Hering’s Laws
by bringing back, or
revisiting, old symptoms;
by stimulating the healing
power of the organism;
by moving sites of disease
from the inside to the outside;
by moving sites of disease
from more vital to less vital areas;
and from top downwards; [(Dr.
Narendra Mehta) Hering’s direction of cure, the movement downwards is in the
same system, the same disease and the same miasm.
If a skin eruption disappears
from the face and joint pain starts, this is not above downwards. Rather, the
disease has shifted from one layer to another].
The Follow-Up –Understanding the follow-up in deep seated diseases.
as a result, during cure,
eruptions on the skin or old discharges are likely to recur.
[Dr. André Saine]
Hering's Law: Law, Rule or Dogma?
Presented at the Second Annual Session of the Homeopathic Academy of
Naturopathic Physicians in Seattle, Washington, April 16-17, 1988.
Introduction
In homeopathy today, Hering's law is widely recognized as the second law
of cure, the first law of cure being similia similibus curantur, or like cures
like. Hering's law pertains to the direction in which the symptoms of the
patient will disappear during a cure under homeopathic treatment.
In his second lecture on homeopathic philosophy given in 1900 to the
Post-Graduate School of Homœopathics, Kent said:
"The cure must proceed from centre to circumference. From centre to
circumference is from above downward, from within outwards, from more important
to less important organs, from the head to the hands and feet.
"Every homœopathic practitioner who understands the art of healing,
knows that the symptoms which go off in these directions remain away
permanently. Moreover, he knows that symptoms which disappear in the reverse
order of their coming are removed permanently. It is thus he knows that the
patient did not merely get well in spite of the treatment, but that he was
cured by the action of the remedy. If a homœopathic physician goes to the
bedside of a patient and, upon observing the onset of the symptoms and the
course of the disease, sees that the symptoms do not follow this order after his
remedy, he knows that he has had but little to do with the course of
things." 1
Here Kent does not differentiate between acute and chronic disease in
the application of the law. It is reasonable to assume, because of the lack of
precision, that he meant all diseases, acute and chronic of venereal and
non-venereal origin, would disappear in the direction described above.
When first studying homeopathy, I listened to the teachers and read the
"classic" modern works, and assumed, like my fellow colleagues, that
Hering's law had been an irrefutable fact recognized by Hering and the many
succeeding generations of homeopaths, and that all patients, acute and chronic,
without an exception, would, at all times, be cured in the afore-mentioned
direction under careful homeopathic treatment.
Later as a practitioner, I carefully applied myself to put the general
homeopathic training I had received to the test. Since then, I have been able
to substantiate most but not all of the rules, principles and laws contained in
the homeopathic doctrine promulgated by several generations of homeopaths.
So far, however, I have been unable to substantiate Hering's law.
Indeed, very rarely do I see, for instance, in a patient with chronic
polyarthritis, the symptoms disappearing from the head first and then to the
hands and feet.
More often, the pain and other joint symptoms disappear in the reverse
order of their appearance, even if it is from below upwards. In other words, if
the arthritis manifested itself, as it happens at times, first in the knees and
then in the ankles, the ankles would get better before the knees.
Or in a patient affected by a complex of essentially functional
complaints such as fatigue, anxiety, irritability, difficult digestion, joint
pain and acne, rarely would I see the disappearance of the emotional
disturbance first, then
the poor digestion followed by the joint pain and lastly the acne. With
the simillimum most symptoms begin to improve simultaneously and disappear in
the reverse order of their appearance, and not necessarily from above downwards
and from inside outwards. In fact it is not uncommon that in such cases the
acne, the last to have appeared, would disappear readily and the emotional
state (the oldest symptom) would be the last to completely disappear.
While treating a patient with an acute febrile disease that had
progressed in the first stage from chills to fever, then to perspiration and
lastly to weakness, I would observe a rapid and gentle recovery but without the
patient re-experiencing the perspiration, then the fever and lastly the chills.
While recovering from acute diseases under homeopathic treatment, the patient
does not re-experience the original symptoms one by one in the reverse order of
their appearance. Many more troublesome exceptions similar to the above could
be cited.
What was wrong with Hering's law as quoted above from Kent's Lectures on
Homeopathic Philosophy? Had I misunderstood the law?
According to Webster's dictionary, a law is defined as a sequence of
events that occurs with unvarying uniformity whereas a rule permits exceptions,
and a dogma rests on opinion. Was this lack of confirmation of the said law due
to "suppressive" homeopathic treatment as suggested by a number of
theoretical and perhaps dogmatic homeopaths? If so, why have these so called
"purists" not stood up and proven that all their cured cases followed
the said law? To my knowledge this proof has not been forthcoming.
Was I the only practitioner in this position?
I questioned teachers and colleagues, some with many years of
experience. Few could answer my questions and none has been able to
substantiate from their own experience without the shadow of a doubt that
Hering's law was
a true law of nature. It seems that most were in the same situation as
me, even the supposed authorities would discuss the matter but in private with
the author. It seems that we all had classic cases of cure from above
downwards, from within outwards, from more to less important organs and in the
reverse order of appearance of symptoms. But these absolutely
"perfect" cases were only occasional. The majority of cured cases did
not fulfill all the four
cited criteria.
So I decided to go back to the sources.
On one hand, neither Kent, in his Lectures on Homœopathic Philosophy of 1900,
nor Stuart Close, in The Genius of Homœopathy of 1924, nor Herbert Roberts, in
The Principles and Art of Cure by Homœopathy of 1936 while discussing the above
law, refer to it as Hering's law. None of these three authors makes any
reference to Hering in their lectures on the law of direction of cure. On the
other hand, Garth Boericke, in A Compendium of the Principles of Homœopathy of
1929, refers to it as Hering's rule but not as a law. Confusing, isn't it? Did
Hering ever formulate a law on the direction of cure? If he did, why was his
name not clearly associated with the law and
was it as a law or a rule? Why was the literature so ambiguous?
At this point, I realized that the sources had to be explored further.
The answers would all have to be within the literature of the nineteenth
century. After a thorough examination of this literature I have so far been
unable to find any of Hering's famous contemporaries and close colleagues
discussing or making any reference to a law of direction of cure. Writings of
Boenninghausen, Jahr, Joslin, P.P. Wells, Lippe, H.N.Guernsey, Dunham, E.A.
Farrington, H.C. Allen, Nash, etc, were all silent.
When Hering died in 1880, colleagues all over the world assembled to pay
tribute to the great homeopath. His many accomplishments were recalled.
Strangely, none made any mention of a law of direction of cure promulgated
by Hering. Arthur Eastman, a student who was close to Hering during the
last three years of the venerable homeopath, published in 1917 Life and
Reminiscences of Dr. Constantine Hering also without mentioning a law
pertaining to direction of cure. Calvin Knerr, Hering's son-in-law, published
in 1940, 60 years after Hering's death, the Life of Hering, a compilation of
biographical notes. Again no mention is made of the famous law. Not only
confusing,
but also puzzling.
Obviously, the sources had to be further explored. Here are the fruits
of this exploration.
THE HISTORY RELATED TO THE FORMULATION OF HERING'S LAW
A. Hahnemann - 1811
With the first publication of his Materia Medica Pura in 1811, Hahnemann
inaugurated a new arrangement of the symptoms: from above downwards, from
inside outwards, but also from the parts to the generals.
