From all this we many conclude that the negative colloidal silicic acid can unfold a series of biologic actions on the body colloids and a very small amount but a very fine division is optimal for this. In these states of physical alteration silicic acid furthermore possesses some selective property, a certain grade of specificity which is dependent on the one side on the type of body colloid and on the other side by the dispersion and time sequence of the addition of the SiO2.
Likewise a series a observations are available on the action of silicic acid on the white blood cells.
G. Zickgraf found generally an increase in the white blood cells after the oral administration of silicic acid. In the tuberculous the Glashager springs are said to improve the neutrophilic blood picture in the sense of a relative increase in the polynuclears. But the studies were not sufficient. From the tables the leucocyte increase in the mineral water patients is not evident in comparison with others.
S. Schwarz proceeds more exactly under the stimulation of the work arising from Kobert. At least he considers the definite variations in the number of leucoytes throughout the day. Through blood counts repeated 4 times a day t 2-hour intervals the number of white cells was determined systematically for 3 days. On the 4th 5th, and 6th, days the patients received 3/4 liter, in some case 1 1/2 liters Glashager spring water, that is, 40-80 mg. silicic acid while the blood counts on these days were continued in the same way. In other patient who received no or pure spring water control counts were made. From the records and graphic representations it may be concluded that in a vast majority the Glashager water cases showed a hyper-leucocytosis during the days the water was administered. Unfortunately no observations were made in respect to after effect. The increase amounted in three cases from 0 Percent of the original maximum in 10 cases up to 40 Percent in 10 cases 200 Percent of the original maximum. In some cases at first a slight hypoleucocytosis was observed exactly as has been demonstrated wtih nucleic acid by other investigators.
The increase of leucocytes by drinking Glashager water was also confirmed by Helwig in the healthy. In some cases a fall was also observed by him soon after beginning the ingestion, that is a hypoleucocytosis or a negative phase. Also an improvement in the sense of a nuclear maturation can be confirmed by Helwig on the basis of the blood pictures. Furthermore according to size, shape and coloring his blood pictures show that after the drink cure is begun there is a sudden new formation of small but very well differentiated leucoytes which gradually become replaced by normally colored and shaped active cells. Furthermore helwig tested the opsonic index of Wright and found after the administration of Glashager water in the healthy, a positive opsonic index of 2.4.
Helwig then studied the influence of silicic acid on the leucocytes and the opsonic index in a more detailed manner by animal experiment. As a preliminary investigation he determined the hemolytic dose of sodium silicate (Merck) in 1-2 mgl in 1 ccm. of a 0.9 Percent sodium chloride solution in 0.5 grams of defibrinated blood. The ingestion of bacteria in the leucocytes was studied by a simple method wherein apparently he did not separate the white cells form the red. Next the rectal injections of Glashager water or pure sodium silicate in rabbits showed a distinct special influence on the grade of phagocytosis. The bacterial ingestion was about 80-143.5 Percent higher than the normal. The total dose of silicic acid in Glashager water amounted to 3 mg twice in 24 hours. If the double dose, 6 mg. of sodium silicium was rectally injected then the special silicic acid influence increased from 80 to 143.5 Percent, On the other hand further increase of the dose evoked no increase but more a diminution of bacterial ingestion. Here also a distinct optimum is observed. When one thinks that it involves healthy rabbits, the dose in 48a hours, and particularly rectal injection, by which part of the grade of dispersity would be lost, then one can designate the dose as smell, since distinct effect differences are shown within the third decimal potency. Helwig himself remarks that smallest and small doses seem to act more markedly exciting o the ingestion by the leucocytes than do the next corresponding larger amount. The microscopic picture corresponds to the grade of phagocytosis in so far that in the lower grade the leucocytes and bacteria were scattered in high, leucocytes and bacteria were always more markedly clumped. Here too, one must think of the agglutinating action of silicic acid. Likewise the subcutaneous and intravenous injection of pure silicic acid solution gave a distinct optimum which lay within the 4the decimal potency. In doses withing the 3rd decimal potency the grade of phagocytosis was indeed distinctly lessened in comparison to the normal. The third decimal potency of sodium silicium indeed acted hemolytically in 0.5 ccm. of blood.
