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This week we explore the bizarre — and surprisingly persistent — history of bloodletting and medicinal leeches.

From ancient Egyptian practices and the theory of balancing bodily humors to the 19th-century leech craze fueled by François Joseph Victor Broussais, leeches were once prescribed by the millions across Europe. Harvested in dangerous conditions and nearly driven to extinction, they eventually fell out of favor as modern science advanced.

But here’s the twist: leeches made a comeback.

Today, Hirudo medicinalis is FDA-regulated and used in reconstructive and plastic surgery to relieve venous congestion, thanks to its powerful anticoagulant properties.

Ancient theory. Modern application.
Sometimes medicine comes full circle. 🪱

📚 References

1. FibonacciMD. History of Leeches in Medicine. Published online. https://www.fibonaccimd.com/post/history-of-leeches-in-medicine. Accessed February 19, 2026.
2. Science History Institute. Medicinal Leeches and Where to Find Them. Science History Institute Stories & Perspectives. https://www.sciencehistory.org/stories/magazine/medicinal-leeches-and-where-to-find-them/. Accessed February 19, 2026.
3. National Geographic. Leech Blood Health Craze & Near Extinction. National Geographic Premium. https://www.nationalgeographic.com/premium/article/leech-blood-health-craze-extinct. Accessed February 19, 2026.
4. Ancient-Origins.net. Leech Collectors and the Perils of the Leech Trade. https://www.ancient-origins.net/weird-facts/leech-collectors-0019529. Accessed February 19, 2026.
5. Old Treasury Building. Leech Merchant. https://www.oldtreasurybuilding.org.au/lost-jobs/odd-jobs/leech-merchant/?srsltid=AfmBOoqZmmW7Nm2wfS1v0m8z85TmWchJF4GfK6g5gqf9QOHcVVhTeyXq. Accessed February 19, 2026.
6. Lethbridge News Now. Leech Collectors and the Leech Craze of the 1800s. https://lethbridgenewsnow.com/2017/11/24/leech-collectors-and-the-leech-craze-of-the-1800s/. Published November 24, 2017. Accessed February 19, 2026.

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Bloodletting has been practiced for over 3,000 years — but how did it go from a common cure to a cautionary tale in medical history?

In this episode, we explore the origins of bloodletting in Ancient Egypt, where illness was believed to have both spiritual and physical causes. We unpack the influence of Hippocrates and his theory of the four humors, and how Galen helped popularize bloodletting as a standard treatment for centuries. From medieval barber surgeons to the aggressive overuse that harmed patients, we trace how the practice evolved — and why it persisted for so long.

We also look at how bloodletting survives today in the form of therapeutic phlebotomy and the controlled use of medicinal leeches, highlighting how modern medicine differs from its historical roots.

Remember, main episodes drop on Mondays, and companion case files drop Fridays. Thanks for listening!

📚 References

1. Zubair A. Therapeutic phlebotomy. Clin Liver Dis. 2014;4(5):102-106. Published online 2014. https://pmc.ncbi.nlm.nih.gov/articles/PMC6448745/
2. Ascensao A, Moreira R, Gomes R, et al. Clinical applications of therapeutic phlebotomy. Accessed https://pmc.ncbi.nlm.nih.gov/articles/PMC4957680/
3. Blood and the cells it contains. In: Blood Groups and Red Cell Antigens. National Center for Biotechnology Information Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2263/
4. Whitaker IS, Izadi D, Vanek PF, et al. European medicinal leeches—new roles in modern medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC7277884/
5. Greenstone G. The history of bloodletting. BCMJ. 2010;52(1):12-14. https://bcmj.org/premise/history-bloodletting
6. Hemochromatosis. In: StatPearls. National Center for Biotechnology Information Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430862/
7. Polycythemia Vera. In: StatPearls. National Center for Biotechnology Information Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557660/
8. Porphyria Cutanea Tarda. In: StatPearls. National Center for Biotechnology Information Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK563209/

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In the 1980s, three young brothers — Ricky Ray, Robert, and Randy — contracted HIV through contaminated blood transfusions used to treat their hemophilia. What followed wasn’t just a medical crisis — it was a public reckoning with fear, stigma, and misinformation surrounding HIV/AIDS.

In this episode, we unpack the tragic and infuriating story of the Ray family: the school expulsion battles, the national media spotlight, and the horrifying act of arson that forced them from their home. As their community turned against them, their fight became emblematic of the broader discrimination faced by people living with HIV during the epidemic’s early years.

We also explore how Ricky Ray transformed personal tragedy into activism — advocating for awareness, education, and policy reform. His legacy lives on in the Ricky Ray Hemophilia Relief Fund Act of 1998, which provided financial compensation to hemophiliacs infected with HIV through federally regulated blood products.

📚 References

1. History.com Editors. (2021, July 9). HIV-positive Ray brothers’ home burned down. History. https://www.history.com/this-day-in-history/august-28/hiv-positive-ray-brothers-home-burned-florida
2. Carter, C. (2025, November 7). “A town without pity” revisits a dark chapter of Arcadia’s history. WUSF. https://wusf.org/text/arts-culture/2025-11-07/a-town-without-pity-revisits-dark-chapter-arcadia-florida-history
3. Remembering the Rays: A story of intolerance, acceptance and dignity. (2007, September 9). Herald Tribune. https://www.heraldtribune.com/story/news/2007/09/09/remembering-the-rays-a-story-of-intolerance-acceptance-and-dignity/28575891007/
4. Hemophilia Federation of America. (2014, March 23). 1998: Ricky Ray Relief Fund Act passed. https://www.hemophiliafed.org/1998-ricky-ray-relief-fund-act-passed/
5. Revisiting a tragic chapter in the history of hemophilia and AIDS. (n.d.). Hemophilia News Today. https://hemophilianewstoday.com/columns/revisiting-tragic-chapter-hemophilia-aids/