Anthroposophic Medicines

Their origin| production|and application Anthroposophic Medicines

All anthroposophic medicines are designed to stimulate the patient’s powers of self-healing. In this way they complement conventional medication. Where conventional medicine concentrates solely on destroying the agents of disease, suppressing associated processes and replacing missing substances (e.g. vitamins, hormones, blood elements), anthroposophic medicine, wherever possible and sensible, aims to enable the human organism to overcome a disease through its own resources. The emphasis is on restoring the balance of bodily functions and strengthening the immune system. The right medicines play a major role in this process.

2 All kinds of naturally occuring raw materials are used in the production of anthroposophic medicines: substances of vegetable origin - marigold (right), mineral origin - pyrite (left page, above right), animal origin - bee venom (left page, above left), as well as metals such as gold. Producing yellow gentian root tincture (gentiana lutea) in the laboratory: the root is separated from the rest of the plant, finely chopped with a knife, and then crushed in the mill.

Anthroposophic pathic medicines; herbalists favour sub- pathic potencies, vegetable concentrates, stances of vegetable origin, while synthe- not to mention compounds of a more medicines tic chemical substances dominate modern complex nature. In addition, there are Anthroposophic medicine uses mineral, conventional medicine. several substances that typify anthroposo- vegetable, metal, and animal-based raw Anthroposophic medicines, on the phic medicines – such as metal mirrors materials in the production of medici- other hand, are multi-faceted in orienta- or tinctures derived from plants fertilised nes. For instance, quartz, sulphur, and tion. Their spectrum includes homoeo with metallic salts (vegetabilised metals). lime are typical mineral substances, while An anthroposophic pharmacopoeia is arnica, yellow gentian, and chamomile currently being created with the aim of Homoeopathy and allopathy are well-known medicinal herbs. Of the providing a published summary of all metals, gold, silver, iron, and tin are Both terms are derived from the Greek: substances used in the production of frequently used, while animal-based sub- homoios = similar, allos = different, pathos = anthroposophic medicines and the forms stances include insect venom. disease. Homoeopathy seeks to heal “like with of processing approved. The raw materials used by anthro- like”. For each patient, the doctor must find posophic medicine are also common to the substance that causes similar symptoms The context is crucial other therapies, such as homoeopathy and in healthy individuals. This substance is then What's special about anthroposophic herbal medicine. Even conventional medi- administered in a particular dilution (poten- medicines? As with anthroposophic the cine uses bee venom, iron or sulphur in a cy), thereby stimulating the organism's capa- rapy as a whole, they are both disease- number of medicines, eg “Forapin” – bee city of self-regulation. Conventional medicine, and patient-oriented. Or in other words, venom used in the treatment of rheuma- on the other hand, uses allopathic medication a prescription is not just based on a tism – albeit in highly concentrated form. as a means of supplementing a bodily insuffi- single diagnosis supported by findings, To a great extent, the character of a ciency and of regulating and sometimes even but instead on the entire context of the particular therapy is determined by its suppressing processes associated with the individual’s health profile as demonstra- medication: homoeopaths use homoeo- disease. ted by the disease. The task of the doctor is During the final stage, the crushed pieces of root are brewed in a solution of water and alcohol (producing a decoction).

to recognise what forces – occurring to the into account. For instance the same medi- crystallise into lumps and dissolve into wrong degree, at the wrong time, and cation – in this instance rock salt (natu- liquid. In contrast to other salts, it is in the wrong place – are causing the rally occurring salt, also known as halite, unique in that it doesn't require a rise in problem. chemical abbreviation: NaCl) – is used to temperature to dissolve or a drop in tem- Is the principal cause of the disease treat a variety of diseases, from chronic perature to crystallise. Anthroposophic disrupted organ function (physiological rhinitis and chronic bronchitis to wet medicine therefore posits – and this has level), or mental tension (psychic level), eczema. Why? Because the characteristic been confirmed in practice – that rock or have organs undergone a real physical profiles of these three diseases are similar: salt is especially suited to restoring the change (anatomical level)? Such analysis in all of them, two opposing tendencies disturbed balance between solidification helps the doctor decide which medicine or – solidification and liquefaction – occur and liquefaction in the above-mentioned therapy should be prescribed. simultaneously. In cases of chronic rhini- diseases. The use of rock salt in the treat- At the same time, the doctor also con- tis, the nose can become encrusted, yet it ment of all three diseases is founded on siders to what degree the disease has wea- still continues to run. this anthroposophic rationale. kened the patient. Sometimes it is neces- In cases of chronic bronchitis, That which initially seems strange sary to stabilise the patient's physical con- mucous membranes in the respiratory or incomprehensible becomes logical on dition with conventional medication first, tract waste away as though scarred, yet closer examination. The selection of anthro- subsequently administering anthropo they nevertheless continue to produce posophic medicines in the treatment of sophic medicines in order to stimulate the mucous. Skin demonstrating symptoms other diseases follows similar principles. individual's powers of self-healing. of wet eczema becomes thicker and Even in conventional medicine diffe- When selecting a medicine, the coarser, yet still manages to secrete a lot rent diseases are often treated with the anthroposophic doctor does not simply of fluid. Rock salt is similarly contradicto- same medication: tonsillitis, nephritis, consider what has caused the disease in ry in its make-up. It occurs both in solid and traumatic erysipelas are all treated question. The decision-making process form in underground salt reserves and in with penicillin – since all three are caused also takes other factors and characteristics soluble form in seawater. It can both: by strains of streptococcal bacteria. Gentiana lutea, yellow gentian. The root is used in medicine production.

