F i nt e l mann | unde rstandi ngautoi mmune di s e as e s | De
rMe rkurstab Engl i s hI s s ue 2 005 1The issueIn the medicine
based onmodern science, a number oftheories and hypotheses have
been developed on thecausesofautoimmunedisorders. (1,
2)Examplesarethereleaseofinflammationmediatorsandcytotoxiccells by
antibodies, production of antigen-antibody im-munocomplexes which
are deposited inthe organism,or sensitized T cells attacking
structures in the organism.Genetic and other factors are said to be
the causes. (3)Generally a disruption of normal immunotolerance
pro-cesses is postulated, and again a number of hypothesesfor this
are under discussion. (4) All in all we have here aremarkable lack
of knowledge, despite the fact that au-toimmune disorders have
become common over the last30 or 40 years and major scientific
advances have beenmade in the field of immunology.Can more light be
thrown on the matter by conside-ring the phenomena and their
non-physical backgroundin the anthroposophical science of the
spirit?In the invitation to the Anthroposophical Medical
As-sociations Conference on 22 and 23 November 2003 inKassel it
said:Autoimmune disorders on the other handreflect disruption in
the human organisms self-recogni-tion and self-regulation. Internal
organs become foreignelements in the body. This would therefore
also affectthe immunotolerance which functions in health, i.e.
theimmunesystemattackstissuebelongingtotheorganand to the body as
though it were foreign. Quite naivelyonemight ask:
Hastheorganismgonemad? (seeingthat it is senselessly destroying
itself).A basiclawinanthroposophicalmedicineisthat alarge part of
disorders are due to auto- rather than he-terogenic factors. These
take effect in the wrong place,at the wrong time, or show excessive
or inadequate in-tensity in the site where they normally take
effect: (5)Disorders reflect bodily processes whichtake effectin
the wrong place, at the wrong time and/or act withthe wrong
intensity (too powerful/too weak).Does this basic law also apply to
autoimmune disor-ders? This is what we want to explore in what
follows.Polarity of I and bodyA first area for our consideration
derives from anot-her basic fact in anthroposophy. It is that the
differentia-Anthroposophical basis for understanding autoimmune
diseasesVol ke rF i nt e l mannTranslation of Menschenkundliche
Grundlagen zum Verstndnis der Autoimmunkrankheitenby Volker
Fintelmann. Der Merkurstab 2004; 57/5:336-40. English by A. R.
Meuss, FCIL, MTA.Anthroposophical basis for understandingautoimmune
diseasesI AbstractIn modern scientific medicine, questions
concerningthe aetio-logy of autoimmune diseases do not take us
beyondestablishing a number of hypotheses with a theore-tical
basis. Findings made in anthroposophical spiri-tual investigation
by Rudolf Steiner can help us tosee autoimmune diseases as an
attempt to makeuntransformed (not individualized) remnants of
theinherited body ones own at a later time in the bio-graphy, i.e.
create an individual body that accordswith the I or self also in
this organic site. Inflamma-tory and digestive processes to destroy
matter andthen give a new configuration are pathophysiologi-cal in
the case. Suppressing them with anti-inflam-matory drugs or
immunosuppressants is counterpro-ductive, for the self is impeded
in its efforts to healitself. World substances such as Phosphorus,
Quartzor mistletoe treat the causes by guiding and suppor-ting
I-activity. Reconciliation with the world of theancestors from whom
the body primarily comes isanother element in causal treatment.I
KeywordsAetiologyAutoaggression Inherited body Individual
bodyRemnants of inherited body ted body (organism) is seen as the
instrument or toolof the real human being who is wholly spiritual
by na-ture. Rudolf Steiner called it the I. With the help of
hig-her (hierarchic) spirits, this I creates instruments for
it-self in soul and body so that the intentions it had in thespirit
before birth (plan for life) may be brought to reali-zation in
existence between conception, birth and death.The body must be seen
as polar opposite to the I, withthe soul active between the
opposite poles (matter andspirit),
alwaysmediatingandmaintainingbalance. Aspecial aspect is that the
body is pre-formed and gene-tically determined by the parents,
which makes it prima-rily foreign and not self. It only becomes
self in long sta-ges of development taking 20 to 30 years. This
will be animportant aspect when it comes to understanding
au-toimmune disorders.Let us first consider the opposite nature of
body andI (spirit). Rudolf Steiner spoke of a fact which his
investi-gations had shown and I want to quote him here.
