D e r M e r k u r s ta b | E n g l i s h I s s u e 2 0 0 4 1

Content

2 | Mathias Girke
Editorial

3 | Hendrik Vögler
Whole person — twisted back.
Anthroposophical medicine
in general practice

10 | Markus Sommer, Georg Soldner

The human spine. Configuration,
development and pathological
tendencies in the rhythmic system's
solid foundation

20 | Matthias Girke
Osteoporosis from the
anthroposophical point of view

28 | Franziska Roemer
Bamboo as a medicament for
back problems

39 | Harald Hamre, Claudia Becker-Witt,

Renatus Ziegler, Stefan N. Willich,
Helmut Kiene
Anthroposophical vs. conventional
treatment of low back pain —
results of a prospective study.
Abstract

40 | Ludger Simon
Aspects of fourfold diagnosis and
constitutional treatment
of spinal conditions

47 | Michael Hübner
The vertebral column and spinal
conditions at different stages in life

52 | Ricarda Meyer
Qualities of rhythmic massage and
its potential for spinal conditions
2 D e r M e r k u r sta b | G i r k e | E d i to r i a l English Issue 2004

Editorial

I
n our daily work with patients it is getting rent approaches using anthroposophical
increasingly more important to broaden physiotherapy, massage, medicaments and
the limited view gained in the dialogue be- eurythmy therapy, art therapy and also sug-
tween physician and patient so that it will cov- gestions relating to biography may lead to cli-
er more than just the clinical condition. Med- nically impressive evolutions. In future it will
ical reductionism has been influencing the be important to define and mutually harmo-
doctor-patient relationship for a long time. nize the different therapeutic methods
Asked how they are, many patients will today against the background of a comprehensive
present the clinical condition, in the case of os- view of the disease and the need for treat-
teoporosis therefore by speaking of a bone ment arising from this. The caduceus (staff of
density that is outside the normal for their Mercury) may be seen as an archetype for the-
age. Patients are, however, above all concerned rapy if one considers the double S shape which
with the question of how they are perceived, the spine forms around the vertical line of the
and it is their wish that the whole of them upright human form.The vertical does not ari-
may be considered as the dialogue evolves. se as a mechanical, static phenomenon but a
This means that physicians need to widen spiritual quality of the I-endowed human
their horizons. Carl Friedrich von Weizsäcker being, which rhythmic movement must conti-
spoke in a similar situation of the ‘limited hori- nually recreate in body, soul and spirit.
zons of a culture’that limit the comprehensive Matthias Girke
image of the human being, and of a science
that seeks to be objective and subject-free.
Conditions affecting the spine, the main
theme for this Merkurstab issue, must there-
fore be liberated from the ‘limited horizons’ of
a mechanistic view. Diagnosis and treatment
thus take account of the physical aspect, of vi-
tal processes in osteogenesis, of the soul qua-
lity which comes to expression in posture, for
instance, and finally of the spiritual power to
be upright.The I imprints this power in the de-
veloping human form at the beginning of life
and withdraws it again in the end—as may be
seen with many conditions of the spine. Diffe-
English Issue 2004 Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k | D e r M e r k u r sta b
Whole person—twisted back
Anthroposophical Medicine in general practice
H e n d r i k Vö g l e r
■ Abstract
On the basis of a case history, the question is con-
sidered as to how the pathophysiological dyna-
mics of an organically defined syndrome (hernia-
ted 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 interpenetra-
ting 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
3
The patient
T
he patient is almost 40, c. 185 cm tall, weighing 80
kg, dark-haired, organizational developer, fashion-
conscious and casually elegant in his choice of
clothes. He had developed a herniated nucleus pulposus
early in the year. Sometimes you hear him as he comes
up the stairs, his steps vigorous as he approaches the
practice, where he is effusive in greeting me:“Well, doc-
tor, how’s things?” His voice is strong and penetrating.
You sense his pent-up energy if he has to wait, a rest-
lessness that shows itself. He’ll only come if absolutely
necessary and wants to get away again quickly. He’s a
private patient. In conversation he tends to be mocking,
provocative, going outside the limits and bringing a
jovial, jokey style into the situation.
He is married to a teacher who is eight years older
than himself, also a patient of mine. She is, it has to be
said, a “beautiful” woman. The daughter from her first
marriage, now 17, is currently also receiving treatment
for massive autonomic dysregulation symptoms follow-
ing the conflict situation of separating from her friend.
The youngest in the family is a boy aged 6, son of my pa-
tient and his wife. In his case perinatal asphyxia has led
to noncommunicating hydrocephalus and cerebral fits.
His development is supported by a range of measures,
but he is a major challenge to his parents. During the day
he attends an integrative nursery.
Our patient works as an organizational developer for
the local authority of a city in the Ruhr area. Among oth-
er things it is his responsibility to sell the authority’s
policies to the public and develop the work in individual
city districts. He feels well integrated in a team of col-
leagues, of whom he speaks in a very positive way, yet
completely out of place in the local authority setting.
He first came to see me in October 1999 with pain in
the lumbar region (not radiating to the legs). His work
was stressful and he was actively involved in sport. The
symptoms improved rapidly after three treatments with
Disci/Rhus toxicodendron comp. in the region of the
lumbar spine. In April 2001, he presented with lumbar
and sciatic pain which regressed somewhat more slow-
ly with the above treatment. I therefore prescribed re-
medial gymnastics in addition and also Disci comp. cum
Stanno injections. In February 2002, he developed acute
4 D e r M e r k u r sta b | Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k
lumbar sciatic pain on the right within two days. A nu-
clear spin tomogram of the lumbar spine done at the pa-
tient’s request showed medial prolapse L5/S1 with con-
tact to S1 nerve root on the right.
Between the daily treatments for the acute condition
(v.i.) I had said to him that a psychosomatic component
has to be considered when symptoms are recurrent, and
he agreed to come for a talk. His first words were:“Now
you’ll tell me what’s what.” Instead I asked him what he
himself thought. He did immediately turn serious, say-
ing that stress at work was acute at the moment, and he
was getting increasingly more worried that he might
not be able to cope (“Will I manage it all?”). He was also,
he said, highly critical of his own work, dissatisfied with
himself, unsure, and hardly able to relax.
The issue
Let us leave aside the case history at this point and
ask how the patient’s inner situation and his outer
symptoms may be related. At the beginning of the year,
back pain had been the subject of a monthly colloquium
of the group working on quality in general practice for
the medical practices involved in the teaching program
at Witten/Herdecke University in Germany. Following
exhaustive reviews of the literature and practical expe-
rience reported by colleagues, there was consensus that
in 60 – 80 % of cases, back pain did not go hand in hand
with demonstrable organic changes. At the same time it
had been established that 60 % of patients showing
changes in nuclear spin tomograms were symptomfree
(Deutsches Aerzteblatt, 31 May 2002). The question of
correlation between physical findings and symptoms
arose. People attending the symposium also thought
that psychogenic causes must be considered when there
are no organic changes in a case of back pain. No refer-
ence was, however, made to the question as to in how far
psychogenic factors, for instance, may play a role in the
genesis of demonstrable herniated nucleus pulposus).
Here we come to a central problem in modern medi-
cine, which is that no consistent concept has been de-
veloped for the physical aspect (soma), which is entirely
the subject of scientific investigation, and the psyche,
which relates to aspects of the humanities and of phi-
losophy, and in the light of current experiments in neu-
robiology all psychic phenomena are primarily seen as
reflections of neurophysiological processes.
psyche
? body” in anthroposophical terminology, cannot be seen
soma
What can the anthroposophical view of the human
being offer in the field of medicine in this situation and
with reference to the case we are considering? Would it
be possible to consider the spirit-and-soul sphere less in
terms of cause and effect in relation to the physical
sphere but rather in terms of correlation? To get a com-
prehensive picture in this sense, it will, however, be nec-
essary to differentiate the terms “psyche” and “soma”
English Issue 2004
further, as is done in the image of the human being
which Rudolf Steiner developed in anthroposophy.
“Four bodies”
Looking at the human body, we may speak of a pure-
ly physical level of existence which in terms of scientific
medicine may be called the molecular organization. At
this organic level, diagnosis is done by physical exami-
nation and laboratory investigations as well as imaging
methods. The biophysical and biochemical processes
arising wholly at this organizational level come into play
after death, when the dead body decomposes, and the
laws of the mineral world primarily apply.
This physical organization does, however, appear
more stable and real than it is, for the body form and the
forms of organs are only maintained by continuous syn-
thesis and breakdown of matter.The world flows into us,
is taken hold of, reorganized, “used up” and released
again. It is not the material of the body which is stable
but the organization which gives it form or maintains its
form,“vitalizing” it.
This next higher level may thus be called the vitaliz-
ing organization, the totality of vital powers that create
form, maintain it, and let it arise and die away. In daily life
these powers are also active in regeneration and as “self-
healing powers”. These processes take place in the fluid
sphere, in solutes, and are reflected in the principle of
homeostasis or steady states. At this level the human or-
ganization shows a relationship to the plant world.
This level of functional organization is independent
of the physical organization, as becomes evident when
the two separate at death. Then the powers that create
and maintain form separate from the material sub-
stance and the body decomposes.
The existence of this organizational level is denied in
modern science with its strictly materialistic orientation.
Its effects are (hypothetically) explained as processes
that are said to arise purely at the material level.The lim-
itations of such a position show themselves if we con-
sider a work of art, for instance Leonardo da Vinci’s Mona
Lisa. The painting does, of course, consist of paints, and
if we insist, we can characterize these in purely chemical
terms. Yet the essence, the reality, of the Mona Lisa im-
age cannot be found at this level. It is evident, therefore,
that modern science, being explicitly focused on the ma-
terial aspect of the world, cannot encompass the image
aspect in the living world, and the essential nature of
this level goes unrecognized.
The vitalizing organization, also called the “ether
the way the physical organization can be seen. It can,
however, be perceived in its effects on the visible world,
by the traces it leaves if we consider processes in time.
In medicine, all the methods used in natural medicine
work with the processes at this particular organization-
al level. Self-healing powers in the widest sense are stim-
ulated in different ways, e.g. by acupuncture, homeopa-
thy and external applications.
The next level in the total human organization may
be called the emotional organization. It makes it possi-
English Issue 2004 Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k | D e r M e r k u r sta b
ble for autonomic life to “awaken”, for experience of life
and conscious awareness to arise, physiologically essen-
tially on the basis of breathing oxygen. This makes it
possible for the animal organism to have internal per-
ceptions and external movement and mobility. Imagine
a young brown dog running through a large beech-
wood. The trees with their vitalizing organization con-
nect to a maximum degree with the environment; they
extend into the atmosphere in the leafy canopy and con-
nect with the soil through a tremendous root system.
For the running dog, connection with the environment
is limited to four fleet paws, i.e. the emotional organiza-
tion turns in on itself and away from the environment,
which results in the creation of an organic internal
space, with more definite delimitation from the envi-
ronment and increased individualization. This also in-
volves a distinct process of devitalization. Perhaps you’ll
remember how your garden had been all overgrown
when you came home from holiday and how much en-
ergy was needed to cut back this vegetative life, limiting
it, so that the garden might serve your purposes again—
to give you living experience and rest and recuperation.
At this point it is already getting evident that this
contrast between constructive (night side) and destruc-
tive development (daytime side) is essential to the
whole process of health and illness—a difference as be-
tween night and day.
In medicine, the soul sphere is the domain of psy-
chology and psychosomatic medicine. In anthroposophy,
this organization, which gives human beings the ability
to focus attention, is called the “astral body”.
In humans, as distinct from animals, there is a fourth
level of organization which I would like to call the inten-
tional organization. A person is able to direct his atten-
tion. When he turns it on himself, self awareness arises,
the ability to both discover and say “I”. He is in a position
to use the conscious mind, either to concentrate on a
particular thing, or to be open to many things. He is in a
position to identify himself. Finally he can limit, direct
and configure the elements that emerge in soul life. He
is able to “cultivate” the soul and be fully human.
In a book by Peter Handke published in 2002 entitled
Der Bildverlust (loss of image) we read:“What is human-
ly possible for you?”she asked the author. His answer:“To
ask you the right questions and thus get you to tell the
story.”
We come to the level of speech and language, of
thinking, the language for the experience of I and you.
Humanity means the challenge to want to make some-
thing of your life, give form to your own life, share in the
work of creation in a way that goes beyond the purely bi-
ologic and can bring moral aspects to realization. Klaus
Doener spoke of “wanting to against your will” in this
context.This core of soul life is called the “spirit”or the “I-
organization”in anthroposophy.Transpersonal psycholo-
gy is one modern field where this aspect is considered.
This fourfold organization—briefly outlined—consti-
tutes the human being. The transition from one level to
the next does not signify “refinement” or “further devel-
5
opment” but in fact the overcoming of the previous lev-
el. When the vitalizing organization takes hold of the
mineral, it is completely metamorphosed, becoming “fit
for life”, etc.
Four different principles thus exist one inside the
other. They lie hidden in the living human being who
stands before us. Horse and rider are one—a key to un-
derstanding the image of the Centaur known in antiq-
uity.
People taking the modern scientific view doubt the
existence of the level of the vitalizing energies and con-
sider the independent existence of the “I”’, the inten-
tional organization, an illusion, above all from the free-
will point of view. Feelings, thoughts and will impulses
are said to be merely “subjective”reflections of neuronal,
hormonal changes. Do not let yourself be brow-beaten.
Here you have a cube shown in perspective. Which
surface do you see in front? The one at bottom left or top
right? It all depends. You can see it whichever way you
will. No molecule in your organism will make you in-
clined to see the one or the other in front. It is you your-
self who “sees”, depending on how you wish to see it.You
use the whole of your perceptive and idea-forming ap-
paratus, your body, as an instrument to come to this ex-
perience. You, yourself. The colossal uncertainty created
concerning the existence of the I, with self awareness
made relative, has far-reaching consequences in devel-
oping pathological processes—also in the backbone—
and in the lack of health-generating resources, as we
shall see.
Intentionale organization Spirit Human
Psyche
Emotional organization Soul Animal
Vitalizing organisation Life Plant
Soma
Molecular organization Body Mineral
The “four bodies”
Application of the above
In a next step, let us try and apply these differentiat-
ed aspects to the patient. At the level of the physical or-
ganization every physician will first ask: What have we
6 D e r M e r k u r sta b | Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k
here? Physical examination showed indurated paraver-
tebral musculature bilaterally at the transition from tho-
racic to lumbar spine, sciatic pressure points sensitive to
percussion, with radiation to the posterior aspect of
right thigh; no neurological changes such as hypersen-
sitivity, reduced muscle reflexes or positive Lasegue’s
sign. The symptoms had not developed suddenly but
slowly in the course of two days, so that initially one
might consider radicular or also pseudoradicular pain.
The nuclear spin tomogram had shown minimal contact
between the herniated nucleus pulposus L5 on the right
and the S1 nerve root. The patient was generally under
high stress, as stated above, with muscles dense and
hard on examination, and found it difficult to relax dur-
ing the examination.
With reference to the second, vitalizing organization,
the physician will ask about functional change when
taking the history. How did it come about? With a histo-
ry of some years, it was possible to establish recurrence
of the symptoms every one or two years, with increasing
intensity, and stress as a distinct factor. It became clear
that intervals of relaxation were not a regular part of the
patient’s days and weeks, and that the patient had no
feeling for giving rhythm to his days and weeks in this
sense. Instead there was continuous stress, with no
phase for letting go.
Conditions like these would make him a good candi-
date for arterial hypertension. Perhaps he was able to
stave this off because of his exuberance and being
something of an extrovert, so that inner tension could be
released. Following my advice to take up sport he had
chosen badminton, which does tend to get hectic at
times. Considering the symptoms one may speak of a
rhythmic disorder in the movement sphere of the spine.
This arose because tensing, and therefore destructive,
processes were getting too powerful relative to the con-
structive, relaxing processes. His coloring is on the pale
side; he often seems exhausted, with vital energies re-
duced. This was also evident in his impulsive, abrupt, of-
ten jerky movements—the syndrome of having no time.
Let us quote Peter Handke again in Der Bildverlust.
“ ‘Time is money?’ she said loudly again in the darkness
that deepened the further down she went, ‘Yes, but in a
way that differs from the one generally accepted. Inves-
tigations are still outstanding as to what values can be
gained through time. I have time now, and nothing else
has ever made me feel more free and more rich. Yes, and
having time is indeed a feeling, and has nothing to do
with leisure and feelings of leisure. It comes from inside
and is added to what I happen to be doing or not doing
at the time, rendering it complete and giving it meaning
or self-will. Listen, this having time, is it all-embracing?
No, the fundamental feeling which alone makes other
feelings possible —feelings that are more expressive, al-
so greater, and therefore more heart-felt—and also life
at large.’ ”
With reference to the third level, the emotional or-
ganization, the physician asks: “In what kind of psy-
chosocial context did the symptoms develop?” I had ear-
English Issue 2004
lier mentioned the patient’s fear of not being able to
cope with the demands he had to face, which led to con-
stant tension, to holding fast in the small of the back,
and we can see directly that this is the point of origin for
hardening in the lumbar region. Then there is the ten-
dency to be self-critical, devaluing himself and as a next
step hiding this inner conflict to maintain an outer fa-
cade. These hiding processes are very demanding and
exhausting. The patient finally said: “I am not taking
proper care of myself.” His wife was able to show him
that this is not necessarily a male virtue but rather a sign
that one is lacking in sensitivity, in perceptiveness for the
body.Yet another challenge—to be able to do something
which one had not yet learnt.
Considering his liveliness, strong voice, facial expres-
sion, gestures and expressiveness, one could see that
part of the picture was a tendency that ran counter to
the above. On the one hand a tendency to excessive
form, fixation and condensation, on the other a tenden-
cy to go over the limit and hypermobility—with nothing
much in between to mediate and balance.
With regard to the fourth level, the intentional or-
ganization, the physician will ask: “At which stage in the
biography did the symptoms or the illness develop?”A key
motive given earlier was: “to make something of one’s
life, develop a life of one’s own.”On the one hand this as-
pect holds the potential for human freedom, yet on the
other it is also a tremendous challenge—and maximum
stress. With the world increasingly more regimented,
how do you find your own impulses and bring them to
realization? Above all with regard to a freedom to shape
things yourself that is scarcely given for someone with
lively emotions working in city administration. If one
considers the economic and political pressures city ad-
ministrations are under in the industrial Ruhr area of
Germany—especially with the recently announced re-
duction in tax revenues—as they face the need to re-
structure, changing from a society governed by heavy in-
dustry to one of high technology, we can sense how con-
ditions at work are also conditions of life. In this situa-
tion, our patient finds himself someone who has already
gone past midlife, past his “peak”.
If we consider human biography in rough outline, the
first 20 years consist in the individual getting used to the
body and its function, learning to use it until “adult-
hood”is reached.The next 20 years are essentially a time
when the individual explores, tries and individualizes
the potential of the psyche. Once he has achieved au-
tonomy by developing these instruments, the individual
can shape life according to self-chosen goals.The transi-
tion from one stage to the next frequently leads to
crises—will it be possible to find the way. Our patient
had to cope with the focal situation in at work, a family
situation where the disabled child meant special de-
mands, as did a step-daughter in puberty, and his “beau-
tiful” wife. So the question arises: Where does “he him-
self” come in?
At this point, let us return to our initial question con-
cerning the “relationship to organs” and consider how
English Issue 2004 Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k | D e r M e r k u r sta b
the vertebral column, the upright position and self
awareness relate to one another. To begin with, a little
story which Thomas McKean told during a course on the
human skeleton. A little girl watches her younger broth-
er learning to walk and tells her mother, who is in the
kitchen, of the progress made by her brother:“Mum, now
he’s walking along the table. Mum, now’s he’s holding on
to the chair. Mum, now he’s holding on to himself!” Hu-
man uprightness is an allegory of holding on to oneself.
Just as in the drawing by Michelangelo an impulse
takes hold of the body mass, lifting it into buoyancy, the
upright, extension (Fig. 1). Or in a different context, the
German painter Kaspar David Friedrich’s Monk by the
Sea, a human being, small and erect in front of the im-
mense vastness of surf approaching with all the force of
nature—water, wind and darkness. Or the thin figure in
Alberto Giacometti’s Woman with Chariot.The graceful-
ly slender emphasis on uprightness as a characteristic of
purity, nobility (Fig. 2).
Also a detail from Joseph Beuys’ Evolution—the hu-
man being as filigree, standing on the Earth, head turned
to the heavens. Beside him the plant in its corresponding
organization. If we turn the picture upside down, the
Earth is a luminous planet springing from the human
legs—from human works—like a flower (Fig. 3).
7
If we consider the position of the vertebral column Fig. 1
Michelangelo,
between the spherical head as the resting pole and the
drawing of male
radiating limbs as the image of movement, the double- figure. Florence,
S form indicates a mediating function. Like the rhythmic Casa Buonarotti.
functions of heart and circulation, respiration and lung,
Fig. 2
it may be seen as part of the human rhythmic system, as
Alberto Giacomet-
will be shown in what follows. ti, Woman with
We also see evidence of this in human embryonic de- Chariot. Wilhelm-
velopment. The onset of contractions in the developing Lehmbruck-Muse-
um, Duisburg.
heart coincides with the development of the first
somites as precursors of the vertebral column in the dor- Fig. 3
sal embryo, an element of differentiation in space which Joseph Beuys,
appears around the 19th day. The vertebral column thus Evolution (detail).
Private ownership.
has two functions, as it were, in the human organism,
one being posture and the other movement. This also
makes it a potential source for two kinds of pathology—
immobility and rigidity on the one hand, and hypermo-
bility and instability on the other.
Spine
Posture Movement
Rigidity Instability
Looking at the role of the human “I” from this point
of view, we discover another differentiation into what
are almost polar opposites. In the aspect which in-
evitably arises when we look at the different human
bodies in this way, the “I” cultivates and configures the
emotional organization (astral body), acting as “master
of the house”, giving direction and guidance. Again it is
8 D e r M e r k u r sta b | Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k
immediately obvious, however, that excessive form
processes, suppression, and rigidity may quickly develop.
The aspect of the I is that of the “child inside”, the I as
something evolving, germinal, the sphere of potential
and possibility—or in terms of Joseph Beuys’ form ther-
apy the sphere of warmth and chaos, chaos because still
undefined, the source of everything. This aspect should
not be overlooked.
How are the cultural conditions of life for the I today?
On the one hand, the argument of being scientific is
used in presenting ever new detailed studies in the me-
dia to show that the I is all “illusion”, an “imaginary” re-
flection of bodily processes.“There is no I.” Remarkably, a
progressive loss of values, general egotism and a degree
of inhumanity in our “civilization” is going hand in hand
with the prevalence of this public image of the human
being.
On the other hand competition means pressure at
work, and the desire for provocatively lived-out autono-
my shown in the media (Friday evening talk shows) is
tremendous. “Living your own life” turns into the stress
of self realization. Not just ability but originality and
above all authenticity are essential conditions for jobs as
much as for a place in acting school.
As physicians we are also caught up in this. In how far
are we in a position to face these issues without fear and
without expectations? The question as to the patient’s
identity touches immediately on the question as to the
physician’s identity. The origin of the self does not lie in
the world outside, the world of science. It is in the dark.
Or, as Georg Kuehlewind put it: “The I is not something
to see, it is seeing.”
If the attempt to find oneself fails in this zone of fac-
ing up to things in isolation, confusion will ensure and
exhaustion, and often needs to be drowned out by use
of substances, through work or some constant thirst for
new experiences. A considerable proportion of back
problems are partly determined by this.
Treatment
With regard to treatment, let us again take our ori-
entation from the above differentiation into four bodies.
In the acute state, deeply subcutaneous injections of
Disci/Rhus toxicodendron comp. (10 ml ampoules/Wala)
were daily given paravertebrally, two fingers to the left
and right of the vertebral column on the line connecting
the spinous processes. A sickness certificate was issued
for two weeks, and remedial gymnastics were pre-
scribed, asking the patient to practice regularly himself,
and to sleep in the appropriate position. With this treat-
ment in the sphere of the physical organism, the symp-
toms improved within a few days.
If similar symptoms recur a number of times and lit-
tle sport is done to train the muscles of the back, I will al-
so recommend Kieser training, an active medical
method to strengthen, relieve and stabilize the deep ex-
tensor muscles of the spine.
At the functional level, the above-mentioned exercis-
es which are predominantly physical in effect need to be
English Issue 2004
supplemented with therapeutic exercises that will re-
lease blockages, stimulate vital energies and set them in
motion, thus contributing to progressive vitalization. Eu-
rythmy therapy would be the method of choice. I have al-
so seen good results with Dore Jacobs’ back training and
the Feldenkrais method.
In the above-mentioned talk about the psychoso-
matic background to his symptoms, the patient had re-
ferred to frequent panic reactions and that he was in-
creasingly aware of limited self-perception. It became
clear to him that relaxation and exhalation processes
were important for him. His wife had had positive expe-
riences with speech therapy for her asthma, and as
speech and language are also important tools in his own
profession, he was indeed interested to learn more
about these things.
Art therapies generally serve above all to integrate
the different human bodies in the process. With speech
therapy, the first step is to identify blockages in the liv-
ing body so that the breath may flow freely and speech
may be given artistic form. In this particular case, the re-
laxation stage initially involved pelvic floor and foot ex-
ercises which helped greatly to improve exhalation. This
was followed by work on uprightness and stability of
posture, using exercises with palatal sounds which ad-
dress the human life of will, e.g. G and K. Exercises with
the D-sound then served to counteract effusive tenden-
cies and practice focusing on a goal.
Initially the patient had considerable difficulties with
starting the exercises, being worried about appearing
“womanish” or childish. He was, however, gradually able
to overcome these inhibitions and indeed discover “fem-
inine” aspects in himself. This brought relaxation both
physically and generally. After twelve treatment sessions
his symptoms had gone and there has been no recur-
rence to this day. He recently informed me of plans to
have follow-up artistic speech treatment.
If we go back to our initial question as to whether
herniated nucleus pulposus is organic and/or psy-
chogenic in origin, we find from the above that it may re-
sult from the combined effect of pathological tenden-
cies in the different bodies. For the physician, the atten-
tion must above all focus on the constitution of the “vi-
talizing organization”, the body that forms the bridge
between body and soul. In the case of our patient, the
circumstances of his life had weakened the constructive
powers (ether body), letting destructive powers (persist-
ent tension in the astral body) predominate. In addition
to treatment with the above-mentioned preparations
and exercises, there was need to reorganize his life situ-
ation, doing so through the “I”. Initially this involved look-
ing at the self image, changing the approach and gain-
ing more acceptance of self. From this position it was
possible to change attitude and establish a new weekly
rhythm. It was also important for the patient to accept
his own organization at all levels, and considering the
opposite nature of the levels this cannot be expected to
be a process that is always harmonious but will also be
dynamic (and chaotic).
English Issue 2004 Vö g l e r | W h o l e p e r s o n — t w i st e d b a c k | D e r M e r k u r sta b 9

Medicine today imagined successes and through the high esteem in

Looking thus at the whole human being—the whole which the public holds the medical profession. These
person, to refer to the title—the patient’s side is con- two obstacles must be brought to conscious awareness
cluded in this paper, and we come to the other part, that before there can be the open encounter with the human
of the physician—i.e. the aspect of the “twisted back”. being, the patient, which is the precondition for all med-
I myself got to know anthroposophical medicine icine and may indeed arise even with the first question-
about 25 years ago. The impression I have gained is ing look, being ready to listen.
twofold. On the one hand I cannot imagine my work The reflections in this paper thus ultimately lead to
without it, for it provides a comprehensive armamen- some very simple requirements for a modern health care
tarium for the diagnosis and treatment of diseases and system. Firstly, not to leave patients to themselves, but
sick people. On the other hand one finds again and again make people available to whom they can talk about the
that it is all still in its beginnings, that often enough ide- various questions that touch on their existence. Second-
al and reality differ, and above all, research and evalua- ly to create conditions where physicians can use their
tion are still needed for many of the views and thera- will to heal—no more and no less. The physician’s grow-
peutic methods. ing will to heal can then stimulate the patient’s will to
Against the background of current trends in health get well.
policy, with increasing control brought to bear by insur-
Hendrik Vögler, MD
ance companies and government, Disease Management
Beurhausstr. 7
Program (DMP), Diagnosis-Related Groups (DRG) in hos-
D-44137 Dortmund
pitals, and similar things in terms of quality assurance,
definite questions inevitably arise. Will more control re-
ally improve quality in health care provision today? Let
me refer to Joseph Beuys once more. In his view, more
and more form means more and more coldness and
hence ultimately all life being lost—dropping out of the
system. The way I see it, exactly the opposite quality is
needed. More warmth must be brought into the system,
to put it plainly, more love, or more personal responsibil-
ity. “But how?” Not by reducing freedom.
In principle, there can be no objection on our part to
disease management programs like those currently un-
der discussion for asthma, diabetes, etc. We ourselves
make particular syndromes the subject of our autumn
conferences (e.g. rheumatic conditions/hepatitis C), with
awareness of “diseases” and “sick person” as problem ar-
eas. Academic medicine is frequently limited to devel-
oping diagnosis and treatment for pathological condi-
tions. This leaves family physicians with the major task
of implementing these points of view in the individual
case. All evidence-based medicine developed on the ba-
sis of clinical trials is of necessity de-individualized. This
is essential in order to create a background, but cannot
on its own determine the decisions made in the individ-
ual case. People like to say with reference to statistics:
“One case is no case”; in the same sense we can say in
medical practice: “a hundred guiding principles cannot
take the place of the physician’s conscience.”
Instead, the question arises as to how health care
provision may be given such a form that physicians can
comprehensively identify with their profession. Here the
way a physician sees himself plays a major role, the as-
pect of identity which was mentioned earlier.This sphere
can be subject to the kind of inner development given,
for instance, in general terms by the anthroposophical
view of the whole human being, and in a specific way for
the physician.This may perhaps make it possible to over-
come the two great obstacles in relation to patients—on
the one hand fear of making mistakes, lacking compe-
tence, and of failure, and on the other vanity arising with
10 D e r M e r k u r sta b | S o m m e r · S o l d n e r | Th e H u m a n S p i n e English Issue 2004

The human spine

Configuration, development and pathological tendencies
in the rhythmic system’s solid foundation

Markus Sommer, Georg Soldner

Dedicated to Hartmut Vogel who taught us to look for the essential nature of things in their origin.

