The Rudolf Steiner Archive

Speech followed by a Question-and-Answer Session

[ 1 ] I think the main points we will be discussing should be addressed in response to specific questions you ask. I just want to preface this with a few general remarks.

[ 2 ] Much of what is truly valuable has been lost in the course of human development because the understanding of the spiritual—which, after all, lives within all physical things—has gradually been lost. But among the fields that have lost the most is undoubtedly medicine, for the reason that by limiting oneself solely to the knowledge of nature, any insight into human beings and their lives in general is bound to be lost. For it must be emphasized again and again that all processes that take place in nature are processes that cannot occur in the same way within the human organism.

[ 3 ] Let us set aside the animal and plant organisms. There is a widespread belief today that a process observed externally in nature can also exist in some way within the human organism. People speak of combustion and all sorts of other physical processes within the human organism. In reality, such processes do not actually exist, and just as we have before us—in contrast to the non-human—the self-contained human organism, which, to the outward eye, is something different from a non-human natural object outside of us, so too is every single process within the human organism something entirely different. All processes that take place in nature outside of the human being affect the human being in terms of breakdown and rebuilding. And if we want to understand the human being, we must actually recognize a threefold breakdown within him.

[ 4 ] The first form of deterioration is the one that, so to speak, occurs from within through everything that acts upon the human being from the Earth. The Earth’s forces act in such a way that they cause the human being to deteriorate from within. The forces that act from the air—primarily through breathing—and are transmitted to the human being have a degrading effect as they approach from the Earth’s atmosphere. And the forces of light act upon the human being from the cosmos in a degrading manner. Thus, the extra-human forces of the cosmos act upon the human being in a degrading manner in threefold ways, and this degradation occurs immediately when the ego organization and the astral body are not active within the human organism. The astral body and the ego organization counteract the degrading principles within the human being. Thus, the destructive influence of the extra-human forces must set in at the very moment when the “I” and the astral body cease to be active within the human being. This, however, also testifies to the fact that we cannot possibly gain a true understanding of the human being without acquiring ever deeper insight into the higher aspects of human nature, even when we are considering the medical field.

[ 5 ] Medicine has come to rely solely on trial and error and experimentation precisely because, in more recent times, it has no longer dared to take into account the higher aspects of human nature—the supersensible. However, the disease process cannot be understood unless it is viewed as connected to the higher aspects of human nature. Nor can the process of recovery—the healing process—be understood without being placed within such connections to the higher aspects of human nature. For let us consider the following: In the human head, processes of breakdown of the physical body and the etheric body are essentially at work. These processes of breakdown that are at work there are precisely what make it possible for the astral body and the ego to function independently within the human head. In contrast, in the metabolic-limb organization—in everything related to the motor system and metabolism—we are dealing with constructive processes of the human organism, involving both the etheric body and the physical body. In these constructive processes, the “I” and the astral body are active in the most eminent sense, specifically within the metabolic and motor systems. In everything that takes place in metabolism, the astral body and the “I” are active. In everything that involves movement, the “I” organization is active. Thus, in the metabolic-limb system, the “I” and the astral body are engaged; in the human head, they are, so to speak, exposed, where the “I” and the astral organization are entirely free. So that if we wanted to draw a schematic diagram, we could draw: the physical head, the etheric head, but now the astral body and the “I” are free, not engaged in the physical and etheric. In contrast—if we now set aside for the moment the middle human being, the rhythmic, “blood” human—and consider the metabolic-limb human being, then, first of all, the etheric body is fully active there. It is active in the head as well, but in addition, the astral body and the “I” organization are active here—not internally released, but bringing about the processes.

[ 6 ] When we observe the child, we see a complete connection between everything that is free in the head—as the astral body and the “I” organization—and that which is bound to the physical organization, such as the body; whereas in the adult, we do not have such an inner connection, and therefore the whole body is not as dependent on what is happening in the head as it is in the child. In the child, the entire body is still entirely dependent on what is happening in the whole head.

