Subacute and the chronic suppuration of the mucous membranes and the deeper lying organs also not rarely offer a phase adapted for silicea; for example, when the tonsils undergo prolonged suppuration, and the purulent materials are difficult to evacuate or are discharged incompletely. Soreness and sticking as from a needle in the throat on swallowing are subjective indications from the provings. A sensation as if there was a hair on the tongue has been cited as a symptom ever since the first provings and shows a striking agreement with the other great inflammatory remedy, hepar sulphur calcareum. In chronic purulent pyelitis or prostatitis, silicea is at times indicated. In old ulcerative processes of the cervix the already mentioned acrid, excoriating leucorrhoea irritates the vulva in silicea cases. On the respiratory passages a purulent, offensive profuse expectoration with purulent bronchitis, bronchiectasis or prolonged pneumonias suggests that silicea is to be considered as an agent of reaction and interpolated remedy.
The old clinical report: mucus pulmonary tuberculosis in stone cutters, millers, in old people is worthy of mention in respect to the etilogic connections to such “pituitous” gland processes from silicic acid containing dust.
From Pg. no. 607
TUBERCULOSIS AND SCROFULOSIS
In tuberculosis of the lungs difficulty exists in determining the suitable case and the adapted stage from the organ symptoms. Sensation of soreness in the chest, occasionally sticking in the chest going through to the back, deep hollow cough with bloody expectoration or cough with vomiting of mucus or the previously mentioned foetid-purulent expectoration, shortness of breath when lying on the back, or cough on exertion, profuse acid smelling night sweats, are too little differential signs and the aggravation from drinking cold liquids is also present in other remedies (for example, phosphorus) and characteristic of them, so that the aggravation of the cough and shortness of breath at night seems the surest. Moreover in reference to this modality one might think of pressure from swollen bronchial glands in silica. And it is exactly these in the first but also often in the chronic stage of tuberculosis with the lymphogenous metastasis when adenitis and peritonitis appears and which have the tendency to scar by proliferative processes, where one may expect a favor- able result from silicea; it is similar in chronic mesenteric lymph gland tuberculosis of emaciated children with swollen abdomen.
The glandular swellings and indurations in silicea are slightly painful and merely itching of the overlying skin signifies the development of a chronic inflammation. Together with the skin manifestations and a chilly or easily chilled constitution the glandular swellings give the general for the indications in scrofula. The skin is “sickly,” unhealthy; it has a lowered power of resistance. At first there is itching over the entire body without a visible eruption, then the skin irritation progresses to erythema and red nodular patches, vesicles and pustules and eczematous eruptions appear. The itching is worse at night, but also from cold and contact, as in general with silica, warmth relieves. Nose, throat and ear symptoms may accompany the scrofulous state: persistent occlusion and dryness of the nose, alternating with flowing coryza with acrid excoriating discharge and ulcers in the nose; occlusion of the ears with explosive sounds and difficulty in heating which indicates the participation of the eustachian tube. But again the average pathognomonic symptoms are not able to say in which cases and phases of scrofula silicea is suitable but the decision. Silicea is especially suitable in thin, pale, “anemic” children (not pasty as in calc. carb.) with swollen abdomen and weak musculatu- re; thereby a certain hypersensitivity against external influences, particularly cold, drafts and contact is present (the last in any case in contrast to calc. carb.) Ricketic symptoms are also mentioned for silicea: difficulty learning to walk, retarded labored gait, weakness of the joints, enlargement of the head with open fontanelles, evening head sweating, great muscular weakness. But these clinical indications give less occasion for the use of silicea in florid rickets; rather they indicate a further source of depressed development in the constitutional picture as it, differing in calc. carb., correspounds to silicea. In such children occasionally an enuresis nocturna may be present.
SKIN AND CONNECTIVE TISSUES
But the action of silicea on the skin is in no way limited to typical scrofulous manifestations. Acne and furuncles appear but here the agents of the sulphur group are superior. The behavior of the sweat is typical for silicea: it is offensive or acid smelling, appears especially profuse on the feet making the toes sore, the skin between the toes and fingers desquamates but there may also be suppuration or vesicles on the fingers, toes and heels; severe itching on the soles or burning in the tips of the fingers announces the eruption. But silicea is most valuable for the results of suppressed foot sweats. Not only the persistent annoying coldness of the feet but also diverse disturbances involving the entire body can be correctly traced to this. This sweat will obviously again reappear after the administration of silicea and the equivalent, perhaps recurrent catarrh or asthma, disappears.
