It was my second year as a medical student. We had woken up nice and early, attended our yoga class and rushed to the hostel mess awaiting a breakfast of Mangalore Buns. The cook was amazing, and so were our appetites! Mangalore Buns, in case you didn’t know, is not a bun. It starts out as maida mixed with sugar, mashed bananas, salt and cooking soda left to rise overnight, and ends up being deep fried in boiling oil. It was one of my favourite dishes, back in college. My friends and I would eat at least 8 Buns each, and skip lunch every time Buns were prepared. Of course, the next day, we would have to struggle really hard. If you’ve eaten that many Buns any time, you’d know why I say this.
Anyway, we got ready and promptly caught the college just as it was leaving from the bus stop. Our bus driver. Lingappa anna, has a name for never waiting for an extra minute. When the second hand on his watch strikes the time to leave, his bus engine starts and he leaves, period. This particular day, however, the bus developed some starting trouble, and some of us got down to push it and make it start, as a result of which the bus was unusually full when it finally started, with the usual late comers grinning in satisfaction.
We were on our way to the hospital for Preventive and Social Medicine practical class. The hospital went by the name ‘TBS’. Now, the board outside the hospital read SDM Hospital (SDM being the name of the College where I studied; It stands for Shree Dharmasthala Manjunatheshwara), and so I was understandably perplexed at this choice of a nickname, which did not seem to mean much. So I enquired with one of the nurses who worked there, who told me TBS was a short form for Tuberculosis Sanatorium.
Dr. Prabhash Kumar, our Dean, would send us to the wards to talk to the patients and learn from them. We would scurry around in our aprons, mob the poor patients, try not to confuse them with medical jargon, listen patiently to their stories of how they were at the top of their game, and then suddenly they started coughing and the cough just wouldn’t stop, and they tested positive for TB, and that scared them out of their wits, and they got admitted here. We didn’t know much about anything back then, but the serious looks on the faces of the patients and their relatives told us that this was a disease to be dreaded, not one to be taken lightly. We would later learn the TB was perceived to be a highly infectious disease, which was at many times detected only after it was too late, and led a very large number of deaths in our country. It was, of course, highly infectious and deadly if undiagnosed for too long. One of the aims of the community TB programs was to educate the public that TB can be cured, if detected early enough, and that after the first few weeks of treatment, it is no longer infectious.
After talking to them and writing down everything we observed in our case books, we would sit outside the wards, waiting for Prabhash sir to come there to take class. The strongest memory I have of his class is him saying ‘Of Course, …………………………………….’. Precisely that, because that would be all we can hear if we sat at the back. He is an extremely sweet, soft-spoken person, and only the beginning of each of his sentences would be loud. You had to listen closely to catch the rest, but he gave us gems of knowledge. More than the subject matter itself, he would tell us about the public health scenario in his younger days and how it has changed now, what are the problems the society faces today that cause these diseases, and how these problems are all within our power to change.
Tuberculosis is not at all a recent issue – in fact, Ayurveda calls Tuberculosis the ‘King of Diseases’, because it is clearly marked by a set of symptoms before its onset, followed by the disease itself, and a whole set of clearly defined complications. The mythological story of the origin of Tuberculosis clearly indicates the importance of immunity in preventing this disease.
The Vedas call this disease ‘Yaksma’. In the second Canto, sixth Anuvak, thirty second Sukta, the Atharva Veda describes various forms of Krimis (Microbes), processes for their destruction, their toxic nature etc. Sukta thirty three says the eye, tongue, brain, nose, neck, chest, heart, spleen, liver, intestines, bones, marrow, nails, genital parts and skin, are the parts mainly affected by TB. Apart from describing in detail how to enhance one’s immunity and prevent this disease from occurring, the Atharva Veda also gives a detailed prescription of various drugs that can be used for its treatment, including pepper!
In more recent news, yesterday was World Tuberculosis Day, March 25, and millions of people throughout the country were thankful for it, to have found a cure for their illness. In 1962, India’s National Tuberculosis Campaign was launched, to stop TB from being the major community health issue that it was. The BCG vaccine had come into popular use in 1948, and DOTS was widely administered to control and cure Tuberculosis from 1997 onwards.
Until the middle of the 20th century, no drug or combination of drugs were effective against TB, and the only prescribed treatment was nutritious food, fresh air and plenty of rest! Unfortunately, today, though good drugs are available, patients are rarely still prescribed good food, fresh air or enough rest!
India’s Revised National TB Control Programme is the largest TB Control Programme in the world today, placing more than 100,000 patients on treatment every month. 70% of the Tuberculosis cases in India are detected and treated, which is actually a big number, though it looks like it should definitely be increased. HIV has given a new dimension to TB care – persons infected with both HIV and TB face a deadly challenge in finding the road to recovery.
The question is, how much have these programs helped? Today, India has about two and half million people suffering from TB, the highest in the world. Even worse, an increasing number of these cases are Totally Drug Resistant Tuberculosis (TDR TB). Where will we go next? How many newer medicines can we discover?
The Vedas were right, they usually are. The key to fighting an infection like TB lies in the body’s own immunity. Numerous research studies have proven this. There are studies that show how nutrition and specific Yoga Therapy techniques enhance and speed up recovery in Tuberculosis patients. Every patient we spoke at the Tuberculosis Sanatorium to is a living example of this. The prescription that was given until last century – good food, fresh air and plenty of rest – seems to be the most thought-out prescription for TB until today. I fervently hope and pray for every doctor who comes across a patient with Tuberculosis rememebers to include these in his or her prescription.
Dr. Achyuthan Eswar
Naturopathy, Yoga and Acupuncture Physician