Silicea

Cachectic or senile patients. Large head, with wasted body. Fair, clear complexion. KEENLY SENSITIVE; to noise, pain or cold; hugs the stove. Violent sticking pains; localized; in ears, throat, ulcers, etc. Exaggerated reflexes. Contracted sphincters. Spasms. Tendency to easy exhaustion, abnormal sweats and suppuration. Cerebral softening (Phos.). Slow, incomplete processes, then induration. EVERY HURT FESTERS; stubborn suppuration; fistulæ; abscess; proud flesh; induration; cicatrices, etc. Torpid cellular tissue. Mal-nutrition. Arrested development. Late learning to walk. Swelled, diseased glands. Emaciation. Scrophulo-rachitic diathesis. Parts lain on go to sleep. Œdema in A.M. Extrudes foreign bodies. .................... Mental acuteness, with physical weakness or torpidity. Fidgety. Lacks grit. Slouchy gait. Sullen and stubborn. ASCENDING EFFECTS; violent vertigo; OCCIPITAL PAINS, etc.; > pressure. Headache, then blindness. Migraine. Vertex throbs. Open fontanels, with distended abdomen. Lumps on scalp. Inflamed eyes. Spotted vision. Cataract. Deafness; hears again with a snap. Frothy nasal discharge. Coryza; with epistaxis. Waxy pallor. Enlarged parotids. As of a hair on tongue, in throat, etc. Bitter taste in throat. Abscess at roots of teeth. Hawks down foul lumps. Averse to hot food. Averse to mother's milk; vomits it. Big, hard or hot belly; with thin legs. Rectum; cutting; cramping; paining into testes; < coition. Stools; receding; < menses; retained, for fear of pain. Fissure ani. Foul urethral discharge. Itching, moist spots on scrotum. Hydrocele. Cutting upward in vagina, < urinating. Nursing < utering flow. Biting, gushing leucorrhœa. Itching vulva. Retching, shaking, gagging cough; < cold drinks. Respiration difficult from draft on neck. Profuse, foul, lumpy sputum. Rattling in chest. Sore, retracted nipples. Nodes or fistulæ in mammæ. Sharp pains in breasts and uterus. Axillary glands swelled. Fingertips painful; dry. Panaris. Weak ankles. FOOT-SWEAT; FOUL; itching; acrid, destroying shoes; suppressed. Sore ache in arch of foot. Distorted, ingrown nails. Bunions. Soggy, wilted skin. Acuminate eruptions. Carbuncle. Ulcers; painfully sensitive; foul; spongy; on feet, toes; at nails; > heat. Osteitis. Somnambulism. Frightful dreams, wake him on falling to sleep. CHILLY; < lying in bed, exertion, etc. Coldness of painful part. Icy chills. Hectic. SWEAT; profuse; on upper parts; head, or affected parts; at night; foul; easy; acrid. Follows: Calc-c. or Hepar.

COLD CHANGES: AIR. DRAFTS. Damp. Uncovering. Bathing. Checked sweat, < feet. Sensitive to: Nervous excitement. Light. Noise. Jarring spine. Change of moon. Night. Mental exertion. Alcohol.

WARM: WRAPS; to head. Becoming. Profuse urination.

NUTRITION. Children. Tissues: Elastic. Cellular. NERVES. GLANDS. Tubes: Eustachian. Tear ducts, etc. Fistulæ. Bones. Cartilage. Mucous membranes. Skin.

Complementary: Flu-ac. Pho. Thu. Related: Calc-c. Hep. Kali-p.

Silicea

Pure Silica, Silicic Oxide.

Adapted to the nervous, irritable, sanguine temperament; persons of a psoric diathesis.

Persons of light complexion; fine, dry, skin; pale face; weakly, with lax muscles.

Constitutions which suffer from deficient nutrition, not because food is lacking in quality or in quantity, but from imperfect assimilation (Bar. c.. Calc.) ; oversensitive, physically and mentally.

Scrofulous, rachitic children zvith large heads; open fontanelles and sutures ; much sweating about the head (lower than Cal.), which must be kept warm by external covering ( Sanic. ) ; distended abdomen; weak ankles ; slow in learning to walk.

Great weariness and debility; wants to lie down.

Nervous debility; exhaustion with erythism; from hard work and close confinement; may be overcome by force of will.

Restless, fidgety, starts at least noise.

Anxious, yielding, fainthearted.

Mental labor very difficult ; reading and writing fatigue, cannot bear to think.

Ailments: caused by suppressed foot-sweat (Cup., Graph., Psor.); exposing the head or back to any slight draught of air; bad effects of vaccination, especially abscesses and convulsions (Thuja) ; chest complaints of stonecutters with total loss of strength.

Want of vital heat, always chilly, even when taking active exercise (Led., Sep.).

Inflammation, swelling and suppuration of glands, cervical, axillary, parotid, mammary, inguinal, sebaceous; malignant, gangrenous.

Has a wonderful control over the suppurative process— soft tissue, periosteum or bone — maturing abscesses when desired or reducing excessive suppuration (affecting chiefly the soft tissues, Calend., Hep.).

Children are obstinate, headstrong, cry when spoken kindly to (lod. ).

Vertigo: spinal, ascending from back of neck to head; as if one would fall forward, from looking up (Puls. — looking down, Kal., Spig.).

Chronic sick headaches, since some severe disease of youth (Psor.) ; ascending from nape of neck to the vertex, as if coming from the spine and locating in one eye, especially the right (left, Spig.) ; < draught of air or uncovering the head; > pressure and wrapping up warmly (Mag. m., Stron.) ; > profuse urination.

Constipation : always before and during menses (diarrhoea before and during menses, Am. c., Bov.) ;

difficult, as from inactivity of rectum ; with great straining, as if rectum was paralyzed; when partly expelled, recedes again (Thuja).

Faeces remain a long time in the rectum.

histulo in ano alternates with chest symptoms (Berb., Cal. p.).

Discharge of blood from vagina every time the child takes the breast (compare, Crot. t. ).

Nipple is drawn in like a funnel (Sars.).

Night walking; gets up while asleep, walks about and lies down again (Kali br.).

Unhealthy skin; every little injury suppurates (Graph., Hep., Merc., Petr.).

Crippled nails on fingers and toes (Ant. c.).

Takes cold from exposure of feet (Con., Cup.).

Sweat of hands, toes, feet and axillae ; offensive.

Intolerable, sour, carrion-like odor of the feet, without perspiration, every evening.

