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Hahnemann's Direction of Cure and Hering's Laws.

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  • Hahnemann's Direction of Cure and Hering's Laws.

    Dear students and colleagues,

    It has become popular in certain circles to criticize Hering and Kent
    and call the postulates known as Hering's laws spurious. Some say that
    none of Hering's laws can be found in Hahnemann's writings. Others admit
    that the reversal of symptoms is found in The Chronic Diseases. Now a major
    target is the maxim from within to without. They say that healing does not
    progress from with to without because the internal and external cure happen
    at the "same time". The opine that all externalizations are the fruitless
    efforts of a diseased vital force that have nothing to do with healing and
    are only the outcome of improper treatments.

    Over the years Hahnemann noticed that the vital force tried to remove
    disease from the more important internal organs by setting up local
    affections in the less important external parts of the body. At the same
    time, the vital force was willing to sacrifice a great deal of its energy,
    humours and tissues in an effort to preserve the organism through crisis.
    These efforts as self-healing cannot cure a chronic disease.

    During the processes of homoeopathic healing the primary action
    replaces the natural disease with stronger but temporary medicinal
    diseases. The secondary action of the vital force seeks to remove the
    remedy disease from without while restoring homeostasis within with renewed
    vitality. During the homœopathic healing process the action of the vital
    force is similar to its actions in the natural disease but it is not the
    same. In the place of painful and unproductive crises there appears
    definite curative signs associated with proper direction of cure.

    Hering wrote about the direction of cure in the Preface to the American
    edition of The Chronic Diseases in 1845. He that there was a "law of order"
    which Lippe called it the "law of cure" and Kent called "Hering's laws".
    The essence of Hering's postulates are based on Hahnemann's teachings on
    the development of psora and the reversal of the order of the symptoms
    while under antipsoric treatment. Vide The Chronic Diseases, Theoretical
    part, p 230.

    "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 to all other respects almost totally

    In The Chronic Diseases (p. 203-204) Hahnemann wrote that a when a
    well chosen remedy is acting the patient may feel a moderate headache, sore
    throat, diarrhea, pains in one part or other that they experienced in the
    past. This is no reason to give a new remedy because these are a "sign that
    this medicine acts deeply into the very essence of this disease, and that
    consequently it will be more effective in the future". The return of old
    unresolved symptoms is closely related to the maxim of the reversal of the
    symptoms but the situation is slightly different. In the reversal of
    symptoms the signs just disappear in order, while in the return of old
    symptoms old unresolved diseases states and suppressions reappear before
    being removed.

    Hahnemann wrote that it is essential to treat the internal psora rather
    than suppress the external lesion. He stated the healer should "first of
    all treat the internal malady, whereby the cutaneous eruption will, at the
    same time be removed and destroyed and all the subsequent innumerable life
    long chronic suffering springing from the Psora be prevented or, if the are
    already embittering the life of the patient, be cured." (Page 47,
    Theoretical Part, Chronic Diseases). Statements like this have been taken
    out of context to say that internal and external healing takes place all at

    The meaning of these statements are that one should treat the internal
    psora because this will treat the external eruption at the same time
    without external treatment. This statement does not mean that the newest
    (the most serious developed secondary organic pathology) and oldest
    symptoms (the original skin eruptions) are healed at the exact same time.
    Let us study this maxim in its original paradigm, the cure of psora.

    In the Chronic Diseases Hahnemann taught that the primary stage of
    psora began with an infection of the skin that dynamically permeated the
    human organism with internal psora and then produces a skin eruption. This
    external eruption acts as a "pressure value" that slows the advance of the
    internal malady. If the psoric lesion is suppressed or spontaneously leaves
    the skin, the internal psora enters a latent stage that is associated with
    certain functional symptoms. As the patient ages, or if they are placed
    under undue physical and mental stress, the internal psora breaks out into
    secondary psora associated with organic pathology in the vital organs.

    1. The 1st stage of psora includes the primary symptoms of psora on the
    SKIN, the most external part of the body. This appears as innumerable kinds
    of infectious skin eruptions. Hahnemann wrote "The local symptoms has it
    place on the least dangerous part of the body, the external skin" (CD, page

    2. The 2nd stage is latent psora which produces systemic functional
    symptoms. Hahnemann recorded 60 symptoms of latent psora in The Chronic
    Diseases. This includes paleness of the face, bad smell from the mouth,
    perspiration, tedious catarrhal discharges, obstruction of the nose, cough,
    breathing difficulties, digestive upsets, flushes of heat, falling out of
    hair, twitching, itching of anus, dark urine, painful joints, dry skin,
    itching vesicles here and there, etc.

