(Original title: Krankengeschichte mit ausfuehrlicher DarsteUung der Heileurythmiebehandlung. Der Merkwstab 1994; 47:487-91. English of clinical report by A. R. Meuss, FIL, MTA, eurythmist's report by J. Collis, MIL. Also published in Circular Letter of the Medical Section at the Goetheanum No. 7.1994.) 

Clinical report

A woman aged 29, who from her 18th year suffered from continuous bouts of deep, painful ulcerations on both legs. A diagnosis of ulcerative dermatitis had been made (a deep ulcerative vasculitis formerly called "pyoderma gangrenosum").

The first enteric symptoms developed in her 20th year, taking the form of watery diarrhea with intestinal bleeding. Crohn's disease involving the colon, with rectovaginal fistulas, was diagnosed some years later. Systemic cortisone therapy had been given almost continuously from her 18th year, currently Ultralan 10 mg. Azathioprine was given at intervals, but the ulcers did not heal.

When first admitted in 1992 (five weeks at the Filderklinik) the presenting picture was as follows. Patient aged 29, with relatively narrow face, its features well developed; generally adipose, looking somewhat ungainly, with excess fat mainly in the pelvic and hip region and on thighs. The whole person had fallen into gravity. Lower legs bilaterally showed extensive, sharply defined ulcerations, some as deep craters, weeping, with greasy coating and offensive odor. The surrounding skin was indurated, reddened, and looked partly devitalized. The ulcers developed from deep, subcutaneous nodules that opened to the surface with purulent discharges, leaving deep craters. Healed ulcers left soft tissue defects and hard scar tissue. Healing took weeks if not months; some skin areas had been open for more than 10 years. As regards her Crohn's disease, the rectovaginal fistulas were a problem; the 3-5 doughy stools were not a primary concern.

Patient appeared depressed, disheartened and despairing and had little hope of real improvement. Anything below the diaphragm, i.e. abdomen and legs, felt alien to her, as if not her own.

Attempt to consider the human aspect

In the lower part, the dominant tendency was one of falling into gravity. The watery element appeared to lack organization and vitality. The warmth organization did not come in strongly enough. Intervention from the upper human being was catabolic and destructive (Crohn's disease, painful leg ulcers). The creation of boundaries against the outside world through the skin and against the internal outside world (intestine) was disrupted.

The mental picture was dominated by heaviness and dullness.

Treatment

The aim was to vitalize and strengthen the life organization, and stimulate the structuring, form-giving powers of the upper human being, reducing excessive catabolic forces; stimulate the forces that set outer boundaries; bring light into the inner life and develop prospects for the future.

Medical treatment included Mercurius viv. comp. alternating with Cuprum sulph. comp.; Cichorium pi. tota 1x, Stibium 6x or Dyscrasite 6x; Platinum chlor./Pancreas comp.; Quartz 30x or Equisetum 30x; Abnobaviscum Quercus lOx, twice weekly s.c. Wecesin Ointment (wound healing oint- ment) proved excellent for local application to the legs.

Additional and essential parts of the treatment were whole body rubs with Equisetum Oil, a vegetarian diet, painting, later modeling, individual eurythmy therapy and biographical conversation.

Cortisone could be discontinued altogether during her 5-week stay. Intestinal functions became normal, two thirds of the ulcers healed, with the pain disappearing completely. The patient came out of her depression, was able to face the future with new-found courage and make plans again. She was soon able to resume work.

Nine months later family stress caused an aggravation of the skin condition, with new ulcers, increased diarrhea, and migratory joint pain. Admission for another 3 weeks resulted in rapid, thorough improvement. This time the ulcers healed almost completely. With continued outpatient treatment (Dr. Paolo Bavastro, Filderklinik) the situation stabilized extremely well, and 6 months later the skin on her legs was wholly intact for the first time in 12 years.

The biographical background and evolution have been deliberately omitted from this report.

Eurythmy therapist’s report

First treatment period. Status During the early sessions the patient could only move a little and this while lying down. Her legs were tightly bandaged (vasculitis), and she lay there, passive and heavy, moving only when necessary.

I sensed that she felt almost no connection with her body which she experienced merely as a heavy mass weighing her down.

She was non-committal but showed some expectancy, observing what was going on with wide open eyes. There was no rejection in her attitude.

She sensed that "something"was being done for her and was gradually persuaded to come to the eurythmy room, where we practiced at first sitting down but later standing up.

It soon became obvious that her arm movements were subject to the same leaden heaviness as her massive, clumsy legs. The more she managed to attain to the vertical position the more apparent this became.

To bring about a change in this was the aim of our first series of sessions comprising 15 treatments of approximately 30 minutes.

The eurythmy therapy exercises

Lying down with her legs heavily bandaged:

Contraction - expansion .......with the feet A-U.........................with the legs M ............................with the feet B .............................with the feet

Since the patient was able to sit or walk but not stand, we began by doing the consonant exercises sitting down; later we stood.

