Arterial Hypertension: Anthroposophic Medical Insights
(Paper presented at the 2nd Exchange of Experiences in Anthroposophic Medicine Conference, 25 September 1993, Belo Horizonte - MG, Brazil in Medicina Antropos6fica, Ampliacao da Art Medica, AnoXTV - Outono/94, (Brazilian Journal for Anthroposophical Medicine).
In general terms, the aim of this type of meeting is to provide mutual training and exchange of experiences in the field of medicine and therapeutics. For this reason, I feel encouraged to report the issues discussed in Belo Horizonte. In preparing the subject I was surprised at how little literature there is on this topic. There are many roads which can lead to hypertension. While we deal with this condition in our daily practice, theory in anthroposophic medicine is sketchy.
According to Steiner, "Hypertension is the result of astral hyperexcitability at the level of the rhythmic system". In German, this pathology is called hypertonie, that is, exacerbated or intensified tonus. We know cramping as a constrictive action of the astral body on the muscles acting from outside as if a hand were gripping them. To understand "hypertonus", imagine this exacerbated astral tonus going deeper, as if it were generating exaggerated tonus at the level of the rhythmic, or cardiovascular, system. Here we see that this astral activity does not act from outside as it does in the case of a cramp.
It is not my intention to diminish the importance of the pathophysiology of hypertension. The comparison with a cramp is used only to get us closer to the constrictive, tension element of the astral process - something which is almost mechanical in the case of a cramp.
We find the causes of this astral tension of the rhythmic system in psychic disorders, moral tremors which affect the human being as a creature of soul and spirit. A simple and instructive example of the effects that a threat can cause to our feeling life is fright. When someone is startled, a feeling of abandonment arises, as if presence of mind abandons them. In other words, the activities of the Ego and the astral body move out of harmonious relationship with the physical-etheric body. These four bodies balance harmoniously in our rhythmic system. The consciousness of our Ego dwells in our cardiovascular system. If fright overcomes us, our capacity to react is impaired; the "shield" of the Ego and the astral body does not fully protect us. As a result, fear can invade us.
Rudolf Steiner points out the importance of disorders of the rhythmic system in human beings between the second and third seven-year periods as a cause of hypertension. It is well known that the second seven-year period of life is the solar phase, which is essentially a rhythmic one when the child suffers very little illness. In his book. Children's Destinies,(1) Dr. Holtzapfel explains this very well. The aesthetic and artistic experience of the world and the experience of beauty have their roots in this period. The child perceives everything around it through its most genuine feeling; we can state unequivocally that this feeling is an organ through which the child receives the world and through which he goes out to meet it. In this way, traumas of the soul from different sources will disturb the above-mentioned attitude of soul, and the soul will absorb these elements during the process of structuring the personality.
What is it that happens in this situation? It is as if the activities of the Ego and the astral body are attempting to settle on the base of the physical-etheric body, whose node of confluence is at the cardiovascular level, but does not succeed in doing so properly. Traumas are like frights in installments which cause the Ego and the astral body to hover, thus making it difficult for them to fit into the lower bodies like a hand in a glove. The attempt to incarnate occurs more from outside, irregularly, in the cardiovascular system, generating an increased tonus, hypertonus, or hypertension.
In a talk on the heart(2), Steiner states the following:
The human heart is a center where the cosmic forces and karmic activation are interlaced. From the age of seven up to the beginning of puberty/adolescence the individual etheric heart is born, originating from the cosmic spheres of influence (fixed stars, zodiac, planets). Together with this process there is a penetration of the astral elements (which were formerly outside) into all the physical organs; and it is as if the heart is the central point of this interiorization. These astral elements consist of karmic elements developed during the prenatal life. And it is in the heart that this clash between the cosmic-etheric forces and the karmic-astral forces takes place. The ego joins this process in sympathy from the astral body, inscribing in the astral body its aims and ideas based on which man carries out his actions... Indeed, here there is complete union of the karma with the laws of the cosmos... After death, the etheric body, upon dissolving in the starry cosmos, hands over to the universe, as it were, everything that was created by karma on earth.
This is an incomplete account of the lecture designed to illustrate the importance of the cardiovascular system in the deeper context of the existence of a human being.
Dr. Mees(3) also deals with the heart, asking us to consider the muscular continuity of the heart-aorta-arteries (with the reservation that the first of these is a syncytium, and the arteries smooth musculature). Since the heart is the stage on which the "dramas of the soul" are enacted, it is possible for a tensional process to materialize in the arterial system. He also reminds us that it is not only the heart that beats but the entire arterial system.
In his book, Der Leib als Instrument der Seek in Gesundheit und Krankheit(4) Dr. Walther Buehler describes the heart as the "perceptive" organ of the arterial circulation; it is the latter which really beats, leading the heart to beat with it.