B. Hahnemann - 1828
In 1828, Hahnemann published his first observations and theories on
chronic diseases.8 I summarize here the points most pertinent to the present
discussion:
- "All diseases, acute and chronic of non-venereal origin, come
from the original malady, called psora. (page 7)
- "A skin eruption is the first manifestation of psora. (page 38)
- "The skin eruption acts as a substitute for the internal psora
(page 11) and prevents the breaking out of the internal disease. (page 13)
- "The more the skin eruption spreads the more it keeps the
internal manifestations of psora latent. (page 40)
- "But when the skin eruption is suppressed with an external
application or other influences the latent psora goes unnoticed and its
internal manifestation increases. Then "it originates a legion of chronic
diseases." (page 12) Incidently, for Hahnemann, a suppressed skin eruption
is not driven into the body as it was popularly thought in his time, and even
today by most homeopaths, but rather the vital force is compelled "to
effect a transference
of a worse form of morbid action to other and more important
parts." (Introduction of the Organon of Medicine p.62) 9
- "Latent psora, an abnormal susceptibility to disease, will
manifest itself as severe diseases after exposure to stress (or as he calls it,
unfavorable conditions of life) acute infections, trauma and injuries,
exhaustion from overworking, lack of fresh air or exercise, frustration, grief,
poor nutrition, etc, and by "incorrect and weakening allopathic
treatment". (page 48)
- "During the treatment of chronic diseases of non-venereal origin
with antipsoric remedies, the last symptoms are always the first to disappear,
"but the oldest ailments and those which have been most constant and
unchanged, among which are the local ailments, are the last to give way."
(page 135)
- "If old symptoms return during an antipsoric treatment, it means
that the remedy is affecting psora at its roots and will do much for its
thorough cure (page 135). If a skin eruption appears during the treatment while
all other symptoms have so far improved the end of the treatment is
close."
C. Hahnemann - 1833-43
In paragraphs 161 and 248 of the fifth and sixth edition of the Organon
of Medicine of 1833 and 1843 respectively, Hahnemann says that in the treatment
of old and very old chronic disease, aggravation of the original disease
does not appear if the remedy is accurately chosen and given in the
appropriate small doses, which are only gradually increased. "When this is
done, these exacerbations of the original symptoms of the chronic disease can
appear only at the end of the treatment, when the cure is complete or nearly
complete." The original symptoms of a chronic disease should be the last
to aggravate or become more prominent before disappearing. 10
In paragraph 253 of the same work, the author states that in all
diseases, especially in quickly arising (acute) ones, of all the signs that
indicate a small beginning of improvement (or aggravation) that is not visible
to everybody,
the psychic condition of the patient and his general demeanor are the
most certain and revealing.
In paragraph 225, Hahnemann states that some psychic diseases are not
the extension of physical disease but, "instead, with only slight physical
illness, they arise and proceed from the psyche, from persistent grief,
resentment, anger, humiliation and repeated exposure to fear and fright. In
time such psychic diseases often greatly harm the physical health." In
other words, Hahnemann had recognized the existence of psychosomatic diseases, those
diseases which progress from within outwards and from above downwards.
This is the background that now leads us to Hering, who, among all
Hahnemann's students, was most similar to him. Like Hahnemann, Hering was a
true scientist who totally adopted the inductive method in his scientific
pursuits.
D. Hering - 1845
In 1845, Hering published in the preface of the first American edition
of Hahnemann's Chronic Diseases an extract of an essay which was never
published elsewhere, called "Guide to the Progressive Development of
Homœopathy".
In this essay, Hering writes:
"Every homœopathic physician must have observed that the
improvement in pain takes place from above downward; and in diseases, from
within outward. This is the reason why chronic diseases, if they are thoroughly
cured, always terminate in some cutaneous eruption, which differs according to
the different constitutions of the patients.
"The thorough cure of a widely ramified chronic disease in the
organism is indicated by the most important organs being first relieved; the
affection passes off in the order in which the organs had been affected, the
more
important being relieved first, the less important next, and the skin
last. (page 7)
"Even the superficial observer will not fail in recognising this
law of order.
