Abstract: Homoeopathy follows the law of individualization in all the aspects of treatment which includes, case taking, formation of totality of symptom, and even prescription. For the evaluation of the treatment, Hering’s law of cure has been used by physicians for years but there is no evidence-based tool available to prove the law in any individual case. This lack leads to the difficulty of the practical use of Hering’s law of cure. The Hering’s Law Assessment tool is formed by researchers on the basis of Hering’s law of cure to use it systematically by providing evidence of its practical utility.
Keywords: Assessment, Cure, Healing, Hering’s law of cure, HELAT, Homoeopathy, Individualization.
Introduction
The Healthcare sector has many modes of treatment among which homoeopathy is a one who continuously serves humanity since centuries across the globe. In India approximately more than 100 million people are dependent on Homoeopathy.1
This health care system is based on the individualization of the patient rather than the disease or nosological classification of disease by applying law of similar to find the most similar remedy for that particular patient. Homoeopathy applies to the law of individualization at every level including, case taking, formation of totality of the symptom, prescription of most similar remedy to assessing a cure. Among this all the steps, assessment of cure systematically following administration of individualized or most similar remedy has remained debatable topic since the origin of homeopathy.2
According to Cambridge dictionary, assessment means3, “the act of judging or deciding the amount, value, quality, or importance of something.”
Mostly assessment in homoeopathy done by following Hering’s law of cure which was given by Dr C. Hering and widely used by Dr J. T. kent.2,4 Hering’s law provide the direction in which the symptoms of the patient will disappear under purely Homoeopathic cure.5
This article explains about the assessment tool which formed from Hering’s law of cure known as – HELAT: The Hering’s Law Assessment Tool.
Material & method: article is a metanalysis about the assessment tool HELAT.
Material used:
- Books: Organon of medicine
- Online material: Existing peer reviewed article.
Literature review:
Hering’s law of cure:
Hering’s law of cure is one of the important pillars in many complementary therapies like, Homoeopathy, naturopathy, acupuncture etc.4
According to law, Cure takes place,
- “From within outward,
- from above downwards,
- from the most important organs to the less important organs, and
- symptoms disappear in the reverse order of their appearance.”
From within outward:
It can accompany with some manifestations, like, high temperature, sweat, bowel movement disturbance, excessive mucus production, frequent urination, etc. which known as
“HEALING CRISIS”.
From above downwards:
Ex. Sore throat moves toward sore knee.
From the most important organs to the less important organs:
Ex. Lung or liver to skin – disease travel.
Symptoms disappear in the reverse order of their appearance: Ex. Case of childhood eczema followed by hay fever. Then after the disappearance of hay fever the eczema will reappear.
Although this law is used by many physicians worldwide, there is still no systematic way to assess or measure this principle.
HELAT: The Hering’s Law Assessment Tool.
This assessment tool is developed by researchers to establish and understand the systematic healing process after the homoeopathic interventions.7,8
It can be a change in symptom character, state of patient at both level – physical as well as mental, etc.
The above flow chart explains about the HELAT in detail.
Flow Chart A: consist of all the possible symptom responses produce due to a constitutional remedy.
Flow Chart B: consist of the symptom information by using visual analogue scale (VAS) which includes, chief complaint, vitality, well-being, etc.
Flow chart A:
Homoeopathic intervention can lead to 3 possibilities,
- New symptom appearance
- Improvement of Existing symptoms
- Aggravation of Existing symptoms
It further divided into 11 possible categories which coded as A to K.
New symptom appearance: it can be due to the proving of homoeopathic medicine or a genuine new symptom.
A genuine new symptom leads to,
A: Adverse event unrelated to remedy.
Proving symptom leads to,
B: It can persist.
C: It can resolve.
Aggravation of Existing symptoms:
It can be healing crisis which leads to,
D: Increase health
E: More aggravation of symptoms.
Other than healing crisis,
F: Aggravating symptom resolves and then improvement starts
G: Symptoms remain as it is.
I: Symptom resolves but the state remains as it is.
