Anthroposophical Views Dora Wagner

Getting under the skin

Dora Wagner

Everyone is in his own consciousness As in his own skin and lives directly only in the same.

Arthur Schopenhauer, trans. D. Wagner

Two months ago, I injured the tip of my middle finger very badly when I was cutting faded plants. The bleeding was difficult to stop, so I had to quit gardening for a while. Two months later, there is nothing left of the wound and I consider this a great miracle. The capabilities of skin are fascinating, aren't they?

One of the most remarkable features of human skin is its nakedness. Unlike other animals, humans have no fur, no feathers, no spines, no horns, no manes with which to equip themselves for life under particular environmental and climatic conditions (Jachens, 2012). As an outpost of the brain, our skin has numerous sensors that react to changes in our environment and warn us of possible dangers. The mechanoreceptors of the skin include cells for touch, pressure or vibration; thermoreceptors convey the sensations of warmth or cold; nociceptors, sensations of pain. Positive tactile perceptions are the basis for our primal trust in human existence. Body and skin contact are vital for all of us, carrying real social bonds and enabling self-awareness. In the sense of touch, we experience ourselves, our ego, the boundaries of our body as distinct from the environment.

Jachens (2018) describes our perceptions of touch, warmth and vibration as conscious perceptual activities, whilst smell, taste and certain aspects of the perception of light are unconscious perceptions of matter and its properties. There is some evidence (e.g. Yong, 2009) that when we follow a speaker, we not only listen with our ears but watch their facial expressions and experience the air puffs of their speech as tactile stimuli via the skin. In this way, the skin is also involved in hearing. We also ‘see’ with our skin, to the extent that the absorption of light interacts with melanin, effects vitamin D synthesis, and accelerates growth in our hair follicles (Bäumler, 2006; Buscone et al, 2017). Our skin has even been shown to respond to the scent of Sandalwood (Santalum album), and other odours (Gelis et al, 2016). In fact, the skin’s olfactory receptors have been found in increased concentrations within melanomas and also in mRNA. In both cases, the olfactory receptors are upregulated; when activated, they inhibit both the growth and the migration of cancer cells, suggesting potential as a novel target in the treatment of skin cancer or disorders of pigmentation (ibid.).

The skin says a lot about the person inside it; our facial skin may redden with excitement, turn pale with panic, itch with nerves. These phenomena are due to changes in blood circulation and can tell us much. Thus, as an intrinsic element in human facial expression, skin becomes a representatively designed surface. No wonder it provides such rich material for metaphor. A person wearing a thick coat is not necessarily ‘thin-skinned’; even if you ‘don't feel comfortable in your skin’, you may not wish to ‘jump out of’ it; nor does anyone hope to succeed merely by ‘the skin of their teeth’.

Maintaining skin health is a very complex matter, involving diet, environment and lifestyle. Therefore, I will not report here on plants used to treat skin conditions, but describe how, in anthroposophical medicine, healing substances are applied to specific areas of the skin to benefit the whole person.

The four elements— earth, water, light and warmth —can have healing effects on our body from the outside. Since the physiological reactions of our skin are immense, intentionally administered external applications have a firm place in treatment, including self-treatment, especially for less severe but distressing complaints.

Warming and cooling the body has always played an important role in healing. For thousands of years, compresses, therapeutic baths, ointments and liniments with oils have been among the healing treasures of many cultures (Nedoma, 2020). There is both a physical and a mental-spiritual dimension at play here: when it is warm, we expand; in the cold, we withdraw. This is why warmth is an important therapeutic and nursing element in anthroposophical medicine, and many treatments aim to protect and promote warmth in body, mind and soul. We are all familiar with calf compresses for fever. A century ago, based on holistic diagnosis and treatment, external applications were integrated into the anthroposophical healing at the Ita-Wegmann Clinic in Arlesheim, (Steiner & Wegmann,1925). Still today, they form an essential element in the professional competence of anthroposophical nurses and doctors, even in acute situations (van Dam, 2007). Since mainstream medicine has turned to evidence-based scientific research, external applications to the skin have become less popular— possibly because it is not easy to calculate the amount of substance absorbed. However, if active ingredients are absorbed through the skin and not the digestive tract, side effects can largely be avoided. Thus, cutaneous application— in the form of herbal pads or poultices; beeswax presses; compresses with herbal tinctures, oils or ointments; or steam and foot baths with plant additives —is always accompanied by awareness, sensation, and immediate perception. Oral medication is only initially perceived via taste and touch, whilst any further processes occur unconsciously, and possible effects and side-effects are only noticed much later.

Four aspects are important when carrying out an external application: substance; medium; area of application; and attitude. The substance used could be a plant extract— such as Yarrow (Achillea millefolium), Lemon (Citrus limon) or Ginger (Zingiber officinale) —a mineral (such as magnesium, copper or gold), or an animal substance (such as honey, quark or beeswax). The medium could be warm, cold, dry or moist. The area of application might be the back, chest, kidney, liver, face, or feet.

