Tuberculosis in the Ayurvedic System of Medicine
Item
- Title
- Tuberculosis in the Ayurvedic System of Medicine
- Creator
- Dhruv Mankad
- Date
- 1985
- extracted text
-
Medico friend Circle - Annual Meet 1985
BACKGROUND PAPER
IV
/
TUBERCULOSIS IN THE AYURVEDIC SYSTEM OF MEDICIN#
DHRUV MANKAD
The term ’allopathy1 has been used forthe sak< of
descriptive case as an equivalent to Modern Medicine, more
precisely the system of medicine taught in the M.B.B.S. Course.
This is despite the fact that the equivalence is not accurate.
Tuberculosis has been with humankind and has been known
to it as a dreadful disease since ancient times. Over a period
ofseveralcenturies , the understanding of this disease has
evolved differently under different cultures. Andras a
necessary consequence, we find that the disease is looked at
differently by various non-allopathic systems .
An attempt is made here to briefly present how Ayurveda,
one of the two major non-allopathic systems-the other being
homeopathy-extant in India regard tuberculosis: its aetiopathogenesis, treatment and prognosis.
TUBERCULOSIS IN THff. BRUHATTRAYI OF AYURVEDA;
Bruhattrayi (the three major texts) consists of the
three major original textual sources of Ayurveda. They are
Charakasamhita (c.700-600 B.C.), Sushruta Samhita (c 100 AD)
Ashtangahriday Samgraha (c 400 - 500 AD). These three texts
together describe the aetiopathogenesis, clinical features,
diagnosis and medical (mainly Charakasamhita) as well as
surgical treatments (Sushrutasamhita) of diseases.
In Ayurvedic texts only pulmonary tuberculosis is
described as a separate disease and is known to them as
Rajyakshama (Raj=King$ Yakshama=Wasting disease). It is so
named because, according to a myth it first affected Chandrama
the King of Consellations.
HISTORICAL BACKGROUND
Rajyakshama finds it first mention in Rigveda which
describes how a physician treated a patient of Yakshama with
mantras? But its more ’rational’ history dates from Atharvaveda
in which it is described under the section of fevers
(Atharvaveda 5/5/22-1 34).
AETIOLOGY:
According to Ayurveda, diseases are caused as a
result of several factors viz., genetic, congenital, consti
tutional, environmental, regional, occupational, sex, diet and
so on. But the most important factors are those related to
the constitution of a persons’ body. A human body is deemed
(...2
t
-s2
to have been constituted by seven tissues (saptadhatus - blood,
muscle, fat, nerve tissue, semen/ fibres and oj-energy) each of
which in turn, is formed as a result of the combinations of two
or more of the five basic elements (pancha mahaboots, air, water,
space, earth and fire). The tissues carry in various proportion
physiological qualifies of tridoshas (kapha, Pitta, Vayu) each
of which again comprise of a combination of the qualities of
two or more panchamahaboots.
In a healthy state of body, the saptafihatus , panchamahabhoots and the tridoshas are in a state of equilibrium both
quantitatively and qualitatively, Any dearangement of this
equilibrium causes a disease state o
According to Ayurveda, tuberculosis is caused by an
excessive accumulation of all the three doshas as a result of
one of the following causative factorss-
(a)Excessive strain beyond one’s physical capacity
(sahasik)
(b) Suppression of natural urges like, thirst, hunger,
micturition, defaecation, sexual - urge etc.
(Vegavidharanaj)
(c)Emaciation of tissues following injury etc.
(Kshayaj)
(d)Intake of food etc. which is unsuitable to one’s
constitution (Vishashanaj)•
PATHOGENESIS 2
Any of the above factors leads to irregularity in one's
digestive power, By digestive power, it is probably meant what
in modem terms could be called the process of metabolism as
Ayurveda talks of both digestion of food (aharagni) and that of
tissues (dhatragni), (Vishamagni). As a result, metabolism
(Digestion and .assimilation of food as well as tissue metabolism)
suffers. This in turn ends up in accumulation of kapha, Kapha
vitiates body channels thought to be carrying vital body - fluids
other than blood (Srotodushti) and result in destruction of tissues
like blood (Raktadidhatukshaya) and loss of tissue metabolic
power (dhatvagnikshay) . This causes imbalance in the constitution
of faiia body tissues and accumulation of waste products (malas) in
the body causing in turn accumulation of all the three doshas
viz. Kapah, Vata, Pitta..