Fistula lachrymalis; ingrowing toe-nails (Mag. p. a.. Mar. V.); panaritium; blood boils; carbuncles; ulcers of all kinds ; fistulae, painful, offensive, high spongy edges, proud flesh in them ; fissura ani ; great pain after stool.

Desire to be magnetized, which > (Phos.).

Promotes expulsion of foreign bodies from the tissues; fish bones, needles, bone splinters.

Compare: Hep., Pic. ac.. Kali p.. Hyper., Ruta, Sanic., Gettysburg.

Follows well: after. Calc., Graph., Hep., Nit. ac., Phos.

Is followed well: by, Hep., Fluor, ac., Lyc., Sep.

moon; uncovering, especially the head; lying down.

Amelioration. — Warmth, especially from wrapping up the head; all the symptoms except gastric, which are > by cold food (Lyc.).

Silicea is the chronic of Pulsatilla.

Lecture LII — Silicea

( Asaf. , Phosphorus, Conium, Graphites.

Silicea. < Sulphur, Calcarea ostr., Lycopodium.

( Gettysburg water. <Mercurius.

Silicea in its crude state is inert. It is insoluble, and hence has very little effect on the system. When potentized according to the formula of Hahnemann it becomes one of the most valuable drugs in our materia medica. It is a grand illustration of the efficacy of potentization.

The great and important effect of Silicea lies in the nutritive changes which are made by it. As nutritive changes are more evident in the growing child than in the adult, you will find Silicea symptoms appearing mostly in children from infancy up, not that it is contraindicated in the adult, but its use is shown more evidently in the young. The child, then, is imperfectly nourished, not from defective quality of the food it takes, but from defective assimilation. The head is disproportionately large; the fontanelles, especially the anterior, are open; the body is small and emaciated, with the exception of the abdomen, which is round and plump, as is often the case in scrofulous children. The head, including the scalp, neck and face, is covered with an offensive sweat. The face is pale, waxen, earthy or yellowish. The bones are poorly developed, as # are also the muscles, consequently the child is slow in learning to walk. Silicea is especially adapted to rachitic children. The fibrous parts of the joints are inflamed, swollen or ulcerated. This gives the joints, especially the knees, a knob-like appearance.

Silicea is complementary to Thuja, especially in nervous affections and for the bad effects of vaccination. Whatever we may say in favor of the necessity of vaccination, we do know but that this operation may be followed by unhappy symptoms, and that, too, when the purest of virus has been used. Hence, at times, you have to counteract the bad effects that may follow the operation. We know that in Paris some 30,000 or 40,000 children were vaccinated after each was given a dose of Sulphur, and this is supposed to prevent the outbreak of any other disease than the vaccinia itself. If such bad effects as erysipelas, convulsions or diarrhoea should follow, then you will give Silicea, which will cure the case. Thuja, itself, is complementary here, and comes in very well for diarrhoea following vaccination, and also when the vaccination fever is high. Pustules, like those of smallpox, together with a rash, appear all over the body. Melandrinum is also useful for ill-effects of vaccine, but as yet it has been only imperfectly proven.

You notice that to the right on the board I have placed Mercurius, prefixed by a "crescendo" mark. That means that Mercurius does not follow well after Silicea. Their symptomatologies are apparently similar, and yet they do not seem to agree, although Silicea will antidote some of the effects of crude mercury, but, as potentized medicines, they do not follow each other well, hence you must be careful in deciding between the two drugs.

Fluoric acid antidotes the over-use of Silicea in bone affections. Hepar also antidotes some of the effects of Silicea.

We are now ready to take up the effects of the drug. First, on cellular tissue. Silicea has long been known as a valuable drug, because of its affinity for cellular tissue. It produces inflammation of this extensive tissue of the body, going on to suppuration, and suppuration, too, which is rather indolent or sluggish in type, not necessarily malignant, but tending to perpetuate itself and become chronic. The termination of the Silicea cellulitis, then, is in suppuration, which is persistent, in ulceration which is persistent, or in induration. I have already illustrated this in the application of Silicea to the tonsils when these glands suppurate and refuse to heal, Silicea is more than ever the remedy when this occurs in rachitic children. You will see it also in the treatment of boils or furuncles, furuncles which occur in crops and which do not heal readily, but continue to discharge a rather thin, watery and even ichorous pus, usually having a foul odor, or less commonly a thick pus. Silicea may frequently be suggested as a remedy to prevent boils, on account of its tendency to produce inflammation of the connective tissue. So, too, it would be suggested in that dread disease, carbuncle, particularly when it is situated between the shoulder and nape of the neck, a common site for carbuncle.

Silicea may also be used for induration. For instance, following the treatment of boils and abscesses, or other inflammations of this kind involving the parenchyma of an organ, you may have plastic exudation, which results in induration. This induration Silicea will cause to be absorbed, thus placing Silicea alongside of Graphites, a drug which you will remember tends to absorb indurated surfaces, even going so far as to effect the obliteration of cicatrices. The same has been said of Phytolacca, but I think that this lacks confirmation. It certainly lacks the confirmation that Graphites has had.

Sometimes you will find that Silicea is unsuccessful in these indurations. Then a dose of Sulphur, interpolated, makes Silicea act better.

Silicea may be given with good result in all forms of ulcers, both benign and malignant. Its distinctive features are ulcers from bone diseases, as caries or necrosis, scrofulous ulcers which appear about joints, ulcers which appear in the back from vertebral caries, and ulcers which appear about the hip in hip-disease, particularly if connecting with fistulse. The pus is thin and offensive, and often mixed with blood and sometimes with little particles looking like cheese. There is very little tendency to heal spontaneously. These ulcers are relieved by warm and aggravated by cold applications.

Silicea acts upon the bones. We find it indicated in scrofulous children where the bones are curved, as for instance in spinal curvature. Not only is it indicated in lateral curvature, but where there is caries of the vertebral column itself.

It may also be indicated in diseases of the hip, or knee-joint, when the discharges are thin and offensive, and when there are fistulous tracks opening into the joint. The patient is of a scrofulous diathesis, and presents the constitutional characteristics that I have already mentioned as belonging to the Silicea patient. In addition to the symptoms there enumerated, the Silicea patient may have an offensive foot sweat, and this tends to make the toes sore and even raw. Sometimes there is an offensive axillary sweat. (I believe that the best remedy for axillary sweat is Petroleum. ) The child also has tendency to swelling of the glands, which suppurate. Now with these symptoms there is a peculiar susceptibility to touch. I would here compare it with Lachesis, which as you will remember has extreme hyperesthesia of inflamed parts. I dwell on this symptom for two reasons; first because it will help you to differentiate from the closely allied lime salts, and secondly because it illustrates a property of Silicea which you will see when we come to speak of its action on the nerves. Let us now stop to compare Silicea with its related remedies. Asafoetida has offensive discharges from the bones. It is distinguished, however, by the intolerable soreness around the ulcer. For instance, in caries of the tibia, with an external outlet and discharging pus, the parts around the ulcer are so sore and tender to the touch that the patient cannot bear the softest dressing.

