Stepan in one underwear shirt was sitting at the wheel of the chaise, protruding his lip, watching how leeches, sucking into the convex hemispheres of his chest, swelled with black blood. Near the regimental paramedic stood smoking, filtering tobacco smoke through rare teeth.
- Is it getting easier?
- From breasts pulls. The heart is bigger.
- Leeches - the first remedy!
M. Sholokhov. "Quiet Don".
A medical leech (of the four hundred species known to science, only one species of Hirudo medicinalis and its three subspecies are useful for humans) was used to alleviate the condition of patients and to prevent diseases already in the fourteenth century BC. There have been ups and downs in the history of hirudotherapy. The heyday of this treatment method can be considered the XVIII-XIX centuries. Then leeches in Russian exports occupied a place along with grain, being an important source of income for the state treasury. And the fashionable women, preparing for the ball, put leeches over their ears for the appearance of a delicate blush on her cheeks and to give her eyes a special shine, while the dances were not so tiring until the morning.
At the beginning of the last century, the leech occupied the "red corner of the pharmacy." This method was most popular in France: from Napoleon’s records it is known that six million leeches were imported from Hungary alone during the year to treat soldiers in his army. Our Russian barbers masterfully mastered the methods of leeching, saving the merchant who walked well the next morning: just a couple of leeches by the ears. When summarizing observations of military practice during the Crimean War and the Caucasian expedition, N. I. Pirogov noted: “I put from 100 to 200 leeches. Even in simple fractures, where only a slight tumor was noted, leeches were immediately set.” Of the last forces wishing to help a dying friend, the military doctor V.I. Dahl will put 25 leeches on the stomach of a mortally wounded Pushkin. The heat and bloating of the abdomen will decrease, the pulse will become smoother. “It was a moment of hope,” Dahl writes later.
Excessive enthusiasm for doctors with leeches in the absence of scientific data on the effectiveness of this method, indications for its use and sanitary standards has sometimes discredited hirudotherapy. Only at the end of the nineteenth century were the first attempts to study the mechanism of the therapeutic effect of leeches made. World science owes this knowledge to our domestic scientists. They first collected the secretion of the salivary glands of leeches, after which the study of the composition and properties of its active principle began. The extract from the body of a leech, called hirudin, obtained in 1884 by Professor K. Dyakov, served as the starting material for the isolation and study of biologically active substances entering the bloodstream of the body when leeches are used. After all, before it was thought: treatment occurs mainly due to the fact that the leech sucks "bad blood". Indeed, a leech sucks from 3 to 5 cubic centimeters of blood. The effect of bloodletting, for example, with high blood pressure is a well-known and useful thing. However, the main thing, as studies have shown, is the composition of the leech saliva, which is absorbed by body tissues. It is believed that its components have been generally studied, but a number of substances introduced by leech saliva, and today requires decryption. A medical leech injects over a hundred bioactive drugs into the body in one session! They have an anti-inflammatory effect, activate local capillary circulation, improve the supply of oxygen and nutrients to tissues, prevent blood clots and dissolve fresh blood clots. Clinically, this is expressed in the rapid disappearance of heart pain, the elimination of edema, the restoration of impaired blood circulation of the brain and other organs. There is every reason to call a leech a pharmaceutical mini-factory. The most important leech secretion enzyme, hyaluronidase, is a vector with the help of which all other biologically active substances that make up the secretion are absorbed by the body, penetrating the tissues to a depth of ten centimeters. Thus, the therapeutic effect is achieved not by suction, but, on the contrary, by injection. Where else can you find such a unique disposable syringe? (In accordance with sanitary standards, the leech is destroyed after application.)
We list the range of diseases where hirudotherapy is successfully used. These are diseases of the cardiovascular system (hypertension, angina pectoris, heart failure), lung diseases (bronchitis, bronchial asthma), stomach (ulcer, gastritis), liver (hepatitis, cirrhosis), surgical diseases (furunculosis, abscesses, varicose veins, thrombophlebitis , trophic ulcers and wounds, acute mastitis, consequences of injuries). The use of hirudotherapy was also effective in the treatment of gynecological diseases, in urology, ophthalmology (glaucoma), with inflammation of the sinuses of the nose, ear and so on.
