TUBERCULINUM [Tub]:

– Tarkas P. and Ajit Kulkarni.

Region

Absorption. Nutrition

Mucous membranes alimentary tract respiratory tract lungs

Nerves; solar plexus

Glands; lymphatic mammae, thyroid

Kidneys

Joints

Brain

Skin

L. side

Worse

Weather: changing; extremes of; before a storm; damp; cold damp Spring; Summer

Air: drafts; sea-air

Heat : Closed room (Cold) Bath; becoming cold

Periodically: moon-waxing; full, annually

Suppressions: Vaccines and sera; Immunizations; triple antigens; Inoculations; BCG; PAS.

Antibiotics: Penicillin, Stremptomycin Eruptions. Warts Exanthemas. Pains

Infections; streptococcal; malaria; ‘flu; typhoid

Hair-dyes. Fur

Discharges (pains)

After sleep. Early morning (on rising)

Exertion; even slight; strain; standing; motion; when exhausted

Lying on r. side

Pressure of waist band

Slight causes

Excitements; shock; grief; worry; mental strain; thinking of it; noise; music; alcoholism

Better

Cool wind; riding in open air

Mountains

Pine forests

Cold applications (headache, itching)

Heat of stove (pains, itching); bath

Wet weather: rains

Twilight, at

Continued motion (pains)

Warm drinks (throat)

Chronicity. Psychoneurotic. Changeful

Allergic. Declining. Wasting. Chesty

Make-up :

Light, attractive complexion, long eye-lashes and fine hair, blue sclera (Carc.), flat narrow chest (‘pigeon-breasted’), tall, slim,(due to rapid fat combustion), active, nervous and precocious but physically weak (like Phos.). Lax fibre, anaemic, low recuperative power. Susceptible to weather-changes; martyrs to respiratory catarrhs; takes cold easily without knowing how or where, every time one takes in a breath of cold air; there is hardly a respite between two attacks; travels from place to place in search of a congenial spot.

Lowered vitality, increasing general exhaustion; always so tired, any movement causes an intense fatigue; averse to any work, an undertaking is a far cry.

Rapid and complete physical break-down without any apparent cause, but generally after acute infections as pneumonia, influenza, no signs of vital reaction, declining, a running down without finding the right relief, or at best but temporary, inspite of well-selected remedies and best attention which fail to impress; they simply do a lip-service, without touching the deep-rooted dyscrasia and chronicity.

Persons with history of : pneumonia, pleurisy, whooping cough, diphtheria, tonsillitis, otitis, measles, influenza or typhoid (cp. Strept.,Carc.); or those having aches and pains in damp change or rainy weather (like Dulc.), or during storms; but also occasionally persons who are better during damp and worse during dry (esp. cold) weather.

Inherited phthisis the main cause; a mainfestation of tubercular taint or a tuberculinique state.

Children : Dwarfish, puny and sickly; flat – chested; teeth notches or rudimentary; nails concave, spotted; scrofulous adenomas; mentally undeveloped (but more intelligent than Bac. children), irascible and headstrong; desire to break things; destructive; prone to brain troubles (Bac. respiratory); grind teeth in sleep, drum-bellied and diarrhea; dentition delayed; cry out or talk in sleep; dark hair along the spine.

Nerves

Pains: Sore bruised feeling all over body (worse in damp cold stormy weather); with aching and weariness in morning on waking. After suppressed eruptions, warts etc. Worse from discharges: more menstrual flow or sweat, more pain (like Cimi., Puls.; unlike Lach., Sep., Zinc.) or no pain no flow. Appear and disappear suddenly. Intense neuralgias; neuritis of influenza or diabetes.Tension throughout body, a nervous tension. Troubles after suppr. pains (Sep.).

Menacing nervous disturbances (even when looking quite well).Various nervous conditions; psychoneurosis,and troubles therefrom: gastroses, diabetes, from any severe suffering or even from a bath; always a sensation of fatigue and faintness. Adynamia, exhaustion, collapse after prolonged suffering esp. cerebral, in those with a tubercular heredity. Tremblings. Formications.

Globus hystericus; conversion hysterias (nausea, vomiting etc.).Epilepsy. Stupefying headache before convulsion.

