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By Erin ConnellyIn 2015, Youyou Tu jointly won the Nobel Prize in Physiology or Medicine for the development of a new therapy (Artemisinin) to treat Malaria, a disease which has been on the rise since the 1960s. Significantly, the antimalarial component was successfully extracted from the plant Artemisia annua only after consulting the instructions found in the ‘ancient literature' of traditional herbal medicine.As the drugs (chloroquine or quinine) used to combat the malarial parasite have experienced decreased efficacy, such is the case with a wide range of conventional antimicrobials. In fact, major pharmaceutical companies and government agencies have identified antimicrobial resistance as one of the most pressing concerns for global health. The World Health Organization (WHO) stated in September 2016 that antimicrobial resistance is ‘an increasingly serious threat to global public health that requires action across all government sectors and society.’In response to this threat to global health, the Ancientbiotics team was formed. Originally based at the University of Nottingham, the team is an interdisciplinary group from the Arts and Sciences comprised of microbiologists, medievalists, parasitologists, wound specialists, and pharmacists, who are united by the belief that novel avenues of antibiotic discovery are crucial, along with the shared conviction that the past can inform the future. At the same time that Youyou Tu was awarded the Nobel Prize for her work with malaria, the Ancientbiotics team was investigating a tenth-century Anglo-Saxon remedy for eye infection, known as Bald’s eyesalve. The full paper is available here.[caption id="attachment_8730" align="aligncenter" width="216"] Recipe for an eyesalve from Bald’s Leechbook, England (Winchester?), mid-10th century, Royal MS 12 D XVII, f. 12v. Image and caption credit: British Library[/caption]The 1,000-year old recipe has been shown to effectively kill a range of microbes, including, but not limited to, Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, Escherichia coli (E. coli), and leishmania. All of these species are causes of chronic, opportunistic, drug-resistant, or difficult to treat infections. While each ingredient in the eyesalve demonstrates some antimicrobial activity on its own, what is remarkable is that only in the combination of ingredients, exactly as specified by the medieval instructions, do we see the synergistic, potent antimicrobial effect in clinically realistic infection models.An interview on Radiolab with Freya Harrison and Christina Lee is available to explain the full story of Bald’s eyesalve.[caption id="attachment_8731" align="aligncenter" width="300"] Clusters of Methicillin-resistant Staphylococcus aureus (MRSA) Image Credit: Annie Cavanagh, Wellcome Imageshttps://creativecommons.org/licenses/by-nc-nd/4.0/[/caption]The Ancientbiotics project also extends to medical texts of the later medieval period. The Lylye of Medicynes (Lylye) is one such text that offers a diverse range of recipes, including many promising treatments for infectious disease. The Lylye is the only extant Middle English translation of Bernard of Gordon’s Lilium medicinae; it exists in one fifteenth-century manuscript (Oxford Bodleian Library MS. Ashmole 1505). The Lylye is most notable for its pharmaceutical content. There are nearly 6000 individual ingredients in the text; 3500 of those ingredients are contained in 360 specific recipes, which represent over 110 disease states (many of which include symptoms of infection). One of the eye recipes is currently being tested at the University of Nottingham and research is ongoing to identify those ingredients which interact with the same antimicrobial synergy found in Bald’s eyesalve.[caption id="attachment_8729" align="aligncenter" width="300"] Lylye of Medicynes, Oxford Bodleian Library MS. Ashmole 1505 Image Credit: Erin Connelly[/caption]I am also working on the first published edition of the whole text of the Lylye in order to allow accessibility for increased scholarship. A forthcoming paper (2017) in the proceedings from the 8th Annual Disease, Disability, and Medicine in Medieval Europe conference (‘Treating Infected Wounds in the Middle English Translation of Bernard of Gordon’s Lilium medicinae’) conveys in greater detail the potential of this text to be mined for antimicrobial recipes.You may read a little bit more about the Lylye of Medicynes in these short blog posts from 2014: ‘ȝif it be a pore man . . .’: Healthcare for the Rich and Poor in the Lylye of Medicynes and ‘þe best mylke is womman milke’: Does Breastmilk Heal?As a truly interdisciplinary effort between the Arts and Sciences, the Ancientbiotics project has opened new and significant pathways to antimicrobial drug discovery, but it has also challenged the popular categorization of the medieval period as a ‘Dark Age,’ and the centuries-long pattern of dismissing medieval medical texts as ‘unenlightened’ by reason and scientific discovery. In a paradigm-shifting manner, the efficacy of medieval medicines against modern infections instead shows that medieval practitioners were operating within a lengthy tradition of observation and experimentation with recipes that may inspire present day research.