Anthroposophic Medicine, an Introduction; and a Book Review of Anthroposophy and Science

Abstract

Anthroposophic medicine (AM) is a complex, individualized, multimodal, and integrative system of medicine and an art of healing based on both natural science and the transformed, spiritual science as found in Rudolf Steiner’s anthroposophy. A careful and comprehensive study of anthroposophy and AM, as provided in Anthroposophy and Science: An Introduction, can be a new way to see science and the legitimacy of the new direction provided by anthroposophy. The clinical, scientific application of anthroposophy to the field of medicine is AM with its multidimensional diagnostic approach, its various natural remedies, and novel nonpharmacological modalities. These are all aimed at a direction of complete healing of the ill person in their 4-fold nature. Moreover, anthroposophy and AM may provide the approach and direction to begin to truly integrate the field of integrative medicine so that it is both scientific and fully human.

Anthroposophic medicine (AM) is a multimodal and individualized medical system of healing that comes out of Europe and its Western intellectual and scientific traditions as well as its natural healing systems of the time. It was originally conceived as an extension of conventional medicine to include the very real, but nonmaterial, aspects of the human being. The scientific achievements of biomedicine have always been recognized, but AM states that there is much more to the human being besides their physical or even biological aspects. AM shows that the essential aspects of a human being are 4-fold, consisting not only of a physical body where material substances and forces are at play, but also consisting of a “life body” where emergent properties of biology and development occur; a “soul” where emergent properties of mind, feelings, and consciousness occur; and a human spirit or individuality of a person where the self with self-consciousness, the “I” of the person, resides in one’s inner being. These clearly demarcated “4 members” of the human being are all real and determinative, and they interact in concrete and dynamic ways in the human organism’s form, function, and dysfunction that we can detect in the physical, biological, psychological, and spiritual aspects of the person. Through various types of natural remedies and many artistic and nonpharmacological modalities, AM attempts at healing and balancing through time.

Recently, on June 6 to 11, 2016, the first International Congress on Integrative Health and Medicine was held in Stuttgart, Germany. This conference was attended by health care clinicians, policy advocates, and some World Health Organization (WHO) leadership. AM had a prominent place in the congress, and the presentation of its approach as well as the tour of the nearby AM hospital, the FilderKlinik, generated much interest and enthusiasm about AM.¹ Furthermore, the book, Anthroposophy and Science: An Introduction by Peter Heusser, was just published in an English edition in July 2016.² It seems a propitious time to introduce AM and anthroposophy to wider audience of US clinicians.

Anthroposophy

AM comes out of the work and insights of the philosopher, educator, and scientifically trained Rudolf Steiner (1861-1925), who inaugurated and developed the philosophy, worldview, and science that he called anthroposophy. As Steiner uses the term, anthroposophy means the “consciousness of one’s true humanity” and is intended to be a way that “leads what is spiritual in the human being to what is spiritual in the universe.” Through his own disciplined, meditative efforts,^3-5 and the phenomenological, scientific work of Goethe,^6-10 he extended this Goethean science into a rational and empirical phenomenology with appropriate methodology, capable of directly investigating, studying, and knowing sense-imperceptible, or suprasensible, phenomena, such as “life,” “soul,” and “spirit.”

Given his insights into what is true and reliable cognition,^11-13 he felt justified in calling anthroposophy a “spiritual science.” Steiner argued that only with a cognitive, spiritual science that pierces the veil of the sense world can the full reality that is around us be known. Natural science, with its materialist and reductionistic approach, can know a lot about matter and mechanics, but it can often be inadequate and misleading in its conclusions about biological, living processes; about conscious and unconscious soul realms; and about the self-conscious spirit, or “I,” of a person. This is what many patients and integrative clinicians sense and discuss.

Steiner gave specific, technical terms for the 3 realms above the physical. These higher realms can be perceived with a “higher” and more intensified cognition. He chose words that often had a history of use, but he used these terms in new, specific and different ways than in the past.^14,15 By developing this technical terminology, anthroposophical spiritual science allows us to talk more easily and clearly about phenomena of which we are all aware but only abstractly or clumsily approach and discuss in science and medicine.

