Remembering When the Cure Was Worse Than the Disease
From silver spoons to the magic bullet — could we see a return to the “good old days” of medicine?
In 1963, anthropologist George Armelagos found himself in a strange situation.
He and his team were in the Sudanese Nile Valley studying the remains of the ancient Nubians. While scanning their bones for signs of osteoporosis, he found something shocking.
“Imagine if you’re unwrapping a mummy, and all of a sudden, you see a pair of Ray Ban sunglasses on it,” Armelagos said. “Initially, we thought it was a product of modern technology.”
What had the team discovered?
Tetracycline — an antibiotic that had been “invented” in 1948.
Tetracycline binds to both bone and tooth enamel, leaving behind a distinctive yellow discoloration. This permanent marker had even been used to successfully determine the age of bones.
So the team knew they were looking at tetracycline. What they couldn’t figure out was how the Nubians knew about it.
Eventually the secret came out.
Tetracycline is a natural by-product of the bacteria Streptomyces. They use it as chemical warfare against foreign strains of bacteria.
Where is Streptomyces found? Grain.
What did the Nubians use grain for? Beer.
The act of fermenting bacteria to produce beer heightened the production of tetracycline to the point where anyone, including children, who consumed the beverage would ingest a large dose.
Standing on the shoulders of giants
Though germ theory wasn’t yet a concept, the ancient Nubians knew that drinking the beer made them feel better.
This happy accident of fate is found often in the realm of science.
Alexander Fleming is the man who usually gets all the glory for his “accidental discovery” of penicillin. Indeed, Fleming is known as the “father of modern antibiotics.” However, like all discoveries, he stood on the shoulders of giants.
Here are a few other examples of early antimicrobial agents in history — including the good, the bad, and the hopeful.
Blue-bloods
The antimicrobial properties of silver have been known since the dawn of civilization. We have the accounts of Herodotus mentioning that water stored in silver containers would be kept pure.
In fact, this practice survived up until the frontier days of early America. Intrepid pioneers would place silver dollars in wine, milk, and water to prevent spoilage.
Hippocrates used silver compounds topically to prevent ulcers and promote wound healing. In the 1500s, Paracelsus recognized that silver nitrate applied to wounds could remove dead or decaying tissue and stop bleeding, effectively cauterizing the wound.
The preservative nature of silver caught on. It became the fashion for both royalty and the nobility to drink out of silver mugs, dine off silver plates, and eat with silver utensils, including chopsticks. This widespread practice gave rise to the saying, “born with a silver spoon in his mouth.”
Another odd phrase came from a unique side effect of silver — its ability to turn the skin a peculiar shade of bluish-gray. This condition is known as argyria. Although startling to look at, argyria has no other health consequences. However, it did make others refer to the affected members of the upper class as, “blue bloods.”
One of the more exciting uses for silver nitrate didn’t come about until the 1880s. German doctor Carl Siegmund Franz Crede discovered silver nitrate eye drops could prevent the transmission of gonorrhea from mothers to their newborns. This procedure was used up until the invention of modern day antibiotics in the 1940s. Indeed, this era is when silver truly fell out of favor, having been utilized for thousands of years.
Today we use silver nitrate sticks to cauterize wounds or to remove skin growths like warts. Silvadene (silver sulfadiazine)remains a popular prescription agent to treat burns. Colloidal silver, a suspension in water and proteins, is often touted as a “cure-all” supplement, with fans like Goop founder Gwyneth Paltrow and “Papa Smurf” Paul Karason. Karason consumed colloidal silver every day for most of his adult life after seeing a daisy stay fresh in silver spiked water. He still swore by it even after it turned him blue.
However, there has been a renewed interest in silver among the medical community due to its outstanding antimicrobial properties combined with relatively low toxicity. In the setting of growing bacterial resistance to modern antibiotics, we might just see this old therapy gain new life.
“A night with Venus, and a lifetime with mercury”
In 1363, a prescription for treating scabies was written down in Latin.
It contained one-ninth part of argentum vivum, otherwise known as mercury. This crucial ingredient would remain the antimicrobial of choice for almost 500 years for one reason.
It worked.
Mercury in the form of cinnabar was naturally found in volcanic regions. The bright red color made it useful for dyes. However, the risks of handling this poisonous ore were known since ancient times.
When using mercury medicinally, even as a topical ointment, caution had to be exercised. As a neurotoxin, mercury has a list of impressive side effects. Excessive salivation, as much as 3 pints per day, teeth falling out, and “rotting of the guts” were just a few.
Often patients would be forced to suffer in saunas infused with cinnabar fumes. The sweating was thought to flush out the disease and speed recovery.
Eventually ointments and sweat boxes gave way to ingesting mercury in the liquid form called quicksilver.
In the mid 18th century, bar patrons could grab a swig of mercury along with their evening ale. Because the quicksilver slipped right through the digestive tract, it didn’t cause any of the horrible acute symptoms. However, it was not uncommon to find droplets of accidentally voided mercury in shoes, pant legs, and on the floor.
One amusing anecdote tells the tale of a man who believed his date dropped her pearls on the floor. Imagine his shock to find beads of mercury instead.
Naturally quicksilver did not cure any disease, and instead resulted in chronic mercury poisoning.
Mercury showed up in other places too. It was a useful disinfectant for surgical instruments and a popular antiseptic for hand washing or wound cleansing.
In an effort to negate the toxic effects of mercury, various compounds were tested. Eventually mercurous chloride, or calomel, tablets became popular in the early twentieth century. Physicians also started to realize that long-term therapy was the key to success, not copious amounts of drool and sweat.
Only one medical advancement ushered in the demise of mercury. A treatment that seemed even more deadly — arsenic.
Chemio-therapy
Paul Ehrlich and his assistant Sahachiro Hata were undertaking a momentous endeavor.
While studying industrial dyes, Ehrlich noticed that only certain bacteria would take up the color. He wondered if this property could be used against them.
This had long been medicine’s ultimate goal — to find a “magic bullet” which would kill bacteria, but not the host cells.
The disease in the crosshairs? Syphilis.
Ehrlich started with methylene blue. When that failed to show results, he tested trypan red. Finally he turned his attention to a vibrant green dye — arsenic.
His team infected rabbits and systematically began to inject them with various arsenic compounds. The failures piled up until compound number 606 produced a positive result — a cured rabbit which would live to hop another day.
The magic bullet had been found.
Ehrlich used the term chemio-therapy to describe his new compound arsphenamine. A man-made chemical as opposed to biological substances already found in nature. By 1910, his lucky number 606 was trademarked as Salvarsan, “the arsenic that saves.”
Although undoubtably a miracle drug for the time, it was not without concern.
Salvarsan was unstable and difficult to produce in large quantities. Attempts would lead to explosions and fires in the factory.
The chemical was also very irritating. That, combined with the large volume needing to be administered, resulted in an excruciating injection. Often treatment resulted in fevers from an improperly prepared solution. Blistering rash, blackened extremities due to restricted blood supply, heart attack, and stroke could also result from chronic arsenic exposure.
The compound was tweaked in 1914 and a somewhat safer version released, but the path was set for the future. The dawn of modern antibiotics had arrived.
Antibiotic resistance today
Hopefully we will never return to a world where poisons such as mercury, bismuth, cadmium, antimony, and arsenic are used as medicine. However, as the saying goes, “it is the dose that makes the poison.”
Antibiotic resistance continues to increase. The CDC estimates that nearly 3 million Americans each year come down with an infection that will not respond to standard therapy.
So clearly, we need to act.
Who knows, we just may find ourselves taking a prescription from the past.
