Leech therapy, an ancient Ayurvedic method, is utilized for various medical conditions including peripheral vascular diseases and skin disorders by employing medicinal leeches to remove impure blood and introduce bioactive substances. The therapy requires careful pre-operative and post-operative management, including patient education to alleviate fears and ensure safety. Despite its efficacy and minimal side effects, proper aseptic precautions are essential to prevent infections.

1. 1
Dr. Mahesh Kumar
M.S.(Ay),
Department of Shalya Tantra
Ch. Brahm Prakash Ayurved Charak Sansthan,
Under Govt. of NCT of Delhi
Najafgarh, New Delhi-73
drmkguptabhu@gmail.com
Leech Therapy:
“A Marvellous Bloodletting Practice in Ayurveda”
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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

3. 3
Background
 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

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SOME FACTS ABOUT LEECHES-
 The leech is a freshwater annelida worm, usually black
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 -
Medicinalis
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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

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, रक्तज रोग , रक्त विकार ,
Acne
Thrombosed pile mass
Thrombosis
Plastic surgery –skin grafting rejection
Inflammatory Diseases
 Abscess- Vidradhi
 Cellulitis
 Thrombophelebitis
 Chronic Epididymitis-orchits, Carbuncle,
Paronychia
 Inflammatory arthritis
 Lymphadenitis
Wound/ Ulcer
Wound, ulcer(simple)
Non Healing ulcer,
Chronic Multiple wound
Osteomyelitic wound
Diabetic foot ulcer
Venous ulcer
Skin Diseases – त्वक ववकार
Dermatitis, eczema, Psoriasis,
Pruritis, Discoloured skin

7. ENDOSURG-2019 AIIMS NEW DELHI – Leech
Therapy Dr Mahesh Kumar 7

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Therapy Dr Mahesh Kumar 8

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Pre – op preparation
Preparation
of patient
Preparation
of Leech
Method of Leech therapy
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
Main procedure
Close
observation
and care
Bloodletting
Post-therapy care
Haemostasis
and
precautions
for patient.
Vomiting and
care of Leech

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

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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 patient
 Stop bleeding
 Care of wound bite
 bandaged properly.
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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?? LEECH SUCKS IMPURE BLOOD
 The reference came
from A.H.Su.26/43, As
a swan sucks only milk out
of the mixture of milk and
water, leech sucks impure
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

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?? 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

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

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

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

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By sucking blood – local effects
It decrease blood congestion
That lowers pressure in
diseased area
That facilitate inflow of
oxygenated and nutrient blood
Finally improved health status
of regional tissue
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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By injecting bioactive agents – It act
localiy & distally.
Bioactive agents
Anti coagulating
1.Hirudin
2.Calin
3.Factor Xa inhibitor
Thrombolytics
1. Distabilase
Anti-inflammatory
1.Bdelin
2.Hyluronidase
3. Eglin
Vasodilators
1.Histamine like
substances
2.Acetylcholine
3.Carboxypeptidase
A inhibitor
Bacteriostatics
And anaesthetic
agents
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar

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

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

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

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

25. 25
Thank You
ENDOSURG-2019 AIIMS NEW DELHI – Leech Therapy Dr Mahesh Kumar
Thanks for
patience
listening