Littérature sur les sangsues
(dans l'ordre chronologique, surtout les vieux livres sont épuisés)
Kähler Schweizer, Dominique (Dr. med.):
La thérapie par les sangsues
Secrets et bienfaits de l'hirudothérapie
2008, Editions Jouvence
Cet ouvrage est un livre pragmatique contenant de nombreuses informations
utiles, puisées dans la pratique quotidienne de l'auteur, à la fois experte en
hirudothérapie et en culture de sangsues à usage thérapeutique. Il sera utile au
patient en quête de nouveaux traitements efficaces et sans effets secondaires
nuisibles, comme au thérapeute ou au médecin soucieux d'élargir leur moyen
d'action. - C'est le seul livre écrit en français sur ce thème depuis 150 ans:
il comble ainsi un vide littéraire, mais aussi et surtout permet de redécouvrir
une thérapie qui a fait ses preuves et dont les nouvelles applications sont
Michalsen, Andreas / Manfred Roth (Hrsg.):
Stuttgart 2006, Haug Verlag
Moser, Claudia / Karla Moser:
So hilft Ihnen die Blutegel-Therapie
Heidelberg 2002, Haug Verlag
Müller, Ingo Wilhelm:
Handbuch der Blutegeltherapie
Heidelberg 2000, Haug
Blutegel-Therapie, den Körper entgiften
München 1995, Südwest
Propädeutik der Humoraltherapie
Heidelberg 1992, Haug Verlag
Abele, Ulrich / Stiefvater, Erich:
Ulm 1964, Haug Verlag
Der Blutegel in der ärztlichen Praxis
Stuttgart, 1955, Hippokrates, neue Auflage 1971, 1976, 1977
Chambron, Prosper (Dr. pharm.):
La sangsue médicinale
1938 (Lyon, thèse)
C'est un des livres les plus récents en français.
Thèse de pharmacie bien faite. De très bons conseils
pour la conservation des sangsues en officine.
Technik der Konstitutionstherapie
Wien 1936, neu bearbeitet von Ingo Müller Heidelberg,Haug 1995, 7.Auflage
Biologische Therapie des praktischen Arzt
Stuttgart-Leipzig 1935, neu bearbeitet 1948,3. Auflage 1983
Anglas, J. (Dr. ès-sciences):
1916 (Paris, Vigot frères)
Petite brochure sur l'anatomie de la sangsue avec une
très jolie planche colorée et superposée.
Ebrard, E. (Dr. med.):
Nouvelle monographie des sangsues médicinales
1857 (Paris, J.B. Baillière et fils)
Très complet et beaucoup d'expériences personelles.
Fermond, M.Ch. (Pharmacien en chef de l'hôpital de la Salpétrière à
Monographie des sangsues médicinales
1854 (Paris, Germer Baillière)
Monographie très complète. Plutôt théorique.
Moquin-Tandon, Alfred (Dr. ès-sciences et Dr. med.):
Monographie de la Familles des hirudinées
1827 (Paris, J.B. Baillière)
1846 (Paris, J.B. Baillière), 2ème édition largement augmentée
livre de référence.
C'est le premier auteur à avoir tenté une classification des sangsues.
La première édition est encore très rudimentaire. L'édition de
1846 sert de référence jusqu'à nos jours.
Martin, Joseph (Négociant en sangsues à Paris):
Histoire pratique des sangsues
1845 (Paris, Imprimerie Panckouche)
Petite brochure intéressante sur le commerce des sangsues et
Lehrbuch der allgemeinen Heilkunde
Jena 1818,bearbeitet von Ingo Müller,Heidelberg:Haug 1993
Vitet, Louis (Prof. Dr. med.):
Traité de la sangsue médicinale
1809 (Paris, H. Nicolle)
Jusqu'à Louis Vitet on a encore pensé que les sangsues étaient des larves
C'est le manuel le plus complet d'application médicale de la sangsue au
début du 19ème siècle.
sur les sangsues
2005, Ordre national des pharmaciens
(télécharger le texte)
Medicinal leeches: stuck on you.
