Leeching had a fixed and relatively modest range of indications in humoral pathology, the dominant paradigm in ancient European and Arabic medicine until the 17th century. This broad concept of disease was based on the notion that all illnesses are caused by an imbalance of one of the four body fluids, or humors (blood, phlegm, yellow bile, and black bile). The underlying basis for its use was the widespread belief in the concept of body humors (humoral pathology).
Leeching remained part of various systems of medicine through the centuries. Then, most proponents of medicinal leeching deduced its therapeutic efficacy within the framework of the prevailing scientific paradigms of their respective school of medicine. Medicinal leeching initially remained primarily the domain of empirically minded physicians. Leeching was an integral part of conventional and folk medicine from antiquity to the 19th century. In Europe, medicinal leeching was viewed as a science-based therapeutic method right from the beginning. Leeching was also an ever-present force in traditional Chinese medicine (TCM), but was of lesser significance than in Indian medicine. The most extensive descriptions of leeching in the Indian literature appear in the writings of the physician Sushruta (100–600 B.C.E.).
According to Hindu mythology, Dhavantari, the physician who revealed the secrets of traditional Indian medicine to the world, held nectar in one hand and a leech in the other. The first clearly identifiable account of leeching appears in ancient Sanskrit writings from India. Leeching is one of the most ancient healing methods documented in the history of medicine.
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