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No. 71 Swiss Pioneers in Science and Medicine |
In 1921 Ita Wegman founded a clinic in Switzerland based on a revolutionary approach to medicine – healing the soul as well as the body. P. Lavender When Ita Wegman died in 1943, the huge collection of correspondence she left bore testimony to the esteem in which she was held by European medical professionals. An enormously driven woman, in her 67 years, Wegman forged not just a career in medicine – itself unusual for a woman in her time – but founded a new medical doctrine combining patient care with a life philosophy. As the inspiration behind anthroposophical medicine, she was an influential figure in what we now call complementary medicine. 'Many letters she received were extremely reverential – almost worshipping her,' says Gunhild Pörksen of the Ita Wegman Institute in Switzerland, which preserves her archive. 'Her replies were always friendly and positive, but never encouraged this devotion at all.' Anthroposophical medicine is an integrative form of medicine developed by Ita Wegman and the philosopher Rudolf Steiner. It is based on Steiner's spiritual philosophy 'anthroposophy', and is 'integrative' as practitioners are first qualified in traditional medicine. Anthroposophy posits the existence of a spiritual world, which followers attempt to experience through self-development. This has since expanded into the more practical and everyday realms of education, agriculture and medicine. Practitioners of anthroposophical medicine view disease as a result of a biological, psychological or spiritual imbalance. Therapies designed to create a healthier self-image and emotions and are not just 'nice to have', but are essential for a complete cure. Lukas Schöb, a senior doctor at the Ita Wegman Clinic in Arlesheim, Switzerland, sees anthroposophical medicine as stimulating the self-healing mechanisms of the body-mind complex in three ways: • On an intellectual level, the patient must understand the causes of their health and not just their illness – stopping the downward spiral that results from viewing themselves simply as an ill person. • The patient needs to identify more with positive feelings while releasing suppressed negative emotions. Schöb explains: 'We've found music, art and dance therapies to be particularly effective. Cases of extreme pain have sometimes disappeared after a large emotional release.' • On a physical level, given in addition to conventional medical treatment, specific anthroposophical medicines created using natural medicinal ingredients are used – the most well-known of these being mistletoe for cancer. These substances are also utilized in therapies such as rhythmical massage (created by Ita Wegman) and compresses. A healthy diet also plays an essential role. According to this approach, the patient is therefore not simply a passive recipient of medicine, but an active participant in the whole healing process. Reforming Lives Early in Wegman's life there were no indications of her future path. Born in 1876, she was the daughter of a well-off Dutch family living on Java, an island of the then Dutch East Indies. Upon moving to Europe, she soon became taken with the life reform movement, a mixture of groups critical of industrialization and advocating a return to nature. Through this, she met Rudolf Steiner, whose ideas led to the development of the Waldorf schools, and who remained her life-long teacher. Steiner strongly encouraged her to carry anthroposophy into the field of medicine. At the relatively late age of 30 she began to study medicine in Zürich, one of the few European universities to then admit women. She set up a practice shortly after and in 1917 started preparing mistletoe-based medicines for cancer patients (currently known as Iscador). In 1921, she opened her clinic in Arlesheim, with enough room for 12 patients and a small laboratory to prepare medicines, many of which are still in use. Today, the Ita Wegman Clinic has grown to accommodate 63 patients, with many outpatients, and the laboratory has become Weleda, an international producer of natural medicines with 1,800 employees. At the Arlesheim clinic, practitioners followed the philosophy of Steiner, seeking physical, mental and spiritual development for themselves and their patients, with medicine being a way to achieve this. Anne-Marie Gass, matron at the clinic, explains: 'Humans are not just physical beings, but spiritual beings. Ita Wegman wanted medicine that would treat both aspects, to help patients develop further along their life paths.' Although Steiner was not a doctor, Wegman trusted his medical intuition, and he often helped patients and offered some suggestions for suitable medicinal substances. According to Gunhild Pörksen from the Ita Wegman Archive, the respect was mutual: 'Steiner was very impressed with this passionate and strong-willed lady who was able to take his ideas on medicine and convert them into reality – she got things done.' She also picked up on his passion for working with disabled children – particularly those with mental disabilities – at a time when such patients were often subjected to severe medical treatments, if any. In 1922, she founded the Sonnenhof Children's Home, which is still in existence. After Steiner died in 1925, Wegman continued to develop his ideas and worked hard to spread them across the whole of Europe. As a result, there are currently 28 anthroposophical medicine centers with 140 outpatient clinics worldwide, giving weight to Wegman's words: 'Despite difficult times, it is absolutely necessary to keep moving forward and developing.' Related Reading  What Is the Future of Anthrophosophical Medicine in he Era of Evidence-Based Therapy?  Paul Lavender is an editor of the Karger Gazette |
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| The Future of Anthroposophical Medicine P. Lavender In some countries, such as Switzerland, where it was founded, anthroposophical medicine is generally well accepted and is paid for by general health insurance. However, it is subject to the major criticisms leveled at complementary and alternative medicine. Marcia Angell, ex-editor-in-chief of The New England Journal of Medicine, wrote in 1998, 'There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not.' Lukas Schöb, a senior doctor at the Ita Wegman Clinic, acknowledges this problem, but sees it as indicative of a far deeper concern. 'We're still experiencing the results of debates in the Middle Ages centered around the problem of universals – how to define reality,' he says. 'We chose but never proved a world view which we have continued to hold ever since. There are other methods to infer what is real or not other than our current one – we've simply forgotten'. This, he believes, has created a mindset that over-relies upon double-blind placebo studies to the exclusion of other types of research. The view has been echoed by some mainstream scientists, such as Smith and Pell in 2003, who wrote a wry article in the BMJ pointing out that the efficacy of parachutes has never been proven using double-blind placebo studies. With insurers and governments tightening their purse strings, there is increasing pressure on medical practitioners to produce effective and replicable results. However, due to its highly individualized treatments, anthroposophical medicine does not easily lend itself to double-blind placebo studies. Even when such studies are possible on a specific aspect of treatment, clear-cut answers do not always follow. For instance, despite many studies on the effectiveness of mistletoe in cancer, the National Cancer Institute reports that results in humans remain uncertain. In the scramble to gain mainstream acceptance, proponents of anthroposophical medicine, such as Helmut Kiene, have created a new methodology – cognition-based medicine. This places more emphasis on case studies, cross-over designs and cohort studies, and includes physician judgment and intuition as a variable rather than considering it as a confounder. Whether this will satisfy the critics remains to be seen. Schöb is realistic about the immediate future, saying, 'It will definitely become more difficult for anthroposophical medicine practitioners. However, as this pressure increases it will cause a backlash – people intuitively know this treatment works and they want it. They understand that if we continue on our current path, there is a real danger that we will lose the very essence of medicine.'  Music therapy at the Ita Wegman Clinic. © Ita Wegman Clinic Related Reading Healing Mind, Body and Soul Further Reading Kiene H: Komplementäre Methodenlehre der klinischen Forschung. Cognition-Based Medicine. Berlin, Springer, 2001. Smith GCS, Pell JP: Hazardous journey: parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327:1459-1461. Paul Lavender is an editor of the Karger Gazette |
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