Sociedad Americana de Hirudoterapia

Exploring the Therapeutic Potential: Ta'līq al-'Alaq (Leech Therapy) for Qarha Khabītha (Non-Healing Ulcer): A Case Study

Begum S, Fareed R, Shoaib M, Sultana A (2025) · Alternative Therapies in Health and Medicine · n=1

RCT evidence detailTrial reference
GRADE Very LowInsufficient evidenceCondition: Venous Leg Ulcer
Sample size of this trial compared with other Venous Leg Ulcer trialsBegum S 20251Bopparathi S 20231
This trial (highlighted) by sample size alongside other indexed Venous Leg Ulcer trials. Larger trials generally carry more statistical weight.

Study Profile

Design
single-patient Unani-medicine case report of bilateral chronic non-healing lower-extremity ulcers (27-year duration) treated with weekly Ta'liq al-Alaq (leech therapy) over 6 weeks (Indian Unani medicine institutional context)
Sample size (n)
1
Intervention
Weekly hirudotherapy (Ta'liq al-Alaq) sessions for 6 weeks, applied to three non-healing ulcers on bilateral lower extremities; Unani principle of Istifragh (expulsion of morbid humours)
Comparator
Not applicable - single case report; historical conventional wound care had failed for 27 years before leech therapy
Primary endpoint
Wound healing parameters (size, discharge, smell, pain, edge morphology, wound floor) at 2, 4, and 6 weeks
Primary result
Two of three ulcers completely healed at 6 weeks; third ulcer showed partial healing; authors report substantial improvement in pain, discharge, and wound edge morphology; case framed as cost-effective alternative when conventional methods fail
Follow-up duration
6 weeks

Key Findings

  • Weekly leech sessions for 6 weeks produced complete healing in 2/3 chronic ulcers and partial healing in the third
  • Patient had failed 27 years of conventional care prior to leech therapy
  • Authors highlight Unani Istifragh principle (expulsion of morbid humours) as the conceptual framework
  • Pain, discharge, and wound morphology all improved
  • Adds Indian Unani-medicine geography to the leech-venous-ulcer literature

Limitations

  • Single case (n=1) - cannot generalize
  • No blinded outcome adjudication
  • 27-year ulcer duration with prior conventional-care failure introduces regression-to-the-mean / unusual responder bias
  • Concurrent adjuvant Unani modalities may have contributed to outcomes
  • No biochemical or microbiological wound markers

Clinical Implications

Begum 2025 is a hypothesis-generating case report that adds Unani-medicine geographic and methodological context to the small leech-therapy venous-ulcer literature. For US clinicians, the case does not directly support practice changes but reinforces the need for properly powered RCTs in this indication. For Indian and South Asian Unani-medicine integration, the case adds to the published wound-healing leech literature relevant to traditional-medicine practice contexts.

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