top of page
Search

The History of Leeches in Medicine and the Era of the “Leech Mania”

  • Writer: FibonacciMD
    FibonacciMD
  • 7 days ago
  • 5 min read

Leeches: A Curious Chapter in the History of Medicine


Explore the strange and fascinating history of leech therapy—from ancient medicine and 19th-century “leech mania” to their modern medical revival in reconstructive surgery.


The use of leeches for bloodletting started thousands of years ago and reached Europe in the Middle Ages.  The word leech comes from the old English word “laece” which meant physician.  Bloodletting was supposed to balance the body’s humors.  The body’s humors were blood, black bile, yellow bile and phlegm, a theory attributed to the Greek physician and philosopher Hippocrates (460–370 BC). 


The leech commonly used in medicine, Hirudo medicinalis , has three jaws with approximately 100 teeth.  The teeth bite through the skin and the saliva contains an anesthetic so it doesn’t feel painful to the person when they are bitten.  Leech saliva also causes dilatation of blood vessels to bring more blood to the area.  The saliva contains hirudin a substance that inhibits thrombin and prevents blood clotting.  Hirudin has been synthesized and used in modern medicine as an anticoagulant.  Leeches’ saliva also has been found to have an anti-inflammatory effect.  A leech can drink up to ten times its body weight in blood. 


The first reported medicinal use of leeches was by the Greek physician Nicader of Colophain around 200 BC.  Ancient Indian physicians around the time of Christ also used them for bleeding.  A Greco-Roman physician, Galen, who lived from 129-199 AD popularized the concept of bodily humors, which when out of balance could cause disease, and advocated the use of leeches to draw off blood and restore this balance.  This practice continued for centuries.

 

At the beginning of the 19th century a “leech mania or craze” occurred in Europe and America.  François-Joseph-Victor Broussais, a French physician believed that inflammation caused most disease and that leeching could reverse that process.  Broussais was the chief physician at Val-de-Grâce military hospital in Paris and to a large extent most of his ill patients received the same therapy, which was the application of 30 leeches.  There had been objections to more standard bloodletting, but Broussais and his followers felt leeches were a kinder and gentler method.  They also could be applied to specific areas of the body that were affected such as ears, nostrils, the mouth, or even private parts.  British surgeon Rees Price, author of “A Treatise on the Utility of Sangui-Suction or Leech Bleeding” in 1822 wrote that use of leeches led to a “state of relaxation of the nervous energy of the body.”



François Joseph Victor Broussais
François Joseph Victor Broussais

As bloodletting was an accepted form of treatment at the time for many diseases, using the less traumatic leech rather than incisions with lancets to remove blood appealed to both the general public and the medical profession.  The “leech craze” which started in France soon spread widely which created an entire industry which was profitable for leech farmers, importers, apothecaries and both the “legitimate” medical profession as well as medical quacks.


Leeches became fashionable in the culture of that time, which inspired poems, leech-shaped patterns on dresses, and ornate leech jars that decorated the windows and counters of apothecary shops and parlors of the wealthy. 


leech jar

At the height of “leech mania” France imported 33 million leeches in a single year and demand far exceeded supply.  The U.S. in the mid-1800s was importing almost the same number of leeches per year from Germany.  By the end of the 18th century, leeches were starting to become extinct in certain countries due to their popular use.  Harvesting large amounts of leeches required access to wetland areas and laborers to both act as lures and collectors.  People started breeding leeches and according to one account, a breeder had 800,000 leeches on his marshland which he fed by driving 200 cows and dozens of donkeys into the marshes.  Books on how to breed leeches became popular with tips such as, adding iron to water leeches lived in helped make the water less putrid and reduced the need to add fresh water as often.  One of the reasons so many leeches were needed for medicinal purposes is that once a leech was fed it might not need to feed again for six or more months. 



Cuppers & Leechers business card
19th Century Leech Seller’s Business Card 


Leeches were used in a cholera epidemic in the 1830s.  However, they proved not to be very effective and in Europe leeching began to become less popular.  Leeching also did not fit in with the emerging concepts of modern medicine at the time and became more associated with medical quackery.  However, in the U.S., leeches were regularly used until the end of the 19th century and even in the early 1900s jars of leeches could be found in some American bars and barber shops.


Leeching became a disrespected practice until the 1960s through the 1980s when plastic surgeons started reported using them for engorged skin flaps.  In 1985, there was a well-publicized case where an American plastic surgeon, Joseph Upton, treated a five-year old boy that had part of his ear bitten off by a dog.  Small capillary blood vessels needed to reconnect for the reattached ear segment to survive.  This was made more difficult if extra fluid and blood accumulated in the tissues due to the veins not draining the area adequately enough.  Upton remembered reading about microsurgeons who used leeches, and when the child’s ear tissue looked like it was not going to survive, he ordered leeches from a company called Biopharm which was located in Wales.  Biopharm was started by a zoologist who felt that with all the interesting substances in leech saliva there was a strong possibility of their renewed use in medicine.  Upton attached several leeches to the boy’s ear which sucked up the pooled blood and extra fluid and allowed the reattached ear to survive.  


In 2004, the FDA approved the use of medicinal leeches in reconstructive and plastic surgery to reduce venous congestion in tissues grafts and flaps.   






References


Comments

bottom of page