Ellie Bennett explores how answers to the global problem of antimicrobial resistance, a decidedly modern phenomenon, may lie in the lotions and potions of our ancient predecessors.
The Romans gargled urine for mouthwash, the Ancient Egyptians used dung as remedy for, well, everything and Hippocrates diagnosed his patients’ by nibbling on an amuse bouche of their snot and earwax. Oh, and he also drank their wee. Ancient medicine, for the most part, was really disgusting.
You can’t blame them though. Back then nobody had the knowledge of, or access to, the types of antibiotics, antivirals or even basic sanitation that we have today. The majority of remedies were a mash-up of whatever was living in your back garden. With disease rife and a lack of supervision from any ethics boards, there were plenty of human candidates to experiment on. But behind what, to us, might appear to be misguided and desperate attempts at curing disease, there were elements of method to the madness.
A number of examples exist of natural precursors to modern drugs, which were used as treatments for centuries long before they were claimed by today’s scientists and pharmaceutical companies. Aspirin, which is derived from the bark of willow trees, is known today for its effective pain killing properties, but it has been used in this way for thousands of years. Our urine-swigging Hippocrates quite sensibly applied willow leaves and bark to treat aches and fever in his patients. Artemisinin from sweet wormwood, morphine from poppies and digoxin from foxglove are just a handful of the other nature-derived pharmaceuticals that were first used millenia ago.
The bad news is, novel drug discoveries like these have been drying up since the ‘golden age’ of the late 90s, when key treatments for HIV-AIDS, cardiovascular and respiratory disease were added to our arsenal. This is especially worrying in light of growing antimicrobial resistance, currently one of the biggest threats to human health in the modern era. With around 540,000 species of known plants and fungi in the world, and a multitude of active chemicals in each one, it is perplexing that we haven’t had much luck turning these into effective new drugs.
However, scientists at the University of Warwick think that we might be tackling the issue from the wrong angle. The research team led by Dr Jessica Furner-Purdoe tested a Anglo-Saxon ‘eye salve’, one of hundreds of remedies found in ‘Bald’s Leechbook’, possibly one of the earliest known medical textbooks. The salve was found to be effective against 5 species of pathogenic bacteria. This builds on previous research carried out by the University of Nottingham that found a 90% reduction in colonies of MRSA in mice wounds that were treated with the salve.
This type of research highlights the importance of an interdisciplinary approach to discovery.
The recipe – garlic, onions, leeks, cow bile and wine left to sit in a brass vessel for 9 days – was followed to the letter by the researchers, just as Bald himself would have done.
But here’s the intriguing bit: its bacteria-killing ability relied on the recipe being used as a whole and not by isolating any one active compound. The latter is how most research efforts look for potential therapeutic compounds in plants, animals and microorganisms, which hasn’t proven especially fruitful. Removing any one of the ingredients from the concoction decreased its effectiveness against the bacteria. Dr Furner-Purdoe thinks that a number of things may be going on. Either the combined activity of each ingredient attacked the bacteria in several different ways, or the ingredients reacted with each other to form novel bactericidal compounds.
Multi-targeting antibiotics (single compounds which target two or more bacterial defense and survival mechanisms) have been touted as a possible solution to the problem of drug resistance. Bald’s eye salve suggests that we may be able to recreate this multi-targeted approach using a more humble source.
We must be cautious however, as this ancient recipe is just one of a myriad out there. The Greeks, Egyptians, Romans and the Chinese all had their own versions of Bald’s book, with the majority of remedies being entirely redundant or downright dangerous. Before we can even pinpoint the potential targets for research, a huge amount of interpretation will need to be done. We would need to rely on linguists and classicists to scour through and interpret the ancient languages before we could even think about bringing a recipe to life in a laboratory.
Using whole plant matter or animal products as a treatment, rather than extracting their active components as is the norm in drug development now, could exclude groups with allergies. We don’t want to find ourselves having to tell the woman with the food allergy that she can’t have access to life-saving treatments. Equally, the thought of ingesting many of these concoctions or even applying them to your skin is unappealing. It is hard enough to get a child to swallow a pill, let alone garlic-infused cow bile. So these remedies will need to be made palatable without detracting from the unique multifaceted properties that make them effective.
Clearly, there is a long way to go in regards to the clinical application of ancient remedies, but we should take these findings seriously. The proponents of herbal or ‘natural’ treatments have long been at odds with those in support of modern Western medicine. Whilst I myself fall into the latter group, I am gradually understanding the importance of taking a leaf out of the other book. Whilst our mainstream methods make use of the established scientific method, the success story of Bald’s Leechbook recipe shows that taking inspiration from our natural world, even from the most crude of sources, may be vital to the advancement of science. As well as incorporating the ideas of ‘natural medicine’, this type of research highlights the importance of an interdisciplinary approach to discovery. Using the expertise of the arts, alongside botanists, microbiologists and medicinal chemists could prove to be a powerful combination, much like Bald’s eye salve.
Written by Ellie Bennet and Ailie McWhinnie.