"This law of order which we have pointed out above, accounts for
numerous cutaneous eruptions consequent upon homœopathic treatment, even where
they never had been seen before; it accounts for the obstinacy with which many
kinds of herpes and ulcers remain upon the skin, whereas others are dissipated
like snow. Those which remain, do remain because the internal disease is yet
existing... It lastly accounts for one cutaneous affection being substituted
for another." (page 8)
Here Hering assumes that all chronic diseases (it is likely that he is
referring here to diseases of psoric origin, i.e., non-venereal) progress from
less to more important organs and disappear in the reverse order. This is
compatible with Hahnemann's theory that all chronic diseases of
non-venereal origin manifest themselves first on the skin then internally.
(Concerning the theories of Hahnemann, Hering wrote in 1836 in the first
American
edition of the Organon of Medicine: Whether the theories of Hahnemann
are destined to endure a longer or a shorter space, whether they be the best or
not, time only can determine; be it as it may however, it is a matter of minor
importance. For myself, I am generally considered as a disciple and adherent of
Hahnemann, and I do indeed declare, that I am one among the most enthusiastic
in doing homage to his greatness; but nevertheless I declare also,
that since my first acquaintance with homeopathy, (in the year 1821),
down to the present day, I hve never yet accepted a single theory in the
Organon as it is promulgated. I feel no aversion to acknowledge this even to
the venerable sage himself. It is the genuine Hahnemannean spirit totally to
disregard all theories, even those of one's own fabrication, when they are in
opposition to the results of pure experience. All thoeries and hypotheses have
no positive weight whatever, only so far as they lead to new
experiments, and afford a better survey of the results of those already made.
(page 17)
E. Hering - 1865
It seems that Hering did not further elaborate on this subject, at least
in the American literature, until 20 years later. In 1865, he published an
article in the first volume of The Hahnemannian Monthly called
"Hahnemann's
three rules concerning the rank of symptoms". Hering states in this
article that:
"The quintessence of Hahnemann's doctrine is, to give in all
chronic diseases, i.e., such as progress from without inwardly, from the less
essential parts of our body to the more essential, from the periphery to the
central organs, generally from below upwards - to give in all such cases, by
preference, such drugs as are opposite in their direction, or way of action,
such as act from within outward, from up downward, from the most essential
organs to the
less essential, from the brain and the nerves outward and down to the
most outward and the lowest of all organs, to the skin... All the antipsoric
drugs of Hahnemann have this peculiarity as the most characteristic; the
evolution
of their effects from within towards without. (page 6-7)
"Hahnemann states, in his treatise on Chronic Diseases, American
translation p.171: Symptoms recently developed are the first to yield. Older
symptoms disappear last. Here we have one of Hahnemann's general observations,
which like all of them, is of endless value, a plain, practical rule and of
immense importance.
"The above rule might also be expressed in the following words: In
diseases of long standing, where the symptoms or groups of symptoms have
befallen the sick in a certain order, succeeding each other, more and more
being added from time to time to those already existing, in such cases this
order should be reversed during the cure; the last ought to disappear first and
the first last." (page 7-8)
It is very clear here that Hering makes no mention of a law but rather
of a rule, that the symptoms ought to disappear in the reverse order of their
appearance during the homeopathic treatment of patients with chronic disease of
psoric origin, the ones that progress from without inwardly, from less
important to more important organs and generally from below upwards.
F. Hering - 1875
In 1875, Hering published the first volume of Analytical Therapeutics of
the Mind in which he stated that "only such patients remain well and are
really cured, who have been rid of their symptoms in the reverse order of their
development". (page 24) Here Hering makes no mention of the three other
propositions regarding the direction of cure: from above downwards, from within
outwards and from the more important to the less important organs. Why? Were
they not considered as important to evaluate the direction of cure as stated in
previous years?
In the same work, Hering also explains that he adopted Hahnemann's
arrangement of the materia medica: "First inner symptoms, then outer ones.
This order we have now uniformly preserved throughout the whole work."
