelling out the vitiated
blood.
 Improvement of an endocellular exchange.
 Early wound healing effect.
 Local Anesthetic effect.
 Anti-bacterial effect.
84

85. Mode of action in Infected Wounds
85

86. Mode of action in TAO
 In case of TAO, where the arterial insufficiency is the main
cause for discoloration of wound site.
 Hirudin and Hyaluronidase, breaks down hyaluronic acid.
86

87. Mode of action in Varicose veins & Ulcers
Venous decongestion
Reversal of edema
Hyper pigmentation reduces
Healing of varicose ulcer
87

88. Mode of action in inflammations
88

89. Mode of action in skin grafting/microvascular surgeries
 Failure of adequate venous return from a graft reduces blood supply,
causing tissue necrosis.
 Placing a leech on the congested skin flap, finger or compromised
area removes the congested blood and enables the graft to be salvaged.
 Leeches are currently used during post-operative care of reimplanted
fingers, skin grafts and breast reconstructions.
 Fresh leeches are applied as required for several days or weeks until the
venous congestion is relieved and normal venous drainage of the graft
has had time to develop.
89

90. 90

91. 91

92. 92

93. 93

94. Complications
 The histamine emitted by the leech can lead to an allergic
reaction, which may immediately occur, or within four
days.
 •A soreness after the bite rarely appears.
 •A small scar at the bitten area may remain for weeks.
 •
A plaster allergy is more often found after a treatment with
leeches, therefore it is advisable to use skin preserving,
hypoallergenic plasters.
94

95. •Chemical Advancements
•Mechanical Leech
•Certified Leech therapists
•Leech Oil in Cosmetics
95

96. •Two Slovenian surgeons, M. Derganc and F. Zdravic who published a paper in
the British Journal of Plastic Surgery in 1960 describing leech-assisted tissue
flap surgery (in which a flap of skin is freed or rotated from an adjacent body
area to cover a defect or injury).
•That paper and many other studies had helped put leech therapy in the list of
approved and classified medical devices in the very early of the 21st century,
the year of 2004.
•The French made it again by having the first approval for the
marketing of medicinal leeches in North America. 2004 was really the
greatest year for the surgeons and other physicians who have worked
with leeches in micro and constructive surgery.
•That was the year the FDA approved the request of the French company,
Ricarimpex, for the commercialization of medicinal leeches in the United
States. This approval of medicinal leeches as a medical device in the field of
plastic and reconstructive surgery has helped LEECH USA to do the
commercialization of the medicinal leeches in United States for the French
company. Leech USA has been selling medicinal leeches since 1986.
96

97.  Hirudin (and related substances) are synthesised
using recombinant techniques called as BIVALIRUDIN.
 Devices called “Mechanical leeches" that dispense
hirudin and perform the same function as medicinal
leeches have been developed, but they are not yet
commercially available.
97

98. Mechanical Leech
 A device invented to
augment blood removal
after passive bleeding
98

99. Working of the mechanical leech
99

100. Uses of Mechanical Leech
 Used to relieve venous congestion
 Prevents pooling of blood
 Increases tissue perforation and thus maintains
viability of the tissue until neovascularisation occurs.
100

101. BIVALIRUDIN
 Semi synthetic derivative of hirudin.
101

102. Uses of Bivalirudin
102

103. Advantages over heparin
103

104. Leech use in Cosmetics
 As for the advantages of the leech saliva, it improves blood
microcirculation and supplies oxygen to the tissues, stimulates the
local immune system, antioxidant activity, eliminates pigmentation
disorder, protects the skin from environment, slows down aging, makes
the skin more elastic and keeps moisture.
104

105. Leech extract
105

106. 106

107. 107

108. 108

109. 109

110. 110

111. 111

112. 112

113. 113

114. 114

115. 115

116. DISCUSSION
 Indications of leech told by Sushrutha holds good till today as
it can be safely applied in all ages and variety of raktha
pradoshaja vyadhies.
 Many people fear or faint just by the sight of blood. Hence, it is
visually appealing as the blood let out by the leech wont be
visible to the patients making them comfortable.
 They are very effective in treating very grave prognosed cases
like diabetic foot , DVT, Gangrene etc where it’s a limb saving
as well as life saving treatment.
116

117.  Its very cost effective treatment modality
 Its easily available
 Its a painless procedure in contrast to surgical techniques
used for blood letting.
 Can take up leech therapy as a profession
 Can take up leech farming as it is a very lucrative business
117

118. CONCLUSION
 क्षेराखण ग्रिणृं जातत: पोषण िावचारणृं ॥
जलौकिाृं च यो ववत्त तत्िाध्यान ि जयेत गदा ॥
 “The clinician who knows all about the leeches, habitat,
their method of collection, varieties, storage and method of
application is successful in treating the diseases amenable
to them” –
[Sushruta Su. 13/24].
118

119. e-References
 http://www.irjponline.com/admin/php/uploads/1247_p
df.pdf
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC329634
3/
 http://www.ncbi.nlm.nih.gov/pubmed/22736888
 http://interscience.org.uk/v2-i2/17%20ijahm.pdf
 https://www.researchgate.net/signup.SignUpFinished.
html
 https://www.google.co.in/search?q=jalaukavacharana+
ppt&oq=jalaukavachara&aqs=chrome.0.69i59l2j69i57.9
98358j0j8&sourceid=chrome&es_sm=122&ie=UTF-8

120. Points of Interest for discussion
 After how many days a same leech can be re-applied ?
रक्षन् रक्तमदाद््य: िप्ताहृं ता न पातयेत् ॥ अ.ह्रु.िू २६:४४
 What’s the maximum number of leeches that can be applied at a
single time ?
 What’s the quantity of blood that a leech sucks at a single time ?
 Does it act as a vector to transmit any blood borne diseases ?
M. Nehili , C. Ilk, H. Mehlhorn, K. Ruhnau, W. Dick, & M. Njayou; Ilk; Mehlhorn; Ruhnau; Dick; Njayou
(1994). "Experiments on the possible role of leeches as vectors of animal and human
pathogens: a light and electron microscopy study". Parasitology Research. 80 (4): 277–90.
doi:10.1007/BF02351867. PMID 8073013.
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121. 121

122. 122
Thank you