[ 7 ] It is quite impossible to acquire an understanding of human nature without truly taking into account the higher aspects of human nature. For no one can truly understand what goes on in the human motor and metabolic systems without drawing upon the spiritual and soul aspects. At best, one can draw upon the organization of the head, which is, in its inner physical structure, very strongly modeled after the way non-human laws operate. The organization of the head is permeated by an etheric body and differs from non-human organizations, but it is still the most similar to them.

[ 8 ] What does it actually mean to understand a disease? Suppose you are dealing with some organ of metabolism; you must assume a very specific connection between the physical and the etheric bodies, and the way in which the astral body and the “I”-organization intervene in this organ—let’s say, the liver. The astral body and the “I”-organization must intervene in a very specific way. The moment the “I” and the astral body withdraw somewhat from this organ, at that very moment the organ becomes similar to the head organs, and one must always be aware that when any metabolic organ—or anything related to metabolism—exhibits an irregularity, the astral body and the “I”-organization are not sufficiently involved in the organization of that organ; and in the head, the opposite is true. When the astral body and the “I” intervene too strongly there, a pathological condition arises in the human head; so that, in fact, the human head is what is most strongly predisposed toward the vegetative-mineral realm within the human being, and the motor and metabolic organs are those that are most strongly predisposed toward the animal-human realm. In reality, however, we see only the opposite. We believe that the head organization, in particular, is the most spiritual of all. But when the head organization becomes the most spiritual, consciousness becomes clouded. The moment vegetative processes become too strong and interfere with the head organization, illness sets in from the head. The moment there are too few processes originating from the ego or the astral body that intervene in the metabolic-limb organism—the moment the metabolic-limb system becomes similar to the head system—that system becomes ill.

[ 9 ] The physician’s approach must therefore be to ask: When I see that a particular illness is associated with a clouding of consciousness, how do I go about preventing this? I must prevent the ego and the astral body from intervening too strongly. — Or, how do I ensure that the astral body intervenes more strongly when its intervention is too weak? — And you see, this is where we really encounter the factors that show us how, especially in medicine, the way of thinking plays an extraordinarily important role. For certainly, one must become familiar with the healing substances, the remedies. But of course you will rightly ask, how does one come to know these remedies? And one cannot know them unless one first experiences in the spiritual realm what is truly taking place within the human being. Now you see, in order to experience what is truly taking place within the human being, a certain way of thinking is necessary. And that is what I wanted to say, in principle, by way of introduction: that a certain way of thinking must already permeate the physician. First of all, for example—I would say—one must start from what is more external and natural. It must first be clear to the physician: Yes, everything that can be called warmth, light, and so on actually exists in two ways. — You see, first of all, in the summer, light and warmth come down to Earth from the sun; there, sunlight and solar warmth take hold of what sprouts and grows on Earth, leading it into flowering and fruiting. And in fact, what makes flowering and fruiting essentially interesting to us is that they are the carriers of sunlight and solar warmth,

[ 10 ] But what about winter? In summer, sunlight and solar heat penetrate the ground; they remain there, and the sunlight and solar heat stored within continue to have an effect throughout the winter. And so, light and the sun come into play from two directions.

[ 11 ] But when we look at what the sun and, in general, the Earth’s orbit—that is, the cosmic forces—bring about on Earth from within this orbit, we come to realize that all of this has an effect on the human metabolic and musculoskeletal systems. The entire metabolic and musculoskeletal system is already influenced by what comes in from the cosmos. Everything that is in the head is influenced by what has already been preserved in the Earth by the cosmic forces. In this respect, the human being stands upside down on the Earth. His metabolic and musculoskeletal system is influenced by what is extraterrestrial and cosmic. But you can extend this to every single substance. Take lead, for example, because lead is precisely a distinct remedy for certain conditions. Lead, as it exists in nature outside the human being, we find just as it was formed by the total cosmic forces; thus it acts in the most eminent sense when it exists through the cosmic forces; there it acts in the most eminent sense through the limb-metabolic system up into the head. If we melt the lead—that is, if we apply an earthly process and have thus subjected it to an earthly process—then it acts directly on the head system. Hence this great difference exists.

[ 12 ] Among our medicines, we have an essential remedy: antimony, or gray antimony. When we take it as it occurs in nature as a fibrous ore—this fibrous substance is formed from the cosmos—then we have in antimony a remedy that acts on the metabolism. If we subject antimony to an earthly process so that it becomes antimony mirror, then we act, in a specific sense, upon the human head.

[ 13 ] And you see, the point is to apply this way of thinking everywhere—not just to the substance, but to the processes, to what is happening. It is not correct to say that lead is a remedy for this or that. The point is to know how the process has unfolded—whether we have a raw substance or whether we have subjected the substance to some process. The way the substances are treated—that is, in essence, what matters. And we must stop thinking of the substance itself as the remedy. We should increasingly tell ourselves: If there is a disease, there is a process that is not encompassed by the human organism as a whole. If we want a remedy, then we must strengthen the person; we must subject the person to processes that we understand thoroughly. That is what matters.

[ 14 ] I would now like to tell you what this entire introduction is leading up to—something that may seem somewhat paradoxical at first, but which is nevertheless essential to truly grasp throughout one’s entire medical career. That is, when studying all the processes in the universe, one must examine whether they are cosmic or terrestrial processes, or those that interplay from both. We have no way of truly approaching these processes unless we can understand how, within this threefold human being, the soul is also structured into three distinct regions. Without an understanding of the soul, it is actually impossible to truly approach the human being.

[ 15 ] And you see, here one must take the following into account. In adult human beings, the soul is actually a much stronger unity than the physical organism. The physical organism is clearly divided into three parts: the nervous-sensory system, the rhythmic system, and the metabolic-limb system. These must be distinguished from one another. But the soul permeates the head system—the nervous-sensory system—as well as the rhythmic system and the metabolic-limb system. It is only very dormant, dreamlike in the lower system, but it permeates the whole human being across its three parts. But when a person is to develop one system in particular—that is, when the soul is to pour its activity specifically into one system—what actually happens then? After all, a person can engage in thinking, can engage in walking, or can engage in working with their hands and legs—in such cases, we must speak of the middle system separately. But what happens to the soul when a person is engaged in activity, when a person is engaged in walking? When a person walks or works with their hands, it is truly the case that the same force is expressed in all that in the world is called love; this force remains in the arms and hands, in the legs and feet (gap in the text). A person must reach the boundary of their skin when they engage in physical activity; what then, when it flows out beyond the person, unfolds as love.

[ 16 ] But what does it actually mean when we say, “A person walks”? It means that he lovingly animates the human organism from within his own body; that is, he exerts his astral body or ego-organization in an appropriate manner. And when a person walks, they exert their “I” organization in such a way that they draw it out to a certain degree from the physical and etheric organisms. When a person thinks, they exert it in such a way that they pour it into the physical and etheric organisms. A person withdraws their astral limbs and ego limbs when they walk; while extending their legs, they withdraw the astral body and the ego as they walk. When they think, they radiate them inward—of course, only as far as the skin. And when one takes this into account, one can say that the onset of illness lies simply in the activity of the organism. For when, without the person lovingly filling their organism, the astral body and the “I” organization withdraw from the metabolic limb system, pathological conditions arise. When the etheric body and physical body are filled in the head without this being the result of volition, pathological conditions arise again. So that what a person does arbitrarily is immediately corrected afterward. Daily life in thought and movement: it is a continuous process of making oneself sick. Only the human organism is able to restore itself to health immediately.

[ 17 ] And understanding these things depends precisely on being able to muster enough love for what is happening in the case of illness—enough to view it as what actually reveals, in a physical way, what the spiritual aspect of a human being is. You see, when a person develops liver disease—let’s say, some kind of abnormality in the liver—it means that their astral body is not sufficiently engaged in the liver. What is the corresponding spiritual activity where something similar occurs? It occurs when I take a particularly strong inner interest in something external. At the very moment when a person gazes at something with intense concentration, they are, in that moment, effectively suffering from a liver disease. At that moment, the astral body withdraws from the liver, but the balance is immediately restored. And as one experiences the various disease processes in the human organism, one can always study what happens in a healthy person through their volition, through their volitional life. If these arbitrary processes were not constantly balanced out, human beings would constantly make themselves sick through them. One can therefore learn what the soul and the spirit are like if one willingly regards the processes of illness as opportunities for study—if one truly loves them.