Antimonite, antimony. Anti-inflammatory; known to heal ulcers.

Tartarus crudus, potassium bitartrate. Raw material of other medicines

Matricaria chamomilla, chamomile. The whole plant (planta tota) is used. The decoction of yellow gentian root (left) and the preliminary final product: the tincture (yellow liquid in the bottle to the right). This will be succussed further to produce medicinal drops.

Instead of common disease characte- have been altered by the disease. Depen positories, and vaginal suppositories ristics, the determining factor in this case ding on the type of disorder in question, • for injection and inhalation as sterile is the physical presence of streptococci. the substances may be administered in a dilutions and ampoules. variety of different forms: In terms of external application, the • externally as eye drops, nasal sprays, skin is less a vehicle for introducing the From globuli to emulsions, gels, essences, oils, pastes, substance into the organism and more a injections ointments, tinctures, powders sense organ capable of recognising the All medicines are prescribed with the aim • internally as drops, homoeopathic externally applied medicinal substance. of influencing particular processes that potencies (dilutions), powders (tritura “Recognise” in this case takes on a far tions), globuli, tablets, capsules, teas, sup- broader meaning – on the face of it we find it hard to accept that skin can re- The different routes for treating the patient cognise something other than the sensati- The patient can be treated by various different routes: by means of the senses, the digestive ons we know from conscious experience: system, the respiratory system and the bloodstream. What response the doctor is seeking to hot or cold, wet or dry, rough or smooth. stimulate in the body determines the form of access taken. Compresses, rubs, or packs using But according to anthroposophic tinctures, ointments, or essential oils, for instance, stimulate the nervous system via the skin medicine, the skin is capable of much and senses. This encourages forming and structuring processes to take place. Drops, globuli, more: it can recognise the unconscious, syrups and powders influence the digestive system and stimulate regenerative, dynamic pro- such as the properties of substances cesses. When inhaled or injected, substances enter the body‘ s circulation directly and have an applied – the calming effect of lavender, immediately balancing effect. the stimulation brought by rosemary, the The means by which a medicine is administered is therefore of considerable importance, since boost to the circulation afforded by the body reacts differently to the various methods. When applied externally as an oil, lovage powdered mustard, to name but a few. (levisticum), for instance, has an anti-inflammatory effect on neuritis and otitis media acuta; The skin communicates this property to when taken internally as drops, it stimulates the digestion. the organism, which in turn reacts accor Distilling chamomile flowers to extract the essential oil: respective filled weights of chamomile flowers and water (left), and assembling the distillation equipment in the laboratory

dingly. Substances applied to the skin can pharmaceutical processing potential bolic processes within the organism, all therefore affect the entire body – without of the individual medicinal substance of which lead to an increase in production necessarily penetrating the bloodstream and on what therapeutic goal is being of the body's own substances. All these directly. aimed for. Oil warms, emulsions and gels phases happen at a subconscious level. All medicinal substances that are cool, ointments and pastes conceal, while One example: drops of yellow genti- applied to the skin are principally admi- a tincture is gentle on oozing and broken an extract contain bitter substances that nistered to generate forming and structu- skin. stimulate the secretion of gastric jui- ring processes within the body, since the When taken internally, medicinal ces and enzymes from the pancreas and skin stimulates these processes via the substances enter the bloodstream via gall bladder. These break down nutrients nervous system. the mucous membranes in the mouth, ingested as food into their basic elements: Whether the different substances are stomach and intestines. They stimulate protein into amino acids, carbohydrate applied as oils, emulsions, ointments, activity in the various digestive glands and into monosaccharides and disacchari- or in some other form depends on the thereby promote a wide variety of meta- des, fat into glycerine and fatty acids. the healing powers of s tinging nettle, eucalyptus, and lemon…

