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Medical leeches in Marseilles

Genealogical capsule N° 2

(Picture of a leech in action placed on the skin)

- All the pictures added to this article are available on this french page,click HERE -

From the Latin name "Hirudo", the leech is a small flattened amphibian earthworm and sticky unattractive at first sight, with its 5 pairs of eyes, its pair of ovaries and its 9 pairs of testicles among others...

It is its anticoagulant salivary qualities that have made it internationally renowned.

There is every reason to believe that one of your ancestors crossed one of them very closely ...

Used more than 1500 years before Christ by the Egyptians, it dethroned the widespread bleeding introduced by the Greek physician Hippocrates in the 5th century BC.

France "consumed" more than 80 million leeches in 1824 for therapeutic purposes, no doubt under the impetus of the military physician and surgeon François-Joseph BROUSSAIS, who generalized its use at that time.

In those times, it was used several times between different patients during their care.

However, a leech was a vector of infections: not only because of its bacteria foreign to humans, but also from a hygienic point of view, with a risk of nosocomial transmission.

The arrival of Pasteur, his discovery of microbes and the use of asepsis will inevitably lead to the temporary loss of the use of leeches in the 1860s.

Medical Genealogy is usually used to track a pathology through the generations. Here, I propose to cheat it a little, and steal its rigorous practices of specific research.

Through the life of our ancestors thus "cheated" and the various archives (of hygiene, justice or trade for example), Medical Genealogy will allow us to discover curative practices a little forgotten.

So now, let's go down the medical-genealogical tree, and explore behind the scenes of history!

Let's go on the tracks of the leech merchants in Marseilles alongside this little being who now only wants us to do good or almost good...

(Picture "marchand de sangsues", extract from the civil status certificate of a Marseilles resident, cote 201 E 4406, source: Archives Départementales des Bouches-du-Rhône website A.D.13)

Marseilles, 1852.

With the extension of the French possessions in Africa and the intense commercial exchanges with the East, the Phocaean city does not cease to grow on sea as well as on land.

The railway company "Paris-Lyon-Méditerranée" (known as P.L.M., the forerunner of the SNCF) linked Paris to the Saint-Charles station in Marseille under the title of imperial artery.

The Old Port is on the verge of saturation and is bustling with activity at all hours of the day. An auxiliary port is built at La Joliette on the English model of the Liverpool docks.

(Marseille. Cathedral of Sainte-Marie-Majeure dite La Major, overlooking the Joliette basin, mid 19th century, FranceArchives)

In a ceaseless sea sweep, cargo ships enter and leave after unloading their precious cargoes from the end of the world.

The Egyptus, a steamship arriving from the east and belonging to the Maritime Messenger Company, has leeches and other extravagant goods on board.

The Marseilles merchants await their orders at the quayside: the "tubs of iruges" in Provençal (include cases of leeches).

Sold by weight, the leech costs "150 francs per kilo".

Provençal fishermen equipped with a landing net, or the "Parisian leech renters" whose legs soaked in the Seine were used as bait, are no longer sufficient to meet the demand of French buyers alone.

The bloodthirsty young lady is very popular.

Her market is so coveted in France that laws must be tightened. Traffic and tricks are raging.

No alternative text for this image

(Extract from the archive 5 M 9 "Hygiene and Public Health" on the leech trade, A.D.13)

Insurance for leeches is even provided.

Ten years earlier, Antoine COPPA, a leech merchant in Marseille, had 22 cases of leeches worth 15,000 francs loaded onto the American ship Minerva, bound for New York for the sum of 7,200 francs per trip. Landed in another port after 93 days of crossing, the loss and mortality of the leeches will be noted by expertise. (Journal de jurisprudence commerciale et maritime, page 130, published in 1844 in Marseilles, digital source BNF, Gallica website).

(Directory of leech merchants in Marseilles: Marseilles Indicator, Guide du commerce 1855, source Gallica website)

These leech merchants will sell their leeches to pharmacists, doctors and hospitals in Provence for patient care.

The leech is indeed used in several medicinal uses for its local anesthetic, anti-inflammatory, vasodilator and powerful anticoagulant role.