Phosphorus is very similar to Silicea in bone disease. It resembles it in abscess, particularly in mammary abscess, with fistulous openings. It is similar, too, in the caries of bone, particularly in necrosis. Phosphorus, like Silicea, has over-excitability of the nervous system. Platinum mur. is also a valuable drug in caries of the bones. Another is Angustura, which is particularly useful in caries of the long bones, as the humerus, tibia, femur, etc.

Strontiana carbonica is especially useful in caries of the femur with coexisting watery diarrhoea.

Gettysburg salt is rich in carbonate of lithium, and is very useful for symptoms precisely like those of Silicea, namely, carious ulcers, or ulcers about joints, such as occur in hip-disease or in caries of the vertebrae. The discharge is acrid and excoriating.

Sulphur, Calcarea, and Lycopodium are similar to Silicea in the scrofulous diseases of children. The distinction between Calcarea and Silicea is as follows : the Calcarea head sweat is confined to the scalp, and is sour rather than offensive. The feet also are damp from sweat, but the sweat does not, as in Silicea, make the feet sore or raw. Calcarea lacks the sensitiveness to touch of Silicea.

In this sweating of the head, the body being dry, Silicea is exactly opposite to Rhus tox., which has sweating of the body, the head being dry.

The mucous membranes do not escape the action of Silicea. We have otorrhcea, the discharge from the ear being offensive, watery, and curdy. Often you find the membrana tympana perforated, the purulent discharge thence containing little pieces of bone, the result of involvement of the mastoid process or the ossicles of the middle ear by the disease.

There is keratitis, especially with tendency to the formation of sloughing ulcers, which tend to perforate the cornea like those of Nitric acid. In the Silicea child they are not vascular, so there is not much infiltration of the surrounding tissues. Hypopyon is present. The lids are swollen and covered with suppurating styes. The nose is also affected. Silicea is especially useful in nasal catarrh -when ulcers exist on the mucous membranes, and these discharge a thin, bloody excoriating matter; or they may be dry, and then there is annoying dryness of the nose. It is also useful when the catarrhal process extends backwards and involves the outlets of the Eustachian tubes, producing an intolerable itching and tingling in this locality. We also find Silicea indicated in some forms of hay-asthma, especially that which begins with itching and tingling in the nose and violent sneezing and excoriating discharge from the nose.

Silicea has also an action on the lungs. It produces hoarseness and roughness and dryness, with a tickling cough w Thich seems to come from the supra-sternal fossa very much like Rumex crispus. There is also a feeling as if a hair were lying in the throat, larynx or trachea. The cough is excited by cold drinks, as under Rhus tox. and Scilla, by the very act of speaking, as in Phosphorus, Rumex, Ambra grisea, etc., and worse at night when lying down, just like Rumex, Phosphorus and Lycopodium. Sometimes it ends in the vomiting of mucus. Silicea is useful in the suppurative stage of tuberculosis, when the cough, at first dry, becomes loose, with the expectoration of offensive muco-pus. You will find it of great service in the phthisis mucosa of old people. After great exertion the patient expectorates nasty pus, which is horribly offensive. But Silicea will seldom cure these cases. It can only palliate.

Phellandrium aquaticum is an excellent remedy in the last stages of phthisis when the expectoration is terribly offensive.

I would advise you to remember Capsicum for bronchial catarrh when the breath is not offensive except during the cough. You know that the Capsicum patient is of lax fibre and cannot get up the expectoration; so some of it lies there and undergoes decomposition. The air of ordinary expiration is not offensive, but as soon as the patient brings that from the very depths of the lungs, the offensive odor becomes quite marked.

In the Silicea diarrhoea the stools are offensive and usually painless and lienteric. The child vomits its food. These symptoms are associated with the characteristic skin lesions and constitutional peculiarities which go to make up the Silicea child.

The constipation of Silicea is quite characteristic. The stool partially escapes from the rectum and then seems to slip back again. I think that this symptom is easily explained. There is defective expulsive power on the part of the rectum. With a great deal of straining the stool is partly pushed down. When the bearing ceases then it slips back.

Next you have to remember the action of Silicea on the nervous system. It has here a very peculiar effect, which was pointed out first by Dr. Dunham. It causes a tendency to paralysis and paralytic weakness. Here, too, the trouble seems to be due to defective nutrition of the nerves themselves, both in the brain and spinal cord. Then you will have to remember it as a remedy in paralytic weakness accompanying disease of the spinal column. Often, with this condition, there is the peculiar constipation I have just described. With all these paralytic troubles there is an over-susceptibility to nervous stimuli. The senses are morbidly keen. The brain and spine cannot bear even an ordinary concussion or vibration. The surface of the body is tender and sensitive to the touch. Cold aggravates the symptoms and heat relieves.

Silicea may be given in convulsions of an epileptic character, with well-marked aura, when it starts from the solar plexus, as in Bufo and Nux vomica. The attacks are also said to come in certain phases of the moon. The patients are worse from any over-strain of the mind or emotions.

The headache of Silicea is of a nervous character, and provoked by any excessive mental exertion. It is generally worse over the right eye. It is aggravated by any noise, motion or concussion, and better from wrapping the head up warmly. It is not the pressure, but the warmth, that relieves. Sharp, tearing pains rise from the spine into the head. At the height of the paroxysm there is apt to be nausea and vomiting from sympathetic involvement of the stomach. You should here compare Menyanthes, Paris quadrifolia and Strontiana carb. Menyanthes was first confirmed by Dr. Dunham. It has a peculiar headache coming from the nape of the neck, over the head. There is a bursting pain, as if the membranes of the brain were tense, and were pushing the skull open. This is relived by pressure rather than by warmth.

Paris quadrifolia has headache of spinal origin, which arises from the nape of the neck and produces a feeling as though the head were immensely large.

Strontiana carb. produces headache coming up from the nape of the neck and spreading thence over the head. It is just exactly like the headache of Silicea. You will have to distinguish by the collateral symptoms.

There are other nervous symptoms produced by Silicea. The patient has vertigo, which, like the pains, seems to rise from the spine into the head. It also causes difficulty in balancing. He has a fear that he will fall, and always to the left. Speech is somewhat confused. He finds it difficult to grasp the exact expression he wishes, and this even in ordinary conversation, and yet, when warmed up to his subject, he sometimes speaks quite fluently. Sluggishness is a contraindication of Silicea in nervous conditions. You cannot use it in torpid, flabby, nerveless persons. Remember that exactly the opposite is the case with disease of the lower tissues.