The close connection between silicic acid and the skin and its appendages particularly the connective tissue parts, its capacity to stimulate fibroplastic processes makes still another series of indications, necessarily infrequent, understandable. Influences on the keratinization of the skin are observed in the provings in the bunions and painful hard callosity on the soles deserves a trial with silicea. The new excitation of old scars, known from the provings, leads to its employment in excessive granulations as keloids. Even the complaints from old scars in the internal organs after operations or other trauma at times have shown striking improvement after silicea. But also connective tissue tumors, fibroma, lipoma and enchondroma and moreover elephantiasis-like states of the subcutaneous connective tissue in conjunction with phlegmasia alba dolens, indeed, even hydrocele are cited as clinical indications, in which naturally one will proceed without excessive expectation in silica. The appearance of ganglia on the hands which has been observed three times from silicea is peculiar. 502 The report: funnel shaped retracted nipples recalls that silicea is to be considered in malignant tumors. After the above discussion one ought not to restrain trying a remedy so little toxic in sarcoma, particularly since Stauffer has reported a result from it.
Silicea is often mentioned as a remedy in turbidity of the lens. Therein it is to be recalled that silicic acid is found in the lens and this hydrophilic colloid will not be without significance for its state. That in the cataract of Indians, more silicic acid is found than in those of America 503 has been attributed by Kobert to the vegetarian diet followed in India. In the provings one can find many reports such as fiery spots and black spots before the eyes, short attacks of blindness which might make one think that silicea also plays a role in the vitreous humor.
The appendages of the skin are disturbed in their growth with silicea; the hair falls out easily, the nails are brittle, contain white spots, pulverize on cutting.
DIGESTION AND METABOLISM
In the silicea picture the persistent failure of the mesenchymal defense system with its fixed and monable cells of the lymphatic apparatus and the skin functions is again reflected. From this alone a marked involvement of the general state in the sense of defective vitality or indeed a chronic illness can be understood. But in addition there is a failure of metabolism, predominantly in its assimilative phase, in the utilization of the energy introduced by the food. Digestion is slowed. The tonus of the gastro-intestinal canal and at the tense; colic and gurgling in the abdomen, worse from pressure and better from heat. The stool remains in the large intestine for a long time. In persistent constipation the symptom of weakness of expulsion is characteristic: the stool occurs only with great effort and then returns to the rectum; it is delayed, laboriously evacuated with much pressure and in hard dry masses. To this may be added pain from a fissure, or burning from anal eczema. More rarely diarrhoea with tenesmus appears consequent to the decomposition of the long retained stool which then may exert a sudden marked stimulus to the intestinal mucous membrane. However the type of constipation described prevails. As a special indication holds: before and during the menses, the sphincter is sensitive; naturally the provings give no special basis for this. As the result of the impaired digestion and resorption there is aversion to fish and cooked foods; milk is also borne badly and in nursing mothers milk may be vomited. In general anorexia exists, yet often great thirst and occasionally ravenous hunger may also be encountered. Slow digestion causes a series of disturbances in the stomach although naturally not characteristic of silicea: pressure pain after eating, fullness, eructations, sour stomach, even nausea and vomiting. The great desire for sleep after eating is striking and a sign of the strong general occupation with digestion.
The nutritional energy is also deficient and thus the silicea type has “deficient body warmth”; he needs artificial warmth; all his complaints are relieved by warmth. This also holds for the very characteristic headache. It passes from the neck over the vertex to the forehead, often unilaterally and is aggravated by wind and drafts and relieved by warm coverings. General chilliness may accompany the headache. Mental effort readily provokes it. It may also involve a periodic migraine (especially over the right eye) with nausea, sensation of faintness and dimming of vision; here also the improvement from warmth is decisive. In Schussler’s reports are found “headache with small nodules of the size of a pea on the scalp.” Obviously indurative headache is meant by this. That silicea has a connection to connective tissue swelling in the scalp, is comprehensible; the improvement from warmth will also guide the choice here.
The defective vitality furnishes many other signs of lessened capacity for nerve performance. On nearsight the visual pictures swim before the eyes. Vertigo is not rare, especially in the morning and on looking back and is said to increase from back of neck to vertex, at times being associated with nausea and with a tendency to fall forward or to the left. Indeed epilepsy has been included in the effect domain of silicea on the recommendation of v. Boenninghausen, an indication which is also found in the writings of Paracelsists. The aura is said to arise from the solar plexus. If one may assume that old scar processes in the meninges play a role, then one may attack silicea with greater confidence.
