The Path of Anthroposophic Medicine

by Alicia Landman-Reiner, MD

A young woman I know, a college senior, had always wanted to become a doctor. After a conversation with a disheartened doctor she met in a café, she wrote that the doctor had conveyed “the most dismal vision of medicine as a practice, discouraging me from pursuing this path. He had lost his vision. He spoke with an arrogance and disrespect I never thought could come from someone who has been so highly educated and who works with people for his career.” She ended,

I know that I want to go to medical school and I know I want to reach cancer patients. I need to talk to some MD’s who care about patients, who love their work, and who believe that they can make a small difference. Any suggestions?

What can enable doctors to develop and sustain warmth towards their patients, love of their work, and an indomitable will to make a difference in the course of their patients’ illnesses under the challenging conditions of today’s medicine?

In being human for Fall 2011 Christopher Bamford describes how thirty doctors gathered in Switzerland in March, 1920 for Rudolf Steiner’s first lectures to a medical audience (now published as Introducing Anthroposophical Medicine (1)). Steiner begins with Hippocrates of the 5th century BCE who is invoked at medical school commencements as the father of western medicine. Steiner argues that, on the contrary, Hippocrates represents not the beginning of modern medicine but “the last remnant of ancient medical traditions, clairvoyantly acquired.” Steiner describes Hippocrates’ teaching that physical, or earthly forces—embodied in the organic fluid or humour “black bile”—must be balanced by cosmic forces embodied in three humours called “yellow bile,” “mucus,” and “blood.” Well-balanced forces were in 'crasis' or harmony, imbalanced forces in 'dyscrasis'. Direct experience of the balance of earthly and cosmic forces was given in ancient mystery sites, which were centers of both religion and healing. Hippocrates was their last great student.

Over the centuries, Hippocrates’ teachings were less and less understood. Modern Western science began with the articulation of physical laws in the Renaissance, but still carried remnants of the old views. Isolated individuals such as Paracelsus in the 16th century and van Helmont in the 17th recognized and pointed to the existence of “something whose possibilities are not exhausted by the merely earthly element,” but their peers could not understand them. When proponents of vitalism, having lost all real experience of the living, put forth “arbitrary, empty concepts,” the scholarly community appropriately rose up against them. In the late 18th century, the autopsy became the decisive diagnostic authority: medicine was defining living organisms and processes by the non-living.

As late as the 1840’s, says Steiner, traces of a sense for organicity could still be found in medical writings. But by 1858 atomism, as Steiner calls it, or reductionism, achieved a decisive victory when the pathologist Rudolf Virchow posited that the cell was the basic unit from which organs and organisms are built, and therefore the key to understanding disease. (2) This reductionism “lives on and now permeates all of official medical science.”

Today our culture is imbued with a concept so deep in our language and habits of thought that it appears self-evident: that life is built upwards not even from cells but from lifeless biochemicals—DNA, RNA, and proteins,—and we can understand health and cure illness by understanding the biochemical and physical properties of these essential building blocks. Disease is seen as malfunction of the mechanism, and health as mere continuation of function. Health as a positive force or quality has no definition at all in our western medical model. We do not, after all, think of our automobiles as “healthy.” They are mechanically sound—or they need fixing.

In regard to health and disease processes Steiner pointed out in 1920 that “our entire philosophy of medicine suffers from the absence of...a comprehensive view.” Today Andrew Weil, MD, Rachel Naomi Remen, MD, and others point this out and add many corollaries. (3)

Healing is viewed as combat. Medicines and surgeons actively “fix” disease while patients play the passive role. Lacking a concept of the organism’s integrity, “superfluous” organs such as tonsils, thymus glands, and uteri may be removed, while “deficient” hormones like estrogen and testosterone are supplemented after their time. Emotional factors in illness are given lip-service, or treated with an anti-depressant. Healing power drawn from self-awareness and from the exploration of meaning are routinely overlooked. Health care occurs in brief encounters. Medical practice is more and more about managing a bureaucratic and financial environment.

