Monday, May 9, 2016

Spiritual Science and Medicine

Spiritual Science and Medicine. Lecture 13 of 20.

Rudolf Steiner, Dornach, Switzerland, April 2, 1920:

It is possible that the more materialistic tendency in medicine may assume a more spiritually scientific orientation, in respect of three groups of facts; we shall now consider these groups. The first includes all facts connected with the origin, development, and possible cure of tumors. The second includes the so-called mental diseases, and their really rational treatment. And finally there is the field of externally applied remedies: ointments, salves, and so on.
We can hardly hope to reach an understanding of tumorous growths, with their culmination in cancer, by means of merely physical methods, unless the insight given by spiritual science serves at least as a guidance. And contemporary psychiatry is in such a sorry state — mainly because there is no conscious bridge between it and the usual pathology and therapeutics (though such bridges abound everywhere in nature) — that it is probable that these two special fields will be the first to approach the standpoint of spiritual science. They will need to mark all that spiritual science can tell them, and even now you have only to refer to my publications to realize that spiritual science has already told them a good deal. It will be necessary, in fact, to talk of the intervention of the etheric body within the physical organism.
For indeed no one should merely assert that clairvoyance is needed in order to show how the etheric body acts within the organism. It is possible to see that the etheric body is not active in a certain way — or is not adequately active — through the observation of very many processes which are opposed to the action of the etheric body. In order to obtain valid representations here, we must take into consideration all the manifestations associated with inflammation or developing out of inflammation, and also all that is associated with the formation of tumors and spreads its destructive activity through the human body. In the case of tumorous growths there is today a very justifiable effort to dispense with the surgeon's knife in the treatment of tumors. This endeavor is, however, blocked and often frustrated by social, especially hygienic, conditions which should, and must, be changed. But we must find a substitute for surgery — both for what it certainly achieves in some respects, and again fails to achieve in others. Doubtless there are many persons who at present advocate operative surgery for the simple reason that they know of no alternative, but who would be converted immediately if and when the alternative were available.
There is no need for me to analyze the whole nature of inflammatory processes in their specific forms as affecting the different human organs. All that, I can take as already familiar to you. But the unifying process, which is common to all inflammations, is not a matter of familiar knowledge. This unifying common process is perhaps best characterized as follows: in all cases of inflammation, whether very slight or very acute, and leading possibly to ulcers, spiritual science finds that the etheric body of the patient remains as a whole in working order. Thus we may be sure of being able to do something to restore the full efficiency of this etheric body, which has become impaired or impeded in a particular direction; to redistribute its workings, so as to make it a healing source. Our aim is to direct the activity of the etheric body in definite directions, whereas the healthy etheric body acts throughout the organism and permeates it in all directions. It is possible to set up reactive processes — we shall deal with them presently — which have the power to stimulate the etheric body in regard to a system of organs in which its activity has become slack, so that, provided the etheric body as a whole retains a certain measure of health, it resumes its universal efficiency in this special direction.
But tumorous formations of every kind are a different matter. They arise primarily from the actual enmity of certain processes within the physical body against the action of the etheric body; these processes rebel, as it were, so that the etheric body ceases to act in certain regions of the physical body.
The etheric body, however, has very great powers of regeneration, and the methods of spiritual science reveal that if it is possible to remove the hindrance and to expel the inimical action, the tumor can be overcome. We may lay down the rule that in cases of tumor it will be necessary to simulate, through the forces of nature, the removal of the counteracting physical processes which oppose the etheric body, so that the etheric body may once more extend its working to the region where it had temporarily receded.
This principle is particularly important, let us say, in the treatment of carcinomatous growths. Carcinoma, if objectively studied, shows plainly, in spite of its great diversity of form, that it is essentially a revolt of certain physical forces against the forces of the etheric body. For instance, the characteristic indurations, which are so perceptible in the case of deep-seated carcinomatous growths, and, though less perceptible, still present when the growths are nearer the surface of the body — these reveal the preponderance and the encroachments, so to speak, of the physical structure over the etheric structure, which should be there in the particular region. Careful study of their contrasting characteristics will lead us to the conclusion that inflammations, abscesses, and ulcers, on the one hand, and tumors, on the other, are polar opposites. Of course I must remind you that it is quite possible to take a carcinoma, situated on or near the surface of the body, for an ulcer, at least in some features. As the similarity may be misleading, we must study more closely the essence of this polarity.
