The Leech Has a Future in Medicine

Like most of God’s creatures, the leech is a miracle of adaptation.

Slimy, slithery, singularly unattractive to any but another leech or a nearsighted worm, it goes about its business with unrivaled efficiency. It feeds on blood, but is not greedy. A single meal will last six months or more.

So as not to be brushed off during its power lunch, the leech anesthetizes as it bites--kind of like administering a shot of Novocain. To insure a healthy ration of nosh, the leech further injects an anti-coagulant into the bloodstream of its host, thus guaranteeing seconds, even thirds.

Antiseptic Secreted

When it leaves the table, the leech, ever-considerate, washes the dishes, as it were. It secretes a sort of antiseptic, protecting the host’s tiny wound against infection--and, not incidentally, making sure that the leech’s meal ticket will still be around six months hence.

In the old days, leeches were invested with powers they could not possibly possess--ridding the human body of “rheum,” of evil spirits, of “bad blood.” Unable to deliver, the leech eventually got a lot of bad press.

Today, in a startling reversal of public opinion, the leech is again making news. Good news.

Thousands of humans owe their fingers, toes, noses, ears and even more delicate appendages to the once-maligned critter. In time, moreover, the leech may yet play a prominent role in the prevention of heart attack and stroke.

“What has been discovered,” says Roy Sawyer, who raises them, “is that the leech is a living pharmacy.”

In the old days, the leech was said to have cured more ailments than Doc’s Snake Oil, cleared up more conditions than Grandma’s Lye Soap. Gout to gastritis, pimples to pneumonia. Even insanity. A lot of people, treated by the bloodsuckers, went to their graves swearing by the leech. Most of them, in fact.

Even its name evoked wonderment, deriving from the Old English and High German words for magician and healer.

This, of course, was in ancient times, when doctors made house calls and barbers doubled as surgeons/bleeders (whence the red stripe in the barber pole).

Until a century ago (and, in some areas, even today), “bleeding” a patient with leeches was a common practice of physicians at their wits’ end.

“They got carried away,” says Sawyer. “The leech was the aspirin of the day.”

“The theory was, you let the evil spirits out,” says Dr. Robert Unsell, an orthopedist at Loma Linda Medical Center.

Elimination of ‘Bad Humors’

“It was thought that the leech could somehow get the ‘bad humors’ out of the body,” says Dr. William Aiello of Long Beach. “If nothing else worked, they used the leech.”

Now, Unsell and Aiello, among a growing number of American doctors, use leeches for replant surgery (reattaching a severed part of the body) and as an aid in microsurgical procedures.

Marie Bonazinga, president of Leeches USA in Westbury, N.Y., ships 10,000 leeches a year (at $6 a sucker) to hospitals and surgeons across America. Bonazinga, in turn, imports the worms from Sawyer’s Biopharm in Swansea, Wales, which exports 50,000 a year.

“The leech, we now know, secretes a whole cocktail of chemicals,” Sawyer says by phone from Swansea. “One of them, that we’re isolating now, is called hirudin, which prevents the blood from clotting. . . .

“Say you cut your finger off. These days you take it to the hospital with you. They’re very good now at sewing it back on.

“But there’s often a problem: The blood can flow into the finger but there’s not an established route back into the main body. You get congestion. The finger gets cold and blue and runs the risk of being lost, so the doctor will apply the leech.

“After the leech leaves, the wound will continue to bleed, rather ooze, blood for up to 12 hours. There’s no other way of getting localized prolonged bleeding except for the leech bite.”

‘Like a Kink in the Hose’

Meanwhile, Loma Linda’s Unsell says, “while the leech has kept the digit alive, the body can do what it normally would,” i.e. grow new capillaries and veins. “It’s like there’s a kink in the hose. The body will bypass the kink and grow new hose.

“The leech leaves the wound clean, and some of the substances it’s secreted stimulate the body to increase the blood flow to the digit. It’s a ‘salvage’ procedure when we’ve tried everything else. And it works.”

“In some cases, modern medicine can’t duplicate what the leech does,” says Bonazinga, who got into the leech game two years ago. “No, they don’t suck you dry. It’ll take only about 5 ccs.; that’s about a teaspoonful. Of course, if you’re going to put your arm into a whole pool of leeches while you’re hemorrhaging, you’re going to have some problems . . . “

Bonazinga occasionally helps pack the leeches for shipment in an emergency. “They’re attracted to the oils on your skin, and to the heat, but if you work quickly you don’t have to worry. When they’re disturbed, they ball up like a grub worm. Next thing they know they’re on a plane to San Francisco.”

Bonazinga imports from Wales because “as far as I know, they’re the only ones who ship hirudo medicinalis, the kind with the properties we’re looking for. They’re farm-bred, like you breed mink and salmon and all that.”

At Biopharm, Sawyer keeps about 80,000 leeches “on hand on any given day. We keep them in water except when breeding. That we do in soil. We feed them with whole cow’s blood from the slaughterhouse.

‘Traditional’ Purposes

“The leeches are shipped mostly to countries where microsurgery is advanced, but in Eastern Europe you still find people who use them for ‘traditional’ purposes. Some go to Carolina Biological Supply in Burlington, N.C.,” which Sawyer notes caters to universities and schools. “I love doing business with them because I always wind up talking with a lady called Chattie Bird.”

Chattie Bird fields the phone, as promised, and passes the buck to CBS’ Lawrence Wallace, who loses no time in making his pitch.

“We raise crabs, worms, flies, rats--but not leeches. Yeah, we got plenty of leeches in North Carolina, but not the medicinal ones. The wild ones, no tellin’ what diseases they might be carryin’. The ones we get from Wales, they save limbs, digits . . . “

“It’s a sophisticated little worm,” says Aiello, a plastic, reconstructive and hand surgeon. “There are still a lot of things we don’t know about it. You can’t just isolate one of the drugs they secrete and then just inject it. It’s a combo of a lot of drugs, and who knows what proportion the leech uses?

“They’re very useful for venous (vein) congestion, but for arterial occlusion (inflow problems), nothing’s been established. In three of our cases, though, the occlusion problems were drastically reduced by the leech. They were no-return situations; despite all our efforts, we couldn’t correct the problems. It was the leeches that salvaged the reattached parts.”

Aiello recalls a daring and innovative operation he performed with Unsell when both were at Loma Linda. A young man had irretrievably lost a leg and four fingers in a train accident. The doctors attached a toe from the severed limb to where the ring finger of the injured hand would have been, “so he’d have at least a pincer capacity, much like a crab.”

The toe/finger “turned white, ice-cold, no arterial inflow. I decided to leech the patient. In an hour, the toe turned pink. Bottom line: It worked.”

“I’ve been working with leeches all my life,” says Roy Sawyer from Swansea. “No, it’s not your normal everyday hobby. I’ll admit I must have been a very strange child.

“But to be honest, it’s not much different from studying butterflies, is it? Or snakes or spiders. They’re so obnoxious you get a fascination for them.”

Obnoxious or not, Sawyer continues his research, going as far as the Amazon Basin in quest of his prey and their life-enhancing properties.

The Amazon expedition yielded the Giant Leech, which Sawyer now breeds in Wales.

“We’ve discovered a new anti-coagulant,” Sawyers exults. “While the European leech will prevent the blood from clotting, the Amazon species actually dissolves blood clots, Just think of what that might mean in treatment of cardiovascular diseases!

“It’s a complicated animal, the leech. A marvelous animal!”