PAAM Medical Newsletter, Vol. 2, Issue 1, January 25, 2015
Dear PAAM Members!
Welcome to a new edition of the PAAM Medical Newsletter, the first issue of 2015! As always, we at the PAAM Board deeply appreciate your commitment to anthroposophic medicine and your willingness to be a part of PAAM.
I would like to remind you to renew your membership for 2015. Discounts on conferences, the General PAAM Newsletter, and this Medical Newsletter are some of the benefits you receive with your membership. To renew, go to www.paam.net. On the right, under "About PAAM", you will see the second link stating "Become a Member or Renew your Membership". Click the link and complete the online registration. It's simple. And thank you for supporting PAAM!
As a reminder, this PAAM Medical Newsletter will come out about every 2 or 3 months. There may be earlier special editions of the newsletter if there is a timely topic that needs to get out to the membership. All are welcome to make any sort of contribution to the newsletter, such as a question, an important citation, or a possible article to be included in a future newsletter. Please, I invite your suggestions or contributions!
Please note: This Letter is for your thoughtful consideration and personal research and is not to be taken as something dogmatic to believe in nor promote as something official from PAAM or the international anthroposophic medical movement.
The first 2015 edition will be focused on Pediatrics, specifically the interface between anthroposophic medicine's very limited use of antibiotics and conventional medical practice. Given the importance of pediatric medicine and Waldorf education in anthroposophy for generating good health, I wanted to bring to your attention a morning verse Rudolf Steiner wrote for the students of the first Waldorf School in Stuttgart, Germany. As a class, the students from 5th to 12th grade were to recite the verse every morning at the start of the school day. If we can suppress our reactive antipathy, our arrogance and over-sophistication, we can sense the significance of this verse for us, how it helps us anchor ourselves in the world, and provides a necessary mood for our lives as we study and work as individuals and groups of like-minded people.
I gaze into the world
In which the sun is shining
In which the stars are speaking
In which the stones repose,
Where living plants are growing,
Where sentient beasts are living,
Where human souls on earth
Give dwelling to the spirit.
I gaze into my soul
That lives within my being.
The world Creator weaves
In sun light and in soul light
In world space there without,
In soul depths here within.
To thee, Creator Spirit,
I will now turn my heart
To ask that strength and blessing
For learning and for work
May grow within my inmost being.
1. Article #1. Antibiotic use in anthroposophic medicine vs. conventional medicine in routine primary care. This recent prospective, observational study of 529 children with acute URIs or otitis media were treated substantially differently by anthroposophic vs. conventional physicians. Antibiotics were prescribed in 5.5% of anthroposophic patients and 25.6% in conventional patients. Resolution of symptoms was slightly faster and use of analgesics was less in the anthroposophically-treated patients. This was obviously a selected population because the parents of the children chose either anthroposophic or conventional physicians: they weren't randomized. Nevertheless, a style of practice that significantly restricts the use of antibiotics in these conditions (URIs and AOMs) has to be a good thing. There is an ever-increasing body of medical literature that strongly suggests negative consequences of current, excessive antibiotic use: increasing bacterial resistance to antibiotics, increasing atropy, and now possibly increased risk of JRA and IBD (the last two are more preliminary findings that need confirmation).
2. Article #2, Article #3 & Article #4. These next three are review articles that address, from various points of view, the importance of the GI microbiome, antibiotic perturbations of the microbiome, the hygiene hypothesis, and the early immune challenge hypothesis. These review articles give you the context and current understanding of our health being intimately bound up with the GI microbiota and their alteration by antibiotics and other modern lifestyle practices that may be leading to the rise in atopic diseases. You certainly don't have to read them all! You should be aware, however, that not all the data or studies are consistent with the hygiene hypothesis. Like most things in science and in life, "it's complicated"; that is, more complicated than our original ideas.
3. Article #5 & Article #6. To round out this "Pediatrics Edition", I wanted to include published evidence on the beneficial effects of an anthroposophic lifestyle associated with a lower incidence of IgE sensitization and atopy. There are many elements of an anthroposophic lifestyle, including; a high incidence of home births, prolonged breastfeeding for at least 6 months, a lacto-vegetarian diet for young children, very limited antibiotic exposure- if at all, Waldorf education, lactic acid-fermented food ingestion, limited immunizations, exposure to farm animals, gardening, low stimulatory stress for infants and young children, and organic food consumption. There are also papers showing that salivary cortisol levels are lower in infants and children up to 2 years old who live the "anthroposophic lifestyle" (articles not included. Jackie Swartz and Fredrik Stenius are two of the main authors of these studies).
4. Further reading. Rudolf Steiner's Curative Education course, also called Education for Special Needs, given in 1924, has a wealth of medical, psychological and educational insights from an anthroposophic perspective. You can begin to see how Steiner worked, approached children, and explained his findings to the physicians and care workers who attended the course. This lecture series assumes you know the basics of anthroposophy.
5. Questions or contributions. Please send them and we'll put them in this section!
May you be able to accomplish your goals for this year. Please don't forget to RENEW your membership!
For the PAAM Board,
Ricardo Bartelme, M.D.