The specific configuration of the human vertebral

■ Abstract column
The human spine is—next to lung and heart—con-

W
hen back pain limits the ability to stand with-
sidered to be the third organ of the human rhythmic out support we become aware of the signifi-
system. Its embryonic development clearly shows a cance of being upright. The human form is
relationship to the individual nature, the I, of the hu- able to hold a unique position between heaven and
man being. Spinal conditions such as herniated nu- earth. It owes this to the vertebral column which—sen-
cleus pulposus in adults are considered in the light of sitively perceiving the situation with regard to bal-
vertebral-column developmental dynamics; the equi- ance—seeks the upright anew at every moment. It can
librium between buoyancy and gravity, powers of be instantly and actively taken out of this for any form
light and substantiality, is seen as determining spinal of movement, then to return again to its unstable bal-
development and health. At substance level, the cor- ance.The way in which the spine is placed in and against
responding polarity is between phosphorus and cal- the line of gravity makes the upper extremity independ-
cium, in dynamic terms between lordotic areas of ent of support from the trunk, ultimately giving the
high spinal mobility on the one hand and kyphosis hand perfect freedom of a kind not achieved anywhere
on the other, which may also lead to fusion of verte- in the animal world. This provides the basis for the hu-
brae. man capacity for active intervention. With the shoulder
■ Keywords girdle relieved of gravity and the head raised into
VertebralColumn “weightlessness”, as it were, above the spinal column, it
Rhythmic System becomes possible for the word to be freely created.1 To
Notochord understand the significance of these effects which ulti-
Intervertebral Disk mately arise from the spine, consider a cow. The front
Herniated nucleus pulposus legs bear the heavy load of a massive body; the head
Osteochrondrosis hangs heavy, held by mighty neck muscles. The configu-
Osteoporosis ration of muscle and bone immediately shows that the
Calcium phosphate creature (with its impressive metabolic functions) can
Calcium carbonate only produce a dull “moo” sound. The human neck mus-
Scheuermann’s disease cles are relatively slight, and largely relieved of their sup-
Lumbosacral transition portive function; they may, however, be as finely modu-
Craniocervical transition lated as are the delicate muscle fascia of the larynx or
Cervicogenic vertigo the subtle muscles of the face and tongue.
The spine of vertebrate animals more or less forms an
arc from anterior to posterior extremity; this may be
tensed for a leap or (cf. snake, fish) swung sideways, but
shows a functional form that differs fundamentally
from that of the human spine.The human axis also is not
a straight rod, but shows rhythmic alternation of rest
and mobility. The resting position of the head bases on
the vaulted form of the occiput which has developed by
fusion of cranial vertebrae. These gave up their articu-
lated mobility in relation to one another. This kyphotic
gesture of perfect rest is immediately followed by the
Note
1) For detailed descrip-
most mobile part, the cervical spine, which permits the
tions, see Verhulst J. (1) head to turn and incline in all directions. The basic form
English Issue 2004 S o m m e r · S o l d n e r | Th e H u m a n S p i n e | D e r M e r k u r sta b
of a healthy cervical spine is distinctly lordotic. We shall
see in what follows that lordosis always signifies mobil-
ity, whereas kyphosis leads to rest. This is immediately
apparent in the thoracic spine below; slightly kyphotic,
it goes slightly forward towards a thorax made up of the
ribs that arise from it. Continuous rhythmic movement
lives in this space, yet the axis which determines it is
largely at rest. The lordosis of the lumbar spine on the
other hand permits to-and-fro motion in the vertical di-
rection when walking, and also rotation in the horizon-
tal and sideways inclination. There follows a section of
fused vertebrae, immobile in itself and making up the
kyphotic sacrum. This directs the weight of the body via
the ileosacral joints—with minimum mobility—to the
solid pelvis and then the legs.The coccyx, rudimentary in
humans, is inconstant in its curvature.
The rhythmically organized configuration of the
spine separates and relates above and below, buoyancy
and gravity, mobility and rest, sensory and limb activity;
it makes it possible for the human being to be “one who
looks up”(anqropos, anthropos) and yet stands firmly on
the ground.
The vertebral column as an organ of the rhythmic
system
One secret of the vertebral column shows itself in the
middle part. The 12 pairs of ribs starting from the trans-
verse processes of the thoracic vertebrae create the
chest cavity which is closed at the top and opening up
further down; it is both mobile and at rest, the lungs ex-
panding and contracting with it as inner and outer, me-
diating air and blood. The heart beats in this space, re-
ceiving and holding the stream of venous blood coming
from source areas in the organs and combining forces
with the heart to transform it in the arterialized pulse
which is sent from center to periphery. In the course of
respiration, there is a continuous slight coming upright
and moving back, followed by going down again and
forward. Looking at these rhythmic processes we see
how heart, lung and vertebral column are a whole, one
relating to the other, with movement changing from one
to the other—the rhythmic system as Rudolf Steiner de-
scribed it.The role of the vertebral column in this has not
been considered until now, but it shows itself all the
more clearly the more we consider that every movement
of the thoracic organs converts into pressure changes in
the venous plexus in the spine, giving impulses to a
stream of liquor which pulses from the thorax to both
the head and the sacrum. During interventions in the
posterior cranial fossa one can actually see this rhythmic
stream of liquor like a rising and falling surf.
In the middle of the body, with its rhythmic move-
ment, lives our feeling, the true soul element of the hu-
man being—every pleasure, every pain shows itself in
changes in our breathing, pulse beat and posture. The
rhythmic system has its vital focus in the cardiovascular
functions, where fluid and solid, respiratory gases and in-
ner warmth come together. In the lung, the system
opens up to the outside world, connecting with it even
in our speech. The basis, the support for the middle hu-
11
Fig. 1.
Section through
embryo 4 mm long
(26 days old) (from
(2), p. 826)
1 Neural groove
2 Notochord
3 Dermatome
4 Myotome
5 Sclerotome
6 Aorta
man being, also in terms of mineral and solid matter, lies
in the vertebral column.
The spine’s connection not only with feelings but al-
so with the development, the evolution of individual hu-
man nature does not infrequently show itself during
midlife crises. The contrasts and polar opposites that
give rise to biography are taken to extremes at this time,
and have greatest power to destroy. The human middle,
with its balancing function, is itself under threat from
this. Herniated nucleus pulposus, infarct-like by nature,
thus shows maximum frequency between the 35th and
40th years of life. It should never be seen as a purely me-
chanical process, for it is always part of the whole of life.
It has become evident that the development of the
vertebral column cannot be the outcome of random mu-
tation and selection under the pressure of changing en-
vironmental conditions, but must be seen has having
been brought about from the very beginning to make
human freedom possible. Below, the phylogenesis of the
vertebral column will be considered to show how it re-
lates to the individual nature of the human being.
Vertebral column development
The leitmotif of the first week in embryonic develop-
ment is the unity reflected in the spherical form. The
ovum has this form and so do the morula, a mulberry-
shaped group of cells, and the hollow blastocyst. Differ-
entiation into the duality of embryoblast, the future em-
bryo, and trophoblast, the future placenta, marks a new
motif at the end of the first week. Division into two is the
key feature of the second week, which begins with the
embedding of the blastocyst in the uterine mucosa. Sec-
ondary developments, as it were, are the primary yolk sac
beneath and the amniotic cavity like a firmament above
the future embryo, which initially spreads as a two-di-
mensional oval plane between the two. It has two layers
at first, the primitive endoderm which connects with the
yolk sac, and above this the ectoderm which relates to
the amnion. We then have an above and below, though
the other dimensions in space are not yet defined. The
third week marks the development of a third primordial
tissue and of a body axis which will later be established
by the vertebral column.With the appearance of this ax-
is, anterior and posterior, left and right are also deter-
12 D e r M e r k u r sta b | S o m m e r · S o l d n e r | Th e H u m a n S p i n e
Fig. 2.
Transverse section
through an 18-day-
old embryo, 1 mm
long. At the center,
the temporary po-
sitioning of the
head process in the
endoderm (from
(2), S. 114).
mined, creating the preconditions for subsequent three-
dimensional development of the original germ disc. At
about the center of the disc, endoderm and ectoderm
fuse in a stripe-like feature known as the primitive
streak. The stream of cells arising through division in
this region moves to the front (now identifiable) be-
tween the primordial germ layers to give rise to the head
process. This happens on the 17th day. Other material
flows laterally between ectoderm and endoderm to
form the intraembryonic mesoderm. This begins to fill
up the “inside”which now exists. In the 5th chapter of his
monumental Humanembryologie, (2) K. V. Hinrichsen
says that as the head process develops, germinal mate-
rial is for the first time orientated “towards a future bod-
ily form.” The development of this first preembryonic
(we can only speak of an embryo once a three-dimen-
sional body exists) structure with organ character, marks
a key moment in development: “for the first time, the
germinal material is thus orientated towards a future
bodily form. The development of a head process ... es-
tablishes that an individual will arise from the germ
which has so far developed”. (3) Up to this point it was
still possible for identical twins to develop in a process of
separation, but once the axial organ has developed, the
germinal tissue clearly belongs to a single individual.
This scientific discovery runs parallel to one made by
Rudolf Steiner in his spiritual-scientific investigations
concerning the relationship of a purely spiritual individ-
ual who goes through a sequence of alternating lives on
earth and periods of existence in the spiritual world:
“From the moment of fertilization onwards, this de-
scending individual spirit belongs together with the
outcome of physical reproduction ... This spiritual indi-
vidual who is descending does not, however, have an in-
fluence on the development of the physical human be-
ing in the early days following fertilization ... Interven-
tion happens from about the 18th, 19th, 20th and 21st
day after fertilization; then something which has de-
scended from a higher world is already working with the
developing human being.” (4)
The configuring influence of the individual spirit thus
Note begins at the moment which embryologists call “indi-
2) The actual sequence
viduation”. It seems that here (as in many other cases)
is not the more famil-
iar I A O, but A O I. discoveries made independently and heterochronically
English Issue 2004
in both natural and spiritual science substantiate and il-
luminate one another. It may be mentioned in passing
that these aspects may be of significance in the discus-
sion of ethical issues.
Before we look at further development of the verte-
bral column, let us consider the development of the
whole. In the third week, the chorion still shows the uni-
form spherical form, wholly enveloping the germ in a
sphere. Later this will be the limited placenta, the source
for the provision of nourishment and oxygen. Rudolf
Steiner described this sphere as being connected with
the cosmic I of the human being, whereas the ray of the
head process evidently is connected with daytime I-ac-
tivity directed towards the body. If we visualize the
whole germ with its intra and extra embryonic struc-
tures in vertical cross-section, the head process appears
as a dot within the peripheral chorion that lies around it
forming a circle. Both relate to the human I, each in its
own way. They embody the earthly core of the incarnat-
ing spirit and its periphery, which is connected with its
ground and origin. This comes alive for us in the
Point/Circle Meditation.
The head process and the notochord which arises
from it then become the starting point for significant
further developmental processes in the embryonic body.
First, mesenchymal tissue gathers in somites and lateral
plates on either side of the cord (more about this below).
These will later develop into the muscles of the back and
in due course of the limbs. The neural groove, taking the
place of the primitive streak in the region of the ecto-
derm, will close up over the neural groove to form the
neural tube—a process induced by the cord itself. Be-
neath the cord, the aorta will appear, initially as a pair,
and beneath this the coelenteron develops from a folding
process in the yolk sac. The cord, the first organ to have
appeared, is at the center of these evolving organs. It is
the seed for crystallization and a precondition for real-
ization of the developmental impulses. Later it will be-
come part of vertebral column development (Fig. 1).
Before we consider the further destiny of the cord and
its influences, let us consider its qualities. The original
head process changes into the plate (also to be consid-
ered below) and then the notochord. This provides the
first actual supportive organ in the embryo. It is an elas-
tic, flexible, turgid rod extending from what will later be
the adenohypophysis to the region of the future coccyx.
The cord itself is quite undifferentiated, and yet all seg-
mental differentiation of the body is due to its influence.
A strong perichordal sheath encloses the spherical cells
with their high water content, thus allowing for the high
fluid pressure inside which gives the structure its elastic
firmness. The first collagen develops here, as does a gly-
cosaminoglycane-containing matrix rich in silica,and the
differentiating influence which the cord has on sur-
rounding structures is probably mediated by these.
The structure, its large, round, translucent cells hav-
ing a high potassium content, is reminiscent of condi-
tions in the plant body, which characteristically has sim-
ilar cells.
English Issue 2004 S o m m e r · S o l d n e r | Th e H u m a n S p i n e | D e r M e r k u r sta b
Having considered the sculptural powers of the cord,
let us consider its musical qualities.“Chorda”is Greek for
“string”, hence “monochord”. The basic characteristic of
a string is its power to oscillate. The head process does
in fact perform a basic oscillation which, by the say, is
probably typical of the human germ. The first axis phe-
nomenon (looking through the amnion from above) is a
streak-like increase in growth in the ectoderm. The head
process develops between ectoderm and endoderm, and
in its lower part (later this will be ventral) it fused with
the endoderm below at the apex of the coelenteron (Fig.
2)—now referred to as the prechordal plate—only to
separate from the endoderm again and return to the
center. The central position is thus not primarily given;
coming from the ectoderm, stopping at the center for a
moment, connecting with the endoderm, and then re-
turning to a central position, it gradually finds itself. The
earliest axial development in the human being thus
goes through the dorsiventral oscillation which later will
be so typical of the human vertical column in its outer
form. Starck, the embryologist, asks for this specifically
human process, the significance of which has not yet
been understood, to be merely described, not rushing in-
to interpretation. People with real experience of euryth-
my will see here the “archetypal I A O” gesture,2 where
the human being goes back to open up to the world
above, inclines forward to turn to the earth, and finally
freely finds the middle position that belongs to him.
The first stages of neural development can only come
in the presence of cord material, and this is even more
the case for its rhythmic metameric differentiation (Fig.
3). Following removal of the cord, the neural tissues will
merely develop an undifferentiated nerve plate; spinal
nerves, vertebrae and intervertebral discs do not devel-
op.The differentiation of the whole body also is rhythmic
13
Fig. 3.
Dorsal view of a
22-day-old embryo.
Neural groove be-
ginning to close
up, and metameric
somites progres-
sively developing
(from (2) S. 130).
Fig. 4.
Longitudinal sec-
tion through evolv-
ing vertebral col-
umn in 40-day-old
embryo, 12 mm
long. The “oscilla-
tion” of the cord at
the center of the
“vertebral column
metamerism initially (ribs, muscles of the trunk, derma- field” is clearly in
totome and myotome sequences are later consequences evidence (from (2)
S. 829). The arrows
of this basic differentiation for the body).The process be-
mark the begin-
gins with the development of somites at the conclusion nings of interverte-
of the 3rd week and moves down from the occipital to bral discs, preceded
the caudal region. The somites which develop from the by densification of
cell aggregates in
mesenchymal tissue of the mesoderm differentiate
the cord at their
from the outside inwards into dermatotome, myotome level (asterisks).
and sclerotome. The latter is involved in the develop-
ment of the bony vertebral column. Cell concentrations
soon appear rhythmically in the tissue surrounding the
cord; they are the beginnings of intervertebral discs.The
cord itself now also shows densification of cells in these
regions.Their configuration suggests the nodes in an os-
cillating string. The more loosely organized region in be-
tween, around which the vertebra will form, seems to
correspond to the antinode (Fig. 4).
A cross section through the developing interverte-
bral disc shows the cord at the center—its configuration
reminiscent of a bar magnet, with iron filings ranged
around it, or the sun establishing the order for the plan-
ets that orbit it—and around it the cells of the future nu-
cleus pulposus lie loosely and those of the future anulus
fibrosus more densely packed in concentric orbits (Fig. 5).
The growth movement of the vertebrae which follows
presses the central parts of the cord into the region of
the discs. With cell boundaries progressively dissolving,
they are involved in developing the nucleus pulposus. In
terms of substance, therefore, the nucleus has, as it
were, a “homeopathic” share in the original axial form
and the central inductor of vertebral column and nerv-
ous system development (Fig. 6).
The undifferentiated primordial notochord thus in-
duces the development of a rhythmically organized or-
gan, the vertebral column, and this in turn breaks it
down into rhythmically concentric fragments. The polar
arrangement of the column of vertebrae that initially
are preformed in translucent cartilage but grow opaque
as calcium is deposited in them and they become subject
to gravity, and the intervertebral discs which retain their
original translucency, are equally induced by the noto-
chord. It is the “oscillation” of the cord which brings
about their alternation.The discs retain qualities of their
origin not only by being rich in silica and transparent but
14 D e r M e r k u r sta b | S o m m e r · S o l d n e r | Th e H u m a n S p i n e English Issue 2004

Fig. 5.
Cross section of em-
bryo c. 2 months
old, 30 mm long.
Differentiation of
future anulus fibro-
sus and nucleus pul-
posus visible, with
remnants of the in-
ductive, ordering
cord at the center
(from (2) S. 830). Ar-
rows mark the bor-
der between anulus
fibrosus (external)
and nucleus pulpo-
sus (internal). Aster-
isk marks vertebral
body.
also by having a high internal pressure (6 bar in adults).
Fig. 6. The tendency is to neutralize the forces of gravity. An in-
Longitudinal sec-
tervertebral disc taken out of the position where it is
tion through verte-
bral column, 40 mm held between two weight-bearing vertebrae will begin
SSL, c. week 11. Hori- to assume the form of a sphere, like a drop of liquid not
zontal growth pres- subject to gravity. A healthy nucleus pulposus will pre-
sure from the verte-
serve its original configuration even in its physiological
bral body compress-
es and fragments location—as discography has shown.3 The discs make
the cord, causing it buoyancy and mobility possible, whilst the vertebrae
to shift vertically. In that have no discs between them are finally completely The gesture of emphatic involvement with gravity in
the discs [3], parts
of the cord [1] come
ossified (at age 28 to 30 in the sacral region), and this the anterior, and the preservation of buoyancy in the
to lie in the nucleus makes them the abutment for the force of gravity. posterior vertebral column is also evident in the type of
pulposus; the origi- ossification. The vertebral bodies ossify from a core at
nal lumen in the
Substance aspects in vertebral column development the center (enchondral). The process starts in the region
vertebral body is
obliterated [2] As the child matures and becomes ready for earth, he- of the thoracolumbar transition and proceeds from
(from (5) S. 192). mopoiesis moves to the vertebrae. It had originally there—downwards, but predominantly upwards.The os-
started in the periphery of the yolk sac, had then been lo- sification of the arches starts from the periphery and is
cated in liver and spleen, and now finally moves to bone. periochondral, proceeding from the uppermost cervical
The very heart of our dealings with iron enters into the vertebrae downwards.4
inside of the most solid structure in the body where We have previously shown how simple aquatic life-
gravity takes powerful effect, though it also enables us forms such as the oyster originally surround themselves
to extend and rise up against it.The planet Earth has the with a skeleton consisting mainly of calcium carbonate
highest iron content in the solar system, and there is which gradually increases in size as deposits are added.
much to suggest that its core consists of this metal. We The oyster thus becomes more and more subject to grav-
also find iron in our own inmost part. In the blood is re- ity (the transparent larvae still float in the surface water).
connects us with the world, going out from here via res- At the level of the fishes, rich in phosphorus, a differenti-
piration. ated skeleton appears, permitting intensive and differ-
The intervertebral discs are bloodless, on the other entiated locomotion against gravity. Such skeletal differ-
hand. They do have a vascular supply in fetuses and in- entiation and individualization demands a new kind of
fants, but involution begins with the second year of life, “building material”. Apatite (or rather calcium hydroxyl
with the disc bloodless at age four. apatite) has a (relatively) high phosphate content. Phos-
The ventral column of massive vertebral bodies and in- phorus is related to light.The name itself means “vehicle
tervertebral discs just described, which relates to gravity, for light”, and the element is characteristically phospho-
has as its polar opposite the column of vertebral arches rescent in the dark. Phosphorus is a vehicle for light; car-
lying dorsal to it. Here mass loses significance. The col- bon dioxide, subject to gravity, extinguishes light (we
umn encloses primarily the dural sac, with the myelon may think of a burning candle being extinguished if we
floating in it almost weightless, due to Archimedes’ prin- dip it into the CO2 lake at the bottom of some caves). Al-
ciple. The enclosed space, which contains the clear CSF, is kaline phosphatase activity is characteristically an indi-
a space for buoyancy, for light. The column of vertebral cator for bone metabolism. This is not the case with oys-
bodies permits only a relatively limited degree of move- ters, their skeleton being insoluble. The substance of our
ment; the column of vertebral arches with its numerous bones (a percentage of it also being calcium carbonate)
“small vertebral joints” is designed for mobility.The total inherently has a certain equilibrium between forces of
surface area of these joints is greater than that of all oth- gravity and buoyancy. Comparative quantitative analyses
er joints in the body together. have not been done, to our knowledge, but qualitatively
English Issue 2004 S o m m e r · S o l d n e r | Th e H u m a n S p i n e | D e r M e r k u r sta b 15

speaking the emphasis is more on the carbonate in the When an adolescent’s spine develops Scheuermann’s Notes
3) Personal communi-
massive vertebral body, which is subject to gravity,5 disease, clinically evident as pain and postural changes, cation from Michael
whereas the phosphate predominates in the fine, mobile the nucleus pulposus herniating upwards or down into Hübner.
4) It is interesting in
arch surrounding the light space.6 the vertebral body, we can immediately see how part of this context to see that
A second important polarity at substance level is be- the element which above was said to be characterized by Rudolf Steiner spoke of
the (ahrimanic) princi-
tween calcium and silica. Silicon dioxide, or silica, is crys- “power of light” is wrongly moving into the domain of ple which aims to bind
talline in its dry form in rock crystal. It also has a genuine the force of gravity.7 At the same time we perceive that human nature to mat-
ter (and is also con-
relationship to water, however, binding it to produce a this creates a situation on the threshold of adult life nected with gravity) as
gel. All gel-like (basic) substance in us contains silica and which is similar to one that was physiological at the em- acting from below up-
wards in the body. This
has its properties. In the natural world, such gel-like bryonic stage. The notochord as precursor of the nucle- corresponds to the pre-
forms of silica are found in agates, and above all opals. us pulposus was then located at the center also of the dominant ossification
process in the vertebral
The latter contain large amounts of bound water, which vertebral body. Falling back into an earlier developmen- bodies. He said that the
are also necessary for the luster of their colors (silica al- tal state is a general pathogenetic phenomenon which (luciferic) principle
which aimed to make
so exists in opal-like form in many plants, e.g. horsetail we also see in pneumonia, for instance. The lung derives us free of the body (i.e.
and bamboo). from the gut, but in its location above the diaphragm it sought “lightness”) act-
ed from above down-
Our life begins in clarity, free from gravity, and trans- should postnatally be filled with air. In pneumonia the wards, which corre-
parently, and then moves progressively into gravity and lung shows the tendencies belonging to a gland. The sponds to the ossifica-
tion tendency in the
growing opacity. It is not surprising, therefore, that the alveoli fill up with exudate, and the lung becomes simi- vertebral arches. The
translucent part of the eye has a high silica content, lar to another organ derived from the gut, the liver. We spine as a whole is in
balance, like the Christ
though it also grows more opaque as we age, like the in- therefore rightly speak of hepatization of the lung in principle as character-
tervertebral disc which originally was transparent and that case. Scheuermann’s disease is a striking example ized by Rudolf Steiner.
This unfolds freely be-
turgid, and articular cartilage, which gradually grows fri- of a statement made by Rudolf Steiner with reference to tween the two polar
able. On balance, the silica content continues to de- general pathology, which is that a pathological process opposite and one-sided
tendencies. (6)
crease, whilst the calcium content increases—particu- is in fact a healthy one which develops at the wrong 5) Its form may of
larly also in the vascular system. It is interesting to see time in the wrong place. course also change. The
trabeculae do reveal a
that attempts are made today to increase calcium levels With Scheuermann’s disease the nucleus pulposus marvelous inner light
in the body by generous doses of calcium and vitamin D. erupts in the vertical, with herniated nucleus pulposus in structure. It is merely a
question of relative
As we shall see, with pathological processes it is not so the horizontal direction. Instead of counteracting the tendencies.
much a question of the total amount of a substance but forces of gravity, the nucleus breaks through the anulus 6) Rudolf Steiner also
took a look, in a similar
rather of getting the right distribution. fibrosus. Due to pressure or—even more so—osmotic way, at the emphasis
effects and above all due to its high potassium content,8 seen with these two
Wrong distribution of buoyancy and gravity—basic calcium compounds in
it may then irritate sensitive nerve endings in the longi- the neck and head of
principles of spinal column pathology and sugges- the femur, (7) which en-
tudinal ligament or even affect a spinal nerve which
tions for treatment couraged us to make
leads to the typical radicular symptoms. Severe pain re- this study of the verte-
Let us go back to the vertebral column. In many re- bral column.
sults, sometimes radiating along the affected nerve and
spects we have so far established that there are areas 7) It is evident from the
causing paresis, and loss of muscular mobility due to a above study of the sub-
with the emphasis on being subject to gravity and oth- stances why in home-
corset-like permanent contraction of the autochthonic
ers that relate specifically to light, the two forming a opathy Calcium phos-
back muscles. “Power of weight” has irrupted into the phoricum is often an
rhythmic sequence. Anthroposophical readers may at important medicament
domain where weight should not prevail.
this point recall a meditation from the Young Doctors’ on this indication. An
Similar to the way in which separating processes de- outstanding anthropo-
Course where these spheres of activity are characterized: sophical medicament
velop in the course of life in the clear vitreous body with
Yet ne’er shall power of light for this is Stannum
its high silica content, subjectively apparent in “spots be- comp. This combines
take hold of power of weight fore the eyes”, separation of water and water-binding apatite (a natural calci-
Nor shall power of weight um phosphate), gold to
glycosaminoglycane matrix also occur in the disc, with convey psychic powers
penetrate power of light progressive dehydration. Herniated nucleus bulbosus of uprightness
(Scheuermann’s dis-
For if power of light does not have anything to do with such “aging process- ease tends to show it-
takes hold of power of weight es”. In fact, the probability of developing it decreases as self in the crisis of pu-
berty) and connect
and power of weight people get older, among other things probably also be- with the incarnation
enters into power of light cause of the reduction in internal pressure. It also means origin, and tin, which is
particularly effective in
then world goes awry that the loss of body height (by c. 1 %) due to the discs be- regulating connective
as body and soul ing “expressed”during the day is no longer fully made up tissue fluids.
8) These are the main
are bound up in corruption. for during the night as people get older; we start to factors in choosing mi-
And it is also clearly stated that “That corruption is shrink (osteoporotic collapse of vertebrae may worsen croinvasive treatment,
a currently used
disease”. this physiological process dramatically, being patholog- method which is cer-
Below, it will be shown in how far this also relates to ical in that case). As mentioned, herniated nucleus bul- tainly often effective,
consisting in local
the basic tendencies in spinal pathology and these can bosus shows the highest incidence between the 35th lavage using physiolog-
be understood in the light of it. Initially this will be with and 40th years of life, i.e. in midlife, with patients often ical saline.

