From antiquity to present day, people have sought out ways in which to heal themselves, to cure the disease of relatives, and to repair injuries. Some of the earliest written records of medicinal practises in Ancient Egypt tell us that healing included spiritual and ritual practises as well as physical treatments. Before recorded history and potentially even before humans existed, it is likely that our ancestors had ways they attempted to treat sickness and disease. Ancient skulls have been found with holes drilled into them, a practise called trepanning, which people often survived and was thought to be a medicinal practise to relieve head-related diseases. Today, observations have also been made of chimps eating the leaves of certain non-nutritious plants, perhaps in an attempt to cure sickness.
Centuries of scientific progress have brought us from the often brutal and misguided practises of ancient and medieval medicine to this privileged place in the time of modern medicine. Life expectancy for people in Ireland is now 82 years old compared with the 19th century when it was about 40 years old. The main reason for this increased life expectancy is the reduction in infectious diseases such as smallpox and tuberculosis. Humanity has also come a long way in terms of the improvement of nutrition, and making the advancement of evidence-based treatment available to many.
“However using indigenous and local knowledge may provide a way to fast track our search.”
As is still observed in parts of the world today, before people had access to modern healthcare, they often relied on local healers practising traditional cures. These cures were often regional, were mainly plant-based, and had variable success. Since the 19th century, drug discovery for modern medicine investigated the traditional cures found in Chinese and Native American folk medicine for beneficial medicinal properties. However, the traditional cures in many regions of Europe, including Ireland, were not investigated to the same extent until recently.
Ethnopharmacology is the study of indigenous medical systems. It seeks to find out how and why people in certain regions used particular cures, with the potential of discovering new drugs. For those familiar with homeopathy, it may seem dangerous to give credence to old herbal remedies and strange cures, many of which may do nothing other than cause a placebo effect or even do harm. However, using indigenous and local knowledge may provide a way to fast-track our search through millions of the potential drug-yielding entities found in nature, saving time, money, and maybe lives. For instance, when searching systematically through plant species for clinical drugs, the average find is one useful drug for every 20,000 samples analysed. But when samples are identified by locals, plant species are up to 60% more likely to have pharmaceutical potential. Many of the world’s drugs – aspirin, morphine, streptomycin – have natural origins, so it makes sense that with the aid of local knowledge, we can continue to find drugs within the natural world.
“We need to find new drugs to ensure that we do not reach the antibiotic apocalypse.”
A global rise in antibiotic resistant infections has heightened the need for new antibiotic drugs, of which there has not been a new class discovered since the 1980s. In the arms race that is evolution, bacteria are catching up, so we need to find new drugs to ensure that we do not reach the antibiotic apocalypse. Such an event would see us return to the days where basic infections were a death sentence. The World Health Organisation (WHO) sees antibiotic resistance as “one of the biggest threats to global health, food security, and development today”.
Researchers around the world are looking to unexplored regions and unique environments in search of potential new antibiotics from plants, fungi, or even other microbes. Organisms that are slow-moving or cannot move often rely on chemicals to protect themselves from predators or to kill their competitors. Thus, plants, slow-moving invertebrates, and some bacteria are ideal candidates for drug discovery. Streptomyces is a family of bacteria that is responsible for about two thirds of natural origin antibiotics currently in use. They produce secondary metabolites which they use to inhibit rival microbes in their environment, but which we can harness clinically to kill bacteria. They have been found in extreme environments around the world including alkaline lakes and caves.
Investigation of a local folk cure in Boho, County Fermanagh has yielded the discovery of a new species of Streptomyces bacteria, which kills four out of six of the main antibiotic resistant infections listed as the top priority by the World Health Organisation. This curative capacity may have been used in this region of Fermanagh for hundreds of years, and consists of taking some of the soil from a local graveyard, putting it in a cotton pouch, and placing it under your pillow or on the site of an infection. The soil in this region is alkaline and is the only region in Northern Ireland with this particular geology, which, in addition to this unique species of bacteria, also hosts protected species of plants.
The new species was shown by the research team in Swansea University Medical School to inhibit the growth of both gram-positive and gram-negative bacteria. The compound which enables the bacteria to kill the antibiotic resistant bacteria has not yet been identified. They have also discovered additional organisms from the same soil which may also provide novel antibiotics.
The international team of scientists was inspired to investigate the local cure by a researcher, Dr Gerry Quinn, who is from Boho and had heard of the local cure from his grand-uncle. The cure has been in recent times ascribed to a local priest, Fr. James MacGirr, who died in 1815 and told the people of Boho that the soil where he was buried would cure people of their illness. The healing properties of the soil have now been confirmed by modern science. However, the alignment with the prophecy of the priest was not so much an act of God as a coincidence of natural properties and regional knowledge perhaps stretching as far back as the druids.
There is something mysterious about the discovery of this new antimicrobial strain of Streptomyces bacteria from a cure that existed long before modern medicine. The mixing of ritual; putting the soil in a cotton bag, prayers said alongside the cure, and the superstition that requires you to return the soil four to nine days later, along with the fact that this alkaline soil does indeed contain an antimicrobial bacterial species, is quite remarkable. On reflection, it may seem that the connection that ancient Irish people had with the land and nature may not have been quite as ignorant to science as we might believe from our 21st century vantage point.
“It is becoming increasingly clear that our sterile homes and overuse of antibiotics is harming us.”
Our loss of local knowledge and connection with nature could well be a loss for science. Rediscovering these roots where possible may give us answers and clues to our modern maladies that are side effects of modern living. As we discover more about the vital function of the microbiome to human health, it is becoming increasingly clear that our sterile homes and overuse of antibiotics is harming us. Allergies, childhood leukemia, and many more conditions are increasing year-on-year in the western world, but not in developing countries.
While many developing countries still wait to benefit from modern medicine, perhaps we in the developed world need to rekindle our relationship with the earth, with nature, and with good bacteria in order to stem the tide of antimicrobial resistant infections, cancer, and allergic disease. Indeed, we may need to take a post-modern approach to medicine, combining the best of modern medicine with the knowledge and experience of local nature.
Paul Dyson of Swansea University Medical School said of the problem posed by worldwide antibiotic resistance that “it seems that part of the answer to this very modern problem might lie in the wisdom of the past”. This said, the soil in Boho not only provides us with a potential drug to combat multidrug resistant infections, but also a timely reminder that nature and folklore still have much to offer to science.