Michigan MedicineI graduated from the University of Michigan Medical School in the late 1980s. If there’s one thing I remember about the four years I was there, it’s that U. of M. was really hardcore about science back then. In fact, one of the things I remember is that U. of M. was viewed as being rather old-fashioned. No new (at the time) organ system approach for us! Every four weeks, like clockwork, we’d have what was called a concurrent examination, which basically meant that we were tested (with multiple choice tests, of course) on every subject on the same morning. The medical curriculum for the first two years had been fairly constant for quite some time, with a heaping helpin’ of anatomy, histology, biochemistry, and physiology in the first year and the second year packed full of pharmacology, pathology, and neurosciences. Nowhere to be found was anything resembling “energy medicine” or anything that wasn’t science-based!

Of course, back in the 1980s, the infiltration of quackademic medicine into medical schools and academic medical centers hadn’t really begun in earnest yet, although the rumblings of what is now called “complementary and alternative medicine” (CAM) and, more frequently these days, “integrative medicine” (IM) were starting to be heard in East Coast and West Coast schools. Even there, though, the incipient CAM movement was viewed as fringe, not worthy of the attention of serious academic physicians. Indeed, in the late 1980s, even at what are now havens of quackademic medicine if someone had suggested that diluting substances until there is nothing left, as in homeopathy, or waving your hands over a patient in order to channel the “universal source” of energy into a patient in order to heal a patient, as in reiki, had any place in scientific medicine, he’d have been laughed out of medical school–and rightly so.

Not so today, unfortunately. Although the problem of infiltration of quackademic medicine into academic medical centers goes way beyond this example, I can point out that faith healing based on Eastern mystical beliefs instead of Christianity is alive and well and ensconced in academic medical centers such as the University of Maryland School of Medicine Center for Integrative Medicine, where reiki masters are roaming the halls of the University of Maryland R. Adam Cowley Shock Trauma Center and Bonnie Tarantino, a Melchizedek practitioner, holographic sound healer, and an Usui and Karuna Reiki Master holds sway. Meanwhile, all manner of woo, such as acupuncture, homeopathy, craniosacral therapy, reiki, and reflexology are offered. Truly, you know that when an academic medical center has gone so far as to offer homeopathy, reflexology, and reiki, it’s all over as far as academic credibility is concerned, and it has become a center of quackademic medicine. Sadly, even a hospital where I trained, MetroHealth Medical Center, has succumbed to the temptation to add the quackery that is reiki to its armamentarium. That aside, I had never expected that my old, hardcore University of Michigan would go woo in such a big way.

I was wrong.

Over the last decade, the University of Michigan Medical School has gotten into alternative medicine, adding IM to its curriculum and even having a fellowship in IM. At the time I first learned of this a few years ago, as disturbed as I was, I reassured myself that at least U. of M. seemed to be sticking to the milder woo, like acupuncture and massage. Then, while browsing the blogs last month, I came across reports by P.Z. Myers and Tufted Titmouse, both of which contained a link to the University of Michigan Integrative Medicine (UMIM) resource page. And what to my wondering eyes did appear? (Actually, I should rephrase that as, “What to my despairing eyes should appear?”) The answer: Anthroposophic Medicine. Yes, it’s anthroposophy, Rudolf Steiner’s mystical, magical system that is the bottom of a lot of quackery and anti-vaccine beliefs. Indeed, outbreaks of vaccine-preventable disease have been distressingly common at Waldorf schools, where the educational philosophy is based on the teachings of Rudolf Steiner, which is why they are sometimes called Steiner schools or Steiner-Waldorf schools. Although the European Council for Steiner-Waldorf Education, which represents approximately 700 of the 1000 Waldorf schools world wide, has stated unequivocally that opposition to immunization forms no part of the goals of Waldorf education, Waldorf schools are magnets for parents opposed to vaccination. One example occurred in California in 2008, when there was a measles outbreak at the East Bay Waldorf School in El Sobrante. Given that the UMIM program, although interdisciplinary, boasts heavy involvement of family medicine faculty, I can’t imagine the cognitive dissonance that must be going on. After all, many family medicine doctors also take care of children and are responsible for making sure they are properly immunized just as much as any pediatrician.