Nature. 2004 Nov 4;432(7013):10-1
[No authors listed],
Summaries for patients. Leeches to treat knee osteoarthritis.
Ann Intern Med. 2003 Nov 4;139(9):I22. (Full text free)
Multidisciplinary integrative approach to treating knee pain in patients with
Ann Intern Med. 2003 Nov 4;139(9):781-3.
Michalsen A, Klotz S, Lüdtke R, Moebus S, Spahn G, Dobos GJ.:
Effectiveness of leech therapy in osteoarthritis of the knee: a randomized,
Ann Intern Med. 2003 Nov 4;139(9):724-30. (Full text free)
Michalsen A, Moebus S, Spahn G, Esch T, Langhorst J, Dobos GJ.:
Leech therapy for symptomatic treatment of knee osteoarthritis: results and
implications of a pilot study.
Altern Ther Health Med. 2002 Sep-Oct;8(5):84-8.
Michalsen A, Deuse U, Esch T, Dobos G, Moebus S.:
Effect of leeches therapy (Hirudo medicinalis) in painful osteoarthritis of the
knee: a pilot study.
Ann Rheum Dis. 2001 Oct;60(10):986.
Aydin A, Nazik H, Kuvat SV, Gurler N, Ongen B, Tuncer S, Hocaoglu E, Kesim SN:
External decontamination of wild leeches with hypochloric acid
Infect Dis., 2004, Aug 25;4:28)
BACKGROUND: Medicinal leech, Hirudo medicinalis, has been used in plastic and
reconstructive surgery, to relieve venous congestion and to improve the
microrevascularization of flaps. In many countries, wild leeches are still
provided from local markets and utilised with antibiotic prophylaxies. In this
research, results of identification of bacteria in the transport fluid is
reported, oral and intestinal floras and the antibiograms of the identified
microorganisms are investigated. Also, to avoid possible infections, the ability
of hypochloric acid, a disinfectant, to suppress the relevant microorganisms
without changing the life style and behavior of leeches in terms of sucking
function, is investigated. METHODS: Bacterial identifications and antibiograms
of oral and intestinal flora and transport medium were performed for 10 leeches.
The optimum concentration of hypochloric acid which eliminated microorganisms
without affecting the viability and sucking function of the leeches were
determined by dilution of hypochloric acid to 100, 50, 25, 12.5, 6.25 ppm
concentrations in different groups of 25 leeches. Finally, 20 leeches were
applied atraumatically to the bleeding areas of rats, the duration of suction
was determined and compared statistically between the leeches treated and not
treated with hypochloric acid solution. RESULTS: Aeromonas hydrophilia was the
most commonly identified microorganism and found to be resistant to first
generation cephalosporins, frequently used in prophylaxis at surgical wards. In
the next stages of the study, the leeches were subjected to a series of diluted
hypochloric acid solutions. Although disinfection of the transport material and
suppression of the oral flora of hirudo medicinalis were successful in 100, 50,
25, 12.5, 6.25 ppm concentrations; 12.5 ppm solution was the greatest
concentration in which hirudo medicinalis could survive and sucking function was
not affected significantly. CONCLUSIONS: External decontamination of wild
leeches with 12.5 ppm hypochloric acid enables bacterial suppression without
causing negative effects on leech sucking function and life.
Infection risk related to the use of medicinal leeches.