For the living, biological realm he gave the name etheric. All living things—plants, animals, and humans— have a species-specific etheric body that is not directly sense perceptible but is the ultimate cause and organizing principle for all the emergent properties (above the physical) that we see in forms of life (growth, development through time, reproduction, nutrition, enthalpy, self-organization, etc). Without the etheric body of a living organism, one only has left a dead physical body whose structure and organization are now subject only to entropic forces and decay.

Similarly, the next higher, nonphysical realm of the soul (“container” or field of consciousness, inner life of mind, feelings, inner perceptions, the unconscious, etc) he termed the astral body. Only animals and humans have species-specific astral bodies that are the origin and cause of the emergent properties of sentience, consciousness, and inner psychological life, as well as the origin of the organic processes that support these emergent phenomena.

Finally, the individual self, the “I” or spirit, is ostensibly not directly and outwardly perceptible but can be perceived in inner self-perception and is an elusive, but real being. This first inward step can be developed and enhanced through meditative exercises. In medicine we can see that only a human spirit has emergent characteristics and capacities such as thinking, insight, moral and aesthetic judgment, and desire for meaning.

Table 1 summarizes, in a simplified form, the 4-fold realms or hierarchical levels in nature and the human being. Although these levels can clearly be demarcated conceptually, the levels do flow one into another (see double-headed arrows) and thereby may influence a level above or below as well as provide coordinated responses and interactions of the organism to the environment, whether natural, psychosocial, cultural, or spiritual.

Table 1.

The Anthroposophical View of Nature and the Human Beinga^a

Minerals	Plants	Animals	Humans	Phenomena and Emergent Properties
			Spirit or “I”	Self-consciousness, rational thinking, free will, self-control, morality and values, insight, coping skills, spirituality, human form and development
		“Soul” (astral body)	Soul (from astral body)	Consciousness, sensation, pain, emotions, desires, lust, instincts, reflexes, intentions, source of self-propelling motion, catabolism, organ formation
	Life (etheric body)	Life	Life	Growth, reproduction, development, metabolism, anabolism, nutrition, self-healing, self-defense, vitality, sense of well-being
Matter	Matter/physical body	Matter/physical body	Matter/physical body	Physical and chemical properties and structures, mechanics, chemical reactions, states of matter, inorganic forms

^aModified from Heusser.²

The Book, Anthroposophy and Science: An Introduction

What does this all have to do with science, the scientific method, and the picture of the world that modern natural science provides? Another question might be: What does all this “theoretical” anthroposophy and “spiritual science” have to do with medicine and integrative treatment of a patient? Both of these questions are dealt with in Peter Heusser’s recent and seminal work, Anthroposophy and Science: An Introduction.² The purpose of this book is to establish a scientific foundation for and integration of various integrative medical approaches, through anthroposophical spiritual science, for the practice of truly individualized medicine.

This is an unusual book. It is dense and requires a high degree of intense and critical thinking. However, the book rewards careful reading, for it shows a rigorous and scientific way out of the gulf that many integrative clinicians can feel within themselves: There appears to be no real and understandable relationship between the advances of biomedicine with its atomic and molecular reductionism and materialism, and the appreciation and therapeutic use of many nonmaterial modalities that employ concepts such as life, energy, qi or prana, consciousness, mind, soul, and spirit. The reflective integrative practitioner, in the face of the variety of available therapeutic approaches and systems of healing (that are often very helpful), may feel that the field is more like a potpourri of heterogeneous modalities and terminologies instead of a true integration. Heusser attempts in this book to show how a scientific explanation of AM’s view of the human being can provide “the conceptual basis for modern integrative medicine”² and that a systematic application of Rudolf Steiner’s epistemological writings on science and reality “results in a modern, scientifically founded, holistic understanding of the human being which is capable of overcoming the [reductive] naturalism [in much of] science and medicine.”²

Given the book’s purpose and its subject matter of epistemology, the philosophy of mind, anthroposophy, and the all various sciences that have affected the human being, there is no wonder that this is not a light read. It is a logically organized book with 8 chapters that have very helpful subheadings, and slightly more than 300 pages of text. This expanded English edition includes many helpful, explanatory footnotes at the bottom of the text, providing easy access to further comments, explanations, and references. Unfortunately, there is no index at the end of the book, so the reader may have difficulty finding a topic they want to review. There is an extensive bibliography of 49 pages (719 citations), and approximately 48% of them are in the English language.

