Course for Young Doctors. Lecture 1 of 8.
Rudolf Steiner, Dornach, Switzerland, January 2, 1924 [90 years ago today]:
I should like, first of all, to speak to you about certain principles in medical study. Medical study today is based upon a scientific conception of the world, or, better said, upon scientific interpretations, which do not lead to the human being in his reality and which at the present time are not capable of giving a true description of the human being.
And so young physicians approach a sick human being without having any real picture of a healthy human being. For if, after having studied anatomy and physiology, we picture the essence of the human organism to be the organs, systems of organs, bones, muscles, all with their definite contours, and get into the habit of looking at these systems within rigid contours, we have an entirely erroneous view of the human being. All that is drawn and pictured in this way and then becomes the content of knowledge, is in reality involved in a perpetual process of becoming, in a perpetual process of build-up and breakdown (anabolism and catabolism). There is perpetual becoming, perpetual arising, and passing away. If we think deeply about this process of arising and passing away, it is at once apparent that we must pass over from what has contours within the human organism to what is fluid and has, therefore, no contours. We realize that the human being must be pictured as the product of streamings — which persist at certain locations — and that we must add to the solid body (which is, after all, the smallest part of the human being) the fluid man, if I may so express myself, the being who is no longer subject to the laws to which the bodies with definite contours are subject. The conceptions arising from modern anatomy and physiology usually give rise to the opinion that if fluid is taken to quench thirst and then more and more fluid is taken, the fourth or fifth glassful passes through the same process in the organism as does the first. But this is not the case. Up to the point where the thirst is quenched, the first glass of water passes through a complicated process; the second glass of water, when the thirst is no longer so intense, passes through the organism without this process, much more rapidly than the first. It does not go through the complicated ways of the first, and in the case of the second glass of water, what takes place is simply a kind of increased streaming of the fluid man, if I may put it so.
A true knowledge of the human being must, therefore, reckon, to begin with, with the sharply outlined organs but also with what is in flow in the organism. Physiology does, of course, also speak of what is in flow, but the flowing fluids in the human organism are only investigated from the point of view of the laws of dynamics or mechanics. The truth is that the moment the fluid man comes into consideration, we must realize that the so-called etheric body is working in this fluid man.
The drawings to be found in books on anatomy have merely to do with the human physical body. The streaming of the fluids in the organism is left out of account. This streaming of fluids within the organism is not dependent upon earthly forces, fundamentally speaking. It is dependent upon planetary forces. Therefore, we must realize that as long as we are concerned with rigidly outlined organs and systems of organs, earthly forces, pure and simple, come into consideration. The moment we are concerned with what is in circulation, whether it be the circulation of the digestive juice or of the digestive juice that has already been transformed in the blood, the ruling forces are not earthly but planetary. We will go into this more closely. It is merely a question, now, of the principle.
Thus, the physical laws of the physical body apply to the solid man; while the laws of the etheric body rule the fluid Man. But the aeriform, the gaseous, also plays a part in the human organism, a greater part, indeed, than is conjectured. Insofar as the gaseous works within and enlivens the human organism, it is entirely dependent upon the astral body. Human breathing, for instance, in its physical manifestation, is a function of the astral body.
I spoke of the physical man (physical body), of the fluid man (etheric body), of the gaseous man (astral body). So far as the fourth man, the warmth man, is concerned, there is not the slightest doubt that differentiated warmth is present in the space physically occupied by the human being, and even beyond this. If you put a thermometer behind the ear or under the armpit you will find evidence of differentiation in the warmth organism; the degrees of warmth are everywhere different. As the liver has its definite place in the organism, and the intestinal organs have theirs, so do they also have quite different temperatures. The liver temperature is quite different, for the liver has a very special kind of warmth organization. This warmth organization is subject to the ego organization.
Now, and really for the first time, you can picture the human being, insofar as he bears within himself the substances that exist on the earth in the solid, fluid, aeriform, and warmth conditions. The warmth is ruled from the ego organization. When something or other is in a certain condition of warmth, this condition of warmth has an effect upon what it is permeating. And here we come to how things really are as regards the ego organization. What the ego organization does in the human organism is done by way of the warmth organization. Suppose I am walking, simply walking. When I am walking, I take hold of my warmth organization with my ego organization. What the warmth does within the fluids which fill out the solid constituents of the legs is, indirectly, a consequence of the ego organization, but the ego organization only takes direct hold within the warmth organization. In the whole organism, in the solids, fluids, gases, and warmth, therefore, we see the intervention of the ego organization, but the intervention takes place by way of the warmth organization. The astral body also intervenes in the whole organism, but the astral body takes direct hold only in the aeriform organization, and so on. You can work out the rest for yourselves.