Health professionals can fairly be accused of colluding with or being responsible for these deficiencies. Yet as individuals caught in a dysfunctional system, they often suffer from disillusionment and burnout. A recent poll reported 40% of primary care physicians consider leaving practice. 4 And the one-sidedness of our views of the human being in health and illness—pointed out by Steiner, Weil, and Remen—is at the heart of these problems.

Another look at human beings

Steiner suggests we look at human beings “in a way that really leads us to their essential nature.” He points to a kind of practice, a Goethean-style engagement in scientific activity: (5) to observe—precisely, persistently, and with an open mind—the forms of the human organism. Allow them to reveal to us the earthly and the so-to-speak nonearthly, anti-gravitational qualities manifesting there.

First, look at the forms of the human skeleton. Specifically, “deduce the form-creating element” in the human skull. There Steiner points out a kind of vector in the form of the skull that pulls us upright, out of gravity. Next, study the musculature. In this case we are to study not the form but activity, “changes appearing in active muscle.” Observing movement in the devoted, Goethean method we may discover how physical and chemical lawfulness interfaces with informing forces and lawfulness of another kind.

Steiner suggests, in this very condensed way, that we embark on a scientific but not reductionist exploration of both form and activity in the human organism. We are to step back from the microscope and get the perspective from climbing a mountain and look over the landscape. We need to get out not the magnifying but the “minimizing” lens and see the “cohesion of the phenomena rather than the analysis of matter.” 6 We are to look at the form of the bones so as to read their gesture. Then we come closer in our understanding to organicity, to a living wholeness expressed in the organism itself.

These observations about morphology on the one hand and quality on the other will have to constitute our point of departure if we want to discover what actually lies within the human being… if we are not willing to accept a mere formal definition of disease that is useless in actual practice. (7)

We cannot fruitfully return to Hippocratic medicine where a view of the whole human being was once present, but we can—fully in the spirit of modern science—use this observational practice as our point of departure to “re-open the way back to something that has been lost.” Each investigator uses his/her own faculties to grasp the gesture or forces inherent in what is living. Steiner refers to “earthly” and “cosmic” or “non-earthly” forces acting in the human being. Those may not be modern terms, 8 but the scientific-medical discipline he outlines in a masterful, visionary sketch is utterly modern.

Four years later, in the last months of his life, Steiner wrote with Ita Wegman, MD, a second essential anthroposophic medical source, Fundamentals of Therapy. (9) This book begins by outlining a practice, beginning with the activity of ordinary thinking, through which the health professional can achieve a multi-dimensional understanding of the whole human being. While taking the form of a medical text, Fundamentals of Therapy, functions as a kind of workbook for training observation and enlivening medical thinking. It is a challenging book, but if one seeks a scientific, integrative concept of the human being, this book can be a great help in walking the path which Steiner sketches in his first medical lectures.

The movement in practice

Today, over 15,000 doctors practice anthroposophic medicine (AM) in 24 hospitals in Europe and outpatient settings worldwide. (10) Care is multidisciplinary wherever possible. Each anthroposophic health professional masters and certifies in a field of health care according to current standards: an anthroposophic medical doctor has an MD or DO degree, an anthroposophic nurse an RN, etc. The anthroposophic dimension is integrated into that standard training.

If you visit an anthroposophic doctor, you will be asked for your medical history. But the doctor will also ask about your energy level, warmth or coldness, sleep pattern, something of your personal background, and what is meaningful to you. Blood tests or x-rays might be ordered, but the goal is to put together a qualitative picture of your health, not just a quantitative one. Anthroposophic medicine sees the human being as a whole organism of differentiated, interacting forces, which play out on a physical level as well as in living processes of growth and repair, feelings, thoughts and ideals. For the anthroposophic doctor, each child comes to live out his or her unique life. The “I” of the child—that part in which we recognize ourselves as ourselves—inhabits a body which acts as an instrument for living that life. Health and illness is part of our molding that bodily instrument to our intentions. Our path through health, illness, and healing is intimately part of who we are and can become. To be in development is essentially human.