It is written with a modest degree of repetition so that once the crucial Chapter 2, “Epistemology: Knowledge and Truth” is read and understood, then the other chapters can be largely read and comprehended in any order.

In Chapter 2, Heusser gives a detailed and updated exposition of Steiner’s position on cognition, knowledge, science, and reality found in his philosophical writings.^11-13 Through difficult self-observation of thinking, and also through critical analysis, Steiner finds that reliable cognition consists in uniting inwardly the “percept” (the object of outer or inner perception) and the associated concept. In much of philosophy and science, but certainly not all, the concept, thought, or idea of a percept is often mistakenly assumed to be an unreal, subjective, or biased “copy” of the percept. Steiner points out and argues that the concept or idea (a system of concepts) is a real and necessary part of reality that we perceive. In philosophical terms his epistemology is called objective ontological idealism, or universal realism. Despite the fact that the thought or concept is being produced and experienced within us (due to our physical and mental makeup), it is still a part of the full reality we perceive as the percept and not just a subjective, biased product of the mind. A world of observed percepts devoid of their associated concepts would be an unintelligible and unassociated flow of percepts. It would mean the impossibility of any knowledge in general and certainly the impossibility of any science.

For Steiner, Heusser, and Goethean scientists, this universal process of human cognition is the real, “behind-the-scenes” scientific method; not specialized training, experimentation, hypothesis generation, mathematical quantification, statistics, etc. Although these helpful activities are often employed and necessary in the natural and social sciences, they are not a prerequisite to do science. Doing science requires, sometimes in very sophisticated and systematic ways, the union of percepts and appropriate concepts in the conscious, thinking act of cognition. In addition, the often necessary part of scientific replication and verification of results (and specifying the conditions for intersubjectivity) is based on the universal human cognitive need for repetitive, methodical observations in various contexts, and concept-building before claiming something is understood and known.

Heusser argues cogently and persuasively for this view of science and knowledge. He also responds effectively to the many potential objections and misunderstandings that can arise. This is why this chapter can be so helpful for the person who wants an answer to the deeply human question: “How can we know for sure?”

In Chapters 3, 4, and 5, Heusser addresses, in considerable detail, the sciences of physics, chemistry, biology, neurobiology, and psychology in relation to the objective ontological idealism and anthroposophy of Rudolf Steiner. It becomes clear that all these sciences, although having particular biases and habits of thought, are coming up against thresholds that point to a need to incorporate the higher hierarchical level’s formative and organizing activity “impinging” on the lower level that is assumed to be the only real one. One can see through many specific examples how a rational reinterpretation of the findings in the various sciences is definitely consistent with the spiritual-scientific view that anthroposophy brings and has been outlined very briefly previously. The last chapters, 7 and 8, discuss, respectively, anthroposophy as an empirical spiritual science and its way to the transcendence of the “limits of knowledge” imposed by philosophy and science, and the fruitful relationship possible between anthroposophical spiritual science and natural scientific medicine. These last 2 chapters provide a helpful summary of the book and discuss the profound and integrative implications of anthroposophy for medicine and science, as well as the research basis and scientific verification of AM. Consequently, one can begin to see how the multilevel and multimodal view and approach of anthroposophy and AM can be one promising approach to integrate the various modalities used in integrative medicine in a rational, systematic, and scientific (yet, still human)way.

In Section 8.5 of the book, “The status of clinical scientific research in anthroposophical medicine,” Heusser addresses the question of clinical effectiveness of AM. Given the complexity of nature, of the human being and of modern science, it is no wonder that the multimodal and multidimensional nature of AM is complex and that no one study can prove very much. He notes that there is a modest but growing body of medical literature on the effectiveness of AM. In this section, the reader gains an impression of the types of clinical research that have been done to date. Unfortunately, because of space constraints, Heusser does not go into sufficient detail in evaluating the strength and quality of the research supporting AM.

