Therapeutic nutrition for pulmonary tuberculosis. Principles of therapeutic nutrition for pulmonary tuberculosis

Pulmonary tuberculosis - infection, caused by the tuberculosis bacillus (also known as Koch's bacillus) - an aggressive and resistant microbe. For of this disease characterized by the formation of foci of specific inflammation in the affected tissues, as well as pronounced general reaction body. Koch's bacillus is able to survive for a long time in soil, on the surface of contaminated objects, dried sputum and is resistant to many disinfectants.

The main method of transmission of pulmonary tuberculosis is aerogenic, i.e. The bacterium enters the body along with inhaled air. In addition to the aerogenic method of infection, infection is also possible using food products or upon contact with objects contaminated with Koch's bacillus. Under certain conditions, human disease can be caused by microbacteria contained in the body of cattle.

Symptoms

Quite often, pulmonary tuberculosis occurs without visible symptoms and can be detected accidentally, for example, during fluorography. Some of the first symptoms of the disease are: weakness, weight loss, poor sleep, increased sweating, loss of appetite, dizziness, increased body temperature (about 37 degrees), enlarged groups of lymph nodes. If you do not seek treatment at this stage of the disease medical care, then over time the following symptoms will be added to the above symptoms: cough with sputum production, shortness of breath, pain in the chest, discharge of blood when coughing. The last two symptoms are a sign of a complex form of the disease and require immediate treatment.

Useful foods for pulmonary tuberculosis

Features of nutrition in pulmonary tuberculosis

Proper nutrition for this disease can not only normalize the patient’s weight, but also significantly reduce intoxication of the body, and also increase disease resistance. Based on this we can conclude that proper nutrition is important elements in anti-tuberculosis treatment.

First of all, the patient’s diet should contain an increased amount of calories, but the patient should not be overfed. Only when the patient is exhausted should a diet with a high (20-25% of the daily value) calorie content be prescribed. In other cases, preference should be given to a balanced diet, rich in vitamins A, B and C. A long-term diet with excess calories can lead to obesity.

Healthy foods

• Products with high content squirrel. In the patient's body, proteins break down faster than in healthy person, so it is necessary to include in the diet increased content squirrel. These are: dairy products, eggs, fish, poultry, veal.
• Products containing fats. The fat content in the patient's diet should be slightly higher than normal, but do not forget that excess fat in the diet can lead to digestive upset and liver disease. A sufficient amount of fat is contained in olive oil, fish oil, and butter. It is not recommended to consume pork, beef and lamb fat.
• Carbohydrate-rich foods. Carbohydrates are found in cereals, various flour products, and sugar. It is recommended to include buckwheat, rice, semolina, wheat bread, honey, and jam in your diet.
• Vegetables, fruits, berries. During illness, the patient's body needs vitamin C in large quantities. Vitamin C is found in lemons, kiwi, oranges, and strawberries. Vegetables rich in vitamin C include: cabbage, onions, bell peppers, etc. Vegetables can be consumed either fresh or in the form of stews, purees, soups, etc. Vegetables do not have any contraindications.

Approximate daily diet:

• Breakfast: Fried fish with mashed potatoes, various vegetables, butter(about 20 grams), tea.
• Dinner: borscht with sour cream, baked meat with peas or porridge, vegetables, juice from vegetables or fruits.
• Dinner: cottage cheese with sour cream, fruit puree or jam, butter (about 20 grams), coffee with milk or tea.
• Before bedtime: a glass of kefir.

Folk remedies for the treatment of pulmonary tuberculosis

Useful products beekeeping, in case of pulmonary tuberculosis, is not only honey, but also propolis, beebread, drone jelly, comb honey, bee pollen, tincture wax moth. Bee products are strong immunostimulants that increase protective forces body.

• Wax moth larvae extract. Has an anti-inflammatory effect.
• Propolis, which is a natural antibiotic. It should be consumed in two ways: as alcohol tincture or stick a small pinch to the gum for three days. The tincture (20-40 drops) is added to milk or water and taken three or four times a day, an hour and a half before meals. Propolis prevents inflammatory processes and removes toxins from the body.
• Perga

Nutrition for tuberculosis is one of the mandatory elements restoration of the body and a way to avoid the development of complications. It is recommended to consult with several specialists simultaneously for the presenting disease: a pulmonologist, a nutritionist. This will allow you to achieve 100% control over your health.

