Darmnosoden Anhängsel
Chronisch-entzündliche
Darmerkrankungen
Der Sammelbegriff
chronisch-entzündliche Darmerkrankungen (CED) umfasst Morbus Crohn und die sogenannte Colitis ulcerosa.
Von Colitis ulcerosa spricht man, wenn die Darmschleimhaut betroffen ist. Die Entzündung beschränkt sich in diesem Fall auf den Dickdarm. Bei Morbus Crohn kann dagegen der gesamte Magen-Darm-Trakt vom Mund bis zum After betroffen sein. Zudem kann die Krankheit die ganze Darmwand betreffen und die Entstehung von
Fisteln hervorrufen.
Lässt sich nicht eindeutig eine von beiden Krankheiten diagnostizieren, spricht man von einer Colitis indeterminata. Chronisch-entzündliche Darmerkrankungen treten
häufig schon bei Kindern oder jungen Erwachsenen auf. Insgesamt nimmt die Häufigkeit dieser Erkrankungen zu.
http://www.narayana-verlag.de/homoeopathie/pdf/Notes-on-Miasms-Heredity-and-Nosodes-Filip-Degroote.08245_3Bowel_Nosodes.pdf
[Russell Malcolm]
Therapeutic
Guidelines
The
dysbiotic case is a blocked case. Patient’s whose
intestinal ecosystem is significantly disordered have an on-board source of
immunological and physiological chaos.
If
the symbiotic homeostasis is not corrected, the patient will be incapable of
responding to a classical similimum. Or the response
will be weak and short-lived.
One
of the most important considerations for the physician is whether there are
clinical features of dysbiosis. For the very
experienced medical homeopath it may run against the grain to reduce the dynamics
of a complex case down to a diagnostic label. If the diagnosis of intestinal dysbiosis is missed, however, the reactive features will
not be enough to identify a cure for the case. There are a number of features
in the case history to look out for.
Key
indications for the bowel nosodes
1.
Aetiology: infection, antibiotics or both
2.
Never well since... (Acquired intrinsic blocks to cure)
3.
Physiological / metabolic / immune corollaries (signs of fatigue, debility,
toxicity and vulnerabilty to infection). Prominent
‘generals’.
4.
Self-perpetuating illness state (see dysbiosis –
systemic cycle below) Systems-distubances.
5.
Evidence of altered surface immunity (inflammatory conditions skin, mucus
membranes, or internal integuments eg. synovium)
6.
Symptoms referable to GI, GU, respiratory tracts and body orifices (although
there are often persistent bowel symptoms, these can be surprisingly minor in
comparison
with
the systemic corollaries)
7.
Insidious block to cure (cases which are failing to respond to well chosen
remedies, or where the patient consistently fails to build on an early
response)
8.
Bacteriological evidence of reduced lactose fermenting anaerobes, or evidence
on stool culture of significantly increased populations of delayed/non lactose fermentors
or
pathogenic enterobacteraceae.
After
a remedy there is an increased presence of non-lactose fermenters
in the stool.
“...with
regard to the change in the bowel flora [after a remedy]. The appearance of
non-lactose fermenting organisms, I regard as evidence of the action of the
defensive
body
mechanism.
Their
percentage in relation to B. coli and their persistency in point of time may be
used as an indication upon which to base treatment at any period of the
disease”.
“If
the percentage is high (80-100%) clinical experience has shown that the potentised vaccine (nosode) does
definite harm”. [May ‘block’ an acting remedy.]
“Now
with a positive stool yielding 20% or less, I should not hesitate to use the
corresponding nosode or autogenous
vaccine, provided the patient does not show other evidence of improvement”.
The
general consensus in the literature is that the Bowel Nosodes
do not stand repetition. They are given as stat doses, or split stat doses,
over one or two days.
The
author prefers three stat doses, in rising potencies, over twelve hours. The
traditional advice is then to wait, and to avoid repetition of the nosode within 3 months.
In
my experience the patient usually some shows some evidence of a response within
10-14 days after a good prescription. (Sometimes earlier)
Where
the bowel nosode is used on its own account, as the
main therapeutic input, I would leave the resolution to unfold in an open-ended
way (weeks), if they are
Showing
ongoing improvement.
In
uncomplicated cases the patient’s intrinsic block to cure will resolve and they
will become responsive to a classical remedy.
The
indicated similimum should be given if they plateau
in their clinical response.
The
diagram opposite is a representation of resolving dysbiosis
after a bowel nosode, showing the threshold beyond
which a remedy response can occur.
When
the bowel nosode is being used to resolve a block to
cure, or augment the response to a partially effective remedy, I would leave 14
days or more between the nosode and the related
remedy.
My
rationale for this is that many chronic cases show two or more main cycles of
causation, and these may need to be resolved sequentially to achieve progress.
In
some cases if you wait too long after the nosode to
introduce the similimum, the systemic disturbances
will re-evoke the intestinal dysbiosis. If you do not
wait long enough between nosode and similimum the dysbiosis will
continue to block the remedy response. In children the time lapse is shorter
than in adults. Adults with longstanding active bowel symptoms and debility
should be left longer to respond.
A
well chosen bowel nosode does not appear to be
blocked in its response by a well chosen similimum.
However, a well chosen similimum which is slowly
resolving a long-standing illness, may be blocked by early repetition of
itself, or of its related nosode.
In
cases which you have successfully ‘unblocked’ and which are resolving with the similimum, it is best to follow the traditional advice and
avoid repetition of the nosode, unless there are
clear indications that the bowel symptoms are re-emerging and the patient is
deteriorating clinically.
NB
Discharges, catarrhs and eruptions in the post-similimum
phase of treatment are not indicators of worsening surface immunity. These
features are all too frequently treated by orthodox prescribers with antibiotics
- often rendering the patient dysbiotic once again
and returning them to their state of fatigue or debility.
In
infective acutes the early use of the correct similimum will prevent dysbiosis
emerging subacutely. In sub-acute infective cases,
the indicated nosode can be used alternately within a
series of similia, in high potency, which reflect the
dynamic changes in the current state of the patient. Many patients showing
signs of dysbiosis have had two sequential courses of
antibiotics within a short time frame. (usually with different spectra of antibactial activity). If they have also had treatment with
antipyretics they may show signs of thermostatic instability and fatigue. In
this event use a physiological similimum at an early stage
of treatment. (See rubrics for fever suppressed/remittent; or rubrics relating
to the abuse of quinine.)
There
is plenty of room for error in the selection process for a bowel nosode on purely clinical features. Even careful
symptom-analysis using a bowel nosode repertory like
the
one given in this book can lead to the wrong choice of nosode.
The
materia medica of the bowel
nosodes has been worked out in the clinic over the course
of several working lives. A major element in the treatment of chronic cases is
in
the
process:
*
clinical exploration
*
development of models for the illness
*
engagement with the available treatment data
*
selection and timing of treatment
*
re-evaluation and adjustment of models, analyses and treatment
*
feedback into the fund of clinical data and teaching of others
These
cycles of clinical feedback generate information of potential value to other
prescribers. In studying and using the bowel nosodes,
there are several ways in which historical clinical information can be helpful:
*
providing additional information governing choice of nosode
*
understanding the relationship of the nosode to other
treatments
*
informing their timing and placement within the treatment programme
In
the early days, the bacterial composition of the stool was an important factor
in guiding treatment choices. Stool composition changes under the influences
of:
*
illness
*
diet
*
drug treatment
*
the clinical homeopathi
*
similimum
*
the indicated nosode
In
the ill patient with bowel dysbiosis, use of the
clinical similimum or constitutionally based remedy
appears to evoke host responses and a shift in the surface immunity in the
bowel.
In
the clinical experiments of Bach and Paterson, the number of non-lactose
fermenting organisms was frequently observed to increase in the stool, for a
time after homeopathic treatment (perhaps as bacterial surface adherency diminished). This shift in flora was associated
with clinical improvement.
The
observed shift in the bacterial composition of the stool appeared to bear some
relationship to the remedy used. As time went on, this quasi-objective
information
was
collated and became the first major influence on remedy-nosode
relationships.
It
is clear that much of the existing data suffers from some obvious limitations
in mid 20th century microbiological knowledge, and all these basis hypotheses
need to be reinvestigated. It is also clear that many other variables may be
operating in these complex clinical situations, and control group comparisons
are not available, so we have to
be
careful not to rely entirely on these observed associations.
