Medical Anthropology in Anthroposophic Medicine
“Medical Anthropology” is here used as a short term to designate the science of the human being (“anthropology”), with specific application to the field of medicine (“medical”). In this respect “Medical Anthropology” means the same as “Medizinische Anthropologie” in German. This entails foremost basic concepts and notions about what the human being is, and how on this basis health, disease and healing can be understood and influenced therapeutically.
Anthroposophic Medicine relies on a holistic understanding of the human being, whereas in conventional medicine medical concepts are often reductionistic: Organic life processes are mechanistically explained as the result of gene expression “machinery”, and inward psychic or spiritual experiences are believed to be caused by neurophysiological processes. As a consequence, only the physical part of the human being is acknowledged as a “real” entity.
However, reductionism is not an inevitable necessity. On the contrary: occidental philosophy, psychology and natural science have also produced a quite different holistic and humanistic understanding of the human being. For example, in the 20th and 21st century well-known authors in philosophical and medical anthropology such as Max Scheler, Nicolai Hartmann, and Gerhard Danzer have described the human being as a unity of four discernible phenomenological properties or functional levels, respectively, namely those of the physical body, organismic life, the sentient, inwardly experiencing soul, and the reasoning and deliberately deciding spirit (Scheler 1947; Hartmann 1964; Danzer 2013). Because of its fully human orientation and to contrast it to the predominantly molecular and biological orientation of mainstream medicine, this movement has been labelled as “Anthropological Medicine” (Danzer 2011, Selg 2011). In order to extend empirical cognition beyond the physical domain of the human being, Anthropological Medicine has adopted phenomenological methods of observation from psychology and philosophy, mainly to explore the fields of body-related and inner psychic experiences (Merleau-Ponty 1966).
Anthroposophy and Anthroposophic Medicine
Also in Anthroposophy and Anthroposophic Medicine is the human being acknowledged as a unity of body, life, soul and spirit (Steiner 2004, 2014; Steiner and Wegman 1991, 1999; Girke 2012, 2016; Soldner 2011, 2014; Selg 2000, 2004; Heusser 2016a, 2016b). This is done on the basis of an even greater expansion of empirical cognition than in Anthropological Medicine. Anthroposophy was founded as an empirical spiritual science by Rudolf Steiner at the beginning of the 20th century. Steiner had taken his departure from reductionist natural science and from Kantian epistemology at the end of the 19th century, and he had been the principle editor of Goethe’s natural scientific writings in the two representative Goethe editions of the time. On this background he laid the basis of his later work in salient publications on epistemology and the renewal of science through a non-reductionist methodology. He showed how established phenomenological methods in the natural scientific fields of color research and of organismic life (Johann Wolfgang Goethe), in the psychological field of psychic experience (Franz Brentano), and in the noetic field of spiritual experience (Johann Gottlieb Fichte) can be spiritually deepened through systematic mental training in such a way, that not only the externally appearing phenomena of matter, body, life, soul and spirit can be apprehended empirically, but that their inner causative forces and their differentiated interactions in health, disease, and healing processes can be perceived and scientifically explored as well. “Anthroposophy” as described, methodologically developed and epistemologically justified by Steiner is a science of the human being developed on the basis of spiritually expanded empirical perception and cognition, whereas the term “Anthropology” is used by Steiner to designate the science of the human being developed on the basis of empirical perception and cognition in natural science, psychology and philosophy (Steiner 1976, 1996). This naturally includes phenomenological methods in these fields (Steiner 1979, 1988). For Steiner, the resulting concepts of both, Anthroposophy and Anthropology, can and should meet in the field of concepts, i.e. in a “philosophy of the human being”. They complement each other in a comparable way as do the positive and negative versions of the same photographic slide (Steiner 1976, 1996).
Evidence-based Medical Anthropology in Anthroposophic Medicine
Thus, Medical Anthropology in the context of Anthroposophic Medicine designates the coherent but differentiated system of empirically based concepts related to body, life, soul and spirit, whereby the empirical sources of these concepts may lie in natural science, phenomenology, psychology or Anthroposophy. In this sense, Medical Anthropology contains the comprehensive conceptual basis of Anthroposophic Medicine (Selg 2017).
