After preparing a place for the patient to apply the leeches, one should make sure the use of medicinal leeches is suitable for this patient and he/she is familiar with the principles of providing first aid. Only then we can say that we are ready to begin the therapy using medicinal leeches. When applying medicinal leeches, it is important to stress the following points: the first is the size of a medicinal leech. Medicinal leeches can be applied in a variety of sizes: there are cosmetic medicinal leeches which are very small and similar to living strings; next, we have leeches of medium and large sizes. Cosmetic medicinal leeches are hard to find in Slovakia, because it is difficult to take care of them and they often die very quickly. In most cases one can easily buy medicinal leeches of medium size. Taking into account that more and more people use medicinal leeches at home, there is an offer to buy medicinal leeches of a bigger size.
The size of a medicinal leech determines the depth of a bite and this determines the location of a medicinal leech application. An experienced hirudotherapy practitioner can use leeches of any size on any part of the patient’s body. In case leeches are used by people with little experience, I would recommend using that part of a patient’s body, where muscles and joints are located. Thus, it is better to avoid places with soft tissues, such as neck, groin, inner leg from the knee to ankle and the entire facial area. This brings me to another important observation: the application place choice, but we will discuss it in more detail in chapters on separate diagnoses, as there is a very wide range of places where you can use medicinal leeches. In this chapter, we will focus mainly on the preparation of a place.