The reduced capacity for performance and reduction in power of resistance expresses itself in many partly body, partly nervous- psychic general symptoms: heaviness and paretic malaise of the extremities, trembling from slight exertion, diverse sensations up to pains, proceeding particularly from the vertebrae, excessi- ve reaction to external impressions, especially sudden noises and contact, cardiac palpitation and pulsation from alarm and exertion. The profound exhaustion from bodily and mental effort is expressed by inability to concentrate the thoughts and impaired power of attention. Through this, the mental attitude becomes depressed, irritable, anxious and confidence is lost. Coitus also aggravates the symptoms of nervous exhaustion. On the one side the desire for sleep during the day exists and then again restlessness and anxiety which disturbs the night sleep and causes restlessness from alarming, frightening dreams. In an ani- mated fashion Kent pictures that silicic acid supports the nervous system and psyche just as it gives stability and support as to plants.
With this the constitutional type of silicea is carried to the side of lymphatic trend which results from a poor ability in the mesenchymal defense system to react to infections. Moreover, on the other side the failure of the skin and intestinal functions deeply affects the energy and metabolic exchange which has general and chronic results in the entire psycho-somatic impulse and frequently on the reciprocal relation between the excretory processes and the manifestations of internal illness, as is characteristic for the “psoric” remedies. The conception of carbo-nitrogenous constitution covers this only imperfectly. Because the failure in silicea lies more in the assimilative phase than in the dissimilative. Indeed Paracelsus regarded silicic acid as a remedy in stone diseases and in the herbivorous silicic acid causes the formation of stone in the urinary passages; likewise silicic acid containing plants are often prized in folk medicine as teas for stone and gravel; the promotion of diuresis which is also observed in the provings may have a share in this. However in homoeopathic use the rheumatic-lithemic trend lies in the background although reference is made to the gouty-neuritic symptoms (for example, old facial neuralgias) by many.
One can hardly study the merit of the homoeopathic method of investigating the medicinal powers of material and the usefulness created by opening up the substance, in a better way than by this very common material, whose great healing actions after the correct application have been confirmed and can be again confirmed easily by experience.
Slow, persistent action.
1. Mesenchymal defense system (fixed and movable cells).
Stimulation of leucocytosis, demarcating inflammation and fibroplastic activity.
Purulent processes with defective tendency to scarring. Fistula of all types; also tuberculous.
Thin, acrid offensive secretions. Ulcers with hard sensitive borders. Chronic suppuration also of mucous membranes (for example, tonsillar, abscess, pyelitis, cervical erosions, purulent bronchial and lung affections).
Also pulmonary tuberculosis in not very advanced stages. Chronic glandular swellings (also of bronchial and mesenteric glands). Scrofulous skin and mucous membrane manifestations. Marantic children, emaciated with swollen abdomen; also after rickets; head sweating.
Intertriginous, offensive sweats; desquamation and pustules between fingers and toes.
Foot sweat and chronic maladies after suppressed foot sweat.
Disturbances of hair and nail growth.
Painful indurated formations (on the soles), keloids; also internal scars.
Fibroma, lipoma, enchondroma, ganglion; hydrocele.
2. Metabolic disturbances in the assimilative phase with its results.
Inactivity of stomach and intestine. Aversion especially for cooked foods and fish.
Constipation with weakness of expulsion (stool returns to rectum) Deficiency in body warmth and vitality.
Headache better from warmth. Asthenopia; vertigo on looking back, from bending over; epilepsy, nocturnal attacks.
Bodily and mental exhaustion.
Irritable, depressed, anxious, frightened, irritable restlessness.
Lymphatic scrofulous children with nutritional disturbances and chronic infections (chilly, thin, pale, swollen abdomen). Adults: results of failure of skin and glandular functions; chilly defective vitality; “psoric” reciprocal relation between suppressed skin functions (foot sweats, fistula) and chronic internal maladie (lithemic, carbo-nitrogenous fraction, retention processes less expressed).
Modalities and Leading Symptoms:
Better from warmth (also the headache).
Worse from wind, cold.
Worse at night (deep inflammatory processes, sweats).
Worse new moon (epilepsy).
Worse from bodily and mental effort.
Offensive secretions from ulcers and offensive sweats.
Result of suppressed foot sweat or occlusion of fistula.
Sensitive to contact and sudden noises.
Constipation with failure of extrusion of stool.
The 6,12,15,30 D. potencies have proven themselves adaptable to the chronicity of the process and the local or constitutional conditions. One may see striking results many times from the 30th potency given at infrequent intervals.
With silicea are included two naturally appearing silicate stones which have not been proven upon the healthy but have been used empirically.
Lapis Albus is essentially calcium silico-fluoricum. The preparation arises from the region of the Gasteiner springs. It was introduced by v. Grauvogl because he associated the spring water and the stones from which it arises with the endemic goiter and cretinism. Actually Lapis albus has proven useful in hard goiters in the middle and high potencies. Here one will recall the same use of calcium fluoricum. Otherwise the clinical indications of lapis albus are the same as for silicea, particularly bone caries and glandular swellings. In myoma and uterine carcinoma as well as epithelioma and other scirrhous tumors will lapis be preferred to pure silicic acid many times.
