Homeopathy Papers Organon & Philosophy

Hering’s Law of Direction of Cure – A Reliable Tool in Homeopathic Therapeutics

Recently, some colleagues (Saine, 14), have doubted the veracity of terming Dr. Constantine Hering’s observations a law, when they do not observe every aspect fulfilled in a case. This paper seeks to restore faith in this law as an indispensable clinical tool, with the help of reliable perspectives from homeopaths of great capability. Dr. Hering described his observations as a ‘law of order’ (of symptom expression) in his Preface (12, Appendix 1) to the 1845 American edition of The Chronic Diseases by Samuel Hahnemann. (9, Appendix 2)

Nearly a hundred years ago, master homeopaths: JT Kent, HC Allen, JH Allen, PC Muzumdar and others, understood the application of Hahnemann’s theory of miasms in clinical case management in addition to Hering’s Law of Direction of Cure. They regarded this law on a par with the Law of Similars and were tremendously successful.

Essential to observing and accurately applying the law is to first thoroughly understand the expression and progress of disease in an individual case. Second, perceive the conceptual details of the law accurately interpreted in that case, aptly supported by miasmatic interpretation of the phenomenology that develops.

Dr. Praful Vijaykar, (7, 15, 16) a contemporary homeopath, has correlated the ‘law of order’ observed by Hering, with the embryological development of a fetus. He also uses this to explain the concept of ‘suppression’ in homeopathy; recognizing a pattern of deteriorating disease opposite to the direction of cure, individual to every case (15).

A homeopath must seriously consider anomalies i.e. counterfactuals (2, 13) to this natural law and appropriately interpret this for clinical management.


In recent past, an esteemed colleague (Saine, 15) had doubted the veracity of terming the direction of cure a law, since he could not observe every aspect fulfilled. His wide influence on other homeopaths through his article is regrettable. He states (Saine, 15) “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.” I suggest a better understanding and application of the law instead.

This paper seeks to restore faith in this law as an indispensable clinical tool with the help of reliable perspectives from homeopaths of great capability. Dr. C. Hering described this “law of order” in his Preface (12, Appendix 1) to the 1845 American edition of The Chronic Diseases (9, Appendix 2, 2.1) by Samuel Hahnemann.

The Law:

The 5 directions of cure Dr. Hering observed were from above, downwards; within, outwards; center to periphery; from more important to less important organs and in the chronologically reverse order of disease development (Appendix 1).

A Law speaks of a recurrent pattern that exists in Nature. With a thorough conceptual understanding of these patterns and conditions necessary to fulfill or violate them, one uses the law with hindsight in the various clinical decisions of remedy choice or change, as well as posology. Often this is not a conscious application, but an intuitive guide after achieving adequate conceptual training of the patterns of cure, supported by clinical experience.

Dr. ML Dhawale, MD, FAMS, (5,6) a pioneering homeopath and founder of the Institute of Clinical Research, Mumbai, that today runs over 6 successful homeopathic hospitals (apart from clinics) in and around Mumbai (Pavaskar,13), wrote in his article on Experimental design for Clinical Research in Homeopathy (Dhawale, 6):

“Homeopathy is scientific in that it is governed by two laws:

1.                 The Law of Similars: The fundamental law of selection of the similar dynamic force which demands a total understanding of the concept of the Hahnemannian totality, the ability to perceive it in the area of disease (drug as well as natural) and the capacity to achieve its establishment on the similar plane through the adoption of suitable techniques and the application of the right clinical judgment.

2.                 The Law of Direction of Cure (Hering): The law of verification that gives us the requisite feedback in respect of the accuracy we have achieved in respect of the correct application of the Law of Similars.

And we must ever remember that Law does not recognize exceptions.”

If such an intelligent, medically trained, scientific homeopath, with clinical experience spanning over 50 years had little reason to doubt the clinical veracity of Hering’s Law of Cure, we must think seriously before we trivialize the law.

An Embryological Perspective of the Law:

Dr. Praful Vijaykar, (8, 16, 17) an extremely successful homeopath from Mumbai, developed a reliable correlation of Hering’s Law based on an irrefutable pattern in nature – the in-utero development process of an embryo. His book, The Theory of Suppression (16) states, (quoted for brevity)

“The (fertilized) human egg, like that of any chordate egg differentiates into various organs and systems. Before it differentiates…., it gives rise to 3 germinal layers:

a)                 Ectoderm

b)                Endoderm

c)                 Mesoderm

The fourth is a specialized ectoderm called the neuroderm or neuro-ectoderm.

Ectoderm: Gives rise to all the organs which are in connection or exposed to the external environment (skin). It is of least importance, …our first layer.

Endoderm: Forms the respiratory tube lining, gastro-intestinal tube lining and urinary tract lining. This is also … exposed to the external environment. … forms our 2nd layer.

Mesoderm: Gives rise to the viscera (lungs, heart, kidneys) or parenchyma of viscera. These organs arise out of mesothelium of mesoderm. (4th layer)

Connective tissue: …connection between endoderm derivatives and mesoderm derivatives …is established by tissues arising out of the mesenchyme of the medoserm…. the connective tissue includes blood, lymph, bones, cartilages, muscles, dermis and fascias, and coverings of organs. (3rd layer)

The neuro endocrine glands are externally derived from ectoderm, endoderm or even mesoderm, But the functional part of it, i.e. the secretary cells are of either neural crest in origin or neuroectodermal in origin. (5th Layer)

The nervous system, whether it is central or peripheral and the brain are derived from the neuroectoderm which is a specialized ectoderm. (6th layer)

….As the embryo grows, the nutrition is supplied from the first formed organ which acts as the chief source.

