Tuberculinum — the nosode prepared from tubercular material, Kent's own preparation being Tuberculinum bovinum from the glands of slaughtered cattle — is the remedy of the patient who can settle nowhere. Kent's phrase for the mental state is a single word: "Cosmopolitan."
Boericke gives the working indication that has carried the remedy into every practice: "When symptoms are constantly changing and well-selected remedies fail to improve, and cold is taken from the slightest exposure." Around it he sketches the state — "Patient always tired; motion causes intense fatigue; aversion to work; wants constant changes."
Boger compresses the same picture into two lines: "Obscure, changeful indications. Susceptible, given to relapses, increasing exhaustion and lowered vitality... Takes cold easily; ends in diarrhœa. TUBERCULAR TAINT."
A note on method belongs at the front, because Kent puts it there. He rejects the routine use of nosodes for their parent disease — "it is mere isopathy, and it is an unsound doctrine" — and insists the remedy be prescribed like any other: "Always let that stand out boldly, IF THE SYMPTOMS AGREE, and WHEN THE SYMPTOMS AGREE." He classes it with the deepest constitutional medicines: "it goes deep into the life; it is antipsoric; it is long acting", and "it may well be considered a species of Psorinum." Where the tubercular diathesis sits among the inherited dispositions is mapped in our guide to the three miasms.
This guide profiles Tuberculinum for clinical study from Boericke's Materia Medica, Kent's Lectures, Clarke's Dictionary and Boger's Synoptic Key. The originals can be read in full — Clarke's Tuberculinum, Boericke's Tuberculinum and Kent's Tuberculinum — through Similia's free digital materia medica.
The Tuberculinum Constitutional Type
Boericke's physique: "Especially adapted to the light-complexioned, narrow-chested subjects. Lax fiber, low recuperative powers, and very susceptible to changes in the weather." Emaciation is central and insidious — Kent: "The emaciation often begins before there is any sign of phthisis, gradually losing flesh. A gradually growing weakness, a gradually increasing fatigue."
Behind the physique stands the inheritance. Kent transmits Burnett's observation: "Patients who have inherited phthisis, patients whose parents have died of phthisis are often of feeble vitality... They are always tired. They take on sicknesses easily. They become anaemic; nervous; waxy or pale" — the constitution Burnett named "Consumptiveness".
The relapsing pattern defines the clinical behaviour. Kent's exemplar is stubborn intermittent fever that returns "from exposure to cold, from sitting in a draft, from becoming fatigued, from mental exertion, from over-eating" even after the deep remedies have acted. And he draws the fine but crucial line about failed prescriptions: "It is not an indication for Tuberc. when the well selected remedy fails to act... When, the well selected remedy has acted and the constitution shows a tendency to break down, and the well selected remedy does not hold, because of vital weakness and because of deep-seated tendencies; then it is that this remedy sometimes fits in."
Thermally the type is contradictory: Boger's patient is "chilly; yet wants fresh air", with "cold feet; < left; in bed", while Boericke's has "sensation of suffocation, even with plenty of fresh air. Longs for cold air" — the air hunger Boger capitalises.
Mental and Emotional Picture
The desire for change and travel. Kent: "A person gradually running down, never finding the right remedy, or relief only momentarily; has a constant desire to change, and travel, and go somewhere, and do something different, or to find a new doctor." And again: "The desire to travel, that cosmopolitan condition of the mind belongs strongly to the one who needs Tuberc."
Dissatisfied restlessness. Boger: "Dissatisfied; always wants a change; reckless." Nothing pleases for long — places, occupations, physicians.
Irritability on waking. Boericke: "Irritable, especially when awakening." Boger: "SENSITIVE; every trifle irritates; < awaking. Fits of violent temper." Boericke records the recorded extreme plainly: "Desire to use foul language, curse and swear."
Contradictory states. Boericke: "Contradictory characteristics of Tuberculinum are mania and melancholia, insomnia and sopor." Kent's list of the common mentals: "Hopelessness in many complaints. Aversion to mental work. Anxiety evening, until midnight... Weary of life... Tormenting, persistent thoughts during the night."
Fear of dogs. A small, strange, confirmable symptom both Boericke ("Fear of dogs. Animals especially") and Boger ("Fear; of dogs") record.