As
the body of knowledge and experience increased, clinical outcomes became the
main method of establishing remedy-nosode
relationships. ‘Blocked’ cases or cases
which
had plateaued in their response would be found to
improve after the use of an appropriate nosode. Their
response to the similimum or constitutionally based
treatment would then improve, and the empirical relationship between nosode and remedy would be documented.
Clinicians
like Wheeler, Dishington, Griggs and Elizabeth
Paterson have been very influential in reporting cases and gradually extending
these clinical relationships.
I
have found this information very useful in the clinic and there appears to be
more than a little truth in these observed relationships, although proving them
statistically is
an
entirely different matter!
Looking
at the remedy list it is obvious that there are hundreds of remedies in general
use among experienced homeopaths, for which a nosode
relationship is not established. Today we have access to remedy data that was
much more difficult to access in years past. So it is possible to synthetically
repertories on the key clinical information available for each nosode and explore possible relationships further. It is also
interesting to see whether ‘known’ relationships are bourne
out by the repertory.
On
the pages that follow there are a series of experimental repertorisations.
Symptom
information from ‘A survey of the bowel nosodes’ by
Elizabeth Paterson has been entered in various combinations and the rubrics
analysed.
Symptom
groupings have been analysed on various rationale:
*
‘totality’ (selection of the most consistent contextual information)
*
‘essence’ (key mind rubri* and consistent contextual
and local information)
*
‘pathological’ (key rubrics for surface-immunity, system or locality)
The
resulting analysis for each nosode usually contains
‘established’ clinical relationships and also lists a variety of possible
relations that have not yet been confirmed clinically.
Some
nosodes (most notably Proteus) do not align very
convincingly with established relationships and a short impression for each
analysis is given on the pages that follow.
The
rest of this section is made up of a series of tables which bring together
‘established’ and ‘notional’ relationships. I have annotated the entries to
show those that have been ‘confirmed’ in my experience, together with some
theoretical relationships bourne out of the repertory
search. A few of which are annotated to show which of these ‘unknown’
relationships appear to have worked for my patients.
Bowel Nosodes and the
Mind
There
is little doubt that homeopathy has tended to place the mind at the centre of
the case since the time of
Do
the mind features represent attributes that drive the case towards a particular
kind of dysbiosis?
Does
overgrowth of a particular organism accentuate certain mental/emotional
symptoms?
Are
there any psycho-immunological models that help to explain mind phenomena
associated with these nosodes?
Have
the mind symptoms in the literature been projected onto the bowel nosodes from those of their apparently related remedies?
Most
of these questions are difficult to answer in a concrete way. We will briefly
examine some possible immunological models for some of the central effects that
occur
in
infective and dysbiotic states. It is thought that a
number of cytokines have neuro-endocrine effects
which may alter mood and the pituitary adrenal function.
Some
gram negative organisms (including several implicated in dysbiosis)
release lipopolysaccharides which induce TNF,
interleukin-1.
The
presence of these compounds is associated with bacteriologically
mediated inflammatory responses and if their levels are chronically raised, as
a result of dysbiosis,
they
may reduce immunological efficiency and predispose to secondary infection.
IL-1
stimulates pituitary function and evokes a biochemical stress response. In the
acute infection a short term positive increase in adrenal function is probably immuno-stimulatory.
However,
protracted increases in adrenal activity ultimately inhibits cellular immunity.
We observe the same phenomenon in people who are chronically stressed.
The
question of whether emotional disturbance predisposes to dysbiosis
appears to tenable in terms of mind-body relationships and the foregoing
observations. Whether certain mental/emotional themes predispose to specify
kinds of dysbiosis is a tantalising but purely
speculative idea at the present time.
Here
are some thoughts:
Bacillus
7 - driven by material ambition or fear of insolvency - work
Bacillus
10 - driven by fear of aging or losing sexual allure - sex
Dysenteria co. - driven by anxiety of conscience - self
worth
Gaertner - driven by awareness of frailty and the need
to make a mark - creativity
Proteus
- driven by unremitting environmental stress - chronic autonomic overdrive
Sycotic co. - driven by shame (try to compensate for
their dirtiness) - infected
Morganiae - driven by greed for the good life
Faecalis - driven by the desire for understanding
Bowel
Nosodes and the Repertory
At
first glance, the remedy data for the bowel nosodes
seems too vague and general to be of clinical value. The leading symptoms and
keynotes can rarely be classed as ‘strange’, or ‘peculiar’.
So
bowel nosodes are not usually ‘jumped to’ on the
basis of a single strong feature in the case. A variety of inductive methods
(based on the context) are required.
It
may also be necessary to undertake some form of analysis using the available
clinical data.
Empiricism
The
data for the remedies themselves is highly empirical. Most of the patients, for
whom they have been prescribed in the past, have been chronically unwell, or at
least sub-acute.
The
remedies themselves cannot be said to have undergone a standard proving,
although clinical observation and stool culture data lends some objectivity to
However,
what information there is, is in my opinion, more reliable than much of the
proving data in the materia medica
as a whole.
Repertories
Modern
repertories have imported the bowel-nosodes into
their rubrics, but no one appears to have marked up the rubri*
entries as they are clinically verified, in spite of the considerable number of
cases that have appeared in the journal literature over the last fifty years.
As a result, the nosodes have never been elevated
above ‘normal type’ in
the
standard repertories of the day.
This
low-key representation, together with the small overall number of symptoms, means
that these nosodes never turn up in a totality
analysis.
‘Broad
sweep’ repertorisations, which analyse only large
headline rubrics, do not bring them out. Expert systems and family group
searches fail to show them up, even in
those
patient analyses where they are clearly indicated and ultimately shown to be
effective.
Given
this poor representation, it is wise to do two repertorisations
in those cases where the bowel nosodes are clearly
indicated.
-
in one repertorisation you would use traditional methodology
(whether it be totality, thematic, pathological or synthetic) and establish the
range of potential similia.
-
in the other repertorisation you would use a nosodes repertory to assess which remedy is most likely to
address the systems disturbances relating to the patient’s dysbiosis
As
you become more familiar with the nosodes, these two repertorisations will inform one another. So, for example,
if your ‘traditional’ analysis yields Phosphorus, Silica
or
their salts, you will probably use the nosodes
analysis to assess whether Gaertner is indicated.
With
experience you will come to use these empirical relationships to good effect,
using the remedies sequentially to ‘unblock’ the case or augment the response
of each
to
the other. We have included a recompiled bowel nosode
repertory (on page #), which uses the search-word and chapter conventions of
modern clinical repertories.
Because
the listings are short, it takes only a few minutes to do a hand repertorisation on the nosodes.
Analysis
methodology
Unless
you are very clear that an uncommon symptom is unique to a remedy you would be
wise to keep the analysis general and favour the head rubrics. The more unusual
the
feature, the more likely that the data is derived from a single case study, and
potentially the same symptom could arise from time to time in patients who are
sensitive
to
a different nosode.
So
beware, don’t use small rubrics to exclude remedies. Use them only to lend
support. Nosodes which do not appear in the listing
for a common feature are easier to exclude.
Beware
that ‘small’ nosodes like Bacillus-10 are severely
underrepresented, even in a highly selective bowel nosode
repertory like this. It has been used very rarely and has therefore generated
much less data than its counterparts. If an analysis throws up three points of
contact with Bacillus-10, as opposed to six for Morgan pure, you should
consider Bacillus-10 quite carefully and read the materia
medica of the remedy.
Bowel
Nosodes and the Mind
There
is little doubt that homeopathy has tended to place the mind at the centre of
the case since the time of
the
prevailing Kentian methodologies of those who did
most of the seminal work on them. This raises several questions on the nature
of the mind symptoms attributed to
the
bowel nosodes:
Do
the mind features represent attributes that drive the case towards a particular
kind of dysbiosis?
Does
overgrowth of a particular organism accentuate certain menta/emotional
symptoms?
Are
there any psycho-immunological models that help to explain mind phenomena
associated with these nosodes?
Have
the mind symptoms in the literature been projected onto the bowel nosodes from those of their apparently related remedies?
Most
of these questions are difficult to answer in a concrete way. We will briefly
examine some possible immunological models for some of the central effects that
occur in infective and dysbiotic states. It is
thought that a number of cytokines have neuro-endocrine
effects which may alter mood and the pituitary adrenal function.
Some
gram negative organisms (including several implicated in dysbiosis)
release lipopolysaccharides which induce TNF,
interleukin-1.
The
presence of these compounds is associated with bacteriologically
mediated inflammatory responses and if their levels are chronically raised, as
a result of dysbiosis,
they
may reduce immunological efficiency and predispose to secondary infection.