Helpfully, Heusser references a 2006 comprehensive study published in English on the effectiveness, appropriateness, safety, and costs of AM as part of the Swiss Complementary Medicine Evaluation Programme.¹⁶ It covered all areas of medicine. A total of 178 clinical trials were evaluated (17 randomized controlled trials [RCTs]) and 170 had a positive result for AM. Unfortunately, the trials were of varying design and quality, often with major limitations. Nevertheless, most studies did describe good clinical outcomes for AM with few side effects, high patient satisfaction and likely lower costs. Further quality research was urged. An updated report, published in German in 2011, found 70 new clinical studies (21 RCTs) and came to similar conclusions. The authors noted that trials of better quality still tended to show positive results.¹⁷

AM and Clinical Practice

The clinical practice of AM has been developing and evolving for the last 90+ years, ever since the first formal course on AM was given in 1920.¹⁸ One can certainly detect various influences of homeopathy, naturopathy, alchemy, and Western herbal medicine on AM.^15,18 However, an unbiased study of the AM literature will clearly show that the insights of anthroposophy give many new ways to use various older remedies, provide new and unique anthroposophical remedies and modalities for treatment, and provide the foundation for a rational, anthroposophical, and scientific system for diagnosis and therapy. It is not just a conglomeration of various therapeutic and diagnostic approaches, but an integrative, multimodal way to address the fourfold human composition.^19-21 Medicinal plants and natural minerals, and their associated processes, are looked at in new and insightful ways to develop diagnostic and therapeutic insights that become uniquely anthroposophical.^22-24 Although potentized homeopathic remedies are made and used in AM, the single remedies are often, although not exclusively, rationally combined in ways to attempt to enhance their effect and address the imbalance in the 4 members of the human being (physical body, etheric body, astral body, and “I”). A transformed and more scientific, alchemical, and Paracelsian thinking²⁵ applied to nature, the human being, medicine, and the manufacture of remedies is another hallmark of AM.^18,26,27

There are also other modalities that have been developed in AM. Therapeutic eurythmy is one uniquely anthroposophical therapeutic modality that involves an eurythmist helping a patient perform soulful and imaginative, healing movements. These repetitive movements are designed to address the directly suprasensible, but indirectly observable and emergent, properties of the etheric body, astral body. and the “I.”^28-29 A systematic review of the clinical effectiveness of eurythmy therapy in various conditions shows positive results.³⁰ Various artistic therapies and modalities including therapeutic speech formation are also all used in uniquely anthroposophical ways to heal from organic and psychological illnesses.³¹ Healthy, organic nutrition, free of toxins, through biodynamic agriculture, is also a foundational aspect in AM.^32-33

Anthroposophic mistletoe extract from Viscum album is used as adjuvant treatment in cancer and is perhaps the most well-known part of AM. There have been many reviews indicating moderately strong evidence for improved quality of life for cancer patients using anthroposophic mistletoe and weak, but growing, evidence that it provides improved overall survival.^34-39 A recent, well-designed RCT using adequate doses for mistletoe therapy in advanced pancreatic cancer shows improved overall survival.⁴⁰ Despite the difficulty in finding funding, research, deeper understanding, and improved clinical use of mistletoe therapy and integrative cancer care are ongoing.⁴¹

Importantly, whole-systems research in AM has also been done on common outpatient problems. The prospective, observational study, Anthroposophic Medicine Outcomes Study (AMOS), is one such set of studies showing clinical effectiveness, high patient satisfaction, low side effects, and equal or lower costs.⁴²

Summary

AM is a complex, individualized, multimodal, and integrative system of medicine and an art of healing based on both natural science and the transformed, spiritual science as found in Rudolf Steiner’s anthroposophy. A careful and comprehensive study of anthroposophy and AM, as provided in Anthroposophy and Science: An Introduction,² can be a new way to see science and the legitimacy of the new direction provided by anthroposophy. The clinical, scientific application of anthroposophy to the field of medicine is AM with its multidimensional diagnostic approach, its various natural remedies, and novel nonpharmacological modalities. These are all aimed at a direction of complete healing of the ill person in their 4-fold nature. Moreover, anthroposophy and AM may provide the approach and direction to begin to truly integrate the field of integrative medicine so that it is both scientific and fully human.⁴¹

Biography

Ricardo R. Bartelme, MD, is a clinical assistant professor of family medicine in the Department of Family Medicine at the University of Michigan Medical School in Ann Arbor, Michigan.