*The first to form is the Precordial plate which represents the head part. In the cure axis, the head or brain or upper part is more important than other parts which are formed later.

* The cephalo-caudal axis so formed denotes the higher to lower level importance

* The spread of mesoderm paraxially from inside out

*  and from dorsal to ventral region also denotes the importance of that direction.

All these indicate the 4 directions of cure:

a) More important to less important

b) Above downwards

c) Inside out and

d) Centre to periphery

Ectoderm is least important when it forms skin and most important when it forms brain and neural tissue. The Endoderm and Mesoderm give rise to organs which are in between. How beautifully the circle becomes complete! From ectoderm – to endoderm – to mesoderm – to neuro-ectoderm – to ectoderm once again.”

Explanatory details can be read in my article (D’souza, 8). Embryological development involves serious study, but is worth the investment. One develops a conceptual idea of natural patterns in this process, which is a sophisticated explanation of Hering’s Law of Cure. Dr. Vijaykar’s insight into embryology, maps suppression (in 7 layers) and miasmatic deterioration therapeutically, and is brilliant and clinically reliable.

Clinical Perspective of the Law:

Science today has realized the necessity of natural laws; universal patterns in nature, though these rely on inductive logic based on a priori premises. We could add to our conditions on laws, that in addition to being universal in form, they support counterfactual conditions. It is crucial to bear in mind that this is a symptom of their being laws, not an explanation of it (Rosenberg, 14). This is how we understand the difference between a law and an accidental generalization. Laws are not expected to express logical necessities of truth. It is not necessary for a universal law to hold true in every instance, because there will exist counterfactual conditions to them (Appiah, 2).

Hence it’s possible to detect an anomaly in natural law, as a clash with observation or experiment, without rejecting the law. What makes a mere generalization a law, is the necessity of linking cause with effect as seen in applications of Hering’s Law. It is expected that universal laws continue to be modified over time, as conditions are added to it and anomalies further explained.  Straightforward cases and acute clinical conditions always support the law of cure. One counterfactual condition for observed anomalies of the law in complicated clinical cases is Hahnemann’s theory of miasms.

Groups of homeopaths who perceived miasmatic expression in individual disease evolution, also successfully applied Hering’s Law. Among contemporary groups, listed in ‘References’ are Dr. ML Dhawale’s ICR, Mumbai (5, 6, 13); Dr. Praful Vijaykar (8, 16, 17), Mumbai; David Little (12) www.simillimum.com . Among master homeopaths that had effectively done so, were JT Kent, JF Allen and HC Allen, Stuart Close, PC Muzumdar. These homeopaths also correlated the philosophy of miasms parallel to their spiritual backgrounds.

JH Allen, reflects the necessity of combining Hering’s Law with miasms, in The Chronic Miasms Vol 1 (1), pg.106-108

“We can only understand the forces of nature by and through law; because law is the relater of all things, as it is only through it the unknown principle (the miasm) is clearly revealed to us with all its attending phenomena. It is also true that we can only see through law the mystery of suppression, for suppression itself is a retrograde process or a deflection of law, or it is a physiological law opposed. The physician who suppresses any miasmatic state, or disease process if you wish, is an enemy of law or at least there is no mutual understanding between him and law. We must first know that law rules not alone the visible things, but all invisible as well…… Why? Because both the life and the disease (and you know disease is perverted life) work from within outward and from above downward and not from without inward; even the very unit of life (the cell) works from within outward or from its nucleus. The life is within, not without; the disease is within, not upon the surface. It is only an expression of it that you see. You can never see disease any more that you can see life itself. ……

….Therapeutically speaking then, we must enter into correspondence with it (life), we must deal with that which animates the organism and gives it its being, the life. Nature is the complement of life; but we must assist nature through its right channels and by the way of law. Disease appears through the medium of the same law that governs life, and we must work with it along these lines.

The miasm is the opposing force to the life force; therefore the forces being against it must be in true opposition to the miasm and not alone against the life itself or we disturb it more. It must go with the life (force) and work through the life (force) and be in co-operation with life (force). Any other procedure endangers suppression or a greater deflection of the perverted life force.”

About the author

Leela D'Souza

Leela D'Souza

Leela D'Souza-Francisco, MD (Hom), CIH (Cardiology) is a Mumbai-based homeopathic professional whose experience includes intensive graduate medical training at India's leading homeopathic medical institution in Mumbai, completed in 1990. She completed her MD (Hom) from MUHS, Nashik in 2008 with a Dissertation entitled "Emergency Management in Homeopathy". She obtained a post graduate MSc (Homeopathy) degree from UCLAN, UK in 2009 with a Dissertation entitled "How Can We Develop Suitable Clinical Trials for Research in Classical Homeopathy". Her present interests include management of in-patients in homeopathic hospitals, and clinical research in classical homeopathy. She has been in practice for over 20 years and is online at www.homeopathy2health.com for the last 15 years. Presently she is Consulting Homeopathic Physician, with specialization in Cardiology at Holy Family Hospital, Bandra, Mumbai. Visit Dr. Leela D'Souza at her website : http://www.homeopathy2health.com/member.htm and contact her at: leela@homeopathy2health.com

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