01a Introducing anthroposophic medicine

Report of a lecture by Otto Wolff, M.D., Ph.D. Given at the Waldorf School Teacher Conference, Sacramento, CA 1986.

Open access: Anthromed Library gratefully acknowledges permission to share this booklet by Mercury Press and SteinerBooks, 2023.

On the basis of a case history, the question is considered as to how the pathophysiological dynamics of an organically defined syndrome (herniated nucleus pulposus) may be seen against the background of a stress situation from a holistic point of view (anthroposophical medicine) and treated accordingly. The basics of the interpenetrating levels of the human organization (“four bodies”) are given and also applied to the patient in question (physical diagnosis, evolution, psycho-social context and bio-graphy with reference to the vertebral column, power of uprightness and self-awareness). In addition to medical treatment and physiotherapy, therapeutic speech was used to good effect. In the second part of the paper, the significance of such an approach to medicine for the individual doctor-patient relationship is considered against the background trend towards evidence-based medicine.

Keywords: Herniated nucleus pulposus, Anthroposophical medicine, The four bodies, Art therapy, Evidence-based medicine, Medical conscience

By: Hendrik Vögler
Original title: Ganzer Mensch - krummer Rücken. Die anthroposophische Medizin in der allgemeinmedizinischen Praxis. Der Merkurstab 2003;56(5):252-259.
DOI: https://doi.org/10.14271/DMS-18352-DE
This article is published with the kind permission of the journal Der Merkurstab.

DM English issue 2004

Anthroposophic medicine includes special medications and special artistic and physical therapies. More than 200 clinical studies of varying design and quality have been conducted on anthroposophic treatment. Half of these studies concern anthroposophic mistletoe therapy for cancer. Clinical effects of mistletoe products include improvement of quality of life, reduction of side effects from chemotherapy and radiation, and possibly increased survival.

Apart from cancer therapy, the largest studies of anthroposophic treatment have been 2 naturalistic system evaluations: In German outpatients with mental, musculoskeletal, respiratory, and other chronic conditions, anthroposophic treatment was followed by sustained improvements of symptoms and quality of life. In primary care patients from 4 European countries and the United States treated for acute respiratory and ear infections by anthroposophic or conventional physicians, anthroposophic treatment was associated with reduced use of antibiotics and antipyretics, quicker recovery, and fewer adverse reactions; these differences remained after adjustment for relevant baseline differences. (Altern Ther Health Med. 2009;15(6):52-55.)

Objectives: The objective was to evaluate the scientific status of anthroposophic medicine (AM) according to demarcation criteria proposed in contemporary philosophy of science.

Design: Criteria for what is science were retrieved from eight publications in the philosophy of science, focusing either on science in medicine or on the demarcation between science and pseudoscience or non-science. Criteria were combined, redundancies were excluded, and the final set of criteria was ordered in a logical sequence. The analysis yielded 11 demarcation criteria (community, domain, problems, goals, axiomatic basis, conceptual basis, quality of concepts, methodology, deontic basis, research products, tradition).

Results: Assessing the scientific status of AM according to the 11 criteria, all criteria were fulfilled by AM.

Discussion: AM is grounded on the notion that specific non-atomistic holistic formative forces exist and can be empirically and rationally assessed. From a position claiming that such holistic forces cannot possibly exist or cannot be empirically and rationally assessed, the axiomatic and conceptual basis of AM can be contested. However, such an a priori rejection is problematic in the presence of empirical evidence supporting the validity of holistic concepts, as discussed in the paper. Future research should therefore focus on the tenability of the ontological reductionist position in science and on the further validation of AM non-atomistic holistic concepts, methods and practices.

Conclusion: In this analysis, using criteria from philosophy of science, AM fulfilled all 11 criteria for what is science.

Keywords: Anthroposophic medicine, Demarcation criteria, Philosophy of science, Scientific research field

Citation: Baars, E. W., Kiene, H., Kienle, G. S., Heusser, P., & Hamre, H. J. (2018). An assessment of the scientific status of anthroposophic medicine, applying criteria from the philosophy of science. Complementary Therapies in Medicine, 40, 145–150. https://doi.org/10.1016/j.ctim.2018.04.010

Abstract
Introduction: Anthroposophic medicine is a form of integrative medicine that originated in Europe but is not well known in the US. It is comprehensive and heterogenous in scope and remains provocative and controversial in many academic circles. Assessment of the nature and potential contribution of anthroposophic medicine to whole person care and global health seems appropriate.
Methods: Because of the heterogenous and multifaceted character of anthroposophic medicine, a narrative review format was chosen. A Health Technology Assessment of anthroposophic medicine in 2006 was reviewed and used as a starting point. A Medline search from 2006 to July 2020 was performed using various search terms and restricted to English. Books, articles, reviews and websites were assessed for clinical relevance and interest to the general reader. Abstracts of German language articles were reviewed when available. Reference lists of articles and the author’s personal references were also consulted.
Results: The literature on anthroposophic medicine is vast, providing new ways of thinking, a holistic view of the world, and many integrating concepts useful in medicine. In the last 20 years there has been a growing research base and implementation of many anthroposophical concepts in the integrated care of patients. Books and articles relevant to describing the foundations, scientific status, safety, effectiveness and criticisms of anthroposophic medicine are discussed.
Discussion: An objective and comprehensive analysis of anthroposophic medicine finds it provocative, stimulating and
potentially fruitful as an integrative system for whole person care, including under-recognized life processes and psychospiritual aspects of human beings. It has a legitimate, new type of scientific status as well as documented safety and effectiveness in some areas of its multimodal approach. Criticisms and controversies of anthroposophic medicine are often a result of lack of familiarity with its methods and approach and/or come from historically fixed ideas of what constitutes legitimate science.
Keywords anthroposophic medicine, scientific status, whole person care, integrative medicine

