In this edition, Hugh Harrison describes how the Hering’s Law Assessment Tool (HELAT) was developed during a randomised controlled trial of individualised homeopathy in the treatment of rheumatoid arthritis. Harrison’s work in developing HELAT represents a fascinating step towards translating a concept from homeopathic philosophy into a formalised assessment tool, suitable for use in homeopathy research.
‘Hering’s Law of Cure’ is used by many homeopaths to help assess clinical outcomes. These ‘Laws’ are an historical evolution of Dr Samuel Hahnemann’s observations and thoughts regarding clinical changes occurring in patients after taking a homeopathic prescription.
Hahnemann’s ideas were subsequently developed by Dr Constantine Hering, then latterly emphasised by Dr James Tyler Kent.
These ‘rules’ suggest that following a homeopathic constitutional remedy, healing occurs by stimulating the patient’s ‘vital force’ which responds by eliciting a distinct and consistent pattern.
Hering’s Law stipulates that during a curative response to a prescription, symptoms improve in the following way:
- From the head down
- From the inside out
- From the most important to the least important organs
- In the reverse order of symptoms that they first appeared
Thus, Hering’s Law is used clinically to contextualise symptom reporting during treatment and to monitor signs of cure by differentiating positive healing responses from other symptoms (which may be due to the disease process or side effects from conventional medication).
What is HELAT?
The HELAT flowchart aims to allocate any symptom presented by a patient after taking the remedy to one of eleven possible categories coded A – K, which are then simplified into four categories:
- No change in symptoms – categories I and J
- Symptoms due to adverse remedy reaction – categories B, E and G
- Symptoms due to an adverse event unrelated to the study medication – categories A and K
- Symptoms due to healing responses – categories C,D,F and H
H is further subdivided into Ha (from the top down), Hb (from more to less vital organs), Hc (from centre to periphery) and Hd (in reverse order of appearance).
At each consultation, to assess the clinical response to their previous prescription, the homeopath performed the HELAT scoring by entering a value of either 0 or ≥1 in each of the categories A-K: ‘0’ meaning that none of the patient’s symptoms fitted that category and ≥1 indicating that one or more symptom was allocated to that category.[ Read full text]: