External Applications in Anthroposophic Nursing

Farmer’s Cheese Arnica Knee Compress

Kind of substance

Farmer’s cheese (quark), Arnica essence

Guiding principle

Farmer’s cheese is made in acidified milk when the liquid whey separates from the cheese. This process continues on the skin during a quark application. While the farmer’s cheese is drying on the skin, whey continues to separate from it. This results in a gently sucking and freeing effect, which relieves watery stasis and enables metabolic toxins to be removed from the body; inflammatory substances can be flushed out, leading to a cooling and pain-relieving effect; excessive metabolic processes can be subdued. Farmer’s cheese also has an intrinsic mild, plasticizing power.

Indications

  • Osteoarthritis of the knee joint, activated, also with joint effusion and bursitis
  • Osteoarthritis in other joints
  • Bursitis (housemaid’s knee)

Instructions

1st method: for patients who are lying down (recommended)
2nd method: for patients who must stand up, move about or be normally active with the compress

Materials:

  • Arnica essence (planta tota)
  • Wooden spatula or knife
  • 2 hot-water bottles (40°C or 104°F max., filled flat), covered with a layer of cling wrap to warm up the farmer’s cheese
  • Approx. 300 grams of farmer’s cheese, organic if possible, take out of the refrigerator at least 2 hours before use
  • Drain on a sieve if the cheese is too wet
  • 1 kitchen board
  • Inner cloth individually measured on the patient’s knee: it should wrap around the knee and overlap a few centimeters; double the height to make a pack
  • Intermediate cloth: Kitchen towel laid double lengthwise and rolled up from both sides
  • Outer cloth: Duvetyn or terrycloth towel rolled up from both sides, if necessary 2 elastic bandages 8–10 cm wide
  • 1 waterproof pad as bed protection – do not wrap around the knee!
  • 2 small cushions


Instructions for the 1st method:
  • Drain the farmer’s cheese in time, if necessary
  • Prepare the patient and the room
  • Prepare the bed: place the small pillows at knee height, lay the waterproof pad over them, followed by the rolled-up outer cloth, and lastly the intermediate cloth
  • Spread the inner cloth out on the board
  • Using the spatula, spread the farmer’s cheese approx. ½ – 1 cm thick centrally on the inner cloth so that the knee joint can be completely covered, including the hollow of the knee
  • Fold in the fabric from above and below, the ends remain open
  • Turn the pack upside down so that the side with only one layer of fabric that will lie against the body is on top
  • Place it on two hot water bottles until it becomes hand warm
  • Sprinkle the top side with an essence suitable for the clinical picture and spread it by brushing gently (do not mix the essence with the farmer’s cheese, it could become too thin, and you will use more essence than necessary)
  • In this case: Arnica essence
  • Take the pack to the patient
  • Mold the pack snugly around the knee joint, folding the ends over each other
  • Roll the intermediate cloth snugly over it from below
  • Then wrap the outer cloth snugly over it as well
  • The two cushions relieve each knee individually


Instructions for the 2nd method:
  • In this case the compress must be firmly secured in place
  • To do this we apply the farmer’s cheese pack and intermediate cloth as described above, but replace the outer cloth with 1–2 elastic bandages, wrapped snugly
  • Start with one wrap below the knee and fix in place by wrapping around again. Do the same for the final wrap above the knee joint
  • Fix the ends of the bandage in place with plaster strips
  • At least put on socks, even better would be to pull loose tights over the compress
  • Duration: 2 hours or longer
  • Remove when the farmer’s cheese pack begins to dry out, at the latest, at which point it would otherwise begin to cause congestion
  • Afterwards: remove everything, pat the knees dry, pull clothing over them


Post-treatment rest: After removing the pack, rest for 10–15 minutes, or for the night

Follow-up:
  • Remove the farmer’s cheese from the substance cloth. Tip: let the pack sit for a longer period of time, it is then easier to remove the farmer’s cheese from the cloth with a scraper. The drier the farmer’s cheese, the better it comes off the cloth
  • Immediately rinse the cloth in cold water

Evidence
Proven in many cases
Dosage
1 x daily for acute cases, less often for longer use
Onset of effect
Immediate
Length of therapy
Until the pain subsides and the effusion recedes
Other recommended therapies
Knee rub (Einreibung) with Peucedanum officinale gel (recipe)
Warning
Never apply farmer’s cheese directly from the refrigerator to the patient’s body! Warm the farmer’s cheese up to hand warmth

Case example

Example case 1
83-year-old woman, still quite present and mobile. She is very prone to osteoarthritis, both hip joints were replaced with a TEP 13 and 10 years earlier. In the summer of 2019, the patient fell and suffered a kneecap fracture on the right, which healed well without surgery, with total immobilization of the joint for about 8 weeks.
During immobilization her slight osteoarthritis, which had already started before, developed unnoticed into a pronounced case. Her musculature was not yet fully developed when she injured herself on the inside of the joint when awkwardly standing up from squatting.
As shown later in the MRT, her inner meniscus is slightly torn at this point. As a result, a full case of activated osteoarthritis developed, with painful restriction of movement, overheating, joint effusion, swelling of the entire area, i.e., all synovial bursae.
At the peak of the symptoms, farmer’s cheese arnica compresses were started and applied daily for 2 hours. This was done for one and a half weeks.
These applications had an immediate beneficial effect on the oppressive feeling of tension in the knee joint, the temperature subsided within a few days, the swelling in the joint and its surroundings slowly subsided, the knee gradually became useable again and the patient was able to move safely. This extensive regression of the symptoms proceeded continuously but slowly.
The patient said “Good that this medicine exists, what else could I do that would be useful and healing. I have the impression that the farmer’s cheese also exerts its own sculpting force on the joint.” After three months the joint is again “slim” and well formed. It has long been painless when moving in all directions.
MK

Example case 2
An elderly farmer reported that she suffered from rheumatic fever in 1943 at the age of 19. All her joints were inflamed and painfully swollen. The disease lasted for several weeks. As an adult and the mother of three children, she also suffered from recurring abscesses of the axillary sweat glands. She received her first treatment with penicillin at the age of 42. Because of an allergic reaction to this drug she could only be treated twice. The glandular abscesses healed and never reappeared. Chronic, reoccurring joint inflammation of the knee joints, at times also of the elbow joints, has recently become apparent. She treated the joints as follows: each evening for one week, before going to bed, she applied a hand-warm farmer’s cheese compress for an hour. Every Sunday she took a break from compresses. Every other week she treated her affected joints with cabbage applications. She carried out these measures alternately for one month at a time. After that, she was pain-free for several months.
Even during the inflammatory phases she never stopped working and she rode her bike during the day to move her joints. “I never wanted an artificial knee joint and our family doctor supported my measures.”  She continued this treatment several times a year for 40 years.
TB

Author

SK, MK, TB, MM, Red.

Substances