But let’s look at what UMIM’s webpage on anthroposophy says about it:

Anthroposophic medicine views health as a matter of mind-body-spirit balance. It is centered on the idea that humans are not independent organisms but, instead, beings composed of the interactions of physical body, inner life body, soul (mind and emotions), and spiritual ego (self-awareness). Whereas conventional medicine focuses on “fixing” the part of the physical body that is “broken,” anthroposophic medicine prescribes treatment for the whole being through conventional methods in combination with holistic methods. As such, anthroposophic medicine integrates theories and practices of modern medicine with alternative, nature-based treatments and a spiritual-scientific understanding of the human being. The practice is based on Austrian philosopher Rudolf Steiner’s concept of anthroposophy, a scientific and philosophical world view that connects the spiritual within the human being to the spiritual in nature, the world and the cosmos.

This is consistent with what the Holistic Health Internet Community says about anthroposophic medicine:

Austrian scientist and philosopher Rudolf Steiner (1861-1925) refused to accept the contemporary scientific view of the body as a purely physical entity. From that conviction was born the doctrine of anthroposophy, a word he coined from the Greek words for “man” and “divine wisdom.” Steiner believed in the uniqueness of each human being, and contended that health and well-being deteriorated without that belief. Trained as a scientist and a mathematician, he was influenced by Hindu and Buddhist beliefs and founded a school in which his theories became practice.

Anthroposophical medicine determines the nature of illness based on Steiner’s principal of polarity. His system attempts to link and harmonize both the upper and lower poles of the body. Good health then depends on a harmonious relationship between the physical, etheric and astral bodies, and the ego. Practitioners are trained as medical doctors and may treat childhood infections, hay fever and asthma, anxiety, depression, cancer, musculoskeletal problems and fatigue.

If twenty years ago someone had told me that one day that not only would my medical alma mater be publishing dreck like this, but that it would have formed an interdisciplinary program devoted to it, I would have told that person he was delusional. If you had told me that anthroposophy would be part of a larger program of woo run by a physician who is described as having “studied herbalism and spiritual healing for 14 years with a Native American Healer” and as having research interests that include the “use of herbs, energy healing, environmental healing, and the therapeutic relationship” or that a physician trained in “functional medicine” would be a big part of a program in anthroposophic medicine there, I wouldn’t have believed it. All I can wonder is what Bill Kelley, the infamously hardcore scientific chair of the Department of Internal Medicine while I was at Michigan, would think or say if he were still at U. of M. In fact, having read the section on anthroposophy on U. of M.’s website, I wish I were delusional. But I’m not. The section is real, and the medical school from which I graduated has not only started to tolerate such nonsense, but begun to embrace it.

Anthroposophical medicine, it turns out, is rooted in prescientific vitalism. Rudolf Steiner, before he came up with the idea of anthroposophy, had led the German section of Theosophy. When he became enamored of his spiritual concept of anthroposophy, Steiner in essence caused a schism. Anthroposophy, it further turns out, is far more a religious and spiritual philosophy than a scientific or medical one. Based on his philosophy, Steiner created Waldorf schools, anthroposophic medicine, and biodynamic farming, the last of which would be a suitable topic for an amusing post on a non-medical blog. Suffice to say that some of the practices of biodynamic farming involve stuffing Yarrow blossoms (Achillea millefolium) into urinary bladders from Cervus elaphus, Red Deers, placing them in the sun during summer, burying them in earth during winter and retrieving them in the spring, all to strengthen the “life force” of the farm. There’s also a lot of use of cow horns, based on Steiner’s rationale, “The cow has horns in order to reflect inwards the astral and etheric formative forces, which then penetrate right into the metabolic system so that increased activity in the digestive organism arises by reason of this radiation from horns and hoofs.” Moreover, many of the concepts of homeopathy are combined with Steiner’s woo, such that many of the concoctions of biodynamic farming, which consist of various bits of dead animals plus or minus ground quartz crystals, are diluted into many tons of compost, to be spread over acres of farmland.