Furthermore Helwig studied 8 animals in which he had artifically suppressed phagocytosis with opsonogen, that is, with a vaccine made from dead staphylococcus culture. He also used the negative phase developing after such an imitated infection which was still distinct, according to his studies, 24 hours after subcutaneous injection. This negative phase is a well known phenomenon as the primary effect after infections and after some time will release increased phagocytosis. Now in this phase intravenously injected silicic acid solutions 18 hours before withdrawal cause a distinct increase of the opsonic index. And indeed this increase is proportional to the doses of silicic acid employed which varied from 0.00005-0.01 pro ccm. Whether this increase of action with increasing dose which far exceeded the hemolytic dose in other studies will be confirmed, is not determined as yet. But in no case does it mean that the same proportionality lies at the basis of therapeutic trials in actual infections. Because such a negative phase of infection never comes to treatment as it lies in the incubation period. In obvious disease the patient is in the positive phase also before increased phagocytosis and in order to stimulate this we need certainly not more but less than the amount necessary for the increase in phagocytosis in the normal animal. Much more we should be warned sufficiently through the existence of an optimum of action in order to summate the equally directed stimulus in the sick organism. But in any case one must select a dose smaller than the 4 decimal potency in order to expect a favorable result.
Finally Helwig made chemotactic studies. Thereby crok protected glass capillaries containing vaccines were introduced under the skin in accordance with Hamburger’s method. Also in these studies a distinctly more marked leucocytic infiltration occurred under silicic acid than without it. A relative leucocytosis and eosinophilia after administration of silicic acid has been reported many times.
Whatever significance one attaches to the leucocytic increase and the increase in degree of phagocytosis, it is clear that within certain limits they signify defense and protection for the organism and indeed exactly against the pus-producing bacteria. With this also stands that this defense can be supported through suitable silicic acid.
NON-SPECIFIC IRRITANT THERAPY
After the therapy of silicic acid was based first on a quantitative balance in SiO2 metabolism, later it was incorporated into non-specific irritant therapy. The appearance of fever and disturbance of general well being which one notices after parenteral introduction of being which one notices after parenteral introduction of being which one notices after parenteral introduction of colloidal silicic acid, for example, in the tuberculous who are capable of reacting with liable heat control and the hyperleucocytosis with neutrophilia are certainly non-specific irritant actions; but it is exactly the specific which interests us. For this reason nothing is gained for explanation when Zimmer also brings the oral administration of silicic acid under the general conception of non-specific irritant therapy. The production of general and focal reactions in rheumatic-arthritic processes is in general bound to parenteral administration, but it seems that it is obtained with certain organic silicic acid preparations orally. It is certain that the silici acid actions will be determined
by the sensitivity of the patient and his lability and furthermore by the form of division of the preparation. Not only absorption depends upon the fact that small amounts are administered in finely divided from but the size of the particle is decisive in oral administration the increase of temperature appearing in dogs and man after a few milligrams of SiO2 in a highly dispersed colloidal form does not appear with less dispersed silicic acid preparations.
Silicic acid irritant therapy has been employed at times in typhoid. Here an excitation of a leucocytosis in the presence of leucopenia was guiding. The typhoid bacilli have, as we have seen, only a slight affinity for silicic acid and the opposing influence of the white blood cell picture (whereby in this respect the negative phase is to be considered as a hypoleucocytosis), also cannot give a very good basis for this therapy.
