Ailmemts & Remedies

Typhoid fever

Typhoid fever is an illness caused by the bacterium Salmonella typhi. Common worldwide, it is transmitted by ingestion of food or water contaminated with feces from an infected person. The bacteria then multiply in the blood stream of the infected person and are absorbed into the digestive tract and eliminated with the waste.


Typhoid fever is also called enteric fever. It happens due to the involvement of the intestines and may become very serious if treatment is not provided to the patient at the right time. Typhoid fever has a tendency to relapse the patient. It is sometimes accompanied by hoarse cough and constipation or diarrhoea. Typhoid fever is mainly transmitted by ingestion of food or contaminated water from an infected person. Typhoid fever is still common in many developing countries like india, where it affects about 21.5 million persons each year.

Who gets typhoid fever?
Anyone can get typhoid fever if they drink water or eat food contaminated with the S. typhi bacteria. Travelers visiting developing countries are at greatest risk for getting typhoid fever. Typhoid fever is still common in the developing world, where it affects about 12.5 million persons each year. Only about 400 cases occur each year in the United States.

Typhoid fever is usually recognized by the sudden onset of sustained fever.
During typhoid fever you may also suffer from severe headaches.
Nausea is an another symptom for typhoid fever.
Some times Stomach Pain is also accounted.
Sometimes the person also suffers from severe loss of appetite.
Typhoid fever accompanied by insomnia and feverishness, particularly at night.
In the beginning the temperature of the body is slightly high in morning, then it gradually becomes normal in the afternoon and then again rises in the evening. The temperature of sustained fever may go up to as high as 103° to 104° F (39° to 40° C ).
They may also feel weak, or have gastroenteritis, headache, diarrhea and anorexia (loss of appetite). In some cases, patients have a rash of flat, rose-colored spots.

Classically, untreated typhoid fever course is divided in 4 weeks. In the first week, there is a slowly rising temperature with relative bradycardia, malaise, headache and cough. Epistaxis is seen in a quarter of cases and abdominal pain is also possible. There is leukopenia with eosinopenia and relative lymphocytosis, a positive diazo reaction and blood cultures are positive for Salmonella typhi or paratyphi. The classic Widal test is negative in the first week.

In the second week of the infection, the patient lies prostrated with high fever in plateau around 40ºC and bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave. Delirium is frequent, frequently calm, but sometimes agitated and this delirium gave to typhoid the nickname of “nervous fever”. Rose spots appear in lower chest and abdomen in around 1/3 patients. There are rhonchi in lung bases. The abdomen is distended and painful in the right lower quadrant where borborygmi can be felt. Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea-soup. Howewer, constipation is also frequent. The spleen and liver are enlarged and tender and there is elevation of transaminases . The widal reaction is strongly positive with antiO and antiH antibodies. Blood cultures are sometimes still positive in this stage. In the third week of the typhoid fever a number of complications can occur:

Intestinal haemorrhage due to bleeding in the congested Peyer patches; that can be very serious but generally does not lead to death.
Intestinal perforation in distal ileon: this is a very serious complication that is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in.
Toxic myocarditis with collapse
Metastatic abscesses, cholecystitis, endocarditis and osteitis
The fever is still very high and oscillates very little around the day. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week defervescence commences that prolongs itself in the fourth week.

The ways typhoid fever spreads:

Typhoid fever appears to have affected thousands of human beings from last so many years, but the cause of the illness is a poisonous and interruptive bacterium called Salmonella typhi . Typhoid fever mainly spreads when people eat food or drink water which is already been infected with Salmonella typhi. This bacteria lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. Therefore, typhoid fever is more common in unhygienic areas of the world where hand washing is less frequent and water is likely to be contaminated with germs. It also spreads through direct contact with a person who is already infected with this disease.

A different pathogen, Salmonella paratyphi , causes paratyphoid fever. Although they’re related, these aren’t the same bacteria responsible for salmonellosis, another serious intestinal infection.

After treatment, some people who recover from typhoid fever, even then continue to harbor the bacteria in their intestinal tract or gallbladder, for some years. These people are called chronic carriers, usually shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves.

The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood tested for the presence of S. Typhi.

Diagnosis is made by blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar). In epidemics and less wealthy countries, after excluding malaria, dysentery or pneumonia, a therapeutic trial with chloramphenicol is generally undertaken while awaiting the results of Widal test and blood cultures.

