…proved to be a first choice remedy for a young woman presenting with various symptoms including enlarged glands and blisters, explains Roger Neville-Smith

I saw Susan, who was 18 years old, at the request of her GP because she had not been well for the preceding four years. Before this she had suffered a glandular fever type of illness. The GP had already referred her to an endocrinologist where the investigations found no abnormality and she had been prescribed antidepressants (but stopped them after two months). She was complaining of sore throats, recurring blisters on her lips, throat and inside her cheeks, as well as persistently enlarged glands in the neck.

Susan attended with her mum who was a warm, rounded person; the daughter, in comparison, was slight, with lean features, blond haired, being rather timid but attentive. She told me that she was tired all the time, felt withdrawn, tended to make mistakes when talking, had difficulty getting up in the mornings and was missing school. Her appetite was reduced and she had lost some weight. At night she would wake with hot sweats and complained of vivid dreams. She agreed that any stress worsened her symptoms. She also suffered from indigestion with bloating and burping.

In her early life she had been a forceps birth and when aged four years old had been disturbed by a house move. She appeared to have settled well after this until getting ill a few years ago. Other than the acute infection mentioned above there did not appear to be any other stress factor, which had made her ill.

She had a certain ambivalence to friends and company. She enjoyed gymnastics and disco dancing as well as club activities. She is sociable but never makes the first move. She enjoys her friends and is better when she is in their company.

However at school she pushes herself hard, is desperately conscientious, serious and sensitive. She feels insecure and needs to feel in control. She hates doing presentations. Although she is sympathetic to others in trouble she is shy and reserved about her problems.

She had two specific fears; firstly of being trapped and drowned and secondly of needles, loathing immunisations. She told me that as a child her brother had held her under water in the swimming pool so, I think, this is not a surprising fear. Not many patients claim to like needles and injections but her fear seemed to be extreme.

She was a chilly individual with very cold feet. Recently she had started needing fresh air, which is a change for her. She has a variable appetite with changing fads and fancies, recently loving curries. She dislikes ice cream and coffee and is quite thirsty, drinking two litres daily.

I wondered about a number of medicines including Calc carb because of her persistently enlarged glands, withdrawn nature, hard work, and infections. I considered Tuberculinum because of her recurring infections, desire for fresh air and night sweats.

However, I chose Silicea based on her lean figure, porcelain-like skin, recurring infections, enlarged glands, sweatiness as well as her temperament; lack of confidence, conscientiousness, anxiety when presenting things in class, and fear of needles. A funny selection of features, you might think, but I thought she matches the drug picture well. I prescribed Silicea 200c one tablet daily for three days.

I next saw her seven weeks later. In most respects she made improvement over the first two weeks, which was sustained until about two weeks before this appointment. Sadly her sweats, indigestion, sleep and tiredness had all got worse again. Her mum attended again with her and agreed that she had been significantly better. I was encouraged that she had responded to the Silicea so repeated exactly the same prescription. I asked her to repeat this as and when she felt it was needed.

I did not see her for another 14 weeks but she had continued to make good progress. This time she attended without her mother. I hoped this was a measure of her increased energy and self-confidence. She declared that her energy was nearly 90 per cent of her previous level, her sleep was now refreshing. She had no digestive problems; she looked well and had started a job. She said that she had taken Silicea on three occasions and quite quickly she felt improvement. I suggested that she continue the same plan.

I did not see her again so wrote to check on progress after another six months. She had been well but continued to take occasional Silicea if she felt the need.

In summary, this girl who has always been nervous and conscientious, particularly with her schoolwork became ill following a significant acute infection, probably glandular fever. It seems that her inner vitality was reduced so much that she could not get properly better even over about four years. In this case a mixture of her local pathological symptoms and her emotional features lead me to the medicine. Some of the reactions, for example recurring infections and enlarged glands, are shared by many other medicines; other features such as fear of sharp objects is not shared by so many.

This time my first choice did well. This good result from a first choice is not always the case and sometimes the main features of the illness change as time proceeds leading me ultimately to a more successful prescription.

The remedy
Silicea (silica dioxide) is a mineral from which much of the Earth is made, the source in homeopathy being pure flint and, so far as I am aware, it is not used in other systems of medicine. Not only is it found throughout the Earth’s crust, it is also found in many sea creatures and most plants. Indeed it is the silica in the stem of straw that makes it rigid.

The materia medica for Silica is very long so I will only mention a few interesting features which are characteristic. They tend to be mentally indecisive, “lacking grit”, dreading failure. Useful when suffering from mental exhaustion from studying, referred to in some books as “brain fag”. The face can have a silky, anaemic, waxy and tired appearance, rather like porcelain.

Specific actions attributed to Silicea include helping excess foot sweat, clearing abscesses, which are slow to discharge. The constipation described is that which requires much straining and if the movement is not successful it will return inside the anus, described in some books as the “bashful stool”. Patients do not need all the features of the remedy to have a successful prescription but a number of keynotes may be enough to indicate this.

Dr Roger Neville-Smith MB ChB DRCOG MFHom works part time in general practice in Saltburn where he prescribes homeopathic medicines when appropriate. He has an NHS clinic running two sessions per month locally and undertakes some private work. Currently he is the convener of the Members’ Committee of the Faculty of Homeopathy and sits on the Faculty Council.