§ 166. E. Rkeumatismus cephalicus and rheumatic odontalgia.

The pain is chiefly seated in the temporal, occipital or facial muscles, or in the aponeurosis, generally on one side of the head only; it is tearing, and follows the course of the muscle. The disease sometimes invades the nose (as a catarrhal affection), the conjunctiva (frequently increasing to rheumatic ophthalmia), and the ear. The fever is slight, and is sometimes wanting.

Of itself, the disease is not dangerous; but it may become complicated with otitis, leading to permanent otorrhaea and hardness of hearing, or with rheumatic ophthalmia, terminating in disorganization of the eye, or with meningitis. Sometimes the pain increases to a real neuralgia, particularly in females, and feeble, irritable individuals, who had formerly been liable to megrim.

Sometimes the pain invades the teeth and jaws, either a few teeth or both rows, and extends even to the ear and eye, or shifts from one place to another. It is generally tearing, sticking, gnawing, boring, sometimes continuing for a long time, is most violent at night, and particularly in bed. After some time, the cheek and the gums of the affected side swell up, after which the pain generally disappears, and the swelling disperses again.

§ 167. Among the many remedies which correspond to the various symptoms of rheumatic toothache, we notice Chamomilla, Nux vom,, Bellad., Mercur., Pulsatilla, Staphysagria.

Chamomilla is suitable for pains which are most violent at night, come on in paroxysms, and do not affect any tooth in particular; when slight, the pains are creeping, jerking; when violent, they are tearing, or even darting, striking into the ear, aggravated by warmth, eating or drinking, or by cold water, and accompanied by swelling of the cheeks, excessive secretion of saliva, heat and redness of one cheek, excessive irritability, sometimes by swelling of the gums, looseness of the teeth, and sensation as if they were elongated.

Nux vom. is a chief remedy for rheumatic pains of the head and face, teeth and jaws; the pain is principally drawing, tearing, less frequently jerking and sticking; it invades the soft and hard parts of the face, with or without swelling of the cheeks, is frequently attended with vertigo, dulness of the head, nausea, heat of the face, buzzing and pains in the ear. The toothache is principally aggravated by open air, cold, wine and coffee, sometimes relieved by warmth; it frequently affects only a decayed tooth, as a boring pain, or as if the tooth would be wrenched out of its socket, accompanied with single stitches which concuss the whole body, and with painful swelling of the gums; sometimes the pain shifts from the decayed to sound teeth, or to adjoining parts; it appears rather periodically, generally at night and in the morning, is less during rest and warmth, but is made a good deal worse by mental exertions, chewing, or opening the mouth in the open air.

Belladonna removes a pain in the forehead, and one side of the head which appears periodically, is aggravated by moving the eyes, by concussion, warmth of the bed at night and in the evening, with bright-red swelling of one side of the face, sticking and boring in the ear, inflammation of the inner and outer ear, otorrhaea, inflammatory swelling of the parotid gland, violent digging and sometimes boring toothache, which is rendered intolerable by contact, air and eating, relieved by cold water, attended with swelling and sensitiveness of the gums, and swelling of the submaxillary glands.

Mercurius is a specific remedy for rheumatic sticking and tearing pains in the ear, for inflammation of the inner ear, with violent boring and gnawing pains, which are most violent at night, with otorrhaea, or even if caries of the ossicula should have already set in; for tearing, boring pains in the eye and the surrounding parts, with evening and night-exacerbations, inflammation of the sclerotica and conjunctiva, ulcers on the cornea, with broad, whitish-gray, opaque edges. It is particularly suitable for sticking, jerking, darting, tearing-gnawing and boring toothache, generally in decayed teeth, particularly in the roots, aggravated by the warmth of the bed, in the evening, and at night, also by eating and drinking, momentarily relieved by the application of cold water; the pain extends to the temples, ears, over the whole side of the head, with swelling of the cheek and gums, swelling of the submaxillary and parotid glands, copious secretion of a fetid, tenacious mucus, fetid smell from the mouth, thick-coated tongue, flat taste, febrile sensations, profuse sweat, which does not afford any relief; the gums are frequently inflamed, interstitially distended, standing off from the teeth, ulcerated, readily bleeding, with looseness and elongation of the teeth.

Pulsatilla is suitable for periodical hemicrania of a tearing, sticking and throbbing character, aggravated by warmth, and in the evening, generally extending as far as the ear, where a tearing, darting pain is experienced, with hardness of hearing, buzzing and painfulness of the region of the ear to contact. Pulsatilla does not seem to be of any avail in internal otitis, with discharge of pus. The Pulsatilla toothache is drawing-gnawing, tearing in the upper and lower molares, both sound and decayed, most violent at night, extending to the eye, temple and ear, aggravated by warmth, and particularly affecting individuals with a mild and gentle disposition, great patience and equanimity, delaying catamenia, etc. It corresponds to toothache, which abates in the open air, and returns in the warm room, with stinging in the gums, and drawing-jerking in the nerve, (as if the nerve were violently pulled, and then suddenly let loose again.) with chilliness and paleness of the face; the toothache usually appears in the evening, much less frequently in the morning, is aggravated by the warmth of the room and bed, relieved by the contact of cool air, not increased by chewing, but excited by picking the tooth. Pulsatilla is seldom ever useful when the gums and cheeks are swollen.