[ 18 ] And this love of diseases must, of course, be connected to something else. One does not merely wish to study the disease; that is the less important part. But if one can heal, what does one gain? Then one gains insight into the way in which the divine world has come into being from the most diverse spiritual activities and beings—how the world was created. And that is the starting point in the practice of medicine: first, to tell oneself that disease processes lead one into an understanding of human nature. They are genuine processes of understanding. However, the healing processes can only be grasped with a religious attitude. To truly relate to the world with a religious attitude—this must permeate the entire practice of medicine. Without it, detailed understanding will never come about.

[ 19 ] Of course, you can always say: Well, yes, we have the remedies, and anthroposophy also comes along and prescribes remedies, but the whole thing isn’t easy to understand! — It can be understood if one takes into account such things as have now been characterized, if one can truly penetrate the process of diagnosis and the process of therapy. These things must be taken very seriously. It is from this mindset that one must understand what has ever been put forward as what anthroposophy has to say about medicine. The details, of course, are only what can be put to practical use. But it is necessary, with this mindset we have spoken of, to thoroughly understand everything that unfolds in medical practice.

[ 20 ] Now I would like you to ask one or two more questions so that we can move on to specific considerations tomorrow. I just wanted to touch on the qualitative aspects.

First question: As a doctor today, one is sometimes forced to use treatments that one would rather not use, and some of these treatments are certainly such that one should not be allowed to use them. Could anything be said about treatments that one should not be allowed to use?

[ 21 ] Dr. Steiner: I would like to say the following about this question, purely as a matter of principle: There is a big difference between being able to say about a remedy, “I understand how this remedy works in the human organism,” and not being able to say that. That is a big difference. Admittedly, this difference is initially relative to external practice, as long as we do not have medical schools where students undergo the kind of training that can be taught through anthroposophy. Until then, it will always be the case that the practicing physician will also take note of what is recommended by anthroposophy: “This is a remedy for this or that.” Of course, we here would most like it if we could begin by imparting knowledge of human nature, so that by looking at an onion, one would then know how the onion process works in the human organism under these or those antecedents. That would naturally be our greatest wish. But for now, this is relative, and for the time being, it can only be the case that a remedy is given for this or that. Yet hardly any remedy is prescribed from this perspective without its inner effects on human nature becoming known. For example, one does not say, “Take silicic acid from Equisetum,” without knowing precisely that this will induce a renal process. The irritated kidney is calmed in its hypersensitivity. Thus, the hypersensitivity of the kidney is reduced when silicic acid from Equisetum is administered to the kidney. This is therefore understood, and one would have to know (gap in the text). But now I ask you in all sincerity: How are the studies conducted out there? — They are conducted entirely superficially with the help of statistics; they are conducted by administering the remedy to a certain number of patients. One actually has no idea what is going on there, and above all, the major difference between a true remedy and one that is not is that with a true remedy, one understands the process and knows how it affects human life as a whole. If you cure something today with any remedy, you cannot possibly know what the outcome will be in five years. But if you fully understand the process, you certainly don’t need statistics. With our remedies, it’s never a matter of statistics. You’ll see from the book, which will be published shortly, that whether a remedy works or not does not depend on statistics, but on the study of the individual case. If you have a box of matches and test one, you won’t burn all the matches; rather, once you’ve burned one, you know that every one will burn. Likewise, you know that every process must unfold exactly as you understand it. It is therefore not a matter of statistics, but of understanding the individual case. That is why we will always face great difficulties when people say: “Hand over your remedies—they must be tested!”—But that accomplishes nothing; it does not build trust in the remedies. Certainly, statistically speaking, our remedies will yield an exceptionally favorable result, but the typical cases are either not correctly diagnosed, or they are cases where additional treatments must be administered. Now I believe that the essential point with such remedies—which heal without one fully understanding them—is, above all, to truly understand how things actually unfold. You see, it is remarkable that even the process of testing leads to all sorts of interesting insights. All kinds of remedies for syphilis are appearing today. Arsenic plays a role in all of them. Why is that? As you’ll hear from us: Arsenic is something that stimulates the astral body—when it is sluggish in its interaction with the physical body—to intervene more actively in the physical body. This astral body is made more active by introducing arsenic into the human being. Those remedies, discovered through trial and error, are actually based on this effect on the astral body. Of course, you can also see how people are deceived, how these remedies are brought about by an illusion. One relies on the potent effect of arsenic in cases where the astral body can truly be strengthened by it. And in the case of syphilis, it is actually only arsenic that cures it. Thus, with all such remedies, one must always see through to the remedy’s true efficacy. One should strive to always see through to the efficacy of a remedy. Our way of thinking must therefore become increasingly well known, and that is precisely what we aim to achieve through this book: to introduce readers to the medical way of thinking that should be cultivated here, rather than focusing so much on the remedies themselves. It will also be important to highlight this way of thinking when it comes to remedies that we do not prescribe. After all, there are good remedies outside our field as well, and when necessary, one prescribes this or that one.