Silicea acts just as powerfully on the spine as it does on the brain, causing general motor weakness. Here, too, it is attended with the same irritability. The neck is stiff, causing headache. This stiffness of the neck is not from cold, not from rheumatism of the various muscles, but from spinal irritation. The small of the back aches as if beaten or pounded. The patient complains of pains about the coccyx, and cramps such as one experiences after sitting a long time or after, riding a long time over a rough road. The legs tremble. They easily grow weary, particularly in the morning. I^oss of animal fluids causes marked aggravation of the symptoms. For instance, seminal emission or coitus causes, or is followed by, bruised aching all over the body. There may also be symptoms of the spine which indicate locomotor ataxia. The fingers feel stiff, with loss of power in them. The part of the body on which he lies goes to sleep.

Silicea is useful in chronic rheumatism. It is one of the remedies on which to depend in treating hereditary rheumatism. The pains are predominantly in the shoulders and in the joints, and are worse at night and worse when uncovering.

A related remedy here is Ledum, which has exactly the opposite aggravation to that of Silicea. The patient is worse from covering up. The symptoms usually extend from the feet upwards.

Yielding, faint-hearted, anxious. Nervous and excitable. Sensitive to all impressions. Brain-fag. Obstinate, headstrong children. Abstracted. Fixed ideas; thinks only of pins, fears them, searches and counts them.

Imperfect assimilation and consequent defective nutrition. It goes further and produces neurasthenic states in consequence, and increased susceptibility to nervous stimuli and exaggerated reflexes. Diseases of bones, caries and necrosis. Silica can stimulate the organism to re-absorb fibrotic conditions and scar-tissue. In phthisis must be used with care, for here it may cause the absorption of scar- tissue, liberate the disease, walled in, to new activities (J. Weir). Organic changes; it is deep and slow in action. Periodical states; abscesses, quinsy, headaches, spasms, epilepsy, feeling of coldness before an attack. Keloid growth. Scrofulous, rachitic children, with large head open fontanelles and sutures, distended abdomen, slow in walking. Ill effects of vaccination. Suppurative processes. It is related to all fistulous burrowings. Ripens abscesses since it promotes suppuration. Silica patient is cold, chilly, hugs the fire, wants plenty warm clothing, hates drafts, hands and feet cold, worse in winter. Lack of vital heat. Prostration of mind and body. Great sensitiveness to taking cold. Intolerance of alcoholic stimulants. Ailments attended with pus formation. Epilepsy. Want of grit, moral or physical.

Worse, new moon, in morning, from washing, during menses, uncovering, lying down, damp, lying on, left side, cold. Better, warmth, wrapping up head, summer; in wet or humid weather.

Aches from fasting. Vertigo from looking up; better, wrapping up warmly; when lying on left side (Magnes mur; Strontia). Profuse sweat of head, offensive, and extends to neck. Pain begins at occiput, and spreads over head and settles over eyes. Swelling in the glabella.

Skin cracked on margin of lips. Eruption on chin. Facial neuralgia,

throbbing, tearing, face red; worse, cold damp.

Angles of eyes affected. Swelling of lachrymal duct. Aversion to light, especially daylight; it produces dazzling, sharp pain through eyes; eyes tender to touch; worse when closed. Vision confused; letters run together on reading. Styes. Iritis and irido-choroiditis, with pus in anterior chamber. Perforating or sloughing ulcer of cornea. Abscess in cornea after traumatic injury. Cataract in office workers. After-effects of keratitis and ulcus cornæ, clearing the opacity. Use 30th potency for months.

Fetid discharge. Caries of mastoid. Loud pistol-like report. Sensitive to noise. Roaring in ears.

Itching at point of nose. Dry, hard crusts form, bleeding when loosened. Nasal bones sensitive. Sneezing in morning. Obstructed and loss of smell. Perforation of septum.

Sensation of a hair on tongue. Gums sensitive to cold air. Boils on gums. Abscess at root of teeth. Pyorrhea (Merc cor). Sensitive to cold water.

Periodical quinsy. Pricking as of a pin in tonsil. Colds settle in throat. Parotid glands swollen (Bell; Rhus; Calc). Stinging pain on swallowing. Hard, cold swelling of cervical glands.

Disgust for meat and warm food. On swallowing food, it easily gets into posterior nares. Want of appetite; thirst excessive. Sour eructations after eating (Sepia; Calc). Pit of stomach painful to pressure. Vomiting after drinking (Ars; Verat).

Pain or painful cold feeling in abdomen, better external heat. Hard, bloated. Colic; cutting pain, with constipation; yellow hands and blue nails. Much rumbling in bowels. Inguinal glands swollen and painful. Hepatic abscess.

Feels paralyzed. Fistula in ano (Berb; Lach). Fissures and hæmorrhoids, painful, with spasm of sphincter. Stool comes down with difficulty; when partly expelled, recedes again. Great straining; rectum stings; closes upon stool. Feces remain a long time in rectum. Constipation always before and during menses; with irritable sphincter ani. Diarrhœa of cadaverous odor.

Bloody, involuntary, with red or yellow sediment. Prostatic fluid discharged when straining at stool. Nocturnal enuresis in children with worms.

Burning and soreness of genitals, with eruption on inner surface of thighs. Chronic gonorrhœa, with thick, fetid discharge. Elephantiasis of scrotum. Sexual erethism; nocturnal emissions. Hydrocele.

A milky (Calc; Puls; Sep), acrid leucorrhœa, during urination. Itching of vulva and vagina; very sensitive. Discharge of blood between menstrual periods. Increased menses, with paroxysms of icy coldness over whole body. Nipples very sore; ulcerated easily; drawn in. Fistulous ulcers of breast (Phos). Abscess of labia. Discharge of blood from vagina every time child is nursed. Vaginal cysts (Lyc; Puls; Rhod) hard lumps in breast (conium).

Colds fail to yield; sputum persistently muco-purulent and profuse. Slow recovery after pneumonia. Cough and sore throat, with expectoration of little granules like shot, which, when broken, smell very offensive. Cough with expectoration in day, bloody or purulent. Stitches in chest through to back. Violent cough when lying down, with thick, yellow lumpy expectoration; suppurative stage of expectoration (Bals. Peru).

Weak spine; very susceptible to draughts on back. Pain in coccyx. Spinal irritation after injuries to spine; diseases of bones of spine. Potts' disease.