Typhoid fever in most cases is not fatal. However, in some cases it is. Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and ciprofloxacin, have been commonly used to treat typhoid fever in developed countries. Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.

When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. Vaccines for typhoid fever are available and are advised for persons traveling in regions where the disease is common (especially Asia, Africa and Latin America). Typhim Vi is an intramuscular killed-bacteria vaccination and Vivotif is an oral live bacteria vaccination, both of which protect against typhoid fever. Neither vaccine is 100% effective against typhoid fever and neither protects against unrelated typhus.
Resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole and streptomycin is now common, and these agents have not been used as first line treatment now for almost 20 years. Typhoid that is resistant to these agents is known as multidrug-resistant typhoid (MDR typhoid).

Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia. Many centres are therefore moving away from using ciprofloxacin as first line for treating suspected typhoid originating in India, Pakistan, Bangladesh, Thailand or Vietnam. For these patients, the recommended first line treatment is ceftriaxone.

There is a separate problem with laboratory testing for reduced susceptibility to ciprofloxacin: current recommendations are that isolates should be tested simultaneously against ciprofloxacin (CIP) and against nalidixic acid (NAL), and that isolates that are sensitive to both CIP and NAL should be reported as “sensitive to ciprofloxacin”, but that isolates testing sensitive to CIP but not to NAL should be reported as “reduced sensitivity to ciprofloxacin”. However, an analysis of 271 isolates showed that around 18% of isolates with a reduced susceptibility to ciprofloxacin (MIC 0.125–1.0 mg/l) would not be picked up by this method. It not certain how this problem can be solved, because most laboratories around the world (including the West) are dependent disc testing and cannot test for MICs.

Ayurvedic Treatment for Typhoid fever
Given below course you may follow for general treatment of typhoid fever, it depends on subjective or objective symptoms of the patient.

In first week: You may take 125 mg each of Muktashukti Bhasma and Mrigshringa Bhasma, at least three times daily which should be mixed with honey. A decoction of 12 gm of Khub Kalan and 10 gm of dried grapes with one litre of water, boiled down to about one-third, can be given along with the above medicines.

In second week: You may take a dose of Muktashukti Bhasma (10-12mg) & a dose of Kasturibhairava Rasa (120-125mg) with honey thrice daily. You may also take a mixture of Saubhagya Vati (240 mg) and Jwararyabhra (120 mg) three times in a day with juice of fresh ginger.

In third week: Mix 120 mg of Pravala Bhasma and 120 mg of Vasantmalati Ras with atleast 120 mg Amritsattva, to be taken with honey at least two times in a day. After at least three hours of serving the above medication give a dose of 240 mg of Powder of Pippali & also 240 mg of sarvajwaralauha with honey atleast two times in a day.

That is first, second & third, second should be taken alternatively.

In fourth week:You may take a mixture of Navayasa Choorna (Powder) – 2.5 mg & Vasantmalati Ras 125 mg & Sitopladi Choorna – 1.5 gm (Two Doses) to be taken with honey at least two times in a day. After meals, take a liquid compound prepared from- 10ml of Amritarishta & 5ml of Vishmushtayasava with 10ml of Lauhasava (one dose to be taken for each with equal quantity of water after lunch & dinner meals).

If whole body is massaged with oil, preferably Mahalakhshadi Tail daily, it will provide much desired relief to the patient and also help in quicker recovery. Some people suggest massage with olive oil or Johnson’s Body oil but, then, it is simply a matter of individual response and suitability, availability and choice.

Now vaccines for typhoid fever are also available, but these vaccines are not effective so much and are just partially effective and are usually reserved for people who may be exposed to the disease or are traveling to areas where typhoid fever is endemic. No vaccine has been discovered till date for paratyphoid fever.

It is always adviced to follow the Tips (Specially in Typhoid prune area)

Avoid foods and drinks that you may think may be contaminated. Also avoid eating things that have been kept in the open for long time.

Most important thing – Get vaccinated against typhoid fever.

