[True and artificial leeches and their use in otology. Images from the history of otorhinolaryngology, presented with instruments from the Ingolstadt German Medical History Museum collection].

Based on the concepts of humoral pathology in former centuries bloodletting was used as remedy to great extent, systematically by puncturing a vein or locally by scarification and cupping glasses. In the 18th and 19th century leeches were introduced and applied in huge numbers to cure all conceivable affections including diseases of the ear. J. M. G. Itard in Paris in 1821 for treating various types of hearing disorders recommended to place leeches at the anus or in the nose to imitate bleeding of haemorrhoids or nose-bleeds, which were considered natural resources of the body to cope with disorders of the humours. H. Schwartze in Halle in 1885 still followed this suggestion. W. R. Wilde in Dublin in 1842 and A. F. von Tröltsch in Würzburg 1867 advocated local blood-letting by leeches around the external ear. The surgeon Ch. L. St. Heurteloup in Paris 1840 invented an artificial leech, which was soon widely used in otology and ophthalmology. After the first World War the application of leeches became obsolete. The humoral pathology had found new approaches: immunology including stimulation of the inherent bodily means of defence, and rheology, particularly haemodilution. The historical development and the technique of applying live and artificial leeches in otology are described in detail.