Tuberculosis

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Western Diagnosis
A chronic recurrent infection caused by Mycobacterium tuberculosis, bovis, africanum Most common in the lungs

**Etiology**
1. Airborne 2. Considerable innate defense against initial infection 3. Elderly, blacks, HIV+ 4. Undernourished, unhygienic

**Signs & Symptoms**
1. Very commonly asymptomatic in initial stages 2. Not feeling well 3. Cough- initially non-productive 4. Dyspnea 5. Simon Foci: nodular scars in apices. -Most common sites for later active TB

**Diagnosis**
-Chest x-rays -Sputum analysis for acid-fast bacilli 3. Sputum culture 4. Tuberculin skin test - induration equal or greater than 10mm. indicates infection but not activity 5. Quantiferon-Gold Test: relatively that looks for serum antibodies that does not have false positives from immunizations

Treatment
1. Usually use 2 drugs with different mechanisms of actions (bactericidal, bacteriostatic) in order to prevent develop of resistance 2. INH, RMP, PZA, SM, EMB

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============================================================================================= IBIS:

Definition:
An acute or chronic infection caused by Mycobacterium tuberculosis and, rarely in the USA, by M. bovis.

Etiology:
TB is characterized clinically by a lifelong balance between the host and the infection, in which pulmonary or extrapulmonary foci may reactivate at any time, even after long periods of latency; TB is characterized pathologically by the formation of tubercles made up of giant cell and epithelioid cells, by a tendency for fibrosis to occur, and by caseation, a unique form of nonliquefying necrosis. Infection is primarily by inhalation; may contaminate the air in enclosed spaces for long periods of time. Bovine TB may be transmitted through contaminated milk. A non-sensitized host has no specific immunologic defense against TB.

Nutrition:
eating principles: • moderately low fat • low sugar • high complex whole carbohydrates • protein 12-15% diet • vegetarian cleansing diet or short alkaline fasts

therapeutic foods: • foods rich in Vitamins A and E • foods that tonify the Yin, Lung foods, Metal foods • garlic, onions, leeks, turnips, grapes, pineapple, honey, green leafy vegetables (Jensen, p. 61) • watercress, apple, apricots, parsnips, oranges, quinces, grapes, parsley, carrots, turnips, collards, salsify, onions, seaweed, kelp, seagrass, oysters for lymph nodes

fresh juices: • carrot (Walker, p. 155) • carrot and spinach (Walker, p. 155) • celery (Walker, p. 155) • carrot and dandelion (Walker, p. 155)

specific remedies: » Tuberculosis of lymph node: • boil 30 g fig and fig root (Lu, p. 65) • grind dried taro root into powder and drink 15 g powder dissolved in warm water twice daily (Lu, p. 98) • eat 15-20 oysters at meals or use oyster sauce as seasoning if fresh oysters not available (Lu, p. 125) • boil 20 g sea grass at low heat in 4 cups water until water is reduced to 2 cups. Drink 1 cup twice daily (Lu, p. 127) • eat kelp with honey (Lu, p. 128) • boil together 50 g dried lychee, 15 g seaweed, 15 g kelp and l tsp. wine in water. Eat per day (Lu, p. 143) • boil 120 g fresh kelp or 60 g dried kelp with an adequate amount of rice vinegar. Eat as soup. Contraindications: gastric ulcers or hyperchlorhydria (Lu, p. 143) • take 30 g fresh mulberries, add water and steam until cooked. Serve three times daily (Yin-fang and Cheng-jun, p. 73)

» tuberculosis of lung: take 500 g of pear fruit, peel discarded, 250 g of lily bulb and 250 g of sugar. Mix and simmer in water until thickened. Take 1 tbsp. in the morning and evening (Yin-fang and Cheng-jun, p. 30) • take 250 g of watercress and some pork bones, salt for flavor and simmer into a soup. Eat 2-3 bowls throughout the day (Chao-liang, Qing-rong, Bao-zhen, p. 37) • take 250 g soybean sprouts and 250 g pork backbones. Add water and simmer for several hours, add salt to taste. Eat three times daily (Chao-liang, Qing-rong, Bao-zhen, p. 72) » Tuberculosis fever: take partly ripe fresh apricots, wash and pit. Peel the fruit, mash and squeeze to a pulp. Simmer until it becomes a thick paste. Take 1 tbsp. twice daily (Yin-fang and Cheng-jun, p. 33)

avoid: • cow's milk and other dairy products, white bread, refined foods, processed foods, sugar and sweets, catarrh-forming foods: tofu, meat, ice cream, shellfish

