“Men would rather pop Viagra forever than let a leech near their body,” Dr. Andrei Dokukin says with only a hint of hyperbole. From his Long Beach, California, clinic, Dokukin is one of the only medical doctors in America practicing leech therapy (also known as hirudotherapy) for internal medicine and non-surgical conditions. While his clients are treated for chronic pain, arthritis, and circulatory issues, rather than erectile dysfunction, Dokukin notes that ED could, in fact, be successfully remedied by using leeches to improve blood flow to such tissue. “If people were more accepting, I’d have a line around my office,” he speculates.
Dokukin, an alcoholic in recovery, received leech therapy himself to treat his liver cirrhosis. Before turning to hirudotherapy, he was offered few other choices. “We don’t have anything for liver diseases in this country besides liver transplant,” he says. “Or, basically, we can wait and see or die.” Underwhelmed by either option, Dokukin tried hirudotherapy at the behest of his mother back in Russia, where it remains common practice. Five years later, he claims that his liver has fully compensated and that his Western doctors are “astonished” by his recovery.
Dokukin’s experience illustrates westernized medicine’s hesitation to accept leeches as a legitimate therapeutic. When it comes to folk remedies, it can be challenging to extricate the science from pseudoscience. Leeches have been used across centuries and cultures to treat a litany of conditions, from hemorrhoids and fevers to psoriasis and tinnitus. The sheer range of purported applications, as well as a history steeped in spirituality and mysticism, makes it easy for skeptics to dismiss hirudotherapy as unscientific.
But while traditional notions of leeches restoring “bodily harmony” might strike the modern reader as hokum, they carry a shred of truth; leeches do indeed work for a wide range of conditions. Leeches not only draw contaminated blood from the body but also inject the surrounding tissue with various molecules that have been proven to decrease inflammation.
Dokukin’s Long Beach clinic.
The problem, however, is that we don’t know just how well they work. Despite leeches’ having gained FDA approval as a medical instrument in 2004, a frustrating lack of clinical evidence persists. The most commonly cited review, for example, does not compare the use of leeches to non-leeches in surgical reconstruction, itself noting an “absence of robust randomized controlled trials on which the evidence may be based.”
Still, it would be a mistake to write off leech therapy as an ancient tradition of little worth. Many highly beneficial modern treatments, from bacteriophage therapy to cancer drugs, began their journey as “folk remedies.” These, too, battled both the Western standard of evidence and its biases. Yet as we have learned more about the molecules and mechanisms responsible for their efficacy, we have come to recognize their brilliance.
It's time we do the same for leeches.
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