Published Paper Details:

Irsale Alaq (leech therapy) is a cornerstone of regimenal therapy (Ilaj-bil-Tadbeer) in the Unani system of medicine, traditionally employed for the targeted evacuation of morbid humours (Khalte Fasid) from diseased sites. Its principle is based on diverting morbid material (Imala-e-Mawad) to restore the body's innate balance (Tabiat). After a period of decline in the West, Leech therapy (Irsaal-e-Alaq) has experienced a renaissance in modern medicine, particularly in microsurgery and reconstructive procedures, prompting a re-evaluation of its traditional principles through the lens of contemporary science. This systematic review aims to critically synthesize the traditional Unani principles of Irsale Alaq with current scientific evidence on its mechanisms and clinical efficacy. A comprehensive literature search was conducted following PRISMA 2020 guidelines across electronic databases (PubMed, Scopus, Web of Science, Cochrane Library) and repositories of Unani literature (CCRUM, Jamia Hamdard) until December 2023. Findings demonstrate a remarkable congruence between Unani knowledge and modern science. The classical classifications of Alaq-e-Kabir and Alaq-e-Saghir correspond to the species Hirudo medicinalis and Hirudinaria granulosa, respectively. The therapeutic effects, empirically observed for centuries, are now known to be mediated by a complex cocktail of bioactive compounds in leech saliva, including hirudin (a potent anticoagulant), hyaluronidase (a spreading factor), eglins (anti-inflammatory agents), and vasodilators. This pharmacological profile validates its traditional use and underpins its modern applications in managing venous congestion, osteoarthritis, varicose veins, and other inflammatory conditions. Irsale Alaq thus stands as a paradigm for the integration of traditional wisdom with evidence-based medicine, offering a safe and effective non-pharmacological treatment modality with significant potential for wider adoption in mainstream healthcare.