Citation: Bartelme, R. R. (2020). Anthroposophic Medicine: A Short Monograph and Narrative Review—Foundations, Essential Characteristics, Scientific Basis, Safety, Effectiveness and Misconceptions. Global Advances in Health and Medicine, 9, 2164956120973634. https://doi.org/10.1177/2164956120973634

Background Anthroposophic medicinal products (AMPs) are widely used in Europe and world-wide.

Objective To determine the frequency of reported adverse drug reactions (ADRs) from all AMPs on the market, in absolute numbers and relative to the maximum daily administration doses (MDADs).

Patients and Methods Retrolective safety analysis of AMP-related ADRs in pharmacovigilance databases of four AMP Marketing Authorisation Holders in Germany. For each ADR, information about the patient, outcome, causality and AMP was retrieved. Primary outcome was the frequency of reported ADRs relative to MDADs sold.

Results In the period 2010–2017, a total of 5506 ADRs were reported that had occurred in 2765 different patients, comprising 370 different AMPs. A total of 104 ADRs (1.9%) were classified as serious. The frequency of ADRs for all AMPs was 1.50 per million MDADs. For serious ADRs the frequency was 0.03 per million MDADs. ADRs were more frequently reported with parenteral AMP administration (injections) than with oral or local administration (18.85 vs. 0.59 vs. 1.61 ADRs per million MDADs, respectively; p < 0.0001). The large majority of users (91.9%) had recovered or were recovering from the ADRs and there were no reports with a fatal outcome. Most frequently reported ADR symptom was injection site inflammation for parenteral AMPs (4.66 ADRs per million MDADs), nausea for oral AMPs (0.03 ADRs per million MDADs), and eye irritation for locally administered AMPs (0.23 ADRs per million MDADs).

Conclusions In this retrolective safety analysis of pharmacovigilance data, the frequency of ADRs to AMPs was 1.50 per million MDADs. Notably, the ADR frequency in this study based on spontaneous reporting is not directly comparable to frequencies in prospective clinical studies nor to frequencies based on other measures of patient exposure than MDADs.

Citation: Jong, M. C., van Wietmarschen, H., Glockmann, A., Baars, E. W., & Hamre, H. J. (2021). Safety of Anthroposophic Medicinal Products: An Analysis of Adverse Drug Reactions from German Pharmacovigilance Databases. Drugs - Real World Outcomes, 8(4), 589–601. https://doi.org/10.1007/s40801-021-00262-7

Background: Regulatory assessment of anthroposophic medicinal products (AMPs) can be challenging due to their specific features.

Objective: The aim of this paper is therefore to provide adequate scientific information on AMPs for regulatory purposes.

Methods: A literature review was executed with database searches in PubMed, Cinahl, Merkurstab, Anthromedics, and https://iaap-pharma.org/. Search terms were: anthroposophic medicinal products, anthroposophic medicines, anthroposophic pharmacy. There was no language restriction; searches were executed from onset until June 11, 2020. In addition, experts were invited to suggest relevant literature.

Results: Eighty-seven of 660 identified publications were included. The system of anthroposophic medicine (AM) with its conceptual background and various aspects of AMPs was described: definition, pharmaceutical properties, an example of AMP development, use in clinical practice, similarities with and differences to conventional medicinal products, societal aspects, scientific and regulatory assessment.

Conclusion: AMPs are part of the integrative whole medical system of AM. AMPs are manufactured according to Good Manufacturing Practice and national drug regulations and have an excellent safety status; the limited available evidence suggests clinical benefits. Current drug regulation of AMPs in the EU and most European countries does not take the special properties of AMPs into account. Future research should focus on appropriate methodologies for the evaluation of effects of AMPs as part of the AM whole medical system, the scientific quality of its non-atomistic holistic ontological position, and the integration of AM and conventional medicine in clinical practice. Future policies should focus on appropriate ways of addressing regulatory challenges to AMPs.

Keywords

anthroposophic medicinal products, drug regulation, conceptualization, integrative medicine, whole medical system, literature review

Citation: Baars, E. W., Kienle, G. S., Heusser, P., Pedersen, P. A., Wietmarschen, H. A. van, Kiene, H., von Schoen-Angerer, T., & Hamre, H. J. (2022). Anthroposophic Medicinal Products: A Literature Review of Features, Similarities and Differences to Conventional Medicinal Products, Scientific and Regulatory Assessment. Global Advances in Health and Medicine, 11, 21649561211073080. https://doi.org/10.1177/21649561211073079