-;3;~
SYMPTOMATOLOGY
The disease caused by each of the causative factors
outlined above manifests as different symptoms. Out of these,
five symptoms are common to all the aetiological types of
Rajyakshama. They are; cough with expectoration, loss of
appetite, fever, headache and backache. Others like change
in voice (in a, b, d. above), weaknessQf voice (in c.) pain
in the thread (in b) , feeling of discomfort in thread, (in a),
or hemoptysis (ind), hot sensation around throat (in c, d)
are the differentiating symptoms.
Out of these change in
voice, backache, are caused by accumulation of vata; fever,
hot sensation around throat and hemoptysis are caused by
accumulation of pitta; and headache, cough with expectoration,
loss of apetite and loss of voice are caused by Kapha dosha.
The patient spitsout a thick, sticky, sour smelling,
yellow, green or white sputum.
The patient may spit blood
too, as a result of bursting of blood vessels.
TREATMENT
Since, according to Ayurveda, tuberculosis is caused
by accumulation of all the three doshas, the physician should
treat it acording to the relative strengths of the doshas.
The treatment consists of diet (pathya), fomentation
(s wed an) , local application (alepan) and drugs (oushadha) .
(a) DIET; Several strengthening diets are prescribed for a
patient of tuberculosis.
1. Soup of partridge, quail or chicken meat cooked in
ghee to be taken with rock salt, lemon juice and black pepper.
2. Soup of mutton cooked in ghee, with pepper, barley
or horse gram, dried ginger powder (soonth) and seeds of
pomegranate to be eaten with Ami a.
(Charaksamhita Chikitsa
Sthana 6 7 - 68.)
b) Fomentation’
This is prescribed in order to relieve back ache
and pain in the chest.
1. A puultiee of barley, horsegram, kidney bean flour
kneaded with hot milk should be applied to head, chest and
back.
(Ch. sam - Chikitsasthai 71)
- g 4 s-
2. A poultice of jivanti, aniseed, liquorice, root,
vidarikand, meat of wild animals or animals living in water
cooked in ghee, nerve and fibrous tissue should be applied
to the site of pain (ch.Sam. Chikitsasthan 75-76)
(c) Local applications?
relief of pain.
This, too is prescribed'for the
1. An ointment prepared from aniseed, liquorice, costas,
tagar, red sancMwood in ghee should be rubbed at the site of
pain (Ch.Sam. Chikitsa sthan - 77)
2. In case of fever, an application of Chandanadi Taila
followed by a hot water bath is prescribed, Alternatively,
sponging with liquorice root decoction or cow1 s milk is
prescribed (Ch.Sam.Chikitsasthan 85-86)
Bleeding and mild purgaton / taxation is also indicated.
d) ___
DRUGS As
s
mentioned earlier, drugs to be prescribed for
tuberculosis would depend upon the relative strength of the
three doshas. However, some formulations are prescribed which
treat various symptoms of the disease.
1. ch-n9e
voice; Inhalation of a powder of variarmool,
and shalaparni or ghee medicated with vidarikand, liquorice
and rock salt is indicated to relieve this symptom.
(Ch.Sam.
Chikitsasthan 90)
2. Cough with expectoration (kasa), breathlessness
(Shwasa) and chestpain.
A medicated ghee containing dashmool or cow* s milk and
meat juice is prescribed to be taken internally for cough
and breathlessness while a paste made of variarmool is
indicated to be applied at the site of chest pain (Ch. Sam
Chikitsasthan 93)
A linctus made of long pepeer honey, sugar ghee in a
paste of dates and raisins should be given to a patient
suffering from cough and breathlessness.