Whe-reverthespirit
entersdirectlyintophysicalmatterwehaveadestructiveprocess.
Asubtledeathprocessco-mingfromthesensesthusspreadsalongthenervetracts
in the human organism.(6) This relates to the vi-sible humanbeing,
i.e. onceagainthebodywhichthroughout life has an invisible human
being everywhe-re within it. Essentially all constructive processes
origi-nate in this. The body of physical matter, also known
asphysical body, is destroyed under the direct influenceof the I,
or subject to destructive processes. This leads toa first
hypothesis forapossiblecauseof autoimmunedisorders:Autoimmune
disorders reflect an excessively power-ful,
destructiveinfluenceoftheIontheorganism.(The spirit burns up the
body.)Anticipating slightly, let us note that this manifests
ininflammatory processes, aboveallthosethat result inpurulence and
liquefaction. Inflammation plays a
majorroleinautoimmunedisordersandalsodetermineses-sential aspects
of modern treatment. It is, however, scar-cely of the kind
discussed above but rather involves chro-nicdestructionoftissue.
Theimageonemight haveismore that of a smouldering fire.The organ
which has turned foreignThe second area for our consideration is
that of an or-ganortissueturningforeign. Themost
characteristicexample are viral diseases where incorporation of the
vi-ruses in cells of the organs will, in the sight of the
immu-nesystem, causesuchalienation.
Theimmunesystemattacksthematerialaffectedbytheviruses,
ofteninaviolent, acutely destructive way. A typical example is
ful-minant hepatitiswithhepatitisBvirusinfection, for-merly also
known as acute hepatic dystrophy. Essential-ly, however,
inflammatory changes with virus hepatiti-des reflect an immune
reaction on the part of the organ-ism and therefore attempts to
heal and not sickness. Fordecades, acute virus hepatitis was
treated with anti-in-flammatory drugssuchasglucocorticoids. Later,
whentheimmunologicalprocesswasunderstoodandonecouldseewhysuchtreatment
waslargelyineffectiveand did actually in many cases lead to
protracted chro-nic
evolutions.Autoimmuneprocessesconnectedwithvirus-asso-ciateddisorderscontinuetobeseen,
andforatimeitwas therefore also thought that autoimmune
disordersmight beviralinorigin, withresearchtakeninthisdi-rection.
The second hypothesis for a possible cause of au-toimmune disorders
therefore is the following.Autoimmunediseasesindicatethat
anorganhasbeenalienatedunderexternalinfluences. (Theor-gan becomes
outside world.)This hypothesis is more likely to help us find an
ans-wertoourquestionconcerningthecausesofautoim-mune disorders.
Viruses or other pathogens clearly can-not be the only external
factors to be considered. A vastfield has to be opened up for
research to investigate thisand look for answers. There can be no
question but thatthe human organism is today exposed to many
differentenvironmentalpollutantsinmaterialformoralsoinform of
different kinds of radiation. We need only thinkof the
indeterminable number of food additives, pestici-de or heavy metal
pollution, and both natural and artifi-cially produced radiation of
many different kinds. Fromthe point of view of anthroposophy, where
existence insoul and spirit is something very real, one must also
con-sider if external influences of a non-material kind maynot also
cause an organ to become foreign. Think of theindigestibleflood of
images and information providedby the media, but also the actions,
feeling and thoughtsof others and the effect these can have on us.