Heckla lava, the lava of the Icelandic volcano is a silicate of calcium, magnesium, and aluminium and contains at the same time iron oxide. This preparation was introduced by Wilkinson 504 because he observed massive exostosis of the jaw in sheep grazing in the region of Mt. Heckla and also a failure of milk in animals grazing in this region. Heckla lava has been given with good results in diverse bone diseases, and has also been employed in sarcoma, moreover in glandular swellings such as silicea.
How far the carbon preparations should be discussed under the mineral drugs is more a question of convenience than of factual justification. Even the chemical limits between inorganic and organic compounds are subjected to a certain amount of arbitrariness. However we shall consider also undoubted compounds of “organic” chemistry under the mineral drugs because the “minerals” here are substances contrasted to those obtained from plants and animals. But even the substances which arise from them, can be suitably discussed with the mineral substances when they have little or none of the properties of the plant or animal charcoal, petroleum, salicylic acid. The selection amongst the almost innumerable number of carbon preparations must be made dependent upon their significance as drugs or knowledge of their medicinal powers. After considering the individual substances in detail, a review will be made as to the selection of the agent and its suitability and medicinal value from natural associations.
Graphites, as it appears in nature is almost pure carbon. The purest type which Hahnemann employed was the English graphite which contains 96 Percent carbon and 4 Percent iron. Other types are impure from various admixtures, amongst others at times arsenic. One must exclude such admixtures, particularly in future provings, because it is not improbable that these contaminations are responsible for many symptoms of the graphites picture.
Hahnemann reports 505 that the stimulation to the medicinal use of graphites was given by Dr.Weinhold who, while on a journey in Italy, saw workers in a mirror factory in Venice employ graphites externally for expulsion of herpes. Weinhold described his own personal results in 1812 in a paper: “Der Graphit als Heilmittel gegen die Flechten.”
Graphites is the hexagonal crystalline modification of carbon. The carbon atom stands at the corner of regular hexagon which is arranged in a triangular plane. The distances of these triangular planes planes from one another is greater than a side of the hexagon so that each carbon atom is equally removed from the three others lying in the same plane and one is further removed from the others lying in the plane above and below. (This arrangement is known from the so-called space lattice of graphite through v.Laue’s x-ray analysis of crystals.)
This crystalline form is very stabile and can be brought into action only with difficulty; chemically it is quite inert. Graphite is the stabile modification in which C is set free from the carbon compounds by strong heat. The fine structure in the plane with greater intervening spaces than exist between the carbon atoms of one plane is reflected itself in leaf-like crystalline form of graphites as it appears in nature. By trituration the metallic grey leaflets subdivide into ever finer scales.
In contrast to so-called amorphous carbon (carbo vegetabilis and animalis), which apart from impurities, is characterized by greater subdivision and irregular superimposition of minute crystals, graphites is characterized by an even surface one valence is free to each carbon atom (three are fixed in the same plane, the fourth is free because the next plane is too remote). According to the theory of Haber and Langmuir it is the unsaturated valence of the surface which conditions the physical compound (that is, absorption of molecules from a limited gas space or dissolved substance). This loose combination obviously contains the best conditions for exchange reactions by absorption; the inner connection of the atom of the absorbing substance will thereby not be touched at all so that it can act unlimitedly as a catalysor. The type of surface primarily differentiates the various modifications of carbon and this certainly has its share in the difference of actions on the organism. Wood and animal charcoals, for example, because of their fine division (greater surface) from the start have a greater capacity for absorption than graphites. Moreover they are still further complicated partly by chemical compounds and partly by impurities. How far the material character is maintained during trituration according to the homoeopathic method cannot be determined simply through mathematical calculation of the atomic size; it depends much more on the technical possibility of subdivision.
In regard to details the type of colloidal actions of graphites on the organism have not been determined with certainty by organ or cell experiment. However we can assume that colloidal graphites is able to provoke states of alteration in the biocolloids, just as silicic acid.
If even the colloids themselves have an optimum of action within a certain breadth of dispersion, then an upper limit of particle size for those within the organic substance, and here especially for their influence on the cells must be presumed for purely mechanical reasons. In the foam-like structure of gelatin, which is assumed also for protoplasm, the capillary space between the structural walls has, at most, a diameter of a few micro-microns; if an excessive pressure is not available, then for the finest actions within the cells the size of the particles must remain below this diameter of the hollow spaces. In any case the size of the particle of a colloid such as graphites, as far as it acts upon the organism, is limited above, while from below on the other hand no limit has yet been found.