Leech commonly known asLeechIt is the dried whole body of various leeches. Found throughout the country, they mostly grow in swamps or relatively humid forests. Leeches are naturally bloodthirsty creatures, often attaching to humans or animals to suck blood, causing wounds to bleed for a long time without clotting. Their ability to promote blood circulation is unmatched among all medicinal herbs. In the past, they were mostly captured naturally, but now they are often artificially bred. After capture, they are strung together, dried, and used as medicine. They are commonly used raw or roasted.
I. Efficacy of Leech:
Leech tastes salty and bitter, neutral; slightly toxic. It belongs to the liver meridian. Its effects includeBreaking Blood Stasis and Promoting Menstruation, Dispelling Blood Stasis and Eliminating Abdominal MassesIts ability to activate blood and expel stasis is particularly strong, especially effective in treating various blood stasis syndromes of the liver meridian.
Commonly used inBlood stasis amenorrhea, abdominal mass and lump, hemiplegia due to stroke, traumatic injuryTreatment of conditions such as
Summary of Famous Works by Renowned Authors:
The Classic of Materia Medica: "Primarily expels malignant blood, stagnant blood, and amenorrhea, breaks up blood stasis and accumulations, treats infertility, and promotes water passage."
"Bie Lu": "Induces abortion."
Bencaoyanyi: "Treats injuries and fractures."
Changsha Materia Medica: "Effective in breaking up accumulated blood, capable of dissolving hard masses."
Among many physicians, Zhang Xichun's application of leeches is the most representative. His theories are very detailed and contain unique innovations, making them worthy of study.
Zhang Xichun said, "Leech tastes salty, appears black, smells foul, and has a neutral nature. Because it is salty, it is adept at entering the blood aspect; because it originally feeds on blood, it is adept at breaking blood stasis; because its smell is foul, its odor resonates with stagnant blood but not with fresh blood, thus it only breaks stagnant blood without harming fresh blood; moreover, its black color tends to descend, and it is also adept at breaking stasis in the Chong and Ren meridians. In essence, breaking blood stasis is the inherent ability of this substance, not due to its violent nature."
II. Compatibility and Application of Leech:
1. For blood stasis syndromes such as amenorrhea due to blood stagnation, abdominal masses and accumulations, and traumatic injuries with blood stasis obstruction. Leeches are particularly effective at breaking blood stasis and promoting blood circulation, with a strong potency, making them an essential medicinal substance. For conditions like amenorrhea and abdominal masses, they can be used alone by grinding into powder and taking with water, or combined with blood stasis-dispersing and mass-resolving herbs such as Sanleng (Sparganium rhizome), Taoren (peach kernel), and Sumu (sappan wood). For individuals with weak constitutions, they can be supplemented with qi-tonifying and blood-nourishing substances to prevent damage to healthy qi, such asHuazheng Huisheng Dan。
If treating injury and stasis blood internal obstruction, heart and abdominal pain, constipation, often combined with rhubarb, morning glory seeds, etc., that is夺命散。
If treating women with amenorrhea, or postpartum lochia not completely discharged forming abdominal masses, or men with consumptive diseases, all types of visceral masses, accumulations, qi stagnation, spleen weakness, fullness and oppression, distension and fullness, inability to eat and drink, etc., one can use raw leeches combined with raw astragalus, raw sparganium, raw zedoary, angelica, anemarrhena, raw peach kernel, etc., made into pills for long-term consumption, that isLi Chong Wan。
Xu Lingtai said: "When stagnant blood in the human body has just formed and there is still vitality, it is easy to treat. If the stagnation persists for a long time, the vitality will be completely depleted, making it difficult to treat. Once blood leaves the meridians, it becomes entirely disconnected from the body's vital energy. Administering mild medicine will cause rejection and prevent absorption, while overly potent medicine may harm the unaffected blood. Therefore, treatment is extremely challenging. Leeches are most adept at consuming human blood, and their nature is both gentle and penetrating. Their gentleness ensures that healthy blood is not harmed, while their penetrating ability makes it easy to break down hardened accumulations. By utilizing their power to dissolve long-standing stagnation, there is benefit without harm."
Zhang Xichun said, "Leeches break up stagnant blood without harming new blood. Most blood-breaking herbs damage the qi aspect, but leeches, with their salty flavor, specifically enter the blood aspect and do not harm the qi aspect in the slightest. Moreover, after taking them, the abdomen does not feel pain, nor does one feel any breaking or opening, yet the stagnant blood silently dissipates without a trace. Truly a fine medicine."
Zhang Xichun also said, "In treating women with amenorrhea and abdominal masses, if the pulse is not weak, I often use only leeches, ground into fine powder, taken with boiled water, one qian per dose, twice a day. Even if the stagnant blood has been hardened for several years, it can be completely resolved within a month."
Yue Meizhong referred to Zhang Xichun's experience in treating uterine fibroids, using raw leeches combined with raw Chinese yam, ground into powder for oral administration, which is worth learning.
Zhu Liangchun treats uterine fibroids, ovarian cysts, and other abdominal masses and accumulations, drawing inspiration from Zhang Xichun's "Li Chong Wan" and formulating his own approachGui Tao Li Chong DecoctionTake leeches in capsules, and then combine with astragalus, codonopsis, angelica, fried atractylodes, chicken gizzard lining, Chinese yam, fried white mustard seed, sparganium, zedoary, peach kernel, and artemisia anomala, among other herbs, to achieve satisfactory therapeutic effects.
In the Treatise on Cold Damage Diseases, there isDahuang Zhechong Wan, Didang Tang, Didang WanThe three formulas all use leeches for their effects in promoting blood circulation, removing blood stasis, and unblocking meridians. They can be used as references for treating conditions such as abdominal masses and accumulations, amenorrhea in women, blood stasis in the Yangming meridian, and consumptive diseases caused by dry blood.