Nutrition for tuberculosis associated with the pulmonary system should remain high in calories. However, this does not mean that one should strive to overly actively feed a person when they are ill.

The opinion that super-enhanced nutrition is necessary for a patient with mild to moderate forms of pulmonary tuberculosis is a prejudice. Exclusively as part of a person’s exhaustion or during other complicated processes, it is necessary to prescribe a diet that will exceed daily norm in terms of calories by 20-25%. In other situations, it is enough to give preference to a nutritious diet rich in various components. The most useful are vitamins C, B and A, and mineral complexes.

Overfeeding is unacceptable because it provokes obesity and worsens the functioning of the gastrointestinal tract, which negatively affects the functioning of the body.

Basic goals

Nutrition for pulmonary tuberculosis is the key to correct treatment of the disease. The goals of such anti-tuberculosis nutrition should be considered:

• providing the body with complete and comprehensive nutrition;
• a person achieving an optimal weight category;
• increasing the body's resistance to infectious diseases;
• reduction of concomitant and other processes associated with probable damage to the body.

To further saturate the body along with nutrition, rich vitamin complexes are required, which will slow down the development and increase in the number of mycobacteria. It is also important to consider which products are allowed for consumption during tuberculosis and at what time it is permissible to do this.

Authorized Products

The most recommended foods are those that contain a significant ratio of protein and fat. In the body of a person with tuberculosis, proteins begin to break down faster than in a person with normal health. In this regard, it is necessary to introduce into the diet an increased ratio of the protein component, which is found in significant proportions in dairy products, eggs, fish, poultry and veal.

It is important to control the consumption process and not use too large portions, because this can affect the formation of an imbalance in the body. Speaking about products containing fats, it should be noted that the patient’s menu should contain them slightly above the norm. We should not forget that too high a ratio of fats in the menu can provoke digestive disorders and pathological processes associated with the liver. This can be disastrous for a healthy person and, even more so, for someone who...

A sufficient ratio of fats is concentrated in foods such as olive oil, fish fat and butter (there are also essential vitamins here). Pulmonologists point out that it is undesirable to use types of fat such as pork, beef and lamb.

More about products

Speaking about products, we should note those items that are saturated with carbohydrate compounds. Carbohydrates are found in cereals, all kinds of flour products and sugar.

It is advisable to implement in the menu:

• various cereals - buckwheat, rice and semolina;
• wheat bread;
• not very sweet jam (plum, apricot).

Separately, it should be noted such a category of products necessary for treatment as vegetables, fruits and berries. Within pathological process the patient's body needs vitamin complex C in significant proportions. The presented vitamins are present in exotic fruits: lemons, kiwi, oranges and strawberries.

From the list of vegetables, cabbage, onions and bell peppers are rich in vitamin C. The latter can be consumed not only fresh, but also as stews, purees, and soups. Their significant advantage for tuberculosis is that they are not associated with any contraindications.

Approximate daily diet

Nutritionists together with pulmonologists determine sample menu, designed for 24 hours. It includes four meals, which should be at equal time intervals from each other. The optimal breakfast would be baked or boiled fish with mashed potatoes, all kinds of vegetables, as well as butter, in an amount of no more than 20 grams, and tea.

For lunch, it is recommended to prepare borscht with sour cream, baked meat (chicken) with green peas or buckwheat porridge, vegetables. For drinks, juice based on vegetables or fruits is best. Speaking of dinner, it should be noted that the right option There will be cottage cheese with low-fat sour cream and fruit-based puree or jam. It is recommended to use butter, in the amount indicated earlier, coffee with cream or tea.

Before going to bed, a diet for tuberculosis involves drinking 200 ml of kefir. In order for the treatment to be complete and the vitamins to be absorbed properly, you should take into account preventive measures impact.

Preventive actions

Most necessary products In beekeeping, in case of illness associated with pulmonary tuberculosis, not only honey, but also propolis should be considered. This list also includes beebread, drone jelly, comb honey and additional components. The presented names are powerful immunostimulants that increase the protective powers of the body.

Products to note include:

• extract from wax-type moth larvae, which is characterized by an antiseptic effect;
• propolis, which is a natural antibiotic component and creates obstacles to inflammatory processes, as well as removes toxins from the human body;
• beebread - it includes a high amount of potassium, due to which the activity of the heart muscle is optimized and metabolism is stabilized.