This helps you to understand something else. If you take what is presented to you today in physiology and anatomy all that is so beautifully drawn and is regarded as being the whole man, if you take this, you will never be able to pass over from this human being (who in reality does not exist in this form) to the soul, let alone to the spiritual. Just tell me where and how the soul or spirit could possibly be connected with the human being as pictured by physiology or anatomy today? This is the reason why all kinds of apparently well-thought-out theories have arisen concerning the interactions that take place between the soul and spirit and the body. The most ingenious of them — No, I ought to say the most nonsensical — is that of psycho-physical parallelism. It is said that the life of soul and spirit and the bodily life run their courses simultaneously and parallel to each other. No attempt is made to find a bridge. But the moment you pass on to the differentiation of the warmth and see therein the intervention of the ego organization, you realize: Yes, it is conceivable that the ego organization intervenes in the warmth ether, and by way of the warmth organization in the whole human being, down to the sharply outlined physical organization.
The reason why the bridge between the physical nature and the life of soul in the human being could not be found was because no account was taken of the existence of these organizations of which the soul and spirit take hold in successive stages. It is a known fact that the simple psychical condition of fear, for example, affects the bodily warmth. It is inconceivable that the psychical experience of fear should be capable of actually making the legs tremble. The thing is inconceivable, so a theory like that of psycho-physical parallelism has arisen. But it is conceivable that the organization of soul which is anchored in the warmth ether should be affected by fear, and then that the fear should live itself out in the corresponding change of the warmth, the warmth organization communicates itself to the airy organization, the fluid organization, and downwards to the solid body of the human being. Only in this way is it possible to build a bridge from the physical to the life of soul.
Unless you have this insight into the healthy human being you will never get insight into the sick human being. Take, for example, some part of the human organization, such as the liver or kidneys. In the so-called normal state, the liver or kidney receives impulses from the ego organization inasmuch as these impulses of the ego organization take hold, first of all, of the warmth organization and then pass down to the liver or kidney with its definite outlines. If we understand this process, it is possible to conceive that this intervention on the part of the ego by way of the warmth organization may cause the ordinary process of this warmth organization to be inwardly intensified, to deviate from its ordinary process, in such a way that the ego organization works too strongly upon the warmth organization in the liver or the kidneys. A certain state of balance must prevail in the organism in order that the ego organization can work in it. If this balance is upset, the organism may fall ill. But the organism as pictured by modern anatomy and physiology is, in reality, incapable of illness. From whence could the condition of illness possibly proceed? Somewhere or other the possibility of illness must exist in the organism. Now, the ego organization must work in with a certain strength upon the heart, that is to say, by way of the warmth organization upon the heart. Suppose it happens through some circumstance or other, and remember that in the external world, too, warmth can be guided to some other place where it is not desirable — suppose it happens that what ought to work by way of the warmth organization upon the heart works in the kidneys or liver. Something happens that must happen, but here it is out of place, has gone astray — and then the possibility of illness arises.
Only by remembering this principle will you begin to understand the possibility of illness; otherwise you will not understand. You will have to say to yourselves: Everything that goes on in the human organism is a process of nature. Illness is, however, also a process of nature. Where does a healthy process cease? Where does a process of disease begin? These questions are unfortunately unanswerable if you go no further than the teachings of orthodox physiology and anatomy. You can only get a conception of the possibility of illness when you know that what constitutes illness when it takes place in the liver, may be healthy when it takes place in the heart and so on. For if the human organism, working from out of the ego organization, could not bring forth the warmth that must be present in the region of the heart, the organism would, for example, be unable to think, to feel. But if these same forces were to invade the liver or kidneys it becomes necessary to drive them out again, to put them back, as it were, within their original boundaries. Now, in external nature there are substances and activities of substances which can take over, in the case of every organ, the activity of the etheric body, of the astral body, of the ego organization. Suppose the ego organization is taking too strong a hold of the kidneys. By giving equisetum arvense in a certain way, you enable the kidneys to do what the ego organization is doing in this abnormal, pathological condition. In this pathological condition, the ego organization is taking hold of the kidneys but in the way that ought only to happen in the heart, not in the kidneys. Something is going on in the kidneys which ought not to be there but which is there because the ego organization is pouring in its activity too intensely. We only get rid of this condition if we introduce artificially into the kidneys an activity which is an equivalent of this activity of the ego organization. That is what you can introduce into the kidneys if you really succeed in making equisetum arvense active in the kidneys. The kidneys have a great affinity with equisetum arvense. The activity of this substance throws itself into the kidneys, and the ego organization is sent out. And when the ego organization is given back to its own tasks it has a curative influence upon the diseased organ. You can call up the higher bodies, so-called, into health-giving activity when you drive them out of the diseased organ and set them again at their own proper tasks. Then, through a reactionary force which arises, these higher bodies can actually work curatively upon the diseased organ.
