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At first glance, Christina Lee may seem an unlikely actor in the life-and-death battle to save humanity. An associate professor in Viking studies at the University of Nottingham, Lee has written books on such pressing matters as Anglo-Saxon funerary rites, and teaches classes on Old English and Old Norse literature. Recently, though, the School of English academic has been spending her time investigating things crucial to more than just our understanding of axe-wielding Europeans. And her research may just help solve one of the most pressing medical crises we face today.
As a rule, universities tend to keep their liberal arts and sciences departments well apart. But in an unusual move, two of the University of Nottingham’s main research areas – molecular microbiology and early medieval history – were recently brought together to investigate antibiotic-resistant superbugs: unstoppable bacteria currently responsible for killing 700,000 people a year. What do old Scandinavian pirates and medieval Brits have to do with medical problems? Quite a lot, it turns out.
The story of our current predicament begins in 1928, when Alexander Fleming discovered the first antibiotic, penicillin. It’s difficult to overstate how important this development has been to modern medicine. Without penicillin, we would still be susceptible to the kinds of bacterial plagues that routinely wreaked havoc on the sick, and which could turn even paper cuts into matters of mortal concern. But since the 1940s, when mass-produced antibiotics became widely available, we’ve been throwing the miracle cure around willy-nilly. The fungus-based medicine has even been mixed in with animal feed, making it an almost unavoidable staple in our diets. The result is that, over time, antibiotics have become less and less effective as bacteria have evolved to resist them.
If things continue, we could be heading for the stuff of nightmares – a world in which even an operation for appendicitis would be too risky, and something as simple as a scratch could kill you. “Estimates suggest that over 10 million people will die of antibiotic-resistant infections every year by 2050,” says Michael Gillings, professor of molecular evolution at Macquarie University. “This death toll will be higher than deaths from cancer.”
Little wonder, then, that researchers are scrambling to find ways to combat the problem. Scientists have been toiling away for some time, but their slow progress in the face of pending catastrophe has led some to believe the answers aren’t going to be found in laboratories alone. This niggling feeling was what lead a group of scientists to walk over to the University of Nottingham’s School of English and knock on Lee’s office door. She remembers the stilted awkwardness of the first encounter. “The science people said, ‘In [the early medieval] period, people must have had infections.’ And I said, ‘Yes of course they did, and they died of them.’ And they said, ‘Well, did they have anything [to fight] against them?’”
Lee didn’t have the answer, but she knew where to look: inside the pages of a ninth-century Anglo-Saxon manuscript called Bald’s Leechbook, housed in the British Library. One of the earliest known medical textbooks in the English language, its three volumes include ancient cures for everything from baldness to demonic possession and spider bites. Some of the suggested remedies are, by our modern standards, bizarre to say the least. For swollen eyes, the book suggests catching a crab, cutting off its eyes and putting them against the patient’s neck before chucking the crustacean back in the water. Bald’s cure for nosebleed involves ramming barley into the ear, while the “turd of an old swine” smeared on the affected area apparently works wonders for shoulder pain.
Among all these strange concoctions, Lee remembered one that at least gelled slightly with modern research – a reasonably straightforward treatment for eye infections involving ingredients Lee knew had potential antibiotic properties. In Old English the treatment reads:
Wyrc eagsealfe wiþ wænne: genim cropleac 7 garleac begea emfela, gecnuwa wel tosomne, genim win 7 fearres geallan begean emfela, gemeng wiþ þy leaces, do þonne on arfæt, læt standan nigon niht on þæm arfæt, awring þurh claþ 7 hlyttre wel, do on horn 7 ymb niht do mid feþere on eage; se betsta læcedom.
Curious, Lee set about translating the passage. “There were a couple of words that were ambiguous,” remembers Freya Harrison, a microbiologist who worked with Lee on the project, which now goes by the name AncientBiotics. ‘Cropleek’, for instance, could mean either leek, garlic or shallots. “We had to think about what ingredient was meant by those words.” The team investigated which plants would have been most commonly found at the time and compiled a best-guess ingredient list.
