[Written by Dr. von Boenninghausen about two months before his death, and sent to Dr. Mouremann's of Brussels, for L' Homoeopathe Belge; translated from Revista Omiopatica.]

By Dr. C. Von Boenninghausen.

The partisans of Allopathy no longer deny that Homoeopathy, when practised by skillful and conscientious men, may afford great help in the commonest sufferings and affections which resist allopathic treatment.

This is a fact which we have occasion to verify most frequently, and in a most astonishing way, in the treatment of those diseases which, in spite of their variety and their differences, are comprised under one single general denomination - a denomination, too, which savors more of catachresis than of science.

In the first rank of these affections we place toothache, the treatment of which so often affords to the Homoeopathicians an opportunity to demonstrate the superiority of their doctrine, over Allopathy. This affection, one of the most painful and at the same time most frequent of maladies very rarely yields to the ordinary medical treatment.

A sufferer with toothache applies to an Allopathist; the latter tries to relieve him - now with Opium, now with Kreasote, now with chloroform, now with other heroic remedies which generally fail to produce any curative effect. Often indeed the physician, before proceeding to any treatment, imagines that he perceives it to be necessary to extract the tooth. Wherefore, to avoid this torture, the patient recurs to every variety of more or less absurd domestic remedies, or to secret remedies proclaimed infallible by force of advertisement. He finishes by seeing that it is all useless trouble and that he has thrown his money away. The pains increase; they have reached their culminating point and become insupportable. The execution of the criminal tooth is decreed. A skilful hand accomplishes the task with all possible dexterity. If all goes well, the pain ceases (but this does not always happen) and the unhappy one is freed for the moment from his scourge. But he is far from being radically cured; for the mechanical operation can never destroy the true internal cause of the malady, which will reappear sooner or later with increased violence. It is not a rare thing, moreover, for matters to assume, from the very beginning, a much more unfavorable aspect; as a sequel of the extraction of the teeth the pains augment; with them become conjoined pains of a neuralgic character; the irreparable loss of one tooth involves that of several others; and then comes the recourse to artificial teeth, a most insufficient and impotent equivalent for the natural apparatus.

The result is different when the patient, from the first, seeks the aid of a Homoeopathician. If the malady is of recent date and origin, the simple olfaction of a remedy which corresponds exactly to the totality of the symptoms is often sufficient to cause the cessation of the pains.

This effect manifests itself the more rapidly (often in a few minutes) the more care has been taken to use the remedy in none except the highest potencies. If the toothache is of longer standing or has been treated with palliative remedies which have served only to make it obstinate, the cure will not be so rapid. But it will not be, on that account, the less certain. It will be also radical and enduring, to this extent, that the toothache will not recur with the same character. Moreover, and this is most important, the treatment does not involve other inconveniences; the diseased tooth is not sacrificed; no neighboring tooth becomes hollow or carious; no dental fistulae form; in fine, the treatment never induces any of those long maladies which constitute the martyrdom of certain patients. On the contrary, with the removal of the toothache are put to flight, radically and forever, the affections and the pains which had engrafted themselves on the diseases of the teeth, such as diseases of the eyes, of the ears, and of the head; pains of the face (often very terrible), pains of the throat, fevers, etc. Health becomes re-established and florid, as in the patient's best days.

Every Homoeopathician knows this; in countries over which Homoeopathy has succeeded in diffusing its blessings, all those who have suffered from toothache know it. If, from lack of experience or because they follow the fashion, they have recourse to Allopathy for the cure of other diseases, the treatment of toothache they always entrust to Homoeopathy, knowing well the happy result they may expect from it.

These considerations, based on facts well known and confirmed everywhere and every day, may convince every Homoeopathician, that among the more common diseases, there is none more fitted to cause Homoeopathy to be appreciated by the public, than toothache. Although the merits of our method have already been fully established in many other diseases, often of the most dangerous character, (nervous fevers, cholera, croup, scarlatina, whooping cough, etc.,) these rarely present themselves in a sufficiently great number to enable the public to intelligibly judge the two modes of cure, and to form a conclusion founded on results, astonishing, rapid and impossible to be denied. It is not the same with toothache; the opportunity of curing it is presented every day, and the patients, once cured, never fail to repeat, to their similarly afflicted friends, the story of their sufferings and of their cure.