With
experience you will come to use these empirical relationships to good effect,
using the remedies sequentially to ‘unblock’ the case or augment the response
of each to
the
other. We have included a recompiled bowel nosode
repertory (Repertory of the Bowel Nosodes by Dr
Russell Malcolm), which uses the search-word and chapter conventions of modern
clinical repertories. Because the listings are short, it takes only a few
minutes to do a hand repertorisation on the nosodes.
Analysis
methodology
Unless
you are very clear that an uncommon symptom is unique to a remedy you would be
wise to keep the analysis general and favour the head rubrics. The more unusual
the
feature, the more likely that the data is derived from a single case study, and
potentially the same symptom could arise from time to time in patients who are
sensitive
to
a different nosode.
So
beware, don’t use small rubrics to exclude remedies. Use them only to lend
support. Nosodes which do not appear in the listing
for a common feature are easier to exclude.
Notice
that ‘small’ nosodes like Bacillus-10 are severely
underrepresented, even in a highly selective bowel nosode
repertory like this. It has been used very rarely and has therefore generated
much less data than its counterparts. If an analysis throws up three points of
contact with Bacillus-10, as opposed to six for Morgan pure, you should
consider Bacillus-10 quite carefully and read the materia
medica of the remedy.
Indications for the use of Bowel nosodes: [Dr.
V.R. Agrawal (1981)]
Researched by Dr.Edward Bach/first
isolated by Elisabeth Bach and John Patterson
1.
Bowel nosodes are deep acting remedies and so case
taking must cover the totality of symptoms from the mental to the
physical/should be given and selected as any
other
homoeopathic remedies in accordance with the homoeopathic principles.
2. The nosode should only be given when the patient’s
symptoms correspond to it.
3. If the given homoeopathic remedy is working well and eliciting the desired
result there is no need for a nosode. However, if the
case should lag in any way an appropriate bowel nosode
may give the necessary impetus for the patient to continue to progress.
4. In a new case where the patient has not had homoeopathic treatment before
time ago) if there is a definite symptom picture pointing to a remedy
[constitutional prescribing], then the patient should be given the indicated
remedy and not the nosode. In cases where it is
difficult to make the choice among many probable remedies a nosode
may be given.
5. An old case where a patient may be under homoeopathic treatment, but is not
responding to it, an appropriately selected bowel nosode
can be given.
6. Potency selected in accordance with the
homoeopathic laws.
They are prepared from cultures of
non-lactose fermenting flora of intestinal tract.
Deep acting remedies can be used at any
time if the symptomps agree.
Where there is a group of remedies
indicated but no clear picture of any - if the group of remedies is related to
a bowel nosode than that nosode
can be given to help clarify
the picture. Can also be given when the indicated
remedy fails
Bowel nosodes
can take up to 3 months before they take full effect. After 4 - 6 weeks the
picture should start to get clearer. Do not prescribe another bowel nosode or repeat within 3 months.
As
usual in Homoeopathy, the more obvious the mental picture, the higher the potency,
but lower the potency if marked pathological symptoms are present. But between
these two extremes use the 30th potency (in a combination of acute and chronic
state).
*
Proteus acts best in high potency
* Gartner will not work in low potency
Do
not repeat a bowel nosode within 3 months, instead
prescribe the homeopathically indicated similimum from the group of remedies (previously given)
related to the bowel nosode.
Indications
for use of Bowel Nosodes [Dr. K.N. Mathur]
By
symptom similarity. When the apparently indicated remedy fails to act. When
several drugs seem indicated, but none is clearly the simillimum.
In an old case where several remedies have helped
but
none has cured.
The
selection of potency is guided by the same principles as other remedies. When
the patient has received a homeopathic remedy within the preceding month, it is
safer to give a low potency.
In
advanced pathology the C 6 can be given daily. When used in high potency, it is
wise not to repeat a bowel nosode within 3 months.
1. Dr.Edward Bach (1886 -
1936): discovered
that certain intestinal germs belong to non lactose fermenting gram negative
coli typhoid group has close connection with chronic disease and its cure/
it
is present in healthy and diseased individual but in the latter it is
pathogenic. Isolated bacilli given back to the patient in the form of an autogenous vaccine and claimed to cure disease with this
method.
Years
later he potentised the vaccine according to the
homoeopathic principle and administered it this way, and cured so many
patients. First full preparation of clinical proving was done in 1929
by
Thomas Dishington on Dysentry.co.
2. John Paterson (1890- 1955)
A
co-worker of Bach concentrated the research after 1929. He studied more deeply
the characteristics of the bowel flora (in health, disease and drug proving).
He examined more than
20.000
stool specimens and conducted research over 20 years. He came to the following
conclusions
The non lactose fermenting non pathogenic bowel flora (B.coli)
undergo definite changes in the disease condition. While this alternation in
the nature of bowel flora might be
a
more concomitant to the disease condition, this is reason to believe that the B.coli actually can turn pathogenic.
Bowel flora is out of balance distributed in disease. Similar changes are also
observed in drug proving.
He
advocated specific recommendation on potency/dose/repetition of Bowel nosodes/He related each of the Bowel nosodes
to a group of remedies.
Bach found that the non lactose fermenting was closely associated with the
symptoms collectively called Psora by Hahnemann.
He grouped and typed the flora by continues experiment and observation. He was
able to detect a definite relationship between certain drugs and certain type
of bowel flora. When particular drug was administered in potencies the bowel
flora was altered in a particular way.
He divided the Morgan group of bacteria into 2 sub classes on bacterilogical grounds and thus created nosodes:
Morgan pure and Morgan gaertner.
showed
fermentation reaction in tubes in which they have produced no change at 18
hours. This made him to classify Morgans into 2
categories.
In1933
Paterson presented a paper on Sycot.co/in 1950 he
published summary of his accumulated experience/After his death in 1954, his
wife, continued the research.
[Christiane Petras]
Darmnosoden kommen viele Behandlungen zum Einsatz, oft sogar als wichtigstes Element, zur Unterstützung der Leistungsfähigkeit in jedem Sinne, also auch organisch.
Sie haben eine tiefgehende Wirkung, auch auf die Gemütsebene und das Nervensystem, in diesem Bereich finden sich viele charakteristische Hinweise für ihre Anwendung. Sie lassen sich gut kombinieren, ergänzen einander und arbeiten oft Hand in Hand. Nur selten werden sie über längere Zeit einzeln gegeben, meistens erscheinen Symptome, die den kombinierten Einsatz verschiedener Darmnosoden fordern.
Wahrscheinlich ist dieser Umstand auf unsere moderne Lebenssituation zurückzuführen. Abgesehen von gesellschaftlichen Zwängen ist unsere organische Arbeit auch durch medizinische Maßnahmen, wie Impfungen oder Medikamente, oder durch äußere Einflüsse, wie z.B. Elektrosmog, schadstoffreiche Ernährung, Strahlenbelastung, psychischen oder sozialen Stress usw., in seiner Organisation beeinträchtigt. Wir werden deshalb wohl kaum noch ein Mittel finden, das alle diese Störfaktoren, einschließlich der ererbten Krankheitsbelastung, gleichzeitig erreichen kann.
New
cases:
1.
In a new case where a definite symptom picture points to a remedy, that remedy
should be given, not the nosode.
2.
In cases where the choice may be from a number of possible remedies, eg. Sulph. Calc. Graph. and it is
difficult to select a remedy from this, Morgan pure can be considered to cover
the totality of symptoms by referring to the table of related remedies.
Old
cases:
An
individual who has had Homoeopathic treatment over a period of time and
received a considerable number of remedies in various potencies. These are
difficult cases, there is no available evidence from stool culture to give a
clue to the group of remedies likely to be useful, or indications as to the
phase in which the patient is at the moment.
If
the percentage of non lactose fermenting bacteria in the stool is greater than
50% the administration of bowel nosode is
contraindicated, the nosode given at that time
produces a negative phase with a corresponding period of vital depression in
the patient. In such cases use a nosode in C 6
potency in the first instance to avoid the chance
of
violent negative reaction.
Bowel
Nosode Group: -- Bodily Systems: -- Conditions:
B
stands for Bacillus;
1. B. Morgan Co. (Bach):
two subtypes of Morgan Pure (
2. B. Proteus (Bach)
3. Mutable (Bach)
4. Bacillus No. 7 (
5. Gaertner (Bach)
6. Dysentery Co. (Bach)
7. Sycotic Co. (
8. Faecalis
9. Bacillus No. 10 (
10. Cocal Co. (
Bowel Nosode Group: Bodily Systems: Conditions:
Morgan
Group: Portal System Sluggish - Congestive
Morgan (Bach)/Morg-p/Morg-g.