reference to some pathological conditions that mani- feeling that demands from outside determine their life,
fest in the intervertebral discs. and there is a loss of inner buoyancy, with heaviness pre-
16 D e r M e r k u r sta b | S o m m e r · S o l d n e r | Th e H u m a n S p i n e English Issue 2004

Notes dominant.This often also relates to heaviness in the psy- (probably giving people the first experience for a long
9) Taking matters in
hand oneself can che, which will likewise show itself in wrong posture. A time of this sphere, or at least do so in a painfree and
sometimes prove help- mechanical factor, if present at all, is merely an occa- pleasant way), and also with rhythmic massage, reme-
ful at quite an early
stage. I recently had a sional cause as a rule. Instead, one sees general strain, dial gymnastics, eurythmy therapy, listening practice,
patient with a large se- and not too infrequently also a real connection with in- and meditation.There are many possibilities for medical
questered herniated
nucleus pulposus and ner feelings of knowing no way out, or of humiliation. treatment, especially also with substances connected
incomplete paresis The proverb of the last straw breaking the camel’s back with silica, though we only mention this briefly. It is not
who showed marked
improvement when—a is very apt in this sense. Herniation will very often arise by chance that Bambusa and Equisetum play a particu-
few days after the inci- on the basis of an existing weakness in the rhythmic sys- lar role in the composition of the well-proven Disci
dent—he wrote to his
parents, endeavoring tem, its roots often going back to the 2nd seven-year pe- preparations. They are plants from the family of grasses
to resolve a difficult riod in life, the most important period in the develop- that show strong rhythms and impressive stability and
situation.
10) The pancreas is the ment of the psyche. Physical or surgical measures ad- capacity to oscillate. As already mentioned, they can be
central digestive gland. dressed to the local problem will therefore not prove ad- seen to work with silica processes in a living way, de-
Here we show maxi-
mum self-assertion in equate (though they may, of course, be indicated); it is positing quartz in opal form. They particularly mediate
the face of the outside rather a matter of establishing a new connection be- powers of lightness and can vitalize a deteriorating con-
world, to have the
power to dissolve it tween the I and the body and the region which is so pro- nective tissue matrix. Given on their own or in other
completely and ulti- foundly and originally bound up with its activities in the compositions (e.g. Pancreas/Equisetum10 or Solum ulig-
mately make it the ba-
sis for creating one’s living body.We need to encourage the practicing of inner inosum comp.11) they often act deeply in cases of disc le-
own substance. On the uprightness and together trace the more deep-seated sions. Potentized discs, having a proportion of healthy
one hand many back
problems go hand in causes of the condition and encourage the patient to nucleus pulposus which in substance and process terms
hand with digestive work through these. Ultimately that has to be an active relates to the origin of the spine, establish a relationship
disorders, on the other,
stimulating the active balancing out, done of one’s own volition, of one-sided to the inherent etheric healing powers that give rise to
confrontation with the demands and burdens; powers of buoyancy must be cul- regeneration and healing.
outside world which
the human I is seeking tivated where weight has gained too much power. Pain The bony vertebral column also shows the basic ges-
can also prove signifi- may be transformed from a bad thing which one wants tures of pathology.These are polar opposites with regard
cant in a transferred
sense with back prob- to get rid off as quickly as possible into a teacher who to their relationship to gravity and buoyancy. With os-
lems. One indication helps to track down one-sided bias and to experience teochondrosis, forces of gravity take hold of the column
that the medicament
is taking effect can be the function of the back in a living way. When pain is of vertebral arches. The bluish, translucent articular car-
marked stimulation of acute, this may, however, lead to being held in the ban of tilages diminish, chalk deposits weigh down the arches,
diuresis, no doubt
largely due to the such a (painful) experience, and we must free the pa- even forming structures to fill the spaces between them,
horsetail component. tient from this. This may be done with warming, relax- so that the most mobile part of the vertebral column
11) In this medicament,
potentized common ing external applications such as ginger or arnica packs, grows rigid. Chalk dynamics take hold of it, the space for
horsetail (Equisetum for instance, injections with medicines such as poten- light becomes subject to gravity. In extreme cases the
arvense) and horse
chestnut (Aesculus tized Stannum to reduce swelling, or potentized anal- spinal marrow, originally floating freely in the CSF, is
hippocastanum) sur- gesics such as Rhus toxicodendron or Colocynthis. In caught and held between spondylophytes.
round a preparation of
peat. Stagnation in principle treatment will follow the order: first getting The situation is different with osteoporosis. Here the
connective tissue fol- treated, then progressively taking action oneself, which bone matrix dissolves and finally the mineral salts also
lowed by hyperacidity
(typical of moorland), does, of course, mean a gradual transition as a rule.9 Sub- disappear from a vertebral body which is getting lighter
pain and muscle ten- sequently it will then be a matter of taking the one- and lighter. No longer an abutment for gravity, it turns
sion can be resolved
with this medicament. sided bias of a turn that will frequently have come to the into a fragile web that threatens to collapse under the
Body-related psy- fore in this way and placing it in the space immediately weight of the body. Powers of buoyancy gain the upper
chotherapy has many
techniques (e.g. cran- in front, which is the field of vision and also the sphere hand, something one often also perceives in the individ-
iosacral therapy) that where we take actions with a purpose, the sphere that uals concerned who can have a somewhat unearthly, al-
will help to release
overwhelming experi- lies before us. This must be related to the area behind most birdlike aura, especially with high-turnover osteo-
ences that have be- me, the sphere of the back, which is also the sphere porosis. Phosphorus dynamics enhance dissolution (as in
come bound to the
muscular body memo- whence the original goals came. If we recall how in em- bird bones with their high phosphorus content, bones
ry close to the back and bryology we saw that the original impulse for the whole that may even contain air). Lightness and excessive light
then maintain patho-
logical changes in the differentiation of the body came from the dorsal aspect, quality take hold of the sphere of gravity which finally
region, so that they can we realize that this is the sphere from which we took our threatens to crumble. It is not uncommon for the calci-
be worked through.
Solum uliginosum origin, connecting with the living body, that it is a sphere um migrating from the vertebral column to be deposit-
comp. also comes into of inscrutable intentions from which our most profound ed in the vessels. Many an X-ray picture of a vertebral col-
this. Apart from this is
has proved extraordi- original goals arose and which we must rediscover. Phys- umn that is getting progressively more transparent will
narily effective with iotherapists often say today that our ventral muscula- also show the elastic aorta changing into a rigid chalk
muscular pain aggra-
vated by climatic influ- ture has shortened, demonstrating the imbalance in tube. This maldistribution of calcium called “transmin-
ences, above all which we are caught up because most work is sedentary eralization” does not mean absolute calcium deficiency.
changes in the weath-
er, and external influ- today, with attention and activity largely directed to the In the Agaricus comp./Phosphorus preparation, calci-
ences of all kinds (in- sphere that lies before us. In undoing the imbalance in um from shells—representing the forces of gravity—
cluding psychic ones).
our attention to what lies before and what lies behind, and phosphorus—the element of the degenerative ten-
the above-mentioned external applications can help dency just described—are pharmaceutically brought in-
English Issue 2004 S o m m e r · S o l d n e r | Th e H u m a n S p i n e | D e r M e r k u r sta b 17

to a new equilibrium. Substances from simple living connected with what we call the rhythmic system, Notes
13) He arrives at the fol-
plants act as mediators to counteract dissolution of the which is inseparably bound up with life itself. Life can on- lowing insight in his
matrix and stimulate regeneration. In eurythmy therapy, ly be prevented from sliding into its deadly extreme by book, which is some-
what mysterious in
the “U” sound can help establish a relationship to gravi- continually restoring the balance through rhythm. It is places:“The structure
ty and rest, which would counteract the general trend in no exaggeration to call the craniocervical transition the of the central nervous
system as a whole and
osteoporosis. “vital center in human beings”, (11) nor is it by chance the form and position
that manipulation in this region (with the aid of the of its individual struc-
The vulnerable areas in the spine tures reflect the bodily
rope, garotte and guillotine) was used only too fre- experiences mediated
Lumbosacral transition by the relevant cen-
quently to “promote people from life to death”.
The localization of the different pathological tenden- ters”. (9) Earlier, Carl
Elegant embryological experiments13 have demon- Gustav Carus wrote in
cies in the spine does not show random distribution. a more general way:
strated a whole series of further, at first sight unexpect-
Whilst Scheuermann’s disease affects the thoracic spine, “The body is the physi-
ed, relationships between craniocervical region and cal reflection of the
the most mobile parts of the spine in the lumbar and soul, the soul the
trunk. It has been shown, for instance, that the first oc-
cervical regions are particularly prone to herniation of meaning of the living
cipital somites are involved not only in developing the body.” (10)
the nucleus pulposus. These are the lordotic areas char- 14) These facts, discov-
fine cervical muscles that position the head and the
acteristic of the human axis. The human center of grav- ered in 1987, (12) im-
muscles of the tongue, but also the laryngeal muscles15 pressively substantiate
ity is at the level of the lumbosacral transition. Human statements made by
governing the subtle rhythmic vibrations of the air that
beings came upright out of the horizontal of the animal Rudolf Steiner in 1921
enable us to utter sounds and develop speech. It has al- (13), that the larynx
around this point. This is also where the majority of disc should be seen as a
so been shown that the blastema of the pronephros de-
prolapses occur. metamorphosed oc-
rives from the region of the embryonic cervicooccipital ciput.
Craniocervical transition transition, with the parts of the urogenital system which 15) This in itself makes
it necessary to have
This mysterious point has the craniocervical transi- show rhythmic movement (renal pelvis, ureter, vas def- careful attunement be-
tion for its opposite, another area of transition from the erens and tubes) evolving from it. The developmental tween vestibular func-
tions and spinal pos-
most profound rest to maximum mobility and vice versa. movements of the heart, central organ of the rhythmic ture. The phenomenon
Very early in embryonic development the five uppermost system, that lead to the crossing of aorta and pulmonary of cervicogenic vertigo,
clinically undoubted
evolving vertebrae were kyphotic, soon fusing to form artery are dependent on the change from occipital but disputed by many
the immobile occipital bone. In the second month, the kyphosis to cervical lordosis. Transposition of the major in theory, has its origin
here. In terms of evolu-
next seven cervical vertebrae develop the lordosis which vessels is a regular occurrence in the absence of neural tion, too, there can be
will be characteristic for the cervical spine for the rest of crest cells in this particular region. Finally it has been no doubt but that the
freeing of the head
life. demonstrated that neural crest cells from the first sev- from the movement of
The depth of the relationship which develops be- en somites migrate to the intestine where they form the the body in general
(v.i.) called for separate
tween head and trunk in this transition area is evident if intramural enteral nervous system which governs mo- and differentiated per-
we take a closer look at the cervical region. Here the res- tion and is nowadays referred to as the “brain of the ception of the head’s
position relative to the
piratory and food passages cross in a site which is both gut”; this is important for perception of emotions aris- body that went beyond
decisive and dangerous for terrestrial creatures. Numer- ing “from the gut”. (14) vestibular perception,
which is bound to the
ous reflexes protect the separation between air and wa- All these relationships substantiate the impressive re- head. A separate per-
ter in this site, where the consciously tasted and shaped lationship between vertebral column and rhythmic sys- ception of position is
needed within the cer-
bolus goes down into the sphere of the unconscious.The tem. What is more, the craniocervical transition appears vical spine, and this
thyroid shows itself to be a regulator at this level, a kind as the downright inductor of the rhythmic system and may of course also be
subject to pathological
of “respiratory center” for the chemistry in us. A bit more shaper of rhythmic processes in the trunk which itself changes. From the phe-
cranial to it lies another crossing point—that of the py- (and with it the whole vertebral column) has arisen by in- nomenon of motion
sickness we are famil-
ramidal or corticospinal tracts which serve to transmit duction from a rhythmic process in the notochord.We al- iar with the “mis-
impulses that steer conscious voluntary motor functions. so see the fundamental original relationship between match” between visual
and vestibular percep-
The crossing motif creates conscious awareness, some- head-and-neck region and whole body, and above all tion causing nausea. In
thing eurythmy also teaches us when the cross-over “E” those parts of it that are directly connected with the psy- a similar way, cervical
malposition and func-
gesture leads to touch and awakens conscious aware- che. The many relevant experiences gained with cran- tion may trigger “un-
ness. iosacral therapy can thus be seen in their right context. characteristic” bodily
sensations that are dif-
The wide range of crossing phenomena in the hu- Lordosis of the cervical spine develops early on, but ficult to describe and
man central nervous system has been considered by from the second month onwards soon disappears in the experienced as “verti-
go” by patients. In view
Friedrich Rothschild,12 for whom the bodily form reflect- overall kyphosis of the embryo’s body. Birth, which in- of the lack of agree-
ed the concentration and focusing of self and world ex- volves leaving the embryonic resting state and entering ment between patho-
logical bodily percep-
perience. It is not surprising then to find the reticular for- into the outside world, results in propulsive extension of tion, with the world
mation in the region of these cross-overs, a neural or- the spine. In the newborn, this is still like a straight rod, perceived in the usual
way at a different sen-
ganization which conveys vigilance and alertness. The with the double S-form only developing gradually as the sory level, the impres-
respiratory center, which lies cranial to this, is involved in child comes upright.The craniocervical area is subject to sion of something
false, something that
the rhythmic organization of respiratory flow. A general particular stress in the birth process and remains unsta- “cannot be”, arises.
signature for the region is emerging, showing that it in- ble for some time after birth (until about the 5th month).
fluences the shaping of rhythmic processes in the body The area is nowadays given considerable significance
in many ways (further examples to follow). It is directly with sudden infant death syndrome (SIDS). Among oth-
18 D e r M e r k u r sta b | S o m m e r · S o l d n e r | Th e H u m a n S p i n e English Issue 2004

Fig. 7.
Freedom and the
bound state—the
relationship be-
tween gravity and
buoyancy is imme-
diately evident in
the human and
gorilla skeleton
(from (1) p. 165).

16) Rudolf Steiner

made this the starting
point for his lectures to
members of the med-
ical profession. (15)
17) Humans evolve pro-
gressively towards
freedom, with the con-
figuration of the spinal
column gradually de-
veloping. Animals
move downward from
a condition which orig-
inally is closer to the
human and freer. Thus
the skull of anthropoid
apes is still quite simi-
lar to the spherical hu-
man skull at birth. It is
above all with the on-
set of sexual maturity
that the region of the
jaws grows forward, er things the role of the twist between head and trunk extremity. In humans, the mouth becomes the region
and the whole form
then becomes subject in the sleeping position has been seen in association where the word is freely created. The reconfiguration of
to gravity. Loss of the with SIDS. the jaws and teeth is paleoanthropologically the earliest
ability to learn goes
hand in hand with this and surest indication that skeletal remains found are
The area of the cervical spine in particular shows fun-
change in the physical human and not close to apes. The fundamental differ-
form (experimentally damental differences between animals and humans. In
anthropoid apes were ence in general form is particularly impressive and has a
many mammals it is dominated by muscles to hold the
even shown to have tragic note in the case of the primates, who are close to
some capacity for head, so much so that the neck does not appear as a rec-
speech) and a play us at the bodily level. A gorilla skeleton shows how much
ognizably distinct part, with the head sunk down into
drive, which means the creature is bound to gravity16 and that words cannot
openness. Then any- the trunk, as it were. In other cases the neck is extended
thing that has devel- arise freely from its mouth parts. In humans, head and
like a rod, for instance in the giraffe, whose whole neck
oped becomes fixed oral parts are not bound in this way. Comparison of go-
and developmental po- is supported by seven cervical vertebrae—as in hu-
tential is lost, including rilla and human skeletons clearly shows that humans
mans—but these are enormously elongated. Nowhere
cognitive faculties are designed for freedom, whilst the animal is subject
gained earlier (e.g. ex- does one see the free, mobile play around the plumb line
perimental capacity for and bound to be fixed and wholly subject to gravity.17
which we have in the human spine. Humans are taken
the written language). (Fig. 7)
It is actually possible to into this middle axis—which is not physically appar-
speak of prepuberty The whole human form on the other hand is charac-
ent—by their organ of balance, taking this into an equi-
dementia developing terized by freedom in unstable equilibrium. The human
in apes. librium that is always new when at rest, as perceived and
movement form lives in an erect spine oscillating be-
set by the labyrinth.16 Unlike animals, whose visceral cra-
tween behind and in front, gravity and buoyancy in the
nium grows out anteriorly, humans hold this growth im-
above and below are brought into balance. The original
pulse back. The visceral cranium thus comes to be posi-
dorso-ventral swing shown by the notochord, the origi-
tioned beneath the neurocranium, resulting in the over-
nal I A O we know in eurythmy and which originally
all spherical form of the head. The propulsive tendency
showed itself in the spatial form, reappears in the dy-
in cranial development is held back just as much in hu-
namic movement form at every step we take. The alpha
mans as is their overall movement form. In animals, with
of the embryonic form shows itself again in the omega
their horizontal spines, the overall form of the spine is
of the fulfilled function.
arched. Like the arched back of a cat, it may be tensed in
a global kyphosis which is then released in a propulsive Markus Sommer
leap.The growth tendency of the animal’s visceral crani- Josef-Retzer-Str. 36
um corresponds to this. The snout is often like an added D-81241 Munich
English Issue 2004 S o m m e r · S o l d n e r | Th e H u m a n S p i n e | D e r M e r k u r sta b 19

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2 Hinrichsen KV (ed.). Hu-
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Springer 1987.
3 Loc cit. S. 133.
4 Steiner R (GA 99). Theosophy
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D. S. Osmond. London: Rudolf
Steiner Press 1953.
5 Toendury G, Tillmann B.
Rumpf. In Anatomie des Men-
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6 Steiner R. Balance in the
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Adams. N. Vancouver: Steiner
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8 Steiner R. loc. cit. lecture of 9
Jan. 1924.
9 Rothschild F. Die Symbolik des
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10 Carus CG. Symbolik der men-
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11 Christ B. Entwicklung der cer-
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12 Christ B, Jacob HJ, Seifert R,
Hinrichsen K. Ueber die -Entwick-
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Embryonen. Verh Anat Ges 81:
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14 Le Douarin NM. Cell line seg-
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1986; 231: 1515-22.
15 Steiner R. Introducing Anthro-
posophic Medicine Lecture of 21
March 1920. Tr. C. E. Creeger. Hud-
son: Anthroposophic Press 1999.
20 D e r M e r k u r sta b | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w | English Issue 2004

Osteoporosis from the

anthroposophical point of view
M at t h i a s G i r k e

■ Abstract
Osteoporosis is more than a disease of bone that can
be described by speaking of changes in bone struc-
ture and density. The physical manifestation of
pathology reflects changes in the way the non-physi-
cal human bodies function together. Insight into
changes in the activity of the etheric, astral and I or-
ganizations characterizes a more comprehensive per-
ception of the disease, which affects a considerable
part of the population, and leads to measures relat-
ing to lifestyle as well as therapeutic approaches.
■ Keywords
Osteoporosis
Vitamin B3
Phosphorus
Quartz
O
steoporosis is one of the common conditions
seen in medical practice that affect primarily
the skeletal system. Two million women and
one million men are estimated to have developed os-
teoporotic vertebral body fractures in Germany. (1) This
has led to preventative and therapeutic measures where
patients face long-term medication. The pathophysiolo-
gy is almost exclusively limited to mechanical aspects,
with the stability of bones considered to be dependent
on adequate bone mass. Questions as to the inner sig-
nificance of osteoporosis for the human spirit and soul
and the consequences in this regard of conventional
treatment are given little consideration. How do the ac-
tivities of the different human bodies relate to each oth-
er in human osteoporosis?
Activities of the different bodies
I-organization
In the first place, the known factors carrying the risk
of immobilization point to the importance of movement
and thus the will-related activity of the I. It seems that
this does not concern just the phenomenon of move-
ment in general, for movement against resistance clear-
ly has special significance.We can therefore understand
why weightlessness with its lack of resistance to gravity
may favor the development of osteoporosis. It has also
been reported that areas of the skeletal system which
are subject to high degrees of pressure, traction or rota-
tion are less subject to osteoporotic changes than areas
where no such demands are made. (2)
This shows correspondence with the qualities of the
upper human being. On the one hand it is processual
thinking activity, coming to conscious awareness
against the resistance offered by the structuring powers
of the nervous system, on the other—in the case of the
will being active—the resistance opposed has compara-
ble significance. It is thanks to this quality that conges-
tive and condensation processes arise in movement,
which otherwise merely flows without meeting resist-
ance, and functionally these processes precede osteoge-
nesis with its hardening processes.The qualitative hard-
ness in the soul’s world of thought has its counterpart in
the organic hardness arising with ossification. We recall
Rudolf Steiner’s reference to osteogenesis as neurogen-
esis having come to its end. (3)
E n g l i s h I s s u e 2 0 0 4 | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w | D e r M e r k u r sta b 21

The first characteristic of osteoporosis is from this Fig. 1 a and b.

point of view a reduced will-type activity of the I-organ- Development of
organization of
ization in the system of limbs. Pathological conditions Incarnation and excarnation limbs and its bone
with secondary forms of osteoporosis show a similar pic- I-organization density, reflecting
ture. In the case of diabetes, for instance, extensive ref- the incarnating
erence was made to limitations in the development of and excarnating
Birth Death
movements of the
will impulses. According to present knowledge, type 1 di-
I-organization.
abetes, with the impediment which has been described a) after Waldeyer,
for the incarnation of the human soul and spirit in the Mayet. Anatomie
organization of metabolism and limbs, is particularly des Menschen Bd.
connected with an increased risk of osteoporosis. (4, 5) 2, 16. Aufl., p. 73. De
Gruyter 1993.
Hyperthyroidism has also been characterized as a con- b) After Ringe JD.
dition where the astral organization separates out of the Osteoporose.
system of limbs, as apparent in thyrotoxic myopathy, for Pathogenese, Diag-
instance. (6) Hypogonadism presents a comparable pic- nostik und Thera-
piemöglichkeiten,
ture. Finally Cushing’s syndrome also points in the same Metamorphosis of skull in the course of life (a) p. 98. De Gruyter
direction. Ultimately it is therefore a question of the in- 1991.
dividual spirit incarnating in its body. The metamorpho-
sis of the skull in the course of life (Fig. 1) also throws
light on the syndrome. As the non-physical human being Age-dependent bone density on shaft of radius (b)
incarnates in his body, the organization of limbs devel-
ops progressively, and in the skull correspondingly the Mineral content of radius (1/3) (g/cm2)
viscerocranium. With excarnation, this organization 0,9

goes into involution—the skull of the old person is sim-

ilar to that of the child again. Bone density in the shaft
0,8 › n = 612
of the radius goes through analogous changes (Fig. 1).
Again we can see the connection with the incarnation
and excarnation movements of the human being.
0,7
If the I-organization separates prematurely from its
activity in the limbs, bone organization regresses and os-
teoporosis develops. Osteoporosis as a disease of the
0,6
second half of life (type 1 osteoporosis) or of old people
(type 2 osteoporosis) thus relates biographically to rick-
‹ n = 688
ets in young children. The latter is an abnormal develop-
0,5
ment of the body as the individual spirit incarnates; the
former suggests premature excarnation.
The consequence of this premature excarnation 0,4
movement of the I-organization is not a bone disease
due to calcium deficiency. Osteoporosis is a condition af-
fecting bone structure and therefore form. This applies 0,3
both at the microscopic level (Fig. 2a) and the whole form Age (Years)
of the vertebral column for example (Fig. 2b). 10 20 30 40 50 60 70 80 90 100
Form is a non-physical quality which merely becomes
visible on being filled with matter. Plant forms reveal the
laws of life, animal forms those of life-forms endowed
with souls. The human form relates to I-nature.“The hu- Astral organization
man form reflects I-nature in physical form.”(7) This form The astral organization shows analogous changes in
can imprint itself in the solid mineral part of the organ- its activity. Initially it is involved in every human move-
ization and also separate from it again. Goethe described ment, including those directed and intended by the I.
these dynamics in a poem that ends as follows: Lack of movement will also inhibit its activity in the or-
What more can human beings gain in life ganization of limbs. The constitution of a slender form
But that God-nature be reveal’d to them? which is characteristic of osteoporosis points in a simi-
How it makes solid form melt into spirit, lar direction, with the astral body connecting less with
How it preserves the spirit’s creation in matter. the lower human being and turning more to the neu-
Changes in the form of the vertebral column due to rosensory system. Another observation relating to the
osteoporosis will often lead to kyphosis of the thoracic constitution is a thin skin, again with the emphasis more
spine, with the quality of uprightness first threatened on sensitivity of the senses than on its metabolic organ-
and finally limited.Verticality reflects the I-organization. ization. (8) It has also been reported that female patients
If this loosens its connection with the body the power of with osteoporosis have less muscle mass and power
verticality that determines the human form withdraws. than healthy women of the same age. Remarkably, coin-
22 D e r M e r k u r sta b | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w |
Fig. 2a
Osteoporosis.
Changes in form
qualities of spongy
bone structure.
cidence of severe osteoarthritis with osteoporosis is low,
(9) something we also consider worth noting. The for-
mer often develops in connection with unphysiological
exposure to forces of gravity; with the latter, gravity is
not sufficiently involved, there is too much buoyancy,
and we might speak of early onset of excarnation.
In separating from the system of limbs, the astral or-
ganization can awaken to a quality of conscious aware-
ness which is evidently largely disregarded. (10) These
problems which are more in the psyche no doubt also
have a reactive component, but ultimately they are also
part of the syndrome. A high proportion of patients say
they have grown discouraged, irritable and more sensi-
tive. These symptoms in the psyche go hand in hand
with the pain caused by the osteoporotic changes in the
vertebral column, pain which reflects an astral body ori-
entated towards awakening. It is possible for someone
who has developed osteoporosis to be more sensitive,
with a “thinner”skin not only in the physical but also the
mental sense.
Osteoporosis and depression
A number of studies suggest a connection between
osteoporosis and an individual mental state of depres-
sion. It would seem, therefore, that reduced bone densi-
ty goes hand in hand with depressive symptoms. (11)
Excess of cortisol is often seen as a possible factor in
this connection, a condition that is quite common in
people with depression. If we consider the nature of cor-
tisol and its actions in the human organism, the con-
nection can be seen.
Cortisol activity results in the organization of limbs
being held back. With Cushing’s syndrome one sees adi-
posity particularly of the trunk, with the slender, some-
times gracile limbs in remarkable contrast. Other phe-
English Issue 2004
nomena of steroidal myopathy point in the same direc-
tion.
The anti-inflammatory action of cortisol also fits in,
with inflammation showing itself to be connected with
the system of metabolism and locomotion. An astral or-
ganization in the process of separating from the system
of limbs is—as also described in connection with the
metabolic syndrome (12)—urging awakening in the mid-
dle and upper human being.The higher bodies abandon
their will-related (unconscious) activities in metabolism
and limbs, increasingly turning away from this “night”
side of their activity and towards the “day” side with its
orientation towards conscious awareness.
Increased release of cortisol in conjunction with
stress reactions may also throw light on the situation.Vi-
tal energies metamorphose into powers of conscious
awareness and can here lead to special qualities in the
patient’s inner life.
Coming back to osteoporosis, we once again see the
astral and I-organization withdrawing from the system
of limbs, resulting in form and structural changes in the
skeletal system. With depression, the power of holding
one’s own in soul and spirit is reduced, and with osteo-
porosis the power to be upright is also threatened at the
physical level—like an outward image for the state of
soul.
At this point it is worth considering a study to inves-
tigate the relationship between mental development
(cognitive performance) and bone density in 362 female
senior citizens. (13) One fifth with high bone density per-
formed well more than three times more frequently
than the one fifth who were shown to have low bone
density. It seems that mental development as an inner
light quality and bone development are connected in
this respect.
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Fig. 2b
Osteoporosis. Limi-
tation of power to
be upright in verte-
bral column subject
to pathology
(Fig. 2a and b) after
Ringe J.D. Osteopo-
rose. Pathogenese,
Diagnostik und
Therapiemöglich-
keiten, p. 2 and
p. 118. De Gruyter
1991.