Any kindof childhood abuse must also be mentioned as a
primeexample.Organic focus of destruction within usA third area for
our consideration is again created onthe basis of Rudolf Steiners
investigations. He describedhow in every human organismthere is an
organic andtherefore unconscious area where an intensive form
ofdestruction arises which is directed towards the
organ-ismsphysicalmatter: Matterisnevercompletelyde-stroyed in the
outside world. In more recent times, phi-losophers and scientists
for the external world have the-refore spoken of the conservation
of matter. This law
oftheconservationofmatterappliesonlyintheoutsideworld, however.
Intheinnerhumanbeing, matteriscompletely transformed back into
nothingness. Matteris there destroyed completely in its essence.
Our humannatureactuallybasesonthefact that weareabletothrow matter
back into chaos, destroy matter complete-ly at a level deeper than
the mirroring of memory.(7)He then referred to the way pupils were
taught in ear-lier mystery centres, mainly in Ireland and the West
alto-gether, thoughoriginatingfromtheOrient: Beneaththe capacity
for memory, you bear something in you asa human being which is out
to destroy; without this in-side you, you would not have been able
to develop your2 De rMe rkurstab | F i nt e l mann | unde rstandi
ngautoi mmune di s e as e s Engl i s hI s s ue 2 005abilitytothink,
foryoumust developyourthinkinginthat powersofthought
penetratetheetherbody. Anether body filled with powers of thought
will, however,have the effect on the physical body of throwing its
mat-ter back into chaos, destroying it.(8) Later he introducedtwo
further important concepts, speaking of a focus ofdestruction and a
destructive frenzy.These spiritual facts are profound and may well
awa-kendefensiveornegativereactionsinsomeonefollo-wing the line of
thought. The known facts of research in-to digestion show, however,
that such powers do indeedexist in us. Destruction or degradation
of matter in theprocess we call digestion involves powerful,
aggressi-ve forces located in the different digestive organs,
withcorrespondingdigestiveenzymesactingasmediators.Ourorgansofmastication,
acidproductioninthesto-mach and bile acids also come under this
heading. We al-so find this destructive frenzy in the rejection of
organtransplants, a process with an immunological basis. Ma-ny
readers may perhaps for the first time become awa-re here of a
situation which is experienced and describedallovertheworld,
aphenomenonofourtimethat al-most seemsbeyondcomprehension.
Thisistheenor-mousincreaseina(seemingly?)incomprehensiblede-structive
frenzy as an expression of uncontrolled aggres-siveness which
culminates in terrorism. Do we not beco-me aware of a need here for
research in medicine as tohow far such aggressiveness discharging
itself in an out-warddirectiondoesnot alsoreflect
digestiveactivitynot adequatelyput touse, i.e. digestive powers
stray-ing into the soul sphere? And should not our attentionturn to
causal phenomena in nutrition, fast foods beingbut one form of
expression? Reference must also be
ma-detothehighlysuccessfulcommercializedworldoffilms which profit
from showing such extreme forms ofmaterial destruction, their
material also including thehuman
being.Thesequestionsconcerningthephenomenaofourtimewillnot,
however, helpustounderstandautoim-mune disorders. Here the
destructive frenzy woiuld ha-ve
tobedirectedtowardspartsoftheorganismitself,which is also an
important aspect of self. Suddenly theearlierterm autoaggression
gainsfreshnewsignifi-cance. Permit me to refer to an image from the
world offolk tales. In Rumpelstiltskin we find an accurate pictu-re
of autoaggression of the kind which at the level of or-gans we see
in the extreme situation of pancreatitis, forinstance, a
situationwhere anorgandigestsitself. Weare thus able to formulate a
third hypothesis for under-standing the cause of autoimmune
disorders.Autoimmune disorders reflect an (organ-related)
de-structive frenzydirectedagainst oneself. (Rumpel-stiltskin type
of autoaggression)Acutepancreatitisisnot
anautoimmunedisorder,though the triggering factors do in many cases
remainunknown. But it is striking how often extreme psycholo-gical
stress is seen in conjunction with this disease, of-ten having
persisted for a long time and finally findingan outlet. This is the
field of psychosomatics, interactionbetweenbodyandbody-relatedsoul.