It remains to be seen whether the “odorous slime” will have a role to play in the coming war on superbugs, but it’s clear that ancient texts are an untapped resource.
With their translation complete, the AncientBiotics crew recreated the recipe as faithfully as possible. They used heritage varieties of garlic and onion, and bile from the gallbladder of a cow. In an attempt at authenticity, Harrison even managed to source wine from a vineyard that has been around since the ninth century. “Bald gives very precise instructions for the ratios of different ingredients, and for the way they should be combined and stored,” Harrison says. In this case, the instructions specified that the ingredients be mixed and left to stand in a brass vessel for nine days, then strained through a cloth.
This is where Bald and the AncientBiotics team parted ways. Brass and cloth wouldn’t pass rigid laboratory muster, so Harrison immersed metal filings in the mixture and let it brew in a sterile glass bottle. After the nine-day waiting period, the preparation turned “into a kind of loathsome, odorous slime”. The only thing left to do was follow Bald’s final instruction: “At night-time, apply with a feather on the eye: this is the best remedy.”
Or follow it near enough: the team hasn’t yet applied the golden liquid to a bung eye with a feather, but has done tests in the laboratory to assess how well it works on a modern superbug known as methicillin-resistant Staphylococcus aureus, or MRSA. Harrison applied the gunk to scraps of MRSA-infected mouse skin, and counted how many bacteria were still alive after 24 hours. To her surprise, she found it had killed 90 per cent of the superbug – similar to an effective antibiotic treatment. “When we got the first results, we were just utterly dumbfounded,” Harrison says. “It has a massive, massive killing ability. We did not see this coming at all.”
How the salve actually works remains a mystery – for now. It could be that several active compounds are involved, or that leaving the mixture for several days creates a completely new compound via an as-yet-unknown chemical reaction. “We don’t believe that we have a silver bullet for curing MRSA,” the AncientBiotics team is careful to say. “And there is a huge amount of work to do in determining why our preparation works so well.” But the fact that a 1000-year-old spell works at all is cause for celebration.
For Lee and her historian colleagues, the study has already proved a success. “When [most people] use the term ‘medieval’ these days, it’s often used as a pejorative.” Lee sees her work on superbugs as an opportunity to recast the so-called Dark Ages in a more positive, complicated light. If it happens to save humanity, all the better.
Following the initial experiment, Bald’s salve has been tested on a number of different types of bacteria, with varying results. It remains to be seen whether it will have a role to play in the coming war on superbugs, but it’s clear that ancient texts are an untapped resource. Thankfully this is starting to change, as more scientists look to history for possible solutions. In 2015, the pharmaceutical chemist Tu Youyou shared the Nobel Prize for her work in developing a malaria treatment using a component extracted from sweet wormwood – a 2000-year-old cure for fever she came across while studying traditional Chinese medicine.
Peter Collignon, a professor in the medical school at the Australian National University, believes looking to the past could well be the way forward. “It’s likely we might find something [in the books of the ancients],” he says. After all, penicillin comes from a natural fungus, and may have been used on wounds long ago. It stands to reason, then, that other materials with antibiotic properties were used in ancient times and are now worth investigating. “Equally, there will be a lot – probably most – that don’t work as well.” But the same is true of any new medical treatment.
Medical advancements aside, the AncientBiotics researchers believe their work is an example of how disparate disciplines can combine forces to achieve things neither could do alone. If nothing else, bridging the gulf between the humanities and science – the so-called right- and left-brain divide – is an achievement in itself. “This is a really good and positive thing,” Lee agrees. “We hope that Bald and his colleagues would have been pleased.”
* This story was first published in Smith Journal volume 25 of Smith Journal, with the title ‘Strange Medicine’. Grab a copy from our online shop.