# Spiritual Foundations of Medical Understanding and Healing

## GA 314 — 21 April 1924, Dornach

### Address

I think the main thing we will have to discuss should be discussed in connection with specific questions that you ask. I will only say a few words, I would like to say a few words in advance about the fundamentals.

In the course of human development, much of the reality has been lost because the knowledge of the spiritual, which also lives in everything physical, has gradually been lost. But medicine is undoubtedly one of the things that have lost the most, for the simple reason that by merely limiting oneself to knowledge of nature, all insight into the human being and his life must be lost. For it must be emphasized again and again that all processes that take place in nature are such processes that cannot take place in the same way within the human organism.

We want to disregard animal and plant organisms. Today, there is a belief that a process that is observed externally in nature can also exist in some way within the human organism. One speaks of combustion and all kinds of other physical processes within the human organism. Such do not actually exist in reality, and just as we have before us in the self-contained human organism something unnatural, which, to the external eye, is different from an extra-human natural object outside, so too is every single process in the human organism something thoroughly different. All the processes that take place outside of the human being in nature have a building and breaking down effect on the human being. And if we want to understand the human being, we must recognize three levels of breakdown.

The first degradation is the one that happens from the inside out, so to speak, through everything that affects the human being from the earth. The forces of the earth work in such a way that they degrade the human being from within. The forces that work from the air, primarily through breathing, and are transferred to the human being, have a degrading effect from the earth's orbit. And the forces of light from the Cosmos have a degenerative effect on man. Thus the extra-human forces of the Cosmos have a degenerative effect on man in three ways, and the degeneration occurs immediately if the ego organization and the astral body do not participate in the human organization. The astral body and the ego organization counteract the degenerative principles in man. In that moment, therefore, the breakdown by the extra-human forces must occur, in which the I and the astral body no longer work in man. But this also shows us that we cannot get by without gaining more and more real insight into the higher members of human nature, even when we consider the medical aspect.

Medicine has arrived at mere trial and error, experimentation, only because in recent times it has no longer dared to reckon with the higher limbs of human nature, with the supersensible. But the process of illness cannot be understood if it is not grasped as being connected with the higher limbs of human nature. And the process of recovery, the process of healing, cannot be understood either without being placed in such connections with the higher limbs of human nature. For, let us consider the following: In the human head, in the human skull, the processes of decomposition of the physical body and of the etheric body are essentially at work. These processes of disintegration that are active there make it possible for the astral and the I to be active in the human head. In contrast to this, in the metabolic limb organization, in all that is connected with the motor system and the metabolism, we are dealing with the building processes of the human organism, both of the etheric body and of the physical body. In these anabolic processes, only the ego and the astral body are active in the most eminent sense for the metabolic and motor system. The astral body and the ego are active in everything that takes place in the metabolism. The ego organization is active in everything that is movement. So that in the metabolism-limb system we have: I and astral body engaged; in the human head they are, as it were, exposed, there I and astral organization are quite free. So that if we wanted to draw schematically, we could draw: physical head, etheric head, but now free astral body and I, not engaged in physical and etheric. On the other hand, if we now omit the middle human being, the rhythmic, the blood human being, and consider the metabolic, limb-bearing human being, then, firstly, the etheric body is fully engaged in this. It is also present in the head, but in addition, the astral body and I-organization are engaged here – not left free internally, but rather effecting the processes.

When we look at the child, we see a complete connection between what is free in the head as the astral body and ego organization, and what is bound to the physical organization as in the body, whereas we do not have such an inner connection in the adult and therefore the whole body is not so dependent on what is going on in the head as it is in the child. In the child, the whole body is still dependent on what is going on in the whole head.

It is quite impossible to acquire a knowledge of human nature without really taking the higher aspects of human nature into consideration. For no one can really understand what is going on in the motor and metabolic systems of the human being without also taking the soul and spirit into account. At best, the organization of the head can be used as an aid, as it is very strongly modeled internally on physical, extra-human laws. The organization of the head is permeated by an etheric body and differs from the extra-human organizations, but it is most similar to the extra-human organization.

