A historical term means wasting, and was applied to that progressive enfeeblement and loss of weight that arose from tuberculous disease of all kinds, but especially from the disease as it affected the lungs (see TUBERCULOSIS).
Habitat: Occurs throughout the plains of India, ascending the hills in Orissa up to 210 m.
English: Indian Acalypha.Ayurvedic: Kuppi, Muktavarchaa, HaritamanjariSiddha/Tamil: Kuppaimeni.Folk: Khokli, Kuppi, Aamaabhaaji.Action: Antibacterial (leaf used in scabies). Plant—emetic, expectorant (used in bronchitis, asthma, pneumonia). Tincture of fresh plant is used in homoeopathy for incipient phthisis with bloody expectorations, emaciation and arterial haemorrhage.
The plant contains kaempferol; leaves and twigs contain acalyphamide and other amides, quinone, sterols, cyanogenic glycoside.The herb causes intestinal irritation.... acalypha indicaHabitat: Punjab, Asia Minor.
English: Purging Agaric.Unani: Gharaiqoon; also equated with Fomes officinalis (Vill. ex Fr.) Lloyd.Action: Diuretic, laxative, deob- structant, expectorant; purgative and emetic in large doses; used in the treatment of night sweats in phthisis, and as a supporting drug for asthma.... agaricus albus
Habitat: Throughout tropical India.
Ayurvedic: Lajjaalu (var.) Vipareet Lajjaalu (non-classical), Alam- bushaa (Hindi commentators have equated it with Gorakh Mun- di, Sphaeranthus indicus Linn., Asteraceae.)Folk: Lajoni, Jhalai, Lakajana.Action: Plant—used in insomnia, convulsions, cramps, chest-complaints, inflammations, tumours, chronic skin diseases. Ash—in stomachache. Leaves— diuretic, astringent, antiseptic. Paste is applied to burns, contusions and wounds. Decoction is given in strangury, asthma and phthisis. Roots—decoction is given in lithia- sis. Mature leaves are recommended in diabetes; contain an insulin-like principle.
A saline extract of leaves showed hy- poglycaemic activity in rabbits.... biophytum sensitivumHabitat: Bengal, Assam and Andamans up to 1,000 m.
English: Teri Pods.Ayurvedic: Vaakeri.Siddha/Tamil: Nunigatcha.Action: Root—astringent and antipyretic, used in phthisis and scrofulous affections.
The roots gave a phenolic compound vakerin, identical with bergenin. The ethanol-water extract of roots inhibits the growth of Mycobacterium tuberculosis.The pods contain 28% tannin (without seeds, more than 54%). The bark contains 28% tannin (without seeds, more than 54%). The tannin is pure gallo-tannin and gallic acid.Dosage: Root—3-5 g powder. (CCRAS.)... caesalpinia digynyHabitat: Bihar, Orissa, Bengal, Sikkim, Nepal, Assam, Khasi, Aka and Lushai hills.
Action: Bark of the root, stem and branches—used in the treatment of tubercular cases.
The root contains coumarins, mi- cromelin, phebalosin and yuehchak- ene.Micromelum pubescens Blume, synonym M. minutum (Forst. f.) Seem. is found in the Andamans. The plant is used in Malaya and Indonesia for phthisis and chest diseases. The root is chewed with betel for coughs.The leaves contain coumarins, mi- cropubescin and phebalosin.The bark contains phebalosin. The roots contain micromelumin, phe- balosin, imperatorin, angelical, lime- ttin, scopoletin, minumicrolin and murrangatin.Family: Lamiaceae; Labiatae.Habitat: Kumaon, Upper Gangetic plain, Bihar, Orissa, Western Ghats, Nilgiris.
Folk: Pudinaa (var.).Action: Plant—carminative. Used as a substitute for Mentha piperata Linn.
The plant yields an essential oil (1.6%) which contains mainly pulegone (80%).Micromeria biflora Benth., equated with Indian Wild Thyme, is found in tropical and temperate Himalayas, and in Western Ghats and hills of South India.The principal constituent of volatile oil of Camphorata sp. is camphor; of Citrata sp. is citral; of menthata and Pulegata sp. is d-menthone; and pulegone.... micromelum integerrimumHabitat: On the old trunks of various coniferous trees.
English: White Agaric.Unani: Ghaariqoon.Action: Used in the treatment of sweats in wasting diseases such as phthisis (it checks profuse sweats); also as an expectorant and diuretic.
The drug contains agaric acid (agari- cin). The resinous extract, when burnt, yields not more than 2% of a white ash, rich in phosphates. The drug gives 46% soft resin.Agaric acid acts as a counter-irritant when applied to abraded surfaces or mucous membrane.... polyporus officinalisThe symptoms depend upon the site of the infection. General symptoms such as fever, weight loss and night sweats are common. In the most common form of pulmonary tuberculosis, cough and blood-stained sputum (haemoptysis) are common symptoms.
The route of infection is most often by inhalation, although it can be by ingestion of products such as infected milk. The results of contact depend upon the extent of the exposure and the susceptibility of the individual. Around 30 per cent of those closely exposed to the organism will be infected, but most will contain the infection with no signi?cant clinical illness and only a minority will go on to develop clinical disease. Around 5 per cent of those infected will develop post-primary disease over the next two or three years. The rest are at risk of reactivation of the disease later, particularly if their resistance is reduced by associated disease, poor nutrition or immunosuppression. In developed countries around 5 per cent of those infected will reactivate their healed tuberculosis into a clinical problem.
