ROLE OF LEECH THERAPY IN TREATMENT THROUGH

UNANI SYSTEM OF MEDICINE – A REVIEW

UNDER THE GUIDANCE OF: DR. M. AHSAN FAROQUI,

ASSOCIATE PROFESSOR, HOD, DEPT. OF PG MOALEJAT,

G.N.T.C, HYDERABAD

PRESENTED BY:DR. M. A. LATEEF SIDDIQUI,

PG SCHOLAR,DEPT. OF PG MOALEJAT,

G.N.T.C, HYDERABAD

UNANI TREATMENT

ILAJ BIL GHIZA

ILAJ BIL

DAWA

ILAJ BIT TADBEER

ILAJ BIL YAD

DIETO THERAPY

PHARMACO THERAPY

REGIMENALTHERAPY

SURGERY

MODALITIES OF TREATMENT INUNANI SYSTEM OF MEDICINE

ASBAB E SITTA ZAROORIYA(THE SIX OBLIGATORY CAUSES)

Hawa e Muheet

Makool wo Mashroob

Harkat wa Sukoon e

Badani

Harkat wa Sukoon e Nafsani

Naum wa Yaqza

Istefragh wa Ithebaas

Leech Therapy / Hirudu Therapy

/ تعلیق عمل علق ارسال

Leech Therapy???• Leech Therapy or Hirudo Therapy comes under the Regimen

Istefragh.• In this therapy of blood letting, morbid matter is evacuated, which

is causing ailments in the body.• Medicinal Leeches are used to correct imbalances in humors as

Equilibrium in the four biological humors is essential for health and proper functioning of Human body.

• Leech therapy is advocated for a large number of ailments, including inflammations, Cardiovascular diseases (CVDs), Skin Diseases, Diabetes mellitus (DM) and its complication and various infectious diseases.

Historical Background• Dates back to ancient Egypt civilization 3500 years ago.• Unani physicians used leeches for bloodletting and for treating

rheumatic pains, gout, all types of fever and hearing loss. • Jalinoos (1st century AD) prescribed bloodletting by leech for almost

all illnesses such as simple inflammatory conditions, mental disorders and hemorrhoids.

• Ibn e Sina (980-1037 AD) mentioned in his book “Al-Qanoon” that leech can suck blood from deep veins which cannot be reached by the conventional wet cupping and he also recommended leeching for various skin diseases.

Historical Background• In 12thcentury, Abdul Lateef al-Bughdadi mentioned in his texts

leeches could help in cleaning tissues and promote healing after surgical operations, by encouraging regrowth of microcirculation.

• Ibn al Quff Maseehi (1233-1286 AD) in his book “Umda fil Jarahat” differentiated the medical leeches from the non-medical (poisonous) ones according to their shape and colour.

• Later on, leech therapy has been widely prescribed for bloodletting.• Actually, the widespread indications of leeching might be attributed

to the concept, which suggested that bloodletting by leech was less painful than using the lancet or the blade.

Selection of LeechAccording to Unani Tibb, Leeches can be classified into two types.

1. Non-poisonous Leeches are used medicinally, they are characterized by having small heads, and their bodies are also of small size, bearing yellowish red or brown color or color similar to that of liver and usually found in lakes where small frogs are present.

2. Poisonous Leeches are characterized by big head size, dark grey or black or green color, they have elevations on their bodies and are usually found in polluted water bodies.

Leech

PoisionousNon-Poisionous

Description of Leech• A classic leech body consists of many segments divided as two pre-

oral nonmetameric segments, and 32 post-oral metameres, usually of size up to 20 cm.

• Leeches generally suck 2-20 ml of blood within 10-30 min, then drop-off spontaneously after being completely engorged with no immediate desire of more feeding.

• Leeches absorb blood either through their proboscis which is used to puncture the skin or by bite with the help of jaws

• This is similar to a mosquito bite and is not painful due to the release of an anesthetic substance from saliva.

Scientific Classification Medicinal leeches are any of several species of non poisonous

leeches, but most commonly used is Hirudo medicinalis, the European medicinal leech.

• Kingdom : Animalia• Phylum : Annelida• Class : Clitellata• Order : Hirudinida• Family : Hirudinidae• Genus : Hirudo• Species : medicinalis• Binomial Name : Hirudo medicinalis Linnaeus

Composition of Leech Saliva

Application of Leech• One day before application of leech try that leech should vomit out

by hanging and making its mouth in downward position.• It should be kept fasting in fresh water.• One or more leeches can be applied depending on the part and the

requirement.• The desired part of skin should be cleansed by water and by Bora e

Armani, and rubbed to make it red, before application of leech.• When the leech leaves the skin or after its removal, it is better to

suck some blood with the help of cups.• Then, apply drugs like Haldi or Mazoo sokhta, having astringent and

antiseptic actions.

Mode of action

• With the help of suckers and the biting jaws, leeches are able to absorb prey blood.

• The mechanism of action appears to be the secretion of biologically active substances from the salivary glands of the leech onto living organisms.