Speaking about bee bread, it should be noted that it is taken three times a day, 3 grams - this will increase the effectiveness of the recovery cycle.

For tuberculosis pulmonary system It is recommended to use all kinds of herbal decoctions and tinctures. They help improve and speed up the fight against such phenomena as cough and hemoptysis. Contraindications for tuberculosis should be discussed in each individual case.

People who are sick with tuberculosis require a special diet. It should be complete and high-calorie, however, even in this case it is important to observe moderation, because oversaturation of the body is no less harmful than depletion. To develop an individual menu, it is recommended to contact pulmonologists and nutritionists who will help speed up the body’s recovery.

GENERAL CHARACTERISTICS

Tuberculosis is predominantly chronic infection, in which the lungs are most often affected. Tuberculosis of the larynx, intestines, kidneys, bones and joints, and skin is less common. With tuberculosis, changes in the affected organs, intoxication of the body, disruption of metabolism, and work are possible. various organs and systems, in particular the digestive organs.

The nutritional regimen is based on the nature and extent of damage to the organ, the general condition of the body, and complications from other organs. The calorie content of the diet depends on the characteristics of the course of the disease, body weight and concomitant diseases. For exacerbation of tuberculosis and bed rest, 2500–2600 kcal per day is sufficient. With semi-bed rest – 2700 kcal; when the exacerbation subsides – 3000–3400 kcal. At pulmonary tuberculosis With chronic course, especially in people young, a high-calorie diet of 3600 kcal is recommended. Eating more calories is not healthy. A rapid and large increase in body weight may not improve, but rather worsen the patient's condition.

OBJECTIVES OF THERAPEUTIC NUTRITION

Main tasks therapeutic nutrition for pulmonary tuberculosis are:

1. Providing for the body good nutrition under conditions of protein breakdown, deterioration of fat and carbohydrate metabolism, increased consumption of vitamins and minerals.

2. Increasing the body's resistance to infection and intoxication.

3. Promoting normalization of metabolism.

4. Promoting the restoration of tissues affected by tuberculosis infection.

To accomplish these tasks, it is necessary to introduce an increased amount of protein with food (at least 120–140 g), the consumption of which is increased in patients with tuberculosis. Easily digestible protein products(milk, fish, eggs, meat). The amount of fat is recommended within physiological norm(100–120 g). Fats should be easily digestible, rich in vitamin A (butter, cream, sour cream), about a third - in the form of vegetable fat.

The amount of carbohydrates is within the physiological norm (450–500 g). In cases where there is a violation of tuberculosis carbohydrate metabolism, allergization of the body (allergic diathesis, bronchial asthma, chronic eczema), overweight body, patients need to limit carbohydrate intake to 300–400 g, mainly due to easily digestible ones (sugar, honey, jam, syrup, etc.).

With an exacerbation of the tuberculosis process, an increased release of mineral salts (calcium, potassium, phosphorus, sodium chloride) may be observed, so foods rich in them are introduced (milk, cheese, cottage cheese, eggs, figs, dried apricots, raisins, meat and fish products, nuts, etc.).

With exudative pleurisy, transudate, tuberculous meningitis, if there is an increase in secretions into the bronchi, kidney damage leading to edema, a hyposodium diet is prescribed, i.e. food is prepared without adding table salt. This diet helps to increase diuresis, resorption of fluid accumulated in the cavities, and subsidence of the inflammatory process. The liquid is administered in an amount of 900-1000 ml. If there is a large loss of blood, repeated vomiting, diarrhea, excessive sweating, the amount of table salt is increased to 20 g.

Patients with tuberculosis develop vitamin deficiency (especially ascorbic acid, vitamins A and group B). Consuming sufficient amounts of ascorbic acid increases bactericidal properties blood serum, increases the formation of antibodies, reduces intoxication. The need for vitamin C is especially high in patients with fibro-cavernous process, at high temperatures and tissue breakdown. Products recommended in this case sufficient quantity vegetables and fruits, and also need to periodically take up to 300 mg of ascorbic acid per day.

