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A World Without Antibiotics – How Did Doctors Treat Infections?

by — 2016-03-12 in Drugs & Medications
The discovery of penicillin in 1928 was most probably the biggest medical breakthrough of the 20th century. Illnesses such as syphilis, gonorrhea and tuberculosis could then be treated. How did doctors manage these issues before antibiotics though?

Over the last 2000-3000 years, physicians from early civilizations such as the ancient Egyptians, Greeks and Romans right up until the early 1900's were managing cases of infections without the aid of antibiotics. During Roman times, doctors treating gladiators with infected wounds wouldn't know what the cause of the problem was, but they would note signs such as inflammation and draining wounds. 

Conservative measures

Through the following centuries, physicians would then manage infected and inflamed wounds by keeping them clean and dry and by applying warm compresses. Performing these procedures were then noted to have beneficial effects for the involved individual. 

These various remedies were made from herbs, plants, tree barks, mud, molds and acids or caustic liquids. Some of these treatments may have benefited the patient but probably many didn't. Honey was found to be a very good treatment of infected tissue and is even used in medications up to this day.

Surgical intervention

During these times, surgical intervention was a heavily relied on form of treatment to try and remove infected material and tissue before the sepsis would spread further throughout the body. Of the most common form of surgical intervention was lancing, or cutting open, and draining pus filled cavities such as abscesses and boils. In general, amputations of infected limbs and body parts would also be performed in order to prevent the infection from spreading and thus halt worsening of the patient's condition.

During wars and battles, more soldiers would die from infections that would spread throughout the body than from bullet wounds. This would be the case up until World War 1 as guns would propel bullets at lower velocities which would result in pieces of clothing entering the flesh together with the bullet. These pieces of clothing would introduce bacteria into the body and the infective process would start shortly thereafter. Dentists would manage infected teeth, due to root abscesses, by pulling these teeth out. This would help get rid of the cause of the pain and patients would actually be quite grateful.

Removal of infected tissue did end up being quite destructive to the patient though, often leading to severe disabilities and unflattering cosmetic outcomes.

The body's immune system

As humankind evolved then so did our immune systems. As we became exposed to more pathogens, our immune systems would be stimulated to produce antibodies to those harmful microorganisms. Conservative measures; such as rest,lowering the body's temperature with lukewarm baths and compresses or by making sure that the patient was well hydrated, would help to control the symptoms of the illness so that body had a good chance of fighting of the infection. Surgical procedures to remove infected tissue would also help the body launch an appropriate immune response in order to help combat the offending organism.

READ Natural Antibiotics: Foods that Work as Antibiotics

Methods that caused fatalities   

Some methods not only were ineffective but they actually ended up killing patients. Of these methods included bloodletting, or blood draining, which was believed to allow "dangerous toxins" to be expelled by draining the patients blood. Patients would be drained of up to 2,5 litres of their blood which resulted in hypovolaemic shock. This method was recorded as being used by the ancient Egyptians and it's popularity peaked in the 18th and 19th century. There were also physicians who would treat patients with mercury and arsenic but these were quickly found to cause more harm rather than good.

The Discovery Of Antibiotics And Beyond

The first antibiotics

The French bacteriologist Jean Paul Vuillemin introduced the term antibiosis as a way to define the interaction between bacteria and organism which produced antibacterial products. Louis Pasteur and Robert Koch first described antibiosis in 1877 when they noted that airborne bacilli would suppress the growth of Bacillus anthracis (anthrax).

In 1928, Sir Alexander Flemming discovered the first antibiotic, although this term would first be used by Selman Waksman in 1942. This happened when he was working on a Petri dish with the bacterium Staphylococcus aureus and he came back to his work to find that a fungal mold had grown in the dish. The astonishing part was that the bacterium didn't grow near the mold and he deduced that the fungus produced antibacterial products. He then named this antibacterial product penicillin.

It wasn't until 1932 though that the first antibacterial sulphur based product, Prontosil, became commercially available. In 1939 the first naturally derived antibacterial product, tyrothricin, became available but was discontinued as it caused toxic effects in the human body. In 1942 the first purified penicillin, called penicillin G (PenG), was produced and became available to the Allied military forces in World War 2. By 1945 the antibiotic was available to the public as well. 

The effect that penicillin had was unbelievable and unprecedented. Not only did it end up treating previously debilitating illnesses such as syphilis, and other sexually transmitted diseases, but it also had a low toxicity on the human body which made it very safe to use. Even though penicillin has been available as a viable treatment for bacterial infections for over 60 years, it still has potency against most pathogenic organisms despite the presence of drug resistant bacteria.

Where to from here?

Antibiotic resistance is a growing issue though and further research into new antibiotic treatments are currently being done. Besides pathogenic bacteria evolving to be able to withstand the activity of antibacterial agents, other reasons for bacterial resistance is over-prescribing antibiotics and prescribing antibiotics for infections which are not bacterial in origin. Therefore greater care needs to be taken by healthcare providers when treating patients with infectious diseases.

The fluoroquinolones were the last broad spectrum antibiotics discovered and they introduced in 1961 with resistance to them already noted in 1968. The last antibiotics to be discovered were the dairylquinolones in 1997 and since then no new antibiotics had been found.

Currently there are a few antibiotics awaiting phase 2 and 3 research to be concluded on them but they are combinations of drugs which already exist. They are aimed at managing Gram-negative bacilli (GNB) rather than being available for broad spectrum antibacterial activity. 

READ New NDM-1 Superbug Gene Resistant to Even the Most Powerful Antibiotics

Nanotechnology regarding antibacterial activity is a very exciting concept where microscopic nanobots are introduced to the infected individual, and these bots then isolate pathological bacteria and destroy them through various mechanisms. These can include cell wall disruption, negatively affecting their enzymatic processes, protein denaturation, mitochondrial damage and DNA damage. Nanotechnology can also be used to make products which can coat instruments and medical devices to protect them from getting infected with pathological bacteria.

    

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