Another drug prescribed for these symptoms is a
linctus called Yakshmanashaklehs (i) date$ long pepper, raisins
bark of myrobalan, Kakdashringi, Durlabha (ii) Triphala
/
-:5s-
(Amla, Behada, Harada) long pepper, Nagarmotha, Water Chestnut,
gur and sugar ( iii) Kshir Kakoli, Kachur and gur., any of
these powders taken with honey and ghee cures cough with
expectoration, breathlesm ess, change in voice and chest pain
(Ch.Sam chikitsasthan 100-102)
Another formulation prescribed is sitopaladi chuma
containing sugar - 16 parts, vamshalochana 8 parts, long pepper
5 parts, small cardamom 2 parts and cinnamon 1 part to be taken
with ghee and honey. This relieves the symptoms of breathlessness,
cough, loss of appetite, loss of digestive power and backache.
(Ch.Sam.Chikitsasthan 103 - 109J).
Other drugs like Vasaghrita and Shatavari ghrita
are also prescribed (Ch.Sam Chikitsasthan 105).
SPREAD OF THE DISEASE:
According to Madhavnidanam, pulmonary disease is
considered to be an infectious disease. It spreads through the
breath, the saliva and snecz& of a patient. Also one can
contract the disease by using patients
utensils bed, scents etc.
Comments on the research on medicinal herbs used in the treatment
of tuberculosiss
One thing that strikes any one going through the pages
of medicinal and Aromatic Plants Abstract and CSIR bimonthly
claiming to provide the latest information on the state of research
in medicinal herbs, is the absence of any worthwhile reserach
on the medicinal plants used in treatment of this disease.
During the last four years (24 issues) there is only one research
paper reported. It is on the relationship between rifampicin
bioavailability and Adhatoda vasica.
Adhatoda vasica is perhaps the only herb that has been
studied to any extent in its usefulness in the treatment of
tuberculosis, It hasbeen found to have an antitubercular
effect in vivo. Essential oil of A vasica was found to inhabit
all strains of M.tubercle in concentrations ranging from 2-20
Hg/cm in Youman* s modified media (o, 7, 8). But the "drug was
found to be useless in curing or preventing the progress of
the disease either in experimental animals or in human bein'-s.
It only relieves irritable cough by its soothing action on the
nerves and by liquefying the sputum whch makes expectoration
easier".
This view is supported by others too.
Other herbs
found useful as expectorants in Tuberculosis are Allium sativum
(garlic), Moringa oleifera (drumstick tree).
( ....6
- s6 s-
REFERENCESs(Nos. after the name of the work indicate the chapter,
and the shloka in that order unless preceeded by a
when it indicates page numbers)
1. Charaksamhita part 2, Chowkhambha Sanskrit
Stoottha 197 5 3rd Edition.
2. C- -.arakasamhita Chikitsa Sthanam CSS 197 5 3rd
Edition, 1-32.
3. Ibid
51
4. Ibid 81-82
5. Ibid 87-88
6- Madhuvnidanam CSS 1975 ±V
P. 248
7. Barry V.C. Conalty MC, Rylance HS & Smith FR Antitubercular Effect, of an extract of A. Vasica Nature,
London 1955 176 (472) pp 119 - 120.
8. Gupta KC & Chopra IC Antitubercular action of A
vasica. Indian Journal of Medical Research 1954
43(3) pp 355 - 358.
9o
Chopra RN> Chopra IC, Handa KC and Kapur L D.
Medical Plants of India, Academic Publishers,
Calcutta Reprint 1982. P. 266-
10. Chakravarty H. Herbal Heritage of India, Bulletin
of Botonical Society of Bengal 29(1975) pp 27 - 103.
11. Bhagwan Dash and Bedi, Ramesh, Indigenous Drugs
for Import Substitution, ISI Bulle tin Vol.
19, p.” 353.
APPENDIX - I
SOME OF THE HERBS USED IN THE TREATMENT OF 'TUBERCULOSIS IN
BRUHATTRAYIE
Hindi Name
English Name
Botanical Name
1.
2.
Fennel seeds
Jivanti
Saunf
Leptadenia reticulata
Foeniculum vulgare
(••• .7
»
- s7 5-
English Name
Hindi Name
Botanical Name
3. Licquorice
Mulhatti
(Jeshtimadh)
Glycyrrhiza glabra
4.