Patients with tuberculosis of the lungs, larynx, intestines and skin also need increased quantity vitamin A – about 5 mg. To meet the need for vitamin A, dairy products, fish oil, egg yolk, as well as products containing carotene - carrots, tomatoes, apricots, red peppers, etc.

Particular attention should be paid to providing patients with B vitamins. They are directly related to protein metabolism, the need for which is increased in this group of patients. It is necessary to include foods rich in B vitamins into the diet - fresh vegetables, meat, dishes made from bran, brewer's or baker's yeast.

Calorie intake – 2500–3600 kcal.

BASIC PRINCIPLES OF THERAPEUTIC NUTRITION

1. The diet should be varied, taking into account the development of the tuberculosis process and general condition body.

2. Strict modes and limited nutrition can only be assigned to short term(for complications and exacerbations of the disease).

3. At all stages of treatment, nutrition should be differentiated.

It is necessary to adhere to the basic principles of quality and quantitative construction diet depending on the nature and stage of the tuberculosis process, the state of the digestive organs, the presence of complications and concomitant diseases.

There are several therapeutic nutrition options available for people with tuberculosis.

SOME HEALTH FOOD OPTIONS

First food option.

It is prescribed to patients with reduced reactivity of the body, general hypotension, low-grade fever, with a sluggish course of the disease.

The chemical composition of this diet: proteins 140 g, fats 100 g, carbohydrates 400 g, limiting easily digestible ones.

Calorie content 2700–3000 kcal. Content of ascorbic acid up to 350 mg, vitamin B1 5 g.

Cooking is normal.

Second option.

Prescribed for patients with increased nervous excitability, low body weight, elevated temperature– up to 30 degrees, without signs of increased tissue breakdown, during the period of attenuation of the process in tuberculosis of the lungs, bones and joints.

Chemical composition of the diet: proteins 110–120 g, fats up to 120 g, carbohydrates 500–550 g. Ascorbic acid content up to 300 mg.

Cooking is normal.

Meals are fractional - 5 times a day.

Third food option.

This option is prescribed during the period of exacerbation of the process with pronounced tissue breakdown, significant inflammatory phenomena occurring with high temperature and exhaustion. In these cases, there is usually increased protein breakdown.

Chemical composition of the diet: proteins 120–140 g, fats 100 g, carbohydrates 400–500 g.

Calorie content 3000–3500 kcal.

Introduction required excess quantity ascorbic acid. The remaining vitamins are recommended within the physiological norm. Calcium up to 2 mg per day. table salt 8 g. It is advisable to consume a large number of various drinks, raw juices, vegetables and fruits, rich mineral salts and vitamins.

During the period of exacerbation of the disease, appetite often decreases, disorders of the gastrointestinal tract often occur, which must be taken into account when composing the diet.

Culinary processing: all food is prepared pureed.

The diet is split, every 2–3 hours.

NUTRITION FOR PATIENTS WITH TUBERCULOSIS WITH ACCOMPANYING DISORDERS OF THE DIGESTIVE ORGANS

Patients with tuberculosis often experience accompanying illnesses from the digestive organs. Chronic gastritis and colitis often occur in connection with the use of anti-tuberculosis drugs. Gastritis is usually with low acidity. In this case, split meals are recommended with the obligatory exclusion of coarse food from the diet. vegetable fiber. Vegetables and fruits are given only in boiled and pureed forms; tough varieties of meat are also given in pureed or minced forms.

If the activity of the liver and biliary system is impaired, foods that cause irritation are excluded from the diet. Prohibited fatty varieties meat and fish, fried dishes, pastry, smoked meats, canned food, marinades, strong tea and coffee.

SAMPLE ONE-DAY MENU FOR TUBERCULOSIS

First option

First breakfast: curd pudding, buckwheat porridge with milk, tea.

Second breakfast: calcined cottage cheese, fruit mousse.

Lunch: broth with dumplings, fried steak with vegetables, apple compote without sugar.

Afternoon snack: soft-boiled egg (1 piece), rosehip decoction.

Dinner: boiled fish, baked with potatoes, carrot puree, tea with lemon without sugar.

Judging by your diet, you don’t care about your immune system or your body at all. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Nourish your body by taking vitamins and drinking more water(precisely purified, mineral). Strengthen your body and reduce the amount of stress in your life.

