Chronic Fatigue

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By: Basil B. Williams, D.O.
Twenty percent of all adults have fatigue as a chief complaint. They account for six million office visits a year in the US. This problem is so important that I want to share my personal experience in its diagnosis, treatment and prevention.

There are two broad categories of fatigue that I see in clinical practice. Periodic short-term, self-limiting fatigue is seen in the majority of patients. It lasts less than 2-3 weeks. An occasion patient will develop chronic, persistent fatigue lasting longer than four weeks. Over two thousand years ago Hippocrates said, "spontaneous fatigue tokens disease."

The common causes of chronic persistent fatigue that must be ruled out by medical doctors with history, physical and appropriate laboratory studies are: heart disease, hypothyroidism, cancer, anemia, acute and chronic Lyme disease, lung disease, HIV, tuberculosis, drug and alcohol addiction, sleep disorders, allergies and exposure to environmental toxin. There are twenty psychiatric disorders that have fatigue as one of their major symptoms, such as major depression and anxiety disorders.

Chronic Fatigue Syndrome (CFS) is defined by the Centers for Disease Control as sustainable activity of less than 50%. The mean duration of the illness was 37.1 months among a large number of previously studied patients.

Over the past 25 years in the treatment and prevention of fatigue, I have learned that the major therapy must be to restore and balance the patients’ etheric body (life body). Also, for true healing to occur, the overriding influences of the patient's soul (astral body) and spirit (ego) must be strengthened and encouraged. In Western medicine, there was an understanding of the etheric forces by Hippocrates as “Mucus,” Paracelsus as “Archeus,” and Hahnemann as “Vital Force.”

The concept of etheric forces (vital force, life force) of the etheric body is synonymous in Chinese medicine as Chi and in Japanese medicine as Qi. These etheric forces are conducted through the body in pathways or meridians. It was taught that when the Chi is enhanced, a person is well, and when it is unbalanced, then illness may occur. We are on the verge of a new frontier in medical practice today, where an understanding of the supersensory world of etheric forces or Chi will be directly applied to the treatment and healing of many illnesses.

The following are major activities or therapies that you can do alone to enhance your etheric forces:

1. Biodynamic or organically grown food products are the major contributors of balanced etheric forces and are produced without the use of pesticides, chemicals, hormones and antibiotics. They support the liver as the organ of vitality and the seat of the etheric body. Substances such as alcohol, chemical additives, highly processed refined and fatty foods are avoided.

2. Anthroposophical remedies such as Hepatodoron (Weleda) should be taken as directed. This remedy consists of grape and wild strawberry leaves and is excellent to enhance the activity of the liver. Prunus Essence (Wala or Weleda) should be used as directed as a bath 1-2 times per week and by mouth in adults as 12 drops 1-2 times per day. Other therapeutic remedies may require the prescription and direction of a physician.

3. Exercise: A single walk can lift your spirits. Swimming and water-based exercises are also well tolerated in CFS.

4. Daily rhythm can be developed with regular meals, sleep, meditation and general daily routines. The question was asked of Rudolf Steiner: " What is Life?" Steiner replied, "Study the rhythms, rhythm carries life." In my mind, this statement is the basis of all healing work. All of anthroposophically extended therapies are based upon rhythm.

5. Meditation is a continuous stream of uninterrupted concentration on a single thought over an extended period of time. Meditation with inner work is a slowly evolving journey of liberation, awakening, illumination and inner transformation of the self. There is a gradual strengthening of the soul or astral body. It helps find better ways to manage emotions and reduce stress, fears, disappointments, anxiety and frustration. Ultimately, one can reign in the uncontrolled astral body, and balance the soul forces that drain the etheric.

A summary of exercises to strengthen the will by increasing the control of the ego over the astral body can be found in the pamphlet Overcoming Nervousness. Also in this pamphlet are found exercises to strengthen the control of the astral body over the etheric body and exercises to strengthen and consolidate the etheric body in the physical body.

6. Avoidance of anti-life forces, for example, chemicals, electricity, radiation, etc. This important controversial area needs to be thoroughly understood and dealt with in a moderate, healthy way by the general public.

The following are major activities or therapies which require work with a physician or therapist:

1. Therapeutic Eurythmy is one of the major therapies in the treatment of all illnesses. "If an organ of the body is ill, a movement can be found through which that organ can be healed," said Rudolf Steiner. Eurythmy is a metamorphosed language of gesture with each sound having a shape. The vowels and consonants can be represented by gestures which the arms and whole body can sculpt. Therapeutic Eurythmy involves movements which are modified according to the illness under the direction of an experienced physician and a curative eurythmist.

2. Rhythmic Massage strives to restore harmony and balance with the etheric body. Rhythmical strokes with therapeutic oils can lift tissues out of gravity, giving warmth and relaxation. There is also produced increased muscle tone, flexibility, and range of joint motion.

3. Hydrotherapy can be very healing and relaxing, with water as a medium through which healing etheric oils can be absorbed through the skin with the beneficial therapeutic effects of warmth.

4. Cranial Osteopathy: rhythmical cranial and spinal impulses as fluid fluctuations (etheric forces) can be palpated and therapeutically enhanced and balanced by knowledgeable practitioners. I have found this method to be very helpful with other modalities in the treatment of fatigue.

5. Chronic Fatigue Syndrome (CFS) will require help from anthroposophically extended physicians or other therapists and will require the previously mentioned therapies as well as the individualized therapeutic remedies and therapies. The depression and anxiety that may accompany CFS will require trained, experienced physicians and therapists to properly diagnose and treat these psychological conditions.

Basil Williams, DO is a practicing physician in Arlington, MA at the Chrysalis Therapy Center. He is certified in the specialty of General Internal Medicine, subspecialty of Infectious Diseases and Anthroposophically Extended Medicine.


1. Klonoff, David, Chronic Fatigue Syndrome. Clinical Infectious Diseases 1992; 15:812-23

2. Khouzam, Hani Roul. Chronic Fatigue Syndrome: Update on Diagnosis and Treatment Consultant July, 2000; 1441-­1450.

3. Steiner, Rudolf And Wegman, Ita. Fundamentals of Therapy. Rudolf Steiner Press, fourth edition 1983; 1-10.

4. Steiner, Rudolf. Overcoming Nervousness. The Anthroposophic Press, third printing 1978; 7-19.


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