Scientistsack-nowledge that psychological factors can become
soma-tic, connecting with it the idea of a
pathophysiologicalprocess. This may well play much more of an
aetiologi-calandpathophysiologicalroleinthedevelopment
ofautoimmunedisordersthanmodernscientistshaverealizedsofar.
Andnocarefulobservercanfailtoseehowintensivelythesymptomsofautoimmunedisor-ders
also involve the psyche.Untransformed elements of the inherited
bodyThe fourth area to be considered takes us deep downinto the
true causes of autoimmune disorders. It presup-poses the situation
mentioned earlier, which is that theindividual human spirit, the I,
can only incarnate if pa-rents create the necessary living body. In
every case andwithutterlogicthisisforeigntotheI.
RudolfSteinerwouldfrequentlymentioninhiscollectedworksthatthe time
needed for human infancy and childhood deve-lopment
untilmaturationisreachedisextremelylongcomparedtothewholeanimalworldandcanonlybeunderstood
if we consider that the I needs this time totransform the inherited
body, also called a model, intoan individual body, which has to
happen at all levels ofphysical matter, life, sentience and soul
and ultimatelyalso of the spirit. This happens in developmental
stagesof 7 years each. Initially the material consistency of
theinherited body is transformed and replaced, as is clearlyevident
in the changing of the teeth, though it also ap-plies to all
tissues and organs in the organism.More work is done on
transforming physical matterin thesecondseven-yearperiod, but
theemphasisisnow on the sphere of life, most evident in all
functionalprocessesintheorganism. These, too, must becomehighly
individual to serve the unique (individual) natureof the I as ideal
tools for future life. These individuationprocesses come from the
above-mentioned invisible orsupersensible human being who is not
embodied but in-fluences the body by different routes.(9) It is
always thenext highermemberofthesupersesibleorganizationwhich works
on this individuation, always guided by theI which on its part has
the help of spiritual (hierarchic)entities of planetary origin (Fig
1).After 3 times 7 years, i.e. around the 21st year of
life,individuation of the body is complete, the individual hascome
of age. The I then works to develop the three
soulelements(sentient, rationalandspiritualsoul)out ofthe body
which also need to be given wholly individualcharacter.
Inourtimethisreachesitsculminationinabout the 28th year, when
ideally the human being is atrue individual and takes personal
responsibility concer-ning self and world. This is the ideal form
of an indepen-dent individual nature. All kinds of problems,
resistanceand obstacles do, of course, arise, so that the work
willscarcelybewhollysuccessful. Bodilyresidues left in-complete
will persist, with hereditary body elements re-maining in them.F i
nt e l mann | unde rstandi ngautoi mmune di s e as e s | De rMe
rkurstab Engl i s hI s s ue 2 005 34 De rMe rkurstab | F i nt e l
mann | unde rstandi ngautoi mmune di s e as e s Engl i s hI s s ue
2 005Rudolf Steiner characterized two types of wrong de-velopment
in this connection, calling them premature
ordelayeddevelopment.10Hedescribedtheformerasacase where
transformation is too rapid, coming to a
pre-matureandthereforeincompleteconclusionwhichleads to an inner
determination of the individual thatmay be compulsive by nature,
for instance. If individua-tion of the body is too slow, and also
if it persists beyondthe 21st and 28th years, the body is
determined in a wayto which Rudolf Steiner did not give a name, but
whichcomes to expression in addictions. The very brief descrip-tion
given here may lead to my fourth hypothesis:Autoimmune diseases
reflect a late attempt to indi-vidualize residues of the inherited
body.This will of course again and again come upon organ-ic regions
referred to as such residues. This is not to saythat the I will on
principle attempt to individualize themat a later time. The way I
see it, this will be a relatively ra-re occurrence, otherwise the
number of people with au-toimmune disorders would be much greater.