SUBSTITUTION THERAPY WITH SILICIC ACID
The hypothesis of transmineralization, of the balance of a mineral deficit, is given in general for the silicic acid therapy of pulmonary tuberculosis. But in the rare indications of some therapeutists, in arteriosclerosis this explanation has been included in the absence of a better one. Kuhn obtained a favorable impression from the intravenous administration of sodium silicate, particularly in aortic and coronary sclerosis, at least in respect to the subjective symptoms. In old men the silicic acid in all the tissues is supposed to be diminished and the calcium to be increased (according to H. Schulz). Consequently silicic acid therapy is conceived as substitution therapy. But it was not adopted and the subsequent addition of iodine to his preparation, najosil, by Kuhn is not exactly designed to explain the question. Even more uncertain in regard to the basis and in the results has been the occasional use of sodium silicate injections in asthma and diabetes.
From the viewpoint of a silicium deficiency silicic acid has also been employed internally in skin diseases, outside of homoeopathy. For the external use in the form of Aqua silicata in decubitus and other ulcers the adsorption capacity and the cell proliferation propensity of colloidal silicic acid must be taken into consideration. P.G. Unna recommended the oral use of sodium silicate in pemphigus chronicus and foliaceus. Luithlen treated senile itching and eczema which developed on thin, dry and desquamating old person’s skin, moreover lichen and psoriasis as well as angiospatic skin manifestations (“dead hand”) successfully with small intravenous doses of sodium silicate. Results have also been obtained in scleroderma. Loss of elasticity consequent to impoverishment of the skin in silicic acid is said to be removed by the medication.
CARCINOMA AND SARCOMA
Here and there again emerges the treatment of cancer with silicic acid. Best known is Zeller’s internal use of sodium and potassium silicate (nakasilicium = pot. silic., sod., silica 20.0, Sacch. lact 60.0, 1/4 gram three times daily is taken in cancer), and in external tumors his arsenic-cinnabar paste (Acid, arsenic. 2.0, Hydrarg. ox. rubr. 6.0, Carbo. anim. 2.0) in addition. A favorable influence from pure silicic acid therapy in single cases is not dismissed. But to decide on these rare suitable cases out of the great number without closer reports offers an almost insurmountable difficulty. Netrolizky has again employed an impoverishment of the tissue in silicic acid in cancer as an explanation. On the other side the decrease of silicic acid in senile tissue has been shown. The old reports that the silicic acid content of the pancreas may be increased
in carcinoma are scarcely of significance since the theory of Kunkel and Kall that the pancreas is the site of storage of silicic acid has been proven untenable. One might better consider that silicic acid stimulates the fibroplastic activity and thereby under certain conditions can favorably influence epithelial cell growths. Still more significant seems the fact that by the inujection of infusorial silica an outpouring into the peritoneal cavity of guinea pigs can be produced with peculiar granulomatous swellings which are composed almost exclusively of giant cells with numerous hyperchromatic nuclei. Likewise Schirokogoroff by injection of the same substance into the portal vein and pleural cavity of rabbits produced multiple tumors after 1-8 months on the peritoneum and pleura which had a similarity to giant cell sarcoma. Since the formation of giant cells in carcinomatous tissue is considered s one type of healing process silicic acid might introduce or perhaps favor the healing process in carcinoma in this way. We might further consider that many compounds of the related carbon are likewise tumor producing and on the other side also have a reputation in cancer. That results with these agents appear only rarely, lies in the nature of malignancy itself and the difficulty
in obtaining indications for a definite remedy.
In the treatment of cancer this also holds for homoeopathy. The indefiniteness and limitations of the other silicic acid therapy of the school will be decidedly overcome in homoeopathy
by means of studies on the healthy. The effects of silicic acid and its utilization will then show entirely new enlightenment and arrangement. The large number of artificial silicic acid preparations (siliquid, silistern, etc.) Which are brought out by the pharmaceutical industry cannot outweigh the knowledge of peculiar type of action of a simple substance.
A DRUG PROVING
As an example of a drug proving of silicic acid that occasioned by H.Schulz and published by Bootz may be repeated here in summary. It has the advantage that the prover did not know the substance but still it agrees well with the earlier homoeopathic provings which are richerin details.