What does it actually mean to understand the disease? Assuming you are dealing with any organ of the metabolism, you have to assume a very specific connection between the physical and the etheric and how the astral body and I-organization intervene in this organ, say in the liver. The astral body and I-organization must intervene in a very specific way. The moment the I and the astral body withdraw somewhat from this organ, the organ becomes similar to the head organ, and one must always be aware that when any metabolic organ, and also anything related to metabolism, shows an irregularity, the astral body and I-organization are not involved enough in the organization of this organ; and in the head it is the other way around. If the astral body and the ego intervene too strongly, then the pathological condition occurs in the human head; so that actually the human head is that which is most strongly predisposed to the vegetable-mineral interior in man, and the motor and metabolic organs are those which are most strongly predisposed to the animal-human. Actually, one only sees the opposite. One believes that the head organization is the one that is most spiritual as an organization. But when the head organization becomes too spiritual, consciousness becomes clouded. At the moment when too strong vegetative processes intervene in the head organization, at that moment the head becomes diseased. In the moment when too few processes emanating from the ego or astral body intervene in the metabolic-limb organism, in the moment when the metabolic-limb system becomes similar to the head system, that system becomes ill.

The doctor's approach must therefore be to ask: How do I get it to happen that when I see any illness associated with clouding of consciousness, how do I get it to prevent this? I must prevent the too strong intervention of the I and the astral body. — Or, how do I get it to happen that the astral body intervenes more strongly when it intervenes too weakly? And you see, here we have a case where the way we think, our way of thinking, plays an extraordinarily important role, especially in medicine. For it is certainly necessary to become familiar with the healing substances, the healing remedies. But of course you will rightly ask how one comes to know the healing remedies. And you cannot get to know them unless you first experience in the spiritual what is really going on in the human being. Now, you see, in order to experience what is really going on in a person, a certain way of thinking is necessary. And that is what I wanted to say in principle in my introduction, that a certain way of thinking must already permeate the physician. For example, one must start, I would say, from more external natural things. First of all, the physician must realize that everything that can be called warmth, light, and so on, is actually present in two ways. You see, in summer, light and warmth come down to earth from the sun. Sunlight and solar heat take hold of what sprouts, sprouts, blossoms, and bears fruit on the earth. And actually, what is essentially interesting to us about flowering and fruiting is that they are the carriers of sunlight and solar heat.

But what about winter? In summer, sunlight and solar heat penetrate into the earth, and the sunlight and solar heat that are in the earth continue to have an effect throughout the winter. And so light and sun come into consideration from two sides.

But if we look at what the sun and the earth's orbit in general, the cosmic, brings to the earth from this orbit, we see that all of this has an effect on the human metabolic and limb system. The entire metabolic and limb system is already influenced by what comes in from the cosmos. Everything in the head is influenced by what was already preserved in the earth by cosmic forces. In this respect, the human being stands on the earth in reverse. His metabolic-limb 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 a particularly effective remedy for certain things. We find lead as it exists in non-human nature in the form in which it was created by the total cosmic forces; it works in the most eminent sense when it is there through the cosmic forces, and in the most eminent sense it works through the limb-metabolic system up into the head. If we melt the lead, that is, if we subject it to an earthly process, then it acts directly on the head system. This is the great difference.

Among our medicines, we have an essential remedy, antimony, grey spear luster. If we take it as it exists outside as a fibrous ore – the spear-like is formed out of the cosmos – then in antimony we have a remedy that acts on the metabolism. If we subject antimony to an earthly process so that it becomes antimony sulfate, then we are acting in a specifically human way on the human head.

And you see, it is a matter of penetrating everywhere with this way of thinking, not only into the substance, but into the processes, into what is happening. It is not right to say that lead is a remedy for this or that. It is a matter of knowing how the process has taken place, whether we have a raw material or whether we have subjected the substance to some process. The way in which substances are treated is, after all, the essential thing. And the way of thinking should stop looking for the remedy in the substance as such. We should increasingly say to ourselves: When there is disease, there is a process that is not embraced by the whole of the human organism. If we want a remedy, we must strengthen the person, we must subject the person to such processes that we understand exactly. That is what it comes down to.

I would now like to tell you something to which this whole introduction should lead, which may at first seem somewhat paradoxical to you, but which is necessary to be truly grasped in the whole of medical life. That is, if one studies all those processes that one has to study in the universe, one has to study them to see whether they are cosmic or telluric processes or those that vibrate between the two. We have no way of really getting to these processes if we cannot understand how the soul is structured in these three different regions of the human being. Without understanding the soul, it is actually impossible to really get to the person.

And you see, you have to take the following into account. In the adult human being, 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 can be distinguished from one another. But the soul fills both the head system, the nerve-sense system, and the rhythmic system, as well as the metabolic-limb system. It is only very sleepy, dreamy in the lower system, but it fills the whole human being according to its three parts. But when a person is supposed to develop a system in particular, when the soul is supposed to pour its activity into a particular system, what actually happens? It is true that a person can occupy themselves with thinking, walking, or working with their hands or legs – we have to speak of the middle system separately. But what happens to the soul when a person is actively engaged, when a person is walking? When a person walks or works with his hands, it is truly the case that the same power is expressed in all that is in the world that is called love, which remains in arms and hands, in legs and feet (gap in the text). A person must come to the boundary of his skin when he is active, which then, when it overflows beyond the human being, unfolds as love.