It's a disease infectious nature, which is provoked by Koch bacilli or tuberculosis bacilli. Tuberculosis bacteria are very resistant to external factors. They can for a long time survive in soil, humid environments, on contaminated surfaces and are even resistant to disinfectants (for example, the tuberculin bacillus survives on the pages of books for about 4 months).

Methods of penetration of mycobacteria and the causes of tuberculosis

People with weak immune systems are most prone to tuberculosis disease. Most often, infection occurs through airborne droplets, at the moment when the patient coughs, sneezes, speaks, sings, laughs. When a healthy person communicates with a sick person, there is a high risk of contracting tuberculosis. After all, a person involuntarily inhales and at the same time draws in Koch sticks. Also, tuberculosis can be infected through direct contact: during a kiss, through the use of objects that the patient had previously used.

It is worth noting that mycobacteria of this disease cannot develop outside a living organism, but they retain their abilities for a long time. You can also get sick through eating food from animals with tuberculosis (through milk, meat).

Most often, tuberculosis affects people who have low body resistance to various infections and who have immunodeficiency. People who eat poorly, live in poor conditions, abuse alcohol, and take drugs are also at risk.

Tuberculosis can be caused by taking hormonal drugs, for example, when using corticosteroids, which are used to treat bronchial asthma and other diseases.

Forms of tuberculosis

Tuberculosis should be divided into 2 main forms: pulmonary And extrapulmonary tuberculosis . It is according to these 2 types that it is worth considering the manifestations of the disease.

Tuberculosis may be closed And open form . In the presence of an open form, Koch's bacillus is released with the patient's sputum, which can be easily detected during a routine analysis. A patient with this form of tuberculosis is dangerous to others. As for the closed form, it is difficult to identify. It can only be detected during sowing, when the stick sprouts there.

Symptoms of pulmonary tuberculosis

Pulmonary tuberculosis is the most common type of this disease. It can be distinguished by several characteristics.

Let's start with the main symptoms. Adult patients experience increased fatigue, low performance, constant malaise and weakness in the morning time. In children, pulmonary tuberculosis can manifest itself as bad sleep, decreased appetite, low concentration and difficulties in completing the school curriculum.

As for the general appearance patients, they are thin, quickly lose weight, pale, and their facial features become sharper.

Next sign- This temperature. Body temperature rises slightly, to 37.5 or 38 degrees Celsius. The temperature fluctuates in the evening or at night, while the person feels very chilly, there is increased secretion sweat. This is the main difference between tuberculosis and bronchitis, pneumonia, and acute respiratory infections. With these listed diseases, the temperature rises sharply to high mark and can also fall rapidly. With tuberculosis, the temperature lasts for long period time.

Presence of cough– unchanging and main symptom pulmonary tuberculosis. In the initial period of the disease, the cough is dry and persistent, mainly disturbing patients at night or in the morning. As the disease progresses, the cough becomes moist, accompanied by big amount sputum. During pulmonary form tuberculosis cough does not stop. Naturally, with others inflammatory processes There is also a cough, but it is not as long as with tuberculosis.

Spitting blood. This is the most important symptom pulmonary tuberculosis. Blood appears in sputum after severe attacks cough. At neglected form tuberculosis may cause bleeding in the lungs or, as they say, bleeding from the throat. This condition is very life-threatening for the patient, and therefore requires immediate attention to medical professionals.

Depending on the severity and location of the lung lesions, there are: focal, disseminated, miliary, infiltrative, cavernous, cirrhotic, fibrous-cavernous tuberculosis, caseous pneumonia and tuberculoma.

Symptoms of extrapulmonary tuberculosis

The tuberculosis bacillus can affect not only the lungs, but also all other organs. With this type of course it is difficult to determine tuberculosis, because in this case there are many accompanying symptoms, which can be confused with other diseases of individual organs.

