Vol. 21 No. 1 February 2001

by Sue Muller

In relating the findings of my search into the truth or otherwise of Hering’s tenets I have restricted my own input into this article to comment rather than interpretation, as the latter leaves one open to error. It is difficult to source all the material on this matter, and any contributions would be greatly appreciated and acknowledged.

The origins of Hering’s Law
“The last symptoms to appear are the first to disappear.” “Symptoms disappear in the reverse order of their appearance.”

In his article (reproduced on page 10 in this issue) “Hahnemann’s Three Rules Concerning The Rank Of Symptoms”, Dr Constantine Hering refers to Hahnemann’s statement in Chronic Diseases: “The latest symptoms that have been added to a chronic disease which has been left to itself (and thus has not been aggravated by medical mismanagement) are always the first to yield in an antipsoric treatment; but the oldest ailments and those which have been most constant and unchanged, among which are the constant local ailments, are the last to give way; and this is only effected when all the remaining disorders have disappeared and the health has been in all other respects almost totally restored.” (Page 211 of L.H. Tafel’s translation, Indian edition).

Hering’s interpretation of the above statement is that “Symptoms recently developed are the first to yield. Older symptoms disappear last.” He does not qualify his statement as Hahnemann has done (in an antipsoric treatment). Yet he continues by saying, “Here we have one of Hahnemann’s general observations . . . a plain, practical rule of immense importance.”

This statement seems to be the origin of the “last to come, first to go” concept but does not resemble “disappearing in the reverse order of their appearance”; unlike Hering, Hahnemann’s observations do not make reference to the exact order of the disappearance of symptoms.

At this point note the words of Pemberton Dudley’s editor’s preface, namely that Hahnemann uses “qualifying words and phrases in certain peculiar and unusual connections, likely to escape the notice of the casual or careless reader but evidently intended by the author to be taken at their full significance and importance and to constitute an essential element of the discussion. It may be said, in passing, that the failure to note this last-mentioned of Hahnemann’s method has occasioned much misunderstanding of his doctrines.” The above-mentioned interpretations by Hering would appear to be examples of this.

“Cure proceeds from within out.”
“Cure proceeds from the most important organs to the least important organs.”

In the same article Hering says that the quintessence of Hahnemann’s doctrine is to give drugs which act from within outward, from above downward, from the most to the less essential organs, from the brain and nerves outward and down to the most outward and lowest of all organs, the skin. For this we are told to note the preface he wrote for Chronic Diseases (reproduced on page 8 in this issue).

However, the quintessence of Chronic Diseases is Hahnemann’s theory of psora being the causative, original cause of chronic disease, and clinical verifications of the internal results (maladies) of effective, topical treatment to a contagious itching disease he calls “psora”. He also devotes considerable space to instructions regarding the administration and making of remedies. However, it is the relationship of the treatment of the itch and resulting maladies which interest us here, as Hering has assumed that the passage of cure should therefore travel in the opposite direction. This could be the origin of the “within out” tenet and may also explain the “most important organ to the least important organ” part of the theory.

In reference to the above, Hering offers a definition of chronic disease in the article (disease which progresses from without inwardly, from the less essential parts of the body to the more essential, from the periphery to the central organs, generally from below upwards). It is unclear whether he ascribes this idea to Hahnemann, for which I can find no evidence, or whether it is his own or someone else’s. In any case, it would appear that this is the basis for his believing that we are to give drugs which act in exactly the opposite way. Nowhere does he say that this action was observed in any cases of disease.

“Cure proceeds from above down.”
Although I was not able to find a reference to “above down” in Hahnemann’s writings, André Saine in his talk given in Holland in May 1991 said that Hahnemann made reference to pain travelling from above down during a cure.

In passing I feel compelled to add that I find Hering’s misunderstanding of the quintessence of Hahnemann’s doctrine astounding and incredible. All the more as it has been said that he corresponded with Hahnemann.

Hering’s Law in practice
It is quite clear in the literature that Hering’s Law has been considered by many homœopaths throughout history but has not been the only means of assessing remedy behaviour within the organism. On the occasions that it is cited in the literature (approximately 10 times in a library of approximately 2000 books and periodicals dealing with homoeopathy only), it is usually amidst a mass of other guidelines for assessing remedy action and effectiveness as regards further treatment.

It could be mooted that this lack of exposure given to the tenets is because cure is, with time, perfectly obvious to both practitioner and patient and therefore such a set of tenets becomes superfluous considering Hahnemann’s instructions regarding repetition and change of remedy are easy to follow.

