The key idea describing Silica patients is that they are YIELDING. It is a kind of shyness or timidity, but not really a cowardice (like Lycopodium or Gelsemium). It is a submissiveness that arises out of a lack of energy to insist upon his or her point of view, even though it may be strongly held; They are quite agreeable and mild, easy to get along with.

Silica patients are intellectuals, but not aggressive or critical like Lachesis; They have highly refined sensibilities, and they are very intelligent. If you try to impose an opinion upon a Silica person, she will not oppose you. She is sensitive to impressions and therefore takes into account your point of view. She understands very well where you are right and where you are wrong but she holds her opinions to herself. Unlike Pulsatilla, she has an opinion of her own, but she does not want to go to the trouble to impress it upon the world.

Thus, Silica appears mild and reserved – but not at all like Staphysagria, Ignatia, or Natrum mur. It is not an isolation. They are capable of freely talking about themselves when circumstances permit, and they make friends easily. They would never become dependent or demanding of the prescriber’s time. For example, suppose you have been treating such a patient for some time without effect. The Silica patient will never challenge you or become impatient. She will not become dependent, like Arsenicum or Phosphorus. Silica does have the mildness of Phosphorus, but not the extroversion or dependency.

Silica patients are tired. They lack stamina, especially concerning mental work. Therefore, they learn to conserve their energies. They apply themselves to essentials, and they don’t argue about irrelevancies – or merely in order to assert their ego.

Silica patients are very delicate, refined and aesthetic, even aristocratic. Consider for a moment what the term “refined” means; when something is refined, the coarse elements are removed from it. This is the case with Silica patients. They are thin, pale, delicate, and highly refined. They are intelligent and perceptive, but not assertive nor aggressive.

The classic Silica children come from elite, highly educated families. They are delicate, and they easily develop curvatures of the spine. Their intelligence is so great, however, that it has pathological consequences. It seems that they become over-stimulated, and then the lack of mental stamina results later in life. Most children, if corrected by their mother, will remember it for a few days and then go back to making the error. Silica children, however, never forget. They understand quickly the reason for the correction, and they impose upon themselves the correct behavior. In a child, this represents excessive mental suppression. Silica children are too serious, too proper.

The overstimulation of mind followed by lack of stamina if the basis for the descriptions in the books of professional who develop and aversion to their work. They feel incapable of performing their functions any more. This can be compared with Calc. carb., which may also have a lack of mental stamina, but this arises more from anxiety and worries. In general, Calcarea patients are more coarse, more survival-oriented. They worry about expenses, about unforeseen possibilities, etc. and they develop defences against these worries. Silica is more refined, delicate and vulnerable.

Just a Silica can be easily imposed upon, or suppressed, mentally, so this can occur on the physical plane. They tend to perspire profusely, especially in the axillae, the back of the neck, and on the feet, and they always do well as long as the perspiration is permitted. Do not be impatient to treat the Silica perspiration. If you succeed by any means in suppressing it, you and the patient will encounter a lot of trouble. If the sweat is suppressed by deodorants, foot powders, boric acid etc. The patient may well develop tuberculosis, cancer, kidney disease, or other serious disease. Suppression of sweat by medication, of course, presents the most serious problems, but even evaporation can have similar effect – albeit less deep. If a perspiring Silica patient is exposed to a draft ht? which evaporates the sweat, he may develop a headache or arthritic pains. The perspiration itself is highly characteristic in Silica. It is both offensive and acrid. The offensiveness is quite strong. The patient may was his feet three times a day to no avail. The odour arises from the discharge of toxins – like Psorinum, but not nearly so severe; it is impossible to even remain in the same room with a Psorinum patient. Sulphur, of course, is famous for offensive perspiration, but this arises from inadequate washing. Sulphur patients, lost in their minds, wash only in spots and not very thoroughly – a symptom which, of course, is difficult to elicit except by direct (and diplomatic) questioning.

The Silica foot sweat is also acrid. This is not a merely irritating perspiration; it actually chews up socks. If a normal person uses up a pair of socks every two years, the Silica patient uses them up within three months.

Considering the reserved, submissive mental state of Silica patients, it is not surprising that they develop tumours of all kinds – fibromas, breast, cysts, swollen glands, warts etc. These tumours are usually hard, (like Calc. fluor, and Baryta mur). They even develop keloids, like Graphites. Fissures are another common skin complaint. The nails are brittle, and most characteristically, they have many white spots on the nails.

Of course, Silica is famous for opening up deep abscesses, and curing patients who have a tendency to suppurations. This is true when it fits the patient as a whole. Because Silica is a very deep acting remedy, it is risky practice to routinely prescribe it whenever an abscess needs opening. In patients with suppurative tendencies, Silica may help in the moment, even when it does not fit the patient as a whole. What effect will it have for the suppurations which will develop later – which may well be rendered more deep and more resistant to treatment?

The submissiveness of Silica displays itself characteristically in regard to its well-known constipation. The stool is hard, and the rectal muscles are inactive. There is great straining, but the stool slips back inside, and the patient gives up. The books appropriately, call it “bashful stool”.

Considering the food tendencies Silica has an aversion to salt, meat, and milk. There is an intolerance to both fat and milk. I have also observed that Silica can have a desire for eggs (like Calc. carb. and Pulsatilla).

If you encounter a patient with very little mental or emotional symptomatology it can be somewhat difficult to differentiate Silica from Nitric acid. Both tend to be thin and chilly. Both have acrid perspiration. Both have tumours, warts and fissures. Both have while spots on the nails. On purely physical symptomatology, the key differentials are salt and fat. Nitric acid desires fat and salt, whereas silica s avers to salt and intolerant to fat. Of course, usually the emotional symptoms make the differentiation unmistakable.

Nitric acid is very anxious, dependent, and demanding. Silica on the other hand, is more considerate, patient, and yielding.

Silica feels the cold strongly, but one must also remember that, during acute ailments, Silica can also be intolerant to warm stuffy rooms – like Pulsatilla. Conversely, Silica can be aggravated by drafts, even though he or she may not feel the draft particularly. This is in contrast to Kali carb., which feels the draught but is not much aggravate by it. Sometimes, Silica is ameliorated when the weather turns to dry cold.

It is very interesting that Silica, like Calcarea is aggravated during full moon. It seems that patients which are lacking in elements which are prevalent in the earth – and probably the moon as well – are affected by moon phases.

Silica patients have a peculiar relationship to pins. They do not volunteer this fact, but you can elicit through questioning that they have a fear of pins and of pointed things. This can occasionally be useful confirmatory symptom; Another peculiar Silica symptom is the sensation of a hair on the tongue – like Kali bich.

Silica patients do not usually develop severe pathology on the emotional or mental planes, in my experience. They mostly complain of a lack of mental stamina. Sometimes they may develop fixed ideas, which is not surprising in view of the formation of hard tumours. They have absolute prejudices which they simply cannot alter; i.e. “Sex is sinful under any circumstances”. It is as if a small portion of the brain has become sclerosed, causing a loss of flexibility in thinking in regard to specific concepts.