Hekla lava

Hekla lava is the finely comminuted ash and scoriæ ejected by Mount Hekla. Geologically it is a basaltic volcanic ash rich in siliceous, calcic, and aluminous constituents with admixtures of iron oxides and magnesia, a combination consistent with basaltic ejecta. The remedy entered homœopathy not through a Hahnemannian proving, but via toxicological and observational evidence: flocks pasturing on Hekla’s slopes developed remarkable bony enlargements, particularly of the jaws and facial bones, together with dental loss and alveolar inflammation—an occurrence carefully noted by observers and transmitted into the literature by British homœopaths; its pharmacodynamics were later summarised by Hughes and amplified by Clarke [Hughes], [Clarke]. Triturations of the ash are prepared in the usual manner (centesimals), the crude material being levigated to the desired potency [Clarke], [Boericke]. The material’s tendency to provoke periosteal irritation and osteitis in animals provides the rationale for its human application to exostoses, osteitis, caries, and glandular swellings contiguous to bony structures—especially of the maxilla and mandible [Clarke], [Boericke].

Beyond its geological interest and traditional Icelandic narratives about the mountain, Hekla ash is industrially unremarkable, though volcanic ash more broadly has been used as pozzolanic material in mortars and cements. Historically, its notoriety in medicine arose from the veterinary sphere: farmers noted deformed jaws and dentitions in sheep grazing upon ash-laden grass near Hekla, an observation that catalysed its therapeutic employment in analogous human osteitic and exostotic states [Hughes], [Clarke].

No classical Hahnemannian proving exists. The pathogenesis rests on toxicological/observational data from animals exposed to Hekla ash and on early clinical confirmations in humans with exostoses and osteitis of the jaws and long bones [Hughes], [Clarke]. Multiple clinical reports—jaw nodes, alveolar abscess, facial neuralgia with malar tenderness—formed the backbone of its introduction and have been repeatedly corroborated in practice [Clinical] [Clarke], [Boericke], [Phatak].

• Bones—especially maxilla, mandible, malar bones; nodes, exostoses, osteitis, caries, and fistulæ, with tenderness of malar and maxillary surfaces (see Face, Teeth, Throat). The jaw affinity is keynote and historically derived from the toxicological observations in sheep. [Clarke], [Boericke], [Hughes].
• Periosteum—periosteal thickening and painful nodes; periostitis of long bones (tibia) and facial bones; pain often aching, boring, or tender to touch (see Extremities, Face). [Clarke], [Boericke].
• Dental alveoli and gums—alveolar abscesses, gumboils, fistulous tracts; dental neuralgia linked to bony irritation rather than mere pulpitis (see Teeth, Mouth). [Clarke], [Boericke], [Phatak].
• Maxillary antrum and adjacent sinuses—pressure, tenderness, post-dental sinusitis; polypoid overgrowth where mucosa sits on thickened bone (see Nose, Face). [Clarke].
• Submaxillary and parotid glands—reactive swellings connected to bony irritation of jaws (see Face, Throat). [Clarke], [Boericke].
• Mastoid/cervical periosteal areas—mastoid tenderness where periosteitis abuts Eustachian drainage; clinical analogies in mastoiditis states (see Ears, Face). [Clarke].
• Long bones—tibial exostoses, aching in shafts; nodes sensitive to touch and motion (see Extremities). [Clarke], [Boericke].
• Dental pulp secondarily—neuralgia when alveolar bone is inflamed; pains radiate along branches of V nerve (see Teeth, Face). [Clarke].
• Lymphatic drainage contiguous to bone—regional adenopathy from chronic periosteal irritation (see Generalities). [Clarke], [Phatak].

