The Healing Sun by Richard Hobday presents evidence showing an increase in disease with a decrease in sunlight exposure. This article addresses the topic: Tuberculosis and the Sun
How Sunlight Can Prevent Serious Health Problems
by Richard Hobday, taken from his book, The Healing Sun
Tuberculosis and The Sun
Moving from a country which has many hours of sunshine each day to one where sunlight is in relatively short supply can lead to vitamin D deficiency. In Asian families, infants who are breast-fed for long periods are prone to vitamin D deficiency, rickets, if their mothers are not getting sunlight or taking vitamin supplements. Women who come to Britain from South Asia are particularly susceptible to tuberculosis because their diet, strict dress codes and tendency to remain indoors prevent them getting sufficient sunlight and vitamin D to ward off the disease. In their country of origin, where sunlight is strong, the small areas of skin they expose to the sun when wearing traditional clothes are adequate for the photochemical production of enough vitamin D to stay healthy. But not in Britain, where the sun shines far less often and its ultraviolet rays are weaker. So, their vitamin D levels can fall rapidly in the first year after their arrival, and the risk of their developing active tuberculosis then remains high for the first five years of residence. Elderly white males are also sometimes at risk of developing TB because they show the same tendency to remain indoors during the day and consume a diet which lacks vitamin D.
Tuberculosis is a disease which was once thought to have been vanquished but which has moved back to the top of the public health agenda during the last decade. The incidence of tuberculosis in the UK population peaked in the early 1800s and then fell steadily as public health reforms were introduced and nutrition, hygiene and housing improved. At one time the so-called ‘white plague’ killed more of the UK population than all other infectious diseases combined, but by the 1950s, when drugs such as streptomycin became available and the BCG vaccination was introduced, tuberculosis was no longer the threat to public health it once had been.
With the apparent defeat of TB in the UK and in other developed countries in the years that followed, pharmaceutical companies saw little merit in developing new drugs, so fundamental scientific research into the disease came to a halt and has only recently resumed. Fifty years after the introduction of streptomycin, tuberculosis is still responsible for more deaths worldwide than any other single infectious disease. Some eight million people contract tuberculosis each year and three million die from it. The incidence of the disease is increasing in both developing and industrialized countries, partly because of the emergence of strains that are resistant to the limited range of available antibiotics. These strains are becoming established in the developed world and elsewhere, posing a serious threat to international public health.
Tuberculosis requires treatment with a combination of antibiotics for anything from six months to over a year. Any interruption in the programme allows the bacterium to develop resistance to the drugs and, as a consequence, become more dangerous. In the UK tuberculosis is still comparatively rare: there are now about 6,500 new cases each year. About 5 per cent of these new cases are resistant to one antibiotic, and just over 1 per cent are multi-drug resistant. Tuberculosis has close associations with the human immunodeficiency virus (HIV) which causes AIDS. The chances of someone infected with tuberculosis going on to develop the active form of the disease are much higher if they are also carrying HIV infection: they succumb as their immune system deteriorates. In several parts of the Third World these two diseases, tuberculosis and AIDS, have been spreading concurrently, with tragic consequences.
About a third of the world’s population is infected with tuberculosis bacteria. But in the vast majority of cases the body’s immune system keeps the bacteria dormant or inactive. This is because when the bacteria enter the body via the respiratory system they become enclosed in the lymph nodes around the lungs where they are coated in layers of calcium. These enclosures can break down. Poor general health, poor immune status, malnutrition, alcoholism and drug abuse can cause this to happen, but most infected people lead normal healthy lives and only 5 to 10 per cent develop active tuberculosis.
The symptoms of tuberculosis include a cough, rapid loss of weight, loss of appetite, night sweats and haemoptysis — spitting blood when coughing. Tuberculosis is usually diagnosed after a chest X-ray has been taken and a sample of phlegm examined under a microscope. Patients who have bacteria visible in their sputum are usually admitted to hospital. After a minimum of a fortnight’s treatment they are non-infectious and can continue their drug therapy at home. In cases where the disease has reached an advanced stage, patients may have to spend long spells in special wards. The microbe Mycobacterium tuberculosis is carried from one person to another in airborne droplets, so it can be spread by coughing and sneezing. It can also be spread by spitting, and can attach itself to dust particles. Given the right conditions, tuberculosis bacteria can stay viable for months; but fortunately it is quite difficult to become infected unless one is in a confined space with little fresh air circulating and no sunlight. This is why tuberculosis often spreads amongst poorer families who live in cramped conditions, or homeless people in crowded, badly ventilated public dormitories, or amongst inmates in overcrowded prisons.
Sunlight can help prevent tuberculosis developing in susceptible individuals by keeping up their vitamin D levels, and it can also prevent the disease spreading in dwellings by killing the bacterium. This is why there has been such a close association between sunlight and tuberculosis in the past. The beneficial effects of sunlight on tuberculosis patients were widely recognised in the early years of the 20th century. Sunlight therapy was used to prevent people who were susceptible to the disease from developing it, and also to spare those who had tuberculosis from the attentions of surgeons.
The most common form of the disease is tuberculosis of the lungs, or pulmonary tuberculosis. There are other forms which can manifest in the joints, bones, spine, intestines and skin. These are now referred to collectively as extra-pulmonary tuberculosis, but used to be called ‘surgical tuberculosis’. This is because during the second half of the 19th century, with the introduction of anaesthetics and antiseptics, surgery had entered what was to become known as its ‘golden era’, and radical, intensive surgery became the accepted treatment for non-pulmonary forms of the disease. The results of all this surgical activity were often disappointing: patients were left permanently disfigured or crippled, with no guarantee that the tuberculosis would not return. So rather than resort to surgery, some physicians began to use so-called ‘conservative’ measures such as nutritional therapy, exercise and fresh air to improve their patients’ general health, and increase their resistance to the disease. A few used sunlight. And so it was a revolt against surgery which brought heliotherapy back from obscurity and into mainstream medical practice, as we shall see in Chapter 4. Given the right conditions, the sun’s rays can be used to prevent and treat tuberculosis. They may also have rather more positive influence on other diseases, such as cancer, than is generally accepted.