Botanicals
• Allium sativum: bacteriostatic to Mycobacterium tuberculosis (Mitchell, p. 7) • Chimaphila umbellata: (Harper-Shove, p. 194) • Conium maculatum (toxic): (for discussion of its use with iodide of iron, see Felter and Lloyd, p. 594; Harper-Shove, p. 194) • Geranium maculatum: tonic, astringent; night sweats (Ellingwood, p. 348) • Inula helenium: lung tonic; after protracted disease (Ellingwood, pp. 276-277) • Lycopus virginicus: tendency to hemorrhage, irritation with cough (Felter and Lloyd, p. 1215) • Marrubium vulgare: stimulant tonic, expectorant (Felter and Lloyd, 1241) • Passiflora incarnata: cough, sleeplessness (Ellingwood, p. 108) • Phytolacca decandra (toxic): tuberculosis of spine and mesenteric glands (Harper-Shove, p. 194) • Rumex crispus: (Ellingwood, p. 379) • Sticta pulmonaria: irritating, persistent, exhausting cough; see indications (Felter and Lloyd, p. 1835) • Stillingia sylvatica: as an alterative (Ellingwood, p. 376) • Veratrum viride (toxic): early stage: expectorant, quiets cough, controls circulation, temperature and restlessness (Felter and Lloyd, p. 2053) • Verbascum thapsus: as a demulcent

Chinese Formulae
• Yun Nan Bai Yao (patent): hemoptysis. (Zhu, p. 243) • Lily C. (Bai He Gu Jin Tang); Da Bu Yin Wan (patent); Qing Hao Bie Jia Tang (patent): Lung Yin Xu (Deficiency) (Lily: Hsu, 1980, p. 253; Yeung, p. 35; Dharmananda, 1986, p. 206; Bensky and Barolet, p. 161; Da Bu Yin Wan: Zhu, p. 306; Qing Hao Bie Jia Tang: Zhu, p. 84) • Dang Gui Liu Huang Tang: Kidney Yin Xu (Deficiency) with Empty Fire Blazing: fever, night sweats, dry mouth and parched lips, dark scanty urine, rapid pulse, red dry tongue (Bensky and Barolet, p. 354; Yeung, p. 75). • Yang Yin Qing Fei Tang Jiang (patent): chronic dry cough. • Chuan Xin Lian Antiphlogistic Tablets (patent): Lung Heat with yellow sputum (Zhu, p. 189) • Placenta Pills (patent): Chronic tuberculosis: to strengthen patient (Zhu, p. 265) • Alrodeer Pills (patent): General weakness due to Deficient Qi, Xue (Blood), Yin and Yang (Naeser, p. 321) • Astragalus 16 (patent): chronic lung disorders (Dharmananda, 1990, p. 80)

Acupuncture
after assessing the person and palpating, consider these patterns: Lung Yin Xu (Deficiency); Lung Qi Xu (Deficiency); Spleen and Kidney Yang Xu (Deficiency); Kidney Yin Deficiency with Empty Fire Blazing

