A Pre-Penicillin World: What Did Humans Do Before Antibiotics?

October 7, 2025 •

4 min read

Before antibiotics revolutionized medicine, a minor cut or a common infection like pneumonia could easily be fatal. What did humans do before antibiotics to combat illness? The answer lies in a combination of folk wisdom, herbal remedies, and medical practices that, in retrospect, were a mix of the helpful and the outright dangerous.

Quick Summary

Before the era of modern medicine, humans treated infections using herbal remedies, mold-based applications, unproven rituals, and early antiseptic methods combined with basic surgery.

Key Points

Reliance on Natural Remedies: Before antibiotics, ancient and traditional societies used substances like honey, herbs, and molds to treat infections with varying degrees of success.
Dangerous and Ineffective Practices: Many historical medical interventions, such as bloodletting and the use of heavy metals, were often more harmful than helpful, causing severe side effects or death.
Rise of Aseptic Techniques: The development of germ theory in the 19th century and the pioneering work of figures like Joseph Lister led to the adoption of aseptic surgical practices, significantly reducing infection rates even before true antibiotics.
Early Synthetic Treatments: Early 20th-century discoveries, like the arsenic-based Salvarsan and sulfonamide drugs, represented a chemical approach to fighting specific bacteria before penicillin.
The Penicillin Revolution: Alexander Fleming's 1928 discovery and the subsequent refinement of penicillin by Florey and Chain marked the beginning of the modern antibiotic era, saving countless lives and fundamentally changing medicine.
A Reminder of Modern Challenges: The historical struggle against infection provides critical context for the current challenge of antibiotic resistance, highlighting the need for continued vigilance and innovation.

Fighting Infections in the Ancient World

For millennia, humans developed remedies by experimenting with substances from their environment. Though the germ theory of disease was unknown, many ancient cultures understood that certain treatments could help with wounds and infections. These early attempts laid the groundwork for modern pharmacology, even if their mechanisms were not fully understood at the time.

Herbal and Natural Remedies

Ancient civilizations relied heavily on natural substances with proven or perceived antimicrobial properties. Among the most widely used were:

Honey: Used by the ancient Egyptians and Sumerians as early as 2000 B.C., honey was applied to wounds to prevent infection. Its high sugar content dehydrates bacteria, while its acidity and enzyme-produced hydrogen peroxide inhibit bacterial growth.
Moldy Bread: The ancient Egyptians, Greeks, and Chinese all documented applying moldy bread to infected wounds. This practice prefigured the discovery of penicillin, which is derived from the Penicillium mold.
Herbs and Botanicals: Various cultures had extensive traditions of using herbs. Native Americans used Echinacea to treat infections, while Traditional Chinese Medicine and Ayurveda from India utilized plants like turmeric, neem, and garlic for their antimicrobial effects.
Other Substances: Wine and vinegar were used by the Greeks to cleanse wounds, while early Mesopotamian cultures used beer.

Dangerous and Ineffective Practices

Not all pre-antibiotic remedies were helpful. For centuries, dangerous and ritualistic practices were common, often based on flawed medical theories.

Bloodletting: A dominant medical practice for over 3,000 years, bloodletting was based on the ancient theory of "humors". Infections were thought to be caused by an excess of blood, leading physicians to bleed patients using knives, syringes, and even leeches. This practice often weakened and killed patients rather than curing them.
Heavy Metals: From the medieval era through the early 20th century, toxic heavy metals like mercury and arsenic were used to treat infections, most notoriously syphilis. While sometimes effective against bacteria, the side effects were severe, including kidney and brain damage.

The Dawn of Modern Antiseptics and Chemotherapy

The Rise of Aseptic Surgery

The 19th century brought significant advancements in understanding disease transmission. Inspired by the work of Louis Pasteur and Ignaz Semmelweis, British surgeon Joseph Lister championed the use of antiseptic techniques. By sterilizing instruments, bandages, and his hands, Lister dramatically reduced the incidence of post-operative infections, even before penicillin. This shift marked a critical turning point, moving medicine away from a reliance on often-ineffective remedies toward prevention and hygiene.