(Department of Pharmacy, University
Hospital, De Pintelaan 185, B-9000, Ghent, Belgium)
OBJECTIVE: To assess the incidence of postoperative wound infections related to
treatment with medicinal leeches at Ghent University Hospital. METHOD: A 2-year
retrospective analysis of bacteriologic culture results of soft tissue
infections in patients treated with medicinal leeches. RESULTS: Cultures of
suspected wound infections were taken and susceptibility testing of isolates was
performed on 17 of 47 patients (36.2%). Aeromonas was frequently isolated
(18.5%). CONCLUSIONS: A high incidence of infection during and after application
of medicinal leeches, despite their external decontamination, necessitates an
antibiotic prophylaxis. In particular Aeromonas must be covered, as soft tissue
infections with these bacteria can give serious complications. The prophylactic
antibiotic should cover the most frequent isolated species taking into account
the importance of Aeromonas and the susceptibility pattern. Based on the results,
fluoroquinolones seem to be a good choice. The authors believe that practical
recommendations to hospital pharmacists on prophylaxis during Hirudo medicinalis
treatment, might enhance the safety of it's use by reducing the number of
Sensitivities of Aeromonas hydrophila cultured from medicinal leeches to
(Microsurgical Replantation Transplantation Department, Davies Medical Center,
San Francisco, CA 94118)
Infections associated with medicinal leech application are caused by Aeromonas
hydrophila, an organism that resides in the leech gut. We cultured the
intestinal tracts of 25 leeches and evaluated the efficacy of oral antibiotics
against Aeromonas hydrophila. Cultures of this organism showed no sensitivity to
ampicillin and inconsistent sensitivity to cephalothin (equivalent to cephalexin).
The Aeromonas hydrophila cultures did show consistent sensitivity to
ciprofloxacin, tetracycline, and trimethoprim-sulfamethoxasole. These three
antibiotics should be considered if oral antibiotic coverage is used in
association with leech application.
Bacterial flora of Hirudo medicinalis and their antibiotic sensitivities
in the Middle Black Sea Region, Turkey.
(Division of Clinical Microbiology and
Infectious Disease, Ondokuz Mayis University, Faculty of Medicine, Samsun,
The rate of infectious complications of leech therapy is almost 20% because Hirudo medicinalis has endosymbiotic bacteria. The aim of this study was to
determine the bacterial flora of H. medicinalis and their antibiotic
sensitivities in a region in Turkey. Sixteen adult leeches were collected in
Middle Black Sea region, Turkey. They were rubbed onto blood agar plates
directly under ether anesthesia to obtain surface cultures. They were then
killed to obtain mouth and gut cultures. Culture swabs were applied to blood
agar, eosin methylene blue agar, and ampicillin blood agar plates. Gut contents
were applied to blood culture medium as well. Bacteria were isolated in 15 of 16
leech surfaces, in 7 of 16 mouths, and in 15 of 16 guts. Isolated bacteria were
identified with Analytical Profile Index 32 E and Analytical Profile Index 20 NE
(fermentative and nonfermentative respectively). Most common types of cultured
bacteria were Aeromonas hydrophila (N = 25), Ochrobacter anthropi (N = 23),
nonfermenting Gram-negative rods (N = 12), Acinetobacter lwoffi (N = 3), and A.
sobria (N = 2) in 73 isolates. A standard disk diffusion test was performed on
isolated bacteria. All isolates were 100% susceptible to ciprofloxacin,
cefotaxime, ceftazidime, gentamicin, and trimethoprim/sulfamethoxazole. Because
leeches are carriers of Aeromonas and other bacteria, appropriate antibiotic
prophylaxis should be administrated to the patient who needs leech therapy.
Antibacterial agents can be determined by the resistance pattern of the
bacterial flora of regional H. medicinalis.
Experiments on the possible role of leeches as vectors of animal and
human pathogens: a light and electron microscopy study.
