`Lift Them, Keep Them Away'

Twenty-five years ago I wrote a story for my newspaper about a revival in the use of leeches in medical procedures. For centuries, bleeding was a much-favored cure-all among doctors otherwise helpless in the face of disease, but who wished to appear decisive to their patients. The Theory of Humors encouraged the practice. As a sort of automated blood-letting device, leeches were dramatic, and anything stirring primal revulsion had to be efficacious. In one of the recent additions to its “Animal” series, Reaktion Books has published Leech by Robert G.W. Kirk and Neil Pemberton, who write: 

“Once in position leeches were generally allowed to work until they chose to detach themselves, which could take anything from 30 minute to an hour. Physical removal was thought equally damaging to leech and human and so was discouraged. However, if a patient began to feel faint, physicians could intervene by sprinkling salt, pepper or ashes onto the leech, causing the animal to detach.” 

The story I wrote involved the use of leeches in microsurgery to correct “venous insufficiency,” helping to permit blood flow to such damaged tissue as a reattached finger. The saliva of leeches contains an enzyme that prevents clotting. Patients can bleed for hours, permitting oxygen-rich blood to reach the wound until the veins resume healthy circulation. Kirk and Pemberton call the leech “a horror and a healer.” When I think of leeches, my first thought is of the creek that flowed behind our house when we were kids. Before pollution turned it uninhabitable, the shallow, rock-filled stream was home to leeches and crayfish – suckers and pinchers. My next thought is of the most pitiable scene in all of literature of a writer suffering. This is from Vladimir Nabokov’s Nikolai Gogol (New Directions, 1944): 

“With as fine a misjudgment of symptoms, as a clear anticipation of the methods of Charcot, Dr. Auvers (or Hovert) had his patient plunged into a warm bath where his head was soused with cold water after which he was put to bed with half-a-dozen plump leeches affixed to his nose. He had groaned and cried and weakly struggled while his wretched body (you could feel the spine through the stomach) was carried to the deep wooden bath; he shivered as he lay naked in bed and kept pleading to have the leeches removed: they were dangling from his nose and getting into his mouth (Lift them, keep them away—he pleaded) and he tried to sweep them off so that his hands had to be held by stout Auvert’s (or Hauvers’s) hefty assistant.” 

Nabokov plays the scene for grotesque comedy (the mock-pedantry of settling the doctor’s name), an impression increased when we remember the treatment is medically worthless and that Gogol’s greatest story is “The Nose.” In his biography of Gogol, Divided Soul (1973), Henri Troyat describes the same scene more prosaically: 

“As though following the author’s stage directions, Dr. Over [!], after consulting his colleagues, prescribed bloodletting and warm baths alternating with dousing of cold water on the head….Then he was put naked into his bed, and Dr. Klimentov applied a half dozen leeches to his nose; and thus that nose, the subject of so much of Gogol’s writing, now became the pretext for yet another nightmare. Fat creatures were hanging from his nostrils, gorging on his blood. They squirmed and writhed, they touched his lips. He yelped, `You mustn’t! Take the leeches away! Get the leeches out of my mouth!’ But nobody listened. His hands were pinned down so he could not tear the cluster of worms with the voracious suckers from his nose.” 

In a bizarre coda, Troyat adds: “To ease the dying man, he administered a dose of calomel and placed loaves of hot bread around his body. Gogol began to moan again.” At eight o’clock the following morning, Feb. 21, 1852, the author of Dead Souls died. He was forty-two years old.