The caregiver's attitude should be supportive— attentive, nurturing, calm. These four aspects are highly interdependent and can be modified in various ways— for example, by duration, frequency, time of day, or combination of substances. Simply taking the time and permission to lie down and be cared for, to be enveloped, is itself beneficial. Accordingly, it’s preferable if the application can be carried out in a quiet room, and the presence of a carer can be important— for example, to intervene in cases of discomfort.

Whilst any of these external applications can be wonderful, one in particular has brought me great relief. The discomfort and pain of an impingement syndrome had been going on for a very long time, when I started using ginger applications on my back and shoulders. Zingiber officinale is an ancient plant that has been valued in the diet and traditional medicine of Eastern cultures for thousands of years. It can ward off a cold, aid digestion, help with travel sickness and sometimes even relieve nausea during chemotherapy. Anthroposophical doctors still use Ginger compresses for states of exhaustion or depression. Ginger also has a warming and relaxing effect when applied externally. European hospitals specialising in anthroposophical medicine report beneficial effects for a range of chronic health conditions, when Ginger is applied externally as a compress, patch or in a footbath and the application is even suitable for self-treatment (Therkleson, 2010; Thiesen, 2014; Chrubasik et al., 2005).

To prepare the poultice, soak five tablespoons of freshly grated Ginger or Ginger powder in about 150ml of boiling water for ten minutes, in a covered bowl. Then, infuse this extract with about one litre of hot water. Soak a cotton cloth with this hot ginger infusion, wring it out and cover with a second, slightly larger cloth. Place the whole on the back, over the kidney region, for thirty minutes, holding it in place with a thick woollen bandage. For self-treatment, it is best to put these materials in place before lying down. Cover up warmly and lie comfortably and quietly during the entire treatment— if necessary, have a hot water bottle ready for the feet. After about ten minutes, you’ll notice an intense feeling of warmth, which leads to a strengthening of the entire body and thus to a pleasant relaxation. After 30 minutes, remove the compress and rest for a further 15-30 minutes. The moist, fresh root is more stimulating than the powder, although the latter is easier to handle. At the same time, you need more strength to cope with the mild pungency of freshly grated Ginger (adapted from Sommer, 2018; Therkleson, 2010).

Positive tactile experiences are absolutely necessary for humans to maintain health and to develop a strong and vibrant confidence in life. They form the basis for our sense of security, rootedness in our own bodies, and the feeling of being at home. Particularly in these difficult times of social distancing and fear of infection, healing external applications are of inestimable value and ‘play an essential role in the effort to humanise medicine’ (van Dam, 2007).

Images: Dora Wagner, except ‘Sensory receptors in the skin’, from Sunshineconnelly at English Wikibooks, licenced under Creative Commons Attribution 3.0

References Bäumler, W. (2006) Wechselwirkung von Licht und Gewebe, in Landthaler, M. & Hohenleutner, U. (eds) Lasertherapie in der Dermatologie. Springer: Berlin, Heidelberg Buscone S.; Mardaryev A-N.; Raafs, B. et al (2017) ‘A new path in defining light parameters for hair growth: Discovery and modulation of photoreceptors in human hair follicle’ in Lasers in Surgery and Medicine 49(7):705-718 Chrubasik S.; Pittler, M.H.& Roufogalis, B.D. (2005) ‘Zingiberis rhizoma: A Comprehensive Review of the Ginger Effect and Efficacy Profiles‘, in Phytomedicine, 12 (9): 684–701 Gelis, L.; Jovancevic, N.; Veitinger, S.; Mandal, B.; Arndt, H-D.; Neuhaus, E.M. & Hatt, H. (2016) ‘Functional Characterization of the Odorant Receptor 51E2 in Human Melanocytes’, in Journal of Biological Chemistry 291(34):17772-17786 Jachens, L. (2018) ‘Die Haut als Sinnesorgan‘, in Der Merkurstab. Zeitschrift fur Anthroposophische Medizin 71(1):23-33 Jachens, L. (2012) Dermatologie; Grundlagen und therapeutische Konzepte in der AnthroposophischenMedizin. Salumed-Verlag: Berlin Nedoma, G. (2020) Traditionelle Hautmedizin. Servus: Salzburg Sommer, M. (2018) Heilpflanzen, Verlag Urachhaus: Stuttgart Steiner, R. & Wegmann, I. (1925/ 1997) Extending Practical Medicine: Fundamental principles Based on the Science of the Spirit, trans. Anna R. Meuss, 5th edition. Rudolf Steiner Press: Forest Row Therkleson, T. (2010) ‘Ginger Compress Therapy for Adults with Osteoarthritis’, in Journal of Advanced Nursing, 66 (10): 2225–2233 Thiesen, A. (2014) ‘Ingwerauflage bei Rückenschmerzen‘, in Zeitschrift für Komplementärmedizin, 6 (02):62–63 van Dam, J. (2007) ‘The Role of External Applications in Modern Medicine’, in Der Merkurstab, Zeitschrift fur Anthroposophische Medizin, 60(2):148-150 Yong, E. (2009) ‘How our skin helps us to listen’, in National Geographic, November 25th issue.