Certain not precisely old but somewhat medieval technical terms are misleading and unhelpful in this respect — and when I use the phrase medieval, I refer not to the Middle Ages but to those times which we have only just passed through. It is not quite correct to refer to tumors as neoplasms. They are “new” only in the trivial sense of not having been there before, but they are not “neoplasms” in the sense of sprouting on the actual soil of the organism, i.e., on its boundary, the skin. But owing to the vehement opposition developing in some special process of the physical body, as against the etheric, the body of man becomes subjected to the outer nature inimical to man; the formation of a tumor provides an easy passage for all manner of external influences; and thus we should not neglect the study of the complementary opposite of this whole phenomenon. For this I refer you to the study of the extra-human world — let us say, to the formation of the mistletoe, to begin with.
First of all we must observe the precise manner in which the varieties of mistletoe (viscum) develop on the soil of other plants. But this is not the main factor under consideration. For the botanist, of course, the parasitism of such plants as mistletoe is the essential point. But for the study of the inter-relationships of extra-human nature to man, it is far more significant that the mistletoe as it grows on trees is compelled to follow a different yearly rhythm from that of other plants: its blossoms have been formed before the trees which are its hosts begin to put forth their leaves in spring. Thus the mistletoe is a kind of winter-blooming plant, protecting itself under the shelter of alien foliage from the extremes of the summer sun's rays, or better, from the light workings of summer; there is something of an aristocratic attitude about the mistletoe. (See Diagram 24). 

Diagram 24 from Spiritual Science and Medicine

The sun must be taken — in the sense of the eleventh lecture — as being the representative only of the light workings: but this subject forms a chapter of physics and does not interest us here; it is unfortunately impossible to avoid phrases introduced into our language by an incorrect conception of nature. The whole manner in which the mistletoe attaches itself to other plants in order to grow and thrive is the essential point: it acquires and appropriates particular forces which may be described as follows. Its nature is to oppose all the tendencies of the straight course taken by the organic forces, and to urge toward all that to which the straight course taken by the organic forces is opposed. Let us try to elucidate this by means of a rough sketch, (see Diagram 24) representing an area in the physical body of man which revolts against the whole access of the etheric forces, so that the latter are, as it were, dammed up and stopped and thus what appears to be a “neoplasm” is formed; and the mistletoe counteracts this “pocketing” which has been formed and draws the forces again to the area which they do not want to enter.
You may corroborate this statement by means of a test which can only take place as occasion offers. You can study the tendency of the mistletoe against the straight-lined organizing forces, by its effect on the afterbirth. Mistletoe prevents or delays the emergence of the afterbirth from the human body; that is to say, it opposes the straight course of the organic process. And that is its most characteristic and significant property: to prevent the normal course of organic forces. But quite the same tendency of opposition is to be found in the mistletoe effect in general.
The counteraction of mistletoe against the etheric body's refusal to take hold of the physical body may lead one to a certain administration of viscum; it may happen, then, that the physical body is taken hold of too strongly by the etheric body, and convulsions may result. Other cases, on being treated with mistletoe, have the peculiar sensation of falling (vertigo.) And these symptoms are in line with a further pharmaceutical effect of mistletoe, i.e., its stimulation of seminal pollutions.
Thus in all its manifestations, e.g., in connection with epilepsy also, mistletoe works “against the stream” in the organism of man. And this is due not so much to its parasitism as to its inherent contrariety: it claims always special indulgences from nature as a whole. This plant, for instance, will not thrive in the normal course of the seasons, blossoming toward the spring and then bearing its fruit, but during an unusual time, in winter. By so doing, it conserves those forces which counteract the normal course of events. If it were not giving too much offense, one might say that nature had “gone mad” and did everything at the wrong time, in reference to the mistletoe. But this is just what must be made use of if on the other hand the human organism becomes physically mad, i.e., in formation. Here the need arises to cultivate the understanding of precisely these connections.
