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World Tuberculosis Day: Ayurvedic Treatment For Pulmonary Tuberculosis
A person can get tuberculosis (TB) by breathing in air droplets from a cough or sneeze of an infected person [1] . TB is a global health crisis. About 25 per cent of the world's TB cases are found in India [2] . TB continues to remain as the number one killer infectious disease in developing countries even today.
Apart from modern scientific medication and techniques, Ayurveda too has shown some promising and interesting approach towards providing a solution to the effective treatment of TB. On this World Tuberculosis Day, read on to know how Ayurveda can be used in the management of pulmonary tuberculosis.
Ayurvedic Explanation For Pulmonary Tuberculosis
In Ayurveda, pulmonary tuberculosis has been compared with Rajayakshma. Rajayakshma is primarily associated with Dhatukshaya (tissue emaciation or loss). Dhatukshaya initiates pathogenesis in TB patients. Rajayakshma also sees inevitable metabolic dysfunction (Dhatwagninasana) [3] . In this Rasa (tissue fluid), Rakta (blood), Mamsa (muscle), Meda (adipose tissue) and Sukra (generative tissue) are lost. Eventually, the ultimate deterioration of immunity (Ojokshaya) happens [4] .
The unusual metabolic change that occurs during Rajayakshma leads to the loss of various Dhatus (tissue) such as Ojokshaya, Sukra, Meda Dhatus followed by loss of Rasa Dhatu (process referred to as Pratilomakshaya) [5] .
Causes Of Rajayakshma (Pulmonary Tuberculosis)
Ancient Ayurvedic Acharyas have classified causes of Rajayakshma into the following four categories [6] :
- Sahas: In spite of being physically weak, if a person does excessive physical work (beyond his or her capacity) then the Vata dosha gets vitiated. The lungs get directly affected due to this, causing lung disease. The vitiated Vata dosha vitiates Kapha dosha and both of them, in turn, vitiate Pitta dosha causing Rajayakshma.
- Sandharan: Vata dosha gets vitiated when urges are suppressed. This, in turn, makes Pitta and Kapha doshas move around in the body causing pain. The resulting effect could be seen in the form of fever cough and rhinitis. These ailments cause internal weakness and lead to depletion of tissues.
- Kshaya: If a person is physically weak and suffers from tension, depression and anxiety, he is more prone to being affected by various diseases. Also, if a weak person fasts or takes meal lesser than the requirement of his or her body, then the Ras Dhatu is affected that leads to Rajayakshma. Ruksh (dry) diet for a weak person also causes several health issues.
- Visham Bhojan: Acharya Charak has talked about eight laws of diet in Charak Samhita. If a person takes a diet against this law, then the three doshas get vitiated. Vitiation of the doshas blocks the passages of Srotas. The tissues of the body stop receiving any nutrition from the person's diet. This depletes the Dhatus. Various symptoms are observed in the body in this stage. Finally, internal weakness is followed by the occurrence of Rajayakshma [7] .
Symptoms Of Rajayakshma (Pulmonary Tuberculosis) On The Basis Of Doshas [8]
1. Vataj Rajayakshma - hoarseness of voice, pain in flanks [9]
2. Pittaj Rajayakshma - fever, blood mixed sputum, burning in the body, diarrhoea [10]
3. Kaphaj Rajayakshma - cough, anorexia, heaviness in the head [11]
Stages Of Rajayakshma (Pulmonary Tuberculosis) On The Basis of Symptoms [12]
1. Trirupa Rajayakshma (first stage of the disease): This stage includes the following signs and symptoms [13] :
- Fever (pyrexia)
- Pain in the shoulder and ribs (scapular region), pain in flanks
- Chest pain
- Burning of palms of hands and soles of feet
- Pneumothorax
2. Shadarupa Rajayakshma (second stage of the disease): This stage includes the following signs and symptoms [14] :
- Fever
- Cough
- Hoarseness of voice
- Anorexia
- Haematemesis
- Dyspnoea
3. Ekadash Rupa Rajayakshma (third stage of the disease): This stage includes the following signs and symptoms [15] :
- Pain in shoulders (scapular region) and in flanks
- Cough
- Fever
- Headache
- Hoarseness of voice
- Dyspnoea
- Anorexia
- Diarrhoea
- Haematemesis
Treatment Of Rajayakshma (Pulmonary Tuberculosis)
1. Sanshaman Chikitsa - Performed when the patient is weak [16]
- The primary cause is treated first.
- Thorough cleaning of the body should be followed by a body massage using Bala Tail.
- Medicines that increase appetite should be given after Shodan of Srotas.
- Milk, ghee, meat, eggs, butter, etc., should be included in the diet. This provides nutrition of Dhatus.
- The patient should preferably be kept in a separate room.
- Sound sleep of the patient is essential. The patient should, therefore, be kept in a silent and comfortable room, especially during the night.
- It is essential that the patient's body temperature is checked multiple times a day.
- It is also important to note that symptomatic treatment is preferred alongside Ayurvedic formulations for Rajayakshma.
2. Sodhan Chikitsa - Performed when the patient is healthy [17]
- Purgation and emesis should be given to the patient under the supervision of Ayurvedic experts.
- Mild Asthapan Vasti can be given based on need, for Sodhan Karma [18]
- A diet that is light, good to taste and appetizing in nature should be given.
- Oil and fats mixed soup made from goat's meat should be given.
- Ghee prepared using Anar, Amla and Sounth should be given to the patient.
- It is also important to note that symptomatic treatment is preferred alongside Ayurvedic formulations, but consult an Ayurvedic specialist before proceeding with this.