Sciatica, pains through hips, legs and feet. Cramp in calves and soles. Loss of power in legs. Tremulous hands when using them. Paralytic weakness of forearm. Affections of finger nails, especially if white spots on nails. Ingrowing toe-nails. Icy cold and sweaty feet. The parts lain on go to sleep. Offensive sweat on feet, hands, and axillæ. Sensation in tips of fingers, as if suppurating. Panaritium. Pain in knee, as if tightly bound. Calves tense and contracted. Pain beneath toes. Soles sore (Ruta). Soreness in feet from instep through to the sole. Suppurates.

Felons, abscesses, boils, old fistulous ulcers. Delicate, pale, waxy. Cracks at end of fingers. Painless swelling of glands. Rose-colored blotches. Scars suddenly become painful. Pus offensive. Promotes expulsion of foreign bodies from tissues. Every little injury suppurates. Long lasting suppuration and fistulous tracts. Dry finger tips. Eruptions itch only in daytime and evening. Crippled nails. Indurated tumors. Abscesses of joints. After impure vaccination. Bursa. Lepra, nodes, and coppery spots. Keloid growths.

Night-walking; gets up while asleep. Sleeplessness, with great orgasm of blood and heat in head. Frequent starts in sleep. Anxious dreams. Excessive

gaping.

Chilliness; very sensitive to cold air. Creeping, shivering over the whole body. Cold extremities, even in a warm room. Sweat at night; worse towards morning. Suffering parts feel cold.

Complementary: Thuja; Sanic; Puls; Fluor ac. Mercurius and Silica do not follow each other well. Compare: Black Gunpowder 3x (Abscesses, boils, carbuncles, limb purple. Wounds that refuse to heal; accident from bad food or water.––Clarke). Hep; Kali phos; Pic ac; Calc; Phos; Tabasheer; Natrum silicum (tumors, hæmophilia, arthritis; dose, three drops three times daily, in milk); Ferrum cyanatum (epilepsy; neuroses, with irritable weakness and hyper-sensitiveness, especially of a periodical character). Silica marina-Sea sand––(Silica and Natrum mur symptoms. Inflamed glands and commencing suppuration. Constipation. Use for some time 3x trit). Vitrum-Crown glass––(Pott's disease, after Silica, necrosis, discharge thin, watery, fetid. Much pain, fine grinding and grating like grit). Arundo donax (acts on excretory and generative organs; suppuration, especially chronic, and where the ulceration is fistulous, especially in long bones. Itching eruption on chest, upper extremities and behind ears).

Sixth to thirtieth potency. The 200th and higher of unquestioned activity. In malignant affections, the lowest potencies needed at times.

Silicea

The action of Silica is slow. In the proving, it takes a long time to develop the symptoms. It is, therefore, suited to complaints that develop slowly.

Generalities: At certain times of the year and under certain circumstances peculiar symptoms will come out.

They may stay with the prover the balance of his life. Such are the long-acting, deep-acting remedies; they are capable of going so thoroughly into the vital order that hereditary disturbances are routed out. The Silica patient is chilly; his symptoms are developed in cold, damp weather, though often better in cold, dry weather; symptoms come out after a bath.

Mind: The mental state is peculiar.

The patient lacks stamina. What Silica is to the stalk of, grain in the field, it is to the human mind. Take the glossy, stiff, outer covering of a stalk of grain and examine it, and you will realize with what firmness it supports the head of grain until it ripens; there is a gradual deposit of Silica in it to give it stamina. So it is with the mind; when the mind needs Silica it is in a state of weakness, embarrassment, dread, a state of yielding.

If you should listen to the description of this state by a prominent clergyman, or a lawyer, or a man in the habit of appearing in public with self-confidence, firmness and fullness of thought and speech, he would tell you he had come to a state where he dreads to appear in public, he feels his own selfhood so that he cannot enter into his subject, he dreads it, he fears that he will fail, his mind will not work, he is worn out by prolonged efforts at mental work.

But he will say that when he forces himself into the harness he can go on with ease, his usual self-command returns to him and he does well; he does his work with promptness, fullness, and accuracy. The peculiar Silica state is found in the dread of failure.

If he has any unusual mental task to perform, he fears he will make a failure of it, yet he does it well. This is the early state; of course there comes a time when he cannot perform the work with accuracy and still he may need Silica. Another case is illustrated in a young man who has studied for years and is now nearing the end of his course. He dreads the final examinations but he goes through them all right, then a fatigue comes upon him and for years he is unable to enter his profession. He has this dread of undertaking anything.

Irritable and irascible when aroused; when let alone he is timid, retiring, wants to shirk everything; mild, gentle tearful women. The Silica child is cross and cries when spoken to. It is the natural complement and chronic of Puls. because of its great similarity; it is a deeper, more profound remedy.

Religious melancholy, sadness, irritability, despondency. Lyc. is stupid, the dread of undertaking any thing in from a general knowledge of inability. In Silica it is imaginary. Silica is not suitable for the irritability and nervous exhaustion coming on from business brain-fag, but more for such brain-fag as belongs to professional men, students, lawyers, clergymen. A lawyer says, "I have never been myself since that John Doe case"

He went through a prolonged effort and sleepless nights followed. Silica restores the brain.

Skin: The remedy produces inflammation about any fibrinous nidus and suppurates it out. It acts upon constitutions that are sluggish and inflames fibrous deposits about old imbedded missiles. Slow nutrition; if the individual receives a slight injury it suppurates and the cicatrix indurates, is hard and nodular.

Along the track of a knife-cut, is a fibrinous deposit due to inferior and slow nutrition. An old ulcer heals with induration. Where cicatricial tissue forms, it is indurated, shiny, glassy. If Silica is given in such cases, it will throw out abscesses in these cicatrices and open them out. It will open up old ulcers and heal them with a normal cicatrix.

In ordinary people if a splinter lodges in the tissues, a suppuration will slough it out, but in these feeble constitutions a plastic deposit takes place about it and it remains. This is not the highest state of order. Suppuration takes place about a bullet and pushes it out, that is the best state that can be asked for.

Silica, therefore, hastens the formation of abscesses and boils. It suppurates out old wens and indurated tumors. It has cured recurrent fibroids and old indurated tumors.

It there is a deposit of tubercle in the lungs, Silica establishes ail inflammation and throws it out, and if the whole lung be tubercular a general suppurative pneumonia will be the result; hence, the danger of giving such remedies and the danger of repeating them in advanced stage of phthisis. Not only Silica but many other remedies have the power to suppurate out deposits, the result of poor nutrition.