Every Homoeopathician who understands his own interests seeks to obtain, in the treatment of toothache, those results which our doctrine authorizes him to expect. But it seems to us that this alone is not enough; there is something more which should cause all those who would contribute to the ever-increasing prosperity of our fair science, to attach a special importance to this part of our curative method. We believe, therefore, that we are fulfilling a duty in submitting to the enlightened consideration of our colleagues, some advice on the subject the fruit of a great many years of practice.

1st. The totality of the characteristics of the remedy ought to correspond as completely as possible to the totality of the characteristics of the malady, and of those of the patient. This is a principle of which it is needless to remind the majority of Homoeopathicians, but which, nevertheless, it is always well to repeat and to place at the very beginning of these remarks, inasmuch as it constitutes the first condition of a proper selection of the remedy for each particular case. In this connection, the various symptoms of the pains in the teeth are rarely important, unless they impart to the totality of the symptoms that determinate character which Hahnemann designated by the words, characteristic, strange and extraordinary. [Organon] Among the number of these characteristic symptoms, are to be enumerated, for example, the sensations of fracture, (Ignatia, Natrum mur.), as if polished, (Phosphorus, Selenium, Sulph. acid,) of paralysis, (Sulphur,) as of a current of air, (Natrum carb.,) of sponginess, (Causticum,) of tension of the nerves, (Colocynth, Pulsatilla,) of softening, (Causticum, Mercury, Nitric acid, Nux mosch.,) of stiffening, (Rhus,) of insensibility, (China,) and others.

Nevertheless, these symptoms ought not to be taken into consideration to the exclusion of all the others, because these symptoms observed and verified in other organs and in other parts of the body, indicate still other remedies.

These latter remedies, therefore, possess the faculty of producing the symptoms in question, and consequently, they should not be excluded, even although the symptoms have not been hitherto classified under the title of pathogenetic symptoms, among the pains of the teeth.

As regards the more common morbid sensations which are experienced in the teeth, they possess, as a general rule, but very little importance when the question concerns the more certain selection of the remedy. They are common to many remedies, and scarcely ever deserve to be denominated characteristic symptoms. This inconvenience is not the only one; few persons are capable of describing, in proper words, their subjective sensations. The same difficulty has undoubtedly been experienced by all those who have proved remedies upon themselves and who have sought to express, in writing, the results of their provings. The experimentor who is much more experienced in this respect than the patient is likely to be, finds himself often much embarrassed when he desires to give an exact description of a sensation which he has himself experienced. This is the reason why the larger portion of the terms in which the pathogenetic symptoms are expressed, are borrowed from mechanico-physical phenomena, and may be reduced to the words, pressing, tearing, stitching, pricking, stretching and their compounds. When they are applied to sensations alone, it is extremely difficult to attach to them a clear and precise idea. The patient moreover, adheres obstinately to the word “pain,” declaring that it is impossible for him to designate with greater precision, the kind of suffering which he is experiencing.

Several of our proved remedies and even some of those which have been diligently proved in all their peculiarities, are wanting in symptoms relating to pains in the teeth. We mention, in this connection, only Asafetida, Chamomilla, Cicuta vir., Digitalis, Dulcamara, Ledum, Moschus, Opium and Valerian. And yet our literature contains notices of cures of toothache effected by Asafetida, by Cicuta vir., by Dulcamara, by Opium and by Valerian. [We may add Coffea. (See American Homoeopathic Review, Vol. V, pp. 164-214.) D.] Among the five-hundred-and-forty-one symptoms attributed in the third edition of the Materia Medica Pura (Vol. I.) to Aconitum nap., that perfectly proved and variously used antiphlogistic, there are enumerated only two true symptoms of toothache. [114. Stitching pain in several teeth, after thirty-six hours. Wahle. 115. Pressing toothache in the left upper jaw. Wahle.]