The mind–lung relation. Kent devotes a striking passage to it: "It is true that phthisis and insanity are convertible conditions, the one falls into the other... The intellectual symptoms and the lung symptoms are interchangeable" — his ground for studying the nosode in mental cases with a tubercular family history.
Night terrors. Boger: "Dreams, frightful, vivid; of shame; awakes in horror." Kent quotes the Guiding Symptoms: "Screams in his sleep. Is very restless at night."
Physical Affinities
Head
"Tuberculinum cures the most violent and the most chronic periodical sick headaches, periodical nervous headaches. Coming every week; every two weeks" (Kent) — triggered by damp weather, overwork, mental excitement or a disordered stomach. The characteristic sensation is Boericke's "intense pain, as of an iron band around head"; Clarke's schema has "as if the brain were squeezed with an iron ring", and Kent quotes the Guiding Symptoms: "Pain in the head, as if the head had a tight hoop of iron around it." Kent adds a prognostic warning: when a chronic headache is broken up and the patient instead begins to lose flesh and cough, "a new organ is affected" — and this is Tuberculinum territory.
Respiration
"Of undoubted value in the treatment of incipient tuberculosis" (Boericke): enlarged tonsils, "hard, dry cough during sleep", profuse bronchorrhœa, shortness of breath, broncho-pneumonia in children, "deposits begin in apex of lung." Boger: "Cough; fits of; with chill and red face; < evening; < raising arms", with "mucus rattle in chest, without expectoration" and asthma. The air hunger runs throughout — worse in a close room, better in cool wind and open air.
Digestion and abdomen
"Averse to meat. All-gone, hungry sensation... Desire for cold milk" (Boericke). Kent confirms both: "Such aversion to meat that it becomes impossible to eat it", "craving for cold milk", and "an all gone, hungry feeling, that drives him to eat. This has been cured by Tuberc. after Sulphur had failed." Stool: "Early-morning, sudden diarrhœa... Stools dark-brown, offensive, discharged with much force" (Boericke); Boger: "brown, foul, watery, explosive stools"; constipation with large hard stool alternating with diarrhœa. Burnett's tabes mesenterica case in Kent carries the abdominal picture: "Indurated and palpable glands everywhere. A drum belly."
Skin, glands and the periphery
"Chronic eczema; itching intense; worse at night. Acne in tuberculous children" (Boericke). Boger: "Skin: dry, harsh; sensitive, easily tanned; itching in cool air", "many enlarged glands", "delayed dentition", and two fine peculiars — "Clothes feel damp" (Clarke: "as if the clothes on the back were wet") and easy, cold, clammy sweat "in upper parts." Clarke adds "shivering when beginning to sleep" and "cold feet in bed" as marks of low vital reaction, and notes sensitivity to music.
Female sphere
"Menses too early, too profuse, long-lasting. Dysmenorrhœa. Pains increase with the establishment of the flow" (Boericke) — the reverse of the common pattern in which flow relieves. Boger calls the dysmenorrhœa "frightful", and notes "menses soon after child bearing."
Key Modalities
Worse from:
- A close room — Boger capitalises it; air hunger throughout
- Motion and exertion — "motion causes intense fatigue"; Clarke: "< by slightest exertion (it = excessive fatigue; sweat)"
- Changing weather, damp cold, before a storm; draughts
- On waking and after sleep; early morning
- Noise; music; mental excitement
- Standing; pressure of the waistband (Boger)
Better from:
- Open air — the single amelioration Boericke lists
- Cool wind (Boger)
The relapsing tendency is itself a modality: complaints return from every trifling exposure, and "cold is taken from the slightest exposure."