Immunosuppressed patients such as those infected with HIV are at much greater risk of developing clinical tuberculosis on primary contact or from reactivation. This is a particular problem in many developing countries, where there is a high incidence of both HIV and tuberculosis.
Diagnosis This depends upon identi?cation of mycobacteria on direct staining of sputum or other secretions or tissue, and upon culture of the organism. Culture takes 4–6 weeks but is necessary for di?erentiation from other non-tuberculous mycobacteria and for drug-sensitivity testing. Newer techniques involving DNA ampli?cation by polymerase chain reaction (PCR) can detect small numbers of organisms and help with earlier diagnosis.
Treatment This can be preventative or curative. Important elements of prevention are adequate nutrition and social conditions, BCG vaccination (see IMMUNISATION), an adequate public-health programme for contact tracing, and chemoprophylaxis. Radiological screening with mass miniature radiography is no longer used.
Vaccination with an attenuated organism (BCG – Bacillus Calmette Guerin) is used in the United Kingdom and some other countries at 12–13 years, or earlier in high-risk groups. Some studies show 80 per cent protection against tuberculosis for ten years after vaccination.
Cases of open tuberculosis need to be identi?ed; their close contacts should be reviewed for evidence of disease. Adequate antibiotic chemotherapy removes the infective risk after around two weeks of treatment. Chemoprophylaxis – the use of antituberculous therapy in those without clinical disease – may be used in contacts who develop a strong reaction on tuberculin skin testing or those at high risk because of associated disease.
The major principles of antibiotic chemotherapy for tuberculosis are that a combination of drugs needs to be used, and that treatment needs to be continued for a prolonged period – usually six months. Use of single agents or interrupted courses leads to the development of drug resistance. Serious outbreaks of multiply resistant Mycobacterium tuberculosis have been seen mainly in AIDS units, where patients have greater susceptibility to the disease, but also in developing countries where maintenance of appropriate antibacterial therapy for six months or more can be di?cult.
Streptomycin was the ?rst useful agent identi?ed in 1944. The four drugs used most often now are RIFAMPICIN, ISONIAZID, PYRAZINAMIDE and ETHAMBUTOL. Three to four agents are used for the ?rst two months; then, when sensitivities are known and clinical response observed, two drugs, most often rifampicin and isoniazid, are continued for the rest of the course. Treatment is taken daily, although thrice-weekly, directly observed therapy is used when there is doubt about the patient’s compliance. All the antituberculous agents have a range of adverse effects that need to be monitored during treatment. Provided that the treatment is prescribed and taken appropriately, response to treatment is very good with cure of disease and very low relapse rates.... nature of the disease tuberculosis has
Habitat: Native to Europe; found in Kashmir.
English: Water-Germander.Action: Stimulant, antiseptic, sudorific. Given for phthisis and cough. An infusion is used as laxative in piles, as a gargle in sore throat and stomatitis. An extract of the herb is given in lupus and actinomycosis. Flower tops and leaves—astringent, diaphoretic, vermifuge.
The herb contains iridoids, including harpagide and acetyl harpagide; fu- ranoid diterpenes; also choline, rutin, quercetin, iso-quercetin, stigmasterol, beta-sitosterol, beta-amyrin, chloro- genic and ursolic acids.... teucrium scordiumIn pulmonary tuberculosis – formerly known as consumption and phthisis (wasting) – the bacillus is inhaled into the lungs where it sets up a primary tubercle and spreads to the nearest lymph nodes (the primary complex). Natural immune defences may heal it at this stage; alternatively the disease may smoulder for months or years and fluctuate with the patient’s resistance. Many people become infected but show no symptoms. Others develop a chronic infection and can transmit the bacillus by coughing and sneezing. Symptoms of the active disease include fever, night sweats, weight loss, and the spitting of blood. In some cases the bacilli spread from the lungs to the bloodstream, setting up millions of tiny tubercles throughout the body (miliary tuberculosis), or migrate to the meninges to cause tuberculous *meningitis. Bacilli entering by the mouth, usually in infected cows’ milk, set up a primary complex in abdominal lymph nodes, leading to *peritonitis, and sometimes spread to other organs, joints, and bones (see Pott’s disease).
Tuberculosis is curable by various combinations of the antibiotics *streptomycin, *ethambutol, *isoniazid (INH), *rifampicin, and *pyrazinamide. Preventive measures in the UK include the detection of cases by X-ray screening of vulnerable populations and vaccination with *BCG vaccine of those with no immunity to the disease (the *tuberculin test identifies which people require vaccination). The childhood immunization schedule no longer includes BCG vaccination at 10–14 years of age; vaccination now targets high-risk groups, such as immigrants from countries with a high incidence of TB. There has been a resurgence of tuberculosis in recent years in association with HIV infection. The number of patients with multidrug resistant TB has also increased due to patients not completing drug courses. Many centres have introduced directly observed therapy (DOT), in which nurse practitioners watch patients taking their drugs or administer the drugs.... tuberculosis
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