2. Modern Applications of Leeches.
In recent years, leeches have been used to treat thrombocythemia, also taking advantage of their blood-breaking effect, with certain therapeutic efficacy.
For treating cerebral thrombosis, leech can be combined with herbs such as Siegesbeckia orientalis, that isXizhi Tongshuan Wan。
Zhu Liangchun treats rheumatic heart disease. For patients with obvious signs of blood stasis and relatively strong constitution, he often uses blood-activating and stasis-resolving methods, supplemented with warming yang, promoting diuresis, replenishing qi, and calming the heart. He commonly prescribes leeches ground into powder for oral administration, combined with Codonopsis pilosula, raw Astragalus membranaceus, stir-fried Atractylodes macrocephala, Poria cocos, Angelica sinensis, Salvia miltiorrhiza, peach kernel, safflower, and honey-fried licorice. For patients with severe deficiency, he first administers warming yang, replenishing qi, and supporting the body's vital energy, and then incorporates blood-activating and stasis-resolving leeches. It is essential to carefully assess the deficiency and excess conditions to avoid errors.
In the treatment of angina pectoris or even myocardial infarction caused by qi stagnation and blood stasis, meridian spasm, and poor blood circulation, with obvious ecchymosis on the tongue and lips, adding leech to the formula for promoting blood circulation, removing blood stasis, regulating qi, and unblocking yang can enhance the therapeutic effect.
For the treatment of venous thrombosis, leech and earthworm can be combined in the Taohong Siwu Decoction, that isWater Dragon Four Substances DecoctionIt is effective in treating deep vein thrombosis. Alternatively, applying fresh leeches externally can also be effective for thromboangiitis obliterans.
For the treatment of hyperlipidemia and fatty liver, leeches can be dried, ground into powder, and taken in capsules. For fatty liver, it can also be combined with centipedes, scorpions, black-tailed snakes, silkworms, and cicada pupae, all ground into powder or taken in capsules.Five Insect FormulaAll are good at unblocking collaterals, and can be used for reference.
In the treatment of nephrotic syndrome, leeches also have the effects of promoting diuresis and reducing swelling, decreasing proteinuria, lowering lipids, and reducing viscosity, which are worthy of further research.
If treating kidney disease with massive proteinuria, it can be combined with Astragalus, Bupleurum, Poria, etc., that isHuangqi Shuzhi MixtureIt has a certain therapeutic effect on delaying renal failure.
Zhu Liangchun treats esophageal cancer, for patients with a prolonged course of the disease and difficulty in eating, he often combines roasted scorpion, centipede, silkworm, and honeycomb, grinding them into powder for oral administration, which isTongge Liye PowderFor advanced esophageal cancer, some cases can control progression, alleviate symptoms, and extend survival.
For the treatment of ovarian cysts, leeches can be combined with red vine, patrinia, oldenlandia, red peony root, cinnamon twig, rhubarb, zedoary, licorice, prunella, and poria.Leech and Sargentgloryvine DecoctionModify the prescription according to the symptoms, often achieving good results.
For treating hemangioma, simply grind leeches into powder and take it orally, the effect is significant.
If treating hemorrhoids and anal fistulas, leeches can be combined with rhubarb, silkworm, and sophora flower, that isXiaozhilou Wan。
For the treatment of facial neuritis, 15 grams of leeches can be decocted in water for oral administration, one dose per day, with reduced dosage for children. A treatment course lasts 15 days. Concurrently, mustard acupoint application can be used as follows: grind yellow mustard or white mustard seeds into a fine powder, take 10 to 15 grams, mix with water to form a paste, spread it on sterile gauze, and apply it to the affected cheek, between the Dicang, Xiaguan, and Jiache acupoints. Secure with adhesive tape. Each application should last 4 to 8 hours, with a maximum of 12 hours. After removing the mustard paste gauze, sterile gauze can be used to protect the local area.
For treating chloasma, one can use dried and finely ground raw leeches, taken in capsule form, combined with motherwort, peach kernel, Chinese angelica root, fleeceflower root, red sage root, trumpet creeper flower, bupleurum root, cyperus tuber, Szechuan lovage rhizome, and dahurian angelica root, that isLeech Decoction for Resolving MaculesSimultaneously, boil the medicinal dregs again in water, use a sponge to absorb the medicinal juice and apply it externally to the facial spots. This is truly an excellent method, worth learning.
III. Usage and Dosage of Leech:
Leech can be used in decoctions and is also suitable for making pills and powders. Its potency is strong and fierce, so it is more appropriate to use in pill or powder form. The usual dosage in decoctions ranges from a few grams to over ten grams; when taken as powder, the dosage is about one gram per serving.
Leech has a fishy and foul smell, encapsulating it for oral administration is indeed a good method.
Leeches can be used either raw or processed, with significant differences in efficacy, as raw leeches have stronger medicinal potency. Many physicians, particularly Zhang Xichun, have provided detailed discussions on this matter, which can serve as a guide.
Zhang Xichun said, "Its salty taste is the taste of water, its black color is the color of water, and its putrid odor is the odor of water. It is purely generated from the essence of water, so it is best used raw and should not be roasted over fire. Roasting damages the essence of water, rendering it ineffective."
Zhang also said, "Many medical books claim that it must be used after being roasted, otherwise it can reproduce several leeches in the human abdomen, which is completely unfounded."
IV. Application Precautions for Leeches:
Leech breaks blood and dispels stasis, can cause abortion, thereforeContraindicated for those without blood stasis and stagnation and for pregnant women。
For those with blood stasis and accumulation but weak constitution, it is not advisable to take in large doses, or it should be combined with tonics for qi and blood to ensure safety.