Paralysis. Poliomyelitis is probably tubercular, occuring usually after suppressed measles or whooping cough (both of which are tubercular (cp. Dros.)); with burning along spine.

Tissues

Emaciation : Sudden, rapid and pronounced, inspite of good appetite; decidedly losing flesh though feeling and eating well; more marked in legs. Rapid metabolism (Fl-ac.).

Dropsies : Hydrocephalus. Renal (after Ant-a.).

Mucous membranes : Catarrhal. Discharges : Greenish; brownish; a peculiar fetid odour of body.

Glands : Everywhere (lymphatic) enlarged and indurated; cervical, axillary, mesenteric, inguinal, hilar. Cervical adenitis after antibiotics, suppressed otorrhea or gout; with fistulous openings; tuberculous. BCG adenitis. Tabes mesenterica. Mononucleosis: prostration, tension and tenderness in neck, adenitis marked. Thyroid disorders; myxoedema, t.b. and cretinism (here Bac. complemented by Thyr.).

Blood : Scurvy. Septic conditions, abscesses; pus greenish, thick, copious. Leucocytosis. (“Leucocytes aid tubercular bacilli” says Bhumanand). Leukemia. Hodgkin’s disease.

Bones : Aching. Skull affected. Joints: arthritis; acute arthritic rheumatism. Worse before a storm. Suppuration; tubercular sinuses in bones; t.b. of vertebrae after diphtheria. Osteomyelitis; spinal caries; spina bifida.

Nails : Spotted white (like Sil.); concave; hard, dry and brittle; ribbed; corrugated; glossy (“A sure sign of tubercular taint” – P. Sankaran).

Growths : Nodes or benign tumors, in breast.

Malignancies : Cancer sometimes results from maltreated t.b. It perhaps involves absorption, while t.b. involves nutrition and our Tub. covers both. Suspicious malignancy after PAS. Leukemia. Bac. has been successfully employed in mammary cancer. Also Tub. cases: cancer mammae after headaches had ceased; small, hard tuberculous nodules, a superficial string of them extending up to axilla; after Tub. burning pains previously suppressed by sedatives reappeared first before cure. Palliated a case of lung cancer with secondary metastasis in brain in a person who had a tendency to take cold and throughout life employed laxatives for his obstipation. Lupus (Tub k.) (on nose). Epithelioma. Various malignant skin affections. Incipient malignancy, burnings, anemia etc. after Radium treatment for (recurrent) septic tonsillitis; pt. warm blooded (like Sul. but) neat, active, shrewd and jovial, a capable executive, with tendency to take cold, and history of: typhoid, recurring axillary boils (or glands?), brown spots on body, bleeding after tooth extraction, hepatitis (i.e. multi- infections like Carc.).

Peculiar features

1. Symptoms constantly recurring or relapsing (like Sul. or Psor., of which Tub. may be regarded as species), but (unlike Sul. or Psor.) everytime appearing with a new set of them (different in characrer and / or location). Every coming back of the case calls for a fresh assessment and another remedy (without however rendering a satisfactory help); e.g. headaches cease and tuberculous growths or wasting appear, colic then wandering pains in body then cough. Symptoms play between lungs, brain, kidneys, liver, stomach or nervous system.

2. Obscure, masked, paucity, unusual or contradictory symptoms: chest symptoms of Stan. but with a hopeful cheer. Throat symptoms of Phos. but hoarseness better by using voice. Insomnia with sopor. Malaise after bath. Mania with melancholia. More menstrual flow or sweat, more pain (unlike Lach. but like Cimi. or Puls.); like Puls. in generals but is more obstinate and wayward.Good health during pregnancy, rapid decline after parturition (lactation or otherwise?).

3. Slight causes bring on troubles: Takes cold from slightest exposure, from slightest change in weather. Anger from slightest provocation. Headache from a little mental work. Menorrhagia from slightest excitement. Frightened from a medical check-up or presence of strangers. Slightest exertion or strain upsets. Tired and faint even from a partial bath. Against both cold or warm bath, can tolerate only a tepid (sponge) bath. (Grave troubles from slight causes : Psor.).

