elastase and cathepsin G [63], responsible for the anti-inflammatory effect of leeching. C. Medicinal leeches also secrete hirustasin, which selectively inhibits tissue kallikreins that are largely responsible for the maintenance of a normal level of blood pressure. Hirustasin can also play a role in the intrinsic coagulation process [50] D. The anti-inflammatory and analgesic properties of leeches are subjects of modern hirudo-biochemistry and hirudo-pharmacology 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 [48] E. Leeches may also secrete a vasodilative, histamine-like substance, which increases the inflow of blood after a leech bite and reduces local swelling [53] F.Hyaluronidase, which is known as the ―spreading factor,‖ can degrade tissue hyaluronic acid, thus facilitating the infiltration and diffusion of the remaining ingredients of leech saliva into the congested tissue. Tissue permeability, restored with the help of hyaluronidase, promotes the elimination of tissue- and circulatoryhypoxia as well as local swelling [47] G. The persistent bleeding largely potentiates tissue decongestion and leads to loss of blood, relief of capillary net, decrease in venous congestion, decompression of the nerve trunks and endings, increase in lymph flow, positive changes of local hemodynamics, amelioration of hemorheology, increase of oxygen supply, improvement of tissue metabolism, and elimination of tissue ischemia [64] VI. DISCUSSION In the 18th and 19th centuries, medicinal leeching was popular for treating a variety of human illnesses, including mental disorders, whooping cough, gout, tumors, headaches and obesity. A lack of documented success led to a sharp decline in the use of leeches in the 20th century that is, until its application in managing a common postoperative complication of micro-vascular surgery became evident. Medicinal leech therapy should be considered an exciting new tool in your medical toolbox for treating challenging conditions like woundcare and reconstructive surgeries. No complications were seen with this therapy. Provided specific recommendations regarding the handling of leeches, monitoring during leeching and patient management after leeching should be followed. Specifically, prophylactic antibiotics must be instituted, and depending on the number and length of leeching treatments, blood transfusions should be expected. The salivary gland secretions are a cocktail of proteinatious enzymes of tremendous medicinal value. These have got wide range of therapeutic actions ranging from anti-inflammatory, anesthetic, to anti-bacterial and fibro lytic and many more. Mode of action is dependent upon the actual time of leech-therapy. This is the time required to apply the leeches, the blood sucking period, the detachment of leech, and the capillary oozing period which may range from 6 to 24 hours, and in some extreme cases up to 48 hours. VII. CONCLUSION The majority of studies on leeches are related to: internal and external morphology. Fewer research projects focus on the indications and the pharmacological aspects of the salivary gland secretions. In the past, leeches were used for a variety of applications; their mechanism of action behind this therapy was obscure, and all that mattered was curing or relieving the problem. Today, the research studies concerning the active substances in leeches have given us a better understanding of how the therapy works and have increased their therapeutic use. Leech therapy may be applied to various diseases known nowadays, due to its anticoagulant, vasodilator, and thrombolytic, anti-inflammatory and anaesthetizing qualities. But with further studies, the spectrum of effects may widen. The technique is cheap, effective, easy to apply, and its modes of action have been elucidated for certain diseases. In conclusion, for treatment of some diseases, Leech Therapy is not an alternative, but is a complementary and/or integrative choice. It is a part of multidisciplinary treatments, and secretes various bioactive substances. These substances vary among species and different species should be An