(p.21)
In explaining why he adopted this arrangement he says: "The
arrangement as well as the style of printing, has the one object especially in
view, viz.: to make it as easy as possible for the eye, and through the eye,
for the mind to find what is looked for." He makes no mention of this
arrangement corresponding to a direction of cure, as it has been suggested by
some well wishing homeopaths.
G. The origin of the term "Hering's law"
Where does the term "Hering's law" come from as it seems never
to have been mentioned in the literature during Hering's time? The earliest
mention I have been able to find in the homeopathic literature dates from 1911,
in an article published by Kent in the first volume of the Transactions of the
Society of Homœopathicians called "Correspondence of Organs, and the
Direction of Cure".
Kent writes:
"Hering first introduced the law of direction of symptoms: from
within out, from above downward, in reverse order of their appearance. It does
not occur in Hahnemann's writings. It is spoken of as Hering's law. There is
scarcely anything of this law in the literature of homœopathy, except the
observation of symptoms going from above to the extremities, eruptions
appearing on the skin and discharges from the mucous membranes or ulcers
appearing upon the legs as internal symptoms disappear.
"There is non-specific assertion in the literature except as given
in the lectures on philosophy at the Post- Graduate School."
It is reasonable to assume that Kent was the one that officialized the
term "Hering's law" and so inadvertently popularized the concept of
the existence of a clear and precise law of direction of cure. (At least up
till 1899, at Kent's Post-Graduate School of Homeopathics, the directions of
cure were still called "the Three Directions of cure [given by
Hahnemann].) 16 By using the name of Hering it is reasonable to say that Kent
thus created false and misleading historical assumptions. Since H.C. Allen had
died two years previously (1909), the profession, at least in North America,
had no other leaders capable to refute Kent and defend the classic Hahnemannian
tradition.
(It is to be remembered that in 1908 H.C. Allen had severely criticized
the materia medica of the new synthetic remedies that Kent had been publishing
since 1904 in The Critique. Kent was at the time the associate editor of this
journal in which, almost monthly, he had been publishing the materia medica of
a new synthetic remedy, each of very questionable value. During an open session
at the annual meeting of the International Hahnemannian Association, Allen and
G.P. Waring accused Kent of publishing materia medica that was "without
proving or any clinical experience", which would have been completely
contrary to the strict inductive method intrinsic to homeopathy.
Kent then stopped permanently the publication of these synthetic
remedies, even the ones that he had previously promised for upcoming
publication in The Critique. 18 Although Kent continued to publish regularly in
The Critique until 1911 he restricted his articles to reporting clinical
cases rather than materia medica. Never was a synthetic remedy ever published
by Kent after the initial criticism of Allen even in his own journal, The
Homœopathician, that he founded in 1912. Furthermore, when Kent published the
second edition of his Lectures on Homœopathic Materia Medica in 1912 [the first
edition was in 1904], all the synthetic remedies published between 1904 and
1908 were omitted.)
In this same article, Kent says that in the course of treatment of a
patient suffering with a psychic disease of the will (problems of affections,
grief, anger, jealousy, etc), the heart or liver will be affected as the
treatment
progresses.
While in a patient suffering from a mental disease (problems of the
intellect), the stomach or the kidney will be affected during appropriate
homeopathic treatment. Were these comments on the direction of cure and correspondence
of organs based on Kent's impeccable and meticulous observations or was he
rather formulating hypotheses? He does not explain further but he does mention
later in the same paper that "through familiarity with Swedenborg, I have
found the correspondences wrought out from the Word of God harmonious with all
I have learned in the past thirty years. Familiarity with them aids in
determining the effect of prescriptions."
Nowhere was I able to find in the writings of Kent, including in a
collection of not yet republished lesser writings, any other mention of
Hering's law as to the direction of cure.