Use careful selection of food and drink while you are in a developing country. This will also help protect you from other illnesses such as cholera, dysentery and hepatitis A.
Only use clean water. Buy it bottled or make sure it has been brought to a rolling boil for at least one minute before you drink it. Bottled carbonated water is safer than uncarbonated water.
Ask for drinks without ice unless the ice is made from bottled or boiled water.
Only eat foods that have been thoroughly cooked.
Avoid raw vegetables and fruits that cannot be peeled.
When you eat raw fruits or vegetables that can be peeled, wash your hands with soap, then peel them yourself. Do not eat the peelings.
Avoid foods and beverages from street vendors. Many travelers get sick from food bought from street vendors.
Even if your symptoms go away without treatment, you may still be carrying the S. typhi bacteria, and your illness could return and be passed to other people.
If you work at a job where you handle food or care for small children, you should not go back to work until a doctor has determined that you no longer carry any S.typhi bacteria.
Even if you are vaccinated, you should carefully select your food and drink, especially when visiting areas where typhoid fever is common.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

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Herbs & Plants

Jatamamsi(Indian Spikenard)

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Common name: Spikenard
Nepali name: Jatamamsi
Latin name: Nardostachys grandiflora
English Name: Muskroot, Indian Spikenard
Family: Valerinaceae

An erect and perennial rhizomatous herb, 10 to 60 centimeters in height. It grows in open areas all along the Himalayan range from 3,200 to 5,000 meters. The distribution of jatamansi in Nepal is scattered and thinly populated. Spikenard produces flowers that are reddish-white in color.

Click to see the pictures

Himalayan Valerian. Herbaceous perennial from the mountains of the NW Himalaya of Nepal and India. This rare and endangered Valerian species has a unique musky aroma resembling a cross between European Valerian and Patchouli.


The fragrance from the roots is identical to the fragrance of the true nard or Nardostachys jatamansi and is often used as a substitute in the production of Nard oil.

The plant makes a sweet ground cover with heart shaped leaves and delicate pinkish white flowers which bloom starting in mid winter. It prefers a moist and shady location and will form a lush green patch with its spreading medicinal rhizomes.

Like its cousin, Himalayan Spikenard, the Himalayan Valerian is suffering from over-harvesting in Nepal and India.

Very hardy and a sturdy, easy to grow plant. This very rare and unique Valerian species is in need of preservation.

Medicinal uses:
Jatamansi has the power to promote awareness and calm the mind. it is a very useful herb for palpitation, tension, headaches, restlessness and is used for promoting awareness and strengthening the mind. It aids in balancing the body of all three Ayurvedic doshas. This herb’s sedative properties increase awareness, as opposed to valerian that dulls the mind.

Rootstocks yield an essential oil that is used as a bitter tonic, stimulant, and antipasmodic

Spikenard Root Powder (Jatamansi; Nardostachys jatamansi)

Complexion, strength, kidney stones, jaundice, removes blood impurities, spasmodic hysteria and other nervous convulsive ailments; heart palpitations, nervous headache, flatulence, epilepsy, convulsions, respiratory and digestive diseases, skin conditions, typhoid, gastric disorders, seminal debility.
Jatamansi is a useful hair tonic and is commonly used in hair oils, promoting hair growth and lustre. It is also used in oils and pastes that improve complexion and general health of the skin.

According to Ayurveda, herbs are taken in combination with other herbs to neutralize the toxicity of one herb with the opposing effect of the other or to enhance the particular effect of one herb with the help of other.

Himalayan or Indian Valerian has been used traditionally for thousands of years in Ayurvedic and Unani systems of medicine. It is commonly used for migraine symptoms, epilepsy, insanity, delirium, insomnia, skin diseases, obesity, scorpion stings, snake bites and as an essential oil in perfumery.

No side effects have been noted so far.

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Tremor (When the muscles refuse to obey)

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At 40 plus, just at the peak of a successful career, the sudden onset of tremor can be devastating. Careers nosedive as the young executive, although with intelligence undiminished, is unable to speak lucidly. The handwriting has little spidery spikes and is illegible. The head constantly moves in a side-to-side motion, a  yes-yes no-no  see saw oscillation that sends confused signals to the bemused bystander. Eventually, the involuntary to and fro motion affects other muscle groups in the arms, legs and trunk. Gait is affected and becomes unsteady and lurching. Speech becomes tremulous with an up and down intonation as the vocal cords get affected. Even daily tasks like dressing and eating become difficult to perform. Worse still, typing and computer keyboard coordination become impossible. And once rapid button-pressing skills are compromised, life in the 21st century becomes impracticable.