If we are to understand such forces and the connection of the human organism with the cosmos and with the three kingdoms of nature around man on the earth, we must cultivate a different kind of natural science from what is cultivated today. I will give you an example.
You all know that formic acid comes from ants. Certain things are known by chemists and pharmaceutical chemists about formic acid, but the following is not known. A forest in which no ants are carrying on their work causes great harm to the earth through the roots that are falling into decay. In the organic fragments that are falling into dust the earth goes to pieces. Just think of wood from which the vegetative process has gone and which has passed over into a kind of mineral condition; it is pulverized, is falling into dust. But when the ants are doing their work, formic acid in an extremely high potency is always present in the soil and in the air within the area of the forest. This formic acid permeates what is falling into dust and the connection of the formic acid with the dust safeguards the development of the earth; the dust is not just scattered away in the universe but can provide material for the earth's further evolution. Substances which seem merely to be the excretions of insects or other forms of animal life are seen, in very truth, to be the saviors of the further evolution of the earth when we know what their true function is.
The way in which the modern chemist investigates substances will never lead to a knowledge of the cosmic tasks of these substances. And without knowledge of the cosmic tasks of substances it is quite impossible to know the tasks of substances that are introduced into the human being. What formic acid does in external nature, quite without being noticed, is going on all the time within the human organism. And so I said in another lecture that the human organism must always have a certain quantity of formic acid in it because the formic acid restores the physical substances that are succumbing to the process of growing old. In certain cases it may be found that the patient has too little formic acid in his organism. It is essential to know that the different organs must each have different quantities of formic acid. When we discover that some organ has too little formic acid, this substance must be introduced into the organism. There will be cases where the introduction of formic acid gives no help, others again where it is a very great help. There may also be a case where the organism strongly resists the direct introduction of formic acid but will be inclined, when its oxalic acid content is increased, to manufacture formic acid itself, out of the oxalic acid. In cases where nothing can be done with formic acid, it is often necessary to apply an oxalic acid cure, because formic acid is produced out of the oxalic acid in the organism. This is only one indication of how necessary it is not only to understand the nature of the organs with definite contours but also the nature of the fluids, the fluid process outside in the cosmos as well as within the human organism. This must be known in all detail.
You see, certain processes outside in nature which are occasioned by man can be observed, but their whole significance cannot be revealed by scientific interpretations. Let me tell you about a very simple phenomena. Fig trees grow in the South. There are fig trees which produce wild figs and specially cultivated trees which produce sweet figs. People are shrewd in the way they produce sweet figs. They do the following: they cause a certain species of wasp to lay eggs in a fig, an ordinary fig. A wasp maggot comes from this germ and passes into the chrysalis stage. This process is interrupted and the young wasp is caused to lay a second lot of eggs in the same season. The result of this second lot of eggs from the wasps which have been generated in the same year is that sweetness is produced in the fig in which the second generation of wasps has laid eggs. In the South, people take figs that are nearly ripe, tie two together with string and hang them on a branch. The wasps come and deposit the eggs in the figs; the ripening process is very much accelerated through the fruit being cut away from the tree and the first generation of wasps develop very quickly; then the wasps go over to other figs that have not been cut, and they become very much sweeter.
This process is very important because here, within the fig substance itself, there takes place, in concentration, the same thing that happens when wasps, or, if you will, bees, take nectar from the flowers into the hive and produce honey. The bees take the nectar from the flowers and then produce honey in the hive. This same process takes place within the fig itself. The people in the South set a honey-producing process going in the fig by way of the young generation of wasps. A honey-producing process is generated in the fig which is inoculated by the young generation of wasps.