Keynote Symptoms
- Constant desire for change, travel, new plans, a new doctor — the cosmopolitan mind
- Symptoms constantly changing; well-selected remedies act but do not hold
- Takes cold from the slightest exposure; every cold "ends in diarrhœa"
- Always tired; motion causes intense fatigue
- Longing for open, cold air with suffocative air hunger indoors
- Irritable on waking; fits of violent temper
- Fear of dogs
- Iron band or hoop sensation around the head; periodical sick headaches
- Averse to meat; craves cold milk and sweets
- All-gone hungry sensation driving him to eat
- Early-morning sudden diarrhœa, offensive and explosive
- Rapid emaciation while eating well
- Clothes feel damp; easy cold sweat
- Menstrual pains increase once the flow is established
Clinical Applications
The sources record its territory as: incipient tubercular states and the pre-tubercular constitution; relapsing intermittent fevers; chronic periodical headaches; adenoids, enlarged tonsils and tuberculous cervical glands — Kent: "It cures most cases of adenoids and tuberculous glands of the neck"; children's diarrhœa "running for weeks, extreme wasting, bluish pallor, exhaustion" (Boericke); epilepsy, neurasthenia and nervous children, including night terrors; chronic eczema with intense night itching; tubercular meningitis in its early stages, on the record of Biegler's cure; and the chronic after-states of influenza, where Clarke found it "the best general antidote to the chronic effects of influenza poisoning." Boericke transmits two cautions from Nebel of Montreux: in renal affections "where skin and intestines do not perform normally even high potencies are dangerous", and the remedy "should not be given without a most careful cardiac examination." Clarke, for his part, treats Koch's Tuberculinum and Burnett's Bacillinum as "practically identical" in action — "the one will answer to the indications of the other."
Differential Diagnosis
Tuberculinum vs. Phosphorus. Boger lists Phosphorus first among the related remedies, and they share the narrow-chested, light-complexioned physique, the chest affinity and the craving for cold drinks. Phosphorus is the more sympathetic, diffusible, burning remedy; Tuberculinum is flagged by the relapsing pattern, the changing symptom-picture and the travelling discontent. In threatening chest cases the nosode is studied precisely where Phosphorus-like prescriptions act but do not hold.
Tuberculinum vs. Calcarea carbonica. Kent: "The relationship between Tuberc. and Calc. is very close. They are interchangeable; that is, the one may be indicated for a while, and then the other." Boericke makes Calcarea the first complementary. The restless desire to go somewhere "is found so often in the Calcareas and especially in Calc. Phos." — but Calcarea's ground is the chilly, sweaty-headed, security-seeking constitution, where Tuberculinum's is the dissatisfied, weather-beaten relapser.
Tuberculinum vs. Medorrhinum. The two inherited-taint nosodes of restless dissatisfaction. Medorrhinum hurries because time passes too slowly, burns in the palms and soles, and is better at the seaside and lying on the abdomen; Tuberculinum roams — new places, new projects — takes cold at every exposure and longs for cold open air. Both are prescribed on symptoms, with the family history as the pointer, never the proof.
Tuberculinum vs. Sulphur. The cross-references run all through Boericke's schema: the "all-gone, hungry sensation (Sulph)" and the "early-morning, sudden diarrhœa (Sulph)". Kent settles the practical relation: the all-gone hunger "has been cured by Tuberc. after Sulphur had failed" — and where Sulphur-like cases carry a phthisical inheritance and keep relapsing, the nosode deserves study. When Tuberculinum itself fails, Boericke notes, "Syphilinum often follows advantageously, producing a reaction."
Repertorisation Tips
These rubrics carry Tuberculinum in high grade:
- Mind; TRAVEL; desire to
- Mind; DISCONTENTED, displeased, dissatisfied
- Mind; IRRITABILITY; waking, on
- Mind; FEAR; dogs, of
- Generalities; COLD; taking a cold; tendency to
- Generalities; CHANGING symptoms
- Generalities; AIR; open; desire for
- Head; PAIN; band or hoop, sensation of a
- Head; PAIN; periodic
- Stomach; AVERSION; meat and Stomach; DESIRES; milk; cold
- Rectum; DIARRHOEA; morning; early; driving out of bed
- Sleep; SCREAMING during sleep; children, in
Anchor on the generals — the relapsing, cold-taking, weather-sensitive constitution and the desire for change — supported by the inheritance in the family history, then confirm with the peculiars: fear of dogs, the iron band, cold milk, the explosive early-morning stool. Kent's discipline applies at every step: the symptoms must agree. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke carries the classic indication sentence — changing symptoms, failing remedies, easy cold-taking — plus the Nebel cautions on kidneys and heart
- Kent's Lectures are the doctrinal heart: the case against routine isopathy, the Burnett "Consumptiveness" constitution, and the Calcarea–Silica–Tuberculinum triangle
- Clarke's Dictionary documents the Koch/Bacillinum question, the collected cures — vertebral, glandular, pneumonic — and the wet-clothes and iron-ring sensations
- Boger's Synoptic Key compresses the changeful, relapsing, dissatisfied state and the air hunger into a page for rapid comparison
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Tuberculinum among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