But let’s get back to anthroposophic medicine, which is based on the same sort of mystical philosophy that biodynamic farming is. Simon Singh and Edzard Ernst characterize this form of medicine thusly in their book Trick or Treatment?:

Applying his philosophical concepts to health, he [Rudolf Steiner] founded, together with Dr. Ita Wegman, an entirely new school of medicine. It assumes metaphysical relations between planets, metals, and human organs, which provide the basis for therapeutic strategies. Diseases are believed to be related to actions in previous lives; in order to redeem oneself, it may be best to live through them without conventional therapy. Instead, a range of other therapeutic modalities is employed in anthroposophic medicine: herbal extracts, art therapy, massage, exercise therapy, and other unconventional approaches.

Perhaps the most common example of anthroposophic medicine is the use of mistletoe extracts for the treatment of cancer. Perhaps you’ve heard of Iscador? While Iscador might actually have some activity against, for example, breast cancer, it is not without toxicity, and the evidence for its efficacy in cancer is at best conflicting. Even if Iscador turned out to be an effective treatment for breast cancer, it would be an example of being right for a reason that is spectacularly wrong. That’s because Steiner argued that mistletoe is a parasitic plant that eventually kills its host. To him, this represented a striking parallel to malignant tumors, which, like mistletoe, are parasitic entities that eventually kill their hosts. Steiner’s conclusion? Because of this resemblance, mistletoe must be an effective treatment for cancer. Readers knowledgeable about homeopathy will immediately recognize that Steiner clearly must have believed in the homeopathic principle of “like cures like.” In fact, he even went beyond that to generalize that “a plant is a healing plant when it has a distortion or an abnormality in its physiology and morphology,” presumably related to human disease. Indeed, according to Dr. Peter Hindenberger this represents a “modern, scientific reformulation of what, in former times, existed in the ‘doctrine of signatures‘”; i.e., the belief that God has marked everything he created with a sign (signature) that is an indication of the purpose for which the item was created.

Although you can read more about anthroposophic medicine, either at a Steiner website or the Physician’s Association for Anthroposophic Medicine (to get it right from the horse’s mouth, so to speak) or over at The Skeptic’s Dictionary and Quackwatch, including a description of what being a student at a Waldorf school is like, because this is about UMIM’s apparent embrace of anthroposophical medicine, I think that I will close by discussing what UMIM says about it. But, before I do so, let me quote a passage from what PAAM says about it in a PDF booklet. After all, U. of M. includes a link to PAAM on its website, which leads me to assume that the UMIM program in anthroposophic medicine endorses PAAM. So does the fact that PAAM is based in Ann Arbor. But back to the PAAM pamphlet:

Medicine based purely on material science is limited to explaining an illness solely on the basis of the laws of physics and chemistry.

I’m sorry. I can’t help but interject here that PAAM says this as though it were a bad thing. Personally, though, I’m curious as to how we can explain illness not based on the laws of physics and chemistry. Unfortunately, PAAM is more than happy to tell us how anthroposophic medicine is “more ambitious” than us mere practitioners and proponents of science-based medicine. I suppose it is, casting off, as it does, all those inconvenient laws of physics and chemistry that took hundreds of years to discover and understand:

Anthroposophic medicine is more ambitious. It takes into account additional factors, both general and individual, that may affect the patient’s life, mind, and soul, and their physical manifestation: in growth, regeneration, microcirculation, fluid retention in the skin, muscle tone, biorhythms, head distribution, posture, uprightness, gait, mental focus, speech. When illness occurs, examination of the above may reveal deviations, imbalances, and extremes–additional diagnostic parameters that need to be considered when selecting a therapy. Anthroposophic medicine also has a different understanding of the role played by the patient in overcoming illness. The patient is not simply a passive recipient of medical skill, but an equal partner with the doctor. After all, nobody can know the patient better than the patient. During an illness, the patient has the opportunity to recognise the state of imbalance body and soul have reached, to understand this and rectify it. The illness can provide an opportunity to learn new modes of behaviour, to develop further insights, and acquire greater maturity.