Etheric organization Table 1

Bone reveals etheric body activity both in its devel-
opment and in the healing processes that follow frac-
ture.The impressive “biological plasticity”of bone points
to its life organization. At the etheric level, reduced re-
generation has been described especially in connection
with Type 2 osteoporosis at an advanced age, considered
to be an osteoblast deficiency. (14) Powers of the etheric
organization have progressively withdrawn from their
organic activities as the individual grew older, and are no
longer adequately available for bodily development. It
may also be that premature development of powers of
consciousness results in weakness in the etheric.
Physical organization
At the physical level we have the pathology of bone
form and structure of bone tissue as described earlier.
The compact and spongy parts of bone tissue are af-
fected differently by osteoporotic changes (Table 1).
Clinical examination may show dowager’s hump and
shortening of the trunk, also the “pine tree” phenome-
non, with skin folds running obliquely on either side of
the spine.Thin skin with thin skin folds has already been
mentioned as a possible indication of osteoporosis.
Basic treatment goals
If the different bodies develop non-physiologic activ-
ities in the organism, bringing in a foreign quality, we call
on the healing powers of inflammation.The excarnating
activity characteristically seen in the different bodies
with osteoporosis is countered by a suitable healing im-
pulse. Osteoclasts derive from (special?) monocytes, cells
therefore that serve inflammatory processes in the or-
ganism. Cytokines can be used to activate them with
their proinflammatory connections. (15) These osteo-
clasts are active above all in connection with post-
Difference in loss of cortical and spongy bone mass
at age 90, relative to peak bone mass (after Riggs et
al, quoted from Ringe JD. Osteoporose. Pathogenese,
Diagnostik und Therapiemöglichkeiten. De Gruyter
1991.)
Age 90 Men Women
Loss of maximal
cortical bone mass 5% 20 %
Loss of maximal
spongy bone mass 10 – 25 % 40 – 50 %
menopausal osteoporosis, changing a bone structure
that no longer reflects physiologic activity of the bodies.
Resorption of bone, which comes close to inflamma-
tion, evidently has deeper significance in this case than
one would first assume on the basis of pathophysiolog-
ic insights. Then, if not before, it will also be evident that
treatment must involve more than inhibition of osteo-
clast degradation processes or encouragement of bone
building. What therapeutic goals may be considered in
the light of the activities of the different bodies in os-
teoporosis which have been described above?
First the attempt must be made to get I-organization
activity to engage in the body again. At the beginning of
life, the infant’s early attempts at coming upright and all
that follows until he is able to walk upright indicate a
first I-organization activity. Conversely, its premature
separation represents a threat to uprightness, as evident
in the typical curvature of the spine, with consequences
for the whole human form. Exhibition of phosphorus
aims to direct I-organization activity to the limbs in a
will-related way. This therapeutic principle which has
been used for a long time in Anthroposophical Medi-
24 D e r M e r k u r sta b | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w |
cine, has a connection with the modern biphosphonate
treatment for osteoporosis. This forces the I-organiza-
tion into its human body; it also appears that a bone
structure develops that does no longer correspond to I-
organization activity in every detail, which makes it arti-
ficial. It may indeed be justifiable to give such high dos-
es of phosphorus if the indication is there, and for the
time being at least, the clinical value in reducing the risk
of fracture is considered to be beyond doubt, yet the
physician prescribing it should be all the more on the
alert in case such medication inhibits development in
soul and spirit. This might make the currently one-di-
mensional evaluation of the treatment more relative.
Exhibition of a potentized phosphorus preparation can
“invite” the I-organization to increase its activity in the
system of metabolism and limbs.
This medication stimulates the I-activity that fully
warms. It needs to be associated with something that
gives form, however, taking the active processes into
configuration. Clinically this means silica, which has ma-
jor significance in osteoporosis. Given by way of “its”
medicinal plant, which is Equisetum, quartz gains addi-
tional efficacy. The aim is to stimulate the structuring
powers of the I-organization, for these have been re-
duced in the process of developing osteoporosis.
If osteoporosis is seen in the above way, with the
stated treatment goals, the indicated methods will be as
follows. First of all, the aim should be a conduct of life
where there is more movement, which is in contrast to
developments in our present civilization. It will be the
quality of movement which matters, however. For bone
development, it is important to work with the forces of
gravity. Just as a patient with hemiparesis due to cere-
bral insult may also develop “hemi-osteoporosis” as the
higher bodies withdraw on the affected side, so may
bone mass increase on the healthy side because addi-
tional demands are made on it. Similarly it has been ob-
served that tennis players may show increased bone
density in the region of the most used arm, and weight
lifting, interesting as a phenomenon but not relevant for
treatment, is also said to increase bone mass.
Apart from forms of movement therapy—eurythmy
will be discussed later—nutrition is of further impor-
tance. Here it is essential to consider the acid and basic
qualities which have already been characterized in spir-
itual-scientific terms. Any diet leading to acid produc-
tion forces astral activity into a quality similar to in-
flammation, going more in the direction of dissolving
bone. (16)
Ultimately it is adequate exposure to sunlight which
takes the form-giving powers of light into the process of
giving form to the skeleton.
This reference to light immediately characterizes the
principles of medical treatment. Two substances, polar
opposites in terms of the threefold human organism, re-
late intensely to light—quartz and phosphorus.
Quartz connects with the neurosensory system and
its configuring activities in the human organism. Phos-
phorus, which on the one hand has gained configuration
English Issue 2004
where it occurs in the skeletal system, on the other has
its sphere of activity in the sphere of dynamic, will-relat-
ed metabolic processes. Exhibition of phosphorus may
therefore support the incarnation of the I-organization
in the human organism, and osteoporosis sufferers need
this. The author frequently uses the preparation Agari-
cus comp./Phosphorus in the treatment of osteoporosis,
and it may be prescribed in this context. Phosphorus re-
lates to the activities of the I-organization, Agaricus
muscarius to the astral body. This medicament from the
world of fungi strengthens the connection between as-
tral and etheric bodies.“In cases where we perceive a dis-
order due to the I-organization making too great a de-
mand on the astral body, not allowing it to enter into the
etheric body, we must have recourse rather to the fungi.”
This is how Rudolf Steiner characterized it in the Educa-
tion for Special Needs course. (17) The spores of ferns,
which also appear to go in the direction of fungi, have al-
so been included in the medicament. Ferns develop their
relationship to the etheric in a powerful leaf organiza-
tion, yet when the spores are shed, a quality separates
from the organization of the plant that grows into a pro-
thallium, which is like a fern flower, and may thus be con-
sidered to relate to the astral sphere. (18)
Lead guides phosphorus, which apart from its dy-
namic action in the human skeletal system also enters
into the configuring powers of the I-organization, into
the consolidation of bone. Pyromorphite is a compound
of phosphorus and lead.
There will be many occasions when the metal quali-
ty which is the polar opposite of lead will be indicated
constitutionally or to support the generative etheric
quality. Argentum is thus also part of the above-men-
tioned Agaricus comp./Phosphorus preparation.
Quartz and therefore silica compounds channel con-
figuring powers to the skeletal organization. In this case,
living light, as it were, remote from conscious aware-
ness, takes hold of the organism to configure it via the
nervous system. Silica is thus found in particularly high
concentrations in embryonic structures close to the neu-
rosensory system in the amnion. (19) The amnion is like
a sky arching over the ectoderm, the embryonic layer
from which the nervous and the sensory system devel-
ops. The aim of silica medication is to take the configur-
ing powers connected with the I-organization into the
skeletal system. Equisetum silicea cultum may be indi-
cated, or also Bambusa. Apart from the impressive vital-
ity apparent in the rapid growth of bamboo, the plant al-
so has a high silica content, a further therapeutic princi-
ple which gives the medicinal plant its powers of up-
rightness (see Franziska Roemer’s paper in this is-
sue(20)). Equisetum is also part of Solum uliginosum
comp. (WALA, e.g. 10 ml i.v.), an important medicinal
composition which may find clinical use in treating the
pain of osteoporosis.
A further therapeutic step to follow the configurative
powers of light which are active below the threshold of
consciousness would be to effect the hardening and
consolidation which is so essential for bone develop-
E n g l i s h I s s u e 2 0 0 4 | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w | D e r M e r k u r sta b
ment: Plumbum takes the living silica light into a cata-
bolic quality and into consolidation. Barysilite, Plumbum
silicicum, may be used for this.
Finally the light-related configurative power which
still lives in the supersensible sphere must be brought to
materialization. Supersensible form needs filling out
with substance. Here we come to the calcium sphere of
activity. Calcium, its true sphere of activity being be-
tween the generative etheric processes and the physical
organization, (21) takes the osteogenic processes in life
into physical hardening. Calcium carbonate may be giv-
en in low potencies in this case, or also in material dos-
es. Calcium phosphate has a different quality that re-
lates to the genesis of mobile skeletons as distinct from
the shell-like calcium carbonate skeletons (oyster, Sepia).
Calcium phosphate skeletons alone can be “modeled”,
their structure broken down and reshaped; here mobili-
ty enters into the skeleton (personal communication
from Georg Soldner). Calcium phosphoricum will there-
fore be indicated rather in higher potencies for the
“phosphorus-type”patient who seeks to flee gravity and
tends to be in restless motion.
The polarity between calcium phosphate and car-
bonate at substance level thus belongs in the field of
tension between buoyancy and gravity, cosmic and
earthly spheres. Rudolf Steiner characterized its as fol-
lows: “Calcium phosphate is the point of attack for the
cosmos in giving form to bone” and: “With calcium car-
bonate, bone gains the peculiarity of being subject to
the earth”. (22) The example he gave of an axial long
bone and the tendency to spherical structure in the
“neck of the femur” throw light on this polarity in the
language of form, with cosmic forces relating to the
spherical form, earthly forces, being connected with
gravity, to axial configuration. In making this compari-
son, it is, however, important to consider the substance
processes involved. These may on the one hand be con-
nected with the anabolic, constructive powers, and on
the other show themselves as secretion. “If you have a
part of bone that is essentially created out of the cos-
mos, calcium phosphate is the constructive principle. In
another part, calcium phosphate will be found as a se-
cretion. Conversely, calcium carbonate is the construc-
tive principle in long bones, whilst it exists as a secretion,
is secreted to the part which is created out of the cos-
mos. ... it never is a question of one substance or anoth-
er being present, but of the route which these sub-
stances take, the significance they have at one place or
another in the organism.” To sum up, the spherical con-
figuring principle which is close to the cosmos and the
forces of buoyancy is close to calcium phosphate. Calci-
um carbonate “as a secretion” takes it into solidification.
Conversely, axial bones, relating to gravity, are connect-
ed with the calcium carbonate processes, with calcium
phosphate presenting as a secretion.
The Agaricus comp./Phosphorus preparation, which
goes back to a suggestion which Rudolf Steiner made in
a different clinical context, contains Conchae (7x). The
medicament thus comprehensively addresses the activ-
25
ities of the different bodies when these have changed in
the case of osteoporosis. Phosphorus influences the in-
carnating activity of the I-organization, Agaricus the
connection of the astral body with the life organization,
and Argentum the vital processes in the skeletal organ-
ization. Conchae finally takes the activities of the bodies
into physical consolidation.
After medicaments based on the mineral and plant
world, the next level of medical treatment involves med-
icines from the animal world. Organ preparations may
be used to support the constructive powers of osteoge-
nesis, serving as archetypes to direct the laws pertaining
to the skeletal system into the constructive processes of
the etheric.
Considering the long-standing use of phosphorus
and calcium compounds in Anthroposophical Medicine,
it is surprising to find that these very two principles have
currently gained significance in the treatment of osteo-
porosis with biphosphonates and with medication to in-
fluence calcium metabolism ranging from calcium sub-
stitution via vitamin D3, to calcitonins and parathyroid
hormone. Rudolf Steiner also considered the properties
of fluorine, speaking of the significance of fluorine in
dental development in his discussion of the fluorine and
magnesium processes. He did, however, immediately re-
late these properties to the child’s development of con-
sciousness, placing them in a comprehensive context
that went beyond a monocausal principle.
At this point, a comment may be made on vitamin D3
which is better called a hormone and not a “vitamin”.
What qualities does this substance have?
Cholecalciferol is produced from a precursor derived
from cholesterol in the skin under the influence of UV
light. It is also taken in with food—mainly in animal fats
and particularly sea fish. From the skin sphere, which is
open to light and has sensory functions, it is trans-
formed (25-OH metabolite) in the liver, an organ domi-
nated by the etheric body, and then goes to the kidney
organization, which is connected with the astral body.
Here it changes again, into 1.25-(OH)2 vitamin D.This hy-
droxylation may also happen in other organs (skin,
lymph nodes, pancreas, prostate, adrenals, brain, breast,
colon, endothelium (23)), though the kidney is the only
organ capable of secreting this metabolite into the cir-
culating blood. Having passed through the kidney or-
ganization, this substance, so closely related to light, de-
velops the wide range of its characteristic activities.This
is the route by which the light-related configuring pow-
ers connected with the upper human being are taken via
the warmth-related kidney organization into the vital
processes of metabolism and limbs. Clinically these con-
figuring powers first of all show themselves significant-
ly in increased muscle power. The calcium-dependent
movement metabolism of the musculature clearly has
significance in this. The part played by vitamin D in re-
ducing the number of fractures due to osteoporosis is
probably due not only to an effect on bone metabolism
but in older subjects particularly also to improved mus-
cle strength (24), so that there are fewer falls. Apart from
26 D e r M e r k u r sta b | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w |
this power to improve function in the locomotor organ-
ization, cholecalciferol is involved in osteogenesis at an
organic level. Light-related powers of configuration of
the upper human being are taken to the vital processes
especially of the lower human being. In the treatment of
rickets, this incarnating gesture makes the “heavenly
human being” into an “earthling”. The light-related con-
figuring power of quartz accompanies the processes of
calcium metabolism.
This form-giving activity connected with the neu-
rosensory system as much as with the material process-
es of vitamin D metabolism also comes to expression in
other important phenomena. Following first indications
as long as 50 years ago, it is now known that increased
exposure to sunlight goes hand in hand with reduced in-
cidence and mortality for most forms of cancer (breast
cancer, ovarian cancer, cancer of the uterus, prostate,
pancreas, esophagus, stomach, colon, rectum, bladder,
kidney and lung) (25). Vitamin D is said to have anticar-
cinogenic properties in this respect. This is a further im-
portant example of the way in which the configuring
powers of the upper human being also influence prolif-
erative processes in life. Connections with other patho-
logical conditions due to inadequate incarnation of the
upper bodies in metabolism and limbs point in a similar
direction. Epidemiologically, there are indications that
higher 25-OH vitamin D levels have a protective effect
with conditions such as type 1 diabetes, multiple sclero-
sis, less evidently so with systemic lupus erythematosus,
Sjoegren’s syndrome and possibly also rheumatoid
arthritis. (26) Excessive, uncritical exhibition of vitamin
D may cause the supersensible human being to be
bound too strongly to the physical organism, making
other developmental steps more difficult. If secondary
osteoporosis and osteomalacia should develop in con-
junction with renal failure, thus being partly renal in ori-
gin, substitutive treatment principles may gain in sig-
nificance again.
Osteoporosis presents as a disease relating to pre-
mature excarnation. In a sense it may therefore be con-
sidered physiological in old age. It affects not only
spongy bone but also the compact bone which encloses
the spongy bone rather like a cranium. Special condi-
tions pertain with postmenopausal osteoporosis. The
fundamental aspects of treatment so far discussed may
be part of a comprehensive treatment of menopausal
symptoms.
Prevention and treatment of postmenopausal osteo-
porosis with hormone replacement therapy is currently
seen to have limits in several respects. HRT was previ-
ously recommended almost right across the board.
When it is discontinued, bone loss is “caught up on”.With
hormone treatment rarely given for more than 10 years,
the overall osteologic benefit would thus be rather
small. (27) Corresponding data for Raloxifen are still out-
standing. The HRT principle was made subject to limita-
tion in 2002, as an increased incidence of conditions
such as breast cancer, cerebral accident, myocardial in-
farction and increased ‘“treatment-associated mortali-
English Issue 2004
ty” contraindicate its use for ethical reasons. Disease
cannot be cured by using monocausal approaches. In
the case of osteoporosis prevention and treatment,
these have led to death and suffering due to pathology.
The use of monocausal therapies to correct symptoms
may at times be indicated and meaningful; the indica-
tion and assessment of rationality need the background
of comprehensive insight into the pathology.
Remedial gymnastics, eurythmy therapy—
setting inner tasks
Movement—and hence the will of the human soul
and spirit active in the organism—serves outstandingly
well in prevention and treatment. Remedial gymnastics
are clearly based on the laws pertaining to limbs and lo-
comotion in the physical body, yet since the precondition
is for mind and spirit to be active in human beings they
go far beyond the physical organization. Remedial gym-
nastics exercises can be comprehensively extended on
the basis of anthroposophy.
Additional principles come into play with eurythmy
therapy.This involves processual gestures that are never
finished or complete but in continuous development.
Any positional, finished movement lies outside this
processual region, becoming a gesture of the physical
body. The movements of eurythmy therapy make it pos-
sible to experience the spirit of consonants and vowels
as the visible speech of the etheric.
Eurythmy therapy exercises may with reference to
osteoporosis take up the theme of buoyancy and gravi-
ty, which also relates to the upright position as a factor
which constitutes the human organism.The light of con-
scious awareness develops in the weightlessness and
resting quality of the head, whilst will activity enters in-
to gravity with every movement of the limbs. Two
sounds reflecting this polarity are C and D. In the D ges-
ture, taken downward, the human being relates to grav-
ity, developing inner uprightness in the process of this
sound gesture. Powers of buoyancy connect with the C
when it is taken upwards. The vowels U and I [German U
and I sounds] can effectively complement the quality of
uprightness in walking and standing.The LMS sequence
may then be used in conjunction with U and I. L and M
address the rhythmic quality of breathing, S also has sig-
nificance in connection with the pain of osteoporosis
(the author has found these indications in collaboration
with eurythmy therapist Marlies Adams).
The inner task concerns a number of practice fields.
Initially, attention may be directed to the quality of
thinking. If thinking is largely associative and restless, for
instance, it will not be possible to have the condensation
and concentration needed for a world of formed-out
thoughts. The opposite, with too much form quality in
the thinking process, may also be the case. Just as re-
sistance is a major precondition for the treatment of os-
teoporosis, so it is also possible to consider the relation-
ship between processual and form-giving qualities in
thinking.
E n g l i s h I s s u e 2 0 0 4 | G i r k e | O st e o p o r o s i s f r o m t h e a n t h r o p o s o p h i c a l p o i n t o f v i e w | D e r M e r k u r sta b 27

Another important area for practice is movement and Reference 16 Wolff O. Zur Osteoporose –
1 Pfeilschifter J. Rationale und Pathogenese und Therapie. Der
the unfolding of the will. Reference has been made in
rationelle Osteoporoseprophyla- Merkurstab 1993(46) 5: 440 – 447
several ways to external movement. In human life, there xe und -therapie. Der Internist 17 Steiner R. Education for Speci-
should be an inner movement to correspond to the out- 4.2002: 554 – 562 al Needs. Tr. M. Adams, revised.
2 Delling G, Dreyer T, Hahn M, London: Rudolf Steiner Press
er. Exercises done mechanically untherapeutic in this re-
Röser K, Vogel M, Welkerling H, 1998.
spect, for instance using a running ergometer and call- Wolf E. Pathomorphologie meta- 18 Pelikan W. Heilpflanzenkunde
ing for no appreciable activity in mind and spirit to go bolischer Osteopathien – Aussa- Bd.II. Philosophisch-Anthroposo-
gemöglichkeiten an Becken- phischer Verlag am Goetheanum
with it, and also external movement done in isolation,
kammbiopsien, Pathophysiologie / Dornach (Schweiz) 1982
and not accompanied by an activity in the sphere of the und neuere Vorstellungen zur 19 Wolff O. Grundlagen einer
senses that would be relevant to this, relating to the Spongiosastruktur. Internist geisteswissenschaftlich er-
(1990)31: 737 – 744 weiterten Biochemie. Verlag
moving world and not withdrawn from this sphere of
3 Steiner R, Wegman I. Extend- freies Geistesleben Stuttgart
sensory perception by use of a walkman or the like. The ing Practical Medicine. Tr. A. R. 1998
capacity for inner mobility should unite with that for ex- Meuss. London: Rudolf Steiner 20 Roemer F. Bambus – Heilmit-
Press 1996. tel für die Rückenbehandlung.
ternal movement and lead to movement with soul qual-
4 Siegmund T, Fassbender WJ. Der Merkurstab 2003 (56)
ity. In the sphere of feeling, one will often see the sentient Diabetes mellitus und Osteopo- 5:280 – 291
configuration described for osteoporosis, often in con- roserisiko. Dtsch Med Wschr 21 Steiner R. The Healing Pro-
2003;128:937 – 940 cess. 1st lecture. Tr. C. E. Creeger.
junction with depressive qualities. Here it is a matter of
5 Girke M. Diabetes mellitus Hudson: Anthroposophical Press
bringing light into the darkness which sometimes pre- unter Gesichtspunkten der An- 2000.
vails in the soul. This is not only the external light which throposophischen Medizin. Der 22 Steiner R. Course for Young
Merkurstab, Sonderheft V Diabe- Doctors. 3rd lecture. Tr. rev. G. F.
in terms of vitamin D metabolism has significance for
tologie 2002(55): 4 – 29 Karnow. Spring Valley: Mercury
osteogenesis; the inner life is just as important which 6 Girke M. Die Schilddrüse. Teil I Press 1994.
can unfold in the human being and gain healing quali- und II. Der Merkurstab 1995(48)5 23 Barthel HR, Scharla SH. Mehr
und 6 als nur Knochenschutz-Vitamin
ties.
7 Steiner R. The Mystery of the D zur Prävention von Stürzen,
Finally the therapeutic gesture which is to bring Trinity. Lecture of 28 July 1922. Tr. Krebs, Bluthochdruck und Auto-
about incarnation of the human soul and spirit also de- J. H. Hindes. Hudson: Anthropo- immunerkrankungen. Dtsch Med
sophical Press 1991. Wochenschr 2003; 128:
mands an appropriate biographic goal. It is particularly
8 Ringe JD (Hrsg): Osteoporose. 440 – 446
with postmenopausal osteoporosis that the question 2. Kapitel. De Gruyter.1991 24 Loc. cit.
often arises as to finding a new biographic goal— 9 Loc. cit. 25 Loc. cit.
10 Minne HW. Klinik und röntge- 26 Loc. cit.
whether and how one’s essential humanity can connect
nologische Verlaufskontrolle der 27 Pfeilschifter J: Rationale und
with the body again at a new level. A positive attitude, a Osteoporose. Internist (1991)32: rationelle Osteoporoseprophyla-
basic openness to the future, is important here, being 70 – 75) xe und -therapie. Der Internist
11 Cizza G, Ravn P, Chrousos GP, 4.2002: 554 – 562
able to look to the future in an unbiased way. These five
Gold PW. Depression: A major, 28 Genth E, Burmester GR, Gross
qualities come together in an organ which evolves with unrecognized riskfaktor for oste- WL, Märker-Hermann E, Ringe JD.
a sixth exercise that brings the individual exercises to- oporoses? Trends in Endocrinolo- Rheumatologie. Der Internist
gy und Metabolism Vol. 12 No. 5, 1999 (40) 4; 401 – 406
gether. The ‘six qualities’ which Rudolf Steiner charac-
Juli 2001, Übersicht
terized as control of one’s line of thought, control of will 12 Girke M. Diabetes mellitus
impulses, equanimity with regard to pleasure and pain, unter Gesichtspunkten der An-
throposophischen Medizin. Der
a positive approach to the world, and taking an unbiased
Merkurstab, Sonderheft V Diabe-
view of life are part of the way of inner development that tologie 2002(55): 4 – 29
can take human beings to knowledge of self and of the 13 Wenderlein JM, Hengstler S.
Knochendichte mit Bezug zur
world.With regard to the destiny of the illness, it reveals
kognitiven Leistung im Alter.
its inherent healing powers. Seen like this, healing is Ztsch Geburtshilfe und Frauen-
more than the correction of symptoms, for it reveals the heilkunde 2002; 62:30 – 36
14 Ringe JD (Hrsg). Osteoporose.
way they connect with the individual’s way of inner de-
2. Kapitel. De Gruyter 1991
velopment. It thus does not take us back to past ‘health’, 15 Pfeilschifter J. Der Knochen-
but evolves into the future, towards a new step in hu- stoffwechsel und seine Aktivi-
tätsparameter. Internist (1990)
man development.
31: 727 – 736
The treatment of osteoporosis thus covers much
more than calcium and vitamin D3 substitution, known
as stage-1 treatment, or the exhibition of biphospho-
nates and other substances in the second phase of treat-
ment. (28) It is rather meant to encompass the whole es-
sential human being, letting inner faculties arise in fac-
ing the disease.

