contains enzymes that reduce scar tissue and adhesions. Two types of fibrinases and a collagenase that are also present reduce the density of scar tissue and help reduce fibroblast formation in hypertrophic scars and keloids [56] 4.16. Antithrombotic effect:Anticoagulant complexisolated from lyophilized medicinal leeches exerted pronounced antithrombotic, thrombolytic, and hypotensive effects in experimental animals after intravenous injection and showed antithrombotic activity after oral administration in combination with hirudin.[57] 4.17. Antifungal activity: Antifungal activity of recombinant medicinal leech destabilase-lysozyme was investigated by using fungi: Botrytis cinerea, and Verticilliumlateriticum, and was found to be potent.[58] 4.18 Antibacterial activity: Its antibacterial activity was investigated on gram-negative bacteria Pseudomonas fluorescens and was found to be potent.[59] 4.19.Analgesic and anti-inflammatory activity: The anti-inflammatory and analgesic properties of leeches are subjects of modern hirudobiochemistry and hirudopharmacology and in many aspects are associated with the blockage of amidolytic and kininogenase activities of plasma kallikrein, resulting in prevention of pain or pain relief during leech sessions [60] 4.20 Inhibition of platelet functions:Destruction of the blood vessel wall for sucking blood causes activation of platelets and the coagulation cascade, which are fatal for the leech. For this reason, leech secretions contain many bioactive molecules to locally inhibit these actions.In a normal host, wall destruction causes spread and release of collagen particles and they are targets of free vonWillebrand factor (vWF). This complex strongly binds to glycoprotein (GP) Ib on platelets as vWF works like a bridge. With this binding, up regulatory mechanisms occur, platelets bind to each other to make a plug and stop any bleeding.[61] 4.21Other possible actions:Many in vitro studies have indicated the anticancer effects of leech saliva extracts. Since coagulation is related to metastasis and tumor progression, blocking the cascade can have an antitumor effect.In addition, other anticoagulant derivates are claimed to have similar effects, as well as reducing cell growth and tumor angiogenesis.Effects against cell degeneration have also been reported. Eglin C, bdellastasin, destabilase, bdellins, and hirudin are cytoprotective and exert positive stimulatory actions, especially on neurons, but these studies are only at the preliminary stage[62] In reference to the said context, a search for relevant topic was done through ancient Ayurveda texts, but there is no description found related to the salivary secretions of Jalouka or any other matter which could be correlated for discussion. V. MODE OF ACTION OF LEECH THERAPY Leech Therapy depends on the following main steps of medicinal leeching: 1. The blood-letting action during active suction of blood, 2. Passive oozing of the wound, and An Interdisciplinary Critical Review of Leech Therapy; Evolution, Indications, Salivary Glan…. 15 3. Injection of biologically active substances with the saliva into the host. The saliva of H. medicinalis contains more than 100 bioactive substances, including coagulation inhibitors, platelet aggregation inhibitors, vasodilators, and anaesthetizing, antimicrobial and anti-inflammatory agents [45] A. One of the most important ingredients is hirudin, which is the principal anticoagulant responsible for enhanced bleeding and prevention of coagulation. In addition to hirudin, leeches secrete two inhibitors of Factor Xa responsible for the conversion of prothrombin to thrombin [47] Furthermore, leech saliva is an effective platelet aggregation inhibitor due to the presence of active ingredients such as calin, apyrase, platelet activating factor (PAF-) antagonist, collagenase, and prostaglandin. Their main function is preventing the ingested blood from congealing within the leech‘s gut. The medical benefit to the patient is a sustained local bleeding that can last several hours after the end of each leech session. B. The saliva of the medicinal leech also contains proteinase inhibitors, such as bdellins [46], eglin, inhibitors of α-chymotrypsin, subtilisin, and the granulocytic neutral proteases-