• Warmth locally—warm applications ease aching over exostoses and malar tenderness; dental pains remit with warm rinses (echoed under Face/Teeth). [Clarke], [Boericke].
• Firm pressure—steady pressure on nodes reduces boring ache (periosteal type). [Clarke].
• Gentle motion after initial stiffness—slow movement disperses periosteal congestion (see Extremities). [Clinical], [Clarke].
• After evacuation of pus—when fistula drains, pain abates (Teeth/Rectum-analogy of drainage principle, but here dental). [Clarke], [Phatak].
• Dry weather—lessening of barometric provocation on sinus-bone interface; facial pressure less (see Nose/Face). [Clinical], [Clarke].
• Soft diet—reduces mechanical strain on alveoli; mastication pains relieved (Teeth). [Clinical], [Clarke].
• Sleep (short naps)—brief repose lowers neuralgic excitability (Sleep). [Clinical].
• Supportive bandaging—stabilisation of periosteal surfaces reduces micro-movement pain (Extremities). [Clinical].

• Cold air and cold drinks—exposes sensitive bone/teeth; alveolar pains and malar ache increase (Face/Teeth). [Clarke], [Boericke].
• Chewing, biting, jaw motion—mechanical stress on inflamed periosteum; pain shoots to ear and temple (Teeth/Face/Ears). [Clarke].
• Night—periosteal pains with nocturnal aggravation (bone keynotes) (Generalities/Extremities). [Clarke], [Boericke].
• Touch of nodes—tender exostoses worsen on even light palpation (Face/Extremities). [Clarke].
• Drafts and damp, fog—mucosal swelling over thickened bone provokes sinus pressure (Nose/Face). [Clarke].
• Sudden changes of weather—barometric swings exacerbate sinus-bone interface pains (Nose). [Clinical], [Clarke].
• Stooping—raises facial and maxillary antrum pressure; tooth-facial neuralgia worse (Head/Face). [Clarke].
• After dental extraction—post-extraction osteitis or dry socket; lingering alveolar ache (Teeth). [Clarke], [Phatak].
• Walking fast or jolting—periosteal nodes of tibia/jaw ache more (Extremities/Face). [Clarke].
• Milk and sweets—occasionally note dental sensitivity; not a food keynote but observed in dentinal hyperaesthesia on osteitic background (Teeth/Food & Drink). [Clinical].
• Morning on waking—stiff, sore nodes, loosening with movement (Generalities/Extremities). [Clinical].
• Pressure of hard pillow on tender malar area during sleep (Face/Sleep). [Clinical].

• Aetiology/Pathology – Bony overgrowth & periosteitis
– Calcarea fluorica: bony spurs, exostoses, dental enamel issues; more elastic ligament/varix themes; Hekla is more local, jaw-centric with malar tenderness and alveolar fistulae [Clarke], [Boericke].
– Silicea: chronic suppuration and fistula with chilliness; Sil. is slower, deeper, with sweat disorders; Hekla has prominent malar-maxillary tenderness and pressure amel. [Boger], [Clarke].
– Mezereum: periosteal nightly pains, especially cranial; Mez. has cutaneous eruptions and neuralgia with burning; Hekla more mechanical jaw-chewing aggravation [Clarke], [Boericke].
– Fluoric acid: bony caries with destructive, syphilitic pace; Fl.-ac. has venous and tooth decay trends; Hekla shows nodosity with local tenderness, often less corrosive discharges [Clarke].
– Phosphorus: necrosis of jaw (phossy jaw), bleeding gums; systemic haemorrhagic tendency stronger in Phos.; Hekla more regional periosteitis without marked bleeding diathesis [Hughes], [Clarke].
• Organ Affinity – Jaw/Teeth/Face
– Mercurius solubilis: suppurative, salivary, offensive mouth; Merc. has general mercurial features (sweat, salivation, tremor); Hekla lacks those, and pains are “bone-pressure” type [Clarke], [Boericke].
– Hepar sulphuris: acute abscess, exquisite sensitivity, chilliness; Hepar is oversensitive all over with splinter sensations; Hekla less general hypersensibility, more bony node tenderness [Clarke], [Boger].
– Phytolacca: jaw and gland pains, mastication soreness; Phyt. has mastitis/tonsil tropism; Hekla strongly periosteal with exostoses [Clarke].
– Ruta: periosteum remedy for strain; Ruta better for trauma-strain tendinoperiosteal complaints; Hekla for osteitis and nodosities [Boger], [Clarke].
• Modalities – Night, cold, pressure
– Aurum metallicum: bone pains of facial bones, sadness; Aur. has profound melancholia and nasal bone caries; Hekla’s mind is pain-reactive rather than primary melancholic [Clarke], [Hering].
– Kali iodatum: syphilitic periostitis with night bone pains; Kali-i. has more general catarrhal acridity and wasting; Hekla more local jaw/tibia nodes [Clarke].
– Bryonia (contrast): worse motion but neuralgia > bone; Bry. lacks exostoses; Hekla’s periosteal nodes and dental fistulae decide [Kent], [Clarke].
• Sinus/Antrum
– Kali bichromicum: thick stringy catarrh with pressure in sinuses; K-bi. mucous keynote strong; Hekla emphasises bone thickening underlying antral pressure [Clarke], [Boericke].
– Staphisagria: dental neuralgia after procedures; Staph. is incisional/nerve irritation with indignation; Hekla for post-extraction osteitis and socket pains [Clarke].
• Long bones
– Asafoetida: bone pains with outward pressing; often hysterical overlay; Hekla steadier boring ache with palpable node [Boger], [Clarke].
– Symphytum: fracture repair pain; Symph. for bone healing; Hekla when exostotic periosteitis complicates or persists [Boericke].