During its application, the annelid attaches itself to the skin thanks to its two distal suction cups and, depending on its species, "bites" its victim thanks to its 3 "Y" shaped jaw segments and its 150 teeth.

However, it has the elegance and delicacy of injecting you with a salivary painkiller when it bites. It can then feed on your blood after having made it more fluid and until it falls backwards once it has eaten its fill (gulp of about 55 grams).

The anticoagulant effect usually continues for several hours for the patient who continues to bleed and will have a small, starry white scar afterwards.

Fraud and sequestration of leeches on the port

Let's go back to the port of Marseille in 1852.

Patiently, in the shadow of the unloading of the Egyptus, the Marseilles police commissioner also waits for the arrival of the booty.

He was informed of a leech fraud: gorging leeches after they had taken a gargantuan meal on cattle, increasing their weight on sale and thus their price before embarkation.

Minutes will be issued for "possession of leeches that are of a blood-soaked nature likely to be injurious to public health".

Six leech merchants will be summoned before the Criminal Police Court in accordance with the provisions of the law of 27/03/1851.

(Excerpts from the archive fonds cote 5 M 9 " Hygiene and public health " on the leech trade, A.D.13)

In the days that follow, a medical panel will examine whether these leeches can be "delivered for (medical) consumption without danger to public health" (source A.D.13, rating 5 M 9).

Faced with the demand and the risk of shortage, leech breeding ("hirudiniculture") becomes necessary and is organized in France.

The leech under all its seams

As we have seen, it has been used since antiquity and the leech is used in all sauces.

Therapeutic recipes from the 16th century, such as leech oil, recall its benefits. Cooked in sweet almond oil, it is applied locally for its calming and decongestant action during hemorrhoidal outbreaks.

Added to wine, it would be soothing "for nerve diseases and convulsions" (according to the doctor Guillaume RONDELET in 1554).

A priest of Tours in 1774 would even have used it as a barometer because the leech was said to be sensitive to atmospheric pressure, presenting movements and positions that varied according to the weather: inactive in good weather, the leech would become agitated in case of strong wind and the arrival of thunderstorms, causing it to engulf itself in the depths. The rain made it go up in the container or the ponds ("Monographie des sangsues médicinales,...suivi de l'hygiène des marais à sangsue", by C.FERMOND, 1854 edition, source Gallica BNF website).

There are nearly 650 species, and at the time, each had its own name: cow leech (the biggest), barge, damselfly, bastard, flower, Syrian, dragon (the most resistant) ... The black leech would be the one with the greatest anticoagulant power (more so than the heparin we know).

(Leech jar)

(Treatment extracted from the "Journal de Médecine-Pratique, or collection of the Royal Society of Medicine of Bordeaux", 1836, digital collection of the BNF, Gallica)

"The bleeding of the foot is fixed at 10 francs The bleeding of the arm is 5 francs. 3rd Under order. The application of Sinapisms, vesicles, leeches, is raised to 15 francs" (extract from the Asclépiade of 1823, regulation relating to a uniform evaluation of the fees of doctors in medicine and surgery, paragraph 3, 1821, Departmental Archives of the Bouches-du-Rhône, cote 30 F 12)

(Order of twelve leeches by the surgeon on duty for the hospital of Allauch, Bouches-du-Rhône, 1829, Hospital Archives of the Departmental Archives of the Bouches-du-Rhône, Allauch Hospital, cote 42 HD E 39)

(The dangers of applying leeches, Excerpt from the 1911 medical-surgical clinical journal "accidents at work", page 37, Gallica website).

And... if you are leech "bitten" and curious to know more :

The saliva of the leech Hirudo medicinalis consists of hirudin which inhibits thrombin and prevents blood clotting, protein (such as hug), enzymes (apyrase, destabilase, egline...), prostaglandins which also have an inhibitory effect on platelet aggregation. All its properties are not yet known.

Hirudin is synthesized today for its commercial form by genetic engineering.