4. Allergic: From excessive strain, mental shock or abuse of Penicillin (which is one of the main causes of present-day allergy spurt). It affects the nerves (neuralgias) and the respiratory tract.Helps overcome milk or egg allergy. Neuro- allergic, metabolic skins; allergic dermatitis; a tubercular diathesis also may mask as a skin allergy (Penic., Thyr.). Has cured urticaria from hairdyes (Thyr. from lip-stick). Hay fever, easy sneezing.

5. Symptoms appear suddenly and disappear suddenly.

6. Longs for open air, wants doors and windows open, or to ride in strong wind (to fight suffocation), provided it is not too cold.

7. Fatigue and sickness in stomach and abdomen.

8. Wakeful all night after a bath, it is so stimulating; also malaise (see 2 and 3).

9. Not recovering after acute infection: temperature persists, sweats, prostration, cough, losing flesh, declining.

10. Frank inflammatory processes (not mere congestions), in brain, nerves, joints, lungs, pleura, appendix (Rhus-t.). Viral infections in patients with tubercular taint (Echi., Eucal., Calc-c.); progressing even to septic condition (cp. Pyro.). Active proliferations occur to an intense degree in edges of existing ulcers and in neighbouring glands esp. bronchial and mesenteric.

Injuries : A case: after an injection on gluteum pain shooting from there down to foot (Led. and Hypr. failing); later on her septic fever was met by Pyro.

Reaction : An instant feeling of well-being. Epistaxis (after neuralgias).

Conclusion : Tub. has a sycotic content, being connected with Bryo., Nux-v., Penic., Thuja etc. “TB itself is a sycotic disease.” ……….. Gregg. “Tuberculins are sycosis plus psora.” ……… Bernoville.” TB is psoro syphillis.” measles, whooping cough, or insanity are manifestations of a tubercular diathesis. According to Dr.M.B.Desai, Tub. serves only to remove the active hindrance (against cure) of tubercular process, it cannot help establish an eliminative process or finally the tissue repair, both of them being signs of a cure; is more useful as an intercurrent. Yet Tub. does have a sphere of its own in acute troubles esp., like all polychrests, where the tubercular taint is tangential or nominal and nothing beyond a tendency to take cold could be elicited.

Mind :

General nervous diseases. Various psycho-neuroses.

Sensitiveness: every trifle, annoyed if others are not equal to his expectation; nothing pleases or satisfies him; cannot get along with circumstances; nerves on edge (like Med. or Tarent.), sensitive to music; to sufferings, even mental changes of others; nervous tremors, a flurried feeling, thrills, everyone appears to be hurrying (Med.).

The antirest. In constant agitation and commotion or locomotion. Must always be doing something to ventilate pent-up tension. Always on the go, must walk fast, ride or undertake travels (like Calc-p.). Mental mal – adjustment; detached, dissatisfied, whining, complaining and talking. A drifter, who goes on seeking change (like Calc-ph. again); wants a new doctor every while; ever in search of new ideas (“the cult-consumer”) and new people; never satisfied to remain long in one place… the great cosmopolite; possessed by a wander-lust; nomadic way of life.

Romantic; buoyant. Intelligent. Another facet: fool-hardy; wants, or wants to do, something different, behave differently from others, a routine-hater, a non-conformist. Our hippies and the so called fall-outs are glaring instances, with these features, being products of tubercular diathesis, or abuse of narcotics, alcohol, tranquillizers, immunizers and perhaps other drugs too, like antihistamines.

Discrepancy between expectations and reality creating a lot of problems. Wants to do something special, creative, nice, idealistic; but the anti-rest disposition acts as a hindrance. Irritable, fretful, rude, quarrelsome, sulky; curt; coarse, even wild; unruly; ferocious. Develops acute personal aversions to certain people. Abusive, desire to use foul language, curse and swear (profanity, like Anac., Med.). Fits of rage, esp. on waking. Irascible when sick, though amiable when well (like Bell. which also is tubercular). Heightened sexual activity.