To make her feet more sensitive she was first given a copper cylinder to move rhythmically backwards and forwards with the soles of her feet. Then came the following exercises:

D with the feet, sitting down .... .and walking B with the feet, sitting down .... .and walking B with the legs, sitting down .... .and walking R with the legs, sitting down .... .and walking M with the feet, sitting down M with the legs, sitting down .... .and walking

Becoming able to differentiate the foot and leg region of her body was an important experience for the patient.

A further stage of the treatment involved making the consonant gestures with the arms:

D with the arms, sitting down ... .and walking B with the arms, sitting down ... -and walking R with the arms, sitting down ... .and walking M with the arms, sitting down ... .and walking

Further observations

At this stage, since the patient's legs were ulcerated and suppurating and therefore firmly bandaged, and also because she was so weak, it was not possible to work towards polarizing the upper and lower body by means of the classic jumping exercises for the metabolic system.

We therefore concentrated on bringing about differentiations within gravity. The patient had a lot of unformed ether forces that would let her down abruptly as her arms and legs became exhausted after short bouts of work. When this happened she collapsed in on herself like wet clay.

It took some time before she was able to maintain a flow of movement in a longer sequence without constantly letting her physical body drop away from the etheric stream.

Although she was alert to what went on around her, she was dreamy and dull as far as her physical body was concerned. She required guidance and support without which she could not master the exercises described.

Aim

During her first hospital stay we aimed to put some lightness into her heavy body so far as the circumstances would allow.

We continued with this during the second period.

The cycle of exercises was completed with the big U-exercise.

Vowels

In order to choose the vowel exercises we have to observe and take into account the person as a whole.(1)

We are given further assistance by the colored sketch Rudolf Steiner made for the U.(2) Tones of blue and violet predominate and surround the yellow veil. We gain an image of a sunlit path of light surrounded by dark waters. This may even reflect the brightness we need within the darkness of our heavy bodies.

Summary The patient became more able to cope with her otherwise heavy and dumpy body. She became more aware of the movements of the etheric and was better able to give them some form.

Her legs were markedly improved, and this enabled her to begin transforming overbearing heaviness into lightness.

Second treatment period. Status Approximately 9 months later she was back in hospital. She had not attended eurythmy therapy sessions as an outpatient, as intended, which meant that the foundations laid had been dormant for almost a year.

This time she stayed for 3 weeks and had six 30-minute eurythmy therapy sessions.

Nevertheless there was a definite improvement. The problem with her legs had stabilized and no longer dominated the situation to the same extent.

Diagnosis

She now had various pains in her joints and a painful rectovaginal fistula that made prolonged sitting impossible.

This time, therefore, we had to work while standing or walking, only occasionally sitting down.

The eurythmy therapy exercises

As the patient's joints were swollen we put together and practiced a program of alternating consonant and vowel exercises from the eurythmy therapy repertoire.(3)

Vowels

The big 0-exercise provided the intensification of the vowel aspect.(1)

The colored sketch of 02 shows warmth and brightness in the periphery (dress and veil) while coolness is shown as the character in arm and leg joints: cooling for the inflamed parts.

0 as mediator.

0 between consonants, i.e. between the movements for the metabolic system and arm or leg movements, mediating between upper and lower polarities.

0 was frequently repeated between the different consonants: LOROSO.(4)

Or: The 0 that "reveals the human being as soul" pushes its way into the metabolic process.(1)

Conclusion

To begin with the patient found it immensely difficult to bring form into her ponderous and heavy body and raise it into etheric levity, but during the course of the year (a total of 21 treatments) she succeeded astonishingly well in doing this. She became alert and dynamic, both inwardly and outwardly, clearly gaining in structure. She learnt to balance heaviness and lightness to such a degree that the symptoms in her joints improved, leaving no residual stiffness.

She was discharged from hospital as a healed individual capable of finding her way back into working life.

Gisela Brauner-Gulow

Eurythmy Therapist

Filderklinik

D-70794 Filderstadt

Germany

Renate Schweigert

formerly at the Filderklinik

now at the Klinik Oeschelbronn

D-75223 Niefem

Germany

References
1 Steiner R. Curative Eurythmy (GA 315). Tr. K. Krohn. London; Rudolf Steiner Press 1983, 2^nd lecture.
2 Steiner R. Entwuerfe zu den Eurythmiefiguren (Designs for the eurythmy figures) (GA K 26), Domach: Rudolf-Steiner-Nachlassverwaltung 1984.
3 Steiner R. Curative Eurythmy, op. cit, 8th lecture.
4 Kirchner-Bockholt, M. Fundamental Principles of Curative Eurythmy. Tr. rev. M. Beaumont & E. Lloyd. London: Temple Lodge Press 1992.