Matthias Girke
Havelhöhe Community Hospital
Kladower Damm 221
D-14089 Berlin
28 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s
Bamboo as a medicament
for back problems
F r a n z i s k a Ro e m e r
T
■ Abstract
In bamboo, a powerful incoming light principle
meets with a stable, rhythmically organized and
elastic shoot. The silica process is particularly devel-
oped in the plant, which is the image in nature of a
healthy vertebral column. Introduced to Anthropo-
sophical Medicine in 1951, it has proved its value with
a wide range of disorders affecting processes of
form, movement and coming upright in the whole
vertebral column. The rationale is given for different
potencies corresponding to the activity of the differ-
ent bodies with different pathological conditions.
■ Keywords
Bamboo cane, node
Phyllostachys viridiglaucescens
Spinal conditions
Anthroposophical Medicine
English Issue 2004
he upright posture immediately characterizes the
human form, distinguishing humans from the
more earth-bound animals. In learning to stand
upright by the end of their first year, human beings over-
come earth’s gravity and learn to withstand it by means
of variable positions of the vertebral column. Upright-
ness allows human beings the free use of their arms, giv-
ing them opportunity to use their hands to intervene in
the world and change it.
If one spends some time watching children playing
on a beach, for instance, or by a swimming pool, it is no-
ticeable that in their play they enjoy letting their backs
take on all kinds of different postures.The mobility of the
limbs is held together by the vertebral column as an or-
gan of the middle. If one then compares this mercurial
mobility of a child’s back with the gait of adults walking
past, particularly older people, it may come as a shock to
see how often the posture has grown fixed and rigid,
with movement having become unchanging routine.
One may then ask oneself if, although we do today react
to many of life’s demands with rigidity or even a bowed
back, there is not after all a little bit of free space in every
life situation, a space we must discover and use actively
to maintain inner mobility.
Human uprightness was won in the course of a long
evolutional process and then also in the personal biog-
raphy. It reflects inner uprightness and an inner space for
free play. It is really only today that these can be recog-
nized and made to unfold in personal endeavor and ef-
fort.With a new sovereignty and attitude, it will in future
be more and more possible to be active in bringing
health also to the bodily organization of uprightness,
and thus in the Goethean sense get soul and spirit to
teach the physical bodily organization. At present we
still need the help of material, potentized medicines in
case of illness.
Human beings have the support of the natural
worlds around them as they evolve and develop. Natur-
al substances accompany this developmental process in
the sense that they themselves have only achieved their
present form in the course of a long evolution. Every sub-
stance in the garden of nature thus has a real connection
with a particular human physiologic process of develop-
English Issue 2004 | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s | D e r M e r k u r sta b 29

Fig. 1
Tropical bamboo
grove

Fig. 2
Bamboo tower at
Phenomena Exhi-
bition in Zurich.

ment.When sickness develops in the human

organism, we must find a natural substance
which has this kind of archetypal correspon-
dence and is able to heal, i.e. restore a
healthy balance in the human body. Below, a
closer look will be taken at bamboo, to show
how it can help to meet the need for healing
in the organ system of the vertebral column.

Bamboo as an analogy in nature for the

healthy
vertebral column
Bamboo preparations have a long tradi-
tion in Asian folk medicine. In Europe bam-
boo was not considered a medicinal agent
until recently. In 1951, two anthroposophical
physicians, Gisbert Husemann and Alexan-
der Bruns, were talking to each other at a
medicinal conference on the Comburg in
Germany and with intuitive powers of judg-
ment felt that bamboo might be considered
for medicinal use in the treatment of back
problems (personal communication from
Armin Husemann). This indication differs
greatly from those in traditional Asian medicine. In time,
that conversation led to the development of the Disci
preparations by Wala physicians. (1-6)
Widespread everyday use in Asia
All kinds of different species of bamboo (7) have al-
ways influenced everyday life and the quality of life for
more than a thousand million people. They have a say-
ing that “bamboo is my brother” (Fig. 1). The plant also
had a place in pre-Columbian South American culture,
art and religion. It was brought to Europe towards the
end of the 19th century, having been native there during
the Tertiary period but dying out during the Ice Age. To-
day we can admire it in Bambouseraie Nature Reserve
near Nimes in southern France, for instance, (8, 9) in
Ebert's bamboo and tree garden center in Baden-Baden
in Germany, (10) or also on Mainau, an island in Lake
Constance.
The more robust species provide building material in
Asia that is both stable and elastic (Fig. 2). Scaffolding for
large buildings consists of bamboo which
is light and from an easily renewable
source. Even concrete structures may be re-
inforced with highly tensile and flexible
bamboo stalks rather than steel rods. Re-
cent pressure tests at Eindhoven Technical
University in the Netherlands have shown
bamboo’s properties as a building materi-
al to be absolutely comparable with wood,
brick and concrete.Walls, parquet flooring,
ceilings, roofs, bridges, boats, everyday
household articles such as dishes, baskets
and mats are made of thick or fine bamboo
stalks. Golden bamboo, being delicate, pro-
vides material for particularly valuable wo-
ven or plaited objects. Bamboo is also used
to make paper, saving trees which tend to
be expensive in the tropics. A Chinese say-
ing by Pan Song Tung is: “You can do with-
out a meal, but you must have a house
made of bamboo. If we lack food or drink
30 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s English Issue 2004

Fig. 3
Panda bear feeding
on bamboo.

Fig. 4
Fresh bamboo
shoots.

Fig. 5
Bamboo grove in
Asia.

we’ll grow thin.Without bamboo, however, we’ll lose our

cheerful equanimity.” Bamboo has do to with many
things that provide support in life. Charlie Chaplin’s
walking stick was also made of bamboo.
Gardeners find bamboo to be an undemanding plant
that will green denuded areas and produce attractive
forms. It cleanses the soil and improves both soil and air
quality.
It may also touch our hearts to know that after the
atomic bomb disaster at Hiroshima, bamboos were
among the first green plants to grow again. Here the
plant shows an original, fresh youthfulness, something
that helps renewal. Bamboo is also edible. The leaves
provide food for pandas (Fig. 3), being the staple in their
diet (3 – 6 kg/day); the shoots, suitably prepared, are an
important vegetable for people in Asia (Fig. 4). They are
harvested from the ground like asparagus.
Bamboo also has a natural affinity to the more sub-
tle qualities of light and sound. The first incandescent
fiber in Thomas Edison’s lamp in 1879 was of bamboo.
About 6000 other materials which he had tried before
had burned through. The word bamboo is said to derive
as follows. When Marco Polo went on his journey of dis-
covery to the Philippines, his native companions would
make a bamboo fire at night to drive away spirits and
wild animals. The explosive sound produced when the
air in the internodes got heated sounded like “bamboo”,
and this is said to have given rise to the English name.
There is also another saying:“a whole orchestra is hidden
in every bamboo stick.” Everyone has probably had occa-
sion to listen to the sound of a bamboo or Pan flute.
Apart from the bamboo organ, other bamboo instru-
ments are the anclung in West Java, the valita on Mada-
gascar, and the shakuhachi in Japan. What is more,
Alexander Graham Bell’s first phonograph in 1896 had a
bamboo needle.
Bamboo wood also contains a considerable amount
of bio-energy. Investigations of this as an alternative en-
ergy source are now in progress as part of an EU project
(production of bio oil, coal and gas).
Considering the many uses of bamboo, we see that
with its earthy and physical character it is a building and
support material. Its fluid, etheric element makes it a
valuable food, and its light-and-air nature a good musi-
cal instrument. Qualities of warmth and fire determine
its value as an energy source.
An elastic “tree grass”
There are numerous species of bamboo. About 75
genera comprising 1,250 species have been identified.
Definite classification was made difficult because the
plants flower only rarely and because people in different
countries have different names for them. In recent years,
new biotechnological methods using molecular markers
have brought greater clarity to the taxonomy.
The Bambusoideae are monocotyledons and grasses
(Gramineae). Like our native grasses and cereals they re-
late very much to the sun, growing rapidly towards it in
the rising year, like a ray of light (Fig. 5). Bamboos are,
however, perennials, woody, and branching giant grass-
es; we might call them “tree grasses”. In a report on the
war in India, which he sent to Aristotle, Alexander the
Great wrote of “tubes up to 60 meters high and the
thickness of a Greek spruce”—perhaps a slight exagger-
ation of the possible dimensions bamboo might have.
Bamboos originated in south east Asia. Their zone of
vegetation extends from the 45th northern to the 45th
southern latitude up to altitudes of 3,500 meters, e.g. in
Japan, the Philippines, Thailand, Vietnam, central and
southern China, India, Ethiopia and the South American
Andes. Habit and height vary according to climate and
biotope; the most luxuriant growth is seen in the trop-
ics, near the equator. In China alone, bamboo forests cov-
English Issue 2004 | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s | D e r M e r k u r sta b 31

Internode

Node

Young shoot with stem

sheaths

Underground Lateral root

leptomorphic rhizome

er an area of c. 4.5 million hectares. Bamboo needs hu- Fig. 6

mus soil that is permeable to water and well aerated. Phyllostachys
viridiglaucescens.
Growth is rapid. The habit may vary from delicate,
matchstick-thin grasses that are about 20 cm in height Fig. 7
to giant shoots growing to a height of more than 40 me- Leptomorphic rhi-
ters, and 40 cm in diameter. zome with buds
and fibrous roots
Let us now consider the morphology (11 - 13) of root,
leaf and flower in some detail. Bamboo produces rhi- Fig. 8
zomes, botanically speaking horizontal underground Rapidly growing
young shoot.
shoot elements with nodes and leaves. Two kinds of rhi-
zome are distinguished, with thin fibrous roots growing
from the nodes. Some are short and thick (pachymor-
phic), with short internodes, matted and producing
shrubs. These are the tropical forms that do not over
winter. The other kind of rhizome is long and slender
(leptomorphic); long runners produce culms at relative-
ly long intervals from the nodes, growing in semi-open
groves. They like mainly semitropical and temperate cli-
mates. Phyllostachys viridiglaucescens, the bamboo
used in Wala preparations, is leptomorphic (Fig. 6). The
rhizomes (Fig. 7) are rich in nutrients, have great vitality,
with maximum growth before new culms are produced
in spring. Rhizomes interlace densely, so that the soil
may bulge upwards. The interlaced rhizomes have high
tensile strength, and in Asia the local people run to the
bamboo groves during earthquakes.
Young shoot buds (Fig. 8) also grow from the nodes in
the rhizomes. Bamboo being a monocotyledon, having water (guttation) coming from the tip of the conical
no cambium for secondary thickening growth, the buds shoots running down the culm and dripping on the
show their final diameter from the beginning. All the ground.
nodes which the culm will later have are already laid Shoot growth is the fastest known in the plant world.
down, pushed one inside the other as in a telescope in Even eucalyptus trees and the flowering shoots of agave
the pointed bud which shoots up rapidly. Initially stem (aloe) cannot keep up with this.The rapid growth may be
sheaths hold and enclose the young shoot. Short-lived, connected with the fact that—as with all grasses and al-
they protect the tender tissues of the young shoot. Veg- so horsetails—every internode grows by itself, protected
etable growth hormones have been found in the by the sheaths. Yet it should be stressed that only bam-
sheaths. Their presence is indicated by the fact that lon- boo grows at this rate. The tall bamboo species need
gitudinal growth of the internodes ceases on removal of four weeks for the first three meters.They then grow be-
the sheaths. (14) As the culm grows, rings of fibrous tween 20 and 60 cm a day (max. one meter), and are ful-
rootlets emerge from the nodes, providing additional ly grown in about two months. The leafy branches then
anchorage for the new shoot. develop from the nodes, gradually creating a tree-like sil-
Another special feature is the powerful transpiration houette, their lanceolate leaves showing lively move-
stream during the main growth period in April and May. ment in wind and sunlight.The individual culm has a life
In the Prafrance Bamboo Park one can observe drops of span of c. 10 (up to 40) years, remaining vital, resilient
32 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s
Lamina
Fig. 9 and evergreen. A bamboo forest is made up of numerous
Vascular anasto- elastic culms, all looking the same. The forms of individ-
moses in node of
bamboo culm. ual bamboo culms fit into the configuration of the grove
as a whole, which is very different from oak, for instance,
Fig. 10 a tree that stands out by itself.
Leaf sheaths on
Nodes and internodes alternate on the culm. The in-
bamboo culm,
main shoot (1) and ternodes are generally hollow inside and filled with air.
lateral branch (3) The thickened node always has a woody diaphragm.This
(simplified by general structure gives the culm its elastic flexibility.
Roemer after
The walls of bamboo culms contain a tremendous
Schuster)
system of vascular bundles to conduct water and nutri-
ents. They run vertically, and in the nodes swing across
in lemniscates to the opposite side of the wall. A more re-
cent investigation by Ding and Liese, using serial sec-
tions (Fig. 9), resulted in a three-dimensional recon-
struction of the anatomy. The vertical vascular system
develops frequent V-shaped branching and anasto-
moses at the level of the diaphragm in the nodes, so that
the main vessels lie in a web of these branching struc-
tures.The rhythmic function of the nodes thus shows it-
self even in the fine structure of the vessels.
Bamboo culms harden soon after reaching full
growth. The fibrous cells are relatively long at one cen-
timeter. The lignin content is low compared to true
wood. The shoot gains its actual stability from silica as
well as lignification. As the sheaths die off, silica is de-
posited in the walls of the culm, mainly epidermally and
from below upwards. Silica in solution also cumulates in
the water in the internodes of some tropical species dur-
ing the growth stage. A silica concretion may then pre-
cipitate in the lower segments. This is tabasheer, to be
considered in more detail later. The culm is further sta-
bilized by additional wall lamellae strengthening the
fibers.
Leaves and culms may on occasion—depending on
species—show different colors or striations. Their form
may also vary slightly.
The leaves of bamboo are specialized leaf sheaths on
the culm (Fig. 10). The leaf form is typical of the grasses.
With its base clasping the culm, the leaf initially gives up
part of its own nature, adapting to the vertical principle
of the culm. The circular sheath then goes through a
fringed or ciliated transitional zone to become the actu-
al lamina which stands away from the culm. To the ca-
English Issue 2004
Lamina
Flexible
middle
zone
Lamina
Culm sheath
ring Culm sheaths on main
bamboo shoot
sual eye it may look like an ordinary lanceolate leaf,
though it is in fact part of a tripartite bamboo leaf grow-
ing close to the stem.
As already stated, the leaf sheaths on the culm drop
of as growth proceeds, leaving the perennial culm leaf-
less. The lamina of these leaf sheaths is relatively short.
The branches of bamboo growing to full size also have
leaf sheaths on the culm, but the lamina has the form of
an elongated leaf.
The inflorescence of bamboo has puzzled botanists
through the ages. It develops annually in some species,
as with the grasses, but many other species have long cy-
cles ranging from 25 to more than 100 years. The whole
species will then flower simultaneously, clone-like, all
over the globe, and the factor which triggers flowering
has not yet been established. The flowering process is
like a violent, deathly light insult to the plant. A group of
bamboo bushes are covered with thousands of “grass
flowers”. The rhizomes are exhausted, the leaves often
drop, and lack of assimilation then causes the plants to
die. In 1994, Dendrocalamus asper (provider of shoots in
Thailand) died out in this way, and in 1995-98 Sinarund-
inaria murielae. Later, the European press reported the
extinction of Fargesia murielae. Bamboos generally
flower and fruit in a way similar to that of cereals. The
seeds contain starch and are nutritious, yet their germi-
nating power is of short duration.
Taking bamboo as a whole, we have a plant where the
middle shoot system, the differentiated axis, is domi-
nant. Root and flower are comparatively minimal. As
stated, the “main root” is a rhizome, an underground
shoot element with small fibrous rootlets. The stem-
light principle thus penetrates down into the soil. The
flower is insignificant, and rare, with the light principle
coming in violently in the flowering, causing the whole
plant to die. All in all, bamboo is a shoot-emphasized
plant; part of the leaf principle also adapts to the verti-
cal principle, so that the culm, organ of the upright prin-
ciple, is entirely to the fore. The stem shows powerful
vegetative growth; silicification and lignification give it
stability, the node principle elasticity. The middle princi-
ple of uprightness, well anchored in the soil, determines
the habit of bamboo.
English Issue 2004 | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s | D e r M e r k u r sta b
What makes Phyllostachys viridiglau-
cescens (Figs 11, 12) most suitable among the
Bambusoideae for use in the preparation
Bambusa e nodo and in the Disci prepara-
tions made by Wala? The species is winter
hardy at temperatures down to –20 ºC. In
Europe it grows to an average height of 2 –
4 or at most 10 meters, which gives it “hu-
man proportions”. With two lateral branch-
es to each node, it bears abundant green
leaves. Marked tessellation (numerous
cross links between the parallel veins)
makes them frost-resistant. Like all grasses, the plant
only reaches maximum culm diameter at c. 1 meter
above ground, revealing a special tendency to overcome
gravity. Above the well-developed nodes, Phyllostachys
has a groove (sulcus) running the whole length of the in-
ternode. This is due to thick buds of branches, generally
two, being pushed inwards inside the culm sheaths.This
sulcus is reminiscent of the invagination of the neural
groove which initiates vertebral column development in
the human embryo.
For the Disci preparations, culm nodes with short sec-
tions of the lower and upper internodes are harvested in
the incipient silicification stage, coarsely grated by hand
and processed to a seven-stage aqueous Wala base mix-
ture. This is exposed to light for a week, using the rhyth-
mic Wala process. Capillary dynamolysis, an imaging
method used to follow developments in the mixture,
show an almost Asian mood with colors ranging be-
tween pink and medium grey; forms are delicate, main-
ly vertical, with the middle zone well lightened. Here, too,
the indication is of a mobile middle system which is well
permeable.
Silica skeleton to support the rapidly growing shoot
Bamboo is nontoxic. Chemical analysis yields cellu-
lose (30 %) and some lignin (25 % in the lower, 5 % in the
upper culm), plus organic compounds such as choline,
betain and various sugars. Traces of potassium, calcium,
magnesium, iron, copper, zinc and aluminium have also
been found.
The greatest growth activity is seen in the bamboo
shoots and reflected in the presence of numerous en-
zymes (nuclease and urease-type substances, protease,
33
Fig. 11
Phyllostachys
viridiglaucescens
in the Baden-
Baden park.
Fig. 12.
Leaf form of Phyl-
lostachys
viridiglaucescens.
Fig. 13
Tabasheer in culm
of Dendrocalamus
ssp. (placed hori-
zontally).
diastase) and substances acting like
growth hormones which are localized in
the sheaths. Recent chemoluminescence
experiments are of interest in this context.
They have shown that bamboo shoots give
off light (due to enzymatic oxidation of ty-
rosine). (15) The shoots of many bamboo
species also contain traces of hydrocyanic
acid.
Bamboo gains hardness especially be-
cause of silicification. In the bamboo
culm—above all in the epidermis—spe-
cialized cells contain silica in opal form (i.e.
amorphous and bound to water) as phy-
toliths. The silica content is highest in the
lower, more stable part of the culm and
within the nodes. Combustion of bamboo
culm results in a phenomenon similar to
that seen with horsetail. The outer form
will initially persist as a skeleton. Analyses
of the ash have shown the SiO2 content to
range from 2 to 30 %.
In some rare tropical species such as
Bambusa arundinacea, Dendrocalamus
strictus and Melocanna bambusoides, silica
in the growing internodes of some culms
also dissolves in water, cumulating in the
lower segments. This pure silica water was
used by the Malaysian people to boil rice
in, for instance, and for ritual purposes.
Sedimentation of silica in the lower ele-
ments of the culms that were initially filled
with water leads to the development of
34 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s
Fig. 14. opal-like concretions. These produce a rattling sound
Pieces of when dried-up older culms are shaken. Before the “veg-
tabasheer.
etable stones” grow quite solid, a thickish silica gel is
noted. This tabasheer (Figs 13 & 14) has been known
through the ages. It used to be worth its weight in gold.
In antiquity it could be found in the markets of Alexan-
dria, for instance, and was used as a protective amulet
(e.g. in Java), and above all medicinally by Chinese and
Arab physicians (such as Avicenna). Theophrastus re-
ferred to tabasheer, and it is also described in the 13th-
century Stockholm Papyrus.7
The pieces of tabasheer (16) weigh between 3 and 5
grams, are whitish and opaque, sometimes slightly
bluish, and porous. Against the light they are seen to
have several layers. The fracture is vitreous but soft. Un-
der the electron microscope the structure is granular to
amorphous. The silica content is up to 92 %. Similar to
opals of mineral origin in composition, they contain
more water and additionally also alkalis (oxides of Ca, K,
Na and Mg; Fe, Al, Cu, Zn, Mn).Tabasheer is sometimes al-
so called bamboo sugar, though it is not the same as the
sweet confection made of the inspissated sap from the
nodes of Bambusa stricta, for instance, which is used as
a stomachic.
Images from mythology
The two main themes that have come down by tra-
dition give a good characterization of the main features
of bamboo. One is clearly a moon theme, as in Taketori
Monogatari (17), the earliest known novel-like Japanese
tale from the 9th/10th century. A childless old bamboo
gatherer finds a dainty little girl in a luminous bamboo
stump. He and his wife raise the child Kaguya. The two
old people delight in her gracefulness, and again and
again the old man finds pieces of gold in the bamboo
forest which provide the basis for her education. Kaguya
develops into a beautiful marriageable young woman in
three months. In the three years that follow she rejects
five men who want to marry her and even the emperor,
for deep down she feels that she is not really of this
earth. After nine months of great sadness the moon king
and his hosts come to take her home. She had been self-
ish and hard and therefore banished from the moon for
English Issue 2004
a time. Her foster parents on earth taught her love and
modesty.
The second theme relates to the sun and is found in
the ancient ceremonies of the bamboo-splitting festival,
a cleansing ritual for young men. It emerges even more
clearly in the three myths which W. Chr. Simonis (18) has
brought together. The Bhutanese king and queen are
freed from bamboo culms among which they are
trapped, unable to free themselves. Their call “I’m in
here!” finally made people realize where they were.
In the light of these mythological aspects we can re-
late to the vertebral column “signature” which has been
described by Rudolf Hauschka (6) as moon and sun pow-
ers working together in the earth’s forces. Moon powers
give the human body the ability to grow and reproduce
itself, though in a sphere of coolness. Being taken hold of
by the sun’s power leads to uprightness in self-aware-
ness, and when that power has been made our own al-
so to warmth of soul for the world around us. Moon and
sun coming together in the right way enable us to move
and take our place in this world, supported by the verte-
bral column.
Bamboo in the popular medicines of Asia
So far I have not come across systematic work done
to give a full picture of experiences with the traditional
medicines of China, Japan and other Asian countries.
Schuster does offer a kind of review of different sources.
(14, 19) Different parts of the plant are used—leaves,
shoots, the rare and sought-after tabasheer, and some-
times also the roots. Below, the main uses of bamboo are
shown in relation to the threefold human being.
• Neurosensory system
Paresis, epilepsy (esp. tabasheer), deafness (extract
from flowers), febrile conditions.
Various skin conditions such as inflammation, some
forms of eczema, leprosy, leukodermia.
• Rhythmic system
• Bamboo is part of many preparations for lung con-
ditions, e.g. as an expectorant for coughs, a spas-
molytic for asthma, for pulmonary tuberculosis.
Depurative, styptic, hematogenic in cases of ane-
mia.
• Metabolism and limbs
Stimulating appetite and digestion, toning (bamboo
beer); for meteorism, diarrhea, chronic dysentery,
icterus and other gallbladder diseases; to treat poi-
soning, also after snakebite.
Bamboo serves as an emmenagogue (also in cases
of hypomenorrhea) and to encourage discharge of
lochia; it is considered an aphrodisiac, abortifacient,
and is used to treat uterine conditions and gonor-
rhea.
An ointment made with bamboo nodes, or a tritura-
tion of bamboo shoots with sand was used to treat
inflamed joints and to promote the healing of frac-
tures.
If we look at these indications from the anthropo-
sophical point of view, we come first of all to the activi-
ty of the astral or sentient organization. In its free-of-
English Issue 2004 | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s | D e r M e r k u r sta b
body part it lives in the soul’s rich powers of expression.
On the other hand the part of it that relates to the body
enters deeply into the subconscious physiologic process-
es in the body, among other things taking care of motil-
ity and secretion in the digestive organs, and the mobil-
ity of trunk and limbs. In a healthy person, body-free and
body-bound activities are continually held in balance by
the breathing activity of the rhythmic organs in the mid-
dle system.
Pathologic changes occur if the sentient organization
does not get itself sufficiently well anchored in the me-
tabolism via neurosensory and rhythmic system. On the
one hand the astral body, acting out of the upper human
being, develops pathologic spastic activity, for if it can-
not enter inwardly, it will react by getting caught up in
spasm from outside. This shift in higher body activity is
seen with epilepsy, for instance, spastic paresis, cough-
ing and asthma attacks and irritating dermatoses. On
the other hand the anabolic and eliminatory metabolic
functions are not receiving the impulses they need be-
cause the sentient organization is not entering in suffi-
ciently. The result are poor assimilation, reduced hemo-
poiesis, meteorism, and weak uterine contractions dur-
ing the menses and with the afterbirth. Inflammatory
processes such as febrile conditions or arthritis, are an
attempt on the part of the organism to connect the as-
tral organization more strongly again with the metabo-
lism.
Bamboo in experimental and clinical medicine
Below, some findings made in animal experiments
are reported to show that the exhibition of concentrat-
ed bamboo extracts results in various anabolic effects
that go in the direction of anchoring the astral body
more deeply in metabolism. In rats and mice, bamboo
extract has been shown to have general anti-inflamma-
tory and anti-ulcerative actions with gastric ulcers, es-
pecially those due to stress. Gastric acid secretion is re-
duced, and a serotonin-like calming action has been not-
ed. (20)
A number of authors report an anti-tumor action,
which still needs to be considered with caution, and a re-
duction in the rate of mitosis in tumor cell lines on exhi-
bition of a bamboo polysaccharide. (21 – 23)
At an international bamboo symposium in Anji/Chi-
na in 1997, Zang (24) reported antioxidative activity
against oxygen radicals in mice, and inhibition of oxida-
tion in blood fats. On the basis of this she spoke of a pos-
itive bamboo leaf extract action in cases of inflamma-
tion, cancer, and diseases of old age.
An estrogen-type action is also of interest. Continu-
ous estrus and uterine growth have been observed in fe-
male, and experimental infertility, with the number of
motility of sperm reduced, in male rats. (25) This hor-
mone-type action may relate to the effect on the repro-
ductive organs (PMS, climacteric syndrome) in Schuster’s
(14) drug proving. (14)
With reference to ossification, two recent papers
were found in medical data banks. Li (26) found that
35
bamboo has elastic properties similar to those of bone
and a bamboo matrix in a calcium phosphate solution in
vitro promotes the crystallization and deposition of cal-
cium phosphate salts. Kosuwan (27) used autoclaved car-
bonized bamboo as a tibia spongiosa graft; this filled out
rapidly with bony substance, with no rejection.
Bamboo in homeopathy
Two trials have been done, a smaller one with 23 pa-
tients by Guillaume (28) in 1966, and a fully document-
ed drug proving with 20 healthy adults and 12 single-
case records by Schuster in 1996.
Guillaume had seen good results with Wala Disci
preparations and had thus arrived at Bambusa e nodo
(3x, 4x, 6x, 12x) by WALA. He used this to treat patients
with herniated nucleus pulposus, Scheuermann’s dis-
ease, ankylosing spondylitis, cervicodorsal malforma-
tion, and lichen myxedematosus. He reports definite
symptomatic improvement with half the patients, in
some cases following primary aggravation.
Schuster (14) used a tincture of Bambusa arundinacea
shoots in the 6x, 30 c and Q3. The following have been
recorded (p. 151 ff):
• The subjective condition of a patient with ankylos-
ing spondylitis (bamboo shoot spine) improved
markedly.
• Symptoms of spinal origin
• Vertigo, headache originating in the nape, also pre-
menstrually and migraine-like. Burning eyes, ear-
ache, blocked nose, symptoms in temperomandibu-
lar joint; tachycardia, shooting pains in the heart.
Gastric pain with nausea. Meteorism, diarrhea.
Polyuria.
• Desire for warmth, sleep disorders.
• Stimulation of endocrine system, esp. gonadal func-
tion, but also of thyroid and sometimes adenohy-
pophysis. This is a new finding, and in this form un-
doubtedly because of the processing of shoots, the
leaf sheaths of which contain hormones. Premen-
strual syndrome with tense breasts, cumulation of
water and moodiness. Problems esp. in the second
half of the cycle, menses delayed and weak, whilst
sexually hyper excitable. Early menopause.
• Hypothyroidism. In on case it proved possible after-
wards to discontinue 200 _g/day of thyroxine.
• Numerous Mind symptoms, including
• tension and relaxation—everything is too much,
feeling responsible for everything. Letting it all go,
laughing incessantly, hanging one’s head.
• Split between head and heart. The two halves of the
body as felt to be different, head feels too large (sil-
ver symptoms), head and heart as if separate.
• Inhibition of will, feeling like a dray horse, having to
hold one’s own, unable to let will become deed.
The positive bamboo state of mind Schuster estab-
lished is of someone with staying power who is also flex-
ible, able to make compromises without letting it break
one, and always keeping the goal in sight. One the one
36 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s
Fig. 15
Nodes from bam-
boo culms.
hand able to yield, on the other also returning to the cen-
ter again, and remaining modest throughout.
Bamboo in Anthroposophical Medicine
The idea that bamboo may be seen as a natural ana-
logue of the healthy form and function of the vertebral
column originated in Anthroposophical Medicine (G.
Husemann and A. Bruns 1951). In traditional Asian medi-
cine, bamboo was not, to my knowledge, used directly on
this indication but for various disorders due to problems
with integrating the sentient organization in the rhyth-
mic system (v. s.) which may be considered to relate in-
directly to the basic idea. The homoeopathic trials done
by Guillaume (1966) (28) and especially Schuster (1996)
(14) substantiate spinal conditions as the main area of
use and broaden insight into the basic idea. This is a sit-
uation where anthroposophical and homeopathic med-
icine illuminate and complement one another most
beautifully.
With bamboo, the emphasis is on shoot and differ-
entiated stem principle. Flowering and the development
of actual roots are greatly reduced, even the leaf partly
submits to the vertical principle of the stem. The plant
thus shows that there must be a connection to the mid-
dle, rhythmic system and to the organization for up-
rightness in the human being.
Let us consider the beginnings of the human axial
skeleton (29). It originally develops from the mesoderm,
with the primitive streak first establishing longitudinal
orientation during the transition from two to three ger-
English Issue 2004
minal layers. Invagination, with the ectodermic primitive
streak regressing, then gives rise to the dorsal chord be-
neath the future neural tube. The chord is now an im-
portant induction organ, indispensable in the develop-
ment of the vertebral column and the system of spinal
nerves. It initiates metamerization. To begin with is it an
unsegmented cellular axial organ with high turgor com-
parable to the young plant shoot which with its inherent
etheric power rises into the vertical away from the earth
and towards the light of the sun. In the human being
this upright vertical is, however, no longer linear. The dy-
namics of the human I-organization impose a double S-
curve on the differentiated vertebral column. Moving be-
tween extension in lordosis as one extreme and flexion
in kyphosis, human beings are ably to vary and control
their upright posture and the movements of the axial
skeleton.The uprightness of the human being is thus the
work of the I-organization in the etheric. The physical
foundations for this are laid down on the basis of hered-
ity in the embryonic and childhood periods. In adoles-
cence they are then taken hold of and made wholly per-
sonal. If the process meets with problems at school age
and postural weakness develops, Bambusa e nodo may
be given in medium high to low potency. Positive results
with this have been reported in pediatrics. Bamboo ther-
apy supports the human “chorda principle”, as it were,
which persists throughout life.
The influence of the I-organization goes even deeper,
as far as the physical body, especially with ossification. It
gives the organ which supports uprightness stability
and firmness, without becoming subject to earth’s grav-
ity, however. Silica, which is of course also found in bam-
boo, plays a major role in the depositing of calcium salts
in the bone matrix. (30) In the early stages of ossifica-
tion, the concentration of silica in the matrix is relative-
ly high, as shown in animal experiments. (31) The silica
content increases inversely proportional to the rising
calcium salt content. This indicates that ossification is
not primarily concerned with the absolute calcium con-
centration in the organism. Silica has a kind of perceptive
and mediating function in this; it allows bone calcium
salts to concentrate and precipitate in what is physio-
logically the right place, avoiding pathologic transmin-
eralization in form of arteriosclerosis, for instance.
In January 1996, I suggested at the medical course on
skeletal development in Bad Boll that bamboo be used
also to treat osteoporosis. Key aspects for me were the
rapid growth and production of matter, and on the oth-
er hand the stable mineralization due to silicification.
Since then long-term exhibition of bamboo in low po-
tency has resulted in improvement with a number (not
all) of uncomplicated osteoporosis conditions. The low
potency is indicated as not only the forces but also the
substance must be made available to bone metabolism.
If we now consider the I-guided astral organization
with reference to the vertebral column, a dual aspect
arises with regard to body and soul. In the living body,
the astral organization is the author of the metameric
principle at the early stage of embryonic development,
English Issue 2004 | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s | D e r M e r k u r sta b
showing the vertebral column to be an organ of the
rhythmic system. The chord differentiates into regular
segments which later develop into the gelatinous core of
the intervertebral discs.These chord segments then give
the equally mesodermal tissues of myotomes and scle-
rotomes their orientation as they develop the muscular
and bone skeleton of the spinal column. The segmental
axial organ which develops is given adaptability and
flexibility by the interposed discs. Bamboo nodes show
correspondence especially to this movement aspect of
the intervertebral discs, for they give the culm its rhyth-
mic organization and elastic range of movement. The
laws of rhythm are evident even in the fine structure of
the vessels in the nodes, which permit the rising fluid to
disperse subtly and come together again. It can thus be
understood why the main indication for bamboo node is
the treatment of spinal conditions, especially those due
to damage to the intervertebral discs, but also those ac-
companied by myogelosis or radicular symptoms. Fairly
long-term exhibition of Bambusa e nodo 6x is indicated
(5 – 10 pilules one to three times a day), and in the acute
stage courses of paravertebral subcutaneous injections
in the painful areas in addition (e.g. 2 or 3 times a week
for 5 – 7 weeks).
Apart from this physical aspect of a bamboo therapy
that helps to anchor the astral and I-organization in an-
abolism, leading to relaxation and pain relief, there is al-
so another, more soul-related aspect. Bamboo helps the
I-organization in its endeavor to maintain the balance
between polar opposites in the astral organization—
tension and relaxation, pleasure and pain, forming ideas
and acting on them. Bambusa brings harmony into the
soul’s capacity for fluctuation. Reference may be made at
this point to a patient, E. M., born in 1953, who was un-
able to work from November 1998 to February 1999 be-
cause of a herniated nucleus pulposus at L5-S1 (NMR). A
recurrence at the end of June took the form of sciatica ra-
diating to the ankle region. The trigger had been exces-
sive physical demands at work and separation from his
partner. In addition to treating the acute condition
among other things with Disci/Rhus toxidodendron
comp., he had 10 pilules of Bambusa e nodo 30x per os
twice a week in the evening.The recurrence was stopped
in a few days, with no time at work lost; Mr M. was free
from pain again and also seemed more relaxed mental-
ly. Bambusa 30x was continued for a time. Six months
later, Mr M. continues to be free from pain.
The endocrinologic aspect of bamboo discovered by
Schuster (14) needs to be given further consideration.
The cranial end of the dorsal chord originally extends as
far as the pouch of Rathke, thus establishing a topo-
graphic connection between spinal column and hy-
pophysis which probably persists at the functional level
in later life. The question arises if the bamboo shoot
preparation is more active at the hormonal level than
the bamboo node preparation.This requires further em-
pirical observation. I can only speak of one patient who,
whilst she did not have monotherapy, did show that
functional relationship in the whole picture she pre-
37
sented. V. S., aged 47, had a premenopausal syndrome
with early and very severe menses, premenstrual mood
changes and other signs of PMS, back pain and paraver-
tebral tension, especially in the cervical spine, and ten-
sion headaches. The patient responded well to small
dosages. She was given 4 pilules of Ovaria comp. mane,
5 pilules of Bambusa e nodo 10x nocte, _ ampoule of Hy-
pophysis Gl 10x to drink twice a week at night. Menses
and back pain were well regulated with this.
Summary
In bamboo, a powerful incoming light principle is tak-
en up into a stable, rhythmically differentiated and elas-
tic shoot. The specific habit suggests medicinal proper-
ties. In use since 1951, bamboo preparations (Bambusa e
nodo 3x, amp.; 3x, 6x, 10x and 30x pilules WALA) have
proved effecting with a range of disorders affecting
form, movement and the coming-upright processes in
the whole vertebral column formation.The archetype of
bamboo as an example in the natural world of healthy
vertebral column organization has thus been confirmed
in clinical practice. In Anthroposophical Medicine, the
spine is seen as an organ created by the powers of the I-
organization to establish the vertical in the middle,
rhythmic system, a flexible organ supporting this pow-
er of coming into the vertical throughout life.
The I-organization works with each of the other hu-
man bodies—astral, etheric and physical—in differenti-
ated fashion. In the physical sphere, it ossifies the verte-
bral column to the point of mineral hardness. Low po-
tencies of bamboo therefore promote the mineraliza-
tion of bone, e.g. in cases of osteoporosis. Interaction of
I-organization and etheric organization brings about hu-
man uprightness. Bamboo in low to medium high po-
tencies helps with postural problems and vitalizes the
intervertebral discs. The synergism of astral and I-or-
ganization results on the one hand in the aspect of pain
and movement, and on the other in the whole psychic
significance of spinal conditions. Medium high poten-
cies of bamboo may therefore be used to treat neuralgic
conditions originating in the back that limit movement.
Higher potencies also cover the states of soul and spirit
behind the physical symptoms, supporting “inner up-
rightness” and harmonizing the soul’s fluctuating
changes.
Franziska Roemer, MD
Dorfstr. 71
D-73087 Eckwälden
38 D e r M e r k u r sta b | Ro e m e r | B a m b o o a s a m e d i c a m e n t f o r b a c k p r o b l e m s
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cancer active polysaccharide pre- Liese for their valuable sug-
pared from bamboo grass. J. Anti- gestions and corrections re-
biot. Tokyo, 1966, May, 19 (3), S. lating to the botany.
132–136.
23 Suzuki et al.: Studies on the The text of this paper has
anti-tumor activity of polysac- been published as a chapter
charides, Chem.-Pharm.-Bull.- of Anthroposophische Medi-
Tokyo, 1968, Okt. 16 (10), S. 2032– zin in der Praxis, Bd II, NMM-
2039. Verlag, Bad Boll 2002.
24 Zang, Y.: Bio-antioxidative ac-
tivity of functional factors in
bamboo leaf, Int. Bamboo Works-
hop, Sept. 1997, Anji, China.
25 Manonayagi, S. et al: Effects of
bamboo buds: structural and
functional changes in the epidi-
dymis of rats. J. Ethnopharmacol.
1989, Apr. 25 (2), 201–212.
26 Li, S. H. et al.: In vitro calcium
phosphate formation on a natu-
ral composite material bamboo.
Biomaterials 1997, Mar; 18 (5)
389–395.
27 Kosuwan, W. et al: Charcoal
bamboo as a bone substitute: an
animal study. J. Med. Assoc. Thai.
1994, Sept; 77 (9) 496–500.
28 Guillaume, M.: Action spécifi-
que du Bambou sur les affections
de la colonne vertébrale, Bulletin
du Syndicat National des Méde-
cins Homéopathes Français, Nr. 6,
1966, S. 39–46.
29 Hinrichsen, K. V.: Humanem-
bryologie, Springer 1990.
30 Wolff, Otto: Osteoporose. Pa-
thogenese und Therapie, Der
Merkurstab, 5/1993 S. 440–447.
31 Mertz, W.: Trace Elements in
Human and Animal Nutrition,
5th Edition, Vol. 2, Academic
Press 1986 (suggested by
Thomas Schuerholz).
English Issue 2004 | H a m r e · B e c k e r - W i t t · Z i e g l e r · W i l l i c h · K i e n e | St u d y r e s u lt | D e r M e r k u r sta b 39