Mistletoe provides, beyond question, a means which — when given in potencies — should enable us to dispense with the surgical removal of tumors. The point is only to find out how to treat the mistletoe fruit in combining it with other forces of the mistletoe plant in order to arrive at a remedy. The peculiar “madness” of this plant is shown in its method of fertilization, which depends on transport by birds from one tree to another. The plant would become extinct were it not for this service of the birds. In a curious way, the fertilizing elements of the mistletoe choose the path through the birds, and are excreted on another tree trunk or branch, where they “take root” anew. All these peculiarities illuminate the whole formative process of the mistletoe. The task is to blend the glutinous substance of the mistletoe in the right way with the triturating medium, and so increase gradually the potency of the viscum substance to a very high degree. Having ascertained the main formula, we should vary it, specializing according to the requirements of this or that organ; and also bearing in mind the particular tree on which the mistletoe grew; I shall make further suggestions in that matter. Another important point will be to arrive at a cooperation of this glutinous substance with certain metallic substances; this effect can of course be arrived at also by the metallic ingredients of other plants. But the cooperation, for instance, of mistletoe from an appletree with triturated silver salts could produce something eminently capable of counteracting all cancers in the hypogastric regions.
These things must be brought forward with caution at the present time. The trend of which they are manifestations is correct, beyond question, and based on well-established research in spiritual science. But on the practical side, we are dependent on the actual blending and preparation of the mistletoe substance, and have not yet sufficient knowledge for successful carrying out. Here spiritual science can only work to our full benefit if it is in continuous contact with clinical experience. And this interrelationship of spiritual science and medicine is made very difficult, for the opportunities for clinical observation and the investigations of spiritual science are kept widely apart by our contemporary social institutions. But just this can show that we can only succeed in these matters if and when both lines of procedure cooperate. Thus it is urgently desirable to collect experience in this direction, for it will hardly be possible to convince general public opinion in these matters unless you can provide at least verification by external reports from clinics, etc. It is not so much an internal necessity to obtain such evidence; but it is an imperative external necessity.
It is quite possible to prove that the therapeutic effect of the mistletoe is really based on the fact just put before you. It will only be necessary to proceed methodically. For as I have already pointed out, the trunk formations of trees are really practically outgrowths of the proper substance of the earth; they are only little mounds containing still the vegetable element and from them the other essential parts of all trees sprout forth. Now, suppose a mistletoe grows on the tree trunk: it sends its roots earthward, although it takes root on the tree. Now consider those plants which share the mad “aristocraticism” of mistletoe without sharing its “bohemianism” of living parasitically. One can expect to make similar experiences when testing such plants. This is bound to be so. Examine and test winter-flowering plants with reference to their contrariety, their anti-tendency against the normal tendencies of the human organism, including, of course, the normal tendency to disease. We must expect the plants which flower “out of season” to have effects similar to that of the mistletoe. Extend the experiments to Helleborus niger, the hellebore, and similar effects will be found. It is, however, necessary to take notice of the contrast, already outlined, between the male and female respectively: Helleborus niger will hardly produce any effect — or any visible effect — if administered to women. But on men it will show appreciable influence in the case of tumors if it is applied in a higher potency arrived at in the way already suggested for mistletoe.
In choosing plants for therapeutic purposes, it is necessary to bear in mind whether they flower in winter or summer, and whether their inherent effects are more due to their tendency to the earth itself than are those of mistletoe. Mistletoe shuns the earth, but hellebore likes the earth and is therefore more in affinity with the male system which is akin to earth itself, whereas the female system of forces, as I have already stated, is more akin to the extra-telluric sphere. These differences must never be underestimated. We must learn to get a certain insight into the processes of nature themselves. This is why I have attempted to characterize with the help of such images as bohemians, aristocrats, madness, and so forth: for such concepts are not entirely inadequate in describing the forces in play.
After having formed such concepts one will also find out the characteristic difference between the efficacy of a remedy from outside and one from within. Before considering this difference, we must form certain ideas which will lead us to understand this difference. It will be necessary to study the new forms of disease, already alluded to yesterday, from the therapeutic point of view. One can, e.g., try to expose vegetable carbon to the action of marsh-gas for some time, to immerse it in marsh-gas and then when it is sufficiently saturated, to produce the trituration. One will in this way obtain something which is efficacious when prepared as an ointment, especially in combination with other favorable ingredients. The technical method of such a thing has to be discovered. If this is done — and talcum suggests itself in this connection — there is no doubt that an ointment compounded on these principles would have most useful properties. It is, however, necessary to penetrate such a process. We shall not penetrate it until we have cleared our vision by learning to think on sound lines in the matter of psychiatry, as well.