In a first series of trials Bootz described a study for 4-6 weeks in an amount increasing from 1 to 4 knife points. The observation was continued two weeks after the discontinuing medication. In a second series which goes back 15 years, the silicic acid in one case was given in a trituration with milk sugar in the ratio of 1:10, in 4 cases in a ratio of1:1000; in the first case for one week daily two knife points, then for 2 weeks daily 4 (in total 3.5 grams were given) and in the other 4 cases in irregular increases for a few weeks daily, 4, then 8 or more which made for the total experimental period about 0.1 gram of silicic acid. In a third series 4 men were given a 0.01 Percent solution of silicic acid in water, so-called aqua silicata, and indeed for 4 weeks, weekly increasing from 20-50 drops. Thus in general 0.0075 grams was used, that is, less than a centigram of silicic acid. A period of at least one week of subsequent observation was followed. It should be stressed that in this last series of studies. With the 4th decimal potency the actions were in no way distinct as they were with the studies with the original substance. On the other hand the symptoms in the proving with the potentized silicic acid are more definite. But in general all studies show a great similarity in the symptomatic picture.
On the skin acne appeared several times, especially on the face, forehead, neck and on the back; in 4 of 17 cases furuncles with indeterminate borders and hard infiltration of the vicinity. The in two cases (with the administration of the original substance) a peculiar papular exanthem with sharply limited red elevations was preceded by several more days of severe itching. Such itching was observed in two cases in the 3rd series but without anything appearing externally. The secretion of sweat was strikingly increased in five instances, especially on the feet, and the sweat smalled sour. In four cases there was soreness of the feet and desquamation of the skin between the toes and the fingers, once initially moist and then desquamating rhagades in otherwise unhealthy skin and a tendency to suppuration. Once an old scar became thickened and painful. Twice bunion-like structures appeared, on other time an old bunion loosened without effort. Five times there was marked desquamation of the scalp as well as marked falling out of the head hair and beard. Once the finger nails became painful and seemed to grow more rapidly.
Silicic acid provoked considerable symptoms also in the bones, muscles and joints. At first great fatigue, lassitude over the entire body, especially heaviness, lassitude and tension in the legs, rapid fatiguability of the same on only slight exertion. The movements in the legs were more difficult and stiff, especially in the knee and there appeared the sensation as if the legs could not bear the weight of the body, as though the leg, and here the lower leg was temporarily completely lame, would crumple. Running and jumping were impossible. Still more frequently observed were dull deep seated pains in the leg, drawing or sticking pains in the knees and hip joints of the arms. The intensity of these pains was variable. Sometimes it was reported that pressure did not aggravate the pain and that it was better from movement. But in two reports exceptions are found, that is, aggravation from pressure and relief from motion.
Reports on symptoms in the domain of the nervous system are practically never absent in the three series of studies. The fatigue and relaxation have already been mentioned for the muscles and particularly in the first three was great fatigue, lassitude and desire for sleep, and in the two other series they also appeared in the majority of provers. To this was added aversion for physical work, inability to concentrate the thoughts. Once at the same time occurred a highly increased nervous irritability and in others restless sleep. Practically all reports mentioned headache. They are expressed as dullness and a sensation of pressure increasing up to pain. The headache was now more diffuse, now unilateral (right sided) now limited to single spots, and often began in the occiput. In two provers attacks of vertigo were reported, and once trembling of the hands and uncertainty on movement. Once burning and pains in the eyes was reported, once injection of the conjunctiva bulbi and palpebrarum, and once rapid fatigue of accomodation.
In spite of definite counts of the pulse rate the vascular system did not show many symptoms. In three cases there was a slight increase in the pulse rate, in one case a later decline in the frequency. At another time the increase of pulse was only on one day and was associated with respiratory acceleration and internal unrest, at another time cardiac palpitation appeared with a simultaneous feeling of oppression. Sensation of oppression in the chest was reported 4 times and in one other case sudden palpitation and also internal anxiety once. On the respiratory system no symptoms were observed on the whole.