    3. The 3rd stage is secondary psora where psora transforms from
    functional states to organic pathology disorders involving damage to the
    major vital organs and systems. Hahnemann list around 400 secondary
    symptoms and over 100 pathologic states including consumption, lung
    disease, heart disease, kidney disease, diabetes, bone diseases, intestinal
    diseases, stomach diseases, liver diseases, diseases of sexual organs,
    paralysis, strokes, convulsions, epilepsy, deafness, dropsy, goiter,
    cancer, etc., etc.

    Now according to the reversal of symptoms:

    1. The 1st set of symptoms to be removed is the organic pathology in the
    internal vital organs as these secondary symptoms are the last to appear.
    This would include the 400 symptoms and 100 organic pathological states of
    secondary psora. This shows that the chronological reversal progress begins
    within the most important internal vital organs and systems.

    2. The 2nd set of symptoms to be removed would be the general
    functional states associated with the 60 symptoms of latent psora. The cure
    carries on from the functionally disturbed internal systems toward the more
    external skin, the first and oldest symptom. Thus the reversal of the
    symptoms continues with the movement of the disease from organic pathology
    in the vital organs to the systemic functional changes. Hahnemann wrote
    "When the treatment is about half completed, the diminished disease
    commences to return into the state of latent Psora; and the symptoms grow
    weaker...." (CD. page 231)

    3. The 3rd set of symptoms to be removed is the eruptions on the skin
    as these were the first to develop and are the oldest most external and
    least dangerous symptoms. The direction of the cure is from within to
    without ending less important and less dangerous external lesions on the
    skin. If the skin symptoms were suppressed they may return as this is
    an aspect of the maxim of the return of the old unresolved symptoms. Once
    the external skin eruptions are completely cured the entire internal and
    external psora is cured.

    The disease symptoms developed from stages 1 to 2 to 3. This means the
    disease direction is from the most external, less important skin to the
    more important functional systemic symptoms, to the most important organic
    pathology in the inner vital organs. The reversal of symptoms is from stage
    3 to 2 to 1. The healing direction is from the most important organic
    pathology of inner vital organs to the less important functional states, to
    the least dangerous external skin lesions.

    The direction from above to below may be involve in the healing process,
    especially if the original symptoms began in the lower parts of the body
    and then moved upward. They would naturally pass from above to below as the
    developmental order of the symptoms are reversed. Therefore, the reversal
    of the order of the symptoms, the movement from within to without, the
    return of old symptoms, and the pains being relieved from above to below
    come together because they are all part of the same healing process.

    Hering wrote in his Preface to the Chronic Diseases (p. 8) that the
    cure is marked by an improvement in the mind and general state of
    well-being. "Hence it is that Hahnemann inculcates with so much care the
    important rule to attend to the moral symptoms, and to judge of the degree
    of homœopathic adaptation, existing between the remedy and the disease, by
    the improvement which takes place in the moral condition, and in the
    general well-being of the patient".

    This observation has its origin in Hahnemann's Organon in aphorism 253.
    Hahnemann wrote "When there is a ever-so-slight beginning of improvement,
    the patient will demonstrate a greater degree of comfort, increasing
    composure, freedom of spirit, and increased courage - kind of returning of
    naturalness". Hahnemann also wrote that the "strength of the patient" ought
    to continually "increase" from the commencement to end of the treatment
    (CD, page 233).

    There are 8 observations of the direction of cure found in Hahnemann and
    Hering's writings.

    1. Pains are removed from above to below
    2. Diseases are removed from within to without
    3. Symptoms are removed from the more important to the less important areas.
    4. Symptoms are reversed from the newest to the oldest.
    5. During the process of cure old unresolved symptoms may arise.
    6. An amelioration takes place in the mental condition of the patient.
    7. The strength and vitality of the patient increases during treatment.
    8. The opposite of these progressions are signs the disease is getting
    worse or is being suppressed. That is the pains travel from below to above;
    from without to within, from the less important to the more important; the
    symptoms increase; complaints the patient never had appear; the mental
    state gets worse; and the patient gets weaker. These are sign that the
    disease is getting worse or is being suppressed.

    Sometimes persons try to use examples where cure did not follow the
    direction of cure to refute the entire teaching. Hahnemann made it clear
    that the direction of cure can be disrupted by drugging and suppression and
    that sometimes "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 to all other respects almost totally restored." This is the
    source of the exceptions to the rule.

    The eight factor of healing are interrelated and represent different
    facets of one total phenomenon. It is not easy to say where one maxim ends
    and another begins because they all find their source in the unity of the
    vital force. Where one maxim is not totally applicable another maxim may
    take its place. It is difficult to tell whether a patient is improving or
    declining from just one factor alone. To form a proper prognosis it must be
    supported by several confirmatory symptoms.