Warty growths on the skin, moist eruptions, pimples, pustules, abscesses. Suppurating cavities. It establishes healing in old fistulous openings with indurated margins. Catarrhal suppurations; copious muco-purulent discharge from the eyes, nose, ears, chest, vagina, etc.

Suppression: Complaints from the suppression of discharges; suppressed sweat.

These suppressions produce a state in the economy that threatens what little order is left. An offensive foot-sweat ceases after getting the feet wet, and is followed by chills and violent complaints.

Silica cures long lasting foot-sweat when the symptoms agree, or complaints that have lasted since the suppression of a foot-sweat. Thick, yellow catarrhal discharges.

They say, "I have had this discharge so many years," and when you investigate, you find that there has been some, shock, a cold, that suppressed the foot-sweat and it has not appeared since. Silica will bring back that sweat, cause the catarrhal discharge to cease and in time cure the footsweat.

Catarrhal discharges from the nose and other places, indurations, tumors, chronic gastritis, brain- fag, all dating back to the suppression of foot-sweat or otorrheoa, or to the healing up of a fistula.

Head: Chronic sick-headache attended with nausea and even vomiting.

Headache commencing in the back of the head in the morning or towards noon going to the forehead, worse towards night, from noise; better from heat; supra-orbital neuralgias; better from pressure and heat and attended with profuse head-sweat.

Cold, clammy, offensive sweat on the forehead. When a Silica patient exerts himself he sweats on the face, the lower part of the body is dry or nearly so. It requires great exertion to produce general sweat. A striking feature is the sweat about the upper parts of the body and the head. Headache once a week (Gets., Lyc., Sang., Sulph.). Headache up through the back of the neck and especially to the right side of the head. Resembles Sang. Weight in the occiput as if it would be drawn back, with a rush of blood to the head, like Carbo veg. and Sepia.

Headache worse from cold air. Psor. wears a fur cap even in summer. Magn. mur. is better from wrapping up the head but still wants to be in the air. Rhus sweats on the body; the head is dry. Puls. sweats on one side of the head.

Vertigo to fainting; with nausea; vertigo creeping up the spine into the head.

It is especially necessary for the Silica patient to avoid the cold air, must have the head well wrapped up, especially the part that is painful, and this part perspires copiously.

"Headache worse from mental exertion, excessive study, noise, motion, even jarring from foot-steps, light, stooping, pressing at stool, talking, cold air, touch."

Skin again: Moist, scaly eruption on the scalp, eczema capitis.

Silica is suited to the phagedenic ulcers of syphilis, eating and spreading ulcers on the scalp. Inflammatory conditions between the scalp and skull, tumors forming, filled with a grumous fluid; as in infancy, it will remove blood tumors. Cephalatoma neonatorum, enchondroses. Silica is especially of use in the treatment of affections of the cartilages, growths about the joints, about the fingers and toes.

The complaints of Silica are associated with hardened glands, but especially about the neck, the cervical, salivary, and particularly the parotid glands; large, hard parotids. The parotids enlarge from every cold and get hard. (Bar. carb., Calc., Sulph,)

Puls. suits the acute inflammation of the parotid, but Silica is indicated in the more chronic forms due to psora, "scrofulous glands."

Eyes: Many inflammations and conditions of the eyes.

Ulcers on the cornea; pustules on the lids, falling of the lashes, suppuration of the margins of the lids with burning, stinging and redness. Intense photophobia in all eye complaints.

Scrofulous cases with sore eyes, the most inveterate and chronic cases; suppuration; thin, watery, copious discharge, or bloody, thick and yellow like pus, with ulceration.

Syphilitic iritis.

"Perforating or sloughing ulcer on the cornea. Spots and cicatrices on the cornea.

Fungus haematodes.

Eyes inflamed from traumatic causes; foreign particles have lodged in the eyes; abscesses; boils around the eyes and lids tarsal tumors, styes.

Affections appearing in the angles of the eyes fistula lachrymalis; stricture of lachrymal duct." This is a general survey of the eye affections in Silica.

Ear: There is no deeper remedy than Silica in eradicating the tubercular tendency, when the symptoms agree; most tubercular cases are worse from cold, wet weather; better in cold dry weather.

The most inveterate cases of catarrh of the ear; old offensive, thick, yellow otorrheoa; following scarlet fever; all sorts of abnormalities in hearing, even to deafness.

Roaring in the cars associated with many diseases and hardness of hearing; hissing, roaring like steam; like a train of cars, many times from mechanical cause and other times from a condition of the nerves.

It is commonly the beginning of a dry catarrh of the middle ear; the remedy is especially useful when, in catarrh of the middle ear and Eustachian tube, the deafness goes on for some time and the hearing returns with a snap, due to the escape of the accumulation of fluids somewhere and described by the patient as a snap or report.

Sudden reports in the ear like a cannon, distant noises with return of hearing.

"Otorrheoa, offensive, watery, curdy, with soreness of inner nose and crusts on upper lip, after abuse of Mercury, with caries."

Caries of bone in any part of the body, but especially of the small bones of the car, nose and mastoid process, "Scabs behind the cars."

Rupture of the drum of the ear.

Catarrhal conditions of the internal car and Eustachian tube, with "feeling of sudden stoppage in the ear, better by gaping or swallowing."

Especially with ear troubles, there will be associated indurated parotid glands.

Nose: Accumulation of hard crusts in the nose, loss of taste and smell epistaxis, thickening of the mucous membrane; most vicious catarrh with discharge of bone from the nose.

Horrible, foetid ozaena, old syphilitic cases where the nasal bones are destroyed and the nose becomes a flabby bag, is sunken in or ulcerated away, leaving an opening. Silica may cure and an artificial nose be made afterwards.

Hepar competes with Silica in syphilitic nasal catarrhs where the parts are phagedenic; Hepar, Merc. cor. and Ars., are the principal antisyphilitics when there is phagedenic ulceration of the nose. Babies suffer from bloody nasal discharge. This is often Calc. sul.

Face: The aspect of the Silica face is silky, anemic, waxy, tired. Pustular and vesicular eruptions spread over the face, the wings of the nose crack, the lips easily fissure; crusts form on the margin between the mucous membrane and the skin; eruptions and crusts, indurations form under the crusts, they peel off and there is no healing.

These indurations are the same kind of inferior tissue that is found under lupus and epithelioma, a low tissue formation, a low state of eczema that favors infiltration. The small blood-vessels that lead to them become thicker and thicker until they become gristly. There is a tendency to make the soft tissues harder and the hard tissues harder.