On the other hand in 16 of 17 cases symptoms in the digestive organs were in good agreement. In the one case in the second series where they did not appear, the protocol is very insufficient and the administration of the drug very irregular. Many times the picture was of such a nature that at first marked collections of gas occurred in the intestine with flatulence; there was colic and gurgling in the abdomen, at times very severe cutting pains with urgency for stool. The stools were irregular, often constipated, at times painful and then also after normal stools, suddenly soft, light yellow and diarrhoeic.
The urgency to stool was often without result only flatus being evacuated. Tormenting tenesmus and the sensation as though the stool would be large although it was actually small and frequent.
On the urinary organs only the ingestion of the pure acid produced symptoms, 2 times polyuria, whereby once the act of urination was accompanied by burning pain in the glans; there times the urine was scanty, concentrated and in two cases smalled intensely urinous.
Provings of Silicea are found: 1. Hahnemann: Chr. Kranh, Bd.3, p.208, 1828.
2. Knorre: Allg. hom. Ztg, Bd. 6, p.37 1835.
3. Ruoff: Hygea, Bd. 8, p. 1 97 193 and 330, 1838.
4. Becker: Hygea, Bd. 22, p.401, 1847 (Aqua silicata).
5. Hencke: Allg. hom. Ztg. Bd. 55, p.135, 1857.
6. Sorge: Ztschr. do Berl. V. hom. Aerzte, Bd. 12, p. 267, 1893.
7. Bootz: In. Diss. Greifswald, 1903.
A summary of the indication of Schussler is found in Allg. hom. Ztg. Bd. 98, p 172 1879.
In homoeopathy silicea belongs to the polycrests which have a prolonged action. On the one side as a chief agent for the support of defense functions against external injuries, particularly chronic infections, silicea is suitable; on the other side to fundamentally alter the internal metabolic and energy exchange. We shall first consider the “outer” actions because they are more accessible to observation and easier to comprehend.
SUPPURATION AND FISTULA
Silicea acts on suppurations of all types, acute as well as chronic. The purulent processes in the organism for which it is suited are those which reveal a lessened tendency to scar formation. Therefore silicea is employed less at the beginning or at the height of a suppuration and more at the end of acute processes when they are prolonged and in chronic processes. In particular it is prefered after hepar sulf. calcar. Lersch reports: In Upland silicea is a flok remedy against suppuration in general but particularly against furunculosis, in which, according to Soderberg, one gives a knife point covered with powdered flint stone. From the capacity of silicic acid to stimulate leucocytosis this indication finds explanation. And that healing by it can be perfected or accelerated is due to the stimulation of fibroplastic activity, the promotion of granulations and scarring. For this reason silicea is also a chef remedy in fistula and by suppuration promotes the removal of foreign bodies and sequestra. The suppurations of a suitable character of fistulas may arise from a susceptible tissue or organ, this making no difference inregard to the utility of the remedy; they may be provoked by bacteria of various types, staphylococcus, streptococcus or tubercle bacillus. As the organism exerts itself against all actually with the same indeterminate defense agents, among others phagocytosis and indeterminate opsonins, thus by promotion of this defense power the bacterial actions of the most diverse types can be made harmless. In particular there should be mentioned bone suppurations, old fractures, whether in long or short bones or joint, the vertebra or the teeth with swelling of th check and toothache, which is worse at night and from cold; furthermore begin and malignant suppurations, ulcers on the skin, particularly those announcing their age and defective healing power through their stench; recurrent, indurated styes as well as ulcers of the nails; moreover suppuration in the lymph glands and in the breast, inflammed nipples; for fistula, silicea, as said above is a chef remedy. Here lachrymal fistula as well as those of the rectum and others come into consideration; here as well as elsewhere there is the thin, acrid, offensive secretion, the hard borders which are sensitive to contact; chronicity and defective tendency to healing. Ulcera cruris tending to go into the depths with these characteristics experience improvement by excitation of granulation from the external application of aqua silicata and the internal use of silicate medication.