Believe me, the exponent of spiritual science finds the mere phrase “mental disease” [Ed: In German: Geisteskrankheit, spiritual disease.] to go against the grain; for it is folly simply to use the expression “mental disease”; the spirit is always healthy, and cannot fall sick in the true sense of the term. To talk of mental diseases is sheer nonsense. What happens is that the spirit's power of expression is disturbed by the bodily organism, as distinct from a disease of the spirit or the soul itself. The manifestations in question are symptoms, and symptoms only.
Now, one must sharpen one's eye for the concrete separate symptoms. Perhaps you will be in a position to see the primary tendency or disposition, and then the further development of, for example, a religious mania: — of course the technical terms here are none of them precise. There is great confusion of terminology in this field, but let us for the moment use an accepted term. As I have said, these manifestations are only symptoms. But let us assume that this condition develops — we must be able to form some picture of how it develops. And, having found this picture, we shall require to keep a sharp look-out for any abnormalities in the formative process of the lung of those individuals who display this symptom of “religious mania.” Note: not anomalies in the process of breathing but in the process of lung formation, in the pulmonary metabolism. For even the current term “brain disease” is not wholly correct; “mental disease” is a wholly false and misleading term, and “brain disease” at least half mistaken; for all phenomena of cerebral degeneration are secondary. The primary elements are never manifested in the upper organic sphere, always in the lower. The primary factors always lie in the organs belonging to the four main groups or systems: the liver, kidneys, heart and lung systems. In the case of an individual inclined to those forms of insanity in which all interest in the external world and active life dies out, and man begins to brood and follows delusions, it is before all things necessary to obtain precise knowledge of the pulmonary process. This is extremely important.
Again, take such persons as are conspicuous for what may be termed obstinacy, stubbornness, self-righteousness, and all the other facets of a certain conceptual rigidity, a blind sticking to a certain system of concepts; in their case we should try to ascertain the state of the liver process. In such cases, there is always a defect in the internal organic chemism. Even what is commonly known as “softening of the brain” is a secondary manifestation. In all the so-called mental diseases, the primary cause lies in the organic system, although this is often very hard to detect. And for just this reason it is sad to note how ineffective so-called mental and spiritual treatment often proves; so that there is more chance of obtaining a cure in organic diseases through treatment of the mind and spirit than in the diseases termed “mental.” Yes, we must learn to treat mental diseases with physical remedies. That is a matter of major importance, and the second field in which external medicine will have to let its path be sought and found: the path leading to spiritual science.
The suitable observer in this field will always be the thoroughly trained and competent psychologist. The life of the soul with its immense diversity, with its way of often working by mere indications, is able to reveal very many things, and one has to acquire gradually a capacity to observe it. Take one example: Man is so constructed that in respect of his faculties and capacities — including the faculties and capacities based upon the bodily organization which becomes the implement of the spiritual organization — he is not all of one piece, not of a single mold. It is absolutely possible for an individual to exhibit qualities which compel us to treat him as mentally inferior, feeble-minded: nevertheless the same person may utter things which are full of life and wit to the point of genius. That is quite possible. And why? because of the extreme suggestibility associated with certain types of mental inferiority; a suggestibility open to all the mysterious influences of the environment and reflecting them as a mirror. In the field of pathological-cultural history one can make the most interesting observations. In giving the results, one naturally need not mention names; to refrain may be to undermine confidence in the statements, but it is not well to mention names. Especially in the profession of journalism it happens that mentally inferior people may have success because their mental inferiority enables them to record the opinion of their time, rather than to maintain their own restricted view. The opinion of the time is mirrored. For this reason, the writings of mentally inferior journalists are much more interesting than that of strong-minded, independent members of the profession. The former reveal to us much more what mankind thinks than those who form their own views. The result is — it is only an extreme case, but it often occurs — a masking of the true nature of the case; one fails to recognize an actual mental inferiority, because one is faced with utterances which may even bear the stamp of genius. In the course of everyday life this does not much matter, for why should not our newspapers be composed by mental weaklings — provided, of course, that their “news” is good! But in more extreme cases, the borderline may easily be crossed and definite morbidity result; and in such cases the healing profession needs an unbiased eye — a very unbiased eye — for the diagnosis of conditions which come under the classification of psychiatry. Here we cannot always judge from the masks in which the soul's activity disguises itself; but we must probe for deeper and less obvious symptoms. And error here is the more possible because it is of prime importance for diagnosis not only to note whether the individual gives utterance to clever thoughts, but to observe (granted that such be the case) whether there is a tendency to repeat these clever thoughts more often than the context requires. The “how” of expression of thoughts is important. If thoughts are very often reiterated, or on the other hand omitted, so that there is nothing consecutive or continuous, we have symptoms of far greater importance than if the thoughts expressed are either intelligent or stupid. It is possible to be a very intelligent person and yet at the same time stupid: physiologically stupid, of course, not pathologically so. It is possible to utter clever ideas and yet tend to so-called“mental” disease, and even suffer from it. This condition can be perceived sooner by the following symptoms than by any others: firstly, the omission of thoughts; and secondly, their frequent repetition. The individual who suffers from frequent repetition has always certain organic tendencies associated with a defective formative process of the lungs. The individual who suffers from omission of thoughts has always certain tendencies associated with defective function of the liver process. The remaining manifestations stand midway between.
