New Scientist had an intriguing article about Leeches and their use in modern medicine. Apparently, they are very helpful in preventing problems when limbs are reattached. They help remove excess blood that could be life-threatening, and also inject a chemical that prevent blood-clotting. Who would have thunk it?
These poor leeches, however, have a very disreputable reputation, and probably through no fault of their own. It is not as if leeches deliberately prey on human beings, hide in your cornflakes or wait on street corners for an unsuspecting vein to walk past. Who can blame a leech for not looking a gift horse in the mouth and gorging itself on blood until it is six or seven times its normal size? After all, humans in our decadent West gorge themselves on cupcakes until they are six or seven times their normal size!
Yet, one cannot blame someone who would be weary of the use of leeches as part of their medical treatment. For almost 2000 years they were used as a catch-all treatment by ‘doctors’ who may have killed more patients than they cured. This is nicely summed up from a scene from Blackadder:
Edmund: Never had anything you doctors didn't try to cure with leeches. A leech on my ear for ear ache, a leech on my bottom for constipation.
Doctor: They're marvellous, aren't they?
Edmund: Well, the bottom one wasn't. I just sat there and squashed it.
Doctor: You know the leech comes to us on the highest authority?
Edmund: Yes. I know that. Dr. Hoffmann of Stuttgart, isn't it?
Doctor: That's right, the great Hoffmann.
Edmund: Owner of the largest leech farm of Europe.
Doctor: Yes. Well, I cannot spend all day gossiping. I'm a busy man. As far as this case is concerned I have now had time to think it over and I can strongly recommend a [in chorus] course of leeches.
Edmund: Yes. I'll pop a couple down my codpiece before I go to bed ?
For much of the time, this proliferate use of leeches was based on the belief that our body was composed of four basic substances or humours (blood, phlegm, black bile, and yellow bile) that corresponded to the four Greek elements (fire, earth, air and water). Disease was caused by an imbalance of these humours and significant blood-letting could redress the balance.
Now that, post 19th Century, we do not believe in this theory, how come we still have leeches being used in medicine? Sure, it is not done on the basis of a discredited theory and it would be wrong to discard something just because of a chequered past, but is anachronistic nonetheless. After all, surgeons have great trouble preventing the leeches from straying and there is no guarantee that they will latch on and suck. Equally, if they know the combination of chemicals that stop blood-clotting why don’t they administer it in a different way? And if they don’t, why are we comfortable administering something we don’t have an understanding of?
The same goes for ECT (Electro-convulsive therapy), a commonly used technique in the 1940s and 50s, that passes an electric current through a patient and produces a seizure in the patient. It was used to ‘cure’ a large range of mental illnesses, often without the consent of the patient and sometimes was administered as a form of abuse. Yet, this is still in use today!
There are far more controls to its use, is limited to fewer illnesses, and is more monitored. Interestingly enough, in my psychology course, I learnt that the research shows that ECT is (slightly) more effective in treating schizophrenia than any of drugs currently available. Schizophrenia has a mainly biological rather than psychological cause, and passing current through the brain ‘does something’ to temporarily reset the brain. However, the ‘does something’ is not very well understood. Are we really happy to administer this when we don’t really understand it or its long-term effects just because it seems to work? Couldn’t scientific and medical funding be better directed elsewhere?
This is where the chequered past of a medical method comes in. After all, which modern scientist would a priori think of leeches or electricity as a great way to solve illness based on what we know? We only use it because of a direct link to a past where medicine was more barbaric. After all, the farm that breeds the leeches has been in operation from 1845, when the theory of humours was still believed. Given that it is the only licensed farm, Blackadder’s criticism of Dr. Hoffman of Stuttgart is prescient.
Of course, it’d be all worth it if we could make it up to leeches as a reparation for a history where we have abused their talents! Their life starts well being fed on sheep blood served in a sheep-gut condom. Yum! Alas, as soon as they are used, the surgeon drops the leech into a tub of alcohol and thrown into “Medical Waste”. Neither the leeches or the humans are being given the chance they properly deserve!
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