• There are almost 100 different kinds of bioactive materials in leech saliva.

• The most common found is hirudin, a substance which oppresses the process of blood clotting.

• Secretions from the leech salivary glands also contain anti-inflammatory, bacteriostatic and analgesic actions.

Mode of action

• Leech therapy restores micro circulation and restores the damaged vascular permeability of tissues and organs, eliminate hypoxia, reduce blood pressure, increase immunity, increase the bio energetic status of the organism

• The mechanism of oppressing thrombin, blocks the action of thrombin and the transition of fibrinogen into fibrin.

• Secretions from the salivary glands of medicinal leeches also block the attachment of thrombocytes and this completely suppresses their aggregation on the surface of collagen.

• Thus, medicinal leeches saliva secretions has a direct influence upon cellular and plasma factors associated with blood clotting.

Effects of Leech Therapy

• Thrombolytic (clot destruction)• Anti ischemic (improves bood supply to tissues and organs)• Anti oxidant (removes radicals by improving local circulation)• Normotensive• Anti biotic• Remove toxins• Restore microcirculation• Recovery of neuro muscular impulse transmission• Immunostimulatory

Indications

• It is mentioned that Leech therapy can be practiced in weak and old age patients, children, and pregnant women where Fasd and Hijama are contraindicated.

• Leeches can evacuate the morbid matter from more depth compared to Hijama.

• The leech therapy can be widely suggested because bloodletting by leech is less painful than using the lancet or the blade, as its saliva contains the anesthetic agents.

Indications• Cardio vascular Diseases• Skin Diseases• Arthritis• Non Healing Ulcers• Haemorrhides• ENT diseases• Various types of infections

Cardio vascular Diseases• CVDs are a group of chronic abnormalities affecting the

cardiovascular system including heart, veins and arteries.• Leech therapy is being advocated for treatment of vascular

disorders, as leech saliva can temporarily improve blood flow and lessens the connective tissue hyperalgesia.

• Clinical studies revealed that it can reduce blood hypercoagulability with an antiinflammatory effect in patients with thrombophlebitis.

• Likewise, patients with phlebitis who received topical leech therapy exhibited better walking ability, less pain and minor leg swelling, along with near-normal leg skin color.

• In such cases, 4-6 leeches should be applied directly to the affected area.

Cardio vascular Diseases• Leeches are used for the healing of hypertension, varicose veins,

hemorrhoids, secondary ischemia-related dermatosis.• The effectiveness of leech saliva in CVDs is the results of specific

thrombin inhibitors like hirudin.• Noteworthy, hirudin is the only hematophagous animal-derived

anticoagulant has been approved by FDA for clinical purposes. • Many studies revealed that hirudin is more effective than heparin in

preventing deep venous thrombosis (DVT) and ischemic events in patients with unstable angina.

• Hirudin can be used safely in patients with platelet abnormalities or heparin-induced thrombocytopenia because it has no immune effects on erythrocytes.

Skin Diseases• Eminent Unani Physicians like Ibn Sina preferred Leech Therapy over

all other regimens in treating skin diseases.

• Leech therapy showed wonderful effects in skin diseases like dermatitis, dermatosis, psoriasis, paronychia, scleroderma, acne vulgaris.

• Leech therapy not only detoxifies but also maintains equilibrium among four humors and increases the local blood flow.

Arthritis and analgesia

• The painkiller effects of leech application were ascertained in various trials on patients with osteoarthritis who claimed that leeching was more relieving than topical Diclofenac with no notable adverse effects.

• Likewise, some studies proved that hirudin can reduce synovial inflammation in arthritis patients by inhibiting DING protein, a derivative of synovial stimulatory protein acting as auto antigen in rheumatoid arthritis patients.

• Moreover, the effectiveness of leech therapy in combination with Unani analgesics has better effects. It was observed that patients who received the combined treatment displayed less pain and stiffness with better working ability.

Non Healing Ulcers• The peripheral vascular complications in diabetic patients can

lead to less blood flow to the distal parts of the body resulting in ischemic diseases of limbs like gangrene.

• Leeches suck the morbid blood and increase local circulation which leads to healing of the wound.

• Probably, due to the action of hirudin and hyaluronidase (the factor of penetration) it improves not only the blood circulation in organs, but also the capacity of capillary-tissues exchanging.

• Leech therapy has already been proven to be of help for patients affected by venous disorders. Seeing its miraculous effects these days plastic surgeons are advocating leeches in their management.

Hemorrhoids• Engorgement of a hemorrhoidal vessel with acute swelling may

allow blood to pool and, subsequently, clot; this leads to the acutely thrombosed external hemorrhoid (TEH), a bluish-purplish discoloration often accompanied by severe incapacitating pain.

• It may help reduce the ache and the swelling and heat felt from haemorrhoids and varicose veins, and can also dissolve blood clots that have formed before.

Take Home Message

It is our time based prime duty to rediscover the forgotten Unani

therapeutical components which showed miraculous effects…