Such resi-dues do, however, persist through life, though they act
asforeign elements in the body, and may thus be conside-red to be
sources of all kinds of organic, functional andalso mental
disorders. Perhaps we can in the light of thisunderstand why cancer
manifests in a specific site, in anorgan or as a systemic problem.
Autoimmune disordersmay, however, develop in people who do not
allow the-se residues of the inherited body to persist but
absolu-tely intend to transform them, i.e. make them their ownor
individualize them.Inmy opinion,
thisiswheretherealcauseofthesedisorders lies. We thus see them as
diseases of our timeand can also understand why they are on the
increase.Individuationorthedevelopment ofonesownindivi-dual nature
is something which more and more peopleenter into at the present
time. It is also evident from theabove why the typical time of
onset is between the agesof 20 and 40. Earlier or later onset does
not speak againstthe type but merely raises the question whyfor the
in-dividual
concerned.Thenoticeablypsychosomaticsymptomatologyofautoimmune
disorders, already mentioned in the above,merits further
consideration. The biography frequentlycontainselementsthat havenot
been dealt with, di-gested or overcome, and this with reference to
the adultworldaroundthedevelopingindividual, aboveallmo-ther,
father and siblings, but also other close relations
orfamilyfriends, teachersandclergy. Workingthroughsuch problem
areas in talks and finally achieving recon-ciliation often proves
to be the vital precondition for suc-cessful treatment.We must also
learn to differentiate the times (seven-year periods) when
transformation did not succeed,
andthetrendfollowedbyprematuredevelopments. Foritwill primarily be
these which cause the developmentaldisorders and hence the
residues. At the very centre ofall diagnostic questions and
observations, indispensablepreconditions for rational(causal)
treatment, we mustput the relationship between I and body, i.e.
congruencebetweenindividualnatureandphysicalbody. It isper-fectly
clear that this does not mean making the kind ofdiagnosis learned
at medical school. One has to developempathic intuition, which
results from the results of ob-servations made in the soul using
the methods of mo-dern science (subtitle of Rudolf Steiners
Philosophy ofSpiritual Activity).Prospects of a rational
therapyTheprocessesconnectedwiththefirst
threehypo-thesesareimportant ifwearetounderstandautoim-mune
disorders, though they are not of primary signifi-cance in
understanding the causes. They reflect proces-ses which play an
essential role in the pathophysiologyofthedifferent
autoimmunedisordersandhavebeengivenashypothesesnot
forrhetoricalreasonsbut be-cause they are genuine fields where work
may be doneto gain deep-reaching insight into these disorders,
withthe scientific findings of conventional medicine also
ta-kenintoaccount. Manifestationinspecificorgansandaspects of
treatment will be considered in detail in thelectures that follow.