And, yes, anthroposophic medicine embraces homeopathy:

In addition, other substances tailored to the patient’s unique characteristics are administered. These are frequently homeopathic substances designed to stimulate the organism and its powers of self-healing.

Science-based medicine, anthroposophy clearly is not. Of course, that’s quite obvious from what UMIM itself says about the anthroposophic view of health. According to UMIM, this consists of these tenets, with my comments in brackets after each item:

  • Health involves a dynamic balance and high functioning of all aspects of a person’s life. [This is so vague as to be meaningless and all but impossible to argue with, but it’s the sort of trope common in alt-med circles.]
  • Illness is the result of disharmony and imbalance amongst the three systems of the body and their related forces and effects. [This sounds very much like attributing disease to imbalances in the four humors. Teach the controversy! about the Four-fold Man!]
  • Illness is a tragedy, but also an opportunity for learning and transformation. [This sounds very much like the quackery that is the German New Medicine and Biologie Totale to me; that is, if you strip away Steiner’s belief in reincarnation wherein illness isn’t the working through of unrecognized emotional traumas in this life (as German New Medicine teaches) but is rather the working through of issues from previous lives.]
  • The signs and symptoms of an illness are often the body’s attempts at healing and, in general, should not be suppressed, but rather, aided, observed and resolved. [More German New Medicine– and Biologie Totale-like gobbledygook. Again, odd how U. of M. leaves out Steiner’s belief that these body’s attempts at healing are related to past life experiences.]
  • Many illnesses, especially benign ones, should not be artificially prevented, but should be allowed to occur and be treated and healed. The patient thereby gains strength and experience, both biologically and spiritually. [This would appear to be the basis for so many anti-vaccine beliefs that permeate every aspect of anthroposophic medicine and the education taught in Waldorf schools. After all, what is vaccination, but preventing illness? I guess your kids get so much stronger, spiritually and biologically, if you just let them, take their chances with measles, mumps, whooping cough, and Haemophilus influenzae type B. Because, you know, that worked out so well for children in terms of childhood mortality back in the days before vaccines could prevent these diseases. Oh, wait. No it didn’t.]
  • True prevention of illnesses involves a healthy lifestyle with positive habits, strengthening the biological, psychological and spiritual aspects of a person, and avoiding the detrimental and illness-producing effects of much of modern civilization. [Do I detect a reference to “toxins” here? I think I do.]

UMIM even goes on to link to a company that produces skin care products and medicines based on Steiner’s biodynamic farming (including Iscador and homeopathic remedies), as well as to point out that many anthroposophical remedies can only be administered as an inpatient at a facility like the Rudolf Steiner Health Center in Ann Arbor, Michigan. There, you can find a video about anthroposophic medicine:

Check out the part around 24:25, where a chemist describes how anthroposophic medicines are made, including the part about how he “potentizes” many of them in decimal fractions, just as homeopaths do with their remedies. His goal is, as he puts it, to “strengthen the vital forces within the living organism while at the same time respecting its natural rhythm.” He also heads out to the French border at 4 AM during the summer so that he can harvest Arnica plants at dawn, thus allowing the “morning strength” to be maintained in them. I kid you not. Then, get a load of this description of anthroposophic medicines, right off the U. of M. website:

Many anthroposophic remedies are specially prepared using homeopathic or modern alchemical pharmaceutical processes to naturally stimulate healing processes in the ill person.

Yes, it would appear that alchemy is alive and well at U. of M.!

Fortunately, the Rudolf Steiner Health Center does not appear to be affiliated with the University of Michigan, at least as far as I can tell. Unfortunately, it’s still very disturbing that UMIM would recommend such an institution and even more disturbing that “anthroposophic physicians at the University of Michigan” appear to be partnering with the Rudolf Steiner Health Center to research anthroposophic medicine as supportive care for cancer patients.

