Tubercular meningitis

The current approach is to treat tuberculosis in two phases an initial phase where a combination of three drugs is used to reduce the bacterial level as rapidly as possible, and a continuation phase in which a combination of two drugs is employed. Front-line drugs are isoniazid, rifampicin, streptomycin and ethambutol. Pyrazinamide, which has good meningeal penetration, and is thus particularly useful in tubercular meningitis, may be used in the initial phase to produce a highly bactericidal response. 

Clinical evaluation began in 1944 and streptomycin quickly attained the status of a miracle drug. Whereas patients with tubercular meningitis had previously had a zero chance of survival, as many as three-quarters of the patients could now be saved, and demand for the drug soon outstripped the rate of supply. By 1953, the rate of production in the USA had risen to 20,000 kg each month and there were eight companies in the USA producing the drug, with a further three in France, two in the UK, four in Japan and two in Italy. 

Indications Wind and phlegm harassing above. Recurrent headaches and dizziness, Meniere s disease, neurotic vertigo, hypertension, tubercular meningitis, and orthostatic hypotension... 

For tubercular meningitis, add Buthus Martensis (Quan Xie), Lumbricus (Di Long), and Bombyx Batryticatus (Jiang Can). 

Studies with normal children (Sharma and Sur, 1967) showed that serum sialic acid levels were independent of age and sex. In children with various diseases—tubercular meningitis, rickets, and Hand-Schiiller-Christian disease—the serum sialic acid levels increase. 

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