In childhood the bones become softer and even necrose or there is an inflammation of the periosteum and a consequent necrosis. Caries of the shaft of the long bones, the head of the bones and the cartilaginous portions; abscesses in cartilages, enchondromata.

Bones break down and form fistulous openings. Necrosis of the jaw, the joints, the hip-joint, the tibia, necrosis of the spine, of the vertebrae, so that there is curvature of the spine, lateral especially. The homoeopathic physicians may treat these affections of the bones with the help of accessory contrivances or supports. The Silica patient has rough lips, they crack and peel; rhagades. Scaly appearances at the margins of the lips, fissures in the corners of the mouth that indurate. There is often a line of fissure about the margin of the crust. Little crusts like epithelioma form upon the wings of the nose and when picked off leave a raw surface with no tendency to heal.

Crusty formations upon the ears.

The teeth break down, lose their enamel surface; the dentine is made up largely of the silicate of lime and the surface of the tooth becomes rough, loses its shiny appearance and caries sets in. This often takes place at the margin of the gum; ulcers form on the tip of the fangs. The teeth suffer when it is cold or damp; toothache in wet weather, and the teeth are yellow, decay rapidly, and the gums settle away from. them.

All the neuralgias and toothaches are better in a warm room and from hot drinks. Abscesses about the gums and face, better by warmth. Severe pain in the jaw, rending, tearing at night, better from heat; these pains often end in abscesses about the teeth. Sometimes relieved by pressure unless the part is extremely sore from inflammation.

The tongue takes on inflammation of gouty character; inflammation with threatening abscess, it fills the whole mouth; rending, tearing pains, worse at night and better from heat.

Throat: In the throat and neck we have inflammation and swelling of all the glands, external and internal, all at once or singly. Quinsy with great pain in the tonsils, one or both; threatening suppuration. Inflammation of the parotid, sublingual and much less frequently the submaxillary and cervical glands; painful, tumid and hard, with pain in the neck, shoulders and head, even in acute inflammations. But then we have the opposite state of affairs. In an old chronic case broken down with suffering the symptoms are worse after a bath, he wants warmth, dread the cold, is always shivering. But when in the neck there is an acute inflarnmation the very opposite is present; he suffers from flushes of heat, an irregular, flushing fever, cold extremities while the upper part of the body is hot, sweat about the head and neck, sensation of heat and suffocation in a warm room. This will be present in quinsy and abscesses of the glands of the neck, if acute. Silica here shows its relation to Puls. The latter in its chronic manifestations is overburdened with heat, but in an acute trouble is chilly. They are reversed as to their acute and chronic states. Puls, in the beginning is chilly and sweating. Silica is full of throat symptoms but is seldom indicated in acute forms because its pace is too low; it comes on after there has been a series of colds, such colds as are ameliorated a number of times by Bell. or other acute remedies but still continue to settle in the tonsils and in the glands of the neck.

Silica breaks up the tendency. There is a catarrhal state in the throat that is roused up by every cold into an increased flux, with hoarseness, settling back into the chronic state again; chronic catarrhs of the pharynx. It competes with Natrum mur. in inveterate sore throat.

Stomach: Silica disturbs the stomach, causes hiccough, nausea and vomiting disturbs the liver. All these symptoms are connected and are hard to separate. Decided aversion to warm food, desires cold things, wants his tea moderately cold, he is willing to have his food cold, dislikes warm food. Sometimes there is a decided aversion to meat, but if he does take it, he prefers cold, sliced meat. He likes ice cream, ice water, and feels comfortable when it is in the stomach; it is sometimes impossible for him to drink hot fluids, they cause sweat about the face and head and cause hot flushes. (Bar. c.) Silica is disturbed by the extremes of heat and cold, easily affected, in changes even of a few degrees; he has complaints from being overheated; he gets overheated easily, sweats easily from a slight change in the temperature and comes down with a cold.

Case: A physician waiting on an obstetrical case, had a little difficulty in the last stage and he became overheated; putting on his overcoat and hat he went out on the porch to cool off and was taken down with asthma, violent cough, copious expectoration with gagging and vomiting which lasted him for months.

The acute remedies he had taken only palliated, but a dose of Silica cured him almost as quickly as he was taken down; he could not tolerate a warm room; the acute complaints of Silica are often worse in a warm room and from heat. Silica has an aggravation from milk. Many times the infant is unable to take any kind of milk and, hence, the physician is driven to prescribe all the foods in the market if he does not know the right remedy. Natrum carb. and Silica are both useful when the mother's milk causes diarrhoea and vomiting.

The routinist is likely to give such medicines as Aethusa, entirely forgetting Silica. The latter, as well as Natrum carb., has sour vomiting and sour curds in the stool.

"Aversion the mother's milk and vomiting." "Diarrhea from milk."

Put these two together.

Although the patient has an aversion to hot things and desires to eat cold things, yet in chest complaints cold water, ice cream and cold, things in general, increase the cough to gagging, and then the retching is dreadful; violent, retching, gagging cough. Retching from an endeavor to expectorate is usually controlled by Carbo veg., but Silica his it.

"Water brash, with chilliness, with brown tongue; nausea and vomiting of what is drunk, worse in the morning; water tastes bad; vomits after drinking."

The Silica stomach is weak, in a do-nothing state; old dyspeptics that have been vomiting a long time, especially those who have an, aversion to hot food, who cannot take milk, are averse to meat, where, the mental and bodily symptoms agree.

Silica was one of the greatest remedies for the chronic diarrhoea in the soldiers of our Civil War. It cured a fair percentage of those sick from sleeping on damp ground, eating all sorts of food until the stomach and bowels were prostrated, from long marches, from going into the South from the cold North, from becoming overheated. It is like Sulphur in these symptoms.

Silica has some pain in the stomach and bowels, but there is more soreness to pressure; colic and flatulence and tenderness to pressure; a chronic soreness in the stomach and if it goes on too long, a tubercular state comes on.

Abdomen: Abdominal pain relieved by heat; distension of the bowels with flatulence and rumbling.

Enlarged abdomen in children and adults (Bar. c.); tightness across the abdomen. Disturbed by the pressure of the clothes and worse after eating; the decided feature is the amelioration from heat.

Constipation from inability of the rectum to expel the faeces. It is seldom that the stool lies in the rectum without urging like Alumina; there is much urging to stool but inability to expel. The stool may be in small balls or large and soft or large and hard, but there is much straining and sweating about the head and great suffering while straining; the rectum becomes impacted, he strains until he is weak and exhausted, the stool slips back; and he gives up in despair. The only way he can relieve himself is by some mechanical method. Great straining at stool belongs to many remedies, but especially to Alumina, Alumen, China, Natr. mur., Nux vom., Nux mosch., and Silica.

