Leech is the name of a traditional Chinese medicine. It consists of the dried whole body of Whitmania pigra Whitman, Whitmania acranutata Whitman (both belonging to the genus Whitmania in the Hirudinidae family), or Hirudo nipponica Whitman (belonging to the genus Hirudo). It has the therapeutic effects of breaking up blood stasis, unblocking the menstrual channels, expelling blood stasis, and eliminating masses.It is primarily used to treat amenorrhea due to blood stasis, masses and lumps, hemiplegia caused by stroke, and injuries from falls or blows.
Leech
Leech is the name of a traditional Chinese medicine. It consists of the dried whole body of Whitmania pigra Whitman, Whitmania acranutata Whitman (both belonging to the genus Whitmania in the Hirudinidae family), or Hirudo nipponica Whitman (belonging to the genus Hirudo). It has the therapeutic effects of breaking up blood stasis, unblocking the menstrual channels, expelling blood stasis, and eliminating masses.It is primarily used to treat amenorrhea due to blood stasis, masses and lumps, hemiplegia caused by stroke, and injuries from falls or blows.
Chinese Name : 水蛭
Latin Name : Hirudo
Aliases : Leeches, Zhi Zhang, lice, water fleas, horse leeches, horse leech, leech, horse leech, horse turtle, red leech, water leech, leech-like insect, yellow leech, water leech, sand leech, flesh-boring leech, leech
Authentic Producing Area : Found in most regions of the country
Nature, Flavor & Meridian Tropism : Salty and bitter in taste; neutral in nature; enters the Liver meridian
Benefits & Efficacy
Benefits
Dispels blood stasis and unblocks the menstrual channels; expels blood stasis and dissipates masses.
Indications
Amenorrhea due to blood stasis, masses and lumps, hemiplegia due to stroke, and injuries from falls or blows.
Usage and Dosage
1. Internal use: Decoct and take 1.5–3 g; grind into powder and take 0.3–0.5 g per dose. It is best used in pills, powders, or as a ground powder. Alternatively, place fresh specimens on the affected area to draw blood and disperse stasis.
Precautions
1. This herb breaks up blood stasis and expels stagnant blood; it is contraindicated for individuals with menorrhagia and pregnant women. 2. Should not be used concurrently with antihypertensive medications; should not be taken with Melon Seed Pod (Gua Ti), as this may increase toxic reactions.
Chemical Constituents
It primarily contains amino acids (such as glutamic acid, aspartic acid, leucine, lysine, valine, etc.) and hemolytic glycerophospholipid components (such as 1-O-hexadecyl-,1-O-octadecyl-, 1-O-tetradecyl-, 1-O-9-cis-hexadecyl-, 1-O-hexadecyl-phosphatidylcholine, and trigalactosylceramide), as well as proteins, heparin, antithrombin, and hirudin.
Pharmacological Actions
This product possesses pharmacological effects such as anticoagulation, antithrombosis, improvement of blood rheology, prevention of cerebral hemorrhage, and lipid regulation.
Relevant Discussions
1. *Shennong Bencao Jing*: “Primarily used to expel pathogenic blood and blood stasis, treat amenorrhea, and disperse blood masses and accumulations… promotes urination.”
2. *Mingyi Bielu*: “Induces abortion.”
3. *Bencao Yanyi*: “Treats fractures.”
Applications
Clinical Applications
1. Treats conditions such as menstrual obstruction due to blood stasis and masses and accumulations. It is often used in synergy with Tabanid Larvae and is also frequently combined with herbs such as Curcuma zedoaria, Curcuma phaeocarpus, Peach Kernel, and Safflower, as in the Diangang Decoction (*Treatise on Cold Damage*). For patients with concomitant physical deficiency, it may be combined with herbs that tonify qi and blood, such as Ginseng and Angelica sinensis, as in the Huazheng Huisheng Pill (*Treatise on the Differentiation of Warm Diseases*).
2. For treating contusions and trauma, it can be combined with Suma and Ziran Tong, as in the Bone-Setting Fire Dragon Pill (from *Formulas for Universal Relief*).
