The composition is that of a painting by Jan Steen showing a tooth-drawer at work in a village. The extraction of teeth here represents the extraction by the imperial powers of territories from their previous occupants
As decided at the Congress of Berlin in 1878 (13 June 13 July), Great Britain assumed control of Cyprus from the Ottoman Empire, hence Distraeli is shown extracting a tooth labeled "Cyprus" from the Sultan. He is assisted by Queen Victoria and Lord Salisbury (Foreign Secretary). They are watched by Mac-Mahon (president of France) and by Fransen van de Putte, acting Prime Minister of the Netherlands, both of whom have bandages round their mouths indicating that they have had teeth extracted. The bandages are inscribed with names of things that have troubled them like bad teeth: MacMahon's bandage is labelled "Gambetta" (referring to Leon Gambetta, his Republican opponent) and Fransen van de Putte's is labelled "Atjeh" (referring to the Dutch Aceh war, a colonial war in Sumatra)
Left, Emperor Franz Josef I of Austria walks off with a sack marked "Bosnie-Herzegovina": Austria occupied those lands unilaterally in 1878. Left foreground, Tsar Alexander II of Russia, who has a polar bear and a camel, is being pulled off an elephant by Lord Lytton, Viceroy of India, representing Lytton's provocation of the Second Afghan War in response to perceived Russian expansion towards Afghanistan. They are watched by Pope Leo XIII and by Bismarck, the organizer of the Berlin Congress
Right background, King Umberto of Italy in the form of an ape watches the proceedings. Right foreground, Sir Theophilus Shepstone (British Transvaal Commission) pushes President Burgers of the Transvaal in a wheelbarrow marked Via Delagoa (the railway line to Pretoria?): Shepstone had annexed the Transvaal on behalf of Great Britain against Burgers's protests