combinations: • Lu-6, St-36, jie he xue, GV-14 and UB-13 for pulmonary tuberculosis; can also add: UB-17 and Lu-1 for hemoptysis; Lu-9 for cough; Ht-6 for night sweats; Ht-7 for insomnia and irritability; Sp-4 and CV-12 for lack of appetite; St-25 for loose stools; Kd-3 and Sp-6 for irregular menstruation or spermatorrhea; UB-23, CV-4 and CV-17 (all D) for dyspnea and sensitivity to cold (Shanghai, p. 587-588; Lee and Cheung, p. 231) • Lu-5; GV-14 joined to jie he xue and CV-20 joined to CV-21 for pulmonary tuberculosis (Shanghai, p. 242) • thread UB-10 to UB-13 and GV-14 to jie he xue, CV-17 to CV-18, or CV-20 to CV-21, Lu-5 and St-36 for pulmonary tuberculosis (Shanghai, p. 198) • Lu-1, jie he xue, fei re xue and UB-13 for pulmonary tuberculosis (Shanghai, p. 246) • UB-38/43, UB-13 and UB-23 (D all) for pulmonary tuberculosis (Shanghai, p. 201) • Lu-10, Lu-5, PC-5, Ht-7, Lu-9, PC-8, Lv-8, Kd-3, Kd-2, Lv-3, UB-13 (one-hundred cones of direct moxa), UB-18 (3 cones of direct moxa) and UB-20 (two cones of direct moxa) (Lee and Cheung, p. 232; Shanghai, p. 588) • bai lao, UB-13, CV-12 and St-36 for pulmonary tuberculosis with cough and red sputum (Lee and Cheung, p. 232; Shanghai, p. 588) • Lu-7, Lu-9, Lu-5 and St-36 (also consider Ht-7, Lu-10 and PC-7) for tuberculosis with hemoptysis; for cough add GV-14, UB-13 and St-40; for insomnia add Ht-7, Sp-6 and Lv-3; for chest pain add TW-6 and Ht-6; for night sweats add SI-3 and LI-4 (Lee and Cheung, p. 232; Shanghai, p. 588-589) • Lu-1 and UB-17: lead the Xue (Blood) to return into the channels, esp. with hemoptysis (Finkelstein, p. 1) • Lu-6 and UB-17: treat expectoration of blood (Finkelstein, p. 2) • Lu-5 and Lu-7: spread Lung Qi to treat cough and hemoptysis (Finkelstein, p. 2) • Lu-5, Lu-6 and LI-4 treat hemoptysis (Finkelstein, p. 2) • Lu-6, LI-11 and UB-13 for hemoptysis (Shanghai, p. 243) • LI-16, Lu-5, Lu-6 and Lu-10 for coughing blood (Shanghai, p. 225) • UB-13 and St-40: "For wind damage with constant coughing that eventually develops into consumption, needle UB-13 to treat the cough and St-40 to eliminate copious phlegm." (Ellis, et al, 1988, p. 203) • Kd-1, CV-4 and St-40 for consumptive coughing (Shanghai, p. 298) • UB-37/42 and UB-38/43: "provide a way to treat consumption" (Ellis, et al, 1988, p. 221) • bai lao and UB-38/43 for consumptive disorders (Shanghai, p. 201) • UB-60 and UB-61 for laryngeal tuberculosis (Shanghai, p. 282) • TW-10 and SI-8 for scrofulous lumps (Ellis, et al, 1988, p. 286) • bai lao, TW-10, zhou jian and local enlarged lymph node (five to seven cones of direct moxa each in rotation) for tubercular adenitis (Lee and Cheung, p. 234; Shanghai, p. 589) • UB-13 and UB-38/43 (D): strengthen the Lung (Finkelstein, p. 39) • UB-13, Lu-9 and St-40: regulate the Lung (Finkelstein, p. 39) • UB-13 and CV-17: regulate function of the Lung and smooth Qi circulation (Finkelstein, p. 39) • Lu 5, Lu-6 and Lu-10: cool Heat, arrest bleeding, clear Lung, and suppress Fire • UB-13 and Lu-5: reduce Heat, clear the Lung, and stop coughing (Finkelstein, p. 39) • Lu-5 and Kd-7: clear Lung and nourish Yin when Lung Heat has injured the Body fluids (Maciocia, p. 370) • si hua (UB-17 and UB-19): strengthen and nourish Xue (Blood); used in treating emaciation, chronic consumptive diseases, weakness in bones and other Xue Xu (Blood Deficiency) aspects of tuberculosis • UB-38/43 and St-36: treat emaciation related to the "five taxations" (Ellis, et al, 1988, p. 222) • CV-6 and St-36 (+ and/or D both) with UB-38/43 to enhance and balance actions of UB-38/43 (Finkelstein, p. 47) • UB-38/43, CV-4 and St-36 (D) for general weakness caused by prolonged illness (Shanghai, p. 201) • UB-26 and UB-28 for Wind consumption with lower back pain (Shanghai, p. 213)

Homeopathy
• Calcarea phosphorica: may be tried when the patient grows very weak; give 1M • Iodium: glands are affected; patient usually dark complexion, dry, unhealthy skin and runs high temperature; emaciation is slow; cough is persistent and annoying • Lycopodium: phthisis of children following cough with ill-developed neck and chest; dyspepsia, distention of abdomen, greenish expectoration and rattling of chest • Phosphorus/Kali nitricum: (alternating) fever returns in the evening, loss of weight, night sweats and slight cough • Silicea: shocking cough with a horribly smelling phlegm; phlegm is lumpy, yellow or green, < from cold, wet weather and > in cold dry weather • Sulphur: in persons who are withered, sallow and debilitated; cough harsh and dry, rather than moist and relaxed; burning of feet and hands; high potency and not to be repeated • Tuberculinum: should be used as an intercurrent remedy to remove the constitutional defect and poison • //Arsenicum album// —for cough and chest pain, particularly from infectious causes; symptoms worsen at night and are often accompanied by fever, chills, weakness, exhaustion, and restlessness; this remedy is most appropriate for individuals who often feel scared and anxious • //Calcarea carbonica// —for chills, drowsiness, perspiration (especially at night), and swollen lymph nodes; this remedy is particularly appropriate for individuals who are susceptible to infection, tend to be stubborn, and crave eggs and cold drinks

Subtle Support
• notes: A, A#, B, C, C#, D, D#, E, F, G, G#

• chords: dominant 7th, diminished 7th, diminished 8th, A Major, A# Major, C Major, G Major, G# Major (Gimbel, p. 116)