Good treatment results for patients using leeches were obtained in the maxillofacial surgery clinic of the Moscow Medical Academy (MMA) named after I.M.Sechenova. Boils and carbuncles are difficult to treat: the reduced immunity of the modern patient contributes to the spread of the inflammatory process and leads to serious complications, sometimes threatening the patient's life. Angular vein thrombosis of the face, thrombosis of the sinuses of the brain, meningitis, brain abscess, sepsis - this is an incomplete list of dangerous, not so rare complications from boils and carbuncles in the face. Antibiotics in such cases are often powerless, the infiltrate quickly spreads, causing eye swelling, making breathing difficult. In these cases, two or three leeches (sometimes even one was enough) gave a noticeable effect during the day, after which the usual physiotherapeutic methods allowed to completely restore health.
Remarkable results were obtained in patients with deforming arthrosis of the ankle, hip, shoulder, elbow and other joints. After a course of setting leeches on reflexogenic zones and biologically active points (hirudoreflexotherapy), pain disappeared in many patients. Here is what the doctor G.A. Zakharyin said, noting that leeches act both as a bleeding and as a distracting (reflexotherapy) remedy:
"I was called to a patient with severe nosebleeds: a full deep plate of blood came out, and the bleeding, despite the measures taken, continued. The patient - a woman of about 40, of the strongest build, until recently enjoyed blooming health, and now everything is in order, only the head is heavy and the mood of the spirit is oppressed. I prescribed 4 leeches around the anus. By the end of the leeches bleeding stopped and did not resume anymore. By the next morning the headache disappeared, painful feeling Vala myself, as always, fun and healthy.
The action of the four leeches was not to empty the circulatory system, a small hemorrhoid hemorrhage (4 leeches took a maximum of 8 tablespoons of blood) stopped the bleeding and eased the head. Attributing this to chance would mean turning a blind eye to evidence. "(Extract from the clinical lectures of G. A. Zakharyin. Moscow, 1894)
In addition, it turned out that leeches improve trophic nerve tissue. This was first encountered when they began to use leeches in the treatment of children suffering from one of the forms of cerebral palsy (Cerebral Palsy), which mainly affects the legs. Without exception, all patients felt much better by the third month of treatment, and by the fifth month of treatment one of the little patients could move by himself if he was supported by the arm (about this case St. Petersburg television made a film). Physiologists are interested in the effect of leech extract on nerve cells. It turned out that the nerve cell is less conservative than scientists previously thought: contrary to the well-known assertion about its inability to regenerate, it can recover and even grow, forming new processes under the influence of stimulants, one of which is leech extract.
Of course, it would be a mistake to consider hirudotherapy as a panacea for all diseases, but to refuse this method of treatment is unreasonable.
Today, the hirudotherapy method may seem outdated to some, exotic to some. It is no secret that most of us are used to using medications. Leeches among many shortsighted fellow citizens will cause distrust and rejection: "Brrrr, what a disgusting creature!" Of course, all this is a prejudice.
Another reason for the low prevalence of this method today is that the number of medical leeches in Russia, alas, has declined sharply. Medical leeches are listed in the Red Book, which, unfortunately, does not save them from destruction. Quiet streams with clear clear water disappeared - the habitats of leeches in nature. Now leeches can only be purchased at special biofactories. However, compared with the cost of modern chemotherapy drugs, the price of medical leeches at a biofactory or pharmacy is quite affordable for any of us.
It should be immediately warned that the course of treatment should certainly be prescribed by the attending hirudotherapist. Only he can offer you a competently composed scheme. After several sessions (usually 2-3 times a week), the patient in a number of cases can conduct the course himself under the supervision of a doctor.
From the history of medicine
At the end of the eighteenth and first half of the nineteenth centuries, the popularity of hirudotherapy increased sharply. For example, in France at that time the need for leeches ranged from 20 to 30 million, in England - 7-9 million, in Russia - 27 million individuals.
Illiteracy of catchers, the desire for profit led to the devastation of accessible reservoirs and the search for new ones in the outback.
