Accounts of the use of leeches for the medically dubious practise of blood-letting have come from China around 30 AD, India around 200 AD, ancient Rome around 50 AD and later throughout Europe. In the 19th century medical demand for leeches was so high that some areas' stocks were exhausted and other regions imposed restrictions or bans on exports, and Hirudo medicinalis is treated as an endangered species by both IUCN and CITES. More recently leeches have been used to assist in microsurgery, and their saliva has provided anti-inflammatory compounds and several important anticoagulants, one of which also prevents tumors from spreading.