Dr. D. Ishu Singh occasionally uses leech therapy as part of his orthopaedic surgery practice at Bayhealth’s Kent General Hospital and Milford Memorial Hospital.
New technologies and procedures are regularly incorporated into modern medicine, but that doesn’t always mean ancient techniques are eliminated from use.
At least that’s the case for Dr. D. Ishu Singh, who occasionally uses leech therapy as part of his orthopaedic surgery practice at Bayhealth’s Kent General Hospital and Milford Memorial Hospital.
Singh said the leeches ability to suck blood are perfect tools for relieving congestion caused by issues with soft tissue reconstruction following surgery.
Singh hones in on the specific area to be treated by the bloodletting procedure by making a puncture wound with a sterile needle. The leeches are attracted to the fresh blood, and if cooperative, latch on and get to work. They suck blood from the chosen location to alleviate congestion and address circulation issues.
“It’s a site-specific treatment,” Singh said, while explaining that the use of leeches is gaining popularity in orthopaedic surgery. “They’re making a comeback.”
Use of the blood-sucking worms isn’t making the same comeback as it did in the 1830s, when one French physician began importing tens of millions of leeches every year.
But they’re still around, and it seems like the ancient Greek and Islamic doctors who used the creatures hundreds of years ago were actually ahead of their time.
“There are various bloodletting techniques used over time, like cutting into veins, but leeches were one popular way,” explained Eve Buckley, an assistant professor at the University of Delaware’s history department.
The historical use of leeches coincides with society’s understanding of medicine. Buckley said leeches were initially used in traditional medicine with the understanding that disease is caused by an imbalance of fluids and that releasing blood could restore the balance and cure a disease.
By the time the French physician put leech gatherers into business with a higher rate of imports, Buckley said the idea had shifted from a focus on imbalance in fluids to the idea that a disease is caused by a poison in the body, which also could be released by bloodletting.
“The basic idea that letting blood flow from the body is a route to curing people is something that’s been practiced in a lot of places,” she said. “I didn’t know that leeches were used today, although it makes sense. In part it suggests that some longstanding medical practices, even if the reasons or explanation is much different in ancient times than it would be today, that doesn’t mean it had no merit or that they were totally ineffective.”
Singh said he utilizes his creepy-crawly assistants a few times a year in extreme cases like fingertip amputations, vascular injuries or injuries caused by saws or lawn mowers. And he uses them with a thorough understanding of circulation and the effectiveness of a natural anticoagulant found in the leeches’ saliva.
“We’re even trying to mimic that anticoagulant property in pharmaceuticals,” he said.
The leeches are bred in medical laboratories, kept in sterile environments and are treated as any other biohazard and disposed of after each use.
“The misnomer is that they’re dirty, filthy, but these leeches are raised in a laboratory environment,” he said. “[After treatment] they have a patient’s blood in them, so we treat them like any other needle. You have to dispose of them properly.”
Compared to surgery, leech therapy is relatively cheap. Each leech costs about $8 to $10 plus shipping, he said.
There are only four or five leeches on hand at a time, living dormant in a refrigerated portable home. The dark-colored worms – which grow from 2-centimeters long to 10 times their body length when stretched – only come out a few times a year.
The use of leeches in modern medicine also can provide an alternative to surgery in some cases, he said.
For example, he said, a female patient came to his office complaining of a dark purple fingertip, caused by carrying a heavy, plastic grocery bag on her fingers for too long. At first, Singh thought it might have to be amputated. But then he convinced the patient to give the leeches a try.
For three consecutive days, the woman received leech therapy from Singh, and by the end of the treatment, her finger was back to normal.
“Patients are weirded out at first, but they sense that they’re going to help,” he said. “Now people are intrigued we’re using live animals in modern medicine.”