Dr. Wahle, senior, published them, but no other author has confirmed them; and moreover, they are couched in terms so general, that it is absolutely impossible to make a special use of them. Nevertheless the clinical experience of Ruckert (1.449) and the supplement published by Oehme (204) mention several cures of toothache obtained by the use of this remedy, while, among us, it has never been used, and its efficacy has not been confirmed. It is probable that other Homoeopathicians, have effected, like myself, the cure of toothache by the administration of Dulcamara, of Ledum, and of Valerian, when the symptoms derived from the history of the case, and likewise the actual symptoms, indicated, exclusively, one of these remedies.

We see, then, that the symptoms of the pain in the teeth, such as they are presented in our Materia Medica Pura, are not of themselves, alone, sufficient to give us complete information touching the appropriateness and the efficacy of a remedy.

It is equally clear that they greatly deceive themselves, who pretend that, to conduct a homoeopathic treatment, it is enough to confine ourselves to mere mechanical researches, among the list of the symptoms.

2nd. From what has preceded, the second head of advice naturally follows. It comprehends the facts which, independently of the characteristics common to the remedy and the disease, ought to be recognized with clearness and precision, when the question concerns the cure of toothache. These facts may, it seems to me, be classified under the following three rubrics:

a. Aggravations according to time and circumstance.

b. Ameliorations according to time and circumstance.

c. Concomitant symptoms.

The restricted space at my disposal, does not permit me to develop these three points, important as they are. Nevertheless, I shall manage to say, at least, what is necessary to indicate their great value.

a. We may reasonably wonder that Hippocrates, the founder of the science of medicine, while he attached so much importance to the days called critical, should not have thought of the different periods of the day at which diseases are aggravated or ameliorated and that he should have tacitly denied the influence which phenomena, often very precise and characteristic, exert on the treatment of diseases. Without doubt the aggravation and the diminution in the violence of maladies were manifested at different periods of the day then, and in the same manner, as at present, inasmuch as these facts are evidently founded upon nature, which has not suddenly changed since those very ancient times. If the father of medicine, just like our contemporaries, the Allopathists, was unable to draw, from observations of this kind, indications generally useful in the happy selection of a remedy, the same was likewise true of the critical days; the one might, as well as the other, have been made useful for the purposes of prognostics. This omission in the Hippocratic works is very sensibly felt especially by us; the successors of the physician of Cos have not succeeded in supplying it satisfactorily, although they have expended great efforts in discussing, in all its particulars, another question, that of the pulse, concerning which, likewise, not a word is said in the authentic works of Hippocrates, and which has for us only a secondary importance. Hahnemann himself, when making his first provings of medicines upon the healthy subject, seems not to have attached particular importance to the period of the day in which the symptoms appear, or are aggravated; indeed he does not mention it. The experiments which he made subsequently have, in part, supplied this omission. They are in this regard much more complete and more useful than the first. Instead of purifying (as some are pleased to speak of doing) the Materia Medica Pura, it would be much better worthwhile to complete and perfect it before eliminating a few symptoms which are, for the most part, useless or superfluous and which proclaim themselves to be erroneous or doubtful.

The same is to be said concerning the aggravation of the sufferings by external circumstances. This important branch of the homoeopathic doctrine has been hitherto almost always neglected. Allopathy, likewise, has for the most part neglected it, up to the present day. It is, in truth, very rarely that, in reading ancient or modem works written by non-Homoeopathicians we meet positive indications under this head and when, as an exception, we encounter an isolated indication, the quantity and the diversity of the compound remedies hardly ever permit us to derive from it any instruction. It is not to be denied, meanwhile, that this individual character of the medicaments and of the diseases ought to be taken into consideration much more frequently than the symptoms gathered at all the different periods of the day. It has been our ignorance of these facts that rendered the certain cure of the various forms of toothaches as impossible to us as it is, at this very day, to Allopathy. Placing a just value on the necessity of possessing these items of knowledge, Homoeopathy has set herself to the task of completing, more and more fully, that which remained incomplete, and of verifying, by means of facts, all the doubtful, uncertain or contradictory symptoms; she will never select the remedy at hap hazard; but will always depend upon the experiments which have demonstrated its value. Our Materia Medica Pura has, in this way, received a considerable augmentation and the instructed Homoeopathician of the present day, is in a position to prescribe the efficacious remedy for a majority of cases of toothache.

