Honey- a remedy rediscovered

Honey- a remedy rediscovered
Honey has had a valued place in traditional medicine
for centuries. The prescription for a standard wound
salve discovered in the Smith papyrus (an Egyptian
text dating from between 2600 and 2200 BC) calls for
a mixture of mrht (grease), byt (honey) and ftt
(lint/fibre) as transliterated from hieroglyphic symbols” 2. The ancient Egyptians, Assyrians, Chinese,
Greeks and Romans employed honey for wounds and
diseases of the gut. Honey was the most popular
Egyptian drug being mentioned 500 times in 900
remedies’. Whilst Hippocrates (3rd and 4th centuries BC) made little use of drugs in treatment he
prescribed a simple diet, favouring honey given as
oxymel (vinegar and honey) for pain, hydromel
(water and honey) for ‘thirst’3’4, and a mixture of
honey, water and various medicinal substances
for acute fevers5. During the Biblical era honey
received religious endorsement by both Christianity
and Islam. When the Children of Israel were in
Egypt or were journeying through the desert, the
promise was made that their destination was to be
‘a land flowing with milk and honey’6. The holy
Qur’an vividly illustrates the potential therapeutic
value of honey7’8.
Thy Lord has inspired the Bees,
to build their hives in hills,
on trees and in man’s habitations,
From within their bodies comes
a drink of varying colours,
wherein is healing for mankind,
Verily in this is a Sign,
for those who give thought.
Although a vast number of papers and articles have
been published on the subject, most have concentrated
on the biochemical analysis and food and non-food
commercial uses9″10. In the past, scientific opinions
on honey’s nutritive and medical uses have differed
and clashed with folklore. Controversies within the
scientific community5 have re-kindled interest in the
therapeutic uses of honey in modern medicine.
Recently, scientific support has emerged with a
proliferation in publications on the successful
therapeutic use of honey in several general medical
and surgical conditions.
The antibacterial”l’l3 and antifungal14 properties
of honey have been well documented, with growth of
organisms such as Staphylococcus aureus,
Enteropathogens and Candida albicans inhibited in
undiluted honey. Jeddar et al.12 have shown that
honey at a concentration of 40% was bactericidal to
various gram-negative and gram-positive bacteria. In
particular, Salmonella shigella, enteropathogenic
Escherichia coli and Vibrio cholera – all of which are
major causes of morbidity and mortality worldwide.
Used at concentrations ofbetween 30% to 50% honey
was found to be superior to cephaloridine, ampicillin,
gentamycin, nitrofurantoin, nalidixic acid and cotrimoxazole in inhibiting growth of nine types of
pathogenic organisms isolated from the urine samples
of 149 patients with confirmed urinary tract
infection13. The mechanism of the antibacterial effect
of honey remains speculative. Shrinkage disruption
of the bacterial cell wall due to the osmotic effect, low
pH, and the presence of bactericidal substances
collectively called inhibine may contribute.
Honey has been of proven value in treating infected
surgical wounds, burns and decubitus ulcers’5-‘8.
Cavanagh et al.” successfully used local application
ofhoney in the postoperative management ofpatients
who had undergone radical vulvectomy for vulval
carcinoma. Wound healing was accelerated and less
bacterial colonization noted by local application of
honey in patients who developed postoperative wound
breakdown. A recent study from West Africa19 showed
that skin grafting, surgical debridement and even
amputation were avoided when local application of
honey to wounds promoted healing whereas conventional treatment had failed. These observations have
been borne out by an animal model in which pure
commercially available honey applied on 12 mice
healed wounds significantly faster than those of
controls2O. Honey is extremely viscous2l, hygroscopic,
contains enzymes such as catalase’0 and together
with its antibiotic properties, this enables it to absorb
water from surrounding oedematous tissue, clean the
wound and protect it from further infection. Slough
and necrotic tissue is gradually separated as a
consequence, leaving healthy granulation tissue
behind.
A clinical study involving 169 infants and children
with gasteroenteritis demonstrated that honey, given
with oral rehydration fluid, shortens the duration of
bacterial diarrhoea22. It was concluded that honey
can safely be used as a substitute for glucose in
solution with electrolytes and is just as efficient
as glucose in promoting sodium and water absorption
from the gut. Reports of supplementation of infant
diets with unprocessed honey contaminated with
spores of Clostridium botulinum resulting in botulism
has put honey’s traditional role in infant feeding
rather severely into disrepute23.
Although honey has been used for commercial and
domestic uses for thousands of years, much of the
literature is only descriptive. Further evaluation and
application ofthe healing properties of honey in other
clinical and laboratory situations is warranted. For
example, use of it could be made in the field of leprosy.