Ayurvedic Formulations For Rajayakshma (Pulmonary Tuberculosis)
Several studies have been conducted to equalize the effect of anti-TB drugs with that of Ayurvedic formulations. The Rasayana compound used to manage patients with Rajayakshma is composed of [19] :
- Amalaki - pericarp, 1 part
- Guduchi - stem, 1 part
- Ashwagandha - root, 1 part
- Yashtimadhu - root, 1 part
- Pippali - fruit, ½ part
- Sariva - root, ½ part
- Kustha - root, ½ part
- Haridra - rhizome, ½ part
- Kulinjan - rhizome, ½ part
This Rasayana is usually made available in a capsule form. It was reported by several research studies that this Rasayana compound could decrease cough (about 83 per cent), fever (about 93 per cent), dyspnea (about 71.3 per cent), hemoptysis (about 87 per cent) and increases body weight (about 7.7 per cent) [20] .
Studies were also conducted to research the efficiency of Bhringarajasava as Naimittika Rasayana in treating pulmonary tuberculosis. Bhringarajasava [21] is available in the liquid form and is composed of the following:
- Bhringaraja
- Haritaki
- Pippali
- Jatiphala
- Lavanga
- Twak
- Ela
- Tamalapatra
- Nagakesara
- Gudam
The above formulation was identified as being the perfect treatment for Amsaparsabhitapah (pain in costal and scapular region), Samtapakarapadayoh (burning sensation in palms and soles) and Jwara (pyrexia).
On A Final Note...
As TB is a major public health crisis for developing nations, including India, there is an urgent need to find ways to tackle the spread of this disease. With an increase in the strains of the bacterium causing TB, medical experts now do look into ways other than the conventional medications to find a cure for this infectious disease - Ayurveda being one of them.
- [1] Smith I. (2003). Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence.Clinical microbiology reviews,16(3), 463-496.
- [2] Sandhu G. K. (2011). Tuberculosis: current situation, challenges and overview of its control programs in India.Journal of global infectious diseases,3(2), 143-150.
- [3] Samal J. (2015). Ayurvedic management of pulmonary tuberculosis: A systematic review.Journal of intercultural ethnopharmacology,5(1), 86-91.
- [4] Debnath, P. K., Chattopadhyay, J., Mitra, A., Adhikari, A., Alam, M. S., Bandopadhyay, S. K., & Hazra, J. (2012). Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis.Journal of Ayurveda and integrative medicine,3(3), 141-149.
- [5] Samal J. (2015). Ayurvedic management of pulmonary tuberculosis: A systematic review.Journal of intercultural ethnopharmacology,5(1), 86-91.
- [6] Chandra, S. R., Advani, S., Kumar, R., Prasad, C., & Pai, A. R. (2017). Factors Determining the Clinical Spectrum, Course and Response to Treatment, and Complications in Seronegative Patients with Central Nervous System Tuberculosis.Journal of neurosciences in rural practice,8(2), 241-248.
- [7] Dangayach, R., Vyas, M., & Dwivedi, R. R. (2010). Concept of Ahara in relation to Matra, Desha, Kala and their effect on Health.Ayu,31(1), 101-105.
- [8] Debnath, P. K., Chattopadhyay, J., Mitra, A., Adhikari, A., Alam, M. S., Bandopadhyay, S. K., & Hazra, J. (2012). Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis.Journal of Ayurveda and integrative medicine,3(3), 141.
- [9] SERINGE, W. E. (2018). THERAPEUTIC POTENTIAL OF VATSANABH (ACONITUM FEROX.
- [10] Rani, I., Satpal, P., & Gaur, M. B. A Comprehensive Review of Nadi Pariksha.
- [11] Parmar, N., Singh, S., & Patel, B. International Journal of Ayurveda and Pharma Research.
- [12] Samal J. (2015). Ayurvedic management of pulmonary tuberculosis: A systematic review.Journal of intercultural ethnopharmacology,5(1), 86-91.
- [13] Craig, G. M., Joly, L. M., & Zumla, A. (2014). 'Complex' but coping: experience of symptoms of tuberculosis and health care seeking behaviours--a qualitative interview study of urban risk groups, London, UK.BMC public health,14, 618.
- [14] Campbell, I. A., & Bah-Sow, O. (2006). Pulmonary tuberculosis: diagnosis and treatment.BMJ (Clinical research ed.),332(7551), 1194-1197.
- [15] Dornala, S. N., & Dornala, S. S. (2012). Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis.Ayu,33(4), 523-529.
- [16] Asthana, A. K., Monika, M. A., & Sahu, R. (2018). Significance of Doshas in Management of various Disease.Asian Journal of Pharmaceutical Research and Development,6(5), 41-45.
- [17] Ghosh, K. A., & Tripathi, P. C. (2012). Clinical effect of Virechana and Shamana Chikitsa in Tamaka Shwasa (Bronchial Asthma).Ayu,33(2), 238-242.
- [18] Sawant, U., Sawant, S.,From the proceedings of Insight Ayurveda 2013, Coimbatore. 24th and 25th May 2013(2013). PA01.02. Effect of Shodhana Karma in early Psoriasis– A case study presentation.Ancient Science of Life,32(Suppl 2), S43.
- [19] Vyas, P., Chandola, H. M., Ghanchi, F., & Ranthem, S. (2012). Clinical evaluation of Rasayana compound as an adjuvant in the management of tuberculosis with anti-Koch's treatment.Ayu,33(1), 38-43.
- [20] Samal J. (2015). Ayurvedic management of pulmonary tuberculosis: A systematic review.Journal of intercultural ethnopharmacology,5(1), 86-91.
- [21] Dornala, S. N., & Dornala, S. S. (2012). Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis.Ayu,33(4), 523-529.
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