It could also be suggested that this downplay in the literature could be due to the discrepancy between Hering’s Law, whether applied in its totality or partly, and what is seen in practice. The following reasons are offered as an explanation for this:
• Homoeopathic treatments are often not antipsoric (refer “The origins of Hering’s Law” in this article).
• Potential for reversibility is not considered in Hering’s Law; e.g. in the case of an arthritic ankle, knee and hip, the knee and ankle may heal well while the hip does not due to more extensive tissue damage (André Saine, Holland May 1991).
• Causation may differ, requiring a different remedy; e.g. the case of an arthritic ankle and a sore hip whereby the hip pain, due to damage through poor postural alignment, required a trauma medicine and mechanical treatment, while the ankle required an approach appropriate for treating disease. Naturally, the ankle improved before the hip, as the trauma treatment was not applied simultaneously (clinical case, Sue Muller).
• Degree of malignancy is not considered; e.g. a simple gastritis disappeared and a rodent ulcer appeared on the face (clinical case, Australian homœopath).
• Degree of incapacitation is not considered.
• The theory cannot be observed during the disappearance of a solitary, perceived symptom as no direction is involved.
• Many patients present with complex symptomatology of multiple etiologies; e.g. patients who have existing naturally occurring diseases as well as toxic symptoms from environmental chemicals and/or results of physical and/or emotional trauma.
• Inadvertent proving symptoms cannot be accounted for.
• That diseases have features in common from individual to individual but also vast differences, and that this applies to the healing process also.
• The body is a dynamic structure and changes occur which are not necessarily due to medicine.

It is also interesting to note the following quote from Hahnemann, Volume 1 Materia Medica Pura, R.E. Dudgeon translation: “Even when given in human diseases in order to ascertain their effects, the peculiar symptoms which were solely due to the medicine can never be distinctly recognised, never accurately distinguished, amid the turmoil of the morbid symptoms already present, so as to admit of our ascertaining which of the changes effected were owing to the medicine, which to the disease.”

Hering’s Law in the literature
Herbert Roberts, in his The Principles and Art of Cure, refers to a law of the direction of cure: “Cure takes place from within outward, from above downward, from the important organs to the less important organs; and symptoms disappear in the reverse order of their appearance”. He says that if old symptoms return this is a favourable sign because it is a sign that the condition is being solved in the homoeopathic manner and by the law of the direction of cure. He does not attribute this idea to Hering and, indeed, Hering does not appear to refer to this.

Kent, in his Lectures on Homœopathic Philosophy, asserts that Hahnemann did not tell it all, and that we will see a demonstration of his teaching about the results of suppressing eruptions if we apply principle to the progress of disease:
“. . . that diseases get well in the reverse order of their coming, that the latest symptoms will be the first to go away, and that the older symptoms will come and go in reverse order in which they appeared; old symptoms, in the form of eruptions, come back, old chills, which have been suppressed, come back, and many other chronic manifestations come back again in a sort of successive order.” He does not relate this idea to Hering, however. He then continues to tell us that if we do not see these things our patients are not getting better!

George Vithoulkas, in his The Science of Homœopathy, claims observations culminated in Hering’s Law: “Cure proceeds from above downward, from within outward, from the most important organs to least important organs, and in the reverse order of appearance of symptoms.” However we are not informed of the documentation of these observations.

Vithoulkas’ interpretation of Hering’s Law is that “if cure is in progress, symptoms will manifest at levels which are progressively of less crucial importance to the freedom of the individual to express fullness and creativity in life”. He says this is the concept underlying Hering’s Law. He places some significance to the return of old symptoms during the course of treatment but does not quote it as Hering’s Law.

However, it is interesting to note that he then proceeds to elaborate on the fact that interpreting long-term changes during homoeopathic prescribing is complex due to individual variations from patient to patient.

Gerhard Koehler devotes little space to Hering’s Law and states it simply as Hering noting that cure may be expected when the direction of symptom eradication proceeds from within outwards, from above down and from the present time to earlier times. (The Handbook of Homœopathy, Its Principles and Practice).

Interestingly, Koehler points out how impressed he has always been when reading the Organon of Medicine by Hahnemann by the immense care taken over observations and the self-criticism he applied in checking drug reactions. He adds that one criticism which cannot be levelled at homoeopathy is that drug actions are not noted and carefully recorded.

Conclusion
The results of searching the literature for information on Hering’s Law reveal that it is seldom cited, and when it does appear it is usually amidst a discussion about various methods of assessing remedy action.

The tenets themselves vary from author to author and, it would appear, have been inexactly ascribed to Hahnemann’s observations, unsubstantiatedly ascribed to the observations of others and read into or just stated as plain fact. With this in mind only the tenets which can be exactly ascribed to Hahnemann can be understood to have been based on accurate clinical observation.

In fact, the lack of clinical backing for Hering’s statements and their inapplicability in so many cases of cure in practice has led to them being publicly denounced as a set of beliefs (André Saine, Holland, May 1991) unlike the results of homoeopathy as a whole. In light of the available evidence the label “Hering’s Theory on the Direction of Cure” would seem more appropriate.

The findings as revealed in this article provide much material for discussion about Hering’s Theory on the Direction of Cure, what truly constitutes it and its place in homoeopathic practice.

[The author did not write this examination of Hering’s Law with the intention that it would be published in Homœopathica; she wrote it several years ago to counter forceful lobbying to have the theory and practical application of Hering’s Law given a significant place in the New Zealand Qualifications Authority’s framework for a qualification in homœopathy, at that time being drafted.

The editor was very impressed with this article when he read it, and his enthusiasm has not dimmed – so it appears here, even though its author would have liked the time to rewrite it, because it follows well the lengthy essay by Will Klunker on the misunderstanding and distortion of the miasm theory which appeared in the September 2000 issue. – Editor]