Blood covered the hotel room where Tsetsi Stoyanova had checked in for the night. It stained the sheets and the towels and trailed over the bed. The mess dribbled out from a wound on Stoyanova’s back. It smelled. Not like sweat or iron but something else — something strong.

“The bleeding wouldn’t stop. It just kept on going and going and going,” Stoyanova says. “I made everything red and bloody.”

But Stoyanova, then in her 30s, wasn’t nervous about losing blood. She was excited. It was why she’d journeyed across her home country of Bulgaria.

Earlier that day, she and her boyfriend had clambered up a remote hilltop outside the city of Kardzhali, searching for a special lake renowned among certain locals. When they came across a stand of trees covered in ribbons, they knew they’d found it.

It was the peak of summer and the sun had turned the usually wide lake into a dried-up swamp. Stoyanova wiggled her toes in the muddy shore to entice what she had been pursuing for months: a thirsty leech.

Growing up, Stoyanova had been surrounded by folk remedies and alternative medicine. If someone in her family had a cold or the flu, they would treat it with fire cupping. Her mother and grandparents would take turns lighting a flame over the sick person’s back and extinguishing the fire under a glass cup, making the enclosed skin redden and rise. Later, she got really into enemas. She used them on a daily basis for years.

So when she heard about a lake somewhere in southern Bulgaria, full of an “extremely healing variety of leech” she was drawn to the place. Supposedly, people had been going there for years to seek out the creatures. They would tie a ribbon to a tree if they found a leech to drink their blood. And Stoyanova was determined to join them.

The healing power of leeches has been immortalized for thousands of years, in the tombs of Egyptian pharaohs, verses of ancient Greek poetry, and early medical writings in Arabic, Chinese, and Sanskrit.

The Greek philosopher Hippocrates, sometimes called the father of medicine, asserted that disease arose from an imbalance of bodily fluids: phlegm, black and yellow bile, and blood. He claimed releasing “impure” blood could prevent sickness and cure disease. Physicians took the advice to heart. In the 2018 book Nine Pints: A Journey Through the Money, Medicine, and Mysteries of Blood, journalist Rose George writes, “Bloodletting was as unquestioned as Band-Aids.”

For early doctors looking to rid patients of what they believed was an unhealthy excess of blood, leeches were a perfect fit for the job. Different cultures used a number of species for bloodletting, but the most renowned was Hirudo medicinalis, also known as the European medicinal leech.

In the Middle Ages, the use of leeches spread as barbers added the animals to their toolkits of razors and scissors. At the time, the professionals were just as likely to drain blood and extract teeth from their clients as they were to cut hair.

The leech craze reached a peak in the early 1800s, when a famous French surgeon named François Broussais alleged that all disease stemmed from an inflammation in the gut and could be relieved by bleeding. Since cut-open veins tended to infection and often released too much blood, Broussais advocated for the use of leeches as a safer alternative.

In Biotherapy – History, Principles and Practice, a textbook about the use of living organisms in the treatment of disease, authors Olga Gileva and Kosta Mumcuoglu explain that doctors all over the world, from Brazil to Eastern Europe, used leeches to treat everything from headaches to epilepsy and tuberculosis. Russian emperors and English princes employed leeches when they fell ill. Embroidered leeches adorned women’s dresses in France. Doctors prescribed the creatures with such frenzy that leech populations throughout Europe grew scarce.

Bloodletting eventually died out with the advent of antibiotics and the rise of modern medicine. But the use of leeches didn’t disappear. The therapy survived to treat pain and reduce inflammation alongside other low-cost folk remedies, particularly in Eastern Europe where some pharmacies sold leeches by the jar well into the 1960s.

Today, using leeches for medical treatment is called hirudotherapy. Many of its professional practitioners, called hirudotherapists, promote leech therapy to treat a long list of medical conditions, from asthma to infertility. Through places likes the Academy of Hirudotherapy in Las Vegas — which charges $10,000 for its full course — almost anyone can become certified in the practice.

Some hirudotherapists specialize in beauty treatments and offer leech facials, in which the bloody contents of a leech’s stomach are spread over a client’s face in a sticky mask that’s supposed to reduce wrinkles and promote glowing skin. Celebrities like the actor Demi Moore and model Miranda Kerr have talked about getting the treatment, boosting its popularity in recent years.

Stoyanova hardly knew anything about leech therapy or hirudotherapists back when she was trying to find the fabled lake with its treasure trove of leeches, nearly five years ago. She wasn’t even sure what would happen if one bit her.

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