Parkinsons disease  is the diagnosis that leaps to the mind. However, all tremors are not Parkinsons. Parkinsonism occurs later, around the age of 60 years. The tremor is typical and is described as  pill rolling . The face is mask-like and expressionless.

A young person is more likely to have hereditary essential tremor. This is inherited as an autosomal dominant condition (if one parent has tremor the offspring has a 50 per cent chance of inheriting it). It affects around 0.4-3 per cent of the population (both male and female) around the age of 40 years.

Any malfunction of the areas of the brain that control movement can cause tremor. This can be caused by infectious diseases like meningitis or encephalitis, stroke, traumatic brain injury, tumours and neurodegenerative diseases. Tremor can also be brought on by low blood sugar and a hyper functioning thyroid gland.

However, not all tremors are sinister. Standing for a long time in a particular position may cause the legs to shake. This tremor is normal and disappears if the person sits down.

Sometimes a person may complain of tremor and yet nothing may be grossly visible. This fine physiological or normal tremor can be proved by asking the person to hold a small, lighted torch and focus it on a wall. The light shakes from side to side. This kind of tremor is increased by anxiety and fear but disappears at rest and when the person is calm.

Alcohol can provoke or normalise tremor, depending on whether it is due to excessive consumption or withdrawal.

Tremors caused by an underlying medical condition spontaneously disappear once the condition is removed. Appropriate treatment depends on accurate diagnosis of the cause.

Symptomatic drug therapy is available for several forms of tremor. Parkinsonian tremor can be treated with a combination of levodopa, other dopamine-like drugs and anticholinergic medication. Unfortunately, the response decreases over time so the dosage has to be increased or more drugs added.

Essential tremor may be treated with beta blockers and primidone, an anticonvulsant drug. The response is variable.

Caffeine in coffee, tea and cola drinks, nicotine in cigarettes, and alcohol behave as tremor  triggers . Eliminating them from the diet controls all kinds of tremor.

Sometimes, the tremor can become so uncontrolled that the person expends all his or her energy. Food intake cannot keep pace and the person becomes cachexic and moribund. If the response to medication is also inadequate, surgical intervention may help. These procedures are usually performed only when the tremor is severe and does not respond to drugs.

The thalamus is the part of the brain that is responsible for most tremors. Implantable electrodes can be used to send high-frequency electrical signals to this region. A hand-held magnet can be used to turn on and turn off a pulse generator that is surgically implanted under the skin. This temporarily disables the tremor. The batteries in the generator last about five years and have to be replaced surgically. This procedure can be performed for both Parkinsonian and essential tremors.

If this is not practical, in severe cases the thalamus can be electrically ablated with brain surgery. This permanently cures the tremor without disrupting sensations or voluntary control of the muscles.

Tremor is debilitating and depressing for the patient. The caregiver also has a difficult time trying to cope with the uncoordinated and uncontrolled motor activity of a person whose muscles simply refuse to obey commands. Physical therapy helps to reduce the tremor. A qualified physiotherapist can work with the patient to improve coordination, muscle strength, control and functional skills. Control in a tremulous limb can be regained to some extent by bracing the limb and regularly exercising using weights and splints. Some traditional forms of exercise like yoga and Taichi are also beneficial. They may help to retard the progress of the disease if started in the early stages in conjunction with medication.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Written by:Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at

Herbs & Plants

Chirayta(Swertia chirayita .)

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Botanical Name:  Swertia chirata
Family:    Gentianaceae
Genus:    Swertia
Kingdom:    Plantae
Order:    Gentianales
Synonyms:Chirata. Indian Gentian. Indian Balmony.

Habitat :This plant grows in Northern India, Nepal.

Parts Used: Whole plant

Other Names:Chirayata, Kirata-tikta, Kiryat-charayatahBhunimba, Bhuchiretta, Charayatah, Chiraita, Indian Gentian, Jwaran- thakah, Kirata, kiraita, Kiriath, Kiriyattu, Kiryat-charayatah, Mahatita, Nila-vemu, Nila-vembu, Qasabuz-Zarirah

Habitat: Occur in hilly regions of India. Cultivation recommended in higher regions in the Himalayas, in Kashmir,Himachal Pradesh,Punjab,UP & Assam.
Harvesting time :  Flowering    Fruiting

Description: An annual herb upto about 1.5 m high, leaves in opposite pairs, flowers pale black, tinged with purp.Other Species—In Indian bazaars where Chiretta is much more used than in England, the name Chirata is given to manykinds of Gentian-like plants. The one that is most in use among them is Ophelia augustifolia, the hill Chirata. It can easily be recognized by the stem being hollow, without pith and lower part of stem square. Another adulterant is Andrographis paniculata, also a native of India, one of the Acanthaceae; this in the dried state looks more like a bundle of broomtops, but is used a great deal in India as it has two valuable bitter tonic principles, Andrographolide and Halmeghin.

