Tuberculosis and Traditional Medicine: Fighting the Oldest Infectious Disease Using the Oldest Source of Medicines

Tuberculosis (TB) is the oldest documented infectious disease. Fragments of the spinal column from Egyptian mummies from 2400 B.C. shows definite pathological signs of tubercular decay. The term phthisis (consumption) appears first in Greek literature. Hypocrates identified phthisis as the most widespread disease of the times around 460 B.C. Exact pathological and anatomical descriptions of the disease began to appear in the seventeenth century. In 1720, the English physician Benjamin Marten in his publication, "A New theory of consumption", mentioned that TB could be caused by wonderfully minute living creatures". The introduction of the sanatorium cure provided the first really step against TB. Hermann Brehmer a botany student suffering from TB, was instructed by his doctor to seek out a healthier climate. He traveled to the Himalayan mountains where he could pursue his botanical studies while trying to rid himself of the disease. He returned home cured and began to study medicine. In 1854, he presented his doctoral dissertation under the title, "Tuberculosis is a Curable Disease". This step became the blueprint for the development of sanatoria. In 1882, Robert koch discovered a staining technique that enabled him to see Mycobacterium tuberculosis. By this means the deadliest enemy of humanity had been visualized and the war against this enemy was officially declared. The measures available to physicians were still modest. Improving social and sanitary condition and adequate nutrition were all that could be done to strengthen the body's defenses against the TB bacillus. Sanatoria provided a significant improvement. A further important development was provided by the French bacteriologists Calmette and Guerin, who used specific culture media to lower the virulence of the bovine TB bacterium, creating the basis for the BCG vaccine. Then in the middle of world war II came final break through, the greatest challenge to the bacterium that had threatened humanity for thousands of years: chemotherapy. Compounds such as sulfonamides and penicillins were ineffective against Mycobacterium tuberculosis. The first successful chemotherapeutic agent against M. tuberculosis was introduced to clinic by Selman A. Waksman and his team in 1944: streptomycin, purified from streptomyces griseus, showed a strong inhibitory effect on M. tuberculosis with relatively low toxicity. A succession of anti-TB drugs appeared in the following years: p-aminosalicylic acid (1949), isoniazid (1952), pyrazinamide (1954), Cycloserine (1955), ethambutol (1962) and rifampin (rifampicin in 1963) were introduced as anti-TB agents.