| How do we know that the remedy
is working, namely that a cure is taking place? This is the question
that rightfully occupies each practitioner.
Dr. Hahnemann gives us some
guidance for how to determine whether cure is taking place in terms
of the expansive (improvement) and contractive (worsening)
aspects of the patient that can be discerned (which requires
some supersensible knowing) by the knowing physician.
§253.1. Among the signs
which show a small beginning of improvement or aggravation (not visible
to everyone) in all diseases, especially the rapidly arising (acute)
diseases, the state of mind [Gemüt] and of the
entire behavior of the patient is the surest and most enlightening.
§253.2. In the case of
an ever-so-slight beginning of improvement -- a greater comfort,
an increasing composure, freedom of spirit, increased courage,
a kind of returning naturalness.
§253.3. But in the case
of an ever-so-small beginning of aggravation -- a more self-conscious, helpless
state of mind [Gemüt], of the spirit, of the whole
behavior, and of all attitudes, positions and actions,
drawing more pity to itself, which [state] allows itself with exact
attentiveness to be easily seen or shown but not to be [easily]
described in words.
Hahnemann also spoke of the
disease proceeding from the less to the more noble organs, a hierarchical
observation based on the structural functions of living organisms.
The curative process is here the opposite of the process followed
by suppressive treatment (allopathic).
1.4. It falsely deems
the maladies located on the outer parts of the body as merely local
and existing alone there by themselves, and imagines them to
have been remedied if it has driven away the same by external
means, so that the inner malady now is necessitated to break out
at a more noble and critical place.
45.2. ... this
expulsion of the local symptom onto other more noble parts; the
patient got dangerous eye-inflammations, or deafness, or
stomach-cramps, or epileptic seizures, or asthmatic or apoplectic
attacks, or mental or emotional [Gemüt] disease,
etc., for it.a]
§.205.1.a]1 ...the Sustentive
Power of Life is therefore necessitated to transfer
the focus for the great internal malady to a still more
noble site (as it does with all metastases) and allows blindness, deafness,
insanity, suffocative asthma, dropsy, apoplexy, etc. to follow.
§.216.1.
The cases are not rare when a death-threatening so-called somatic
disease -- a suppuration of the lung or the corruption of
any other noble organ, or another heated (acute) disease,
e.g. in labor, etc., degenerates by rapid ascent of the
hitherto mind symptom into an insanity, a kind of melancholy,
or a frenzy and thereby makes all deadly peril of the somatic symptoms
vanish; in the meantime the somatic symptoms improve almost
up to the point of health, or rather decrease to such
a degree that their crepuscular presence can only be discerned by
the steadfastly and subtly observing physician.
891 ... This in
time passes away again, when the psora again lifts its head,
either with the same disease symptoms as before, or with others similar
but gradually more troublesome than the first, or with symptoms
germinating in nobler parts.
Hahnemann also spoke in general
terms about the improvement in well-being (Wohlseyn) and soundness
(Gesundheit). For Hahnemann, this was a function of kennen -
a deeper, inner knowing based on the Gemüt - and would be determined as
part of the observation following the prescription. However, one
of his closest followers, Constantine Hering, a fellow German
who emigrated to the United States and
corresponded closely with Hahnemann in his latter years, has
provided us with some guidance.
These guidelines are often
referred to as Hering’s Laws or Principles of Cure. Dr. Hering based
his guidelines on Hahnemann’s and his own observations. He
set them out in the prologue to Hahnemann’s first American
edition in English of the Chronic Diseases, New York, 1845.
In this prologue he borrows from an earlier essay he had written,
Guide to the Progressive Development of Homoeopathy. These guidelines
are used widely by those in the natural health field.
First, Hering describes the
natural development of a disease:
As acute diseases terminate
in an eruption upon the skin, which divides, dries up, and then passes
off, so it is with many chronic diseases. All diseases diminish
in intensity, improve, and are cured by the internal organism
freeing itself from them little by little, the internal disease approaches
more and more to the external tissues, until it finally arrives
to the skin.
Next he states the principle
that he derives from this observation:
Every homoeopathic physician
must have observed that the improvement in pain takes place from
above downward; and in disease, from within outward.
After further emphasising the
importance of the skin eruption in preventing a more serious disease,
Hering goes on again to spell out the principles:
The thorough cure of
a chronic disease is indicated by the most important organs being
first relieved; the disease 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. Even the
superficial observer will not fail in recognizing this law of order.
An improvement which takes place in a different order can never
be relied upon.