The object which I have in view and the limits to which I am restricted, do not allow me to enter into all particulars and to make, of this little essay, a complete treatise. I will merely observe, that the larger part of the conditions and of the circumstances which provoke or which aggravate all kinds of pain in other organs, or in other parts of the body, find their application equally here also, and that some among them refer exclusively to pains in the teeth.

Among the latter may be enumerated especially those sensations which are provoked by taking warm or cold food or drinks; coffee, tea, wine; by eating fruit, bread, sugar, sweet, salt or sour food; by using tobacco; by biting, chewing, respiring; by opening, closing or moving the mouth; by rubbing, picking or sucking the teeth; by touching them with the tongue; by speaking, etc. All these circumstances have revealed an aggravating or an ameliorating influence, in a greater or less number of remedies. These points ought all to be consulted, until we shall have succeeded in uniting, a well as possible, all the symptoms that are present in one single remedy, which will then be the remedy of which we are in search, unless indeed the point which we considered, under rubric 3, should absolutely oppose it.

b. As regards the ameliorations, according to time and circumstance, it suffices to mention that their examination serves solely to complete and to verify the preceding researches. Such investigations have the most intimate relations with those of which we have treated; and, moreover, it has been equally neglected by Allopathy, and is of the highest importance to the homoeopathic doctrine.

c. The concomitant symptoms constitute a tolerably independent part of this second head, although already somewhat comprehended in the first.

Homoeopathicians understand, by concomitant sufferings, those which, independently of the general character of the disease and of the patient, accompany the pains in the teeth, or alternate with them. These concomitant sufferings may, on the one hand, extend throughout the entire series of symptoms provoked by the medicine, from the moral symptoms even to the febrile; they serve, in like manner, as a complement of the common symptoms which were the subject of consideration under the first head. On the other hand, although they may be peculiar to many other remedies, they seem to show a very especial tendency to associate themselves with pains of the teeth; it might be said that they spring from the same origin. Such are those which are manifested in the proximity of the painful teeth; notably in the various parts of the head and of the face, in the jaw, in the malar bones, in the nose, in the eyes, in the ears, in the temples, in the cheeks, in the cavity of the mouth, and in the neck. Although many affections of this kind are observed in other diseases, there are certainly some which seem to accompany by preference the affections of the teeth, and these present consequently an almost special importance, although they do not of necessity absolutely exclude the others.

I will limit myself to these brief observations, in order to occupy myself with two cases which do not often present themselves, but which yet may sometimes be met with. First, there are symptoms in our Materia Medica Pura which do not offer a complete simile to the pains of the teeth, and do not contain a sufficient characteristic to correspond with the concomitant symptoms; then again there are others which present the desired conditions, but the remedies which seemed to correspond have been administered without any effect.

In the former case, the defects should rarely be attributed to the insufficiency of our experimentations. The difficulty springs, most frequently, from the empirical use, not only of allopathic remedies, and of secret nostrums recommended as infallible in popular books and in the journals, but even also of homoeopathic remedies prescribed by dilettanti, whose impatience has driven them to experiment with several remedies successively, and at short intervals. There results from this procedure a sort of monstrous affection, compounded of the natural disease and of a medicinal disease; an abnormal totality, in the midst of which one can neither find a convenient starting point, nor form of it an intelligent image. Help is not then possible, except on condition of having recourse to the preliminary rational use of antidotes of short action, by means of which to reconduct the entire malady to its natural and primitive state. When this end has been attained, we may select and employ, with confidence and efficacy, the remedy which corresponds to the case.

Sometimes the failure of a well selected remedy is due to a chronic miasm, which pervades the whole organism. This is observed equally in other diseases. In such a case we shall never attain our object, at least with certainty, unless we first administer a suitable anti-miasmatic (sit venia verbo), and then afterwards give the remedy which may be homeopathically indicated. This will infallibly act, often indeed in a very few hours, if the dose is small and sufficiently dynamized. For the rest I propose to return, in discussing the fourth head, to this point, so often neglected and even disputed.