Sycotic Group: Mucous: Serous
Proliferative Catarrhs
Gaertner Group: Intestinal
Nutrition
Proteus Group: Vascular Nervous
Strain, Spasm/Oedema
No. 7 Group: Skeletal Muscular Weakness, Aging
Dys. Co. Group: Autonomic Apprehensive
Tension
Source: Agrawal
‡ Folgendes hat anthroposofische Einschlüße ‡
[Aart van der Stel]
Pathology
The spastic colon (irritable bowel
syndrome, colitis mucosa, emotional diarrhea) is a
chronic or irregularly occurring familial illness due to changes in the
motility of the
large intestine. According to the
literature we are confronted with this affliction in approximately 30% to 60%
of all gastrointestinal troubles. The colic pains of the nursing infant and
constipation in the young child also belong here though we are more familiar
with the problem in young adults. It occurs more frequently in women than in
men.
The diagnosis, for which the history
is most important, is based on the following symptoms:
1) Pain mostly on the left side and
sometimes on the right side low in the abdomen, of a character ranging from
gnawing to nagging, radiating out to the back or chest.
There are pain-free periods.
2) Frequent production of small
quantities of feces that are of variable consistency;
large quantities of gas. After defecation and release of flatulence the pain
decreases
or even ceases. The pain increases
again in consequence of a meal or emotional stress.
3) Little or no feeling of illness
or loss of weight, etc.
4) Often occurs with another
psychosomatic symptom such as premenstrual complaints, tension headaches or hypoglycemia.
5) Mood usually depressive.
Physical investigation reveals the
patient to be in remarkably good condition. The abdomen is sometimes diffusely
swollen; percussion gives a tympanitic tone. In the
painful region the bowel is swollen in a sausage-like shape, mobile relative to
the under layer. The abdominal wall often feels cold to the touch above the
spastic section of the bowel.
Faeces
This problem demands a thorough
investigation be made into the quality of the stools. The indigestible fiber proves to play an important part in this.
The proportion of fiber in food has fallen drastically in this century. Over
a hundred years ago about 600gm of bread was consumed per head of population;
at the present
day it is barely 200gm. In addition
to this it must be pointed out that nowadays we are dealing with highly refined
flour, as a result of which the fat and sugar content of our food has risen
from 15 - 20% in earlier times to 55 - 60%. Hence the modern diet contains very
little fiber.
This fiber
is important. The more fiber present in the food, the
faster the chyme is passed through the intestine.
With an increase in fiber, the quantity of feces also increases.
It has been found that primitive
peoples produce 3x amount of stool as Europeans. It has also been found,
connected with this, that problems such as constipation, diverticulosis
of the colon, cancer of the rectum, hypercholesterolemia, appendicitis and gall-bladder
troubles are significantly less frequent among these peoples or even do
not occur at all.
In summary, there seems to be a
connection between our culture (or diet) and a number of bowel disorders
(spastic colon). The advice in a case of spastic colon is to increase the
proportion of fiber in the diet.
The question remains whether this
will entirely solve the problem.
The
Organ
The colon is a large, hollow organ
that garlands the rest of the digestive tract (stomach, duodenum, small
intestine). It is about 1.5 meters long. Its wall contains (as does that of the
small intestine) longitudinal and circular muscles, but those of the colon (in
contrast to those of the small intestine) are arranged in three bands (taeniae coli).
The colon is divided into 3 parts -
the ascending, the transverse and descending in that order - going from the end
of the small intestine (the ileum) to the sigmoid, situated before the anus.
It is striking that in its journey
through the abdomen the colon closely approaches almost all the organs of
importance for metabolism in the following order: right ovary, liver and
gall-bladder, right kidney, pancreas, stomach, spleen, left kidney, left ovary.
The colon ends in the anus, which
can be consciously relaxed and contracted. In the whole digestive tract this is
only found elsewhere in the mouth: we can affect the digestive flow by
conscious effort only at the beginning and the end.
Colonic
Movement
The large intestine has no
peristalsis, unlike the small intestine. 2 kinds of contractions:
1. Mass contractions/ where a large section
of the bowel contracts, and the portion situated distally from this relaxes.
These contractions shift slowly (1cm per second).
They occur a few times a day.
2. Haustrating
contractions, which have a mixing and kneading effect but only extend over a
small area and can last several tens of seconds.
The colon is an easily-irritated
organ that reacts to all kinds of substances such as gastrin
and cholecystokinin, which are responsible for the gastrocolic reflex, to substance
P and enkephalins,
which increase motility, and to glucagon and secretin,
which act to reduce motility. Apart from this it is interesting that very
little is known about the movements of the large intestine, especially in
connection with the sympathetic and parasympathetic nervous systems, which are
present in such abundance in the bowel wall, and the relationship between the feces and the movements of the bowel.
Comparative
Anatomy
R.S. points out that a relationship
exists between the development of the colon in successive kinds of animals, in
terms of their stage of development, and the development
of the forebrain. The study of the
various metabolisms reveals that it is only with the coming of warm-blooded
animals that such a thing as a colon comes into existence; that the more highly
developed the animal is the longer the colon; and that particularly the
ruminants develop an enormous cecum, which in man
finally achieves "normal" proportions - the appendix is, in fact, a
shrunken cecum. It is further of interest that the colon
"grows into" the body from its distal end (the anus) towards its
dorsal end. Finally, let us remember that in the course of development the
place where the ileum connects with the colon has become displaced: in the most
highly developed creatures
the ileum empties into the colon
from the side through the ileocecal valve (valvulae Bauhini).
When one looks at the large
intestines of the various creatures side by side, then the human colon looks
the most harmonious. It is as though the organ has found its ultimate
destination in man.
Significance
The colon has no peristalsis, which
indicates a lesser influence from the etheric body
than one observes in the small intestine. The continuous firming up of the
faecal flow also tells us this. What we have here is a hollow organ that is
very sensitive to stimuli. The bowel wall contains a great deal of vegetative
nerve tissue, and the bowel itself can be consciously closed at its end. These
are features that suggest a powerful influence from the astral body and
ego-organization respectively. Just think, for example, of the significance in
child development of the child's learning to hold back its stools. The child
could not be prouder (more aware of its growing ego)! The relationship with
warm-bloodedness (where is the body temperature most accurately measured?), the
occurrence of intensified movements of the colon associated with emotions or
biographical
problems, and the dependence on
cultural influences with regard to the product, reinforce the feeling that what
we have here is a sense organ rather than a constructive metabolic organ.
Life can continue normally without a
colon. A number of years ago there were over 70,000 stoma-patients without a
colon in
an organ is, i.e. the more spiritual
its function in the body, the more easily one can do without it in whole or in
part. Compare Steiner's observations on the spleen.
In summary, the colon is an organ
that, although it belongs to the metabolism, shows a high level of ego and
astral activity and above all seems to have an observing function. So what does
it observe? m order to answer this question it is necessary to understand
something of the metabolism as such.
Metabolism
R. S.'s Occult Physiology, however difficult
and inscrutable, is a good key to understanding the metabolism. The central
theme in this work is the "preparation" of the blood
as ultimate bearer and instrument of
the ego. All organs contribute something to it, and this whole process of
preparation may be called "metabolism".
Food undergoes a long journey of
digestion from outside to inside, which is marked by a number of
confrontations. Steiner speaks of "aussere Regsamkeiten" and uses the example of stubbing a toe
on a table leg, which gives rise to two processes, one directed outwards and
the other directed inwards. Outwardly the table leg (and the same would be true
of a portion of food or a sense impression) is pushed away, overridden, excreted
(Absonderung). Inwardly consciousness arises of the
pushed-away object
(the external world and all it
embraces) and of one's own person: my toe hurts, and I have only become aware
of it by stubbing it.
R.S. speaks in this connection of
the "Emahrungsstrom" (nutritional flow).
The pushing away is not complete because then the pushed-away object could not
have been noticed and remembered; the table leg as it were comes a little into
us. One develops one's inner world in response to the world outside. After
stubbing one's toe a few times one learns that one must be careful in the dark
because one has built up an internal notion of table legs. It is the same with
food: one digests sugars in order to construct sugars inwardly. In this the
organs play an important role. The organs are little bits of internalized
external world and can be seen as the serving-hatches of cosmic, planetary
forces.