Anthroposophical vs conventional treatment

of low back pain—results of a prospective study
H a r a l d J. H a m r e , C l a u d i a B e c k e r - W i t t, R e n at u s Z i e g l e r ,
St e fa n N . W i l l i c h , H e l m u t K i e n e

■ Abstract ■ Keywords

Summary of a lecture given at a German Anthropo- Prospective study

sophical Medical Association conference on spinal Comparative study
conditions and osteoporosis, individualized diagno- Low back pain,
sis and treatment in Kassel on November 23 and 24, Chronic diseases
2002. Eurythmy therapy
As part of a model project on methods used in natu- Rhythmical massage
ral medicine for the Innungskrankenkasse (health Group A: Patients given anthroposophical
insurance company) Hamburg and the Federal De- medical treatment
partment of Transport’s health insurance company, Group S: Patients treated by a conventional
a prospective comparative study on low back pain medical
was run in German medical practices. The subject of practitioner
the study was the evolution over 12 months seen
in patients between 17 and 75 years of age presen-
ting with lumbar pain of at least 6 weeks’ duration.
Patients who had had surgical treatment of the spi-
ne and 12 specific diagnoses were excluded. 44 pa-
tients who were given their first anthroposophical
treatment for low back pain (Group A) were compa-
red with 50 patients receiving their first conventio-
nal treatment for low back pain (Group S). The most
frequently given treatments in Group A were eu-
rythmy therapy (n = 33) and rhythmical massage (n
= 8). Low back pain had persisted for a median of 8.5
years in Group A (interquartile range 2.3 – 19.0
years), and 0.5 years in Group S (0.2 – 2.5 years). Low
back pain rating scale, function of the back (Hano-
ver function questionnaire for back pain) and he-
alth-related quality of life (SF-36 questionnaire on
state of health) improved in both groups. With refe-
rence to SF-36 subscales, Group A showed some mo-
re favourable evolutions than Group S, whilst other
evolutions were comparable. Analgesics and NSAIDs
had been taken by a greater number of patients in
Group S than in Group A during the year preceding
admission to the study. The difference increased in
the first year of the study. About two thirds of pa-
tients in both groups had physical therapies in addi-
tion in the year preceding and the first year follo-
wing admission to the study.
English Issue 2004 | H a m r e · B e c k e r - W i t t · Z i e g l e r · W i l l i c h · K i e n e | St u d y r e s u lt | D e r M e r k u r sta b 39

Anthroposophical vs conventional treatment

of low back pain—results of a prospective study
H a r a l d J. H a m r e , C l a u d i a B e c k e r - W i t t, R e n at u s Z i e g l e r ,
St e fa n N . W i l l i c h , H e l m u t K i e n e

■ Abstract ■ Keywords

Summary of a lecture given at a German Anthropo- Prospective study

sophical Medical Association conference on spinal Comparative study
conditions and osteoporosis, individualized diagno- Low back pain,
sis and treatment in Kassel on November 23 and 24, Chronic diseases
2002. Eurythmy therapy
As part of a model project on methods used in natu- Rhythmical massage
ral medicine for the Innungskrankenkasse (health Group A: Patients given anthroposophical
insurance company) Hamburg and the Federal De- medical treatment
partment of Transport’s health insurance company, Group S: Patients treated by a conventional
a prospective comparative study on low back pain medical
was run in German medical practices. The subject of practitioner
the study was the evolution over 12 months seen
in patients between 17 and 75 years of age presen-
ting with lumbar pain of at least 6 weeks’ duration.
Patients who had had surgical treatment of the spi-
ne and 12 specific diagnoses were excluded. 44 pa-
tients who were given their first anthroposophical
treatment for low back pain (Group A) were compa-
red with 50 patients receiving their first conventio-
nal treatment for low back pain (Group S). The most
frequently given treatments in Group A were eu-
rythmy therapy (n = 33) and rhythmical massage (n
= 8). Low back pain had persisted for a median of 8.5
years in Group A (interquartile range 2.3 – 19.0
years), and 0.5 years in Group S (0.2 – 2.5 years). Low
back pain rating scale, function of the back (Hano-
ver function questionnaire for back pain) and he-
alth-related quality of life (SF-36 questionnaire on
state of health) improved in both groups. With refe-
rence to SF-36 subscales, Group A showed some mo-
re favourable evolutions than Group S, whilst other
evolutions were comparable. Analgesics and NSAIDs
had been taken by a greater number of patients in
Group S than in Group A during the year preceding
admission to the study. The difference increased in
the first year of the study. About two thirds of pa-
tients in both groups had physical therapies in addi-
tion in the year preceding and the first year follo-
wing admission to the study.
40 D e r M e r k u r sta b | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t English Issue 2004

Aspects of fourfold diagnosis and constitutional treat-

ment of spinal conditions
Ludger Simon

C
onsidering the whole human form, we experience
■ Abstract in the limbs, and especially the legs, how the hu-
The dynamics of and the prob-lems arising at each man being positions his bones in the direction fol-
of the four levels in the vertebral column may be lowed by gravity. Standing upright, he can thus take hold
seen to reflect the dynamics of the human being’s of the influence of this physical force and at the same
time also overcome it.
four bodies. Aspects arise from this concerning the
The pelvic basin holds the viscera and gonads and the
polarity between rheumatic diseases of the lower
major anabolic organs such as the liver and intestine.
extremities and lower spine (Bekhterev’s and other
Here we see the vital organization of constructive ether-
forms of seronegative ankylosing spondylitis) and ic powers predominating, and above the diaphragm, in
of the arms and upper spine (rheumatoid arthritis) respiratory and cardiac functions the rhythmic, pulsat-
are discussed. Regarding typical medicines, referen- ing life of the sentient organization that goes hand in
ce is made to the metamorphoses of carbon dioxi- hand with the life of feeling.
de on the one hand (Calc. carb., Kali carb., Carbo In the region of the head and the face, the body
veg.) and of silica on the other, and to the medicinal shows its most individualized form. Facial expression,
powers of colony-forming the look in the eye, the pupil, let the spiritual quality of
insects. the individual shine out, with the human I shining into
■ Keywords the visible world for brief moments.
Vertebral column
The four bodie At its lowest, the vertebral column has its “roots” in
Ankylosing spondylitis the laws of physics
Seronegative forms of spondylitis Looking at the human spine, starting from its lower
Rheumatoid arthritis end, we see that the sacrum consists in five fused verte-
Calcium carb. / Kali carb. / brae that were originally separate, with intervertebral
Carbo veg. discs, but ossified at an early stage.Thanks to the wedge-
Apis shaped sacrum, the spine is securely ‘lodged’ in the hor-
Formica izontal scale beam of the pelvic girdle through the
Vespa sacroiliac joints with their tension-proof ligaments. Im-
Quartz, silica mediately around the physical body’s center of gravity,
Solutio siliciae comp. the “cross” of vertical spinal “column” and the horizontal
Equisetum cum sulphure tostum “base” of the pelvic girdle is placed into the sphere of
physical and mechanical actions. The column is, howev-
er, supported by the two further columns of the legs,
with the pelvic girdle the “architrave”.
This double, piled-up column architecture speaks vol-
umes about the way in which the physical body is built
into the world of physical forces. The related locomotor
dynamics can be observed in the process of coming up-
right from the bent-leg posture of mammals. Tension
ceases in the muscles of the bent leg the moment it is
possible to extend the knee joint. One can try this for
oneself and will find that powers of will come free from
the muscles and are then available to conscious aware-
ness of selfhood at a higher level, that of the psyche. En-
English Issue 2004 | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t | D e r M e r k u r sta b 41

Region Silicia processes

P

...............silica deficiency
Joints develop

a
Incr. mobility

Cervical spine 1 I-organizsation Quarz, Cervical-spine

b Equisetum involvement in peripf.
ZFuture

in light

rh. arthritis (cP)

2
Thoracic spine Astral body Carbo prepara- Formica rufa
c tions/potentized

silica deposits...............
Solutio Scheuermann's
towards the earth

Lumbar spine poisonous plants siliceae disease and other

comp. syndromes
Joints perish

Ether body Kalium carb. Apis mellifica

Incr. rigidity

Sacral region
d Bechterev's disease
Past

30º 4 Physical Conchae Vespa crabro Equisetum c. and other

e body (Calc.carb.) sulfure tost. spondylarthropathies

tering into the region of physical forces in the sacrum,
the human I places itself in the force of gravity coming
from the center of the earth, and is then able to over-
come it again when the upright position is achieved.
In the lumbar spine human beings are plant-like and
open to the environment
The actual process of coming upright is based on the
lumbar spine, which is the first to develop persistent ar-
ticulative functions between vertebral bodies, with elas-
tic mobility all round. Specifically it makes it possible to
bend forward and touch the ground with one’s hands,
and on the other hand to come upright again through an
angle of 180 degrees so that human beings are able to
walk in the upright position. The lumbar spine thus con-
nects the bipolar direction of forces between earth’s
gravity and the light of heaven, in which plants also live.
The sacral region relates to the effects of physical and
mechanic forces.The lumbar spine shows its function to
be governed by the plant-related powers of the etheric
organization.
The thoracic spine lives more in the soul quality of
turning inwards
The rhythmic sequence of spinous and transverse
process in the lumbar spine starts a development like
that of branching plant stems. In the region of the tho-
racic spine this continues on into the development of
ribs, creating a vault-like internal space, as in flowers.
Here the human being shuts himself off from the out-
side world with firmer boundaries, in order to develop
sentient life in this inner world. The ribs show progres-
sive metamorphosis from above downwards, no two be-
ing alike. The relatively immobile upper ribs are short
and curved in the edge, reflecting something of the rel-
ative rest of the cranium. Further down the ribs curve in
the plane, are elastic, with increasing mobility in going
out and in, adding up to the expansion and contraction
of the lower thoracic cage. The seven upper ribs are con-
nected with the sternum through cartilage, whilst the
lower five are free, terminating in the abdominal mus-
culature. The twelve ribs arching around the warm, pul-
sating life of the heart thus remind us of the 12 regions
of the zodiac in the vault of heaven, surrounding the sun
and its planets with 12 different qualities of being. The
thoracic spine thus lives in relation to the twelve-fold Fig. 1
world of soul life, the 12 gestures or potential configura- Synopsis
Curvatures of the
tions that create the field of force in which the human spine (in diagram-
astral body lives. matic form)
1) cervical lordosis
The cervical spine points beyond the animal to the 2) thoracic kyphosis
specifically human 3) lumbar lordosis
4) sacral-coccygeal
The human cervical spine shows specific further de- kyphosis
velopment. In mammals it is still more a fifth extremity, In upright position,
with powerful muscle groups reaching from the tho- the plumb line cuts
racic spine as far as the occiput to hold the skull in a hor- across the anterior
tubercle of the atlas
izontal position. It plays an important role also in tearing (a), the 6th cervical
up prey, chewing and swallowing. In humans, on the oth- vertebra (b), the 9th
er hand, the head balances vertically on the cervical thoracic vertebra
(c), the 3rd sacral
spine. Muscle functions can thus be many times more
vertebra (d) and the
fine and differentiated, as they serve only to turn and di- tip of the coccyx (e).
rect the head according to the intentions of sensory per- The link connecting
ception. the upper edge of
the symphysis and
The small vertebral joints originally develop as syn- of the 3rd sacral
ovial joints, i.e. selective breakdown of embryonic tissue vertebra is at an an-
(apoptosis) resulting in analytical differentiation, with gle of 30º to the
two rounded skeletal elements separating off from a horizontal (from
Rauber/Kopsch,
mesenchyme rich in cells and protein. Phylogenetically Band 1).
this is the most recent and most differentiated type of
articular development. Originally it is part of the animal
organism, especially among vertebrates.
The human being, on the other hand, takes cervical
spine mobility beyond the level of prebirth development.
In about the 10th year of life, fine transverse splits de-
velop in the cervical spinal segments. Proceeding trans-
versally from the outer margin they go through the
whole intervertebral disk and are filled with synovial flu-
id. This gives the cervical spine a higher degree of finely
differentiated mobility which serves the intentional per-
ceptiveness and creative activity of the human I. (1)
Increased activity in mind and spirit will initially
cause subtle destruction (development of split) but this
then turns into the constructive development of a high-
er, most finely differentiated organization—a gesture
typical of the human I which induces selective death
processes, dying processes in the living body in order to
unfold a higher life in mind and spirit.
The human atlanto-occipital joint permits the nod-
ding gesture of saying yes, whilst the atlanto-axial joint
42 D e r M e r k u r sta b | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t English Issue 2004