Discussion and Conclusion
First let us briefly review the highlights of what has been so far
demonstrated:
- Between 1828 and 1843, Hahnemann enunciated his theories of chronic
diseases and described his observations and rules about the progression and
resolution of these chronic diseases. One key point of his theory is that a
skin eruption is the first manifestation of psora, which is the source of all chronic
diseases of non-venereal origin. In chronic disease the presenting symptoms of
the patient ("those ailments which have been most constant and
unchanged") may aggravate and will disappear in the reverse order of their
appearance with the correct antipsoric remedies in the correct posology.
Possibly, old symptoms may return during an antipsoric treatment. In all
diseases, if after a homeopathic remedy the psychic symptoms are the first to
improve or aggravate it is a most certain sign of curative change. For
Hahnemann this inside outward improvement was not a law but rather a most
certain sign of curative change. Finally not all diseases progress from outside
inwards but certain diseases (psychosomatic diseases) can progress from within
outwards.
- In 1845, Hering enunciated the original observations of Hahnemann as a
law of order in a work never to be published. In this law he mentions
essentially four points, that "the improvement in pain takes place from
above downward; and in diseases, from within outward... Chronic diseases if
thoroughly cured, always terminate in some cutaneous eruption" and lastly
"the thorough cure of a widely ramified chronic disease in the organism is
indicated by the most important organs being first relieved; the affection
passes off in the order in which the organs had been affected, the most
important being relieved first, the less important next, and the skin
last". As a reader I do not clearly sense that Hering is officially
proclaiming the original observations of Hahnemann as an absolute law but
rather that there is a "law of order" during a curative process. Also
I was unable to find Hering or any of his contemporaries referring further to
this unpublished work or to a law of direction of cure.
- In 1865, Hering described these observations not as a law but as
Hahnemann's general observations or as plain practical rules. Essentially he
emphasizes the proposition that the symptoms should disappear in the reverse
order of their appearance during the treatment of patients with chronic psoric
diseases.
- In 1875, Hering now discussed only one proposition, that the symptoms
will disappear in the reverse order of their appearance. The three other
propositions are now not mentioned at all.
- All the illustrious contemporaries of Hering seems to remain silent on
this point, at least from my review of the literature.
- In 1911, Kent, almost arbitrarily, calls the original observations of
Hahnemann "Hering's law".
- Now, with Kent's powerful influence, most modern works and
presentations on homeopathy began to declare Hering's law as an established
fact and seemingly assumed that it has been thoroughly verified since the
beginning of homeopathy, although no author, to my knowledge, has so far been
able to substantiate what each is repeating from the other. Here is one clear
sign which indicates how profoundly the homeopathic profession of today has
been cut off from its original and most essential sources. During the years of its
decline in the U.S. the profession experienced a gradual discontinuity from its
original foundation and started to rely more and more on a neo-foundation
dating back to the turn of the present century. Each new generation of
homeopaths has readily accepted Hering's law as a perfect law of cure and so
unintentionally perpetuated a misleading assumption. For students it is an
attractive concept but we clinicians must stand up and report our observations
even if they are contrary to the teaching we have received.
From reviewing the literature, it seems unlikely that the law formulated
by Kent in 1911 is a fair represention of Hering's overall understanding of a
direction of cure and that neither Kent nor anyone else has been able thus far
to clinically demonstrate that the original observations of Hahnemann
constituted in fact a perfect law of nature. But if we assume, for a moment,
that the law formulated by Kent is true, would all symptoms then have to
disappear, not only in the reverse order of their appearance, but also from
above downwards, from within outwards and from more important to less important
organs?
To comply with this law it would mean that all diseases to be curable
must proceed from outside inwards, from below upwards and from less important
to more important organs. Many acute diseases and a whole list of chronic
diseases such as psychosomatic diseases and others that develop from within
outwards (for example cases of arthritis followed by psoriasis), or diseases
that develop from above downwards, as in certain cases of polyarthritis, would
then be theoretically incurable. Or (since we know this not to be the case)
they are curable, but represent notable exceptions to Kent's formulation of a
law of direction of cure.