Thus the kidneys are linked with
Venus, the spleen with Saturn, etc.
This is how man with his
blood-in-the-making figures between two external worlds: the physical, visible
world which has become earth and which man confronts with matter or substances
(what the matter looks
like, what form it has), and the
invisible world of the planets that enables him to see which formative forces
the substances originate from. The former world comes to us through food,
breathing and the senses;
the latter world through the organs,
the access-gates of the world of the planets.
Nutrition
If the blood (the human being, the
ego) is to be formed in the right way, a concept must be formed of the best way
to achieve that. This can be compared to making a cupboard: what kind of wood,
what methods
of joining the components, what
hinges and fastenings, what shape shall I give it? Substance (Latin for
"what stands underneath") and form are the elements which, brought
into an individual combination by the ego,
make the blood into our own personal
blood as the center of our personality. Every
foodstuff contains, for example, carbohydrates (material aspect), but in
different foodstuffs these carbohydrates take on a different
appearance. In the process of
breaking down, of observing, the ego, astral body and etheric
body take control of this in such a way that in the external world, viz. the
bowel cavity, the material and formal aspects of
the foodstuff disappear, and its
physical remains are removed (Absonderung), while at
the same time an inward awareness of the material and formal aspects of a
carbohydrate comes into being, which must contribute
to the building up of one's own
(blood-)sugar (Emaehrung). The ego continues to play
a mediating, regulating and identifying role throughout.
The process which takes place in the
vicinity of the bowel wall could be described as transsubstantiation.
This process continues from the mouth to approximately the ileocecal
valve, during which time the contents of
the alimentary tract undergo a
constantly increasing process of breaking down or destruction. Into the cecum comes an amorphous mass of material, which in many
animals then leaves the body since there is nothing
more to be got from it. In the human
body and that of other highly developed animals it then goes on to receive its
maximal form before the exhausted material finally leaves the body as feces.
Two
Gestures
In order to understand the function
of the colon one may think in terms of two gestures in the intestinal tract.
The first gesture is visible in the descending flow of ingested food, which
gradually (and, for the ego,
productively) loses its outward form
and turns into lifeless matter. This is the observing gesture. The other
gesture, directed more towards construction, is expressed in the acquisition of
form by the fecal mass,
which is maximally observable in the
sigmoid and is less and less apparent as one looks higher and higher up in the
bowel cavity. This form belongs not to the material but to ourselves as the
originators of this form.
In this way two formative processes flow
contrary to one another: from above the external formative process belonging to
the external world and fading away as it moves lower, and from below the
formative process
that comes outwards from within and
is caused by what: the ego or the organs?
That we have two gestures is
apparent from, among other things, the two movements of the colon described
above: a steady, more or less peristaltic movement which conveys the exhausted
matter to the exit, and
an antiperistaltic,
haustrating gesture that brings the material flow to
a halt and, as it were, kneads it and so gives it a definite form.
In this way the colon makes visible
what sort of formative processes are taking place in the body, how the body
offers resistance to formative processes from the outside, and how it can
express itself in matter.
But does one need such a long colon
for this purpose? It is interesting to look again at the location of the colon
and to realize that there are three parts to be distinguished: the ascending,
transverse and descending portions.
One could, in a somewhat associative
way, say that the ascending portion, in which the fecal
flow is upward (towards the liver) corresponds to the effective area of the etheric body, that the transverse portion, extending
between the kidneys, has to do with
the astral body (think also of all the other organs that the colon passes
here), and that the descending portion from the spleen onwards, in which the feces assume their final form and
are "shown" to the
external world, lies in the effective area of the ego. In this way the
formative capacity of the human being at the levels of etheric
body, astral body and ego-organization would become visible and
hence observable in the
corresponding parts of the colon respectively.
Faeces
When we look at the feces we can also distinguish a material aspect and a
formal aspect: (a) how well can we break down (catabolize)
and (b) how well can we build up (anabolize)?
In (a) the occurrence of a lot of
gas in the intestines and/or the finding of undigested remains of food in the
stools indicates an inadequate breaking down or observation of the external
world. Gas in particular
indicates an excess of uncommitted astrality not brought under the control of the ego.
In (b) cramps, diarrhea and constipation indicate disturbed forming processes. "Kraempfe zeigen die Unmoeglichkeit dass Ich-Organisation und Astralleib in physischen und Aetherleib hineinfahren"
(Cramps are a sign that the ego-
organization and astral body cannot penetrate the physical and etheric bodies).
It can be seen from the feces how well the human being is able to manage earthly
reality in such a way that it leads to the building up of one's own inner
reality. Always valid: the better the destruction the better
the construction.
What is here described for the ego vis-a-vis the physical would also be valid for the astral vis-a-vis the etheric. In this
connection Steiner mentions colon and bladder in the same breath.
That there is "a lot of
ego" in the feces is also expressed in the reply
that Steiner gives to a question about the wisdom of using human manure in
agriculture.(8) Steiner advises that no more should be used than what
the farmer and his family produce.
There is too much "ego" in the feces for
one to be able to make excessive use of it; this applies not at all, or much
less, to animal dung which bears an imprint not so much of the earthly
and individual as of the cosmic and
astral.
It would seem that the large
intestine is a sense organ that is intended for the observation of how far the
human ego is capable of manifesting itself in the metabolism, which shows an
interplay of construction and
destruction that must lead to the
blood formation which is the ultimate expression of the ego in the physical.
With this we can make a transition to the pathology, where the question arises
as to why someone cannot
express himself in keeping with his
potentialities, his biographical mainsprings, etc.
Pathology
On the basis of the above we can now
understand what is the matter with a person with a spastic colon. There are
three possibilities, which may occur separately or in combination in one and
the same person:
(1) There is something wrong with
the destruction flow
(2) There is something wrong with
the construction flow
(3) There is something wrong with
both
The correct form is not being
produced due to too much or too little observation, or ditto construction, or
(as an expression of a general ego- weakness) an inability to synthesize. The
relationship to the external world is
experienced too emotionally; the
astral body is stronger than the ego- organization in observing and
constructing. The person who cannot manifest himself fully feels himself
over-addressed or rushed off his feet by the
external world. His body, his
psychic circumstances or the social climate do not allow him enough space to
manifest himself in his full individuality. As a reaction to this, the person
gets trapped either in too much
construction, a desperate need to do
everything without enough substance or careful thought (diarrhea)
or else in too much destruction, endlessly analyzing and working things out
analytically before he finally gets down
to actually doing something
(constipation).
Causes
The situation described - not being
able to achieve one's own form for one's own existence - can have various
causes:
(1) Constitutional. Here, the organs
come into the picture. It is interesting to look into the question of which
constitutions are most associated with spastic colon. An important role is
probably played by
the spleen, the liver, the lungs and
the kidneys.
(2) Diet. The importance of fiber has already been mentioned. Note that fibers are polysaccharides, which underlines once again the
role played in the spastic colon problem by the ego "Wo
Zucker ist, ist
Ego-organisation..." (Where
there is sugar there is ego organization...). Fiber
forms an "aussere Regsamkeit"
of the first order.
(3) Biographical. This involves
mainly young adults where it is, of course, a matter of ego birth. But later
situations in life where a powerful manifestation of the personality is
required can also give rise to
a spastic colon. The relationship
with other psychosomatic illnesses is also seen here.
Therapy
It is remarkable how little advice
on therapy for problems of the large intestine is to be found in anthroposophical medical literature. It would seem that in
the period when Steiner saw patients with Ita Wegman
there was nobody walking around with
a spastic colon. There are a few patients whose problems are not far removed
from this one, although these are mainly in connection with Carpellum
Nor has much been written on the
subject subsequently. Husemann suggests only a few
remedies, having first specifically mentioned "psychiscne
Fuehrung" (psychological guidance).
During therapy it is important first
and foremost to build a picture of the problem with the patient and to check
whether he recognizes anything of his own situation in it. Our account of the
problem as given above
is based on numerous occasions when
we have discussed the formation problem with patients. It is essential to help
these always rather tense people to begin to see things in perspective. If the
tenseness, the feeling
- for whatever reason - that they
cannot assert their individuality is deeply entrenched, some form of
psychotherapy is always necessary.
It is a matter of learning to see
things in perspective ("I'm actually only an ordinary person") and to
be objective ("What can I do?" instead of "What is expected of
me?"). I often advise the patient to take a kind
of retrospective look at the end of
each day on the theme, "When have I really been myself today?"