    Perhaps one of the symptoms appears to be moving downward but the
    others are moving inward toward the more important organs while the mental
    state and the vitality are declining. This would cast great doubt on the
    idea that the patient is getting better. Perhaps an old local pathology
    remains while other older symptoms have already been removed. This may be
    one of the exceptions to the rule Hahnemann spoke of in The Chronic
    Diseases. If the patient has improved emotionally, has more energy and
    other symptoms are being relieved in an orderly manner, the cure is still
    progressing in the right direction.

    The reversing of the order of symptoms is the basis of the direction of
    cure because it inherently includes the return of old unresolved states as
    well as the movement from within to without, from the most important to the
    less important, and from above to below when the disease clearly developed
    this way. This process also includes a beneficial change in the mental
    state, an increased sense of well-being and increased vitality.

    What is true for psora is also true for sycosis and syphilis, etc.
    Sycosis may start with suppressed gonorrhea and/or burnt off HPV warts and
    progress to organic pathology in inner vital organs. In this case the
    internal symptoms would be the first to be removed, and in some cases the
    suppressed discharge or burnt off warts may return before being completely
    cured. If syphilis began with contact of the sexual parts and progress to
    the brain then the process of cure would first start in the brain and
    progress from within to without and from above to below to the skin of the
    sexual glands. Sometimes the organism is so suppressed and weakened that
    it cannot reproduce the original primary symptoms. In this case, the
    organism may produce a surrogate eruption or discharge that takes the place
    of the original symptoms as best as possible. A similar process is
    witnessed in the TB miasm and cancer diathesis, etc.

    That beneficial externalizations take place during the process of cure
    is well documented. For example, Hering had a case of where the syphilitic
    chancre was suppressed and the patient developed more symptoms. He tried
    several remedies but nothing really worked. Then he gave syphiline as an
    intercurrent nosode and the old suppressed chancre came out . After this
    externalization the cure was completed by remedies that formerly did not
    work. This demonstrates the symptom “When well chosen remedies do not work”
    and role of the chronic intercurrent nosode in removing obstacles to the cure.

    The best cure is simply the rapid restoration of health without any
    excessive remedy actions. When the patient is healing they usually feel
    better emotionally with more energy. Any return of old symptoms and
    eliminations are often so slight that they are hardly noticeable and do not
    bother the individual. The old symptoms that manifest the strongest are
    often the symptoms that were heavily suppressed and closely connected to
    the development of pathology. This is a very important moment in the cure
    that should not be misunderstood. Such symptoms should pass through quickly
    and be followed by an increased sense of well-being and more vitality.

    When old symptoms return that are *stronger and more prolonged than the
    original symptoms - this is a sign of remedy caused aggravation*. For
    example, a person may have originally suppressed a skin eruption that was
    the size of a walnut. What if the skin symptom returns and spreads all over
    there body? Some persons would sign that this is a "good sign". The truth
    is that this is a excessive medical action caused too large a dose, too
    high a potency and/or repeating the remedy when it is not needed. These
    reactions are not in harmony with Hahnemann's teachings on a rapid, gentle
    and permanent cure.

    Some of the crises in Kent's cases were actually excessive aggravations
    caused the posology mistakes. This is because Kent did not believe that the
    size of the dose (1 or 1000 pills) mattered in the action of a remedy and
    tended to give high C potencies. Hahnemann taught that the more accurate
    the remedy, and the higher the potency, the MORE the size of the dose
    matters! I have been pointing this for many, many years. Nevertheless, Kent
    was a great homoeopath who cure many 1000s of persons (most without
    excessive crisis). We all make our mistakes and it is best if others learn
    from them. Let those who are perfect be the first to cast stones. No such
    persons exists. Those who live in glass houses should not throw rocks!

    Patients do not need to experience all the pains they suffered in the
    past or every eliminations and eruptions. Many times the symptoms are
    relieved in a order fashion without the return of old symptoms or
    externalizations. Prolong reactions are a sign of over medication and
    signal to be very careful with the remedy, dose and potency. If such
    conditions do arise it is important to know what they mean and what to do
    about them. To call them a "healing crisis" and let the patient suffer
    while continuing to do the same thing is not the proper way forward. If the
    over reaction is mild enough one only needs to wait and watch for the
    improvement to come. In some very strong crisis one may have to intervene
    with a remedy or remedies to correct the situation.

    Lastly, I would like to say that there is no reason to throw out the
    baby (the homoeopathic maxims on the direction of cure) with the bath water
    (excessive reactions due to improper posology and case management). The
    direction of cure as introduced by Hahnemann and expanded upon by Hering
    has been observed 10,000s of times over a 160 year period and proved its
    worth in the clinic. For this reason it is best to take good care of the
    baby, and of course, change the bath water when necessary.

    Similia Minimus
    Sincerely, David Little

    - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
    "It is the life-force which cures diseases because a dead man needs no more
    medicines." - Samuel Hahnemann

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