Early Chemical Interventions

In the early 20th century, scientists began to develop synthetic chemicals to combat infections. In 1909, Paul Ehrlich synthesized Salvarsan, an arsenic-based drug to treat syphilis, representing a major step toward modern chemotherapy. Later, in the 1930s, sulfonamides (or sulfa drugs) like Prontosil were discovered, which proved effective against a wider range of bacterial infections.

The Discovery of Antibiotics and Its Impact

The most transformative moment came in 1928, when Alexander Fleming accidentally discovered penicillin while studying Staphylococcus bacteria. He noticed a mold, Penicillium notatum, had inhibited bacterial growth on a contaminated Petri dish. However, it wasn't until the 1940s that Howard Florey and Ernst Chain successfully purified penicillin for widespread use, beginning the "golden age" of antibiotics.

Comparison: Pre-Antibiotic vs. Modern Treatment


Condition	Pre-Antibiotic Era Treatments	Modern Antibiotic Era Treatment	Mortality Comparison
Pneumonia	Supportive care (rest, oxygen tents), bloodletting	Targeted antibiotics (e.g., amoxicillin, macrolides)	Very high, especially in the elderly and young; now very low with treatment
Wound Infection	Honey, moldy bread, poultices, amputation	Topical or systemic antibiotics, antiseptics	High risk of septicemia, amputation; now minimal risk with proper care
Syphilis	Toxic heavy metals (mercury, arsenic), pyrotherapy	Penicillin (often first-line), doxycycline	High morbidity and mortality from disease or toxic remedies; now highly curable
Tuberculosis	Rest, fresh air, improved nutrition	Multi-drug therapy over an extended period (e.g., streptomycin, isoniazid)	High morbidity and mortality; treatable but drug-resistant strains are a threat

Conclusion

Before the discovery of antibiotics, surviving an infection was a matter of luck, a strong immune system, and, occasionally, effective folk remedies. The leap from these unpredictable treatments to modern, targeted antimicrobial drugs was arguably one of the greatest medical advancements in human history. The development of antibiotics did not just change pharmacology; it dramatically increased human life expectancy and made many medical procedures, from surgery to childbirth, vastly safer. However, the rise of antibiotic resistance in the 21st century serves as a critical reminder that we must not take this monumental achievement for granted, and research into new antimicrobial agents, including looking back at some historical sources, is more important than ever.

Optional outbound link: In a world with no antibiotics, how did doctors treat infections?

Frequently Asked Questions

Before the antibiotic era, infectious diseases were a leading cause of death worldwide. Simple infections like pneumonia, tuberculosis, and wound infections were often fatal.

Yes, some ancient remedies did have real, though limited, antimicrobial effects. For example, honey's high sugar content inhibits bacteria, and compounds in herbs like garlic and turmeric can have antimicrobial properties.

Before antibiotics, surgical infection rates were extremely high. The development of antiseptic techniques in the late 19th century, pioneered by Joseph Lister, involved sterilizing instruments and washing hands, dramatically reducing infections.

Bloodletting is an ancient practice of withdrawing blood from a patient, based on the belief that illness was caused by an imbalance of the body's 'humors'. This practice, used for over 3,000 years, often weakened patients and is now considered harmful.

Penicillin was discovered by Alexander Fleming in 1928 but was not purified and mass-produced for clinical use until the 1940s by Howard Florey and Ernst Chain.

The first synthetic antimicrobials were developed in the early 20th century. Paul Ehrlich created Salvarsan for syphilis in 1909, and sulfonamides were introduced in the 1930s, preceding penicillin's widespread use.

Studying pre-antibiotic medicine is relevant because it highlights the monumental importance of antibiotics and provides context for the current public health crisis of antibiotic resistance. It reminds us not to take these drugs for granted.