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Published On: Fri, Apr 21st, 2017

Medieval Medical Books Could Hold the Recipe for New Antibiotics

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For a long time, medieval medicine has been dismissed as irrelevant. This time period is popularly referred to as the “Dark Ages,” which erroneously suggests that it was unenlightened by science or reason. However, some medievalists and scientists are now looking back to history for clues to inform the search for new antibiotics.

The evolution of antibiotic-resistant microbes means that it is always necessary to find new drugs to battle microbes that are no longer treatable with current antibiotics. But progress in finding new antibiotics is slow. The drug discovery pipeline is currently stalled. An estimated 700,000 people around the world die annually from drug-resistant infections. If the situation does not change, it is estimated that such infections will kill 10 million people per year by 2050.

I am part of the Ancientbiotics team , a group of medievalists, microbiologists, medicinal chemists, parasitologists, pharmacists and data scientists from multiple universities and countries. We believe that answers to the antibiotic crisis could be found in medical history. With the aid of modern technologies, we hope to unravel how premodern physicians treated infection and whether their cures really worked.

Healing the sick, fresco by Domenico di Bartolo. Sala del Pellegrinaio (hall of the pilgrim), Hospital Santa Maria della Scala, Siena.

Healing the sick, fresco by Domenico di Bartolo. Sala del Pellegrinaio (hall of the pilgrim), Hospital Santa Maria della Scala, Siena. ( Public Domain )

To that end, we are compiling a database of medieval medical recipes. By revealing patterns in medieval medical practice, our database could inform future laboratory research into the materials used to treat infection in the past. To our knowledge, this is the first attempt to create a medieval medicines database in this manner and for this purpose.

Bald’s Eyesalve

In 2015, our team published a pilot study on a 1,000-year old recipe called Bald’s eyesalve from “Bald’s Leechbook,” an Old English medical text. The eyesalve was to be used against a “wen,” which may be translated as a sty, or an infection of the eyelash follicle.

Human white blood cells (in blue) take on Staphylococcus aureus bacteria.

Human white blood cells (in blue) take on Staphylococcus aureus bacteria. ( Frank DeLeo, National Institute of Allergy and Infectious Diseases )

A common cause of modern styes is the bacterium Staphylococcus aureus . Methicillin-resistant Staphylococcus aureus (or MRSA) is resistant to many current antibiotics. Staph and MRSA infections are responsible for a variety of severe and chronic infections, including wound infections, sepsis and pneumonia.

Bald’s eyesalve contains wine, garlic, an Allium species (such as leek or onion) and oxgall. The recipe states that, after the ingredients have been mixed together, they must stand in a brass vessel for nine nights before use.

In our study , this recipe turned out to be a potent antistaphylococcal agent, which repeatedly killed established S. aureus biofilms – a sticky matrix of bacteria adhered to a surface – in an in vitro infection model. It also killed MRSA in mouse chronic wound models.

Medieval Methods

Premodern European medicine has been poorly studied for its clinical potential, compared with traditional pharmacopeias of other parts of the world. Our research also raises questions about medieval medical practitioners. Today, the word “medieval” is used as a derogatory term, indicating cruel behavior, ignorance or backwards thinking. This perpetuates the myth that the period is unworthy of study.

This man's leg wound is being treated, while herbs for a soothing ointment or healing drink are being prepared.

This man’s leg wound is being treated, while herbs for a soothing ointment or healing drink are being prepared . ( The Knight with the Lion )

During our eyesalve study, chemist Tu Youyou was awarded the Nobel Prize in Physiology or Medicine for her discovery of a new therapy for malaria after searching over 2,000 recipes from ancient Chinese literature on herbal medicine. Is another “silver bullet” for microbial infection hidden within medieval European medical literature?

Certainly, there are medieval superstitions and treatments that we would not replicate today, such as purging a patient’s body of pathogenic humors. However, our work suggests that there could be a methodology behind the medicines of medieval practitioners, informed by a long tradition of observation and experimentation.

One key finding was that following the steps exactly as specified by the Bald’s eyesalve recipe – including waiting nine days before use – was crucial for its efficacy. Are the results of this medieval recipe representative of others that treat infection? Were practitioners selecting and combining materials following some “scientific” methodology for producing biologically active cocktails?

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