In many cases of chronic disease the direction of disappearance of
symptoms will contradict at least one of the four propositions. I assume that
we all agree that the enunciation of a law must be based on impeccable
observations. A law, if it is to be called a law, must explain all observable
phenomena of direction of cure. It is unacceptable to use limited or even
selected clinical phenomena to confirm a supposed law.
This situation appears to exist when certain homeopaths in their
attempts to defend "pure" homeopathy subscribe to the position that
what is observed as contrary to Hering's law, as formulated by Kent, is only
due to poor prescribing, suppressive at times, palliative at best but surely
not curative. For them what is wrong, is not the law but the prescription:
"the simillimum was not given."
Personally I use and can daily confirm the original observations of
Hahnemann concerning the direction of cure and have found them extremely
helpful to evaluate the evolution of diseases or of cure but I have not been
able to substantiate these observations as a law and have not yet found a
colleague with such substantiation. I use them as plain practical rules.
Probably by the end of my career, homeopathy will have become widely
accepted. I would then resent it if a group of objective scientists clinically
investigate the principles of homeopathy, and find numerous exceptions not
abiding to our idealistic or dogmatic conception of Hering's law; thus
renderiing it only "a plain, practical rule". I would similarly
resent having a group of scientists saying that for the last hundred or more
years the homeopathic profession has been blindly erring in assuming that
Hering's law was an irrefutable fact.
Five of the many plagues that have hindered the growth of homeopathy are
ignorance, egotism, dogmatism, idolatry and the diversion from the inductive
method. In his last address to the profession in an article published in the
August 1880 (Hering died on July 23, 1880.) issue of the North American Journal
of Homœopathy, Hering warned us that "if our school ever gives up the
strict inductive method of Hahnemann we are lost, and deserve to be mentioned
only as a caricature in the history of medicine." Indeed, since its early
beginning the tendency to rationalize the practice of medicine has also
constantly threatened homeopathy. Hahnemann, who had a thorough understanding
of the history of medicine, knew that the only sure way was based on the
experimental method. Hering demonstrated the same rigor. Unfortunatively, we
can not say the same of Kent. Let us now start carefully observing and
reporting any facts that would help to perfect Hahnemann's original
observations. If a direction of cure can be expressed within the context of a
law, then so be it. But until demonstrated otherwise, it should remain
"a plain, practical rule". The law that we suspect still needs
to be rightly formulated.
At present it seems appropriate to refer to these observations as the
rules of the direction of cure. To refer to these as Hahnemann's or Hering's
rules may further prolong the confusion. From my personal experience, it
appears
that the four rules are not applicable to all cases and that there is a
hierarchy among them, i.e., they do not have equal value. The first indication
that a disease is being cured under homeopathic treatment is that the
presenting and reversible (Many symptoms related to irreversible lesions can
not be expected to totally disappear; consequently the more a symptom is
related to organic changes, the less likely, or more slowly it will disappear.
The greater the irreversibility of the pathology the greater the symptoms will
linger. The practitioner can easily be confused by these important exceptions,
which are often not well perceived. Therefore this rule [of symptoms
disappearing in the reverse order of appearance] is generally less applicable
to symptoms deriving from organic lesions.) symptoms of the disease will
disappear in the reverse order of their appearance.
This confirms the observations as pointed out originally and plainly by
Hahnemann in The Chronic Diseases and later by Hering in 1865 and 1875. This
means that during the treatment of patients suffering with chronic diseases
of non-venereal origin and also at times with acute diseases, the
presenting symptoms of the patient's chronic dynamic disease (as opposed to the
symptoms resulting essentially from gross error of living) will disappear in
the reverse order of their appearance. So the presenting symptoms that have
developed in the order of A B C D E seem to consistently disappear in the order
of E D C B A. This rule seems to have supremacy over the other three
rules: from more important to the less important organs, from within
outwards and from above downwards.