A supportive role in this growth
process of the ego in the face of massive astrality
is offered by artistic therapy, especially clay-modeling
and curative eurythmy. Sounds such as R, M, N, B, I
and A and above all
the "seelische
Uebungen" (spiritual exercises) are very
effective.
Regarding medication, there are all
kinds of possibilities. Directly working antispasmodics are Nicotiana,
Chamomilla, Carbo and
Cuprum. Mercurius in one form or another is often
effective. When one has clear
ideas about which organs are having
a disruptive effect, one naturally directs one's medicinal therapy in that
direction, supplementing what one is already doing with the above-mentioned
Cuprum. Apis, Aurum
and Stibium
are particularly ego-strengthening, as is the prescription of a fiber-rich vegetarian diet. It will sometimes happen that a
too sudden and rigorous change of diet brings on a depression.
This can then be used as a point of
departure for subsequent therapy.
Excessively cerebral types must be
made to take up something physical such as walking, cycling or swimming, though
without feeling that they have to achieve great things.
The
Remedy - Carpellum
[Aart van der Stel, M.D., Rotterdam,
Netherlands]
A remedy with which I have recently
been working on the advice of Machteld Huber
(personal communication) is Carpellum mali (= applecore). R.S. advises
this for a hypochondriac, melancholy woman of 37
who is afraid of becoming pregnant
again and complains of "dauerendem Druck der sie
alles falsch anfassen lasst" (a constant
pressure which always makes her go about things in the wrong way). Here we can
recognize much of the patient with a
spastic colon. She has in the past suffered from constipation. Steiner says
that the bowel and especially the colon is too narrow (haustration,
ileus?). Carpellum
"zusammengeflickt"
(patched together) with Juglans regia,
the walnut. These are imitations of the astral body of the large intestine and
the lungs respectively. Steiner relates depression and bowel problems, which
may at the same time have been
responsible for the (earlier?) difficult pregnancy.
In cases described elsewhere, Carpellum
It would seem worthwhile to gain
experience of the remedy (Carpellum
‡ Folgendes hat anthroposofische Einschlüße ‡
Frei nach: Heinz-Hartmut Vogel
If we consider the digestive tract
in its polarity between 1. head/senses/nerves, the beginning of the digestive
tract is subject to a Sal process/the neurosensory
Sal pole with secretion and excretion, Sal process was
the term for degradation and
elimination of matter, coupled with the emanation of vital energies as the
basis for sensory perception;
2. metabolism/limbs/the metabolic
pole of the digestive tract to the Sulfur principle;
The digestive tract may be seen as
taking up the processes connected with senses and nerves and accompanying them
all the way down to the rectum, The term Sulfur
covered the synthesis and incretion of matter and
the development of organs. The vital
organization moves into the synthesis of matter. Metabolic Sulfur
pole with incretion and synthesis;
Conversely, the digestive tract
takes the metabolic processes upward, connecting them with the sensory process
which is active in the region of head, throat and mouth.
Between these poles we have the
actual process of conversion of matter as a middle process, in Paracelsian terms this middle process is the Mercury
principle. Sal, Mercury and Sulfur are thus the vital
principles on
which the whole digestive tract is
based.
Except for its very first part (oral
region) and its end (anal region), the digestive tract has developed from
endoblast (endoderm). The essential parts thus belong to the substance pole in
the organism, embryologically
deriving from the yolk sac.
The anterior part of the oral cavity
and the anal part of the rectum derive from the ectoblast,
the bearer of the sensory organization. Relatively speaking, this gives the
beginning and end of the digestive tract
"sense organ character“.
Morphologically, sense organ development (arising from the mesenchymal
system) includes the evolution of a plexus of veins. Thus, the eyeball is
surrounded by the vorticose veins, the base of
the brain by the mighty transverse
and cavernous sinuses, the spinal marrow by the internal vertebral plexuses.
The beginning and end of the
intestinal tract are similarly surrounded by dense venous plexuses - the
pharyngeal and esophageal-pharyngeal venous plexuses
in the region of mouth and pharynx, and the pterigoid
plexus in the anterior buccal cavity, with the internal nasal, deep temporal and meningeal veins draining into it, the latter intensely
related to the cavernous sinus. This establishes the developmental and
topographic
relationship to the ectoblast and, later, the anterior buccal
cavity.
At the opposite pole, in the rectal
region, the ectodermal sensory organs of the outer
skin extend into the rectum for a distance of about 2 cm. This is, above all,
the site of the rectal venous plexus, which has an internal
and an external part. The internal
plexus essentially drains into the portal vein, the external part into the
lower vena cava. The rectal muscles also show this dual aspect, with an inner
layer of smooth involuntary muscle
and an outer one of striated muscle
under voluntary control. The rectal venous plexus communicates with the
important pelvic plexus, the vesical venous plexus
and, above all, the uterine and vaginal plexuses, a situation
similar to that seen in the buccal cavity. Equivalent venous sinuses exist for the male
pelvic organs.
The rest of the gastrointestinal
tract has no comparable venous plexuses nor the kind of giant capillaries seen
in the papillary layer of the skin or the parietal pleura in the lung.
Passing reference may be made to
venous nature taken to the point of stasis in the area surrounding a sense
organ and to the significance this has in the physiology of the senses.
Exhalation of live carbon dioxide in the
area around a sense organ goes hand
in hand with a process of "liberation", mainly of light and warmth
ether forces that prove the basis for sensory activity. Wherever this process
is found we are able to speak of sense
organ-type "perception".
Here, an organic function may be mentioned that is connected with the generation
of live carbon dioxide in the sphere of renal function. Incomplete vitalization
of carbons in connection with
internal renal function causes
adequate amounts of live energy to be liberated as carbon dioxide is given off
at the periphery of sense organs. We thus have a double exhalation in the
sphere of the sense organs - carbon
dioxide in the process of becoming
physical on one hand, and living etherization on the
other.
Beyond the oronasopharyngeal
space comes the "actual" digestive tract - esophagus,
gastric cardia, pyloric and duodenal region, jejunum,
ileum and large intestine.
Let us now consider glandular
functions. The salivary glands are still part of the head and senses pole of
the digestive tract. In the same way we have sweat and sebaceous glands in the ectodermal part of the rectum,
and mucus-producing glands deep down
in the folds of the mucosa. These may give rise to anal fistulas, which may be
seen as a degenerative form of "sense organ development" (Sil.: anal fistulas).
The salivary glands in the oral
vestibule, in the early stages of development extending to the base of the
skull as the primordium of the inner ear or tympanic
cavity develops (the oral aperture runs from primordial ear to
primordial ear and to the angles of
the mandibles at the early embryonic stage) develop from the ectodermal part of the buccal
cave - submandibular, parotid and major sublingual
glands. The epithelium grows inward
from outside. Because of this,
efferent ducts are sometimes well away from the main gland, as in the parotid.
In the present context, it is important that nerve supply, gustatory and
salivary gland nerves, above all the
chorda tympani and the intermediate nerve,
run with the facial nerve through the tympanic cavity. The "gustatory nerves"
(facial and vestibulocochlear nerves) above all
supply the sublingual and palatine glands and
also the tear glands. The chorda tympani (sensitive sensory and secretory)
owes its name to the course it takes and to immediate vicinity to the medial
wall of the ear drum. Sense of taste and sense of hearing thus
come close functionally and in
sensory terms. R.S. spoke of the "chemical" or "sound"
ether. From this point of view, the soul principle and the conscious mind
intervene into the chemistry of substances via the salivary
glands when we taste things. The
sound ether is released in the ear.
Saliva (1 or 2 liters
produced daily) has a high concentration of bicarbonate which makes it alkaline
up to pH 10, especially if the vagus or the chorda tympani is stimulated. Saliva production is thus
closely bound up
with the emotional life. Greater
alkalinity results in "parasympathetic", thin saliva, sympathetic
tone in mucous saliva. The pH may show daily variation from 5 to 8,5 (muscarine/pilocarpine/physostigmine/choline/nicot.
cause increased secretion).
Taste sensations cover mainly sweet
and salty. The range seems typical for ego activity in the sense of taste. A
spontaneously occurring bitter taste is already pathologic. Dryness and
increased salivation point to psychosomatic swings of the pendulum with a bias
to either sympathetic tone or parasympathetic tone.