This herb is indigenous to temperate Himalayas at altitudes above 4000 feet from Kashmir, Nepal and Bhutan. It is sometimes found in other parts or India. Tinnevelly ‘nilavembu’ is the best form of the herb.

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When the flowering is well advanced the entire plant is collected, dried, and packed into bundles, which are sometimes compressed before exportation. The drug consists chiefly of the stem, which is of a dark purplish-brown colour, quite glabrous, and contains a large continuous pith. In the upper part it branches freely, bearing numerous fruits and flowers, together with a few opposite leaves with prominent curving lateral veins. The fruits are bicarpellary but unilocular, and contain numerous minute brownish seeds. The root is short, stout, and oblique. All parts of the herb have an intensely bitter taste. Various other species of Swertia (e.g., S. angustifolia, Buch.-Ham. S. alata, Royle ; S. trichotoma, Wall. have been found mixed with or substituted for chiretta. From these the genuine drug may be distinguished by its dark colour, intensely bitter taste, and continuous pith. Andrographis Paniculata, Nees , which has been offered as chiretta, has dark green stems with numerous slender erect opposite branches, few lanceolate green leaves, and a fibrous root. The roots of Rubia cordifolia, Linn. are also occasionally mixed with chiretta; they are readily distinguished by their purple colour.

Constituents.  The plant contains the two bitter principles, ophelic acid and chiratin. The latter occurs in the larger proportion, and yields, by boiling with hydrochloric acid, chiratogenin and ophelic acid, but no sugar. Neither ophelic acid nor chiratin has been obtained in crystals.

Other constituents are:

*carbonates and phosphates of potash
*lime and magnesia
*ash 4 to 6 p.c.

It contain no tannin.

Medical Uses:Bitter tonic, stomachic, febrifuge and anthelmintic, appetizer, laxative,
alterative, antidiarrhoeic and antiperiodic.

Whole plant-its used in fever (malarial), diarrhea and weakness

It is an excellent medicine for strengthening the stomach and promoting its action thus used in treating stomach disorders like dyspepsia and diarrhoea. its anthelmintic properties help in destroying intestinal worms. An infusion of the herb is taken for this purpose. The root of the plant is useful in curing hiccups and vomiting. The herb can also be used for range of other diseases and conditions including leprosy, leucoderma, scabies, neuro-muscular disorders, menorrhagia, menstrual irregularity, urinary disease, heart disease, asthma, cough , dyscrasia, Ulcer, jaundice and anaemia.

Action and Uses in Ayurveda and Siddha:
Tikta-rasam, metha veeryam, lagu, ruksham. In sannipatham, swasam, kasam, raktadosham, trishna sodham, kushtam, jwaram, krimi
Chiretta owes its action to its bitterness; it is used in dyspepsia to improve the appetite. At one time it was believed to exert a specific action upon the liver, but there is no evidence to confirm this. It is usually administered in the form of infusion. The preparations of chiretta are without tannin, and may, therefore, be prescribed with iron. Chiretta and kreat (Andrographis) are active ingredients of many advertised bitters. Chiratin has been used in powder form, diluted with milk sugar, but the liquid preparations of chiretta are usually preferred.

Action and Uses in Unani: Tonic to heart, liver and eyes, resolvent, drying, astringent, liquifying, balgham, cough, scanty urine, melancholia, dropsy, sciatia, skin diseases.
According to G. K. Nair and M. Mohanan, authors of “Medicinal Plants of India,” this herb is an excellent drug for:

*intermittent fevers

*skin diseases

*intestinal worms

*bronchial asthma

*burning of the body

regulating the bowels

An infusion of the herb made in hot water with aromatics like cloves, cinnamon etc. is given in doses of half to one fluid ounce. Ayurvedic practitioners often prescribe this infusion in doses of two ounces twice a day before meals as a tonic to check hiccup and vomiting.

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.


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