• see subsections referring to fungal conditions

Mind/Body
• Wasting away from selfishness; possessive; cruel thoughts; revenge. (Hay, 1984, p. 187) • Majority of patients, especially those with frequent relapses or chronic evolution, present a personality structure similar to the character neurosis of the frigid, narcissistic type, fixated at a very early level of affective development. A decompensatory process with neurotic symptomatology precedes the pulmonary episode consistently. Absence of father, smothering mother, frustration, a sense of basic deficiency are listed as contributing factors to this character structure. (Locke, 1986, p. 130) • Chronic dependency patterns. (Locke, 1986, p. 129) • Alcoholism: 382 our of 841 men with TB admitted to the VA Hospital in San Fernando between 1957-1959 were diagnosed as alcoholics. (Locke, 1986, p. 136)

• Lung ~ Fei is the home of the Po (Corporeal Soul); governs the Qi; facilitates the immune function by assisting the dispersal of the Wei (Protective) Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; relates to strength and sustainability; moves and adjusts fluid metabolism; opens at the nose; extends through the skin, controls the pores, and manifests through the body hair. » Healthy expressions are righteousness and courage. » Weakness, dysfunction, and illness associated with excessive grief, sadness, worry, and depression. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; and inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold. Chronic Lung Yin Xu (Deficiency) increases susceptibility to rising Heat and acute Shi (Excess) conditions.
 * Chinese psychophysiology:**

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; governs Water to regulate body fluids; provides the "Fire of Life" through its Yang functions; provides the nourishing and stabilizing qualities of Yin and Water that balance the Yang and the Fiery qualities; controls the bones, particularly the lumbar spine and knees; produces the Marrow which generates the spinal cord, "fills up" the brain, and possibly manifests through the immune system; facilitates inspiration by grasping and pulling down the Qi of the breath; relates particularly to chronic conditions because it carries the constitutional endowment from the parents; and displays the effects of overwork, aging, chronic debilitation or degenerative processes, and extreme stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. As always, chronic Yin Xu (Deficiency) predisposes to Empty Heat and/or acute inflammation. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, sexual dissipation, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).

• Spleen ~ Pi governs digestion; transforms food into Qi and Xue (Blood); governs the Xue (Blood); resolves Dampness and Phlegm; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; pale lips; loose stools; muscular weakness; and, indirectly, obesity. Unresolved Spleen Xu (Deficiency) predisposes to Spleen Shi (Excess), particularly accumulation of Dampness and Phlegm, as the Spleen's functioning declines. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

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================================================================================================ =Treatment= -Epsom Salts Bath

Dietary Recommendations
Patients at risk for vitamin deficiency (malnourished, alcoholics, elderly, pregnant and nursing mothers) or for nerve degeneration (those with diabetes, HIV, or chronic kidney failure) may need vitamin B6. In addition, recent studies have suggested that a diet lacking in certain nutrients may be linked to abnormalities in immune function, resulting in a poor response to TB and to the BCG vaccine, especially among the elderly, children, alcoholics, the homeless, and HIV-infected individuals. These nutrients include: Animal studies suggest that TB may be more severe in persons with diets rich in omega-3 essential fatty acids compared to those rich in omega-6 essential fatty acids. The omega-3 fatty acids appeared to impair the animals' immune systems, diminishing the ability to kill certain organisms including //M. tuberculosis//. While it is unclear how this animal study will translate to humans, it may be wise to avoid foods rich in omega-3 fatty acids if you have tuberculosis.
 * Protein
 * Zinc
 * Vitamin B12
 * Vitamin C
 * Vitamin D

Herbal Supplementation
The antibacterial properties of garlic are fairly well documented. In vitro studies have demonstrated that garlic extract inhibits the growth of many species of bacteria. However, high concentrations of garlic extract were needed to slow down the growth of //M. tuberculosis//. Such high levels could prove toxic to humans. While further study is needed, a recent animal study indicated that garlic oil (which is a higher concentration than the extract) also inhibited //M. tuberculosis,// reducing TB lesions. A combination of garlic extract or garlic oil with anti-TB drugs may eventually prove effective against the disease. Other herbs that may be helpful include:
 * Garlic (//Allium sativum//)
 * Echinacea (//Echinacea// spp.)
 * Tamarisk (//Tinospora cordifolia//)
 * Elecampane (//Inula helenium//)—used traditionally by native American Indians for lung disorders, including TB
 * Barberry (//Berberis vulgaris//) – used traditionally in Egypt and in modern day Iran for lung infections such as TB
 * Sweet coneflower (//Rudbeckia subtomentosa//)—test tube studies suggest that active components of this herb inhibit the growth of //M. tuberculosis//

=Contraindications= Swedish Respiratory Exercises