Silica has removed tape-worm, when the symptoms agree(Calc., Sulf.)

It has also cured fistulous openings. Patients who have a tendency to phthisis are subject to abscesses about the region of the rectum, that break inside or out and form complete or incomplete openings.

These seem to take the place of what would otherwise come, and if healed by operation or other external means, the tendency is to end in chest trouble, either in form of a fixed catarrh or tubercular infiltrations.

Silica is one of the remedies that turns the constitution into order and in one to five years the opening ceases to be necessary and it will heal. Surgeons heal it up at once, and for a time the patient is comfortable, but in a few years he breaks down.

Caust., Berb., Calc. c., Calc. phos., Graph., Sulph., etc., are suitable; in such cases. Silica here follows Thuja well.

Urinary: Suppurative conditions in the urinary tract, catarrh of the mucous membranes; old inveterate catarrh of the bladder with pus and blood in the urine; copious, stringy, deposits in the urine.

Prostatitis, suppuration, thick, fetid pus from the urethra. Gonorrhea, pus, or pus like discharge from the urethra, slight, shreddy discharge, bloody, purulent discharge. It is sometimes thick, or is curdy; this is from any mucous membrane.

Men: Abscesses along the penis, in the perineum, prostate gland, testes.

Chronic inflammation and induration of the testes with much pain; testes feel as if squeezed, sensitive, painful. Hydrocele in boys or adults. In the male, impotence, weakness of the genitals after coition, easily exhausted, lacks power; exhausted if he has coition with anything like ordinary frequency; it takes him a week or ten days to rest up (Agar.).

Much sweating of the genitals with exhaustion, tired out in the spine, weak back. Involuntary discharge of urine at night; enuresis in little boys and girls.

Women: In women a prostrated condition of the sexual functions.

Serous cysts in the vagina, fistulous openings and abscesses about the vulva, which heal with hard nodules or do not heal at all; little oozing fistulae, offensive, cheesy discharge. They heal in little nodules and then break out again in the same nidus. Women who are subject to these abscesses.

Bloody discharge between the periods. In Silica there is very easy flow of blood from the uterus; a hemorrhagic flow comes on before the menses from excitement, and especially when nursing; when the child is put to the breast a flow of blood starts.

Notice the distinction between Calc. and Silica. Calc. has a tendency to flow during lactation, but not when the child is put to the breast. Silica cures hydrosalpinx and pyosalpinx, with copious, watery discharge from the uterus. Sometimes a woman has a lump on one or the other side of the uterus, which steadily increases and all at once there is a flooding of watery, bloody, purulent fluid and the lump disappears, soon to fill up again and empty in the same way in a gushing flow.

Such are the manifestations of hydrosalpinx and pyosalpinx. Entire absence of the menses for months; amenorrhoea.

Serous, cysts in the vagina as large as a pea or an orange, projecting from the vagina or projecting upwards and flattened out in conformation with it. Many little cysts like hickory-nuts grouped together. Rhod. and Silica have cured these even when there is a paucity of other symptoms.

"Leucorrhea, profuse, acrid, corroding, milky, preceded by cutting around the navel, causing biting pain, especially after acrid food; during urination; in gushes; with cancer of the uterus. Hard lumps in the mammÊ."

Threatened abscesses of the breasts. If the remedy is given in time, it will abort the entire trouble. Where the remedy has come too late and suppuration is inevitable, Silica comes in for its share. There may be throbbing, tenderness, and weight, yet the remedy controls the pain, hastens the conclusion, and the opening comes naturally, discharges little and closes at once. As sure as an anodyne is given, a hot poultice applied, you will fail with your remedies. There is too much blood in the part, and the application of a poultice increases the trouble; it causes an increased determination of blood to the part, and if suppuration takes place it causes more breaking down of tissue. Instead of a thimbleful of pus you will have cupfuls for days and half of the gland is destroyed Women who are so weak they tend to abort, or no conception takes place. It would seem if the organs were tired out and unable to perform their functions.

The infant has all sorts of troubles. It grows up sickly; cannot tolerate its mother's milk or indeed any kind of food; vomiting and diarrhoea. A healthy child will digest even unwholesome milk.

Chest: The Silica cough is a dangerous one; the remedy suits the early stage of phthisis, when the lung is not extensively involved; it suits cough of catarrhal character when the symptoms agree.

If there is small abscess in the lung with no tendency to heal, it brings about repair, causes contraction of its walls. Inveterate cases of catarrh of the chest with asthmatic wheezing, overexertion. After violent exertion and overheating, gets in a draft, or takes cold from a bath, becomes chilled.

Humid asthma, coarse rattling, the chest seems filled with mucus, seems as if he would suffocate. Especially the asthma of old sycotics, or in children of sycotic parents. It competes with Nat. sul. in such cases. The patient is pale, waxy, anaemic, with great prostration and thirst. Asthmatic attacks from suppressed gonorrhoea, with liability to develop complaints from overexertion and over-heating, as in most sycotics. Dry, teasing cough with hoarseness, threatening tuberculosis of the larynx, peculiar cracked voice from thickening of the laryngeal mucous membrane or tubercular involvement; soreness of the chest threatening miliary tuberculosis, with aggravation from cold and amelioration from warm drinks.

Pulmonary affections in stone-cutters. The fine dust causes chronic irritation. Silica establishes a suppuration and throws off these particles of stone.

Expectoration profuse, foetid, green, purulent; only during the day viscid, milky, acrid-mucus, at times pale, frothy blood.

Chronic tendency for colds to settle in the chest and bring on asthmatic symptoms. Chronic bronchitis; inflammation of the lungs with suppuration. Silica especially suits the later stages of pneumonia and the old, chronic complaints following pneumonia.

Slow recovery after pneumonia (Lyc., Sulph., Phos., Sil., Calc.). Flushes, rattling in the chest. Flushes in the face during the day (Sulph., Sep., Lach.), rattling like Ant. tart., flushes like Sulph. and Lyc.

Phthisis; thick, yellow, green, foetid sputa, more pronounced coldness than Calc., and head sweat, pains in the lungs, sore lungs, stitches. In the extremities we have inflammation of the periosteum. Corns (Ant. cr., Graph.). Ingrowing toe-nails. Rheumatism of the soles of the feet. Cannot walk (Ant. cr., Med., Ruta, Sil.). Begins to sweat as soon as he falls asleep (Puls., Con.). Epilepsy; aura in the solar plexus creeping into the chest and stomach.

Complementary to Calc., Puls., and Thuja.