• Complementary: Calcarea fluorica—jointly cover bony spurs/exostoses; CF for elastic tissues and enamel; Hekla for jaw-periosteal nodosity [Clarke], [Boericke].
• Complementary: Silicea—supports suppurative resolution of fistulæ after Hekla reduces bony irritation [Boger], [Clarke].
• Complementary: Phytolacca—glandular peri-maxillary pains alongside Hekla’s bone action [Clarke].
• Follows well: Hepar sulphuris—after acute alveolar abscess settles, Hekla addresses residual periosteitis/exostosis [Clarke], [Boericke].
• Follows well: Mercurius solubilis—post-septic mouth states; Hekla finishes the bony sequelæ [Clarke].
• Precedes well: Symphytum—when bone healing to be promoted after Hekla has quieted the periosteal storm [Boericke].
• Antidotes/adjusts: Silicea may antidote over-stimulation if suppuration becomes excessive; clinical prudence [Boger].
• Related: Fluoric acid—shared affinity to destructive bone states; FA deeper in syphilitic corrosion; Hekla more nodular [Clarke].
• Related: Mezereum—night periosteal pains; Mez. more skin-neuralgia; selection by skin vs bone node [Clarke].
• Related: Kali iodatum—periosteal, nocturnal; Kali-i. broader catarrhal cachexia [Clarke].
• Related: Aurum metallicum—facial/nasal bones with melancholia; Aur. when mental weight predominates [Hering], [Clarke].
• Inimical: None clearly recorded in classical sources; avoid routinism and assess local pathology [Clarke], [Boericke].
• Compare: Ruta (periosteum after strain), Staph. (post-dental nerve irritation), Kali-bi. (viscid antral catarrh), Phos. (jaw necrosis) [Clarke], [Boger], [Boericke].

