Written by Shen Mengxi
It's the beginning of a story with a taste.
In the Jin Dynasty 1700 years ago, the famous Chinese doctor Ge Hong recorded such a prescription in his medical book "Elbow Reserve Emergency Formula": "Typhoid fever in time for temperature disease ... It has been six or seven days, hot and anxious, upset, crazy talk, want to get up and go... Grinding fecal juice, drinking the number of drinks to one or two liters, is called Huanglong soup, and it is better to be aged for a long time."
This is the earliest prescription in history to use human feces to cure diseases, although people at that time may not know why feces can cure diseases, but this does not prevent China from using feces as a medicine ever since. Drinking a liter of untreated raw juice at one time is too difficult for patients, so generations of Chinese medicine practitioners have continuously improved the preparation method of this drug, and by the time of the Qing Dynasty, there has been a colorless and odorless version, which is the yellow in people. It's made by pouring licorice into a bamboo tube and soaking it in feces, which we can now buy in a treasure. But all in all, the pharmacology of this drug is unknown, and it is difficult for patients to accept it, so this drug has gradually declined.
Yellow in people Photo/Taobao screenshot
With the advancement of science and technology, scientists have gradually figured out the principle of feces to cure diseases. The active ingredient of the feces is not in itself, but in the gut microbial flora contained in it. There are about 3 trillion cells in the human body, and the total number of microorganisms in the human body may reach 3.8 trillion, that is, more than half of our body does not belong to us. Among them, the number and variety of intestinal microorganisms account for the vast majority, they have formed a harmonious mutually beneficial symbiosis with us, not only to help us digest food, but also to provide us with vitamins that are difficult for the human body to synthesize, while also helping us resist pathogens and enhance our immunity. The feces contain these gut microbiota, making them the most convenient source for extracting them.
In every corner of our gut, there are various microorganisms thriving In The Picture/Wikipedia
In 1958, foreign scientists used fecal enemas in a clinical trial to treat 4 patients with pseudomembranous enteritis, and the symptoms of these patients were significantly alleviated within 48 hours. This application has brought the dawn of the medicinal use of feces. With the deepening of research, scientists have found that many patients with gastrointestinal diseases, obesity, hypertension, cancer, and even parkinson's neurological diseases have a large difference between their gut microbial combinations and healthy people's gut microbial combinations. So, in a recent study, they began to extensively test the effects of fecal extracts on these patients.
Among them, the most in-depth area of research lies in the treatment of Clostridium difficile infection. This is an anaerobic Bacillus, clinically 15% to 25% of antibacterial drug-related diarrhea, 50% to 75% of antibacterial drug-related colitis, and 9% to 100% pseudomembranous enteritis are caused by this bacterium. Mild diarrhea, severe colitis, intestinal perforation, septic shock, and even death. And over the years, its incidence has increased and has become the leading cause of diarrhoea. However, because humans have long used antibiotics, the resistance of this bacterium is also getting stronger, and once infected, it is more likely to cause recurrence. For these recurrent infections, treatment with fecal microbiota transplantation can be more than 80 to 90% effective.
Clostridium difficile figure/Wikipedia
In the latest experiments, there are also people who have successfully cured some people with peanut allergies with capsules made of fecal extract; there are also experiments using mice to make obese human fecal extracts take by mice, which have found that mice quickly gain weight, of course, the reverse of the experiment has also been - the result is to make obese mice successfully thinner; and scientists are exploring the role of intestinal microbes in liver disease, colorectal cancer, esophageal cancer and stomach cancer and many other diseases. These case studies have made fecal microbiota transplantation commonplace and are beginning to gain prominence in mainstream medicine, and in 2013, human feces have become regulated as experimental drugs in the United States.
The use of human gut microbial colonization changed the body size of mice Figure/Wikipedia
However, the preparation of this drug encountered relatively large problems. On the one hand, the vast majority of human intestinal microorganisms are anaerobic microorganisms, which will soon lose their activity due to oxygen after the feces leave the body; on the other hand, the source of feces cannot ensure safety and health, and there have been infections and disease exacerbations abroad, so it is necessary to strictly screen fecal donors. These two concerns have led to a sparse number of fecal donors, making them difficult to find when they are in desperate need.
To address this, a team of MIT scientists founded the nation's first public fecal bank in 2012 to collect fresh feces and prepare agents after rigorous screening of donors. Subsequently, similar institutions were established in Spain and Hong Kong to accept fecal donations.
Capsule pills made from freeze-dried feces reported by The New York Times Photo/npr.org screenshot
Just in 2021, Chinese mainland also launched a similar project, the Tenth People's Hospital Affiliated to Tongji University and many other units together with the establishment of the "Shanghai Human Intestinal Microbiota Function Development Engineering Technology Research Center" for the establishment of "Chinese intestinal mode strain bank" to facilitate domestic related research and treatment.
But no matter what, fecal production is always a psychological obstacle. Therefore, the current direction of scientists is not to use feces on a large scale, but to conduct a thorough study of the combination of human gut microbes, trying to find out the type of intestinal microbial combination in a healthy human body and the proportion of different microorganisms, once these studies are successful, we can artificially prepare "synthetic feces" - in fact, it is to customize the microbial combination according to the specific situation of the patient, and then send these microorganisms into the patient's body in the form of capsules or oral liquids to achieve the purpose of treatment.
Maybe by that time, the fecal bank will eventually disappear and we will no longer have any psychological burden on taking these drugs.