Tuberculosis is an airborne infection that disrupts lung function, and people with reduced immunity and other medical conditions are most vulnerable. The disease progresses slowly, symptoms appear only in the advanced stages, followed by a lengthy therapeutic regimen and, finally, a long list of side effects. Some patients may not complete the course or fall behind over time. This can lead to multi-drug resistance, which will make treatment more challenging. In such cases Ayurvedic treatments integrate with the body's natural environment and, according to several recent studies, significantly reduce mortality rates. The main reason for the increasing popularity of Ayurvedic medicine is the low toxicity studies and lack of side effects when partnered with allopathic medicines. This review covers a brief history of the disease, its mechanism of action and its symptoms, but the main focus is on Ayurvedic herbs and their anti-tuberculosis properties. The objective of this review is to highlight research findings on tuberculogenic plants and their antituberculosis action as well as the chemical constituents of these plants.
Introduction
Tuberculosis, also known as 'white plague', is an infectious disease caused by Mycobacterium tuberculosis. Other Mycobacterium complexes responsible for tuberculosis are Mycobacterium africanum, Mycobacterium avium complex, and Mycobacterium bovis. Tuberculosis bacteria mainly affect the lungs (pulmonary tuberculosis), but it can also attack any part of the body such as kidneys, brain, etc. In Ayurveda, Tuberculosis is known as Rajayakshma (king of diseases) / Shosha (depletion of body tissues) / Kshaya (depletion of internal and external activity of the body), which is mainly caused by Dhatukshaya (loss of tissue or Symbolizes damage).
In the early years of infection, tuberculosis was known as Yakshma in Ayurvedic medicine, later named Rajyakshma. Chandradeva, king of the Brahmins around 500 BC, was the first person to fall victim to the disease, resulting in what is called Rajayakshma or the king's disease. This disease is also called Sosh in Ayurveda because in it the active or essential elements of the body like juice-serum etc. shrink. It is said that this disease occurs when the basic doshas of our body (Pitta, Vata, Kapha) function differently.
The process of pathogenesis/development from bacterial infection of tuberculosis is revealed, consisting of dhatugniyasana (metabolic dysfunction) involving rasa (tissue fluid), rakta (blood), meda (muscle), meda (adipose tissue), and shukra. (Reproductive tissues) become seriously damaged and sometimes destroyed/irreparable. This ultimately leads to a progressive decline in immunity or autodepletion. According to Ayurvedic concept, abnormal metabolic changes (pratilomakshay) occur, leading to depletion of various dhatus (tissues). The metals (tissues) in the body become dry and lead to a weak immune system. Bacteria entering the body due to a weak immune system leads to tuberculosis.
In the Atharvaveda, the involvement of ojas/power of the body is associated with Rajayakshma. Tuberculosis spreads from one person to another (Jayana), it is an infectious disease. Tuberculosis (TB) spreads through the air (also called airborne disease) when a person with active TB coughs, spits, talks, or sneezes.
Symptoms
According to Ayurveda, symptoms of Tuberculosis/Rajayakshma include;
• Getting tired quickly even after working hard, even doing small things
• Decrease in physical urge to sneeze, urinate, defecate
• Lack of body fluids, lubrication, tissues (Ojas), semen
• Improper dietary habits
• Swelling of the scrotum and diarrhea
Due to the above mentioned reasons, Vata Dosha gets aggravated resulting in increased production of Pitta and Kapha, and they spread to all the joints and channels present in the body. As a result, the openings of the channels become blocked or dilated and a reduction in the number of body tissues leads to disease.
Clinical symptoms of these diseases include;
• Difficulty in breathing due to blockage/congestion in the nose
• loss of appetite, loss of appetite/loss of appetite
• Pain in the head, shoulders or sometimes in the body, pain in the joints
• Gastrointestinal tract discomfort, bowel discomfort (either diarrhea or constipation), sometimes accompanied by vomiting.
Diagnosis
Patients with confirmed pulmonary tuberculosis who met the inclusion (incorporated into the body) and exclusion (body surface) criteria were evaluated with the following subjective criteria;
• Cough with or without fever for more than three weeks, production of sputum, and debility, loss of body tissues, weakness, and general state of health.
• Objective criteria include sputum acid-fast bacillus test positive, chest x-ray.
• Testing including sputum bacterial load (patients negative after three consecutive days of treatment on 24-hour sputum collected).
• Immunoglobulin IgA, IgM, was estimated by agar gel prepared separately with human antibody IgA, IgM. The area was calculated and matched with the standard scale provided by Hoechst, India.
• Total body water (TBW), fat free mass (FFM), body mass index (BMI) and total body fat (TBF) were examined in selected patients with pulmonary tuberculosis and normal matched age volunteers. comparative study.
