The decline of leech therapy in the late 1800s was largely due to advancements in medical science, including germ theory and a better understanding of human physiology. Despite its fall from grace, leech therapy experienced a revival in the 20th century as researchers uncovered the anticoagulant properties of leeches, particularly the substance herudin. The journey from ancient practice to modern science highlights the fascinating evolution of medical treatments and the enduring intrigue surrounding these creatures.