A 21 year-old woman presented, she had been receiving Anti Tubercular Treatment (ATT) for nearly

6 months. This was a known case of Multi Drug Resistant Tuberculosis (MDR TB).

    She belonged to a poor family. She had married just 1 year before. Her family showed her affection

but she remained dissatisfied. At the time of her marriage one-year previously she was well.  A few

months later amenorrhoea occurred without pregnancy. Two months after this episode her old

pulmonary TB reactivated. At this time she was diagnosed as a case of MDR TB (resistant to

Rifmapicin and Isoniazid) on the basis of culture and sensitivity of sputum. She was prescribed

second line ATT (Kanamycin, Cycloserine, Pyrazinamide, Isoniazid and Ciprofloxacin).

    She came to me after having taken ATT for nearly 6 months - the sputum direct smear was highly

positive for Mycobacterium tuberculosis and the chest x-ray showed a large cavity in right upper

 lung field and fibroinfiltrative lesions in the left lung field

 (Figure 1)   She was suffering from fever, cough, chest pain and loss of appetite.

      Choice of remedy and potency considered the whole picture including her mentals, particularly

the following: discontented; irritability <consolation; lie down, inclination to; desires sweets; aversion

 to meat; nausea<thoughts of food; violent dry cough<morning and evening; dyspnoea<walking and cough with; vomiting<coughing; chest emptiness< cough during; chest pain<cough; cough dry;

bathing, dread of; sweats profusely on coughing; secondary amenorrhoea.  I prescribed Sepia (Sep)

30c one dose on the day of consultation.     

     Second visit: She was quite happy with the positive effects of Sepia and had stopped ATT.

  Third visit 20 February 1996: Feeling unwell for the last two days. Sepia 30c one

dose repeated. Fourth visit 2 March 1996: Expectorating copious bad smelling, dirty coloured sputum

 for 3 days – no medicine.

  Fifth visit 14 March 1996: She complained mental dullness. She did not want to

do any thing, a sort of indifference to every thing. Sepia 30c one dose. Sixth visit 8 April 1996: She

complained that her skin seemed as if burnt by the sun < perspiration. I repeated Sepia 30c one

dose. 

     22 April 1996: She came with a relapse of dyspnoea, the skin trouble was better. This time Sepia

30c was ineffective.   I then gave her Sepia 200c but without a good effect. I reviewed and

re-repertorised the case and found Sulphur was the most similar to the whole case. Sulphur 30c one dose was sufficient to keep the patient in comfort.

    Eighth visit 16 May 1996. Sudden onset of severe pain on the left side of chest. The sputum was

still positive for M. tuberculosis but they were less numerous. Sulphur again fitted the picture,

Sulphur 30c one dose ameliorated the chest pain.  Chest x-ray showed improvement

    Ninth visit 7 August 1996. She had been improving till two days before when she experienced an

increase in cough and dyspnoea I re-reportorised the case and I found Sepia was the drug of choice

again. She felt better after 200c.

    October 1996: Menses resumed. She gained 3 kg weight. Three consecutive sputum reports were

negative for M. tuberculosis.

    6 December 1996: She came with symptoms of pregnancy.  Chest X-rays showed further

improvement,   sputum reports were negative for M. tuberculosis.  About

this time another doctor convinced her to discontinue the homeopathic treatment for the sake of her

baby. She resumed ATT inspite of the good response to homeopathic treatment.

    October 1997: After having taken ATT for nearly seven months and after having a

normal delivery,

she presented with fever, not relieved by ATT otherwise she seemed well. Sputum was

 still negative for M tuberculosis but the chest x-ray showed some fibrosis in the left

 lung. I prescribed Sepia 200c one does for her fever problem and it was again effective.

     A repeat chest x-ray in May 1998, 30 months after the initial consultation showed some fibrosis in the left upper zone, suggesting inactive TB but was otherwise normal.

Case 2 Mrs N

    Initial consultation 6 June 1991

    A 24 years woman presented, complaining of right-sided chest pain, fever, cough with expectoration

and loss of appetite for 2 months. She had taken ATT without any response. Then she stopped ATT

and all other medicines. Now she displayed hopelessness and indifference with fear of death

superimposed on her personality. The hopelessness was so great that she refused to take any

treatment. She seemed indifferent to every thing though she was very affectionate to her mother. She

 wept throughout the consultation regarding her family life. She became suddenly agitated but

immediately resumed weeping. She seemed somewhat to improve when I consoled her.

     Pulmonary Tuberculosis was confirmed by the chest x-ray. Direct smear

examination of the sputum was highly positive for M. tuberculosis.

   Pulsatilla (Puls) 30c was prescribed on the basis of following rubrics and symptoms – ailments from

 grief; discouraged easily; hopelessness (despair of social position) company aversion

 to; weeping mood; indifference to everything; fear of death; menses irregular; thirstless; desires open air; aversions

to fruit and drinks; likes bathing but feels chilly; cough rattling; cough loose <morning, evening and

night and <lying on; chest pain cough during; respiration difficult lying while; expectoration – viscid and

nauseous; menses late.  Next day: she seemed happier and was not resisting treatment. She felt

surprisingly better in fever, cough and chest pain. Puls 30c three times a day was given.

    14 July 1991: 37 days after starting treatment. No fever, no chest pain, improved appetite, mild

cough remained with little expectoration. Puls 30 repeated again. 

     Chest x-ray shown in , sputum was still positive for M Tuberculosis.

    10 August 1991: Clinically she seemed almost normal. Three consecutive sputum reports were

negative for M. tuberculosis. Sac lac only.

     8 September 1991: Menses now were regular and normal. Seemed as happy as ever before the

illness. X-ray shown in   A further three sputum reports were negative for

M. tuberculosis again. No medicine.

  27 December 1995: (4 years after finishing treatment). Came for routine check-up.

Seemed quite healthy. Had two children since last seen. She had not been suffering

from any sort of health problem for last 4 years.    Chest x-ray normal.

   Pulmonary tuberculosis lesions usually heal by fibrosis and/or calcification. But these two cases

did not follow this rule. In the first case, a large cavity on the right side of the lung field healed without

fibrosis while on homeopathic treatment alone.

    In Case Two, the sputum became negative for M. Tuberculosis after having taken homeopathic

treatment for 3 months. The right-sided tubercular lesion healed without fibrosis within 3 months and

follow-up x-ray after more than 4 years confirmed this.  In both cases there is a clear radiological and

microbiological evidence of improvement coinciding with homeopathic treatment.

    Conclusion

    TB, and in particular MDR TB is a growing threat.  1.7 million people die, worldwide, annually from

TB.  In many parts of the world, particularly south and east Asia many sufferers do not have access to

adequate treatment. Even in developed countries MDR TB remains a threat — in 1991 an outbreak in

New York City killed over 500 people. The World Health Organisation had declared an emergency and

recommends Directly Observed Treatment (DOTS), but the impact has been disappointing.  In India

there has been little change in the epidemiology of TB since 1956.

    Strong reservations about the homeopathic treatment of TB are expressed in the literature.  For

instance, Kent stated in his lecture on Calcara ostrearum (Calc carb), that homeopathy cannot cure

 consumption (pulmonary TB) and advised his pupils to be wary of anyone who claimed to cure it.  

    I have presented 2 cases of confirmed pulmonary TB with well-documented evidence of improvement