When you think about medieval medicine, you might picture leeches or dirty knives, but doctors in the Middle Ages were more sophisticated than we tend to give them credit for. In fact, in 2015, researchers from the University of Nottingham in the UK found that a recipe from a 10th century medical text (OK, yes, it’s called Bald’s Leechbook) was effective against modern-day superbugs.
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Anglo-Saxon expert Dr. Christina Lee translated the recipe in question, ‘Bald’s Eyesalve’ into modern English and microbiologist Dr Freya Harrison and her colleagues recreated it as closely as possible, including letting it steep for nine days. It was originally designed to treat styes (infections of the eyelash follicle), which are now known to be caused by the same bacteria behind MRSA, Staphylococcus aureus.
MRSA (or Methicillin-resistant Staphylococcus aureus as it’s more formally known) is a type of bacteria that lives on the skin of around 30 percent of the population. It usually doesn’t cause a problem, but if it passes into the body as a result of an injury or cut (including surgery), it causes an infection that doesn’t respond to most antibiotics, which can be fatal. Although the Nottingham scientists singled out the eyesalve recipe because it contained ingredients with natural anti-microbial properties (garlic, leeks, onions, wine, and oxgall), they were still surprised by how well it worked, wiping out MRSA in the lab and in mouse models with 90 percent effectiveness. Even when they allowed infections to grow into thick clusters called biofilms, the mixture broke through them.
This means that not only did doctors in the Middle Ages have a trick or two up their hand-woven sleeves, but that the most effective drugs of the future could come from the past. The race is on to find new ways to treat infections, because antibiotic resistance is growing. In 2013, the Centers for Disease Control (CDC) reported that 23,000 people in the U.S die every year from untreated infections. The Healthcare Infection Society says that 700,000 people a year worldwide die because of antibiotic resistance and predicts that number will be 10 million by 2050.
Antibiotic resistance happens when bacteria evolves so that medication that used to control it can’t do so any longer. Dr. Gerald Pier is a microbiologist at Brigham and Women's Hospital and says that it’s been exacerbated by doctors over-prescribing, and the use of antibiotics in farming. “It's basic Darwinian selection, the more we use [antibiotics], the more the microbes that can't be killed become prominent.” Dr Pier says that we could all see longer stays in the hospital and higher doses of stronger medication in the future if alternatives can’t be found.
While not exactly medieval, the antibiotics we use today all date back to at least the mid-1980s, so we’re due for some new treatments. Dr Pier says that part of the issue is economic: only the largest pharmaceutical companies can afford to invest in research, and because we only use antibiotics intermittently, other medication is more profitable, so there’s little motivation. There’s also a high failure rate. “It turns out that a lot of things we thought were easy, like finding essential genes shared by many microbes, don't exist like we thought they would. So there were some suppositions about how to go about finding new antibiotics that turned out not to be correct.”
That makes already-established recipes even more appealing, although, as Dr. Erin Connelly points out, more research is needed before they’re ready for widespread use. She’s the CLIR-Mellon Fellow for Data Curation in Medieval Studies at the University of Pennsylvania and became interested in the eye salve study while she was completing her PhD at Nottingham.
Connelly is now part of a worldwide, multi-disciplinary team studying ancientbiotics for possible future use. Currently, she’s compiling a database of ingredients from the Lylye of Medicynes, a 15th century work by Bernard of Gordon, a respected doctor of the time, in order to find combinations that might lead to lab testing for potential new antibiotics. But it will take time and money before it’s clear whether the recipes she and her colleagues have found could be viable treatments. “While the preliminary lab results for Bald’s Eyesalve show great potential, the effects on human cells are not known,” Connelly says. “With funding support, it may be possible that, one day, novel antibiotics could be developed from medieval recipes.”
But while this might be years away, it’s not a flight of fancy–there’s proof that ancient recipes can lead to effective medication. In 2015, Chinese chemist Tu Youyou won the Nobel Prize for developing an anti-Malaria drug from Artemisinin, a compound she found in ancient Chinese herbal literature.
While we wait for ancientbiotics to become an everyday reality, scientists are broadening their search for solutions to antibiotic resistance. Researchers from Queen’s University Belfast found that fat-soluble vitamins improve antibiotics’ effectiveness in people with cystic fibrosis, and a study from Oregon State University and Sarepta Therapeutics showed that a molecule called a PPMO (or peptide-conjugated phosphorodiamidate morpholino oligomer for long) can be used to suppress the part of bacteria that makes it resistant to a drug. So far, it’s only successfully been used with one antibiotic (meropenem) but it could potentially be extended to others.
Other things you can do in the mean time: support antibiotic-free agriculture by seeking out organic, grass fed beef and grass fed dairy. We can help, too, by not expecting to take medication for every minor ailment, says Dr Pier. “We need to encourage people to understand that antibiotics are useful against bacteria, that most common things like sore throats and upper respiratory tract infections aren't due to bacteria they're due to viruses… and to not demand antibiotics from their physicians when their physicians tell them it's not an antibiotic-treatable disease.” (And when antibiotics are appropriately prescribed, you should also always take the full course, so as not to add to the problem of antibiotic resistant bacteria.)