The following three examples aptly demonstrate how the unique • The eucalyptus has very deep roots and requires so much water that it properties of medicinal herbs determine their specific therapeutic can drain swamps. It is therefore beneficial in the treatment of catarrh, benefits: when mucous membranes are “drowning”. • Stinging nettles grow wherever deposited material is absorbed back • The lemon needs light and heat to flourish. In ripening, however, the into the environment: at the edge of rubbish, rubble and compost fruit doesn't produce sugar – it remains sour. The thick peel keeps the heaps. In treatment they are used accordingly: wherever something juicy flesh contained. In cases of hay fever, where the patient is being has become diverted from the healthy mainstream – varicose veins, “drained” via the mucous membranes, the lemon promotes containment haemorrhoids, rheumatism. and draws the fluids together. Chamomile flowers in distillation flasks: with the application of heat, the volatile essential oils evaporate off from the plant to condense in a flask as azure blue oil

Following absorption through the in- is located under the right-hand shoulder • Succussion of fluids: repeated dilution at testinal lining, the body transforms these blade. If diseased, these organs may be a ratio of 1:10 carried out under rhythmic elements anew into its own substances influenced by injecting this zone. shaking. To produce globuli, tiny sugar – into proteins, glycogen (the form of Anthroposophic medicine combines balls are coated with the potency fluid. glucose stored by the liver), sugars, all three modes of application – external, • Succussion of solids: repeated dilution and fats. internal, and injected. The different forms of solid raw materials (e.g. minerals) at For the different drops, powders, of administration are crucial if a doctor is a ratio of 1:10 through the addition of globuli, tablets, capsules, teas and sup- to design treatments tailored to the needs lactose, the substances being ground positories to have the desired effect, they of individual patients. down rhythmically to a powder (tritu- must be absorbed through the digestive ration). tract (stomach and intestines) and meta- • Maceration: alcohol/water extract made bolised. Production of from fresh or dried shredded vegetable or Substances for inhalation or injection, anthroposophic animal matter. on the other hand, enter the circulati- • Fermentation: blending of individual on directly via the lungs, subcutaneous medicines vegetable extracts with lactic acid bacteria tissue, muscles or blood. They work more Many different processes are used in the – possibly also with sugar – at approxi- quickly and can be applied more specifi- production of anthroposophic medicines. mately 37°C to cause fermentation. The cally – for instance to an inflamed joint, These are generally rhythmic procedures, extracts may also be rhythmically exposed tense muscles, or inflamed nerves. At phased applications of heat, or a combina- to sunlight and warmed. the same time, it is also possible to reach tion of both: • Steeped in boiling water (for an infu- most organs of the body via certain reflex • Dissolution and crystallisation of mine- sion) and brewed in boiling water (to zones on the skin (Head's zones – ref Sir ral salts create a decoction). Henry Head 1861-1940). The reflex zone • Extraction of whole vegetable extracts: in • Distillation of essential oils from vege- for the liver and gall bladder, for instance, water, water/alcohol or oil form table matter. Potassium bitartrate is ground to a powder and purified. The white crystals (tartarus depuratus or cream of tartar) serve as a basis for further medicinal compounds.

• Melting and condensation of metals to ons of its various elements – how many nism to which they are administered plays make metal mirrors. first and second violins, violas, cellos, the resulting “melody”. • Toasting (aromatisation), carbonisation, woodwind, brass, and timpani does the An anthroposophic combination incineration of plants and vegetable orchestra have? The symphony performed medicine is composed of at least two natu- matter. by the orchestra derives its sound from ral substances. These may be of mine- All these different production proces- these factors. ral, vegetable, or animal origin, of diffe- ses are necessary to unlock the properties The nature of anthroposophic medici- rent concentrations, and be produced in of the various raw materials and trans- nes therefore depends on the ingredients different ways (boiled, macerated cold, form them into medicine. The doctor they contain and in what concentrations, etc.). is therefore able to select medicines to and how they are composed – the orga Moreover, succussed and non-succus- match the needs of individual patients, sed preparations may also be blended to- Origin and Distributon their symptoms, and their reaction poten- gether. Special production processes are tial exactly. Such an individualistic approach The principles concerning raw material selec- used in combining the elements of a to treatment requires the availability of a tion for anthroposophic medicines, their combination medicine. These include, for wide range of medicines. processing, and their suitability in treating instance, joint succussion, joint exposure various disease have their origins in the to heat, and mechanical blending through Combination and work of Dr. Rudolph Steiner. He founded the fluid engineering. composition school of anthroposophic medicine with Dr. Through the selection of ingredients, Anthroposophic medicines generally con- Ita Wegman at the beginning of the twen- their quantitative ratio and subsequent tain a number of ingredients. These are tieth century. Since then, the contents and processing, a new medicinal unit emerges, not simply combined – they are com- methods of the movement have continued to in the same way that brass, for example, posed! What does that mean? Like an develop on a global scale. There are currently is a metal in its own right and not just orchestra, the character of a combined 22 producers of anthroposophic medicines in the sum of copper and zinc – its alloy- medicine is dependent on the proporti- 21 different countries. producing components. In extremely hot temperatures, metals condense in a vacuum to produce metal mirrors. Natural gold (left) and its precipitate as a gold mirror on the side of a glass vessel. The gold is then scraped off and used either in powders, potencies or ointments. Adding water (right) to incinerated potassium bitartrate to combine the ashes in a solution.