3. According to what we have stated, Homoeopathy satisfies the first and third of the duties which Celsus imposes upon the good physician, when he says (III. 4): “Asclepiades Officium esse medici dicit, ut tuto, ut celeriter, ut jucunde curet;” it cures with certainty, and avoids the opposite of jucunde, while Allopathy is guilty of this, every day, in her manual operations. The duty remains of curing quickly (celeriter), of putting to flight as quickly as possible the pains in the teeth, which are often violent in the extreme. But it would be to involve oneself in a vexatious contradiction with the duty of curing safely (tuto), if one should understand by a rapid cure the alleviation of the pains by the use of palliatives. Our adversaries understand it in that sense, when they use opium, chloroform, etc.; but this treatment has for its inevitable consequence the reproductions of the pains, the exacerbation of the evil, and, most frequently, affections still more serious. The signification of the saying of Celsus is simply that the existing malady ought to be completely cured in the shortest possible time; but, on condition that there result therefrom no immediate or future injury.

According to my own views there cannot here be any other question, except that respecting the size of the dose of that remedy which has been recognized as the only appropriate one. This dose ought to be sufficiently strong to cure the malady, and weak and innocuous enough to insure that the cure be not uselessly protracted, or that no damage is occasioned by the excess of the medicinal force.

The third head, which has this important fact for its object, cannot be discovered and confirmed except by experience, that is, by the results of very numerous experiments, comparative in their nature, and decisive as regards their effect. Deductions and presumptions, or suppositions, ought to be rigorously eliminated.

At the present day it can no longer be denied that the most skillful and experienced physicians of all countries, when they have made these comparative experiments uninterruptedly and with prudence, have pronounced almost unanimously for the high and the highest dynamizations in the smallest dose. And in this indeed they do but follow the example which the brave and learned founder of our school gave them in the last years of his long and noble career.

America pursues the path of progress, especially in the matter of questions of experience. In fact, she has outstripped in this regard the venerable Europe which continues to advance with tardy footsteps. Already in the month of November, 1856, Dr. B. Fincke, of Brooklyn, in the State of New York, a practitioner of honorable fame, communicated to me a series of thirty-eight magnificent cures, which he had achieved by means of the high and highest potencies prepared by himself. C. Hering, A. Lippe, Carroll Dunham and others, who justly rank among the illustrious of our school in America, have verified similar happy results, and have removed all doubts which might have been entertained of the superiority of the high potencies over the low. Dr. Fincke has gone still farther in the Am. Hom. Rev., Dec. 1860, pp. 561, et seq., he has unfolded a new plan for preparing the high potencies, and he designates the product by the name of contact-potencies. He obtains them by succussing a quantity of dry globules, non-medicated, with a small number of dry medicated globules: the medicinal force of these latter is communicated permanently to the non-medicated globules. This method, as the author himself has taken care to observe, differs a little from that of Korsakoff (long ago forgotten). We read in the same work an account of nine excellent cures, obtained by means of these contact-potencies. The article ends with a series of twenty-two conclusions and observations, which are worthy of being received and discussed, and a short resume intended to give a clear view of the various advantages of the high and the highest potencies.

4. In the conclusion of the second head, I said a few words about the hurtful influence which a chronic miasm, penetrating and dominating the organism, may exercise upon the action of remedies, which are otherwise homoeopathically indicated. This case presents itself most frequently when an amelioration occurs which proves not to be permanent, and which, therefore, resembles the result of a palliative. We may, in such a case, be sure that we have to do with a chronic miasm, and which must be cured, if we desire to radically and permanently remove the actual malady.

In many cases of this kind, I may even say in the great majority, we may obtain a radical cure of the toothache, by giving the patient, immediately after the cessation of the pain, one or more doses of the antimiasmatic indicated. It is the same with many other diseases of which we cannot ignore the chronic, and, at the same time, miasmatic nature. Hahnemann employed this precautionary measure in the latest years of his life, whenever he had the least suspicion of the chronic nature of the malady, whether from a knowledge of an antecedent contagion, or from the fact that the sufferings and the morbid condition were extraordinarily protracted. This precaution almost always gave him the advantage of being able to add to the maxim of Celsus the idea of permanence, (stabiliter perdiu), which was always satisfactory to the patients.

