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Synonym: Hirudo medicinalis
German: Blutegel

1 Definition

A leech is an ectoparasite which feeds on liquid protein. This protein can come from animals as well as humans. In medicine, leeches are also used for therapeutic purposes.

2 Morphology

A medicinal leech has a length of about 5 centimeters, its back has a dark brown or black color, whereas its belly is green. Additionally, there are some red stripes and dots on its long side, depending on the species. Its swimming style is similar to the one of dolphins.

3 Diet

A leech has suckers at its rear end and on his head, which it uses to attach to its host. Using three razor-like jaws, it penetrates the host's epidermis and thus gains access to liquid protein. During this process, analgesic substances and the anticoagulant hirudin are released into the host's bloodstream, preventing blood clotting.

4 Procreation

Leeches are hermaphrodites, they possess male as well as female genitalia. The male and female genitals are mature after 6 and 9 months, respectively. Preferably, two leeches mate lying tummy to tummy, their tails on opposite sides. After 4 to 6 weeks they first show signs of fertilization, a yellow spot on the front part. They then move to the shore of their home waters in order to lay their cocoons above the waterline. The sun's warmth hatches the eggs in the cocoons. Every cocoon contains 5 to 25 eggs, ensuring that the species survives and providing a source of food for other animals.

5 Relevance in medicine

Leech therapy is one of the oldest kinds of therapy, dating back several thousand years to ancient China and India. In Europe, leeches were used as a way of "detoxification therapy". Those types of therapy used leeches, as well as cupping and dressings impregnated with ground beetles. Leeches are poikilotherm and are very sensitive to change of temperature. So it doesn't come as a surprise that they instinctively seek and bite sites of inflammation, being the warmest parts of the body.

In naturopathy, leeches are used for a plethora of pathologies, including varicosis, hemorrhoids, osteoarthritis, headaches and dysmenorrhea. In the surgical department leeches are used to treat lymphedema and to improve blood supply after flap transplantation.

6 Application

First, the leeches are taken from their water glass using a wooden spatula. Then they are put into a small glass container in which they are taken to the place on the patient's body where they are to be applied. This way, it is ensured that they don't crawl aimlessly over the patient's body, causing unpleasant sensations.

The patients usually don't notice the leech attaching to them. At most, the bite can cause a slight dragging type of pain. The blood meal takes about one to three hours.

Light bleeding at the bite sites can last for 8 to 24 hours after the leech has dropped off. The patient is provided with a sterile dressing which should remain in place for several hours. After the bleeding has stopped, the bite marks are surrounded by a hematoma which is no more than a cosmetic issue and disappears after a few days.

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