Definition of efficacy medicines, since the reaction of the indivi- a ratio of at least 1:10 000 (D4) and for dual patient is a crucial factor. The analysis oral or external use only. The ingredients The efficacy of an anthroposophic of patient reactions – such as improved must be described in the European Phar medicine is judged by whether it weakens, quality of life – requires a different inve- macopoeia. As long as they are not listed alleviates or heals a disease, whether it stigative approach, which nevertheless therein, the official national pharmacopo- reduces or heals physical and/or mental fully complies with scientific standards. eias, such as the German Homoeopathic symptoms, and whether it can even pre- Pharmacopoeia (GHP) or the French vent disease. Registration Homoeopathic Pharmacopoeia (PHF) Efficacy is therefore the sum of the and Marketing are in force. Manufacturers must docu- various desired outcomes. The crucial Authorisation ment and submit proof of the consistency factor in all this is the response of the Many anthroposophic medicinal products of quality and safety of the medicinal patient – and that is necessarily unique. are on the market e.g. in Germany, Great product. Mutual recognition within the It is up to the patient and the doctor to Britain, Italy, Austria and Sweden, based Community has been recommended for decide whether the treatment has fulfilled on national legislation. the future. its aim, and thus whether or not the medi- Specific rules, introduced in 1992 2. Authorisation For those homoeo cine in question was effective. On this point govern the circulation of medicinal pro- pathic medicinal products that do not ful- anthroposophic medicine differs from ducts produced according to a homeo- fil the criteria mentioned above Member conventional medicine, which demands pathic manufacturing procedure. This States are granted the possibility to intro- general proof of medicinal efficacy accor- also includes those anthroposophic medici- duce or retain specific rules. To date only a ding to objective criteria. Where such an nal products that are produced accordingly. few EU Member States have taken advan- approach is possible in the case of particu- The directive provides two options: tage of this provision: Finland, France and lar anthroposophic medicines, appropriate 1. Registration A simplified proce- the Netherlands. Belgium and Portugal evidence is provided. Neverthe less, this dure exists for homeopathic medicinal have introduced special regulations is not possible for many anthroposophic products without indication diluted to without the corresponding guidelines. The ash solution is then heated to a high temperature, filtered, and condensed to produce potash crystals.

Austria and Germany had adequate rules for traditional herbal medicinal products specify, among other things, the testing to be retained. Quality and safety must used in minor indications. In order to take and chemical analysis of raw materials. be proven according to EU-standards. advantage of this possibility, a medicinal Vegetable matter is additionally checked Concerning efficacy, the Member States product needs to have been in medicinal for contamination through herbicides determine their own standards and the use for 30 years, with a minimum of 15 and pesticides, heavy metals and radio- extent of documentation to be submitted years thereof within the EU Comm unity. activity, and for the presence of damaging for the requested indication. Due to the The European Agency for the Evaluation bacteria or fungi. Moreover, all medici- differing conditions, mutual recognition of Medicinal Products (EMEA) is to set nes are tested to ascertain whether their is not foreseen. up a special herbal medicines commit- composition complies with the existing Besides these options the general tee that will establish community herbal regulations, and whether they are stable Directive relating to Medicinal Products monographs as a basis for any future enough to fulfil the planned expiry date allows another means of simplified autho- application. Mutual recognition will then (e.g. in the case of tinctures). risation for products that have been in be possible for herbal medicinal products It is an inherent feature of herbal medicinal use for at least ten years (“well- authorised in this way. medicines that the concentration of dif- established use”). This time-span enables ferent whole extract ingredients varies. safety and efficacy to be proven by means Quality controls They fluctuate slightly from year to year of scientific bibliographies and systematic Even in the production phase, anthro- depending on the growing conditions documentation. As far as quality is con- posophic medicines are subject to the – too much or too little sun, too much or cerned, the same standards apply as to regulations of the relevant pharmaco- too little rain. Nevertheless, it is still allopathic medicinal products. poeia. All producers of anthroposophic possible to ensure that the medicines Since the beginning of 2001, a sup- medicines must abide by and document produced remain of a standard quality. plement to the Directive relating to the prescribed quality controls; they are This is achieved by process standardisa- Medicinal Products is under discussion. also subject to routine checks by the rele- tion. This means the medicine producer This would allow a simplified registration vant authorities. These quality controls ensures that the parameters for processes