Hypertension and Sclerosis
In the seventh clinical case of the Fundamentals of Therapy by Rudolf Steiner and Ita Wegman,(5) it is stated that the excess astral activity not absorbed by the physical and etheric bodies causes sclerosis. Later in the book, they state "...the excess of activity of the astral body also increases the activity of the Ego, which is manifested as a rise in blood pressure." Indeed, the correlation between sclerosis and hypertension is very common, especially when deposits are observed on the walls of the arteries. An excess of activity of the soul/spirit can be seen as the basic cause of sclerosis; but it is interesting to note that the degenerative element can be attributed to the astral activity whereas the Ego would be the harmonizing element of this process - if it were in control. Here, however, the astral element causes degradation, irregularity, constriction or hardening, which can lead to hypertension, to more obvious metabolic disorders such as atherosclerosis or arteriosclerosis, or to less obvious ones.
In the same book, they refer to the medicine Scleron: "In sclerosis, the organization of the Ego becomes very weak; it does not do enough breaking down. As a result, the breaking down takes place only by means of the astral body..." From this we see that both in sclerosis and in hypertension there is a predominance of the irregular astral activity, poorly controlled by the healthy activity of the Ego. The effect of Scleron is precisely to give priority to the activity of the Ego over the astral body; it is to fortify and intensify the activity of the Ego in the therapeutic sense, attempting to dissolve the hardening or constrictive tendency of the astral body.
When the activity of the kidneys and adrenal glands is increased, the resulting plethora can, in turn, lead to cardiovascular disorders and sclerosis. The pyknic constitution and the choleric temperament have this tendency.
People with a weak kidney radiation tend to have low blood pressure and a melancholic temperament of the longilineous type. I have seen several patients of this type suffer a reversion to hypertension between the ages of about 35 to 42 after a professional or marital crisis, bearing in mind significant aspects of their case histories.
It is quite common in anthroposophic medicine to come across the following definition of Steiner: "The hypertensive patient is a hypotensive person up against life." I think that, especially in the above case, this definition is perfect if we remember that this type of person generally has little vital energy, which affects the will, especially in the case of a low kidney radiation.
Some very interesting research was recently performed by means of a microneurogram in which the stimuli of the sympathetic (peripheral) nervous system on the arteries related to hypertension was observed.(6) The initial conclusion was that the hyperactivity of this system (due to stress, emotions, intellectual activity, etc.) caused arterial constriction, even going so far as to constrict minor blood vessels. It further concluded that in hypertensive patients the number of nervous stimuli remained high, even in the absence of triggering factors.
From this, it is not difficult to understand the previously-mentioned aspects if we consider the increased astral activity acting "from outside", causing contraction in the arterial system through the channel with which it has most affinity - that is to say, the nervous system.
Common name: chayote, vegetable pear
The possible therapeutic indications for this plant in the treatment of hypertension are manifold. It has been studied and is used in Brazilian folk medicine as an anti-hypertensive.
The plant itself has some interesting characteristics. It is a creeper with green leaves the size of a human hand or larger, gripping tendrils, small yellow or white flowers and a green fruit the size and shape of a pear. The chayote is intensely green, including its fruit, typical of the purest plant forces. This green is the element of water, of cold. The green fruit is edible. When the fruit ripens, however, it becomes yellowish and fibrous with small external spines and becomes inedible. The chayote's yellow or white flower is tiny, even timid looking. Here, in the flower, the vital etheric forces are hardly modified at all through astral intervention. Witness the chayote's tiny flower on the one side and its watery, expansive fruit on the other. Therapeutically, the leaves or tendrils are used as an infusion or the boiled fruit, either separately or in combination.
Pigs fed the chayote fruit suffer from reduced sexual potency or even impotence for a period of time. The relationship between the astral body and sexual activity, in humans as well as in animals, is well known. The more vitality a being has, the more energy it can potentially devote to a vigorous sex life. This excess vitality, which is healthy in animals, becomes pathological in human beings. The plethoric, hypertensive patient is the one that might benefit by treatment with chayote. Chayote would counter this excess vitality which "spills out through the pores." Will chayote work in other forms of hypertension? Possibly. At present, I am acquiring further clinical experience with it.
I'd like to end with the second half of Rudolf Steiner's mantram from the Course for Young Doctors
I will unite
The Knowledge of my soul
With Fire of the flower's fragrance;
I will bestir
The Life of my Soul
On the glistening drop of leafy morning;
I will make strong
The Being of my Soul
With the all hardening Salt
Whereby the Earth with loving care
Nurtures the root.(7)
Fernanda Abrao, M.D.
Sao Paolo, Brazil
1. Holtzapfel, Walter Children's Destinies 1989. Mercury Press. Spring Valley, MY.
2. Steiner, R. Lecture given on May 26,1922, Domach, Switzerland.
3. Mees, L.F.C. About the Heart. Ampliacao da Arte Medica. May/June 1975.
4. Buehler, Walther. Der Leib als Instrument der Seek in Gesundheit und KranKheit. 1962. Verlag Freies Geistesleben. Stuttgart.
5. Steiner, R. and Ita Wegman. Fundamentals of Therapy. 1983. Translated by E. A. Frommer and J. M. Josephson. Rudolf Steiner Press. London.
6. Jomal Brasileire de Medidna (JBM), Cultural Edition, Oct. 1993,65(56):52
7. Steiner R. Course for Young Doctors. 1994.4th lecture. Translator unknown. Spring Valley, NY.