Steiner drew medical attention to form and activity, polar principles active in each of us in ever-varying states of balance. To express it simply, too much form in us tends towards crystallization and fixity—and we may tend to have health problems like vertebral disc degeneration or osteoarthritis, marked by mineralization, a lack of fluidity and regeneration. If we have too much activity—marked by warmth production, excess fluid, and movement—we may suffer from streaming hay fever, recurrent sinus infections, or diarrhea. The “form pole” is more dominant as we age; the “activity pole” in the young.

Treatments used in anthroposophic medicine cover a wide spectrum: from allopathic medicines (conventional prescriptions) to herbs and homeopathics, nursing compresses to the abdomen or chest, and prescribed massage, therapeutic eurythmy movement, or music or art therapy. Three anthroposophic pharmacies in the US supply medicines; their conscientious sourcing, biodynamic or organic cultivation, and specific processing to enhance medicinal properties are an art and science in itself.

True medicine is about a relationship between doctor or therapist and a person who comes to them as a patient. The patient’s wish to be healed is met by the doctor’s will to heal. A medicine “which nature laid down as basis, and human insight brings to realization,” is given and taken. (11) With these three—the patient, the medicine, and the doctor—something occurs in the therapeutic moment through which suffering is relieved. A new level of freedom of functioning is seeded. Development unfolds. This is what anthroposophic medicine is meant to be.

Our current internationally-based training has been held in the USA since 2008. One hundred doctors and nurses enthusiastically took part in May 2012 in California. (12) As well as teaching practical medical and nursing care, training involves re-awakening questions long held close and ideals kept quiet. In groups of ten, we study one medicinal plant and one short text over an entire week. We explore gestures in eurythmy movement and seek them again in plants and in the archetypal forms of organs like kidney and heart. The week’s plan encourages a meditative mood, new ways of looking and thinking, healing will, and warmth of community.

Doctors in this US training have called it “deeply stirring and transformational,” “profound and life-changing,” “extremely clarifying and hopeful for my professional development.” “I see a path before me that transforms my work on every level in a way that aligns with my heart and its thinking… I am so thankful to be walking this path with this very special group of people.”

To a young person aspiring to a health profession, like the earnest pre-med mentioned at the beginning, anthroposophic medicine can offer a way to view the human being and nature as whole and meaningful—a way toward transforming modern medicine without losing an iota of rigor. This starting place, real, and vivid, is what we can make available.

Notes:

1 Hudson, NY: Anthroposophic Press, 1999.

2 Cells had been described before Virchow’s time (1821-1902), but he successfully identified the cell as the relevant unit, over the reigning theory of Bichat which viewed tissues as key.

3 Weil, Andrew, Health and Healing, Understanding Conventional and Alternative Medicine (Boston: Houghton Mifflin, 1983). Remen, Rachel Naomi, Kitchen Table Wisdom: Stories That Heal (New York: Penguin, 2006).

4 http://www.hcplive.com/articles/Poll-Underscores-Continuing-Job- Dissatisfaction-Among-Primary-Care-Docs/ accessed 6/3/12. Especially see physicians’ comments under the article.

5 Bortoft, Henri, The Wholeness of Nature; Goethe’s Way toward a Science of Conscious Participation in Nature. Hudson, NY: Lindesfarne Press, 1996.

6 Quoted of Louis Bolk in Mees, LFC, Secrets of the Skeleton, Form in Metamorphosis. Hudson, NY: Anthroposophic Press, 1984; page viii.

7 Steiner, Rudolf, Introducing Anthroposophical Medicine. Hudson, NY: Anthroposophic Press, 1999.

8 Same, Lecture 6: “…what I am presenting here has not been taken from ancient medical works but is based on present-day spiritual scientific research. Some of my terminology... harkens back to this ancient literature because modern medical literature has not yet developed a terminology of its own in this field. But you would be very mistaken if you were to believe that anything presented here is derived exclusively from ancient writings.”

9 Spring Valley, NY: Mercury Press, 1999.

10 See http://www.ivaa.eu/ for facts and figures.

11 Ascribed to Paracelsus; personal communication from Albert Schmidli.

12 Doctors took part in the IPMT (International Postgraduate Medical Training; www.paam.net). Nurses took part in Foundations of Anthroposophic Nursing certified by IFAN (www.aamta.org).