Integrating technology in leech therapy: Toward standardized evidence-based Ayurvedic practice

Jalaukavacharana (leech therapy), an integral part of Ayurvedic medicine, is widely recognized for its benefits in managing chronic wounds, inflammatory conditions, and vascular disorders. However, its traditional application often lacks standardized procedures, real-time monitoring, and regulatory oversight, limiting its acceptance in modern clinical practice. While these challenges are notable in the Indian context, including species misidentification and inconsistent protocols, they are also encountered globally, even in countries where leech therapy is medically recognized. This narrative review explores the integration of digital technologies, such as wearable biosensors, AI-based imaging, and IoT-enabled platforms, to enhance the safety, efficacy, and standardization of leech therapy. A comprehensive analysis of scientific literature and technical sources was conducted to evaluate innovations for monitoring vital signs, tracking leech activity, assessing vascular changes, and documenting wound healing. Based on these insights, the manuscript proposes a forward-looking implementation framework that includes the development of AYUSH-approved Standard Operating Procedures (SOPs), formal recognition of validated species such as Hirudo medicinalis, traceability systems, clinician training programs, multicentric pilot studies, and digital clinical registries. These strategies aim to modernize Jalaukavacharana while preserving its traditional essence. The integration of AI, IoT, and biosensing technologies offers a pathway to transform leech therapy into a globally credible, evidence-based therapeutic modality suitable for contemporary integrative healthcare systems.