Vidharikand
Ipomea Panniculata
5. Flag
Vach
Acorus Calamus Linn.
6. Costus
Kuth
Saassurea lappa
C.B* Clarke.
7. Wax Tlower
Tagar
8. Red Sandalwood
Rak tachandan
Ervtania coronaria
stapf.
Ptercarbus sanctalinvs
linn
9.
Variyarmool
Desmodium
10,
Salpami
Gangeticum D*c..
11. Long Pepper
Lindipipper
Piper LOngum
12. Dates
Khajur
13.
Munakka
Phen ' dactylifera
Linn.
Vitis Vinifera Linn
14. Myrobalan
Harida
Terminalia Chebula
Retz.
15.
Kakadsingi
16.
17* Emblic Myrobalan
Durlabha
Pistacia integerrina
Sav.
Fegoina cretica linn
18* Chebulic myrobalan
19.
Amla
Emblica officinals
belerica.
Behada
Terminalla Roxb
Nagarmotha
Cyperus rotundus
20* Waterchest nut
22.
Kshirkakoli
Luvunga Scandens
23* Small cardamom
24. Cinnamom
Chhoti Ilaychi
Dalchini
Elettaria Cardomomum
25.
Vasa
Trapa bispincsa'Roxb.
Cinnamomum Zeylanicum
Blum
Adhatoda Vasica.
A
medico friend circle s Annual Meet 1985 s TB AND SOCIETY
BACKGROUND PAPER V
TB in ’SIDDHA*
In Siddha, TB is referred to as “Chaya Rogam"o Chaya
is not a Tamil word originally, It is said to have a
double origins (i) Chayam which means ’phlegm1 (sputum)
in Sanskrit! _d Tamil and (ii) Chinitha which means ’to
become weak’. It is, however, not the same as Kasa Noyee—
a pure Tamil phrase meaning ’phlegm formation’ which in ,
Siddha refers to milder sputum-producing diseases. This
terminology causes some confusion since allopaths use TB
and ‘Kasa Noyee’ as synonyms.
Chaya Rogam is due to a deficiency of food and blood
constituents (? vitamins) such as ’minerals’ and-‘calcium'o
The body is affected by this disease, since it has less
’’resisting power" (? immunity). Predisposing factors include
certain diets (depends on individual constitution) , environ
ments (living in dark places, work in factories) and"customs" (habits - smoking, drinking).The affectation
(? route of infection) is through diet or in the womb itself.
Thus a child whose mother dies in giving birth to it may be
affected. A child whose life in the womb is affected by deficiency may also be affected.
"Pathology" ? The Iral are affected—first t?^re may be no
outward sign or symptom but when the lungs are affected
it is noticed as this is the place ’where Pranvaya (oxygen)
goes to.
The three Iral arof: Man Iral (Earth Iral), Norai Iral
(Drott, Iral) , Kai Iral (Stone Iral) or spleen, lung
and liver. Again confusion occurs here because Iral is
sometimes taken co mean ’liver* alone.
Treatment2 Medicine forms one part and diet forms two
parts of Siddha treatment. The *Chaya Roga’ patient
cannot be simply given the same diet as the rest of the . ..
family e
Specific treatment is expensive and one of the ingredients
is go .Ido The course of this treatment takes at least
two Mandalams (2 x.48 days). After this the body still has
to be strengthened and so the length of treatment depends on
the condition of the body,
Non-specific and cheaper medicine will take 6 months at
least. It will also be effective*
On diagnosis; There are 3 pulses to be felt in the wrist
of these the PITTHA NADI is-1. increased in intensity in Chaya Rogam. Pitham
melts fat and rhe causes the weakness in TB;
2. The 'pitha nadi' "connects" with the SLETHAMAM NADI
(? character of pulse) ,°
3. Pulse rate is raised and corresponding increase in
temperature and respiration rate may occur. Since
pitha is strong after 2 pm the rise in temperature
will be towards evening.
Other locations; Bone affectations causes the bone to be
"bumpy" or "in and out" wherever blood "clots" eg., lymph
nodes, bone, spleen, lungs, but also* nerves abdomen etc.,
can be affected by Chaya Rogam.
—PRABHIR
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