In several other maladies, common enough, the remedies that are otherwise homoeopathically indicated bring no amelioration, but leave the disease, as it were, untouched. This fact affords the most certain proof that the organization is dominated by a chronic miasm to such a degree that the latter successfully opposes every foreign individual action. We should here, without delay, make use of the various antimiasmatic remedies. I will allow myself to add some further observations on the signs of the one or the other miasm, observations which are, in great part, the fruit of my own experience.

It is not, indeed, possible to construct, with a few salient strokes, a satisfactory, characteristic picture of the “innumerable varieties of pains in the teeth, and of their various causes ”(Chronic Diseases, I. 73), which have struck their roots in a psoric soil. This miasm, from its long existence in the most varied conditions, has acquired, much more than all the other miasms, a true Protean nature; almost everywhere, and under every form, it has passed the limits of every state of normal health. It is necessary, then, independently of the anamnesis of the exanthemata, to classify under this head all those diseases of the teeth, with their concomitant symptoms, which, although they may be chronic, do not present the character of one of the two following miasms.

The syphilitic toothaches occur, no doubt, less frequently. Those which we encounter, far from being pure, are almost always complicated with the mercurial disease. They may be recognized by the fact that it is the roots of the teeth which are the first and principal seat of suffering; from the swelling and ulceration of the gums, from the enlargement of the tongue, from the salivation and from the offensive breath, and finally from the fact that these pains break out with greater violence at night.

Independently of the use of Mercury for purely syphilitic toothache, it will be proper, according to the existing symptoms, to administer the corresponding antidote, because the patients have, as a general rule, abused Mercury, and the malady is, often enough, complicated with psora and sycosis.

Toothaches of a sycotic nature are the most frequent. Since the discovery of the great resemblance, rather, indeed, the identity of sycosis and variola, we have been able to recognize the enormous diffusion of this miasm; for inoculation has spread it wherever this procedure has been practised. The characteristics of toothache of a sycotic nature, in so far as I have been able to determine them, comprehend the following signs: the teeth begin to become carious, and to decay on the middle, so that the consequent cavity starts, not from the crown but from the side, immediately above the gum. After that the destruction extends in the direction of the root, which decays and crumbles, and then reascends towards the crown, which breaks and falls into little pieces, while the surface of the tooth is entirely unaffected. The teeth become by degrees yellow and black, get loose in their sockets, and are very sensitive when the patient bites, or when he masticates or drinks cold solids liquids. These signs are often accompanied by ulcers of a whitish blue color, which are seen upon the gums, on the inside of the lips, and in the angles of the mouth, without, however, containing true pus. Up to the present time the first and chief remedy for pains and diseases of this character is Thuja occidentalis. There are various reasons for supposing that the mineral kingdom (perhaps also the animal kingdom) will one day furnish us a remedy still more energetic than those which we oppose to the two other miasms. The Thuja alone will be as insufficient against this miasm, as Sulphur or Mercury against those. Therefore, to obtain more complete and permanent success, it is necessary to resort, besides, to Apis mel. Calc. Caust. Lach. Lyc. Mezer. Nitr. ac. Rhus. Selen. Sep. Sil. or Staph.; all of them remedies which have sycotic symptoms, and among which we must choose, according to the similarity of the symptoms.

From the preceding observations it will appear that we are in a position to afford the rapid, safe, convenient and enduring aid which is justly to be looked for in every variety of pains and disease of the teeth, aid which it is entirely out of the power of Allopathy to afford. Wherefore we have the greater reason to keep in great honor the conquest that we have made, and to combine all our efforts to cultivate and complete this important branch of our beneficent science. Experience will be our guide; and the precious treasure that we have collected will afford us numerous opportunities to demonstrate the value of this especial advantage, and, at the same time, the excellence of our science of Homoeopathy.