Tuberculosis is classified as:

• joints, bones and spine– with this type of tuberculosis, patients note severe pain in the affected areas, limited movement, the presence of pathological, specific fractures;
• brain– such tuberculosis develops within 2 weeks, and most often develops in people with low level immunity (in HIV-infected and diabetic patients). During the first week, the patient's temperature rises, sleep is disturbed, and frequent outbursts of anger and irritability occur. In the second week, severe headaches occur and vomiting occurs. Meninges irritated during the first week. Brain damage manifests itself as tight neck muscles, pain in the back with straightened legs, while pressing the head to the chest, tilting the head in a lying position. Nervous system disorders are observed.
• digestive organs– with this type of tuberculosis, constipation or frustration occurs, severe pain in the abdominal area, bloating, there may be intestinal obstruction and bleeding with feces;
• genitourinary system – the tuberculosis bacillus mainly affects the kidneys, while the patient’s temperature rises, his back hurts, and urination occurs along with blood discharge. May also be affected urethra, ureters and bladder. In such cases, urinary retention occurs.
• skin– with this type of tuberculosis, nodules and lumps appear under the skin, which over time increase in size and rupture the skin, releasing a white thick liquid.

Useful foods for tuberculosis

For effective disposal against mycobacteria must be adhered to therapeutic diet, which is aimed at increasing immunity, normalizing weight, appetite, sleep, regenerating damaged tissues and restoring metabolic processes and impaired functions of one or another organ.

Nutrition is prescribed depending on the site of infection, metabolic processes, the weight of the patient, and also, depending on the stage, the form of tuberculosis.

Depending on the patient’s regimen, he is prescribed food with a certain calorie content for each kilogram of weight. For completely bedridden patients, 35 kcal should fall per kilogram; for patients who spend about 6 hours in bed and have short walks 40 kcal required; for active patients (3 hours of lying down during the day plus training and plus participation in the labor process), food should have 45 kcal; but for workers who work from 3-6 hours a day with a break of 2 hours (during working hours) they will already need 50 kcal per 1 kg of body weight. This increased calorie content is explained by the high energy consumption that is lost due to constant feverish conditions.

Due to the fact that with tuberculosis there is an increased breakdown of protein, food must compensate for its deficiency. During normal course disease, per 1 kilogram of body weight you need one and a half grams of protein, and during the period of exacerbation of the disease, protein consumption should reach up to two and a half grams of protein. It should be noted that half of it must be of animal origin. It is better to replenish protein by consuming milk, cottage cheese, fish, meat, and eggs.

To improve the metabolism of the amino acids tryptophan, arginine and phenylalanine, you need to eat foods with these amino acids: feta cheese, hard cheese, cottage cheese, pork and beef liver, chicken, turkey, mushrooms (dried white), squid, soy, cocoa, peas, chum salmon caviar. These amino acids have antibiotic properties.

In addition, the body needs to be saturated with essential fatty acids(you need to eat vegetable fats and butter), vitamins A, B, C, E, calcium (you can get it by eating cottage cheese, cabbage, legumes, lettuce, raisins), phosphorus, magnesium and iron.

For tuberculosis digestive tract the patient needs to eat pureed light soups, weak broths, steamed dishes, porridges, pureed vegetables (pumpkin, carrots, zucchini, potatoes), jelly, jelly, rosehip decoction, juices, non-acidic cottage cheese and non-sharp cheese, steamed cutlets , meatballs.

When the nasopharynx and larynx are affected by the tuberculosis bacillus, it is important that all food is in liquid, ground, mushy form. Uncool is good for consumption mashed potatoes, tea or coffee with milk, just milk, milk porridges, frozen broths and strained jelly.

If joints and bones are affected by tuberculosis, it is necessary to replenish the body with calcium, phosphorus and fish oil.

When spitting blood, you need to equalize water-salt balance, drink jelly, fruit drinks, jelly, tomato juice, water with lemon juice, eat liquid semolina porridge.

In general, patients should eat in a calm, pleasant environment, always in a ventilated room. Meals should be fractional, the number of meals up to 5 times.

In the nutrition of patients with tuberculosis, the diet of table No. 11 is taken as the basis.

Traditional medicine

• In a saucepan with hot milk, add a tablespoon of internal fat of goose, pig and Indian black tea, add 250 grams of dried currants and raspberries, 2 glasses of vodka, a large handful of aloe leaves. Cook for two hours with the lid closed over low heat. After cooking is complete, leave the broth to infuse for an hour, then filter it and add half a liter of honey (it is better to take linden honey, but under no circumstances should you boil it - it will lose its beneficial features and turns into poison). Take one tablespoon of this decoction three times a day before meals (20-30 minutes).
• For tuberculosis, you need to eat pig fat with tea. To do this, grate 200 grams of lard and 3 green apples, place in a bowl and simmer over low heat. At this point you need to beat until white 12