External applications in health and nursing care

External applications have been part of humanity's treasure trove of remedies since the earliest times. Leaves and plant fibres were not only applied to wounds, when the interior of the body partially opens to the outside, but also to injuries within the body, broken bones, cramps, fever or pain, where the immediate soothing effect of warm or cold wraps, baths and washes was used to relieve and heal discomfort. Traditionally, plant extracts, oils, gemstone triturations but also animal substances such as honey or quark were used externally.

External applications play an important role in Anthroposophic Medicine. They are readily available worldwide, can usually be administered by patients and relatives following instruction, and often provide rapid relief from symptoms. They are frequently used in combination with medication and other forms of therapy.

External applications are wraps and compresses, baths and footbaths, washes, Einreibung or massages. They work through the substances used from the plant, animal and mineral kingdoms, but also through heat, cold, moisture, dryness, pressure or suction. Not least, the caring attentiveness towards the patient during a treatment can convey a feeling of security and relief which reduces stress and pain and enables a positive perception of the injured body. Dosage, rhythm and time of day of the treatment are decisive factors.  It is often necessary to adapt to the condition of the patient. The practised proximity to the patient's body and everyday life, as well as the availability at night, puts carers in an ideal position to use external applications, especially in inpatient and home care.

External applications are used for physical complaints as well as for psychosomatic or psychiatric illnesses. They work through the skin, the largest sensory organ of the human being, and are mostly associated with vivid sensations of warmth, scent and touch. They thus stimulate the organism to respond with a variety of physiological and psychological reactions. It is in this response of the body that the actual effect of the external application lies.

Its nuanced use requires medical, pharmacological and psychological expertise. This is taught in further and advanced training courses for nursing staff, physiotherapists and physicians.

Although external applications have a very long tradition, their evaluation is still in its infancy. Scientific studies are available in, among others, the fields of oncology (1), rheumatology (2) and heat and stress disorders (3).

The Vademecum of External Applications provides a comprehensive description of indications, substances and forms of application: www.vademecum.org.