In physical form or in application of cream based on its saliva, the therapeutic indications are numerous. It is most often used:

- In phlebology: in venous insufficiency (varicose veins or hemorrhoidal crises),

- In rheumatology: in knee osteoarthritis for example,

- In post-operative surgery: to restore capillary circulation or to avoid necrosis (finger or ear graft for example),

- In aesthetics: cases of keloid or painful scars for example.

Because of its active ingredients, the use of leeches is contraindicated:

- In coagulation disorders (hemophilia, von WILLEBRAND disease) and in cases where an existing anticoagulant treatment is indispensable,

- In individuals with immunodeficiency, on dialysis or immunosuppressive therapy,

- If anemia,

- If renal failure,

- If allergic to any of the components of leech saliva.

It is the species "Hirudo médicinalis" which is bred nowadays, in a legislated framework of therapeutic use only in hospitals. Too coveted and overexploited, it is now among the endangered species. There are 4 breeders in the world (France, England, Russia, Germany).

It is today about 6 to 9 euros a piece and on sale on the internet.

Hirudotherapy was reimbursed by social security until 1972, then for a time abandoned by doctors, who turned to synthetic molecules.

In 1995, as a student nurse in a pediatric surgery internship at La Timone Hospital (APHM), I myself participated in a sterile treatment with leeches delivered under medical prescription.

In practice, the leech is made hungry before its curative use (it can fast for more than a year!).

Out of its jar filled with fresh mineral water, the leech is placed by the gloved caregiver on a skin point chosen to deploy its healing qualities. A large sterile field hides the patient from the sight of the treatment. He is not asleep and his participation can be requested. The reconstruction result is slow but spectacular. In addition to its restorative qualities to restore blood circulation after reimplantation of a finger or toe accidentally torn off, the leech saliva allows a more aesthetic healing . It helps the disappearance of oedemas and hematomas.

The only drawback is that it can only be used rigorously for a single patient for reasons of hygiene and risk of nosocomial infection. The leech will then be destroyed in bleach.

Another safety feature is that it has an intestine and carries the Aeromonas Hydrophila bacterium, which is not present in humans, and must be used in conjunction with antibiotic treatment of the patient.

Its feed, formerly based on tadpoles, frog blood, then horses and cows, had to be replaced by chicken blood due to the recent discovery of the zoonosis "mad cow disease" (Creutzfeldt-Jakob) and the risk of transmission for the patients.

An American study even suggests that 20% of patients treated with leeches would develop anti-hirudin antibodies, which would increase its anticoagulant effect on renewed contact with the polypeptide.

Its use is therefore not insignificant.

However, in the world, the use of leeches is once again experiencing a revival of interest, even beyond its indications as a therapeutic supplement.

It is officially declared as a medicine in Germany.

In France, it is not recognized by the health authorities (the leech disappeared from the French pharmacopoeia in 1937) but constitutes a "therapeutic aid".

Just like the use of the snail, some people already present the leech as a leading cosmetic beauty product in the form of shampoos, face creams; and you can easily find for example on the internet an anti-aging cream called "suction cream", often out of stock and based on leech saliva!

So, look at her face between her... 10 eyes, because she hasn't finished surprising you and making people talk about her, our bloodthirsty beauty.

And what about Medical Genealogy in all this?

As said at the beginning, this discipline serves not only to draw up medical-genealogical trees of a family through the collection of archives, but also to track and prevent pathologies in collaboration with the medical teams that will make their diagnosis.

To be a French Medical Genealogist, one must be a professional in 2 fields:

- Genealogy: The professional genealogist has the methods and techniques of rigorous research in all kinds of public and private archives,

- Medicine: Nurses, doctors, etc... have the fundamental scientific knowledge and field experience to understand medical history and put it into perspective.

And you, what subject would you like to see addressed in the next genealogical capsule?

If you would like to know more about the life of your ancestors in Medical Genealogy, do not hesitate to contact me: Agnès Bertrand

I would like to thank Patrice BOURGEOIS, chief hospital engineer at the public hospital of La Conception de Marseille (AP-HM) for his documentary help on leeches, as well as all my faithful readers "Genealiciens" with only a pair of seasoned eyes ...

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