The foul smelling, chronic ulcers contribute to the
social degradation and isolation of the patient. Could
these be treated with this simple, acceptable and
readily available remedy? Deoxyfructose serotonin,
a substance derived from coffee-wax, has an antiMycobacterium leprae action and has been shown in
preliminary studies to be of benefit in patients with
0141-0768/89/
070384-02/$02.00/0
01989
The Royal
Society of
Medicine
Journal of the Royal Society of Medicine Volume 82 July 1989 385
active lepromatous leprosy24. Honey obtained from
beeswax contains fructose in its different forms25,
and may possess an anti-leprosy effect. Effects
of various components of honey on cell-mediated
immunity needs evaluation.
The therapeutic potential of uncontaminated, pure
honey is grossly underutilized. It is widely available
in most communities and although the mechanism of
action of several of its properties remains obscure and
needs further investigation, the time has now come for
conventional medicine to lift the blinds off this
‘traditional remedy’ and give it its due recognition.
A Zumla
Department of Medicine
Royal Postgraduate Medical School
Hammersmith Hospital, London W12 OHS
A Lulat
Department of Medical Parasitology
London School of Hygiene and Tropical Medicine
London WCIE 7HT
References
1 Grossman R. The other medicines: the penicillin ofbees.
Pan Books, 1986:177
2 Majno G. The healing hand: Man and wound in the
Ancient world. Cambridge: Harvard University Press,
1975
3 Guthrie D. A history of medicine. Thomas Nelson
1958:57-8
4 Adams F. The genuine works ofHippocrates. Baltimore:
Williams & Wilkins, 1939
5 Leading article. Honey: sweet and dangerous or
panacea? SAMJ 1974;56:2300
6 Taylor K. The living Bible. London: Hodder and
Stoughton, 1971
7 The Bee (Nahl), surah XVI, verse- 69. In: The Holy
Qur’an (text, translation and commentary by Abdullah
Yusuf Ali), 2nd edn. American Trust Publications, 1987
8 Irving TB, Ahmad K, Ahsan MM. The story of creation.
In: The Qur’an-basic teachings, ch 5. Bath: Pitman
Press, 1987:79
9 Crane E. (ed.) Honey: a comprehensive survey. London:
Heineman, 1975:157-206
10 White JW Jnr. Honey. Adv Food Res 1978;24:287-375
11 Cavanagh D, Beazly J, Ostapowicz F. Radical operation
for carcinoma of the vulva: a new approach to wound
healing. J Obstet Gynaecol Br Cwlth 1970;77:1037-40
12 Jeddar A, Kharsany A, Ramsaroop UG, Bhamjee A,
Haffejee IE, Moosa A. The antibacterial action ofhoney.
An in vitro study. SAMJ 1985;67:257-8
13 Ibrahim AS. Antibacterial action of honey. Proceedings
of the First International Conference on Islamic
Medicine, Kuwait, January, 1981. Bull Islamic Med 2nd
edn, vol. 1. Kuwait: Ministry of Health, 1981:363-5
14 Obaseiki-Ebor EE, Ofonya TCA. In vitro evaluation of
the anti-candidiasis activity of honey distillate (HY-1)
compared with that of some antimycotic agents. J
Pharm Pharmacol 1984;34:283-4
15 Blomfield R. Honey for decubitus ulcers. JAMA
1973;224:905
16 Buliman MW. Honey as a surgical dressing. Middx Hosp
J 1955;55:188-9
17 Temnov VA. Bactericidal properties of honey and
utilisation of honey and other beekeeping products for
healing of wounds. Bee World 1944;25:86-7
18 Armon PJ. The use of honey in the treatment of infected
wounds. Trop Doct 1980;10:91
19 Efem SE. Clinical observations on the wound healing
properties of honey. Br J Surg 1988;75:679-81
20 Bergman A, Yanai J, Weiss J, Bell D, David MP.
Acceleration of wound healing by topical application of
honey An animal model. Am J Surg 1983;145:374-6
21 Lothrop RE. The composition ofhoney and its utilisationrelation of composition and viscosity. Am Bee J
1939;79:130-3
22 Haffejee IE, Moosa A. Honey in the treatment of
infantile gasteroenteritis. Br Med J 198520:1866-7
23 Arnon SS, Damus K, Wood RM. Honey and other
environmental risk factors for infant botulism. J
Paediatr 1979;94:331-6
24 Antia NH, Ambrose EJ, Upleker MW, Mahadevan PR,
Mester L. Effects of Deoxyfructosterotonin (DFS) on
lepromatous leprosy. Lancet 1988;i:619-21
25 Siddiqui IR. The sugars of honey. Adv Carboh Chem
Biochem 1970;25:285-309