Pathophysiology of Tuberculosis
Tuberculosis is a potentially serious infectious infection usually caused by one of two forms of Mycobacterium.
• Mycobacterium tuberculosis
• Mycobacterium bovis which mainly affects the lungs (pulmonary tuberculosis) and also affects other parts of the body (extrapulmonary tuberculosis)
The stages of pulmonary tuberculosis are as follows:
• Primary Tuberculosis/Ghon Complex/Childhood Tuberculosis
• Secondary tuberculosis/reinfection/chronic tuberculosis
Primary Infection
•Latent tuberculosis is asymptomatic and does not spread. Latent tuberculosis is capable of reactivation after immune suppression in the host.
• The immune system can be compromised by immunosuppressive drugs (steroids, calcineurin inhibitors, etc.), human immunodeficiency virus infection, malnutrition, aging, other factors, etc., which can cause bacteria to reactivate, multiply, and cause granuloma. Can spread out and spread to other parts of the lungs causing active pulmonary tuberculosis
• This reactivation can occur months or even years after the initial infection, a condition known as secondary tuberculosis or reinfection.
• In some cases, the bacteria can spread through the lymphatic system or bloodstream to any part of the body, including the meninges, kidneys, bones and lymph nodes.
• This widespread form of tuberculosis, known as miliary tuberculosis or disseminated tuberculosis, usually occurs in the very young, the very old, or those who are HIV-infected.
Allopathic remedies for tuberculosis
ANTI TUBERCULOSIS DRUGS
GROUP 1: First line oral anti-TB drugs
1)Isoniazid(INH) 2)Rifampin 3)Pyrazinamide 4)Ethambutol
GROUP 2: Injectable anti-TB drugs
1)Streptomycin 2) Kanamycin 3)Amikacin 4)Capreomycin
GROUP 3: Fluoroquinolones
1)Ofloxacin 2)Levofloxacin 3)Moxifloxacin 4)Ciprofloxacin
GROUP 4: Second line oral anti-TB drugs
1)Ethionamide 2)Prothionamide 3)Cycloserine 4)Terizidone 5)Para-aminosalicylic acid
GROUP 5: Drugs with unclear efficacy
1)Thiacetazone 2)Clarithromycin 3)Clofazimine 4)Linezolin 5)Amoxicillin/clavulanate 6)Imipenem/cilastatin
Ayurvedic Treatment for Tuberculosis
Ayurvedic approach to the treatment of tuberculosis
Since the side effects of allopathic medicines were harmful and highly toxic to the patients, researchers decided to turn to Ayurvedic medicine. Tuberculosis (Yakshma) is called Barsa in Vedic literature and is also known as Rajyakshma (rot). In 1933, the Patipukur Tuberculosis Hospital was established in Calcutta to conduct preliminary research into the Ayurvedic treatment of tuberculosis. Later, a well-developed, well-trained and well-funded research unit was established. Guidelines for tuberculosis treatment based on Ayurvedic principles were adopted for clinical treatment. This was an important achievement for pre-independence India. Medicines containing elements like mercury, gold, calcium etc. were compounded in the in-house pharmacy and given to the patients along with fresh juices made from herbs from the botanical garden.
Ayurvedic medicinal plants used to treat Tuberculosis
1. Adulsa (Vasaka)
Scientific Name – Justicia Vasica
Common Name – Malabar Nut, Adulsa, Adhatoda, Vasa, Vasaka
Family – Acanthaceae Chemical Constituents – Vasicine, Vasicinone, Cicinolone
Medicinal Uses: It is used to treat all types of cough, chronic bronchitis and asthma. The fruits are used to cure cold, antispasmodic and bronchitis conditions.
2. Ashwagandha
Scientific name – Withania somnifera
Common Name – Indian ginseng, poison gooseberry, or winter cherry
Family – Solanaceae Chemical Constituents – Withanolide, Withaferrin A
Medicinal Uses: It is an immunity booster herb that basically acts on the nervous and respiratory systems. It has some great wound healing properties, as well as anti-inflammatory and rejuvenating properties. It is used to cure TB symptoms like cough, cold, bronchitis.
3. Brahmi
Scientific name – Bacopa monnieri
Common names – Hyssop, Water Hyssop, Thyme-leafed Gratiola, Herb of Grace and Indian Pennywort.
Family – Plantaginaceae
Chemical constituents – Alkaloids like Brahmi, Herpestine and Nicotine; Saponins like D-mannitol and hersaponin, acid A and monierin
Medicinal Uses: Brahmi acts on various systems like respiratory, nervous, digestive, circulatory and excretion. It has many therapeutic effects including rejuvenating properties, and can be used to cure common symptoms like cold, cough etc.