The word "presenting" is here emphasized in order to state perfectly
clearly that the symptoms that will disappear in the reverse order of the their
appearance are only the presenting symptoms, and that it is not at all expected
that every ailment experienced by the patient in his past will again be
re-experienced under homeopathic treatment. In fact only a few of these old
symptoms and conditions will reappear during a homeopathic treatment, usually
the ones that have unmistakably been suppressed by whatever influences. Beside
antipathic treatment that will suppress symptoms and normal functions of the
organism (perspiration or menses) there are other measures which will cause
suppression of symptoms, first, dissimilar diseases, natural or artificial;
second, external influences such as exposure to cold temperature, (i.e.,
suppressed menses from getting the feet wet); and lastly, internal influences
that cause the person to suppress emotions such as anger or grief. This rule
concerning cure in the reverse order of appearance of the presenting and
reversible symptoms of the disease is the most important of the four as it is
observable in almost all cases. The importance of this rule is well emphasized
by Hering in 1865 when he mentioned:
"This rule enables the Hahnemannian artist not only to cure the
most obstinate chronic diseases, but also to make a certain prognosis when
discharging a cases, whether the patient will remain cured or whether the
disease will return, like a half-paid creditor, at the first opportunity."
The second most important (applicable) rule in the hierarchy is that
cure will proceed from more important to less important organs. Third in
importance is the rule that cure will proceed from within outwards. Fourth,
least important and least often observable, the cure will proceed from above
downwards. Hahnemann's observation thatof all the signs that indicate a small
beginning of improvement, the psychic condition of the patient and his
general demeanor are the most certain and revealing is seen as the
source of the last three rules. "The very beginning of improvement is
indicated by a sense of greater ease, composure, mental freedom, higher
spirits, and
returning naturalness." (paragraph 253) 10 This original
observation of Hahnemann, which is verified daily, does not contradict the
first rule in any case because the first sign of improvement can be and is
often different than
the symptom that would first disappear.
Consequent to Hahnemann's theory, (that all diseases, acute and chronic
of non-venereal origin, come from the original malady called psora and its
first manifestation is a skin eruption) all cases of chronic disease of dynamic
origin must develop a skin eruption to be totally cured. As it seems unfeasible
to demonstrate, it should at best be used as a working hypothesis and not as a
law. For a law to exist it must be demonstrable without exception. Hahnemann
had a clear opinion about the role of the physician as theorist when he wrote
in the preface to the fourth volume of “The Chronic Diseases”:
"I furnished, indeed, a conjecture about it [on how the cure of
diseases is effected], but I did not desire tocall it an explanation, i.e., a
definite explanation of the modus operandi. Nor was this at all necessary, for
it is only incumbent upon us to cure similar symptoms correctly and
successfully, according to a law of nature [similia similibus curantur] which
is being constantly confirmed; but not to boast with abstract explanations,
while we leave
the patients uncured; for that is all which so-called physicians have
hitherto accomplished."
To end this thesis, I would like to leave you with the spirit of some
pertinent thoughts of Constantine Hering. In 1879, in the last two paragraphs
to the preface of his last work, The Guiding Symptoms of our Materia Medica, he
writes:
"It has been my rule through life never to accept anything as true,
unless it came as near mathematical proof as possible in its domain of science;
and, in the other hand, never to reject anything as false, unless there was stronger
proof of its falsity.
"Some will say, "but so many things - a majority of all
observations - will thus remain between the two undecided." So they will;
and can it be helped? It can, but only by accumulating most careful
observations and contributing them to the general fund of knowledge."
And finally he wrote in 1845 in the preface of Hahnemann's Chronic
Diseases:
"It is the duty of all of us to go farther in the theory and
practice of Homœopathy than Hahnemann has done. We ought to seek the truth which
is before us and forsake the errors of the past." (page 9)