Hering then claims that all
this is based on Hahnemann’s important rule to attend to the moral symptoms
[mental/emotional], and to judge of the degree of homeopathic adaptation
existing between the remedy and the disease by the improvement
which takes place in the moral condition (morale), and the
general well-being of the patient.
In summary, Hering’s observations are as follows:
1. The "improvement
in pain takes place from above downward..."
Note that this direction of
cure relates to pain or pathology. Pain is a sensation that is mainly physical
and superficial, in terms of the main nerve endings. A painful rash
would move down from head to toe, as does the characteristic
rash of measles.
2. "...and in diseases,
from within outward." "The thorough cure of a chronic
disease is indicated by the most important organs being first
relieved..."
Hering now turns to the disease
itself. The order of remediation is here from deeper in the organism
to the outer layer, the skin, from the centre to the periphery.
This accounts for the numerous skin eruptions during treatment
even where none had existed before. However, Hering also qualifies
this, as does Hahnemann, by stating that the order is of importance
– from more important to least important. Hahnemann always speaks
of "nobler" organs, implying a hierarchy of organs,
including those of the emotional mind (Gemüt). Thus, the direction
of cure here is not simply spatial, but dynamic and functional.
3. "...the disease
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."
Here Hering again refers to
a given disease. He further specifies that this order of "within
outward" is the same order as the disease process.
Let’s take an example, which
reflects any acute miasm or acute epidemic disease:
Indeed, just like symptoms
appear first in the psychic sphere, then in the organs and lastly
on the surface, healing follows the same order because in this
case there is no difference between the order of getting ill
and of getting cured. Infections, eruptive diseases which, in a
few days, allow us to observe objectively and clearly what
happens in an acute case are typical examples. At the beginning
the child is sad, depressive and changes his temper (psychic symptoms).
Then he has chills after which he feels terribly tired, has
fever (he can get very thirsty), suffers from anorexia, etc. (general
symptoms). Lastly, the eruption appears starting by his face, neck,
trunk, limbs, and ending in the same order. Before the eruption
is cured, the psychic and general symptoms have already been
normalized, and this proves Hering's observation is correct. The
same happens with chronic pathological manifestations. (all
the above quotes of Hering as well as this one taken from Eizayaga,
Treatise on Homeopathic Medicine, p. 105).
What happens if you have more
than one disease in a patient?
In fact, we can observe in
nature that their cure proceeds from one disease to the next, in
the reverse order of time. Let’s see how this was expressed
almost a century ago by one of the most influential homeopaths
in the United
States, James Tyler Kent:
...The first prescription
antidotes the drug and liberates the patient from the drug disease,
and then you see the most acute or last appearing natural disease
which comes back first. This is in accordance with fixed law;
the last miasma or the last symptoms that have been made to disappear will
be the first to return and go away to appear no more. (Kent, Lectures
on Homeopathic Philosophy, p. 121)
Thus, within a disease, the
curative process is in the same order as the disease. However, between
diseases the curative process is in the reverse order of the diseases,
that is, in the reverse order in which the diseases were acquired,
the most recent going first. Hahnemann also notes this in his Chronic
Diseases:
998 ...but the oldest maladies
and those which have been most constant and unchanged, among which
are the constant local maladies, are the last to give way,
and only after all the remaining disorders have disappeared and
health has in all other respects almost totally returned.
Glossary No. 10
Direction of Cure:
a) Within a given disease,
the local symptoms (involving pain or pathology) move from above
downward, from the more important organs to the less important organs
(importance being a matter not only of space, but of function or
"nobility"), and in the same order as the disease
process itself.
b) Between given diseases, that is,
where there is more than one disease in a patient (see Aphorisms
40-42), the cure of each disease occurs in the reverse order
of their occurrence in the patient, setting up a sequentiality of
treatment of multiple disease states in a patient.
# # #
Rudi Verspoor is Dean and Chair Department of Philosophy
Hahnemann College for Heilkunst, Ottawa. He served as the Director
of the British Institute of Homeopathy Canada from 1993 to early
2001 and helped to found and is still active in the National United
Professional Association of Trained Homeopaths (NUPATH) and the
Canadian/International Heilkunst Association (C/IHA).
Part of his time is spent advising the Canadian government on health-care
policy and in working for greater acceptance of and access to homeopathy.
His publications include:
Homeopathy Renewed, A Sequential Approach to the Treatment of
Chronic Illness (with Patty Smith);
A Time for Healing; Homeopathy Re-examined: Beyond the Classical
Paradigm (with Steven Decker);
The Dynamic Legacy: Hahnemann from Homeopathy to Heilkunst
(with Steven Decker).
Visit his website at http://www.heilkunst.com/ |