Used as extract, powder or infusion/decoction
4. Garlic
Scientific name – Allium sativum
Common Name – Garlic, Lashuna
Family – Amaryllidaceae
Chemical constituents – Sulfur containing amino acids known as alliin, azoin, diallyl polysulfide, vinyldithin and salylcysteine.
Medicinal Uses: Garlic has tremendous properties to cure various conditions like anti-oxidant, bacteriostatic, antifungal and also cures digestive problems. It plays an important role in treating some of the common symptoms of TB like cough, cold, congestion and others.
5. Basil
Scientific name – Ocimum tenuiflorum
Common Name of Basil – Holy Basil Family – Lamiaceae
Chemical Constituents – Basil essential oil mostly contains eugenol (~70%) β-allemene, β-caryophyllene and germacrene, isothymusin.
Medicinal Uses: Tulsi is one of the oldest herbs prescribed by Ayurveda which has carminative, stomachic, anti-spasmodic, anti-asthmatic, anti-rheumatic, expectorant, liver-protective properties.
6. Guduchi
Scientific name – Tinospora cordifolia
Common Name – Heart-Leaved Moonseed, Giloy
Family – Menispermaceae
Chemical Constituents – Contains berberine, columbine, chasmanthin, palmarin and bitter elements including tinosporan, tinosporoside, tinosporic acid and tinosporol.
Medicinal Uses: Its antibacterial properties help in curing tuberculosis and its major symptoms. Used in the form of powder and extract.
7. Aloe Vera
Scientific name – Aloe Barbadensis
Common Name – Aloe Vera, Aloe, Burnt Plant, Lily of the Desert, Elephant Gall
Family – Liliaceae
Chemical constituents – Anthraquinone glycosides contain active ingredients which have anti-tuberculosis activity. Aloe leaves contain glucose, galactose, mannose and glacturonic acid. Medicinal Uses: Active components help in anti-tuberculosis activity and provide relief to the patient.
8. Amla
Scientific name – Phyllanthus emblica
Scientific name – Phyllanthus emblica
Common Name – Indian gooseberry also known as Amla from Harad, Harad Malacca tree or Sanskrit Amalaki Family – Phyllanthaceae Chemical Constituents – Amla is rich in Vitamin C (ascorbic acid) and contains various bioactive phytochemicals, most of which are polyphenols ( Contains ellagic acid, chebulinic acid, gallic acid, chebulic acid, apigenin, quercetin)
Medicinal Uses: Boosts immunity and improves the digestive process of patients, it also has high anti-bacterial activity. It can be used in the form of syrup and amla juice or Ayurvedic chewable tablets.
9. Black Pepper
Scientific name – Piper Nigrum
Common Name – Peppercorn Family – Piperaceae
Chemical Constituents – Aristolactam, Dioxoporfin Long Chain Isopropyl Amide, Lignin, Longamide, Pluviatilol also contains Methyl Pluviatilol (Fargesin), Asarinin, Piperine etc.
Medicinal Uses: Piperine which is a highly effective phytochemical present in black pepper reduces the intensity of pain and inflammation. It also has anti-congestion properties and clears blocked passages, helping to improve breathing by acting as a bronchodilator in tuberculosis patients.
10. Vidirakand
Scientific Name – Pueraria Tuberosa
Common Name – Kudzu, Indian Kudzu, or Nepalese Kudzu, Vidarikand, Sanskrit: à¤ुकुशमंदी Family – Fabaceae Chemical Constituents – The tubers of the plant contain β-sitosterol, stigmasterol, daudezine, puerarin, and isoflavones. It also contains some purine compounds, puerarin, daidzein and tuberose.
Medicinal Uses: Vidirkand is a highly nutritious plant which mainly acts on the digestive, respiratory and circulatory systems. It helps in increasing the weight of sick patients as weight loss is a major symptom of tuberculosis. It can be used as a tuber extract or dry powder.
11. Mint
Scientific Name – Mentha × piperita also known as Mentha balsamia Willd.
Common Name – Mint, Mint (hybrid between water mint and spearmint) Family – Lamiaceae
Chemical constituents – Mint leaves contain many essential oils including menthol, menthone and limonene.
Medicinal Uses: Mint leaves are useful in managing gastrointestinal problems, provides relief from symptoms of common cold, cough, congestion, acts as anti-bacterial and anti-inflammatory. Mint juice is given to tuberculosis patients to improve their health.
12. Noni
Scientific name – Morinda citrifolia
Common Name – Morinda, Noni Fruit and Indian Mulberry Family – Rubiaceae
Chemical constituents – The major chemical constituents of this plant include anthraquinones, flavonol glycosides, iridoid glycosides and triterpenoids.
Medicinal Uses: Morinda has antimicrobial activity against tuberculosis bacteria. Noni phytochemical present in the plant can destroy the causative agent of tuberculosis i.e. Mycobacterium tuberculosis.
