Reviving Ancient Wisdom: A Medieval Mixture Targets Modern Superbugs in Diabetic Wounds

Imagine a remedy from a 1,000-year-old Anglo-Saxon manuscript holding the key to combating one of today's most pressing health challenges: antibiotic-resistant infections in diabetic foot ulcers (DFUs). Researchers at the University of Warwick have brought this vision closer to reality with their latest study on Bald's eyesalve, a simple concoction of garlic, onion (or leek), wine, and bile salts. This historical antibacterial remedy, unearthed from Bald's Leechbook—one of Europe's earliest known medical texts—shows remarkable efficacy against tough bacterial biofilms commonly found in chronic wounds like DFUs.

In the UK, where diabetes affects over 5 million people, DFUs represent a devastating complication. Up to 25% of individuals with diabetes will develop a foot ulcer in their lifetime, often leading to severe infections that resist standard antibiotics. This new research, highlighted by Diabetes UK in their February 2026 highlights, underscores the potential of 'ancientbiotics' to address this crisis head-on.

The Growing Crisis of Diabetic Foot Ulcers in the UK

Diabetic foot ulcers arise from a combination of neuropathy (nerve damage), poor blood circulation, and high blood sugar levels, creating an ideal environment for bacterial growth. In the UK, these ulcers precede nearly 80% of diabetes-related lower limb amputations, with around 7,000 such procedures annually. The National Health Service (NHS) bears a staggering burden, spending nearly £1 billion each year on treatment, hospitalizations, and amputations—equivalent to 0.9% of its total budget.

Antimicrobial resistance (AMR) exacerbates the problem, with pathogens like methicillin-resistant Staphylococcus aureus (MRSA) prevalent in 15-30% of diabetic foot infections (DFIs). Multi-drug resistant strains in biofilms—protective bacterial communities—make healing even harder, often resulting in prolonged hospital stays and higher mortality risks. Current UK guidelines emphasize debridement, offloading, and antibiotics, but resistance limits options, highlighting the urgent need for innovative therapies.

Unearthing Bald's Eyesalve: From 9th-Century Manuscript to Lab Bench

Bald's Leechbook, housed in the British Library, details remedies prescribed by a healer named Bald around 900 AD. The eyesalve recipe—equal parts garlic and onion/leek crushed in wine and cow bile, aged for nine days—was originally for eye infections but has proven versatile. Warwick's Ancientbiotics team, led by Dr. Freya Harrison, first demonstrated its potency in 2015 against MRSA biofilms. Funded by Diabetes UK, subsequent studies expanded to DFU-relevant bacteria like Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii.

The latest preprint (February 2026) reveals multifaceted mechanisms: the mixture disrupts bacterial cell walls, neutralizes toxins, inhibits biofilm formation, and silences virulence genes, making resistance development rare. Unlike single-ingredient antimicrobials, the synergy of all components is crucial—garlic's allicin alone fails against biofilms.

Key Findings: How the Mixture Outsmarts Resistant Bacteria

In lab tests, Bald's eyesalve eradicated 90% of biofilm-embedded superbugs from chronic wounds, outperforming many modern antibiotics. It targets Gram-positive (e.g., S. aureus) and Gram-negative (e.g., P. aeruginosa) pathogens prevalent in DFUs. Bacteria exposed repeatedly showed minimal adaptation, thanks to multi-pronged attacks on adhesion, toxin production, and metabolism.

• Breaks down protective biofilm matrices for deeper penetration.
• Reduces extracellular toxins that damage host tissues.
• Downregulates genes for tissue invasion and persistence.
• Low cytotoxicity to human skin cells, confirmed in prior safety trials.

Prior phase 1 trials showed no irritation in skin models, paving the way for clinical use.

Photo by iggii on Unsplash

Safety and Prior Validation: Steps Toward Clinical Reality

Building on 2020's Scientific Reports publication, safety profiles were rigorously tested using ex vivo human skin and mouse models. No significant toxicity, even at therapeutic doses. Diabetes UK funding supported progression from in vitro to preclinical stages, with calls for human trials to validate efficacy in DFU patients.

Compared to honey dressings (supported by NICE guidelines for some wounds), this multi-ingredient approach offers broader spectrum activity without promoting resistance.Diabetes UK Research Summary

University of Warwick's Ancientbiotics: Pioneering Interdisciplinary Research

Dr. Freya Harrison's team at Warwick's School of Life Sciences exemplifies higher education's role in tackling AMR. The Ancientbiotics project scans historical texts for forgotten antimicrobials, blending microbiology, history, and pharmacology. This UK-led innovation positions Warwick as a leader in translational research, attracting funding and collaborations.

For aspiring researchers, opportunities abound in higher ed research jobs, where projects like this drive real-world impact. Harrison's work highlights career paths in infectious disease research amid rising AMR threats.

Stakeholder Perspectives: Diabetes UK and Expert Views

Diabetes UK praises the study for inspiring novel treatments amid AMR. Dr. Harrison notes: "This combination could suggest new treatments for infected wounds like diabetic foot ulcers." Clinicians emphasize urgency, as resistant DFIs prolong healing by weeks, increasing amputation risk by 20-fold.

Challenges include scaling production (bile salts sourcing) and regulatory approval, but precedents like medical-grade honey offer hope. Multi-perspective views balance excitement with calls for randomized controlled trials (RCTs).

Broader Implications: Combating AMR Through Historical Remedies

Beyond DFUs, Bald's eyesalve targets ventilator-associated pneumonia and cystic fibrosis infections—Harrison's specialties. Globally, AMR causes 1.27 million deaths yearly; UK's £1bn DFU spend underscores economic stakes. This research promotes 'natural product cocktails' as sustainable alternatives to synthetic antibiotics.

Photo by Szymon Fischer on Unsplash

Future Outlook: From Preprint to Patient Bedside

The February 2026 preprint signals peer-reviewed publication soon, potentially in journals like BMJ Open Diabetes Research & Care. Next steps: phase 2 trials for DFU application, formulation optimization, and NHS integration. Reducing amputations by 30% could save £250-300 million annually.

Actionable insights for patients: prioritize foot checks, glycemic control, and offloading. Researchers eyeing academic careers can draw inspiration from Warwick's model.

Why This Matters for Higher Education and Diabetes Research Careers

Warwick's success showcases interdisciplinary higher ed's value, blending humanities (historical texts) with STEM. For UK academics, funding from Diabetes UK and UKRI abounds in AMR research. Explore UK university jobs or higher ed jobs in life sciences. Rate professors like Dr. Harrison on Rate My Professor to guide peers.

This medieval-modern fusion promises not just healing wounds, but revitalizing research innovation.