(Department of Zoology and Parasitology,
Ruhr-University Bochum, Germany)
The presence and survival of pathogens inside the gut of leeches were studied by
means of light and electron microscopy. In African leeches from Cameroon, blood
was serologically positive for human immunodeficiency virus (HIV) and hepatitis
B; blood of Hirudo medicinalis bought in German pharmacies contained up to 11
different species of bacteria. In experiments done at low (3 degrees C) and high
(22 degrees, 32 degrees C) temperatures, it was shown that ingested red and
white blood cells survive for long periods. The time was prolonged to at least 6 months in cases in which the leeches were stored at 3 degrees C. The same effect
occurred with pathogens. Bacteriophages (viruses of bacteria) and bacteria
persisted in large numbers for at least 6 months in the gut of experimentally
infected leeches. Protozoan parasites such as Toxoplasma gondii, Trypanosoma
brucei brucei, or Plasmodium berghei were even capable of reproducing inside the
gut of the leech. In the case of Plasmodium parasites, this proceeded at low (3
degrees C) and high (22 degrees C) temperatures until all erythrocytes were used
up. These parasites survived as long as the erythrocytes and lymphocytes were of
good shape, i.e., around 5-6 weeks p.i. Single stages survived longer,
especially at low temperatures. However, electron microscopy studies gave no
hint of penetration of such pathogens into the unicellular salivary glands,
which would initiate a direct transmission. Such transmission, however, is
possible--many fish leeches directly transmit several blood parasites--when the
leeches are squeezed during skin attachment or when they are manipulated by
dropping salt solution on their backs while they are sucking. Consequently, the
leech is a potential vector of many pathogens, especially in regions with an
endemic spread of human and/or animal pathogens.
Identification of Aeromonas veronii genes required for colonization of the
medical leech, Hirudo verbana
(Department of Molecular and Cell Biology, University of Connecticut, 91
N. Eagleville Rd., Unit-3125, Storrs, CT 06269, USA.)
Most digestive tracts contain a complex consortium of beneficial microorganisms,
making it challenging to tease apart the molecular interactions between symbiont
and host. The digestive tract of Hirudo verbana, the medicinal leech, is an
ideal model system because it harbors a simple microbial community in the crop,
comprising the genetically amenable Aeromonas veronii and a Rikenella-like
bacterium. Signature-tagged mutagenesis (STM) was used to identify genes
required for digestive tract colonization. Of 3,850 transposon (Tn) mutants
screened, 46 were identified as colonization mutants. Previously we determined
that the complement system of the ingested blood remained active inside the crop
and prevented serum-sensitive mutants from colonizing. The identification of 26
serum-sensitive mutants indicated a successful screen. The remaining 20
serum-resistant mutants are described in this study and revealed new insights
into symbiont-host interactions. An in vivo competition assay compared the
colonization levels of the mutants to that of a wild-type competitor. Attenuated
colonization mutants were grouped into five classes: surface modification,
regulatory, nutritional, host interaction, and unknown function. One STM mutant,
JG736, with a Tn insertion in lpp, encoding Braun's lipoprotein, was
characterized in detail. This mutant had a >25,000-fold colonization defect
relative to colonization by the wild-type strain at 72 h and, in vitro, an
increased sensitivity to sodium dodecyl sulfate, suggesting the presence of an
additional antimicrobial property in the crop. The classes of genes identified
in this study are consistent with findings from previous STM studies involving
pathogenic bacteria, suggesting parallel molecular requirements for beneficial
and pathogenic host colonization.
Culture-independent characterization of the digestive-tract microbiota of
the medicinal leech reveals a tripartite symbiosis.
(Department of Molecular and Cell
Biology, University of Connecticut, 91 N. Eagleville Rd., Unit 3125, Storrs, CT
Culture-based studies of the microbial community within the gut of the medicinal
leech have typically been focused on various Aeromonas species, which were
believed to be the sole symbiont of the leech digestive tract. In this study,
analysis of 16S rRNA gene clone libraries confirmed the presence of Aeromonas
veronii and revealed a second symbiont, clone PW3, a novel member of the
Rikenellaceae, within the crop, a large compartment where ingested blood is
stored prior to digestion. The diversity of the bacterial community in the leech
intestinum was determined, and additional symbionts were detected, including
members of the alpha-, gamma-, and delta-Proteobacteria, Fusobacteria,
Firmicutes, and Bacteroidetes. The relative abundances of the clones suggested
that A. veronii and the novel clone, PW3, also dominate the intestinum community,
while other clones, representing transient organisms, were typically present in
low numbers. The identities of these transients varied greatly between
individual leeches. Neither time after feeding nor feeding on defibrinated blood
caused a change in identity of the dominant members of the microbial communities.
