By Dr. André Saine, D.C., N.D., F.C.A.H.

Presented at the Second Annual Session of the Homeopathic Academy of Naturopathic Physicians in Seattle, Washington, April 16-17, 1988.

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, (A ll italics used throughout this paper indicate my own emphasis of pertinent points.) 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 thesimillimum 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 butwithout 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.

According to Webster's dictionary, a law is defined as a sequence of events that occurs with unvaryinguniformity 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.

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 citedcriteria.

On one hand, neither Kent, in his Lectures on Homœopathic Philosophy of 1900, nor Stuart Close, inThe 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. (1-3) 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. (4) 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. (5) 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. (6) 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. (7) 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.

1. 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.

2. 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 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 page 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.”

3. 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.

4. 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.” (11) (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) (12)