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The page below is a sample from the LabCE course The Story of Phlebotomy: A Historical Perspective. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Medicinal leech - Hirudo medicinalis

Leeching

The Middle Ages - Leeching and Cupping

When leeches were used for bloodletting, the species Hirudo medicinalis, the medicinal leech, was commonly employed. Leeches were most often used on children or adults where “cupping” would be difficult. Leeches could be directed toward the inflamed area. For example, the leeches could be placed on the trachea if the patient suffered from bronchitis or on the ear for an ear ache. Common practice was to place 20 or more leeches on adult patients. In addition to losing too much blood as was previously noted, patients also ran the overwhelming possibility in what ever method of bloodletting of both infection and scarring. Interestingly, “Leechers” were not held in as high esteem professionally as other bloodletters.
A photograph demonstrating the use of scarification and cupping to extract blood.
The second illustration on the right side is showing the placing of leeches on a specific problem site. While unknown, it could possibly have been for arthritis of the elbow.
Images courtesy of Wikimedia Commons