Here is a printout of the main symptoms and which remedies cover most of the symptoms.

Symptoms are listed on the left and remedies at the top. The number corresponding to "total" represents the total point value of the remedy in covering all of the symptoms in the case. The numbers on the "rubrics" line indicate how many of the specific symptoms (rubrics) in the case were covered by the remedy.

If you know about homeopathic remedies, you can now study the case, then turn to page ____.

This case appeared quite straightforward from a homeopathic point of view. Here was a thin, shy, reserved, delicate woman with a chief complaint of headaches due to an excessively demand- ing study schedule and accompanied by lapses of memory. In the homeopathic literature, there is a term, "brain fag", which perfectly describes these symptoms as well as the personality of this patient. That remedy is Silica, sometimes called Silicea, and is made from the mineral, silica (flint). It is a wonderful and far-reaching remedy with many applications. In this case, it applied beautifully to the reserved, reticent nature of the patient, the headaches (one of the most common complaints of a patient needing Silica), and to the marked state of mental debility due to overexertion of the mind. Confirmatory symptoms for Silica in this case were the consti-pation, glandular swelling and history of otitis and tonsillitis, chilliness, general sensitivity, self-doubt, and her reluctance to speak up for her ideas unless it was really important, even though she did have strong ideas about things.

Looking at the MacRepertory analysis, you might ask, "Silica only came up fourth, after Belladonna, Lachesis, and Sanguinaria. Why did you give it?" The analysis helps us as homeo-paths to see which symptoms are covered by which remedies. Then, it is up to us to evaluate which remedy to choose. As for Belladonna, it is more common to have a right-sided, throbbing headache, although she did have the characteristic Belladonna aggravation from noise and pre-ferred to rest in a cool, dark place with the headache. Her reserved, shy nature did not go along with the constitutional picture of Belladonna, which is plethoric, easily angered, hot, and often has hormonal symptoms. The Lachesis type headache is often experienced in the morning on waking or before the menses, relieved at the moment of onset, and is most commonly left-sided. She also lacked the common Lachesis symptoms of jealousy, hypertension, fear of snakes, and dislike of tight clothing around the neck. The Bryonia type headache is usually much worse from motion, which was true in this case, and accompanied by irritability, which was not. So, even though Silica was the third or fourth remedy of choice according to the analysis (Sanguinaria

is listed before Silica because of alphabetization but actually rates lower), it was the remedy which best fit the case.

R.M. was given Silica 30c once daily. When she returned a month later, she complained of no eyestrain headaches, but had a couple of her type l headaches because her doctoral dissertation proposal deadline was approaching and she was beginning to panic. Her mind seemed to be less dull and, overall, she was beginning to feel more energetic. It was difficult to know at the time how effectively the remedy had acted. We knew Silica to be a relatively slow-acting remedy and decided to continue the Silica and see the patient again in a month. At that time she reported that her energy was continuing to improve even though the academic pressure had not let up. She continued the Silica for another month, then stopped. Two months after stopping the remedy, she was not having a problem with the headaches and described herself as more energetic and relaxed, despite having a dental crown put in and being exposed to camphor, both of which often antidote homeopathic remedies. Silica acted in this case just as we expected it would. It is likely that she will need a single dose of Silica 200c to prolong the effect of the remedy and we have instructed her to let us know if her headaches return. She is quite pleased that she can pursue her demanding academic schedule without being drained by headaches and mental exhaustion.