Apprehensive. Fear of animals, esp. dogs (even its picture terrified her) (cp. Bell., Carc., Chin.), cats, spiders, cockroaches, lizards. Nocturnal hallucinations; awakes frightened; screaming. Solar pelxus: apprehension felt in pit of stomach, anticipation troubles, intangible schoolboy fears, gastric forms of conversion hysteria. Various psycho-neuroses.

Depressed, melancholy, despondent, morose; lost-love for the near and dear (like Sep.). Mental prostration; no ambition to do anything. Life loses its mission, its raison d’etre.

Insanity : with skins; with a (family) h/o t.b.or allergy (Thyr.); alternating with phthisis (Cur.). T.b. and insanity are consanguineous.

Obstinate, intolerant and dictatorial; these tendencies in children may be due to multiple immunizations and vaccinations apart from a tubercular taint. The problem child. Quarrelsome, naughty, but nervous and timid, with sudden causeless outbursts of fury (esp. on waking), unreasonable, unmanageable, domineering. Obstinate; though may be sensible, affectionate, sympathetic. Sulky, snappish, fretty, morose. Precocious. Stupid (semi – idiotic, mentally deficient, degenerate, cretin… Bac. here preferable). Awkward and careless in work (like Agar.). A prodigy.

Select Particulars

Head : Periodical nervous / sick headaches; deep in brain with cold sweat on head (Calc-c.). School girls headaches. Sun headaches. Tubercular diseases of the brain: meningitis; chronic hydrocephalus. (Post-) encephalitic syndromes, following measles, whooping cough, vaccinations etc. (all nosodes). Plica polonica.

Eyes : Eczema of eyelids. Conjunctivitis. Old corneal cicatrices of ulcers reopen. Corneal opacity. Recurrent styes. Black ring before eye. Horizontal nystagmus.

Ears : Tympanic perforation, with ragged edges. Persistent offensive otorrhea. Suppurative otitis media.

Face : Old-looking, oedematous, pale. Black blisters on lips.

Teeth : Vague toothache; allergic; sensitive to cold air; feel jammed together or too many for his head. Good; or rudimentary, decaying (at edge of gums), notched, serrated.

Throat : Acute throat troubles; after vaccinations etc., abscesses in. Diphtheria, symptoms continually changing. Recurrent, septic tonsillitis; “in many cases a forerunner of t.b.” (Farrington); h/o pleurisy, typhoid, recurring boils etc. Chronic enlarged tonsils. Adenoids.

Stomach : All- gone, hungry sensation (Sul.). Must get up at night to eat (Psor.).Desires: fat (owing to rapid fat combustion), pork, smoked meat, ice-cream, delicacies, hot milk. Allergic to eggs, but esp. milk, which disturbs nutrition (obesity in some, emaciation in others), a diathesis approaching the tubercular. Give Tub. (or Nat-ph.) to children before starting cattle-milk, in order to avoid the tendency to take cold etc. Chronic atonic dyspepsia; after suppressed gonorrhea or warts; Thuj. not helping much; flatulent D. Nausea and vomiting mainly neurogenic, conversion – hysterical; sometimes alternating with tubercular symptoms.

Abdomen : Appendicitis. Koch’s abdomen…tabes mesenterica, tubercular peritonitis. Perforating ulcer in intestines.

Rectum : Obstipation. Early morning urgent diarrhea (cp. Aloe.,Nat-s.,Sulph.). Stools dark-brown, offensive, discharged with much force. Chronic diarrhea and excessive sweat. Alternate constipation and diarrhea. Cholera infantum. Dysentery. Bleeding hemorrhoids. Helminthiasis (which is related both to cancer and tuberculosis) with shaken nerve balance from suffering (hence Tub., Carc.,and Scir. are related).

Urinary : Renal inflammations. Sticky sediment in urine. Chronic cystitis. Urinary tract infections after tonsillectomy, child with t.b. heredity. Bed-wetting. Retention. Dysuria, burning worse after urination. Acute and chronic parenchymatous nephritis (Tub-K.).Diabetes, after severe mental strain.

