HONEY, MUD, MAGGOTS AND OTHER MEDICAL MARVELS

by Robert and Michele Root-Bernstein


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 Avapors@ drank concoctions distilled from the urine of cows (sold to them as AEssence 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 Agross.@ 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 Aaspirin@ of that age. (ATake 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 Amodern@ medical miracles have similarly odd and ancient histories:

We would be remiss not to add a warning or two. We have not written a self-help book. We are not physicians and we do not recommend any of these treatments for private use. Our sole interest in Honey, Mud, Maggots and Other Medical Marvels has been to document the ancient origins of many basic or even Acutting edge@ medical treatments used by trained doctors in valid medical settings. This does not mean that we believe that all old medicine is good medicine. On the contrary, we emphasize the dangers inherent in untested folk medicines and untutored self-use. Any and every medicinal agent is potentially dangerous. This is just as true for folk medicines as for modern ones. It makes no difference whether the medicine is Anatural@ or not. Heroin is natural and so are cyanide, pennyroyal oil, and belladonna. All of them have been used as medicines and all have killed people who took the wrong doses. Clay, if ingested in great amounts, can become addictive, causing a diminution of appetite for regular food and the growth of stones in the intestines that block digestion. Raw honey can contain enough botulism to kill an infant or an immunologically-impaired grown-up. Handled improperly, leeches can introduce infection. Use the wrong maggot and it will eat viable as well as dying flesh, thereby aggravating the original wound. And no medicine will help an individual who has misdiagnosed him- or herself. In our view, we need to rely on medical professionals to evaluate the safety and efficacy of natural, folk medicines in the same way they do manufactured, clinical medicines before they prescribe them for individual patient use.

This does not mean that Western doctors today can afford to ignore folk medicines or dismiss their use out-of-hand. Folk remedies and discarded techniques will play an increasingly large role in modern medicine in the years to come. The reason is simple. We may say Ayuck@ to the Aprimitive@ ways and means of our ancestors, but they were far from being fools. People in the past and around the world have discovered much through trial and error that we in the West have yet to realize. Moreover, it may not be well-known, but Ascientific@ medicine already has a long, if veiled, record of drawing insight from folk remedies, discovering their active principles, and repackaging them in ways that fit our modern sensibilities. Urine, and all the components we derive from it, make only one case in point. We would do well to recognize this creative process in medical culture and find ways to encourage it. Through the judicious and skeptical culling of ancient folk traditions from around the world we can prime the pump of innovation and speed up the (re)discovery of much-needed, safe and effective medicines and medical techniques. The future of modern medicine, in no insignificant part, depends on our understanding of its past.

THE LIBRARY AS LABORATORY

When Dr. Norman Kasting discovered that phlebotomizing, or bleeding, sheep with fevers brought their temperatures back to normal, he naturally wanted to know whether the same thing happens in people. No Human Use Committee in any hospital was likely to permit him to try such a barbaric experiment, so Kasting did the only thing he could: he turned to the records of the past. He quickly discovered that the primary use of bleeding throughout history and in every culture has been to reduce fever. Physicians for millennia have noted its efficacy and one 19th-century physician actually proved it. Indeed, only with the advent of aspirin did bleeding go out of fashion. Thus, although Kasting was unable to perform his experiment, he was able to research and prove his hypothesis-Bnot in the laboratory, but in the library.

We have had the same experience. In this age of laboratory research, computerized information, and the Internet, it is all too easy to overlook the importance of libraries as places to discover knowledge. But our book could not have been researched or written without the resources of the Michigan State University Library and the help of its staff. The majority of materials we used in researching our book were printed prior to 1965 and are not accessible using computerized data bases. In most cases, we ferreted out information by following footnotes from one article to another. We could not have done this without access to the articles themselves. Books, ranging from histories of medicine to translations of ancient medical texts, were equally important sources. And so were abstracting journals such as the Index Medicus, which began summarizing the entire medical literature as early as 1897. We were fortunate that the MSU Libraries actually contained a significant number of the sources we needed so that we could carry out this hand-on research. We were even more fortunate that the staff had the knowledge and training to be able to help us locate almost everything that MSU itself did not own. Like Dr. Kasting, we found that holding old medical texts in our hands, literally, was the only way to get a good grasp on modern medicine itself. We therefore extend our hearty thanks to the librarians and strongly urge MSU alumni to remember that a strong library is the key to strong research and a strong university.

(Authors' notes)

Michele Root-Bernstein received her BA from the University of Pennsylvania and her Ph.D. from Princeton University. A historian, writer, and teacher, she previously wrote Boulevard Theater and Revolution in Eighteenth-Century Paris (1984). Robert Root-Bernstein received his A.B. and Ph.D. from Princeton University. He is a Professor of Physiology at MSU. Previous books include Rethinking Aids: The Tragic Cost of Premature Consensus (1992) and Discovering: Inventing and Solving Problems at the Frontiers of Scientific Knowledge (1991). Their current book, Honey, Mud, Maggots and Other Medical Marvels (Houghton Mifflin Co., 1997), is available in most bookstores or via the Internat (http://www.hmco.com).

Pull-quotes: Even today, people with AIDS . . . have taken to drinking their own urine to cure thrush.

Holding old medical texts in our hands was, literally, the only way to get a good grasp on modern medicine itself.

A number of folk therapies . . . (are) making a comeback in modern hospitals as accepted forms of treatment.