But two points should be emphasized here, especially when considering the use of these concepts in medical practice and medical research. First, the concepts are not meant to be theoretical, but they should be derived from empirical reality, so that their use in medical practice can result in appropriate clinical reasoning, correct diagnosis and effective therapy. But as for Anthroposophy the reality of the human being does not only consist in its physical body but also encompasses life, soul, and spirit, the concepts of Medical Anthropology are differentiated and relate to these domains accordingly. Second, due to the complementary nature of concepts from Anthroposophy on the one hand and from natural science, phenomenology and psychology on the other, it must be possible to test the congruence of these two sets of concepts, especially when it comes to medical research.
This is especially important when considering the frequent problem that, empirically, anthroposophic concepts relate to spiritual perceptions, but that the faculty for such perception is not yet a frequent achievement. So how to deal with anthroposophic concepts in Medical Anthropology in the context of modern medical research? – Anthroposophic concepts can and have to be tested indirectly: Through their complementarity to corresponding concepts from natural science, phenomenology, and psychology, they can indirectly be tested using the well-known empirical research methods of these disciplines. In fact, Steiner himself explicitly emphasized that the results of spiritual anthroposophic research in medicine need to be worked out, tested and verified “as all such facts are verified by the methods of modern medicine. There is no question of asking you to accept these things before they have been tested” (Steiner 1951, p. 59, 1989, p. 138 ff). This clearly means a commitment to what today is called “evidence-based medicine”; and it applies not only to the testing of anthroposophic medicines, therapies and treatment strategies in efficacy- and effectiveness-studies, but also to the testing of anthroposophic concepts anthropologically with those means of modern science. Anthroposophic Medicine attempts to contribute, out of its own spiritual sources, to general Medical Anthropology, with adequate scientific methodology and in a way that fosters the development of a new holistic and humanistic understanding of the human being in medicine.
The present state of Medical Anthropology in Anthroposophic Medicine
To sum it up, Medical Anthropology has always two aspects in Anthroposophic Medicine. The understanding of body, life, soul and spirit, the basic concepts of matter, chemistry, biochemistry, molecular and macroscopic biology, of organism and the functioning of specific organs, the relations between humans and nature, the nature of mind-body-spirit-interaction, sensory physiology, human movement, and furthermore the conceptions of physiology, pathology, and the principles of action of pharmacological and non-pharmacological treatment interventions: all of this has an anthroposophic and a corresponding natural scientific, phenomenological or psychological side. Thus, the general goal of Medical Anthropology as a working field in Anthroposophic Medicine is threefold: to understand human functioning 1. from the perspective of spiritual science, 2. in terms of natural science, phenomenology, psychology, and related fields, and 3., the most rewarding: to understand the relation of these two. Correspondingly, publications and research can have an emphasis in one or the other of these two directions, or it can specifically aim at relating the two in order to gain a comprehensive holistic understanding of human organization and functioning.
Up till now, work of scholars and physicians in Medical Anthropology as a field of Anthroposophic Medicine has mainly dealt with the following fields:
- Epistemology and the sciences of matter, life, psyche, and spirit
- Goethean phenomenological research of basic medical concepts
- Concepts of elements, substance, chemistry, and biochemistry
- Molecular biology, biology, systems biology, concepts of organism, life and causality
- Anatomy and physiology: the three functional systems: the sense-nerve system, the rhythmic system (respiration and circulation), the metabolic and limb system
- Specific organ functions and body-life-soul-spirit interactions
- Rhythmic functions and emotion
- Sensory physiology and sensation; social perception
- Movement and sensation, embodiment
- Brain and consciousness, free will
- Heart function: pressure vs flow conceptions of circulation
- The digestive tract; the regulatory spleen function in digestion
- Psychology and philosophy of mind: soul and spirit, animals and humans
- General concepts of health, disease, prevention and healing
- Whole systems Medical Anthropology as a basis of the theory and practice of medicine and medical education
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Univ.-Prof. Dr. med. Peter Heusser, MME (UniBe)University of Witten-Herdecke Faculty of Health Department of Human MedicineInstitute of Integrative Medicine (IfIM)
Gerhard Kienle Chair of Medical Theory, Integrative and Anthroposophic Medicine
Gemeinschaftskrankenhaus Herdecke, Germany
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