3. For treating internal obstruction by blood stasis, pain in the chest and abdomen, and constipation, it is combined with Rheum and Phaselaris Seed, as in the Life-Saving Powder (from *Formulas for Saving Lives*).
Related Compatibility
1. Leeches combined with Suma: Leeches excel at breaking up blood stasis and expelling stagnant blood; Suma excels at dispersing blood stasis and reducing swelling. When used together, these two herbs enhance the effects of promoting blood circulation, dispersing blood stasis, reducing swelling, and relieving pain. This combination is suitable for traumatic injuries, fractures, tendon injuries, and pain accompanied by swelling due to blood stasis.
2. Leeches combined with Rhubarb: Leeches are effective at breaking up blood stasis, unblocking the meridians, expelling stasis, and resolving masses; Rhubarb excels at purging to eliminate accumulations and invigorating blood to remove stasis. When used together, these two herbs not only invigorate blood, remove stasis, and relieve pain, but also purge to relieve constipation and eliminate accumulations. This combination is suitable for conditions involving internal obstruction by blood stasis, pain in the chest and abdomen, and constipation.
3. Leeches Combined with Peach Kernels: Leeches are effective at breaking up blood stasis and regulating menstruation; peach kernels are effective at invigorating blood circulation and removing blood stasis. When used together, their efficacy in entering the blood system to expel blood stasis, restore menstrual flow, and relieve pain is enhanced. This combination is suitable for conditions such as amenorrhea, menstrual abdominal pain, and masses or accumulations caused by stagnant blood stasis.
4. Leeches combined with Frankincense: Leeches possess a strong ability to invigorate blood circulation and remove blood stasis, effectively breaking up blood stasis and expelling stagnant blood; Frankincense invigorates blood circulation, removes blood stasis, and regulates qi, thereby reducing swelling and relieving pain. When used together, these two herbs synergistically invigorate blood circulation, reduce swelling, and relieve pain, making them suitable for treating swelling and pain caused by blood stasis following trauma.
Medicinal Identification
Raw Leeches and Boiled Leeches: These are two different processed forms of the leech. Their therapeutic effects are essentially the same; both break up blood stasis, regulate menstruation, expel stagnant blood, and eliminate masses. They are both used to treat amenorrhea due to blood stasis, masses and lumps, hemiplegia caused by stroke, and trauma.Raw leeches possess a potent ability to break up blood stasis and expel stagnation, with a strong and potent nature; scalded leeches become crisp and brittle, making them easy to pulverize, and their medicinal properties are milder than those of the raw variety.
Related Medicines
Naoxuekang Capsules (Tablets), Tongxinluo Capsules.
Related Prescriptions
Didang Decoction (*Jin Gui Yao Lue*), Jiegu Rusheng Powder (*Pu Ji Fang*).
Notes
Patients requiring treatment with Chinese herbal medicine should first consult a licensed Traditional Chinese Medicine (TCM) hospital to receive a prescription following a professional TCM differential diagnosis.
Processing & Preparation
Harvesting & Processing
Collected during the summer and fall seasons; scalded with boiling water to kill, then sun-dried or dried at low temperatures.
Processing Methods
1. Leeches: Take the raw material, wash it, steam until soft, cut into sections, and dry.
2. Processed Leeches (Scalded Leeches): Place talcum powder or clean sand in a pot and heat over low heat. Add clean leeches and stir-fry until they puff up slightly. Remove, sift out the talcum powder or sand, and let cool.
3. Rice-Processed Leeches: Place cleaned leeches and rice in a preheated pot; heat over low heat and stir-fry until the rice turns yellow; remove, sift out the rice, and let cool. Use 50 kg of rice per 100 kg of leeches.
4. Oil-processed leeches: Place purified leeches in a pot and deep-fry in lard until they turn a dark golden brown. Remove, drain off the oil, and dry.
Storage Methods
Store in a dry, airtight container in a well-ventilated, dry place to prevent insect infestation.