below this permits the rotation of shaking one’s head in tions, how the I lives in the system of its own powers and
negation. These are two fundamental gestures in the I’s when it enters into the astral, etheric and physical bod-
relationship to the environment—agreement and de- ies (see summary in Fig. 1).
limitation of an inner sphere.
The vertebral column as the time-axis for I-presence
Where the thoracic spine reflects astral laws in the 12,
between past and future
the cervical spine in its development as an organ proves
With regard to the cervical spine we considered the
to bear the touch of the powers of the human I. At the
enhanced joint function in the upper intervertebral
present time, particular importance attaches to the re-
discs, with additional interarticular spaces extending
gion of transition from chest to neck, including the nape.
the function of the unco-vertebral joints. In the lowest
The more and the longer people are inwardly tensed in
part of the vertebral column, articular functions thus
the activity of sensory perception, the more easily does
disappear even before birth, leaving permanent ossifica-
muscle tension develop in the back of the neck, and this
tion (ossification in the sacral and coccygeal regions
may lead to spasticity in their breathing.
which had originally been segmented, a synthesizing
Patient will sometimes say of their own accord that
gesture); in the uppermost part of the vertebral column
their urination has also changed.This tension in the back
we see analytical, separating processes after birth with
of the neck does indeed relate strongly to the kidney as
the creation of new joint functions.
the astral body’s central organ. The power developed by
The lowest part of the spine thus reflects the densi-
the astral body first radiates into the organism via the
fying laws of the head organization, as exemplified in
airy organization of kidneys and adrenals. From the kid-
the bones of the cranium and also dental development.
ney region it rays out as far as the periphery, then to go
The uppermost part of the spine on the other hand takes
through a kind of reflection in the nervous system, es-
up the enhanced mobility of metabolism and limbs;
pecially the spinal nerves and/or the region of throat
here, ether powers enter into the physical body as pow-
and back of neck. The contractile counter movement of
ers of growth and movement’; in the sacral region they
sentient powers coming from the kidney turns back on
are set free for the development of conscious aware-
the etheric and finally the physical activity, which comes
ness, which otherwise happens in the head. The I thus
to expression in the secretion of urine and elimination of
awakens to thinking in the sacral region of its skeletal
nitrogen, and also on the respiratory drive and the ton-
axis; in the neck region it develops will intent to work on
ing of smooth and striated muscle. This mysterious in-
future body development.
teraction between the throat and nape region and the
In terms of the whole body, head development comes
related spinal marrow on the one hand and renal activi-
first, as does the development of bone; the human being
ty at the level of soul and body on the other is evident
gradually descends from the head down into the limbs,
even at the embryonic stage. The pronephros starts in
where development only concludes much later, in
segmented form in the neck region and then continues
around the 20th year of life. From the spiritual-scientif-
downwards in a rhythmic, metameric sequence of
ic point of view, the whole of I-activity itself also radiates
paired renal structures, until those structures finally de-
from the head, the “upper center of gravity”, into the
scend and come together in the metanephros, making
body of the young child, connecting with the past by
the connection with the plant-like calyx system which
means of hereditary exemplars. From the 9th to 12th
sprouts up from the urinary bladder.
year onwards, the I then works itself successively into
the system of powers active in metabolism and limbs,
The vertebral column reflecting the I’s activity in the
from the outside inwards. From then on it also works in-
four organizations
dependently, in the process of overcoming the earthly
The powers active in the four major regions of the
outside world, on the child’s own body, now from the
vertebral column, their posture and the symptoms re-
“lower center of gravity” of the I-organization, the basis
lating to them may thus be considered to reflect the way
of bringing independent life to realization in the fu-
the four bodies of the individual patient are acting.
ture.(2)
When making a constitutional diagnosis and finding the
It is exactly at the time when the orientation of pow-
indicated treatment, symptoms in the region of the
ers changes—a threshold from the past (I reflected in
sacral and iliosacral articulations therefore point to dis-
the head organization) to an earthly future taken up in-
orders or energies being held back in the sphere of the
dependently (primary I-activity in metabolism and
physical organization, or of the way in which the I-or-
limbs) which Rudolf Steiner also referred to as “crossing
ganization influences activity of physical and mechani-
the Rubicon”—that the additional articulate functions
cal forces via the astral and the etheric bodies. Lumbar
in the upper cervical spine show themselves, a bodily re-
spine problems indicate a connection with the etheric
flection of newly gained freedom.
organization (or to I-activity in the ether body), thoracic
spine problems point to one-sided changes in the astral Typical healing processes for diseases of the spine
organization (I in astral body), and cervical spine prob- A first group of medicinal agents comprises mineral
lems to irregularities in I-activity or the I-organization it- substances created in animal, plant or earthly life
self. The whole posture and movement of the spinal col- processes so that they contain carbon that has been tak-
umn shows in the fluctuating interplay of bodily reflec- en into life.
English Issue 2004 | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t | D e r M e r k u r sta b
I Sequence of enlivened carbon metamorphoses
· Calcium carbonicum, a mineral substance secreted by
oysters (Conchae)
The oyster shell is a deep-acting medicinal agent
when someone gets “too earthy”, with the ether body
coming free more than it should, and the mineralizing
tendency which develops when the physical body is left
to itself needs to be overcome. It is therefore an impor-
tant constitutional agent for syndromes that have their
focus in the region of the sacrum and the iliosacral
joints, particularly Bekhterev’s disease (rheumatoid
spondylitis) and other seronegative spondylopathies
with a marked basic hardening tendency.
Start with the 30x locally s.c., especially for anxious
individuals, and if indicated move gradually, as required,
via the 20x and 10x down to the 7x, until a vitalizing,
pain-relieving effect is achieved.
· Kalium carbonicum, a mineral representative of the
fruiting process in plants
The lumbar spine relates to the human ether body, as
stated. Here constitutional problems or configurations
of the higher bodies appear where the ether body is not
adequately penetrated by the astral body. Here Kalium
carbonicum is a typical medicament. Potentized calcium
carbonate (obtained from grapes by Weleda) conveys a
message to the sick individual: “Overcome the calcium-
related plant principle in you with a stronger breathing
process by sending the astral body into the ether body to
impose form.”(3)
For patients with acute or chronic back pain in the
lumbar region (low back pain), especially women, I have
found Kalium carbonicum to be remarkably effective
and fast-acting on thousands of occasions. I give the 30x
locally s.c., later adding the 20x per os, 7 drops once or
twice daily, or, if not sufficiently effective, the 10x, one
ampoule three times a week, with the 10x, 7 – 12 drops
once or twice daily, given in addition.
· Vegetable poison processes and Carbo preparations to
treat syndromes of the thoracic and cervical spine
This mainly involves potentized poisonous plants
with alkaloids and other secondary nitrogenous com-
pounds—e.g. Rhus toxicodendron, Aconitum, Belladon-
na or Gelsemium in potencies ranging from the 30x to
the 6x, letting the appropriate vegetable simile of ex-
cessive conscious activity take over the destructive astral
activity in the physical body and symbolize it for the I.
This ultimately addresses the human I-organization, ask-
ing it to overcome the excessive astral activity (which in
a way makes the human being too “animal-like”) and
support the astral body in a calm process of breathing
through and creating inner light for processes of con-
scious awareness.
In his first medical course, lectures 9 – 11, Rudolf Stein-
er mentioned that charcoal should also be considered as
a constitutional medicine, for Carbo vegetabilis is indi-
cated “when the human being grows too animal-like”.
This tendency can be seen particularly in pain syn-
43
dromes affecting the back of the neck and the thoracic
spine. Animals physiologically need increased muscle
tension in this region to hold the head horizontal and as-
sist with feeding. The carbonization process also relates
by nature to the whole of renal function, including the
retroactive regulative influence on the major and more
subtle respiratory processes in the organism. We are
thus addressing central aspects of the pain process.
For the treatment of spasms and pain in the region of
the thorax and back of the neck, and of syndromes af-
fecting the thoracic spine and back of the neck, special-
ly carbonized preparations of poisonous plants may be
of value, an example being Carbo tabaci (20x amp. s.c.).
Using the three groups of medicinal agents consid-
ered above, metamorphoses of the carbon dioxide
process in the human being, we influence above all the
respiratory processes that create and dissolve substance.
These processes act from the I and astral body via the
ether body down into the physical body, which is partic-
ularly important for the smooth function of cartilage
and other connective tissues.We are influencing carbon
in the sphere of life, providing the basis for the creation
of all organic matter and being the internal physical sup-
port structure for the body, the “house” in which we live.
II The role of silica as a physical instrument for the I’s
sensory activity
Silicon in form of silicic acid is the polar opposite of
carbon dioxide for medicinal purposes. It supports not so
much the internal creation of matter to build up the
body right down to the physical level, to the supportive
skeletal function, but more the translucent peripheral
configuration that serves sensory perception.
Quartz and most other silicates are translucent and
therefore capable of being instruments for the I’s per-
ceptive functions in the physical world. Carbon, on the
other hand, takes effect in the dark internal regions, go-
ing all the way to calcium deposition and the develop-
ment of bone.
Silica is a form principle in all sense organs. These
may be said to be “windows” in the “house” that is our
physical body, enabling us, who are endowed with soul
and I, to receive, perceive and digest the influences from
the outside world. In the first place, silica establishes de-
fined limits and configuration, for sensory perception is
only possible where clear boundaries exist—initially
against the outside world, as in the region of the cornea
and retina in the eyes, for example, and in the region of
the eardrum and oval window in the ear. Such bound-
aries hold back the influence of laws that belong to the
outside world, always permitting only a specific quality
of that outside world to go through—light for example,
or sound, or temperatures, qualities of smell or taste.
Silica deficiency in the region of one of these organs
therefore means that boundaries are too thin. The win-
dow of the sense organ is too wide open, as it were, and
all kinds of influences come in from outside. Hypersen-
sitivity to sensory impressions is the result.
44 D e r M e r k u r sta b | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t
On the other hand the I-organization has to make ef-
forts to penetrate silica, which has a great inherent ten-
dency to crystallize, with warmth, so that the silica will
not follow those inherent tendencies and deposit in the
organism at will. In that case the organ-typical metabo-
lism gets out of tune, with drying and hardening phe-
nomena developing. Sensory perception then finds an
organ encrusted with silica that has dropped out and be-
come physical. The glass in the “window” has grown old
and opaque, as it were.The object of perception will then
be the organ thus made physical and not the outside
world. One experiences problems with directing percep-
tive processes and all correlated movement functions,
with interference due to self perception of the organs.
This may for instance show itself
- in the sense of movement as no longer really hav-
ing awareness of one’s legs and being able to keep
them straight, so that they may suddenly threaten
to fold up,
- in the sense of balance as vertigo,
- in the sense of hearing as tinnitus, possibly in con-
junction with incipient deafness,
- in the sense of sight as partial loss of the field of
vision, flashes before the eyes, and the like.
The last-mentioned tendency of sensory activity to
grow duller, with silica deposits, aging, hardening and
impenetrability in the development of the sense organs,
is a tendency typical of advancing age, and also of being
hard of hearing and developing cataract. Here the phys-
ical body is too independent, sclerotizes, and grows sim-
ilar to the mineral world outside because constructive I-
activity is no longer all-present in the blood.
Sensory hypersensitivity due to silica deficiency in
the organic region is typical for the way children fall ill.
The body is still too soft, not fully formed out, with a ba-
sic inflammatory tendency and the sentient body pre-
dominating over the I-organization.
In a wider sense, every organ is also a sense organ,
perceiving the activity of the other organs. These per-
ceptions interact with specific correlating factors in the
outside world (e.g. climatic factors in the earth’s envi-
ronment); inwardly they find their boundary in coming
up against the unconscious processes of metabolism
and growth, where the will is active. (4)
· Structuring silica exhibited to reduce sensitivity if there
is a silica deficiency syndrome (hypersensitivity)
Ultimately it is then a matter of looking at the indi-
vidual symptoms of each patient to see if hypersensitiv-
ity preponderates, i.e. insufficient silica activity, and the
organism as a whole or a given organ region needs to be
supplied with silica, or if on the other hand there are sil-
ica deposits and signs of problems with directing activ-
ities and a weakening of sensory functions, so that silica
needs to be brought into solution and eliminated via the
kidneys.
Certain tendencies are more disease-typical rather
than individual, however. Bekhterev’s disease, where em-
phasis and onset are in the sacral region, is rather con-
English Issue 2004
comitant with silica deposits, so that typically, patients
will also take no notice of the pathologic process for
years.
With peripheral joint diseases in the extremities, e.g.
rheumatoid arthritis, and a more marked tendency to in-
flammation and dissolution, hypersensitivity and there-
fore silica deficiency are present at least in the synovial
membranes, as evident from sensitivity to the pressure
of a handshake, for instance.With this kind of hypersen-
sitivity in corpulent patients showing weakness of the
form principle, Quartz itself (trit. 6x to 3x) may be given,
or other silicates, or horsetail (Equisetum arvense) as a
tea of in low potency. The plant contains large amounts
of silica in solution which is in an amorphous form tak-
en into the sphere of life (as opal).1
Quite generally, it appears to me that clinically the ex-
hibition of silica in form of quartz, Equisetum or related
preparations with high silica content is most frequently
indicated when treating the region of the upper verte-
bral column and the upper extremities. Constitutional
hypersensitivity to cold and drafts, for instance, often
goes hand in hand with this. For patients of a lean, trans-
parent neurasthenic constitutional type I start with the
30x or 20x s.c.; for stout, unstructured types with the
emphasis on metabolism I use silica in low potency or
material doses, as described above.
· Dissolving sulphur functions to treat silica deposition
syndrome
Sulphur specifically has the power to dissolve physi-
cal deposits. It may thus be used as such, or in the prepa-
ration Equisetum cum sulfure tostum. This is produced by
roasting dried horsetail plants over hot sulphur fumes,
paradigmatically allowing the sulphur function to act on
horsetail silica which has been taken into drying and
condensation processes.
In my experience, Equisetum cum sulfure tostum has
proved highly effective in practice when treating such
conditions, e.g. ankylosing spondylitis, chronic arthri-
tides and related syndromes with hardening and depo-
sition, such as meniscopathies. Initially it needs to be
given long term, using the 15x locally s.c. when uncer-
tainty of movement and inability to follow intent show
themselves in conjunction with a reduction in the po-
tential for perception and tendencies to harden and dry
out. Later it may, if indicated, also be given in the 6x or
4x (the latter if there are marked tendencies to develop
edema, with watery swellings).
The drier and more hardening the gesture of the dis-
ease, the more does the higher potency (15x) prove ef-
fective.
· Dissolution and dispersal of silica to treat mixed syn-
dromes
In many cases one does, however, find a combination
of silica-function disorders, i.e. hypersensitivity in one re-
gion, e.g. the upper extremities with rheumatoid arthri-
tis, and at the same time the phenomena of silica de-
posits and failure to respond to intention occur in the
English Issue 2004 | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t | D e r M e r k u r sta b
large joints of the lower extremities, which are, of course,
more exposed to the physical forces of gravity.
The way I see it, the preparation Solutio silicea comp.
is a kind of archetypal model for this dissolution and dis-
persal of silica. It has been developed as a mineral com-
position on the model of Equisetum arvense. Sulphur in
gaseous form is passed into an aqueous solution of al-
kaline salts (carbonates of potassium, sodium and calci-
um), which initially form an insoluble sediment (mainly
calcium carbonate) to convert this into sulphates of
potassium, sodium and calcium which are easily soluble
in an aqueous medium. Potassium silicate is then melt-
ed in a hot furnace and dissolved in distilled water. This
highly alkaline silica solution at pH 13 is added dropwise
to the solution of sulphuric salts, with the gas still
passed through. In this rhythmic, bubble-forming aerat-
ing process which creates large surface areas, sulphuric
acid (representing the dissolving powers of metabolism)
and silica (representing neurosensory processes) finally
establish a new dynamic equilibrium in the fluid sphere.
The process also involves increased “exhalation” of car-
bon dioxide liberated from the carbonates.
In this special manufacturing process, silica is intro-
duced in a previously heated and dynamized, easily sol-
uble form, whilst solution of the salt principle (carbon-
ates of calcium, sodium and potassium) by using the sul-
phur function also means that silica exhibition and sili-
ca solution are both stimulated by the sulphur function
in the sick individual and taken to a rhythmic equilibri-
um.The medicament may thus be considered to be a hu-
man archetype for the right way of distributing silica ac-
tions out of the powers of the I-organization.
The indication for exhibition of silica is more fre-
quently indicated for the region of the upper spine and
the upper body altogether, as these are functionally
more connected with the neurosensory system. Silica
deposition, on the other hand, seems to be more com-
mon in the region of the pelvis and lower extremities;
here one might first—if deposition occurs on its own—
think of Equisetum cum sulfure tostum, or, for problems
with silica distribution, particularly in the region of the
thoracic and lumbar spine, of Solutio silicea comp. (15x
amp., locally s.c.).
The compositional ordering power of colony-form-
ing insects
As medicinal agents, colony-forming insects bring or-
der into the interaction between physical body and ether
body. The individual animal is, however, an integral part
of the wise I-like activity of the colony, and this estab-
lishes the relationship to the human I-organization.
The wood ant,Formica rufa,relates most powerfully to
the animal world, living in symbiosis with hundreds of
small animals such as beetles and aphids.The toxic effect
of formic acid,a respiratory poison,removes animal pests
that become too preponderant in woodland. It thus em-
bodies a regulative function at the astral level, establish-
ing an ecologic balance among woodland life communi-
ties and also on the soil, i.e. in the sphere of physical
45
forces. Formica is therefore of great value if there are
hardening processes,with respiration inhibited and acids
accumulating in the sphere of organs. Local injections
(3x or 4x) stimulate the astral body to respiratory activi-
ty and hence elimination of the local lactic-acid acidosis.
This treatment combines well with a potentized poison-
ous plant such as Rhus toxicodendron (30 x, 10x),
Tabacum, Belladonna or similar, which reduces pain, for
instance in a combined injection given locally.
Formica thus relates especially to the human chest
and neck region with its astral qualities. The honey bee,
Apis mellifica, on the other hand, is more plant-related. It
carries pollen and collects nectar, taking plant substance
to the ensouled animal level and finally, in making hon-
ey, to a level related to the human. In this process, where
warmth plays an even greater role, the beehive with its
pulsating inner life relates more strongly to the human
heart and circulatory system. Apis preparations used to
treat spinal conditions therefore address particularly the
I’s activity in the etheric—the lumbar region. In many
cases, e.g. with lumbago and lumbar cum sciatic pain, it
is therefore helpful to inject Apis or Apis cum Levistico 3x
not in the area where the pain is but at the level of the
heart and to the left of the lower to middle thoracic
spine. This is an area where these patients often have
trigger points or myogeloses that are painful on pres-
sure.
Use. The more ample and inflammatorily softening
the constitutional disposition, the higher should the
chosen potency be as a rule (6x – 30x, with the 10x and
12x proven particularly effective). If the constitution is
more going in the direction of hardening, forming de-
posits, the lower, 3x potency has proved of real value, es-
pecially in form of Apis cum Levistico D3 (= 3x) amp. s.c..
Here the poisonous astral momentum of the bee’s ven-
om is enveloped in the vegetable mucilage of lovage and
taken up into the etheric. The organism is thus given an
example of close interpenetration of astral body and
ether body, a medicinal principle that is particularly
helpful if the ether body is weakened, as it can prevent
the energizing astral (toxic action) from “striking
through”into the physical body (resulting in destruction
and increased pain).
The hornet, Vespa crabro, is the colony-forming insect
with the heaviest body and deepest, resonantly vibrant
sound. It builds its nests in hollow tree trunks, using dead
matter such as wood and paper made coherent with sali-
va. The hornet is orientated more towards dead physical
matter and is able to integrate this into a new form com-
plex. Medicinally it is therefore particularly helpful with
processes of marked physical hardening in the iliosacral
joints or on tendons or in other connective tissue areas
such as Dupuytren’s contracture,hardening forms of sub-
cromial bursitis, or annular ligament stenosis.
Use. Where reactive inflammatory processes are in-
volved, the 6x – 30x s.c.; the 3x amp. if hardening only.
Fig. 1 gives a synopsis of typical medicines from the
different realms of nature and the related regions of the
vertebral column. It is intended to give orientation only,
46
Notes
1) Silica is not easily sol-
uble in water. The
horsetail should there-
fore be put in cold wa-
ter, brought to the boil
and kept simmering for
15 – 30 min. to extract
the silica.
2) If there is a history of
allergy to bee or wasp
stings, patients will ac-
tually respond particu-
larly well to Apis or
Vespa if these are given
in higher potencies, e.g.
the 10x (6x) or higher,
avoiding the 3x/4x.
D e r M e r k u r sta b | S i m o n | F o u r f o l d - d i a g n o s i s a n d c o n st i t u t i o n a l t r e at m e n t English Issue 2004
as individual assessment and adaptation are needed in Literatur
1 Rauber, Kopsch. Anatomie des
the given situation.
Menschen, hrsg. u. bearb. von B.
A few days ago a patient impressed me deeply as she Tillmann u. G. Töndury. Bd. 1 (Be-
described the effect which a single injection had on her wegungsapparat), Stuttgart
1987, S.96 und 216 – 220.
back pain. The woman, aged 41, had acute pain in the re-
2 Steiner R. Geisteswissen-
gion of the lower thoracic spine as part of a mild schaftliche Gesichtspunkte zur
seronegative spondylitis. She had been my patient on ac- Therapie. 4. Vortrag. In GA 313.
Dornach: Rudolf Steiner Verlag,
count of this for a short time. I gave her an injection of
1963.
Equisetum D15 Formica D10, 1 ampoule s.c. in the painful 3 Genaue Darstellung dieses
area of the mid-thoracic spinal region. A few days later Heilmittels
siehe in Simon L. Die umgekehr-
she telephoned to say that the pain had gone complete-
te Pflanze – Zum Heilmittelver-
ly after 30 minutes, but she had found herself weeping ständnis von Kalium carboni-
and weeping. It became clear to her that having a job cum. Merkurstab 49 (1996), 131 –
151.
and caring for the family at the same time was simply
4 Steiner R, Wegman I. Exten-
too much for her. “Your injection removed the armor- ding Practical Medicine. Funda-
plating around the heart, and as a result I was able to see mental Principles based on the
Science of the Spirit. Chapter 14.
this,” she said. This apt formulation used by the patient
Tr. A. R. Meuss. London: Rudolf
demonstrates the long-term key issue in treating chron- Steiner Press 1996.
ic conditions: With all medication, complemented with 5 Eingehendere Schilderung der
hier nur kurz angedeuteten Heil-
massage, eurythmy and other therapies, it is a matter of
mittel und therapeutischen Prin-
supporting the functions of the I in the body to such ef- zipien findet sich in: Simon L.
fect that the soul principle, held fast in the body by pain, Substanzen und Heilprozesse zur
konstitutionsgemäßen anthro-
is liberated and can go through further development to
posophischen Therapie der chro-
gain new insights. The human being can then find him- nischen Polyarthritis. Merkur-
self in a new way. stab, Sonderheft Rheumatologie,
54. Jg., März 2001, 32 – 59.
Ludger Simon, MD
Vaihinger Str. 24
D-70567 Stuttgart
English Issue 2004 | H ü b n e r | Ve r t e b r a l c o l u m n a n d s p i n a l c o n d i t i o n s | D e r M e r k u r sta b
The vertebral column and spinal conditions
at different stages in life
Michael Hübner
■ Abstract
I
The patients of a specialist orthopaedic practice
could be divided into three age groups, each pre-
senting with specific problems. The vertebral co-
lumn, differentiated in space, is subject to typical
conditions according to the time of life. The diffe-
rent conditions are considered, with suggestions
made for treatment.
■ Keywords
Polarity of Scheuermann’s disease and scoliosis.
Osteoporosis and degenerative diseases of the
spine.
Acute and chronic pain.
Syndromes in the spine.
47
Differentiation of the vertebral column
n Anthroposophical Medicine, the physical body is
seen as a threefold entity, with neurosensory system
on the one hand and metabolism and limbs on the
other as polar opposites, and the rhythmic system acting
as a mediator and establishing balance. A brief descrip-
tion of this (in German) is given by Goyert.(1)
The rhythmic differentiation in space into vertebrae
and intervertebral discs shows that the vertebral col-
umn relates to the middle system. However, strong mus-
cles around it and marked differentiation of muscles in
the region and neck and shoulder do also point to the
system of limbs. The highly articulated cervical spine (2)
makes subtle movements of the head possible. The
“head” articulations (C0 to C2) may be called “joints that
speak”, for it is with their help that human beings indi-
cate agreement, negation, doubt, weighing things up,
and so on. (3, 4)
The gesture of thoracic spine and ribs combined has
a more protective, embracing character, with kyphosis
making space for the typical rhythmic human organs of
heart and lung.
The lumbar spine takes up the style of skull develop-
ment in its transition to the pelvis, developing the prin-
ciple of synarthrosis in the sacroiliac joints. Blockage or
indeed complete stiffness is common in these areas.
The arms and legs, locomotor organs, are connected
with the vertebral column by the shoulder and pelvic gir-
dles respectively. Through the “false” back muscles (e.g.
trapezius and latissimus dorsi muscles), the spine is in-
volved in every arm movement. X-rays have shown (5)
that arm movements are accompanied by a slight scol-
iosis towards the relevant side. The same applies to
walking, with the raising and lowering of the pelvis also
involving movement of the lumbar spine. The vertebral
column is therefore passively involved in all movements
of the limbs.
Age distribution and specific issues
The patients attending a specialist orthopedic prac-
tice can be differentiated in three groups according to
age, each having specific needs and concerns:
1 Children and young people where posture is an is-
sue, including manifest spinal conditions such as
Scheuermann’s disease and scoliosis,
48 D e r M e r k u r sta b | H ü b n e r | Ve r t e b r a l c o l u m n a n d s p i n a l c o n d i t i o n s
1 2
2 conditions affecting the spine in old age, such as de-
Fig. 1 – 4 show the
generative changes and osteoporosis,
evolution between
1999 and 2002. 3 people of middle age with constitutional diseases or
psychosomatic problems that are frequently accom-
Fig. 1 panied by spinal syndromes.
clearly shows left-
convex thora- With the first group it is the parents who seek advice.
columbar scoliosis, Issues concerning the future predominate, and in diag-
with marked nosis one has to consider the form of the vertebral col-
asymmetry of the
shoulder blades
umn—will it serve for life?
and grid lines In old age, the need for treatment predominates;
showing upward changes in the vertebral column cause radicular or
displacement. pseudoradicular pain.The physical body is in pain.The fo-
cus is on the past. “I ruined my lower back when build-
ing a house after the war.”
People of middle age, and we may here consider the
period from the 25th to the 55th years of age, present
above all with what are called spinal syndromes, and
these may involve recurrent and persistent pain. Current
problems in body or also soul will come to the fore again
and again with the pain. Herniated nucleus pulposus de-
velops in this age group.
Scheuermann’s disease and scoliosis
Between prepuberty and puberty, two conditions of
the spine are also gender-specific—Scheuermann’s dis-
ease among boys and scoliosis among girls.
Braces are rarely needed with Scheuermann’s dis-
ease, but with progressive scoliosis there is no other
English Issue 2004
way. The braces should be provided at a center where
people have the relevant experience. The Charleston
Bending Brace has proved effective. It is only worn at
night, when it stretches the shortened muscles. It is on-
ly suitable for scoliosis of the lower thoracic and upper
lumbar spine. Experience has shown that primary lum-
bar scoliosis is markedly less progressive than those of
the thoracic spine. Scoliosis at a high level of the tho-
racic spine can in fact hardly be treated with a brace.Tor-
sion causes a distinct costal hump and is often treated
surgically.
It is thinkable in this case that the upper spine is al-
ready caught up in the dynamics of head development,
of the sphere, whilst the lower spine follows more the
tendency of the radial form, of the limbs. This could ex-
plain the difference in progressiveness.The vertebral col-
umn itself follows the configurative principle of the lem-
niscate, the loop. (6)
Apart from a brace, where indicated, or surgery,
movement therapies will be required. It is helpful to al-
ternate between remedial gymnastics and eurythmy
therapy. The latter can address the deforming forces di-
rectly, thus preparing the field for gymnastics which ad-
dress the movement system.
Measures to reduce spasms are useful, e.g. rhythmic
massage and medicaments such as Magnesium phos-
phoricum, Cuprum, Calcium phosphoricum and
Chamomilla.
English Issue 2004 | H ü b n e r | Ve r t e b r a l c o l u m n a n d s p i n a l c o n d i t i o n s | D e r M e r k u r sta b
3 4
Case record
Veronika, now 12, started treatment in 1995. Develop-
ment had clearly been slow: sitting freely at 13 months,
walking freely only when almost 2 years old. Rickets was
suspected but not confirmed. At age 5, slight left-convex
lumbar scoliosis. Both hips were found to be capable of
asymmetric rotation at 90º flexion, with limited inward
rotation on the left. The child was very thin, also thin-
skinned, with poor appetite, still wetting the bed at age
5, and great anxieties.
Treatment started with eurythmy therapy, using the
specific scoliosis exercises—L, I [German I sound) and
rod exercises.
In 1996, hip rotation was possible bilaterally; in eu-
rythmy therapy, A [German A sound] was much prac-
ticed, among other things. Ferrum rosatum-Graphites
was given by mouth. From 1997, remedial gymnastics
and eurythmy therapy alternated on a regular basis. In
1998, exhibition of Calcium phosphoricum LM18, after
which the mother reported that the child found it easi-
er to come upright. 3-D and X-ray studies by the Copp
method showed that from 1999 onwards the scoliosis
angle had, as against 1995, changed from 21º to 32º. A
Charleston Bending Brace was applied, causing no prob-
lems with sleep.The same year, the constitution showed
a degree of consolidation; she grew stronger and gained
some weight.
49
In 2000, both raster stereography and clinical exam-
ination showed a marked improvement in the scoliosis,
and this held true also for 2001 and 2002 (Figs 1 – 4).
Last time seen on 4 Nov. 02. Height 159 cm, weight 37
kg, height expected to reach 167 cm.
Physically and mentally the child has definitely
grown more stable, with former anxieties overcome. No
problems known with school.
The period of observation has been 7 years and an an-
nual follow-up has been agreed on.
Brief outline of 3-dimensional raster stereographic
optrimetry
Photo optic method, where a camera at an angle of
45º projects a set of lines on to the back. The lines as-
sume wave forms reflecting convexities and concavities
on the back by deviating in an upward or downward di-
rection. Evaluation is not exclusively with a computer, for
the actual image allows the observer to judge for him-
self. The images can be stored chronologically and are
always available for comparison.
Case review
After primary retardation of development, the astral
body seemed to come awake very early.This caused great
anxieties and muscular imbalances as evident from the
different degree of rotation in both hips and manifest
scoliosis. Continuous remedial gymnastics, eurythmy
therapy and intermittent exhibition of a number of
50 D e r M e r k u r sta b | H ü b n e r | Ve r t e b r a l c o l u m n a n d s p i n a l c o n d i t i o n s
medicaments (Ferrum rosatum-Graphites, Hypoph-
ysis/Stannum, Ferrum sidereum 20x, Calcium phospho-
ricum LM 18, Organum quadruplex) brought continuous
improvement in both the physical and the psychological
constitution of the child. My interpretation of the re-
markable response to Calcium phosphoricum is that the
I-organization was addressed at the right moment and
developed its balancing action. (7) It is important to note
that progressive scoliosis makes the wearing of a brace
important, at least at night. A major study has shown
that wearing a brace continually for 23 hours, as usually
prescribed, fails to take account of the reality of life and
is not tolerated by the young people.(8)
The evolution of Scheuermann’s disease in boys is
generally less striking and markedly less progressive.
Weak posture increases pressure on the ventral margins
(annular apophyses) of the vertebral bodies, causing
malformation and hence the typical wedging. Early
symptoms respond well to Plumbum silicicum 30x and
Disci comp. cum Nicotiana. This cannot be expected to
prevent deformation, but the pain, probably due to irri-
tation of the periosteum, disappears quickly. It stabilizes
the vertebral bodies.
Tonic and phasic muscle—muscles for holding pos-
ture and for movement
A look at the musculature may be well worth while
when considering the two spinal conditions seen in
young people.
Imbalance in the tonic extensor muscles of the back
plays a crucial role in the development of scoliosis. Mus-
cles are shortened unilaterally, causing the vertebral col-
umn to bend in the frontal plane where it should really
be completely vertical.
Muscle essentially consists of two types of fiber—
tonic and phasic (slow and fast). Muscles that are more
tonic (postural musculature, e.g. erector spinae) tend to
shorten and go spastic, which is not the case with pha-
sic muscle (e.g. biceps brachii).
It is my impression that the female gender relates
more to tonic muscle and therefore has more of a ten-
dency to develop scoliosis, whereas the male gender re-
lates more to phasic muscle. Experience has shown that
girls maintain the upright position very much better
(based on tonic muscle) than boys. On the other hand it
is a fact that boys are frequently better than girls at run-
ning (phasic muscle).
Scoliosis may thus be seen as local hypertonicity, and
Scheuermann’s disease as hypotension in the tonic mus-
cles of the back.
Both conditions need to be seen as processes.The ex-
ternal physical signs are the outcome of a process that
has continued for years, as a rule within the second sev-
en-year period. Observations and check-ups by school
doctors are important at that stage of life. A course of
eurythmy therapy at the right time can be of great ben-
efit, counteracting the forces that seek to deform the or-
gan of uprightness.
The dual nature of muscle can be seen even in the
two muscle proteins actin and myosin. Myosin is a rod-
English Issue 2004
shaped peptide, action a globular molecule. (9) Both pro-
tein structures are necessary for movement. We thus
have the astonishing fact that a protein with spherical
and another with radial structure meet and make move-
ment possible, i.e. they create a short-term actomyosin
complex, which is not a chemical compound but a tem-
porary complex. (10) A compound would meet the con-
ditions for reproduction.
Little work has as yet been done on the role of mus-
cle in the genesis of scoliosis and Scheuermann’s dis-
ease. Yet it is very evident—muscle, as an organ of the
will, matures and comes to its full power in puberty. The
muscle tone must be right. If it is “untuned”, spasms and
hardening will develop on the one hand, and postural
problems on the other.This contributes to the genesis of
the above-mentioned spinal conditions.
Osteoporosis and degenerative conditions of the
spine
In the third group of patients, degenerative changes,
which to a degree also include osteoporosis, are pre-
dominant. Medical treatment gives good results.
Years of observation have shown me that senile os-
teoporosis can be effectively treated with Agaricus
comp./Phosphorus twice a week for 2 months, 1 ampoule
twice a week s.c., and then a lead salt such as Cerussite
8x, Barysilite 20x or Pyromorphite 8x s.c. twice a week for
one month. Bone density monitoring has shown partial
maintenance of, and even improvement in, bone densi-
ty. Annual check-ups will suffice.
The course of treatment may be repeated for years,
depending on the findings or need; it is also possible to
change to oral medication as an alternative. I am not
sure how far periclimacteric osteoporosis gives a similar
response, as the number of my observations is small. I do
have the impression, however, that justification for the
method is not the same in this case as with involutional
or “senile” osteoporosis.
With crush fractures due to osteoporosis, Symphy-
tum comp. amp. (Wala) given daily together with Perios-
teum D5 amp. (Wala) can be relied on to help. The pain,
which is often severe, goes down within days.
Degenerative changes in the vertebral column will,
among other things, frequently also involve spinal clau-
dication, with the walking distance markedly reduced.
Reducing the lordosis, e.g. by an inclination, relieves the
spinal canal, and patients will stop again and again and
make this movement. In this situation one may assume
the syndrome of a narrow spinal canal to be present. Ap-
propriate CT or MRT studies will provide verification.
Disci comp. cum Stanno 10 ml amp. (Wala) combined
with Mandragora D4 (Weleda) and Secale/lead glance
(Wala) has proved effective in my practice.
The polarity between osteoporosis and the typical
degenerative conditions of the spine (osteochrondrosis,
spondylitis) never fails to strike one when seeing the X-
rays. The typical osteoporosis picture usually shows no
degenerative changes at all but merely the typical lon-
gitudinal striation of vertebral bodies, possibly also with
English Issue 2004 | H ü b n e r | Ve r t e b r a l c o l u m n a n d s p i n a l c o n d i t i o n s | D e r M e r k u r sta b 51