Personally, I think that Robert Carroll gets it exactly right when he characterizes anthroposophic medicine as being “even more out of touch with modern, science-based medicine than homeopathy.” Think about it. Homeopathy is based on just two magical ideas: The Law of Similars and the Law of Infinitesimals, which together can be viewed as an expression of the ancient principles of sympathetic magic. In marked contrast, anthroposophic medicine is based on many ideas with no basis in science that can best be described as pure magical thinking. Indeed, to me at least, anthroposophic medicine resembles more than anything else naturopathy in that there doesn’t appear to be a form of unscientific, prescientific, vitalism-based woo that it doesn’t embrace. In fact, anthroposophic medicine appears to go far beyond naturopathy in that respect. It also brings into play a veritable cornucopia of mystical concepts, including the etheric body, the astral body, and the ego. It postulates that the soul, the senses, and the consciousness are beings that have an independent existence outside of the body and further asserts that herbs, essential oils, and movement therapy known as eurythmy can bring these things into harmony and balance with each other and the physical body. Reading about anthroposophy and anthroposophic medicine, I had some serious acid flashbacks to my youth, when I used to be an avid Dungeons & Dragons player. My personal oddities during my high school and college years aside, anthroposophic medicine openly denigrates science-based medicine for only being able to diagnose and treat disease according to its understanding of the laws of physics and chemistry, to which I respond: Upon what else would a physician base his understanding of disease? As Carroll put it:

Steiner approached medicine the same way he approached everything else from astrology to Atlantis to education to farming to metaphysics: He dictated his visions. Why anyone considers him a scientist is a great mystery. His notion of science as involving the explanation of how immaterial entities affect material entities is the very opposite of science.

Indeed, and the medical school from which I graduated over 20 years ago now has a program dedicated to teaching physicians and medical students as fact the medical philosophy of this very man, whose philosophy is not only far more religion and mysticism than science but is indeed antiscience at its very core despite its superficial declaration of allegiance to science. Indeed anthroposophic medicine’s assertion of relationships between the various bodies (physical, etheric, etc.) and astronomical bodies is far more akin to astrology than science. Would that it were only homeopathy U. of M. were teaching and practicing!

I used to be very proud to have graduated from the University of Michigan Medical School. When I was there, it was one of the top public medical schools in the country and compared quite well with any private medical school in the U.S. you could name. In many ways, it still does. Unfortunately, like those other top medical schools, including Harvard, Yale, Stanford, and Columbia, U. of M. appears to have embraced quackademic medicine. I only wish it had, instead of imitating such schools, resisted the siren call of unscientific, prescientific, and pseudoscientific medicine. Unfortunately, as its embrace of anthroposophy demonstrates, it has not. As a result, the pride I have as a U. of M. alumnus is now tarnished with the knowledge that, even though the vast majority of what happens at the medical school and its affiliated hospitals is still solidly science-based and U. of M. boasts some of the best medical research programs anywhere, there now exists section within it that teaches pseudoscientific nonsense as if it were science. It makes me very sad and depressed to contemplate.

No doubt the U. of M. faculty and leadership responsible for this travesty will say that they pick and choose only the bits from anthroposophic medicine that are evidence-based and ignore all the woo. Quite frankly, to me anthroposophic medicine is pretty much all woo as far as I can tell. Or perhaps they would argue that the anthroposophic medicine program is a tiny part of a vast enterprise of science-based medicine. This is almost certainly true. It’s also probably true that relatively few U. of M. faculty even know about the existence of a Steiner-inspired program at their school. To me, however, there is zero place for such religious- and mysticism-inspired nonsense in any reputable medical school, other than as a footnote in courses in the history of medicine. Certainly there is no place for it being taught or practiced as though it had any validity whatsoever anywhere near medical students, residents, or fellows–and especially nowhere near patients.

Finally, knowing that U. of M. is teaching and practicing anthroposophic medicine makes me very irritated whenever I get mail soliciting donations for its medical school. From here on out, I think that, whenever a U. of M. Medical School solicitation arrives in the mail, I’ll send it back with a link to this post as the reason why I must decline.



Posted by David Gorski