Crude Drug Identification
Identification
Take 1 g of the powdered sample, add 5 mL of ethanol, sonicate for 15 minutes, filter, and use the filtrate as the test solution. Separately, take 1 g of the leech reference material and prepare a reference solution using the same method.Test by thin-layer chromatography (General Chapter 0502): Pipette 5 μl of each of the two solutions and apply them separately to the same silica gel G plate. Develop with a mobile phase of cyclohexane–ethyl acetate (4:1), remove the plate, air-dry, spray with a 10% ethanol solution of sulfuric acid, and heat at 105°C until the spots appear clearly.In the chromatogram of the test sample, identical purplish-red spots appear at positions corresponding to those in the reference herbal material chromatogram; under ultraviolet light (365 nm), identical orange-red fluorescent spots are observed.
Properties of Crude Drugs
1. Leeches: Flat spindle-shaped with numerous segments, 4–10 cm long and 0.5–2 cm wide. The dorsal surface is blackish-brown or blackish-brown and slightly convex; after soaking in water, black spots arranged in five longitudinal striations become visible. The ventral surface is flat and brownish-yellow.The sides are brownish-yellow; the front end is slightly pointed, while the rear end is blunt and rounded. Each end has one suction cup; the front suction cup is inconspicuous, while the rear suction cup is larger. The body is brittle and breaks easily; the fracture surface is gelatinous. It has a faint fishy odor.
2. Water leech: Flat and elongated cylindrical in shape, with a body that is often curved and twisted, 2–5 cm long and 0.2–0.3 cm wide.
3. Willow-leaf leech: Narrow, elongated, and flattened, 5–12 cm long and 0.1–0.5 cm wide.
Properties of Processed Slices
1. Leeches: See the “Characteristics of the Herbal Material” section.
2. Processed Leeches: Resemble leeches in shape, are slightly swollen, have a crisp texture, and crumble easily.
3. Rice-Processed Leeches: Resemble processed leeches in shape.
4. Oil-Processed Leeches: Resemble processed leeches in shape, are dark yellow in color, and have an oily texture.
Botanical Information
Morphological Characteristics
1. Leeches: Large in size, with a body length of 60–120 mm and a width of 13–14 mm. The dorsal surface is dark green, featuring five longitudinal stripes composed of alternating black and pale yellow markings. The ventral surface has one pale yellow longitudinal stripe on each side; the remaining areas are grayish-white, mottled with tea-brown spots. The body has 107 segments, and the anterior sucker is small.The gill teeth are underdeveloped; this species does not feed on blood. The male and female genital pores are located between the 33rd–34th and 38th–39th segmental grooves, respectively.
2. Willow-Leaf Leeches: Body length 25–28 mm, widest point 5–6 mm. The body is willow-leaf shaped, flattened, with a slightly concave back. It is brownish-green with dense greenish-black spots that form five longitudinal lines.The ventral surface is pale yellow, very flat, and scattered with irregular dark green spots. The body consists of five segments, all of equal width. The male and female genital openings are separated by four segments and both open between adjacent segments. There are 10 eyes arranged in a horseshoe shape. The anterior sucker is inconspicuous, while the posterior sucker is large and round, with strong adhesive force. The anus opens at the posterior end of the dorsal surface.There is one blind sac on each side at the terminal end of the digestive tract.
3. Leeches: Body length 30–50 mm, width 4–6 mm. The dorsal surface is yellowish-green or yellowish-brown, with five yellowish-white longitudinal stripes; however, the coloration of the dorsal surface and the stripes varies greatly. One of the longitudinal stripes along the midline extends to the posterior sucker.The ventral surface is dark gray and unmarked. The body consists of 103 segments; the genital pores of males and females are located in the 31st–32nd and 36th–37th segmental grooves, respectively, with five segments separating the two pores. When the penis is exposed, it appears as a thin thread. There are five pairs of eyes arranged in a horseshoe shape. The mouth contains three palates, with a row of fine teeth on the dorsal surface of each palate; the posterior sucker is bowl-shaped and faces the ventral surface.
Distribution Area
1. Common leech: Found in the Northeast region and in the provinces of Hebei, Shandong, Jiangsu, Anhui, Zhejiang, Jiangxi, Hubei, and Hunan. 2. Willow-leaf leech: Found in the provinces of Hebei, Anhui, Jiangsu, Fujian, and Hubei. 3. Water leech: Found throughout the country.