changes in the cortical end plates.Transverse trabeculae ca Levisticum D3 Weleda (caution – Apis allergy), or Apis
become rarefied with osteoporosis, so that the longitu- Levisticum I Wala. Apis is the organizer of lymph. In the
dinal trabeculae have to bear more pressure and stand middle region of the spine, the thoracic duct as a collec-
out more in the X-ray. tor of lymph enters into the vascular system. The meas-
With degenerative diseases, on the other hand, we ure therefore addresses lymph flowing from the periph-
see the typical densification in the X-rays. It is important ery to the center.
to differentiate between the two in older people, so that Other measures to give relief are Solum uliginosum
the right medical treatment may be given. Again I have (Wala), 10 ml i.v., and locally, at the level of the hernia, Dis-
found X-rays very helpful in making the diagnosis and ci comp. c. Argento. Analgesics in homeopathic potency
gaining indications for the required treatment. (Con- should be added, e.g. Colocynthis, Rhus toxicodendron,
cerning osteoporosis, see the paper by Matthias Girke.) Aconite. (12) The injections should be paravertebral and
i.m.
In the second group of conditions affecting the
Patients who are more phlegmatic and melancholic
spine—in people of middle age, more or less between
will hardly develop such severe pain, but their back prob-
the 25th and 55th years of age (with gradual transi-
lems will hardly ever come to an end. X-rays mostly show
tions)—treatment is difficult.
protrusion of the intervertebral disk, for there is not the
These are the years when the vertebral column has to
strength to push the nucleus pulposus right out. In the
be considered in its psychosomatic aspects.You see signs
acute case described above, the back pain occurred once
of irritation of the autonomic nervous system, and con-
only. With these patients, on the other hand, one sees
stitutional and biographic elements also play a role. The
continually recurring syndromes. Treatment will often
problems show themselves among other things in re-
be constitutional, as already mentioned, and we may re-
current spinal syndromes, not infrequently ending in
fer to Ludger Simon’s paper.
herniated nucleus pulposus. The latter often indicates
something of a solution to the problem, and if worked Michael Hübner, MD
through properly such a process can be the endpoint af- Wellersweilerstr. 123
ter years of back problems. If this does not succeed and D-66538 Neunkirchen
surgical intervention may be necessary, the situation
may get even worse, ending in chronic pain.
Help is needed here to influence the chronic pain, us-
ing appropriate substances. Antirheumatics and other Reference 10 Kranich E.-M. in: Die mensch-
1 Goyert A. Kompendium für liche Nervenorganisation, Teil 1,
analgesics clearly help for the moment, but in the long die gastroenterologische Praxis. 1992, S.149
run lead to dependence and suppression of the actual Herausgeber: Gesellschaft an- 11 Weber M., Morgenthaler M.
problem. The physician’s task is above all to encourage throposophischer Ärzte in Die Bedeutung der Erweiterung
Deutschland, 70794 Filderstadt. der Berufskrankheitenverord-
patients to become active themselves, also bringing in 2 Kummer D. Morphologie und nung für die Beurteilung von
anthroposophical art therapies and eurythmy therapy. Biomechanik der HWS. In: Prakti- Bandscheibenschäden. In: Z. für
Dietary measures to relieve metabolism can be very sche Orthopädie, Band 19, Kassel, Orthopädie, Band 135, Heft 5,
1987. 1997, S.386ff.
helpful. 3 Husemann A. Vortrag Mai 12 Simon L. Schmerztherapie mit
2002, Orthopädischer Arbeits- homöopathisierten Heilpflan-
Acute and chronic intervertebral disc problems kreis Stuttgart. zen, Haug-Verlag.
The conservative treatment of herniated nucleus pul- 4 Kamieth H. Röntgenfunk-
posus is a positive thing for both physician and patient. tionsdiagnostik der HWS. In: Die
Wirbelsäule in Forschung und
Modern X-ray methods (CT) and nuclear spin tomogra- Praxis, Band 105.
phy have shown that herniated nucleus pulposus will be 5 Schmidt O. Skoliosefrühbe-
the rule in the course of life, (11) and there is hardly any handlung durch Elektrostimula-
tion, Band 45. Stuttgart, Enke,
person over 50 who does not have it.The hernia presents 1985.
no problems for as long as there are no symptoms. Prob- 6 SSteiner R. Relationship of
lems arise only when it irritates the spinal structures, the Diverse Branches of Natural
Science to Astronomy (GA 323).
leading to radiculopathies. Lecture of 12 Jan. 1921. Tr. R. Man-
Choleric and sanguine patients often have a large se- sell. California: Rudolf Steiner Re-
questered herniated nucleus pulposus which will usual- search Foundation 1989.
7 Steiner R. Relationship of the
ly cause raging pain. One tends to see a clearly definable Diverse Branches of Natural
radiculopathy, e.g. at L5 or S1.This situation, initially most Science to Astronomy (GA 323).
dramatic, will usually respond well to treatment. If the Lecture of 12 Jan. 1921. Tr. R. Man-
sell. California: Rudolf Steiner Re-
pain is unbearable, an initial dose of cortisone, e.g. an in- search Foundation 1989.
fusion of 32 or 64 mg of Urbason®, is helpful to relieve 8 Bönie T. u.a., Ideopathische
the situation at the physical level. It is a matter for the Skoliose und Scheuermannkyp-
hose. In: Der Orthopäde, Band 31,
physician to decide. Heft 1, Seite 11 ff.
To bring down the swelling, which is of primary im- 9 Leonhardt Helmut. Histolo-
portance, subcutaneous injections of Apis given be- gie, Zytologie und Mikroanato-
mie des Menschen. 7. Auflage,
tween the shoulder blades are highly effective, e.g. Arni- Thieme Verlag, 1985.
52 D e r M e r k u r sta b | M e y e r | Q ua l i t i e s o f r h y t h m i c a l m a s s a g e English Issue 2004

Qualities of rhythmic massage and its potential

for spinal conditions
Ricarda Meyer

Wegman/Hauschka rhythmic massage

I
■ Abstract n the 1920s, Dr Ita Wegman developed rhythmic mas-
Overcoming gravity is natural to humans and re- sage from Swedish massage, doing so on the basis of
flected in their upright posture and freedom of the anthroposophical image of the human being. Lat-
movement. Today a number of influences cause er on, Dr Margarethe Hauschka developed the method
people to be increasingly subject to gravity. Back further and made it teachable.
problems going as far as deformation of the spine With serious consideration given to the higher nature
tend to develop at a relatively early age. Rhythmi- of the human being, it became necessary not only to ex-
cal massage involves techniques that address tend pharmaceutics and to develop the art therapies,
lightness and the force of buoyancy in the body, to but also to take up massage techniques in a new way. Dr
strengthen the living organism and powers of self- Wegman sought to do justice to the whole human be-
healing. Tissues are deeply breathed and warmed ing by means of qualities which in the process of bodily
through, resolving tension in both muscles and contact address both the vital energies and the patient’s
the psyche. The human soul and spirit is thus “invi- spirit and soul.
ted” to enter into a new relationship to the orga-
Buoyancy
nism, with inner equilibrium given new form. This
A first step is to overcome gravity in touch and there-
gives rhythmical massage its great importance.
fore also to avoid pressure. Pressure and gravity belong
■ Keywords
to the material, physical, earthly principle. Forces oppos-
Wegman/Hauschka rhythmical massage
ing it are, however, always active in the human body, and
Buoyancy
we may call them levitation or buoyancy. These forces
Qualities of touch
provide the basis for the unfolding of life.
Overcoming gravity
In the plant world we see life turn vigorously away
Guided movement
from the earth and towards the sun. The orientation is
Effleurage
heliotropic. A wonderful way of bringing this to aware-
Kneading
ness is also to consider how much water is drawn up a
Contraction and relaxation
tall tree on a summer’s day, against earthly gravity, so
Other manoeuvres in rhythmical massage
that it rises up into the leaves and evaporates. In the liv-
Lemniscates
ing organism, water is the vehicle for forces of buoyan-
Rhythm as basic principle
cy, and does also follow the laws of levitation itself.
Relationship to the spine as an organ
Healthy intervention of the human soul and spirit in
Therapeutic potential
the living organism lets human beings overcome gravi-
Rhythmical applications to organ regions
ty. This comes to expression in their ability to come up-
Encouraging patients’ own activity
right. Human beings show freedom in holding their po-
Example of a case record
sition between heaven and earth.
Treatment profiles
The vertebral column is a reflection of these influ-
ences.
If the influences of the earthly forces of gravity can-
not be sufficiently overcome, or if imbalance develops in
the interplay between life, soul and spirit, different forms
Note
1) A wash basin will be of diseases may arise.
adequate for a first at-
tempt; a larger surface Qualities of touch
does, however, permit
How can rhythmic massage balance and heal disor-
greater freedom of
movement. ders and diseases of the vertical column as an organ and
English Issue 2004 | M e y e r | Q ua l i t i e s o f r h y t h m i c a l m a s s a g e | D e r M e r k u r sta b
of the whole back? To show this, I would like to begin by
considering the different massage techniques in some
detail.
Overcoming gravity
As mentioned above, the therapist must overcome
gravity in touch. This means overcoming the gravity of
one’s own body, standing in a relaxed state of inner
buoyancy (perhaps best compared with the power of
coming upright in eurythmy, or the inner buoyancy one
may know on the seashore or standing on a mountain
top as the sun rises, able to take in the beauty of the
movement in great calm and with reverence). The
masseur must allow this buoyancy to enter into his arms
and hands.
Guided movement
Movement is guided by the perceptive hand. Neither
arm nor elbow must play an active part. All joints are re-
laxed, merely letting the movements sound through
them. This prevents angular work, or following a beat,
and avoids thrusts transferred to the patient from body
and arm movements that arise out of one’s own will.
In spite of the inner buoyancy it is now, however, nec-
essary to make warm, full, soft contact with the patient’s
body surface. A touch that is too light will feel unpleas-
ant, cold, ticklish or unsure.
An exercise for this. Put your hand on the surface of
some water.1 Connect your palm with the water surface
without letting it sink into it. If you now raise the middle
of the hand very slowly, the water will at first cling to it,
following your movement.You are able to lift the surface
water out of gravity a little bit, as with a suction cup. You
let this contact go again by relaxing your hand. Circling
and stroking movements of this quality which you do on
the surface of the water continue on into deeper levels.
Vortices and waves arise under your hand, currents and
streams. The same principle also applies in body fluid.
Effleurage
The first quality, gently connecting with the tissues
and taking them along into streaming, flowing move-
ment, is effleurage or stroking.
Kneading
If the tissues are to be set in motion more strongly,
the massage technique used is that of kneading (petris-
sage).The hand connects even more intensively with the
tissues, entering into them. Pressure must again be
avoided. In rhythmic massage, this quality of entering
may be described as listening intensely, feeling your way.
The masseur must practice entering sensitively into the
tissues, and on the basis of this develop an inner con-
nection with the depths. Entering is followed by a phase
of letting go, with the hand feeling and sensing the tis-
sues and calmly letting them go. A stroking movement
makes the connection before entering again, or the hand
enters in the same place.
Kneading may be done with one or both hands, de-
pending on the area on the body one is treating. When
kneading with both hands, the tissues are first con-
53
densed by bringing the hands together, and are then Note
2) The processes re-
taken along into the relaxation stage that follows. This ferred to are given as
creates a deep-reaching suction effect. It is also called examples and are not
exclusive. The approach
“condensation whilst lifting off”. will be different for
To stay with our image of the surface water—a gen- each patient, and dif-
ferent qualities and
tle wind passing across calm waters creates a movement aims will be mutually
similar to stroking. If the wind is stronger, the surface complementary.
first becomes ruffled and then waves of different sizes
arise.
Binding and release
The quality of kneading is determined by the intensi-
ty and the relationship between the different phases.
The deeper the hand enters into the tissues, the more
can they be set in swinging motion.
Entering gently, with a slow, calm release phase of the
hand, puts the emphasis on release, exhalation, in the
tissues. Entering strongly and deeply, in conjunction
with feeling one’s way through and molding, promotes
local awareness and binds the element of spirit and soul
to the body. Inhalation then predominates.
The techniques are applied in different sizes in a
treatment, depending on whether, for instance, the
muscles of the back are being relaxed over large areas, or
one wants to work into the depths along individual
joints.
Airy kneading
This is done between the two hands. The quality of
suction in the second part of the maneuver is further en-
hanced in an airy way, taking the tissues along expan-
sively. Inner space is enlarged and the tissues are
breathed through.
Other maneuvers
There are many possibilities.Warmth circles and lem-
niscates are special stroking moves with different qual-
ity. Friction with its elastic vortices generates deep suc-
tion in the tissues. Tapotement is an elastic, springy per-
cussion.
Lemniscates
Lemniscates in particular hold a central position in
the treatment of back conditions and the vertebral col-
umn.They may be transverse to the back, with the cross-
ing point always above a vertebra, or they may go
lengthways, parallel or staggered and swinging; again
with all kinds of different points of emphasis and focus.
Lemniscates link parts of the body and swing through
joints, they create symmetry and a feeling of wholeness.
As a symbol for the apparent movement of the sun, the
lemniscate relates to individual human nature; it con-
nects earthly and cosmic forces, mediates between
forces of gravity and buoyancy.
Basic rhythmic principle
The basic criterion with all maneuvers is to let bind-
ing and release alternate continually. The quality is
breathing, musical, creating conscious transitions be-
tween phases. An effleurage will therefore always have
a musical crescendo-decrescendo in it; kneading is not
54 D e r M e r k u r sta b | M e y e r | Q ua l i t i e s o f r h y t h m i c a l m a s s a g e
simply “taking a firm grasp”, and airy kneading must look
for airy transitions between the experience of going out
expansively and then entering again into the tissues.
Calmness should thus always prevail, not to be confused
with slowness or boredom.
Relationship to the vertebral column as an organ
Looking at the vertebrae, individually or as a se-
quence of metamorphoses, we can see a rhythmic inter-
play of expansion and contraction in its forms. At every
step we take as we walk, the vertebral column swings,
elastically dealing with stresses. Inside, the level of CSF
surrounding the spinal marrow rises and falls with every
breath. Rhythm is the principle which sustains the cre-
ation of form and also function.
In rhythmic massage, this principle is addressed by
the way we configure the two phases of “binding” and
“release”, by consciously configured transitions, and by
our choice of maneuver quality. The impulse thus given
to change the inner processes helps patients to activate
their self healing powers. Individual adaptation and the
way in which maneuver qualities can be changed make
it possible to treat the whole range from chronic to
acute processes and inflammatory as well as sclerotic
processes whatever the degree of severity. Rhythmic
massage is therefore also indicated with diseases where
other methods would be contraindicated.
Therapeutic potential
Rhythmic massage techniques offer qualities that
can prove effective in a wide range of diseases. Adapting
the rhythm to the processes and the needs of the patient
makes it possible to structure, model, bring awareness
and awakening, to emphasize the releasing, breathing
quality, swinging through as it warms, or to mediate
constructive powers.
In most cases rhythmic massage is not limited to the
affected areas only. Treatment for the back is often ex-
tended to include the extremities, abdomen or thorax.
Thus nutrient streams are guided (osteoporosis, in-
tervertebral disc weakness),2 pain is drawn off (sciatica,
cervical syndrome), the connection between trunk and
limbs supported (low back pain, hyperlordosis), respira-
tion deepened locally or generally (tensions, scoliosis),
elimination encouraged (congestive states, pain). The
therapist will work towards the vertebral column to
nourish, support uprightness and conscious awareness,
stimulate forces of buoyancy in the lower organism and
relax individual areas in the musculature, or mediate
and establish balance between the two halves of the
body, as the case requires.
With deformation of the spine, treatment only fol-
lows the physical form in so far as it may sometimes be
necessary to relax parts of the musculature locally. Over-
all therapists will follow the ideal form with their ma-
neuvers, the etheric vertebral column, to stimulate and
affirm the power to come upright.
With extremely painful or inflammatory processes
(e.g. acute stages of MS, ankylosing spondylitis
(Bekhterev’s disease), etc.) the extremely gentle qualities
English Issue 2004
are often needed that belong to the sphere of rhythmic
medicated rubs. This makes it possible to apply the re-
quired substance locally without triggering or increas-
ing pain or inflammatory reactions.
Medicated rubs for organic regions are another im-
portant aid in treating back conditions. It is not possible
to go into the indications for individual organs in the
present context.
Encouraging patient’s own activity
The possibility for patients to find their own inner
balance and a new feeling for the body again, playing an
active role in the changes, is another therapeutic aim
with rhythmic massage. It is often the case that the
treatments open up possibilities for patients to take an
active part in their own process of healing, giving them
the courage and persistence needed also for the art ther-
apy or eurythmy that will follow.
Clinical example
In conclusion a case record which may not be partic-
ularly spectacular by nature but can be seen as repre-
sentative of the mode of action and potential of rhyth-
mic massage.
As a young man (until he was about 23), Mr H. was a
forestry worker, daily doing heavy work. A back problem
then made it impossible to continue in that work and he
did the anthroposophical training as a sculptor. He had
been working as a therapist and trainer for some years.
As a sculptor, he would now and again have to move
weighty objects, and problems had repeatedly devel-
oped above all in the lumbar region in recent years. He
saw a chiropractor on many occasions, having his verte-
brae “adjusted”.
Six months earlier a son was born to him, and since
then the pain had grown more frequent in the back and
right hip. He assumed that this was due to strain at work
in conjunction with too little and restless sleep.
Status. Inclination of pelvis, scoliosis; tension in par-
avertebral musculature, mainly in lumbar region. Ab-
dominal region not breathing much, tensed, above all in
the sides. Patient came for massage twice a week from
May to July 2002. Further treatment sessions followed at
growing intervals after the summer holidays in Septem-
ber and October (about once a week). Then the patient
felt so well that he did not feel the need for further mas-
sage treatment.
Content of treatments. Mainly treating the back; re-
leasing in lumbar region, stimulating buoyancy and per-
meability in the lower back. Improving connection be-
tween lower and upper back. In between treatments of
abdomen to stimulate elimination and support forces of
buoyancy.
Massage of the hip on one occasion was something
the patient did not feel comfortable with, nor did it im-
prove the situation in the joint. He did not wish to have
it repeated.
Subjective and objective outcome. His comment on
the difference in experiencing chiropractic and rhythmic
massage: With chiropractic it always was as if the load
English Issue 2004 | M e y e r | Q ua l i t i e s o f r h y t h m i c a l m a s s a g e | D e r M e r k u r sta b 55

in the back had been taken away, and he was simply re-
lieved of his symptoms. The problem had been “dealt
with”, but really without active involvement on his part.
With rhythmic massage, he said, he had developed a
completely new feeling for his back, being able to take
hold of it himself in a new way; he sensed strength in the
back and felt well in his body. The pain had not all gone,
but he now knew it was possible for him to be active
himself and bring about changes.
His wife, who always gives his back a medicated rub
after the weekly staff meeting said that his back had
changed completely after the first three treatments,
having gained life and being “like 10 years younger”. She
said that since starting treatment he was able to lift
heavy loads again and do physical work without this
causing pain or spasms.

Ricarda Meyer
Klusstr. 3
CH-4147 Aesch