Feature: Honey, Mud, Maggots and Other Medical Marvels
HONEY, MUD, MAGGOTS AND OTHER MEDICAL MARVELS
A fascinating, historical study of folk medicine reveals that some 'old wives' tales' actually make good medical sense. Has your great aunt ever suggested that you treat a sty by boiling a tea bag and placing it on your eye for thirty minutes? Has your grandmother ever suggested that you treat your winter-chapped hands by urinating on them and rubbing vigorously for five? Did grandpa ever tell you how he used to go to the local apothecary shop and buy leeches to bring down the swelling of a black eye or sprained ankle? Did the old woman down the street ever encourage you to eat a bit of choice clay to take care of your morning sickness or nausea?
If you are like most people, you have heard about folk remedies such as these and your immediate reaction has been, 'You must be kidding!' That was our reaction, too, not only to the stories we heard from relatives and friends, but those we encountered in the course of our academic research as well. Reading old memoires, we came across 18th-century notables who took the waters at Bath or Lourdes or Baden-Baden and claimed that their liver or kidney complaints or their palsies miraculously disappeared. Women with the "vapors" drank concoctions distilled from the urine of cows (sold to them as "Essence of a Thousand Flowers") and claimed to be calmed. Physicians throughout history have slapped together poultices of honey, yeast, milk and similar ingredients and asserted their healing benefits on gunshot wounds, cuts, burns and ulcers. Even today, people with AIDS whose infections resist treatment with modern antibiotics have taken to drinking their own urine to cure thrush (a yeast infection) in their mouths and throats. Or they stimulate their immune systems by exposing patches of their skin to DNCB (dinitrochlorobenzene), best known to photographers as film developer. Does any of this, we wondered, make any medical sense at all? The surprising answer in all of these cases is, 'Yes!'
Combining our historical and biomedical training, we decided a couple of years ago to take a scientific look at old wives tales and folk medicines. The result was a book we recently published called Honey, Mud, Maggots and Other Medical Marvels. Amazingly, we found that over a quarter of all prescription drugs currently available today began as folk medicines and more than half of all natural compounds currently used as drugs by licensed physicians were first identified by witch doctors, shamans, tribal healers, or other people without training in modern scientific medicine.
What's more, we discovered a number of folk therapies measuring up to scientifically sound clinical trials and making a comeback in modern hospitals as accepted forms of treatment. In some cases, treatments as old as history itself are out-performing the latest technological advances in trauma centers and surgeries around the world. Consider some examples. Mention maggots and most people shudder. Maggots are the worm-like larvae of flies. We associate them with garbage and decay. The very idea that maggots could be used in medicine is almost unthinkable. And yet there is evidence that the ancient Mayans and Australian Aborigines, amongst other peoples, purposefully introduced maggots into badly infected wounds. At least a few American surgeons did likewise during the Civil War and World War I. Even today, some hospital physicians in this country place these little Abiosurgeons (as they euphemistically call them) in some of the worst bed sores and pressure ulcers they can find. The question is, why? As long as healers, whether in the past or the present, have used the right species of fly, the larvae will only eat dead tissue and the bacteria it contains. At the same time, they excrete sterilizing chemicals. As soon as the maggots encounter viable tissue they stop eating, leaving the wound clean of contaminating material and well on the way to healing. In essence, they do a great job of surgical debridement.
That's all very well for the jungle or the outback, you might say, but why should we use maggots when we've got surgeries and penicillin? For one thing, maggots can get into the nooks and crannies that surgeons often miss. For another, a growing number of infections no longer respond to the use of penicillin or other modern antibiotics. Maggots are the last and best recourse for patients who suffer for years from untreatable bedsores and ulcers and risk losing their limbs to gangrene. Nevertheless, physicians, nurses and patients all find the use of maggots more than a little "gross". At least at first. Patients are relieved to feel no more than a tickle when larvae are present in the wound. In the end they're easy converts to an ancient therapy that really works.
Leeches inspire a similar revulsion and a similar conversion. Wet, wriggly dark brown or black worms that suck blood, they are not creatures designed to inspire patient confidence! And yet the leech has been a mainstay of medicine for centuries as a natural bloodletting tool. People in the past and around the globe have used them whenever the general removal of blood from the body was medically indicated: to lower fevers, to ease the heart pain associated with angina, to treat high blood pressure, and to reduce black eyes and sprained ankles. These particular uses have been validated, but for numerous other medical conditions the leech was definitely no more than a panacea. Indeed, by the eighteenth century, leeches had became so popular in Western medicine that historians have referred to them as the "aspirin" of that age. ("Take two leeches and call me in the morning!") The subsequent development of aspirin and other medical advances during the nineteenth century put paid to most of the traditional uses of the leech, but one major one still remains.
Today, leeches are linked with one of the most high-tech forms of medicine around: microsurgery. If a person has an accident in which a finger, lip, ear, or even scalp has been severed then surgeons will often attempt to replant it. This requires the anastomosis or reattachment of arteries and veins in order to reestablish blood flow in and out of the replanted tissue. Unfortunately, if too many veins are damaged beyond repair, the reattached tissue sometimes becomes congested with oxygen-depleted blood and begins to die.
Enter Hirudo medicinalis, the medical leech. Placed at the site of congestion, Hirudo bites into the skin, injects a saliva containing anticoagulants, and begins to suck blood. More often than not, this is enough to reestablish a life-giving circulation. Half a dozen leeches and several days later, the reattached finger or scalp is well on its way to recovery. Pretty good work for worm! Until we learn to mimic the leech's mechanical, blood-sucking action in the same way we are learning to genetically engineer its blood-thinning anti-coagulants we will turn to Hirudo to do a job that can't get done any other way.
Maggots and leeches are not the only remnants of past medicines in today's medical armamentarium. Other "modern" medical miracles have similarly odd and ancient histories:
Honey was used by ancient Egyptians, Chinese, Indians, and Africans for treating amputations, ulcers, burns, and other major wounds. Physicians in trauma clinics in the U. S., Europe, and Latin America have rediscovered this ancient practice and use honey or sugar pastes to cure infections when modern surgical techniques and antibiotics have failed. Some surgeons even lower the risk of infection after open heart surgery by packing the heart with sugar!