Let us now turn to the colon at the
opposite pole of the digestive tract. The pH of normal stools in adults is
between 7 and 8,7. Secretion of fluids is reduced (100 ml/day). Absorption of
fluids is dominant, with the intestinal contents driven in the physical,
mineral direction. Apart from undigested food particles (above all cellulose)
stools contain 30% of bacteria (up to 42% of the dry matter). In healthy
breast-fed infants, the large intestine still shows the same conditions as the
small intestine, with a slight lactic acid milieu due to dominance of bifidus flora which plays a part in symbiotic production of
vitamin B (aneurine) (betalactose
encourages the bifidus flora). We may say, therefore,
that the whole of the large intestine and - as we have seen - above all the
rectum take the intestinal contents into a physical, mineral state, and it
would be reasonable to say that the vital processes of the chemical and life
ethers are dominant. Secretion gives way completely to "incretion".
This reflects the suction exerted by the chemical ether deriving from the
liver. The whole of the large intestine is thus subject to the distant action
of the liver process. Extremes such as loss of fluids from the large intestine
and its opposite, extreme drying up of its contents, indicate disorders of the
liver process. Chemical processes, which in the sphere of the salivary glands
provide the basis for the secretion of large volumes of fluids, have the
opposite effect in the large intestine, with the as yet fluid intestinal
contents taken into the liver via the portal vein system. This reflects the
interiorizing function of the liver. As a "vitamin B producer" (chemical
ether) the liver is the etheric basis of nerve
development and processes of consciousness. Early emphasis on, and challenge
of, powers of conscious awareness in early childhood can increase the forces of
the chemical and life ethers in the organism and hence hepatic function so such
an extent that the vital processes taking place in the fluid sphere are
withdrawn from the organism (liver-based drying out of the organism;
homeopathic drug pictures of Lycopodium and Alumina).
The esophagus
- The length of the esophagus from the pharynx, the
narrowest part, to the cardia is 22 - 25 cm in adults
(mouth to stomach 37 - 41 cm). The opening (os) is
reminiscent of sensory function in so far as there is a particularly dense
venous plexus beneath the mucosa at this point. Mucous glands continue the
salivary gland function in the upper part of the esophagus,
though now without taste sensation, Innervation: glossopharyngeal nerve forming a plexus with vagus and sympathetic nerve.
Similarly to the small intestine,
the esophagus is in constant motion at its
commencement. The rhythmic peristaltic movement, running through the esophagus like a contractile wave on deglutition, reveals
the interplay of contraction and expansion, of the soul principle coming in
more strongly (contraction) and emphasis on the etheric
(expansion).
This dual process also predominates
in gastric function and, above all, the whole of the small intestine. The large
intestine finally stabilizes the rhythm even to the point of haustration. This gives expression to the physical space
and form principle taking effect in the large intestine.
The stomach - In the region of the
mouth and oral glands, the etheric, fluid principle
and, therefore, weak alkalinity predominate, In the gastric region, the sentient
organization intervenes more strongly in the fluid process and acids are
produced. Gastric activity consists primarily in partial digestion of proteins
with pepsin in an environment of pH 1,5. Secretion is mainly from the chief
cells of the glands in the fundus. Cathepsin activity at pH 2,0 – 5,0. Mucus production at pH
5,0 - 7,0. Calcium, magnesium, sodium and potassium secretion is subject to
similar conditions as in the blood. Characteristically gastric acid production
in the stomach increases with the changes that occur in the soul at puberty and
decreases with old age. Dependence of gastric acid production on the
psychological state is characteristic of the stomach.
Psychosomatics of the stomach
It is known that gastric function,
gastric juice production as a whole and acid production in particular depend on
the emotional state. The question is whether the stomach is an independent
organ or if its development and function are governed by a principal metabolic
organ. Considering the whole symptomatology of
gastric function, we note the characteristic influence of the sentient
organization. Emotions and psychological stresses result in characteristic
gastric symptoms. The stomach becomes an organ for the perception of the whole
sentient organism. This, in turn, is closely bound up with, and has organizing
functions in, the arterial blood processes and, beyond this, in the sphere of
the kidney organization. The whole respiratory human being - both external
respiration and internal tissue respiration - is closely connected with kidney
function. Acid production is an expression of this, rather like footprints left
by the soul principle. Gastric acid production and acid production connected
with minor changes in tissue pH are, thus, polar to each other, going in
opposite directions (muscular rheumatism frequently goes hand in hand with
gastric sub- or even anacidity).
Hyperacidity must, therefore, be
seen in conjunction with kidney function. Extreme ultrafiltrate
production in the kidneys and resorption of this into
the blood can lead to secretion, above all in the gastric region, in the sense
of Volhard's "pronephros nieren. This is
connected with continuous loss of connective tissue fluid from the blood. The
symptom goes hand in hand with loss of tone in the sphere of the blood (LOW
blood pressure/sometimes vertigo/peripheral cardiovascular disorders/THIRST).
The stomach may be said to be an organ that reacts to renal function. Whereas
the walls of the stomach lie loosely against each other in a healthy subject, a
bladder form develops in this case, and corresponding symptoms of a gastrocardiac syndrome. Air in the stomach - and in the
intestinal tract - with increased eructation and singultus
are kidney symptoms. Treatment: if these symptoms go hand in hand with general
pallor and cyanosis, especially of the lips, treatment of the kidneys with Carbo vegetabilis and/or Veratrum album is indicated. The connection between
excessive gastric juice production and ultrafiltrate,
in some cases 8,10 or even 15 liters a day, also
derives from the above-mentioned electrolyte content which, in the renal ultrafiltrate, too, is equivalent to that of blood serum.
Duodenum - In a rhythm, the laws of
which become apparent in successive sections of the digestive tract, the acid
stomach environment is followed by the relative alkalinity of the duodenal
contents. This is largely due to the 1 - 2 liters of
pancreatic juice produced daily. The optimum pH of the pancreatic enzymes is:
lipase pH7, amylase pH6, proteins pH 8 -11.
The thin pancreatic juice contains
proteins, its overall pH is 8 - 9, the taste salty. The average daily 500 ml of
bile produced contributes to the duodenal alkalinity in spite of the 1 - 2 g of
bile acids it contains (produced from 20 - 70 mg/100 ml of cholesterol, the
mean pH being 8 (biliary fistula).
A physiologic polarity exists
between bile and pancreatic enzymes. With the pancreatic enzymes, active
chemistry goes out into the duodenal region, with the bile, substances that have
dropped out of life in erythrocyte degradation are eliminated into the
intestine. According to R.S. both processes, fourfold pancreatic secretion and biliary secretion to the outside, reflect primary "ego
activity". The destruction of red cells and liberation of, above all, heat
energy in the internal and external bile ducts is a physiologic warmth-ego
process (temperature in the gallbladder distinctly above that of the blood).
The fourfold pancreatic secretion and the high bicarbonate concentration (salts),
on the other hand, reflect comprehensive, immanent activity of the whole vital
life organization governed by ego activity.
Let me add at this point that embryologically the hepatic and biliary
system, on one hand, and internal secretory and
excretory pancreatic system on the other each derive from two endodermal structures. This is a process of organogenesis
which also applies to the rest of the organism. One principle here produces an
excretory and an incretory organ development. In the
case of the pancreas, this is clearly reflected in the development of the acinous head and part of the body, on one hand, and the incretory activity located mainly in the tail on the other.
In the case of the liver and gallbladder, an excretory organ develops that begins
with the hepatic parenchyma and extends to the gallbladder, whereas the liver
itself becomes the largest "incretory"
organ in the organism.
"Incretion" here means
synthesis and anabolism; "excretion", in this case into the
intestine, the degradation and destruction of matter.
The duodenum is, thus, the
mid-region of the whole digestive tract, governed by the ego organization in
two respects.
Jejunum and ileum - As the digestive
process passes into the jejunum and ileum, we reach the actual Mercurial part
of the digestive system as a whole. This is also apparent from the motility and
contractility or capacity for expansion in the whole of the small intestine.
Another characteristic of the small intestine is the very slightly acid
environment created by the Acidophilus flora. Acidophilus bifidus
predominates in breast-fed infants, which gives the stools a pleasant, slightly
acidic, yoghurt-like odor (anaerobic lactobacilli
play a role in aneurine (vitamin B) production.) A
healthy intestinal flora is, therefore, physiologic in the small intestine.
Comparing lengths: duodenum circa 30
cm, adult jejunum and ileum 5 meters on average. We shall not go into the
specific glandular situation at this point - Brunner's glands, glands of Lieberkuehn.
