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Jalauka-avacharan (leech therapy): A wonder therapy

Dr. Imlikumba MO (Ayur) Bokajan PHC, B.A. M.S, M.D (Panchakarma), KRTC (Jamnagar), Email: imlikumba@
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Published on 2 Apr. 2017 12:39 AM IST
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The first description of leech therapy, classified as blood letting, was found in the text of Sushruta Samhita, written by Sushruta in 800 B.C., who was also considered the father of Surgery. In medieval and early modern medicine, the medicinal leech was used to remove blood from a patient. In 18th century Europe, leech therapy was on pinnacle. The art of application of leech became a profession in itself. 
Around 19th century, the practice of leeching gradually declined. The main reason was improved understanding of bacteriology and infection in the later 19th century. Leech therapy was being considered outdated and dogmatic treatment. 
Then after the discovery of hirudin, a potent anticoagulant, in the leech’s saliva, leeches made their medical come back. After that Leech therapy gained remarkable attention in modern medicine especially in the field of plastic and reconstructive surgery as in the treatment of post-operative venous congestion and graft rejection etc. The therapy was widely indicated in most of the disorders ranging from skin diseases to musculoskeletal pains. 
Leeches are being used to treat diseases through Raktmokshan, a method where impure blood is removed from body which is being sucked by leech. This traditional method of curing diseases is still thriving today. 
The therapy is equally accepted, tested and widely used in the field of modern medicine and even found the place in microsurgery. Leeches thought “wonder doctors” of science .This therapy is considered as a magical therapy because of its wide range of application in almost all the diseases.
Leech therapy has been mentioned in ayurveda under the name of Jalaukavacharan . Jalauka means leech and avacharan means application. Further word jalauka is a compound word with two components Jala means water and ouka means housing place i.e. animals having water as its residing place. According to ayurveda it is considered as one of the procedure of Rakta mokshana. 
Raktamokshana means blood letting and is described under bio-purificatory procedures .In ayurveda the removal of impure blood from body treats the root cause of the disease. 
At first Leech sucks only impure blood and leave pure blood, so this is a blood purification therapy . Later when it start sucking pure blood, the patient feels pain. 
In 2004, US FDA approved leech as a medical device. 
It is reported that in 1846, 30 millions leeches were used in France and 13 million were used in London and Paris in just a single year. 
In America, leech farms were created so that they could produce their own leech and each day, a thousand leeches were sold, showing how in demand these amazing invertebrates were at that time. With passage of time medical people starting discrediting leeches, choosing instead to rely on antibiotics and other medicines and by the end of 19th century, the use of leeches faded away. 
Recently, however leeches once again found their place in the field of medicine. They are used in the field of microsurgery. Plastic surgeons are using leeches to treat challenging skin grafts and most especially for reconstructive surgery.
CLASSIFICATION OF LEECHES ACCORDING TO AYURVEDA 
 SAVISHA JALOUKA (NON-POISONIOUS) ; They are further of six types a) Krishna b) Karbura c) Algarda d) Inderyudha e) Samudrika f) Gochandana
 NIRVISHA JALOUKA (POISONIOUS); They are further of six types a) Kapila b) Pingla c) Shankhmukhi d) Mooshika e) Pundreeka f) Savarika 
INDICATIONS OF LEECH THERAPY : Eczema, Psoriasis, Osteoarthritis, Rheumatoid Arthritis, Cellulites, Sciatica, Inflammatory Reactions, Blood purification, Varicose Veins, Rheumatic Diseases, Diabetic Wounds, Boils and Abscesses, Hypertension, Thrombosis (blood clot), Alopecia, Herpes Zoster, Piles, Skin disorders, Headache, Eye diseases 
CONTENTS OF LEECH SALIVA
 Hirudin: The well known enzyme, a powerful anticoagulant in existence, then heparin
 Bdellin: A protease inhibitor thus act as anti inflammatory. 
 Eglin: It inhibits inflammation but at same time it is also act as antioxidant.
 Apyrase: A powerful platelet anti – aggregate factor thus making blood flow more fluid.
 Destabilase: Enzyme having powerful platelet anti aggregating activity which act by dissolving the blood clots 
 Hyaluronidase: Act as factor for diffusion and as antibiotic. 
 Lipase and Esterases: Used for hyper lipidemia.
 Antielastase:  These substances act by limiting action of elastases which degrade cutaneous elastin particularly at the level of skin . 
 Vasodilatory Substances: These substances have not yet been identified but it is very similar to histamine. 
 Catecholamines: Act on the nerve terminators, particularly at the level of skin which are dopamine , serotonin and acetylcholine 
CONTRAINDICATION OF LEECH THERAPY: Leech therapy is contraindicated in HIV patients and those who are on immunosuppressive drugs, Hemorrhagic diseases, Absolute Hemophilia, Pregnancies, Severe Anemia, Hypotension, General Fatigue, Allergy to Leech, Active Tuberculosis, Mental Disorders during acute episode, High Temperature.
CONCLUSION: Leech therapy mentioned in ayurveda is one of the most important therapeutic procedure. This therapy is widely used in ayurveda as well as in modern medicine for treating various challenging medical and surgical conditions. 
Therapy is of Ayurvedic origin but it is equally accepted by modern medicine due to its efficacy in healing various kind of illnesses it is also called as wonder therapy.

 
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