K: Adverse event unrelated to remedy.
From this all the 11 points,
4 concluding points will come out which represents Hering’s law of cure.
It is indicated by H in the flow chart: Healing response.
| Symbol | Represent by | Indication |
| Ha | C | From above downward |
| Hb | Point 2 | More important organ to less important organ |
| Hc | D | From within outward |
| Hd | F | Reverse order of the appearance |
At every follow-up and consultation, this criterion should assess to understand the effect of the previous prescription.
The score will be:
0: no symptom is fitted to this category.
≥1: one or more symptom was allocated to that category
At the end, the total HELAT score will count by following formula:
Ha + Hb + Hc + Hd = HELAT SCORE
This score will provide the overall assessment of the patient after intervention of the homeopathic medicine as healing process.7
Conclusion:
Homoeopathy as a complementary system as well as one of the young and emerging systems of therapeutic provides answers to many difficult questions in the form of treatment by applying the fundamental law which helps to find the most similar remedy to provide cure from the root cause. Cure is a healing process which follows some directions which are explained by Dr C. Hering as The Hering’s law of cure. From this law, Dr J. T. Kent provides many observations about the healing outcome. But all things are present theoretically only because of the lack of practical evidence-based criteria and tools. This leads to criticism of pathy as well as physicians. The Hering’s law of Assessment Tool is made by researchers to solve this problem of practical evidence. This tool provides the probable outcomes of any disease process after intervention done by homeopathic medicine. It is subdivided into 11 categories to explain it in detail at the end in 4 different groups which represent Hering’s law of cure – from within outward, from above downward, travel from most important organ to less important organ, symptoms disappear in the reverse direction of its appearance.
Reference:
- Homoeopathy, Ministry of Ayush, Government of India. https://ayushedu.bisag-n.gov.in/AYUSH_EDU/homoeopathy
- Sarkar B. K., Organon of Medicine, 5th and 6th edition, Birla Publication PVT LTD.
- Assessment, Cambridge dictionary, https://dictionary.cambridge.org/dictionary/english/assessment
- Monitoring improvement in health during homeopathic intervention. Development of an assessment tool based on Hering’s Law of Cure: The Hering’s Law Assessment Tool (HELAT)
Sarah B. Brien 1, Hugh Harrison 2, June Daniels 3, George Lewith 4
Monitoring improvement in health during homeopathic intervention. Development of an assessment tool based on Hering’s Law of Cure: the Hering’s Law Assessment Tool (HELAT) – ScienceDirect - Saine A., Hering’s law: Law, Rule or Dogma? The Canadian Academy of Homoeopathy. https://homeopathy.ca/herings-law-law-rule-or-dogma/
- Patel R. P., The Law of Direction of Cure (!) Is it a Law or Rule or an Observation? Who Observed it First, Dr. Hering or Dr. Hahnemann ?, Advancement in Homoeopathic Research, https://journals.acspublisher.com/index.php/ahr/article/view/2030
- Harrison H., The development and use of Hering’s Law Assessment Tool (HELAT) in clinical trials Hugh Harrison, HRI Research Article, Issue 18 Winter 2012, HRI_ResearchArticle_18_Harrison_HELAT.pdf
- Saha S., Koley M., Arya J., Choubey G., Hering’s Law Assessment Tool revisited: introducing a modified novel version–Patients’ Response Assessment Tool after Homeopathic Treatment (PRATHoT) in chronic cases
Hering’s Law Assessment Tool revisited: introducing a modified novel version–Patients’ Response Assessment Tool after Homeopathic Treatment (PRATHoT) in chronic cases – PubMed
About the Author
DR SHAFIN AJIJBHAI MAHETAR , B.H.M.S scholar, Swami Vivekanand Homoeopathic Medical College, Bhavnagar.
DR TWINCLE RAMESHCHANDRA RAVAL, MD (HOM), Assistant professor in department of physiology and biochemistry, Swami Vivekanand Homoeopathic Medical College, Bhavnagar.