Jejunum and ileum are the Mercurial
region of the whole digestive process in the small intestine. The fluid
principle is dominant, with some emphasis on the "sulfuric"
character of this intestinal region. This covers the production of chyme, liquefaction of intestinal contents and first stage
of absorption into and through the villi which
considerably enlarge the surface area of the intestinal wall. The sulfuric character is also evident from the fact that the
number of white cells - "sign of inflammation" - increases in the
intestinal walls and villi as digestion proceeds. The
daily volume of intestinal fluid is estimated to be three liters.
Appearance: turbid, milky, because of the presence of white cells, epithelial
cells and mucus. The fluid is approximately isotonic with blood. The high
sodium bicarbonate concentration makes the environment slightly alkaline in the
ileum. In breast-fed infants, the bifidus flora makes
the contents slightly lactic. In adults, the contents of the small intestine
should give a neutral reaction. A move to the alkaline range suggests
infiltration by coli bacteria. The pH is thus distinctly acid (6,2 - 6,7) in
the region of the jejunum and neutral or just slightly alkaline at the
transition from ileum to large intestine. The intestinal motility throughout
the small intestine is characteristic of Mercurial activity. It is a rhythmic
pendulum swing within the individual segments. In purely external terms this
leads to intense mixing of chyme and digestive
juices. The movements of the villi are also rhythmic.
The mixing movements are said to be up to 10 a minute, continuing for up to 6
hours. The filling of the intestine is governed by the parasympathetic,
emptying and immobilization by the sympathetic system. The term autorhythmia is used. After a period of circa 6 hours (see
above) the small intestine empties through the ileocecal
valve into the large intestine, which happens in portions. The underlying
dynamics of the whole digestive process may be seen as follows.
Upper part of mouth, esophagus and stomach: gradually decreasing sensory
perception as regards both glandular function and neuropsychologic
dependence.
Duodenum: polar function of ego
activity, giving impulses to the whole of etheric
activity (extreme degradation via the biliary system,
with mineralization of live matter; on the other hand ego activity entering
into the whole of pancreatic glandular activity). The day and night rhythms in
both bile production and pancreatic islet function have significance as ego
rhythms. Chyme production in the jejunum and ileum is
dominated by Sulfuric activity, which is metabolic in
the true sense, but in terms of a Mercurial physiologic function relating a) to
pendulum swings and b) to dissolving, absorptive vital activity. The influence
of absorptive hepatoportal activity and a dominant
lymph organization govern digestion in the small intestine. Starting from the
lacteals in the intestinal villi and continuing with
large chyle vessels and intestinal lymph glands as
far as the thoracic duct, the lymphatic system comes to the fore in the region
of the small intestine. It, and the production of chyme
and chyle, may thus be seen as the Mercurial
principle in small intestinal digestion. The increase in white cells also
relates to this.
Generally speaking, small intestinal
digestion has its "head" in the duodenal region and its
"end" in the region of the ileocecal valve,
between the opposite poles of the stomach with its highly acid environment and
the large intestine with its on-the-whole distinctly alkaline character.
The Mercurial character of the whole
small intestine - duodenum, jejunum and ileum - bases on interaction and
Mercurial blending of the chemical, fluid and psychological, airy elements. The
etheric and sentient organizations interpenetrate,
similar to the process seen with saponins in nature,
and emulsify the chyme. Separation of fluid and airy
principles indicates Mercurial weakness. Mercury has the dual quality of
droplet formation and sublimation, i.e. transition into the gaseous state at
normal temperatures. This range in physical properties seen in the element
mercury is reflected by the emulsication of small
intestinal contents - between "droplet formation" (aqueous phase) and
generation of gases. Taking an overall view, the small intestinal processes lie
between the concentrative fluid phase connected with the liver process and the
breathing psychological phase dominating the small intestine, too, from the
kidneys. Pathologic generation of gases, weak/pathologic kidney function and
pathological production of fluids indicate failure of the emulsifying process
which is governed by the ego organization. Inactivity of the sentient
organization in the gastrointestinal region signifies excessive perceptive
activity and consciousness of the organization in the sphere of senses and
nerves.
Apart from the main symptom of
increased generation of gases and a tendency to thin, liquid stools there must
therefore also be corresponding signs of excitation in the sphere of senses and
nerves: restlessness, hyper-sensitivity to sense impressions, neurasthenic
symptoms. Treatment must be in accord with this. Generally speaking, medicines
relating to both kidneys and nerves should induce the sentient organization to
become involved in the fluid process, above all in the intestinal region. Two
examples are Khus toxicodendron
and Chamomilla. The function of the ego organization,
above all in the duodenal region as described above, needs to be strengthened.
This can be done by stimulating both biliary and
pancreatic functions. Example: Cichorium/Pancreas/Stibium
comp.
The colon
The colon is 1 - 1,4 meters long (cecum circa 7 cm) and marks the beginning of the part of
the intestine which, unlike stomach and small intestine, is no longer involved
in the actual process of digestion. Secretory process
occur here (mucous glands secreting dense mucilage with the relatively high,
alkaline pH 8,4). The thickening of the intestinal contents is essentially with
reference to water and salts. Almost the whole (500 ml) of 600 ml water is
absorbed.
Characteristic structures in the
colon are the longitudinal bands known as taeniae
coli, the haustra, the vermiform appendix and the epiploic appendices (tabs of fat). We have already referred
to haustration in conjunction with the nature of
peristalsis in the esophageal region where every bite
swallowed is pushed along by itself, as it were. The situation is similar in
the large intestine, but more in the direction of spatial development, with the
haustra presenting as a kind of static, tied-off
element. Rapid peristalsis causes folds to develop in the inner large intestine
that, from outside, appear as haustra. They divide
the intestinal contents into portions. Together with re-absorption of water and
the increasingly physical nature of the intestinal contents, the process in the
large intestine is, functionally speaking, a Sal process. As already stated,
this comes to a culmination in the tendency to develop sense organs in the
rectum. The stomach may be seen as an organ reacting to the kidneys; the whole
small intestine as interaction between fluid, etheric
(lymph) and psychological, breathing organization (emulsincation)
and, therefore. Mercurial; and the whole large intestine as a distant organ of
the hepatic and portal system. The motility, i.e. movements of the large
intestine showing extreme partial contractions, shows interaction between
expansion and contraction, like all peristaltic movements, emphasis on etheric and sentient organism activity, though in the large
intestine this reaches the borderline of physical organ development. The fluid
content or, conversely, the drying out of large intestinal contents is
connected with the portal and hepatic system's power of interiorization
(incretion). Raccidity, especially of the large intestine,
may go as far as atony or poor rectal development (megacolon) and indicate weakness of shape and form even in
the liver region. Because of this it is possible to treat atony
in particular with a "liver medicine" such as Stannum.
The uniform liver process within a highly fluid principle is then subject to
imposition of form (see also cirrhosis). The three taeniae
coli and the haustration express the process of
becoming physical anatomically and physiologically. Compared to inadequate ensoulment and breathing-through of the small intestine),
the choice of medicaments must take account of the connection with the liver.
We have already mentioned two characteristic liver medicines connected with
drying out of large intestinal contents: Lyc. Alum.
In differential therapeutic terms, a
very different pathologic situation has to be considered if there is a tendency
to diarrhea. This is because the small intestine,
with its emphasis on etheric, fluid, lymph-related
function, is particularly liable to develop "nerve development in the
wrong place". Ars.
Summary
The whole digestive tract has been
considered against the background polarity of neurosensory
and metabolic organization. The interaction of etheric
and astral organization thus comes to expression in the different sections of
the digestive tract. The whole digestive tract is framed, as it were, in polar
fashion by a tendency to develop sense organs in the region of mouth and
pharynx, on one hand, and in that of the rectum on the other. Different pH levels
in the sections also reflect intervention of soul principles (acidity) or etheric principles (alkalinity). The warmth organization of
the ego is involved in this interaction, starting from the duodenum at the center of the digestive tract where we have the functional
polarity of biliary and pancreatic activity. The
"actual" digestive principle is active in the small intestine, where
the Mercurial character of the whole digestive process is dominant
-emulsification of intestinal contents (chyme)
through interaction between fluid, etheric and
psychological, airy principles. Digestive disorders essentially reflect the
organic function of the section concerned:
Duodenum: polarity between biliary and pancreatic function.
Jejunum and ileum: lymphatic system
relating to portal and hepatic function on one hand and respiration in
conjunction with renal function on the other.
The large intestine has been
presented to show resorption of water and salts to be
under the distant influence of the liver, so that one-sided developments in
large intestinal function may initially be treated via the liver.
Vorwort/Suchen Zeichen/Abkürzungen Impressum