Staphysagria removes toothache affecting both sound and carious teeth, which is aggravated by food and drink, with tearing which commences in a decayed tooth and extends over the whole side of the face as far as the pes anserinus, where the most violent pains are experienced, aggravated by slight contact, and relieved by strong pressure. It is useful for gnawing pain in a decayed tooth, with drawing in other teeth, aggravated early in the morning, after chewing, in the open air and by cold drinks, relieved by warmth, with readily bleeding gums, or with painful swelling of the gums.

There are many other remedies for rheumatic toothache, such as Hyoscyamus for violent tearing toothache, which generally comes on in the morning and is excited by cold, with congestion of blood to the head, and heat which is sometimes felt over the whole body; or for tearing, beating pains in the upper anterior and molar teeth of the right side, both sound and decayed, extending over the upper jaw and right half of the nose as far as the root of the nose and right eye, also to the lower jaw and teeth, with swelling of the gums, rush of blood to the head, burning heat of the face and whole body, dulness of the head and dull headache, the teeth feel elongated, loose, and are covered with mucus. Bryonia is useful for flashing-darting pain, which shifts to another tooth on touching the affected tooth; it is aggravated by warm drinks and warmth of the room, also by mastication. It frequently relieves the toothache of pregnant females. Rhus tox. for tearing pains with soreness, aggravated by warmth and at night, less when sitting than when lying; if the teeth be sound, Rhus t. frequently helps in cases where Nux v. has failed. Sabina for beating, tearing pains, with sensation as if the tooth would be shattered, with beating in all the blood-vessels. Colchicum for sticking jerking pain, attended by a feeling of lameness and cramp pain in the articulation of the jaw, and by a peculiar sensitiveness of the teeth on pressing them together, with nightly exacerbations. China for throbbing toothache, the pain being felt even externally, aggravated by the least contact, relieved by pressing the teeth firmly together; warm drinks are more easily borne, but the pains are aggravated by external warmth and a horizontal position. Causticum is useful for pains which are caused by cold air penetrating into the mouth, particularly violent at night, at times affecting the teeth on one side of the face only, at others affecting all the teeth, and extending even to the forehead, with sensation of elongation and looseness, painful, readily-bleeding gums, and inability to lie on the affected side, or to take any thing warm or cold into the mouth. Ignatia removes violent, clawing, digging pain which is felt quite suddenly, particularly after eating, when drinking coffee, or when touching the sound teeth with the tongue; it likewise removes a pain as if the teeth and their nerves would be crushed. Spigelia for constant drawing and tearing in all the teeth, particularly of the upper jaw and in the front teeth; or for a pain flashing through the crown and roots of single teeth, and which is sometimes beating, most frequent in the day-time, less at night, relieved by tepid applications, aggravated and excited by heat or cold; for beating toothache with pain in the face, bloatedness of the face and great sensitiveness of the teeth to cold air, particularly when carious. Rhododendron for toothache which generally returns in the spring and fall during an east wind, with boring in one tooth which feels as if in a vice, with sticking penetrating as far as the ear; the pain is aggravated by contact, cold drink, cold air, or at night, and is somewhat relieved by warmth. Coffea is useful for darting pains, or paroxysms of pressure, for pain when biting, or for pains which seem intolerable, the patients are beside themselves, weep, tremble. Sulphur for sticking jerks in decayed teeth, extending to the upper and lower jaws and to the ear, with swelling of the gums, beating pains, bleeding of the gums, swelling of the gums around an old stump, with pain in the evening or in the open air, or in a draught of air, aggravated by cold water. Sepia for tearing or beating pains, (particularly in pregnant females); the pains are aggravated by warmth and by currents of air, with dulness of the teeth and soreness of the gums; generally at night, and when the pains are chronic. Aconite for toothache which is accompanied by violent vascular excitement, and is relieved by cold drinks.

The north pole of the magnet cures a toothache which affects all the decayed teeth at once, when the gums are swollen and painful to the touch; slight dartings, with pressure, or a digging, tearing, or burning sticking is experienced in the periosteum of the jaw, and the incisors are frequently painful on inhaling air.

For nocturnal toothache: Nux v., Chamom., Pulsat., China, Bellad., Magnes. carb., Acid nitr.

For toothache which is aggravated by cold things in the mouth: Nux v., Merc, Rhus t., Staphysag.

For toothache which is relieved by cold things in the mouth: Bryo., Puls., Acon., Bell.