Female : Polymenia, alternating with t.b. excitement. But also amenia after shock (tubercular persons are easily shocked); in young girls; with indicated remedies failing; in particular months; ceased on 2nd and 3rd days, returned on 4th day (intermittency). Frightful dysmenorrhea, pain starts with beginning of flow and goes on increasing; or only on first day; or flow only during pain.Climacteric flushes of heat.

Mammae : sore before menses; milk in, associated with menses, also suppressed menses; disappears during lactation, patient losing ground. Hard tubercular nodules in. Benign tumors.

Respiratory : Hoarseness (>) using voice (Caust., Rhus-t.). Air hunger, suffocation makes him drive against wind (Bac. has more suffocation). Hyperpnea, ceasing at once when spoken to. Children of tubercular parents are subject to repeated attacks of bronchitis and bronchopneumonia. Capillary bronchitis; with angina pectoris. Bronchiolitis.

Pneumonia (esp. l. lung) with symptoms of Bry., Ant-t.,and Zinc. but patient extremely nervous and sensitive and symptoms constantly changing. A clearing up remedy in delayed resolution with lack of response, abscess forming, a perforating ulcer or caseous hepatization appearing, threatened phthisis. Influenzal, post-vaccinal or repeated pneumonias; esp. in Winter; may be used intercurrently in majority of cases.

Pleurisy, exudative or dry (which is sometimes a harbinger of t.b.); pleura thickened or tubercles on. A wide range of coughs presistent, long-continued and recurrent; also suspicious coughs. Whooping cough; it and measles are both tubercular in nature, either may precipitate it or convert a quiescent lesion into an active one. Various chest pains. Alternation of troubles, mental and pulmonary.

Heart : Waves of nervousness or quiverings rising into heart region (orgasms); pulsation synchronous with heart beat. Intense precordial anxiety, esp. worse on waking. Heaviness at heart. Heart trouble (pain etc.) of influenza, bronchitis, of the aged.

Valvular disease, after rheumatism, with tubercular glands in neck. Mitral insufficiency, stenosis (Bac. more serviceable here). Patent ductus arteriosus; systolic bellows murmur with eccentric dilatation (Nat-m.); auricular fibrillation. Capillary aneurism (Cal-fl., Fl-ac.). Vascular spasm, causing headache.

Back : Feeling of chilliness or freezing in back (Bac., a wet cloth of back); before headache; a shudder descending on spine. Tension, whole spine stiff like a poker (ankylosing spondylitis). Burning along spine, in poliomyelitis. Osteomyelitis after tonsillectomy (Streptc.). T.b. of vertebrae; after diphtheria.

Extremities : Achings and rheumatic pains and stiffness resembling Rhus-t. (Bac. rheumatism after suppressed eruptions). Neuritis of arms. Aponeurositis and ligamentary retraction (Bar- c.). Wandering pains with stiffness in limbs and joint disease. Still’s disease. Tubercular swelling of knee-joint. Brown fingertips (Boger).

Sleep : Shivering when begining to sleep. Cold feet in bed. Sleepless from 3 a.m. Dreams: fearful, gloomy, shame; cries out in dreams.

Skin : Neurogenic skins; flaring up periodically, e.g. anually (in Summer) in a patient poisoned by Rhus. Dry, harsh, discolored; scaly; leucoderma (all nosodes). Addison’s disease. Tub. comes in skins when usual remedies do not act, give a partial relief or aggravate (as do Sul. or Psor. etc.). Itching () cold, or (more usually) heat, diversion, in damp weather. Erythemas. Psoriasis (Thyr.). Lichen planus. Exanthemas. Erythema nodosum. Psoriasis versicolor (or rubra). For eczema on tarsi and ringworms Bac. more useful. Ulcers; syphilitic; with tubercular heredity. Seborrhea.

Thermic : Tendency to periodical and / or repeated attacks of night fever; in patients subject to pneumonias; colds or diarrhea; cases refractory to other remedies. High fever; in meningitis or colic. Intermittent or remittent fevers. Slow, chronic fevers; in children; with wasting; hectic. Subclinical fevers: malaise, depression, headache, somnolence, nausea, oppressed breathing, tightness of chest etc. (‘Dumb ague’).

Influenzas esp. respiratory, with, or, without aching except about the face, appearing (more in Feb.), (