Before coming to a conclusion, ho-wever, let us look at some of the
clinical requirements orconsequences in the light of the above.The
key point, I believe, is that inflammation must notbe suppressed or
reduced but rather encouraged. It go-eswithout sayingthat
thiscallsforgreat experienceand sensitivity. On the basis of many
years experience,Fig. 1:Physical develop-ment in the four 7-year
periods (IO = I-organization;AB = astral body;EB = ether body;PB =
physical body;SS = sentient soul)Sunsupersensible AB +
IOsupersensible EB[[[[1stindividuation PBMoonsupersensible
IOsupersensible AB[[[[1stindividuation EB[[[[2ndindividuation
PBOther planetssupersensible IO[[[[1stindividuation AB[[[[2nd
individuation EB[[[[3rd individuation PBConstellation of fixed
starsIndividual body devloped,soul devt. at same timeAB as basis
for SS2nddentition sexual maturity coming of age
freedomresponsibilityBirth 7 14 21 28F i nt e l mann | unde rstandi
ngautoi mmune di s e as e s | De rMe rkurstab Engl i s hI s s ue 2
005 5Phosphorus and potentized mistletoe preparations
areanelementaryhelpinthis. Secondlythereisneedtohelp the I to
perceive both the inner and the outer boun-daries of the body and
also achieve them, i.e. actively setboundaries. Quartz has causal
activity in this respect.Finally spheres of life must be worked
through in thebiography that have created obstacles or trauma in
theperiod of development and must be seen as
connectedwiththedisease. Reconciliationwiththesesituations,and
often also with oneself, is an important element
inovercomingthediseaseorbringonesbodilydevelop-ment to a good
conclusion.Prof. Volker FintelmannCarl Gustav Carus AcademyRissener
Landstr. 193D-22559 HamburgReferences1 Classen M, Diehl V,
KochsieckK. Innere Medizin. Urban &Schwarzenberg 1993, 402-4062
Johnson AG. Immunologieauf 70 Seiten. Thieme 2001,58-593 Classen M,
Diehl V, KochsieckK. Innere Medizin. Urban &Schwarzenberg 1993,
402-4064 Johnson AG. Immunologieauf 70 Seiten. Thieme 2001,58-595
Fintelmann V. Intuitive Medi-zin. Einfhrung in eine
anthro-posophisch ergnzte Medizin.Hippokrates, 4. Auflage
2000,66-736 Steiner R. The Invisible Manwithin Us. tr. A. Wulsin,
G. Kar-now. Spring Valley: MercuryPress 1987.7 Steiner R.
Cosmosophy vol. 1.Lecture of 23 Sept. 1921. Tr. A.Wulsin. Steiner
Books.8 Steiner R. Loc. cit.9 Steiner R. As ref. 6.10 Steiner R.
Pastoral Medicine.Lecture of 11 Sept. 1924. Tr. G.Hahn. Steiner
Books 1987.6 De r Me r kur s tab | Sol dner Sommer | Autoi mmunedi
sordersoftheTyroi d Engl i s hI s s ue 2 0051) Case recordsMrs M,
age 33, hyperthyroidismA slenderyoungwomanbrought
her8-month-oldinfant fortreatment. Thechildhadbeenbornwithamarked
premature cranial suture synostosis and is alrea-dy showing
definite psychomotor retardationunabletoturn round, communication
not possible inthe wayappropriate to the age. Mental disability had
to be con-sidered. Theindicationforsurgicalcorrection, not wit-hout
risk to life and prognosis, had to be established.
Theinterventionwasduetobedoneat about 12months.Currently the
decision had to be made as to which sur-geonwoulddotheoperation.
Thepatient cameforaroutine check on the child before going on
holiday.Thechildpresentedwithamildupperrespiratorytract infection;
the mother seemed exhausted. As atten-tion turns to her, one sees
the eye signs of stare and lidretraction, she seems rushed, never
taking time for her-self. Asked if there was something wrong she
said thatshe had felt weak and exhausted for the last 2
months,something not right. Further questions elicited that
shehadlost 3or4kginweight, andhaspalpitationsnowand then. The pulse
was 110 120/min, BP 130/75 mmHg,pulsating goitre size 2.
Clinically, Graves disease was su-spected, theholidaytripcancelled,
bloodtaken, andthen an injection given of- Glandula Thyroidea D30
amp. Wala- Cuprum met. prep. D30 amp. Weleda i.v.,on the assumption
of a florid inflammatory autoag-gressive disorder of the thyroid
(for this a relatively highpotency of the homologous organ was
recommended)and also because experience had shown that mothers
ofchildrenwithserious, life-threateningconditionsgainimmediate
relief and relaxation with Cuprum met. prep.D30.Laboratory
findings. TSHdepressed, T319.6pg/ml(normal < 4.2 pg/ml), T4 7.74
ng/dl (normal < 1.75 ng/dl),TRAB12.4(normal