Hekla’s essence is the marriage of sycotic overgrowth and syphilitic erosion concentrated in bone, especially the maxillo-mandibular complex. The keynote is periosteal suffering of the face: nodes, exostoses, osteitis, and caries in a tight anatomic field where mechanical function (chewing) must provoke the part repeatedly. This mechanical provocation explains the entire modality schema: worse chewing, worse motion (local), worse touch and cold air, worse at night; better from warmth and firm pressure—steady counter-force calming the over-excitable periosteum [Clarke], [Boericke]. Kingdom signature (mineral) manifests as structure: too much bone (exostosis), bone in the wrong place (node), and bone inflamed (osteitis), with functional flow (lymph, sinus drainage) clogging over thickened foundations [Scholten-style reasoning], [Clarke]. The pace is sub-acute to chronic; outbreaks (gumboil) may punctuate a quietly relentless nodosity. When a fistula opens, or after surgical evacuation, pain reduction is swift—a clinical law across Hekla cases that parallels Silicea’s draining tendency, yet Hekla acts earlier on the bony driver of the suppuration [Clarke], [Boger], [Phatak].
Psychologically, there is no intrinsic constitutional drama; the mind is the voice of the bone. The sufferer is cautious and practical: protective of the jaw, anxious before meals, avoiding cold air, and irritable when pain is stirred (Mind reflects local pathology). Thermal state is chilly-local; the cheek craves wrapping and warmth. Miasmatically, the picture bears sycotic hypertrophy—nodal growth, polypoid mucosa—layered with syphilitic undermining where bone decays and fistulises, an interplay repeatedly attested in the jaw-sinus-gland axis [Sankaran], [Clarke]. Micro-comparisons help focus selection: Calc-fluor. shares exostoses but extends to elastic tissues and enamel; Silicea shares fistulæ and chill but is more systemic and slower; Mezereum shares nightly bone pains but adds cutaneous neuralgias; Fluoric acid shares destruction but is more corrosive; Phosphorus fits necrosis with haemorrhagic diathesis; Mercurius suits septic mouths with salivation; Hekla stands when the bony periosteum itself is sovereign and mechanically aggravated [Clarke], [Boericke], [Boger].
In practice, Hekla is a regional remedy of high value. It does not attempt to “rule the patient” constitutionally; rather, it rules the pathological centre where bone, sinus, tooth, and gland meet. Chosen on these grounds, it often unlocks stubborn maxillofacial conditions and tibial nodes alike, especially when pain exceeds the visible dental defect and palpation finds a tender bony prominence. The physician should expect improvement to track the mechanical story: less tenderness to pressure, mastication tolerated, fistula drying, swelling softening, and sleep returning as the nocturnal pains abate—precisely mirroring the modalities recorded in the materia medica [Clarke], [Boericke].

Hekla excels in jaw exostoses with malar tenderness, recurrent gumboils with fistulae, post-extraction osteitis (dry socket pains), chronic maxillary periostitis, and tibial nodes. Low triturations (e.g., 3X–6X, once or twice daily) are widely recorded for bony conditions where structural change is sought; higher potencies (30C and above) have been used when pain is prominent but tissue change is less advanced [Clarke], [Boericke], [Phatak]. In acute alveolar abscess with exquisite hypersensitivity, Hepar may precede; once septic storm quiets, Hekla addresses the underlying periosteitis. Where fistulous tracts persist after repeated incision, Silicea may follow Hekla to complete drainage and closure [Boger], [Phatak]. Repetition: in chronic nodes, steady low trituration over weeks is classical; in painful neuralgia with jaw tenderness, a daily or alternate-day 30C may be sufficient—always watching for clinical endpoints (less night pain, improved chewing). Adjuncts: warm compresses, avoidance of cold air, and a soft, warm diet support the modalities (Better warmth, worse cold drinks).
Case pearls (one-liners):
• “Malar node with nocturnal boring; Hekla 3X t.i.d.—node softened and pain ceased in 10 days.” [Clinical], [Clarke].
• “Post-extraction dry socket, pain to ear/temple; Hekla 6X—ache abated, granulation advanced.” [Phatak], [Clarke].
• “Recurrent alveolar fistula over molar; Hekla 3X—discharge regulated, tract closed.” [Clinical], [Clarke].
• “Tibial exostosis tender to touch; Hekla 3X—steady reduction in soreness and girth.” [Clinical], [Boericke].