Here you have the metamorphosis of two nature processes. The one is spread out, so to say, over nature, when the bee fetches the nectar from the flowers at a distance and produces honey from this nectar in the hive. The other process is concentrated in the same tree on which the two figs are hung. These figs ripen more quickly, and the generation of wasps arises more quickly; other figs are inoculated and these become sweet. We must study such processes of nature for they are the processes which come into consideration in medical work.
There are processes at work within the human being of which modern physiology and anatomy have not the slightest inkling because their observation does not extend to nature processes such as I have now described. We must observe the more delicate processes in nature and then we shall unfold a real knowledge of the human being. For all these things, my dear friends, an inner understanding of nature is required and a comprehensive view of the warmth, the streamings of air, the warming and cooling of the air, the play of the sun's rays in this warming and cooling of air, the water vapor in the atmosphere, the wonderful play of the morning dew over the flowers and plants, the marvelous process which takes place, for example, in a gall apple which is also produced by a wasp's sting and the laying of an egg. A sense for nature is required in all these things. And this sense for nature is certainly not present when, as in the modern way of observation, everything is made dependent on what is seen under the microscope where things are taken right away from nature. There is a dreadful illusion here. What is the aim of looking through the microscope? The aim is to be able to see what cannot be seen by the ordinary eye. When the object is enormously magnified people imagine that its workings will be the same as they are in the minute. But in microscopy we are looking at something that is untrue. Microscopy is only of value if you yourselves have a sufficiently true sense for nature to be able, with your own inner activity, to modify the particular object to the corresponding minuteness. Then the whole thing is different. If you see an object magnified, you must be able to reduce it again, simply through its own inner nature. This is not done in the ordinary way. As a rule, people have no inkling of the fact that the magnitudes of the things of nature are not relative. The theory of relativity is great and fine and in most domains simply incontestable. But when it comes to the human organism, that is another matter altogether. Three years ago I was present at a discussion among certain professors. They simply did not understand when one said to them that the human organism cannot be twice as large, for example, as it actually is, for it could not endure such a size. The size of the human organism is determined by the cosmos; its size is not relative, but absolute. When the size is super-normal, as in a giant, or subnormal as in a dwarf, this immediately brings us to conditions of illness. And so when we see an object under the microscope, we see a lie, to begin with. It is a question of reducing objects back to truth, and this is possible only when we have a sense for nature, a sense for what is really happening outside in nature.
It is very important to study a beehive. The single bee is stupid; it has instincts, but it is stupid by itself. The beehive as a whole, however, is exceedingly wise. Quite recently a very interesting discussion took place with workmen at the Goetheanum to whom, in normal times, I give two lectures a week. We had been speaking of bees and a very interesting question was put. People who keep bees know quite well that when a beekeeper who is loved by the inhabitants of the hive falls ill, or dies, the whole bee population falls into disorder. This actually happens. One of the workmen who has the typically modern way of thinking said that surely a bee cannot see such a thing, it cannot possibly have any picture of the beekeeper. How, then, can such a feeling of interconnection arise? He also brought forward the point that a beekeeper looks after the hive one year but the next year there is quite a different population in the hive; even the queen bee is another insect and all the bees in the hive are young bees. How, therefore, can there be this feeling of interconnection? I answered in the following way: It is well-known that in certain periods all the substances in the human organism are changed. Suppose we make the acquaintance of someone who goes to America and comes back after ten years. The person who comes back is really quite different from the one who went away ten years ago. All the substances in his organism have been exchanged for others. Things are exactly the same as in the beehive, where the bees have changed but the feeling of the interconnection between the hive and the beekeeper remains. This feeling of interconnection is due to the fact that there is tremendous wisdom in the beehive. The hive is not merely a cluster of single bees; the hive has an individual soul, a real soul.
The perception that a beehive has a soul is also something that must form part of our sense for nature. Such perceptions are part of a true sense for nature and can be applied in many other things. We can only begin to understand the human being in health and in disease when our knowledge is reinforced by a sense for nature that is not only microscopic but also macroscopic, if I may use the expression. We shall try to understand health and disease in this way during the lectures, my dear friends, and we shall consider, too, what I will call the moral side of medical studies and medical science.
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