These conditions may be studied from life itself. Take such substances as have already established themselves as either foodstuffs or luxuries, but not, as yet, as therapeutic remedies in the accepted sense of the term. Among them I have already often had occasion to mention coffee — at least in certain circles — as possessing a very definite effect on the whole symptomatic process of the soul. Now, it is inadvisable to put one's trust in such effects — for if they are habitually relied on they merely make the soul inert; but they certainly exist. It is quite possible to supplement a lack of logic in thought by means of stimulation through coffee: that is to say, a certain amount of coffee will stimulate the organism so that it yields more forces of logic, than without coffee. Therefore it should be a part of the habits of journalism — which are based on accepted opinions — to absorb large amounts of coffee in order not to have to gnaw their pens too much in order to link up their thoughts! — So much for one part of the phenomenon.
The habit of tea drinking, on the other hand, helps us to avoid linking up pedantically one thought to another like a professor. For certain professions which are now in decline, but in their ancient state were based on wit, there could be given a remedy which would make people extremely witty — not, indeed, internally witty but quite externally through a beverage: namely tea. Just as coffee is the drink for journalists, tea is a remarkably effective drink for diplomats, materially conducing to the habit of making aphoristic remarks and hints, which create the impression of intelligence and wit.
These matters are needful to know, for if we know how to estimate them aright, and possess the requisite ethical attitude, we recognize that in any ethically responsible life, intelligence and efficiency must be promoted by other means than this or that form of diet. But in order to recognize certain connections in nature, such knowledge is very important. There are also significant cultural aspects. For example, we may refer to the very small amount of sugar consumed in Russia up to the present time, as contrasted with the lavish consumption of sugar in the Western world of the English-speaking peoples. And we may conclude that (if and when soul development does not neutralize physiological effects) the mental behavior of men bears the definite imprint of the substances they eat or drink. Thus the Russian in a way gives himself up to the surrounding world and has a comparatively slight ego-feeling, unless it is artificially supplemented by some theory; these attributes being associated with their small intake of sugar. The Englishman, on the other hand, has a strong feeling of his own self, and the organic basis for this quality is associated with a large intake of sugar. Nevertheless in such cases the fact of taking in is less important as an indication than the urge for a certain diet. For the fact of habitual consumption of any special food develops from the urge, and therefore the urge is the main factor to be remembered.
Finally; if you fully realize that the real origin of the so-called mental or spiritual diseases is to be sought in the lower organic systems of man, you will be made unmistakably aware of interactions within man which cannot be neglected in the practice of pathology or therapeutics. These interactions between what I have termed the lower and the upper man must be considered always and equally, both in pathology and therapeutics; otherwise it will not be possible to form an opinion of the manner in which external influences will affect the patient. For instance: there is a very great difference between the application of heat or of water to the head, or to the feet, respectively. But we can find no fundamental principle here unless we are aware of the great differences of function in the two bodily spheres of man: the upper and the lower. For this reason, we will now proceed to discuss external influences affecting man, so far as is possible within the scope of these lectures.

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