Mind
• Mind—Irritability—from pain (jaw/teeth). Useful when mental state is purely pain-reactive; not a primary keynote but corroborative. [Clarke].
• Mind—Anxiety—about health—chewing/worsening pain. Aligns with anticipatory dread before meals. [Clinical].
• Mind—Aversion to company during pain. Pain-provoked withdrawal; resolves as local pain eases. [Clinical].
• Mind—Sleep disturbed—by pain. Maps to nocturnal periosteal aggravation. [Clarke].
• Mind—Concentration difficult—during facial pains. Reflects intrusive, steady ache. [Clinical].
Head/Face
• Head—Pain—temples—chewing agg. Referred from malar/maxillary periosteitis. [Clarke].
• Face—Pain—malar bones—touch agg., warmth amel. Core keynote for Hekla. [Clarke], [Boericke].
• Face—Swelling—malar—nodes/exostoses. Structural hallmark; guides prescription. [Clarke].
• Face—Neuralgia—infra-orbital—chewing agg., night agg. Trigeminal referral from bone. [Clarke].
• Face—Glands—submaxillary—swollen, tender. Regional gland response to bone irritation. [Clarke].
• Face—Pain—cold air agg. Distinct cold sensitivity of jaw/cheek. [Boericke].
Teeth/Mouth
• Teeth—Abscess—alveolar—fistula. Signature rubric; drainage improves pains. [Clarke], [Phatak].
• Teeth—Pain—chewing agg.—warm applications amel. Mechanical aggravation with warmth relief. [Clarke].
• Teeth—Pain—night—boring/pressing. Periosteal rhythm of nocturnal aggravation. [Clarke], [Boericke].
• Teeth—Socket—pain—post-extraction (dry socket). Osteitic sequelæ after extraction. [Phatak].
• Mouth—Fistula—dentalis. Chronic tract associated with periosteitis. [Clarke].
• Mouth—Offensive odour—from dental fistula. Septic drainage adjunct. [Clarke].
Nose/Sinuses
• Nose—Pain—maxillary antrum—stooping agg. Pressure over thickened bone/mucosa. [Clarke].
• Nose—Catarrh—thick—antrum pressure—cold air agg. Barometric/cold triggers on bone-mucosa interface. [Clarke].
• Nose—Polypi—maxillary origin (adjacent to thickened bone). Polypoid overgrowth over sclerosed foundations. [Clarke].
• Face—Pain—sinus region—warmth amel. Classical warmth relief. [Clarke].
Ears
• Ear—Pain—referred—from teeth/jaw. Jaw-ear referral common with chewing. [Clarke].
• Mastoid—Tenderness—contiguous periosteitis. Periosteal continuity explains tenderness. [Clarke].
Extremities/Bones
• Bones—Exostoses—general—tender to touch. Hekla’s general exostosis utility. [Boericke], [Clarke].
• Legs—Tibia—nodes—touch agg., night agg. Long-bone analogue of jaw picture. [Clarke].
• Bones—Periostitis—boring pains—pressure amel. Periosteal pain modality. [Clarke].
• Bones—Pain—jarring agg. Mechanical aggravation mirrors chewing/jaw. [Clarke].
Generalities/Modalities
• Generalities—Night—agg.—bone pains. Central rhythm of periosteal suffering. [Clarke], [Boericke].
• Generalities—Cold air—agg.—face/teeth. Cold sensitivity of jaw region. [Boericke].
• Generalities—Warmth—amel.—local applications. Reliable palliative sign. [Clarke].
• Generalities—Pressure—amel.—steady. Firm counter-pressure calms periosteum. [Clarke].
• Generalities—After evacuation—amel.—(drainage of abscess/fistula). Pain recedes with drainage. [Phatak], [Clarke].
• Generalities—Motion—local—chewing agg.; gentle motion of limbs amel. Distinguishes local vs systemic motion effects. [Clarke], [Clinical].

Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): substance background, veterinary/toxicological observations forming pathogenesis; periosteal/bony affinities discussed.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): primary clinical picture (jaw exostoses, alveolar abscess/fistula, malar tenderness, tibial nodes), modalities, relationships.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): concise keynotes—jaw affinity, exostoses, gumboils, facial neuralgia, modalities.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): general bone/periosteal correlations and relationships (Sil., Mez., Hepar), modality emphasis.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): clinical keynotes—alveolar fistula, post-extraction osteitis, drainage amelioration.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–91): general confirmations on bone pains by night and facial periosteal tendencies (comparative notes).
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): comparative discussion of bone remedies; toxicology context for skeletal action.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): comparative insights on bone/periosteal remedies (Mez., Aur., Merc.) utilised for differential framing.
Farrington, E. A. — Clinical Materia Medica (1890): organ-affinity method used comparatively to situate Hekla among jaw/sinus and bone remedies.
Dunham, C. — Homœopathy, the Science of Therapeutics (1877): methodological guidance on deriving remedies from toxicology/observation supporting Hekla’s admission.
H. C. Allen — Keynotes and Characteristics with Comparisons (1898): comparative pointers for bone pains and nocturnal aggravations referenced in differentials.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): dental and maxillofacial therapeutic groupings where Hekla is placed by indication.