Terminal restriction fragment length polymorphism analysis was used to verify
that the results from the clone libraries were representative of a larger data
set. The presence of a two-member bacterial community in the crop provides a
unique opportunity to investigate both symbiont-symbiont and symbiont-host
interactions in a natural model of digestive-tract associations.
Sangsues et chirurgie
Knobloch K, Gohritz A, Busch K, Spies M, Vogt PM:
Plastische Hand- und Wiederherstellungschirurgie
Handchir Mikrochir Plast Chir. 2007 Apr; 39(2): 103-7
leech therapy has enjoyed a renaissance in the world of reconstructive
microsurgery during recent years. Especially venous congestion is decreased
using hirudo medicinalis application such as following replantation of amputated
fingers or congested flaps. They provide a temporary relief to venous
engorgement whilst venous drainage is re-established. Living in symbiosis with
Aeromonas hydrophila, who can digest the sixfold blood meal related to their
body weight, and a broad number of anticoagulant agents such as the thrombin
inhibitor hirudin, apyrase as well as collagenase, hyaluronidase, Factor Xa
inhibitor and fibrinase I and II, leeches decrease venous congestion. Laser
Doppler flowmetry could demonstrate a significant increase in superficial skin
perfusion following leech application 16 mm around the biting zone. Following
the initial blood meal accounting for about 2.5 ml, the anticoagulant effect of
the various leeches enzymes follows within the next 5-6 hours, which both
account for the beneficial effects. Infection associated with leech therapy is a
documented complication of leech application, with reported incidences ranging
from 2.4 to 20 % and a chinolone antibiotic is currently recommended to face the
potential Aeromonas hydrophila infection. Anemia is a second adverse effect
during medicinal leech application which has to be taken account with repetitive
blood samples. Besides the successful applications of leeches in various
applications in plastic and reconstructive microsurgery, randomized-controlled
trials are pending to elucidate the value of hirudo medicinalis according to
evidence-based criteria above from case series and case studies.
Nielsen A. :
Ask the experts. A resurgence of the medical uses of leeches.
Explore (NY). 2006 Jan;2(1):88
Grossman MD, Karlovitz A.:
Lingual trauma: the use of medicinal leeches in the treatment of massive lingual
J Trauma. 1998 Jun;44(6):1083-5
Pantuck AJ.: Re:
Leech therapy for massive scrotal hematoma following percutaneous transluminal
J Urol. 1998 May;159(5):1647-8
Goessl C, Steffen-Wilke K, Miller K.:
Leech therapy for massive scrotal hematoma following percutaneous transluminal
J Urol. 1997 Aug;158(2):545
Lee NJ, Peckitt NS.:
Treatment of a sublingual hematoma with medicinal leeches: report of case.
Oral Maxillofac Surg. 1996 Jan;54(1):101-3
Menage MJ, Wright G.:
Use of leeches in a case of severe periorbital haematoma.
Br J Ophthalmol. 1991 Dec;75(12):755-6.
Isgar B, Turner AG.:
Large scrotal haematoma treated with medicinal leeches.
Br J Urol. 1989 Nov;64(5):549-50
The contemporary use of the medicinal leech.
Injury. 1981 Mar;12(5):430-2.
Autres indications médicales
Dippenaar R, Smith J, Goussard P, Walters E.:
Meningococcal purpura fulminans treated with medicinal leeches
Pediatr Crit Care Med. 2006 Sep; 7(5): 476-8.
Schwickert M, Saha J:
Recurrent herpes zoster with neuralgia [Article in German]
Forsch Komplement Med (2006), 2006 Jun;13(3):184-6. Epub 2006 Jun 26
Seleznev KG, Shchetinina EA, Trophimenko NP, Nikonov GI, Baskova IP:
Use of the medicinal leech in the treatment of ear diseases
ORL J. Otorhinolaryngol Relat Spec, 1992;54(1):1-4.
Mironov P, Despotov B:
Treatment of myocardial infarct by leeches [Article in French]
Folia Med (Plovdiv), 1966;8(5):273-7.