A very specific kind of mold produces penicillin as a defense mechanism against bacteria. Just like how others produce substances that are toxic to us, or how chilis produce capsaicine to defend against insects.
I think you could eat the mold in the correct amount and get the same effect on bacteria, but propably some other effects too because penicillin is not the only substance they make.
So to get pure penicillin you just let the mold grow and then seperate the penicillin out of it.
Fungus and bacteria compete with each other for food. So the mold produces a chemical that will kill many bacteria. Getting penicillin out of the mold that makes it is going to be similar to extracting anything. You grow lots of the mold, kill it, then use some method to extract the specific chemical you want.
I don’t know what the specific extraction method is with penicillin, but it could be something like steam distillation, or a solvent extraction. In a steam extraction, you steam a substance, and the steam will pick up volatile chemicals. Condense the steam and you will get some of those chemicals. In solvent extraction, you basically make tea. You soak the mold in a liquid, and chemicals dissolve into the liquid. From there, you use other methods to further purify what you extracted.
Long story short, yes, you could – moldy bread has been used to combat disease for millennia.
The distinction is essentially one of refinement/purification and dosage; the antibiotic is «cleaned» from other substances (such as rotten bread) and bits that might not be quite as good for you, and packed into an easier-to-swallow capsule that is less unappealing than old, moldy bread. 🙂
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