Naturopaths like Montreal's
Vadim Buzduja continue to use leeches for non-evidence-based
therapies, such as fertility treatment (above),
but Canadian physicians now use leeches in digit
reattachment surgery
Photo credit: Graham Lanktree/NRM
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Every time Dr Donald Lalonde tells
a patient he's going to stick a blood-sucking leech
on them, he gets the same response. "People are usually,
of course, grossed out," says the Saint John, NB, plastic
and reconstructive surgeon and former president of the
Canadian Society of Plastic Surgeons. But, repulsive
as the idea of hosting the hated Hirudinea may be, their
coagulant and painkilling effectiveness for certain
patients is undeniable. "They go from being grossed
out to not being able to wait for the next leech."
The use of medical leeches —
the proper term is hirudotherapy — is one among
a handful of unusual (and often disgusting) "folk medicines"
long scorned by mainstream medical practitioners that,
in recent years, have experienced a sort of renaissance.
LEECHES
Leeches for 'bleeding' patients were used by physicians
for millennia to balance the humours. The advent of
modern medicine in the 19th century ushered in new standards
and chucked leeches on the slag heap of medical history.
Then, in the 1980s, a new discovery
heralded an end to hirudotherapy's hundred-year hiatus.
Turns out nothing salvages severed fingers and toes
quite like a leech. A 1996 meta-analysis concluded that
hirudotherapy saved 70-80% of grafted tissue that would
otherwise have died. In addition to removing excess
blood that pools up harmfully in reattached digits,
leeches exude analgesic, anticoagulant and vasodilation
chemicals that make them uniquely effective in reattachments.
"Anyone who knows anything about
replantation surgery has been using leeches since about
1990," says Dr Lalonde.
 MAGGOTS
Around the same time leeches came back in vogue with
physicians, so too did maggots. Californian researchers
began clinical trials in 1989, using maggots to clean
major wounds. The results were positive, and the maggots
began their slow crawl to the exalted place they now
occupy in infected wound care.
Canadian doctors are now using
maggots, too. Dr John Maynard, an FP in North Vancouver,
had the rare opportunity to write an order for "maggot
therapy as per protocol" three years ago. The patient,
who had a necrotic wound that wouldn't heal, wasn't
entirely thrilled with the treatment — "He said
to me, 'Last night I thought I could hear them chewing,'"
says Dr Maynard — but then had to admit the larvae
did their job admirably. Dr Maynard was impressed and
didn't find the process all that disgusting, when it
came down to it: "I was more grossed out by the fact
he had this big sacral ulcer."
OTHER
ODD THERAPIES
Like leeches and maggots, other strange treatments,
upon further scientific investigation in recent years,
have been resurrected from their erstwhile obscurity.
Mud clay, for instance, has been
used by indigenous peoples to treat wounds for generations.
Last month, Arizona researchers at the American Chemical
Society in New Orleans confirmed that a certain type
of French mud can kill MRSA, Pseudomonas aeruginosa
and E coli.
And recent research has shown that
bloodletting, the same medieval practice thought to
be the ultimate in quackery, can be useful against staph
infections, hemochromatosis in diabetics, hepatitis
C, porphyria cutanea tarda and more.
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EXTRA
REPORTER-AT-LARGE
My bloodsucking
visit to a leech clinic in Montreal
At first, the Centre Hydrothérapie
Colonique clinic staff were under the impression
that your reporter wanted a colon-cleansing treatment,
owing to the fact none of us was speaking in their
first language. But a few minutes later, after
some explaining and after establishing that sangsues
and leeches were indeed one and the same, everything
was cleared up.
The clinic, located near McGill
University on the third floor of a grimy office
building, is owned and operated by Dr Victor Protsenko,
a Russian physician who now works as a naturopath
in Montreal. Services on offer include leech therapy,
colonics, acupuncture and massage.
The office manager/self-styled
spokesperson insisted hirudotherapy "has
a use for every malady." Asked how physicians
tend to feel about the idea of using leeches for
all sorts of different conditions (three leeches
for hemorrhoids: "It's magic!") she
gave an emphatic double thumbs-down gesture. "Doctors
don't like it."
 The
leeches go for $20 apiece. They come from London,
England -- or maybe North Carolina. (There was
some confusion about their provenance.)
A patient entered the room with
her husband. She disrobed and lay down on an examination
table beneath crudely hand-drawn posters depicting
where leeches should be placed for different conditions.
Vadim Buzduja, a naturopath
from Moscow who works at the clinic, took out
a jar of leeches from a shelf beneath the window.
The patient, he explained, was trying to get pregnant.
Leech therapy helps fertility? "It aids circulation
-- the cleaning of the blood," he replied.
And how does that help fertility? "It stimulates
the immune system." Huh? More questions yielded
only, "More energy."
As new age muzak wafted through
the clinic, Mr Buzduja removed a few leeches from
his jar and plopped them down unceremoniously
on the patient's lower back, buttocks and thighs.
A few leech bites from previous sessions were
visible on her calves. She settled in calmly for
up to an hour of bloodsucking.
And when the leeches are satiated,
then what? Simple, explained the office manager.
They fall off and the staff just flushes them
down the toilet.
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