1 3 Hypericum, St. John’s Wort. The oil extract from the petals alleviates the pain of muscular rheumatism; the water/alcohol whole plant extract is a mood improver.

Sulphur. Applied to drop, ampoule, or ointment form to chronic Potash crystals begin to form out of the potassium inflammations, it has a balancing effect on metabolic processes. bitartrate solution The potash derived from the incinerated potassium bitartrate is used both as a medicine in its own right, and as a raw material for all preparations containing potassium.

central to the production of the substance Negative side effects are reported to the (Heel) injected over a period of five years. always remain constant. These include producer, the medicine commissions and This company's total production during the timing of the harvest, as well as the the monitoring body. these five years was 350 million ampou- technique and location used, the vegetable All anthroposophic medicines have les using over 800 different substances. matter mixing ratio, extraction and sterile very few side effects. This is also true of During this period not one single side filling procedures, and testing the ingre- injections, which are commonly held to effect was reported for the remaining 290 dients of the final product. These may be higher risk. A review (Stock 2002) million ampoules. – with the approval of the authorisation – the results of which were published by The anthroposophic companies Wele da body – only fluctuate within a certain the Deutsche Apotheker-Zeitung (DAZ, and Wala sold a total of 185 million range. German Chemists' Newspaper) – based on ampoules between 1990 and 2000. With The constancy of anthroposophic a survey of 327 doctors who use injectable reference to these, 36 negative side effects medicine quality is thereby ensured. homoeopathic and anthroposophic medi- were reported in all. That converts to a cines, found the risk of side effects to risk percentage of 0.00000019%. Medicine safety be 0.000036%. One thing therefore is for certain: The same principles apply to medicine This figure is based on 61.5 million anthroposophic medicines – even the safety in terms of anthroposophic medi- ampoules of 21 homoeopathic prepara- injectable ones – are among the safest on cine as to all other types of medication. tions produced by a specific company the market.

On the risk of poisons present in anthroposophic medicines

Some anthroposophic medicines contain poisons, e.g. deadly nightshade (belladonna), foxglove (digitalis), monkshood (aconitum), and strychnine (Strychnos nux-vomica). However, as with all medicines, following the correct dosage, as shown on the pack or accompanying leaflet, ensures safety in use. Moreover, such medicines are only prescribed in small packs, so that were a patient to take the medication incorrectly (i.e. ingest the contents of an entire pack), no serious or incurable symptoms of poisoning would arise.

1 5 Imprint Publishers: Medical Section of the School of Spiritual Science, Goetheanum, CH-4143 Dornach, Switzerland

Editors: Annette Bopp, Hamburg, Germany; Dr. Jürgen Schürholz, Filderstadt, Germany English Translation: Agenda Translations, Freiburg, Germany Graphic Design: Isabel Bünermann, Büro Hamburg, Germany Photography: Nele Braas, Tangendorf, Germany; gettyimages (1) Lithography: Beyer Lithografie, Hamburg Printing: Gaiser Druck, Schwäbisch Gmünd, Germany Circulation: 7.500; September 2004 Copyright: Medical Section of the School of Spiritual Science, Goetheanum, CH-4143 Dornach, Switzerland. Reproduction – partial or otherwise – only permitted with the written approval of the publishers.

Addresses Medical Section of the Goetheanum, Dr Michaela Glöckler, CH-4143 Dornach, Switzerland, Telephone +41-(0)61-7064290. www.goetheanum.ch International Union of Anthroposophic Medical Association (IVAA), President: Dr Giancarlo Buccheri, Via Vincenzo Monti 79/4, I-20145 Milan, Italy. www.goetheanum.ch/medicine/IVAA_new/ivaa_activities.htm European Federation of Patient’s Associations for Anthroposophical Medicine (E.F.P.A.M.), President: René de Winter, Landlustlaan 28, NL-2265 DR Leidschemdam, the Netherlands. www.efpam.org International Association of Anthroposophic Pharmacists (IAAP), President: Manfred Kohlhase, Email: [email protected]