Leeches for Human Treatment

Leeches in Medicine 


The leech  was used in  medicine  as a means  of  "local depletion" (bloodletting) from the ancient days of Greece, Rome, and Arabia. In Greece, they were first  mentioned  by  Themison  (80-40  B.C.),  a  pupil of Asclepiades,  who  lived  a century  before  Christ.11  Ambroise  Par6  (1510-90) recommended  leeches for  bloodletting in cases where cupping-glasses could not  be used,  "to those leeches may for the most  part be put, as to the fundament to open the coat of  the haem-orrhoid veins, to the mouth of  the womb, the gums, lips, nose, fingers.'I16 As part of  the materia medica of the popular bloodletting treatment to get rid  of  bad blood, leeches  were sold  by  apothecaries, both  to physicians and directly to patients. Leeches were gath-ered  in  the spring of  the year  by  netting or simply wading in the water  and  allowing them to attach themselves  to  the  legs.4 In  the 18th century  they became commercially popular to the extent that some unscrupulous dealers bought  u p  old  and  worn-out horses,  drove them to ponds,  fenced  them  in,  and  allowed  the  leeches  to  feed on them. This  barbaric practice  notwithstanding, the  leeches  so nourished would  possibly convey  "poisonous  and  infecting products  to  the  human system." Leeches consumed the  blood  of  both  cold  and  warm-blooded animals, preferably the  latter,  and  sometimes gorged them- selves to the extent that they could not digest the meal and died. Leeches leave visible scars, and  therefore, small  leeches  were  popular  to  use on the  face  or neck.11 There were fluctuations on leech prices as Richard Arnold, a Savannah physician, complained in 1838, when leeches were selling there at 50  cents each. He said the local medical society had contracted a drug-gist to supply the public at 25 cents a leech, but he sold  out before he could complete his contract. Dr. Arnold said leeches unfortunately were "only in the reach of the rich."14  Bloodletting  using  leeches  and  other methods  enjoyed a revival in the early 19th century, particularly  in France. "Leech farms" were unable to keep u p  with the  demand.4 In 1833,  over  41,500,000  leeches were imported into France, and only nine or ten million exported. Francois-Joseph-Victor Broussais  (1772- 1838), a  surgeon  in  Napoleon's army, sometimes  applied as many as ten to fifty leeches at a time for cer- tain maladies. In cases  of  extreme debility  he  used

only five to eight.6  A  healthy  leech can  dr aw  one  or  two  fluid  drachms of  blood. It was noticed that leech bites con-  tinued  to bleed after  the leech was withdrawn. This phenomenon was finally explained in 1884 when John Berry Haycroft, a Birmingham chemist, discovered an  anticoagulant, called "hirudin," that the leech injected into the blood, which kept the capillaries flowing


The Technique

The best leeches were obtained from Sweden and Hungary. They were generally sent out by dealers in
boxes filled with marsh-sod and  clay. The only care they required was to occasionally moisten the earth
and remove dead or sickly leeches. The box had to be kept in a cool place, and preferably with air holes and immersed in rain-water. In their application the part to be leeched had  to be perfectly clean and free of  any medicinal smell or perspiration. The leeches had to be handled  carefully with clean hands,  and placed in a cupping  jar,  wine glass, or  even a pill box  partially filled with water, which helped them bite. After they

attached themselves, the cup could  be removed  and the part surrounded by a soft cloth to absorb the mois-ture and blood and catch the leeches as they dropped off, which usually took about an hour. Often the leech-es needed to be encouraged to bite. A slight scarifica- tion of  the affected part helped. The leech held in a soft towel and its head directed to the scarified part, and withdrawing  it  a  bit  as  it  reached the site  often helped.17 One  author  recommended throwing them  in  a saucer of fresh beer and leaving them until they began to get "quite lively." After they began to move around a bit, they could be taken out and applied. Even "dull leeches" will "do their duty."10 Another, recommended keeping them in a pint  jar with a perforated lid, and merely supplying them with fresh rain-water twice a week. The leeches appear just as "lively in twenty-four hours  after  use  as  before." He  put  them  in  a  clean wash basin after they had sucked themselves full of blood, sprinkled fine salt on them, allowed them to "crawl and squirm" until they disgorged,  and  then washed and returned them to their jar with fresh rain- water.
13 Some  leech  dealers considered the  American leeches worthless and inferior to the European; how- ever, those exported to this country were generally full of  blood. They had to be placed in purging ponds and left to digest their last meal. Until that was digested, the leeches were useless. Sometimes they remained in the purging pond in order for this digestion to occur. Journal of  the History of  Dentistry/Vol. 53, No. I/March  2005 Leeches  were known  to  make their home  in  the human stomach and intestines and to live for fifty to one-hundredyears. Leeches were hardy creatures but subject to skin diseases. Sick leeches could be cured on

a milk diet.2


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