Leech therapy: An ancient method still in practice to treat varicose vein

Ayurveda, one of the oldest medical systems in the world, uses medicines derived from herbs, plants, and minerals. It also employs some unique methods to treat diseases. Jalaukavacharana is one such therapy that utilises leeches to treat varicose veins and many other ailments.

It is also known as Hirudino therapy, after hirudin, a naturally occurring peptide derived from the saliva of leeches. The Ayurvedic text Sushruta Samhita has a detailed chapter devoted to leech therapy.

According to Dr Megha Unnikrishnan, an Ayurveda physician in Thiruvananthapuram, Jalaukavacharana is used to treat various skin conditions, such as psoriasis, eczema, acne, facial melanosis, alopecia, and herpes zoster shingles.

"Leech therapy is also used to treat filariasis, hemiplegia, rheumatoid arthritis, metabolic disorders, pain management, osteoarthritis of knee joints, sciatic nerve compression, the initial stage of inflammation leading to abscess formation, chronic wound, chronic ulcer, venous ulcer and diabetic foot ulcer," says Dr Megha.

To treat varicose vein, the affected area is first cleaned and then tiny pricks are made to let the blood flow out as droplets. Then, the sterilised leeches are placed on those spots. It's a tough task to make leeches cling to the skin. Once it's stuck, it's left there for close to an hour to suck the trapped blood.

"After close to an hour, the leeches are filled with blood from the affected areas of the body and ready to detach themselves. If they don't fall off on their own, a bit of turmeric powder or paste is applied on them, and they come off instantly. Turmeric is also used to make them spit out the blood. When they are emptied of what they are forced to suck in, the leeches are set free in streams or freshwater lakes," Dr Megha says.

There are more than 700 species of leeches in the world. However, only a few are used for medicinal purposes, including Hirudo medicinalis, Hirudo verbena, Macrobdella decora, Haementeria officinalis, and so on.

However, modern medicine does not consider removing blood as an effective way to treat the disease caused by weakened vein walls and valves.

Dr Rajeev Rajendran, senior surgeon at Regional Health Centre Pala, says removing stagnant blood may not cure varicose veins. "When the valves in the veins get damaged, the blood stops flowing up, leading it to remain trapped at a particular spot," says Dr Rajeev. Even if the stagnant blood is removed from the affected parts of the vein, the condition recurs when the blood flows back," he adds.

The treatments involve surgery, laser treatment, sclerotherapy, or the use of compression stockings. "If the valves of the superficial veins are damaged, we surgically remove that part. If Deep vein Thrombosis is present (identified by venous Doppler), then surgery and sclerotherapy are contraindicated."

Anyone can develop the condition, and starting medical procedures early on and detecting the symptoms can stave off or prevent the disease to a certain extent.

The disease does not usually lead to major health problems except in severe cases where the swollen, engorged blood vessels develop ulcers or wounds. "Stockings or bandages can be used to wrap around the affected portion to reduce pressure," says Dr Rajeev.