Gradually, people who devoted themselves to this occupation emerged from random catchers, and intermediary traders appeared. Then large commercial and industrial companies began to appear, which rented lakes, ponds, vast marshy areas and organized intensive fishing.
The catastrophic consequences of this leech boom are still felt today. Back in 1848, the Ministry of Internal Affairs of Russia approved the rules restricting the capture of leeches.
G. Parman, the founder of a specialized farm in Moscow in 1825, was a pioneer in breeding medical leeches in Russia. Over time, a whole network of farms of this kind arose.
The current technology for breeding leeches in artificial conditions was developed in the 40-50s of our century by G. Schegolev, M. Fedorova and M. Sineva. The disadvantages of this progressive method at that time are that leeches from generation to sale were contained in glass jars with a capacity of three to five liters. "Cupping" leeches have a reduced therapeutic effect, the allocation of their salivary glands is less active. Thus, this technology only partially solves the problem of growing full, active individuals.
Given the increasing interest in hirudotherapy, as well as the fact that the medical leech is an endangered animal species and listed in the Red Book in 1984, a group of BIOKON researchers developed and implemented the modern "closed cycle" technology. Thanks to the use of such technology, control over compliance with growing conditions (temperature, illumination, humidity, etc.) is carried out by an automated system. The employee only visually controls the condition and behavior of their pets. In this case, the conditions for keeping leeches as close to natural. A favorable growing environment enhances the immunity of medical leeches and their healing properties.
The method reduces the proportion of manual labor. Thanks to this, one person is able to grow a batch of 250 thousand individuals (with the can method - only 80-100 thousand).
A. S. Zalmanov. The secret wisdom of the human body. - M., 1966.
G.I. Nikonov. Medical leech. The basics of hirudotherapy. - SPb., 1998.
V. A. Savinov. Chronic prostatitis: treatment with leeches and other natural remedies. - M., 1998.
N. I. Sulim. Hirudotherapy in traumatology and orthopedics. - M., 1997.
The second way is scientific
After examining the microflora of Hirudo medicinalis, and studying the sensitivity to antibiotics, leeches are sterilized with a suitable antibacterial drug.
Depending on the regional antibiotic resistance of microorganisms, the recommended mixtures may be different.
- In Japanese studies, it turned out that in most cases, microbes isolated from the gastrointestinal tract of Hirudo medicinalis showed antibiotic resistance to zeporins and were sensitive to aminoglycosides, carbapenems and fluoroquinolones.
- French scientists recommend immersing leeches for 12 hours in a solution of tetracycline or cefoperazone or in a 0.02% chlorhexidine solution for 15 seconds.
- An anti-bacterial mixture appears in Turkish studies: ciprofloxacin and chloramphenicol.
Almost all studies indicate a good sensitivity of leech microflora to fluoroquinolones.
My experience with leech sterilization
I put leeches to my very seriously ill mother. She is greatly weakened by prolonged use of antibiotics, and for her I sterilize leeches. This is an exceptional measure associated with the severity of the condition of the mother.
For this, I use 3-generation Leflobact liquid fluoroquinolone (5 mg / ml), it is inexpensive - 1 bottle costs 60 rubles.
50 ml of solution per 1 liter of water, where there are 10 leeches before application. Animals sit in such a solution 1 hour before use. The day before I leave them in the same solution for the whole night! Their condition does not worsen, and they actively suck. And those that remained unused after bathing in an antibiotic remain alive and unharmed. (If you decide to repeat my experience, first try antibiotic tolerance and concentration on a pair of leeches).
Do not think that a leech can be completely cleaned of microorganisms. Microorganisms still remain and if there is a high risk of infection on the part of the patient, it is recommended to perform hirudotherapy sessions under the guise of antibiotics.
So, I repeat once again: you do not need to sterilize a leech in conventional hirudotherapy.
Sterilization of leeches, as well as the appointment of antibiotics, is required in exceptional cases.
With conventional hirudotherapy, it is enough to properly maintain a leech:
- change water daily
- wash the jar and sometimes boil it,
- Washcloths and napkins are also regularly washed and boiled.
- use only leeches, hungry for more than 8 months!