Second question: The last time we were here, we talked about bronchial asthma. You suggested that meditating on one’s breathing is a remedy. Are we justified in prescribing meditation in such cases? I didn’t know what else to do, so I found a quote by Goethe:

There are two kinds of grace in breathing:
To draw in the air, to exhale it,
The former oppresses, the latter refreshes;
So wonderfully is life blended.
Give thanks to God when He presses you,
And thank Him when He releases you again.

I didn’t know if that was correct.

[ 22 ] Dr. Steiner: You see, with matters like this, one must also accept that, because you are—for my sake—approaching things from a half-spiritual or three-quarters-spiritual perspective, there will also be something spiritual in your response, provided the attitude I spoke of today is present. This inner presence of the human being in the earthly realm, and then—through the head—in the cosmic realm; when the physician has learned to think and feel spiritually and to behave accordingly toward the patient—only then can one take responsibility for such a thing. But if you approach the patient with the attitude that is so often prevalent today due to the materialistic worldview—if you approach them with this attitude of indifference toward the patient, using methods that have nothing directly to do with the spiritual—then you will usually achieve the opposite of what you actually intend to achieve. You see, there really are many people who come time and time again—and this isn’t entirely ruled out among doctors today either—who work with such methods. They will sometimes bring about relief, even if not a cure. If the patient is thereby strengthened, then this relief can truly lead to a cure. But when people ask whether it’s really possible to achieve something like this, I must say that if you truly love the sick person, then it will be possible. But if you are indifferent toward the patient, then it won’t help.

[ 23 ] One really ought to have the courage to heal. That is why, here at our institute—where this is the case—I have always spoken of the courage to heal. The very worst thing is to think of death when dealing with any patient, no matter how seriously ill they may be, even if one wants to heal them. As a doctor, one should absolutely forbid oneself from even considering the patient’s death as a possibility. After all, the imponderables have such a powerful effect. It is an immense, strengthening force when, under all circumstances, you banish the thought of death—until the very end!—and think only of what you can do to preserve whatever vitality can be saved. When such an attitude is cultivated, far more people are saved than when the opposite attitude is adopted—one that somehow predicts death based on this or that sign. One must never do that. And one must certainly take such things into careful consideration. Then one is justified in having the courage to heal.

Question: If one works as an assistant at a hospital and must prescribe morphine and other medications to a patient, can anything else—specifically, one’s attitude toward the patient—prevent one from doing something wrong to the patient?

[ 24 ] Dr. Steiner: One can achieve a great deal simply through one’s attitude. But when interventions with physical substances are necessary, these should, if possible, be taken directly from the plant kingdom—not derived preparations—depending on what one deems necessary; for example, one might use the sap of the poppy plant directly. And not with an awareness of the inner process—on the contrary, by focusing on the plant’s outer form, on what is pleasing about the plant. It is difficult to lay down rules in such matters because, even when one is compelled to administer the remedy, one’s attitude plays a major role in whether one is able to grasp what is manifesting in the patient. One must observe what mood arises in the patient as a result of the remedy; then one can intervene. Through the remedy, the patient has become more transparent with regard to receiving help. We will continue tomorrow, and I ask you to ask whatever is on your mind.