Our Standards

Selection Standards

We have not been able to find a globally recognized standard for selection of leeches for hirudotherapy.

The lack of such a standard could pose, for hirudotherapy as well as in pharmaceutical processing, a threat to the existence of the Turkish wild leech in the foreseeable future.

Leeches are not mass-manufactured products defined by their weight, length, width and height. They are alive. Their nature is established. Each leech is to be regarded as a single living creature and respected in its natural state of being. They might be the same age but of different sizes or of different ages and of equal size. They might be the same length but of differing widths or of differing lengths but of the same width. They could be the same length but be of various weights or be varying lengths and still weigh the same. These differences could depend on individual factors such as diet in the wilderness. We cannot know which kind of blood they have fed on or when they last ate. The currently existing amount of blood in their bodies, its purity and their own body length dictate such factors.

It is common practice in Turkey to select wild leeches for use in hirudotherapy according to their weight and to use their weight as a basis for use in various treatments. This practice has not convinced us. We see the natural characteristics of the animals as a meaningful, natural directive for selection. Thus, we are convinced through more than 50,000 manual inspections of and sorting of leeches by length using optical equipment, that this is the correct way to sort and select leeches for hirudotherapy. We divided the leeches according to approximate sizes into manageable groups. We then further refined these groups. After several such processing, we carefully decided on three provisional lengths: Hiru-small (maximum 6 cm), Hiru-medium (5 to 9 cm) and Hiru-large (over 9 cm). Because the leeches continue to grow before they are sent further for domestic leech therapy, we can sort each group up to one cm shorter. We were therefore able to define Hiru-small as maximum 5 cm, Hiru-medium as 4 to 8 cm and Hiru-large at over 8 cm. This we accomplished already on 14 November 2007. The selection takes place according to the date of the catch in the wild. We are working further on this standardization.

Recommendations for Therapy with Hiru-small and Hiru-mediumLeeches

We have used Hirusan leeches on ourselves hundreds of times. Additionally, our countrymen have given us hundreds of years of experience. We have also tried to understand applications in other countries. We have also investigated applications in other countries. We recommend therefore Hiru-small in the best interests of the patient and doctor or therapist. It is accepted well by patients, lets loose after only a few minutes and the bleeding afterward causes less worry. It therefore does not have any great influence on the vital processes of the patient. It prepares the patient for subsequent treatments in that the bleeding is shorter and thus may be more pleasant. This makes the use of Hiru-medium in follow-up treatments easier. Hiru-small leeches up to four cm are especially suitable for patients who are willing but afraid, especially for fine treatments and for children.

For first-time patients, we recommend consultation before using Hiru-medium leeches. We recommend Hiru-medium for more experienced patients. However, the decision regarding the necessity for its use we leave up to the doctor or therapist.

We recommend that Hiru-large be used only in the rarest of cases, especially as regards initial treatments. Haemorrhaging after the treatment in patients with no blood problems can last up to five days, and this is not in the interests of the persons involved. Besides that, the one-time use of Hiru-large leeches (a mother or prospective mother) is a significant loss because its growth in the wilderness takes years and its cultivation many weeks. It takes an enormous amount of time to breed many smaller leeches until some are large, and many smaller leeches are lost in the meantime. Breeding is difficult, very time consuming and costly. The higher price of large leeches really does not compensate for the great loss when they are used in hirudotherapy once and then destroyed. These animals are of particular value. They can be give birth several times a year.

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