But what does it mean in practical terms: the human being walks? It means that he lovingly animates the human organism within his skin, that is, he energizes his astral or ego organization in an appropriate way. And when he walks, he energizes his ego organization in such a way that he draws it out to a certain extent from the physical and etheric organism. When thinking, he exercises it in such a way that he pours it into the physical and etheric organization. Man withdraws his astral and I-limbs when walking; while stretching out his legs, he withdraws the astral body and the I when walking. When he thinks, he radiates them in, of course, but only to the skin. And if we take this into account, we can say that we simply have the beginning of illness in the activity of the organism. Because when, without the person lovingly filling his organism, the astral body and I-organization withdraw from the metabolic limb system, then pathological conditions arise. If the etheric body and the physical body are filled in the head without it being caused by arbitrariness, pathological conditions will again occur. So that what a person does arbitrarily is immediately corrected. Daily life in thinking and moving: it is a continuous process of making oneself ill. Only the human organism can make itself healthy again immediately.

And an understanding of these things depends on the fact that one can now really muster so much love for what happens in the case of illness that one can look at it as what actually shows one in a physical way what the spiritual in man is. You see, when a person becomes ill in the liver, let's say he gets abnormalities in the liver, then his astral body is not sufficiently active in the liver. What is the corresponding spiritual activity where something similar happens? It occurs when I take a particularly strong inner interest in something external. At the moment when one looks at something with intense attention, one is actually suffering from liver disease at that moment. At that moment, the astral body withdraws from the liver, but it balances out again immediately. And by going through the various processes of illness in the human organism, one can always study what happens in a healthy person through their will, through their arbitrary life. If the arbitrary processes were not continually being balanced, the person would continually make themselves ill through the arbitrary processes. So one can learn what the soul and the spirit are like if one likes the processes of illness as processes of study, really loves them.

And this love of disease must, of course, be connected with something else. After all, one does not just want to study the disease; that is the less important thing. But if one can heal again, what does one have then? Then one has an insight into the way in which the divine world has come about from the most diverse spiritual activities and beings, how the world has been created. And that is the starting point for a doctor's work: to say to oneself, first of all, that disease processes lead one into knowledge of the human being. They are real processes of knowledge. But the healing processes can only be grasped with a religious attitude. To really relate to the world with a religious attitude must permeate all this medical work. Without that, knowledge will never come about in detail.

Of course, you will always be able to say: Well, yes, there we have the remedies, and anthroposophy also comes along and gives remedies, but the whole thing cannot be seen through! — It can be seen through if you take into account such things as have now been characterized, if you can permeate a real process of knowledge with the diagnosis and a real process with the therapy. These things must be taken very seriously. Only by adopting this attitude can we understand what has been put forward as what anthroposophy has to say for medicine. Of course, the details are only what can be put to practical use. But it is necessary to permeate all medical activity with this attitude that we have been talking about.

I would now 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 side.

> First question: As a doctor today, you are sometimes forced to use remedies that you don't like to use, and some of these remedies are certainly so that you shouldn't use them. Can't anything be said about remedies that you shouldn't use?

Dr. Steiner: I would like to say the following in principle to this question: There is a big difference between a remedy that I can understand how it works in the human organism and one that I cannot understand. That is a big difference. Of course, this difference is initially relative for external practice, as long as we do not have medical faculties where one goes through a course of study such as that taught by anthroposophy. Until then, it will always happen that the practical doctor will also take note of what is advised by anthroposophy: 'This is a remedy for this or that'. Of course, we would love to start by teaching the science of human nature, so that by looking at an onion we would know how the onion process works in the human organism under these or those antecedents. That would be our favorite, of course. But for the time being it is relative, and for the time being it can only be the case that a remedy is given for this or that. But from here, a remedy is hardly given without its inner effect in human nature being made known. For example, it is not said that silicic acid of equisetum is taken without knowing that it causes a kidney process. The irritated kidney is reduced in its over-irritability. So the over-irritability of the kidney is reduced when silica from equisetum is added to the kidney. This is obvious, and one should know (gap in the text). But now I ask you on the basis of trust: How do the investigations happen outside? They are done externally with the help of statistics, they are done in such a way that so and so many patients are given the remedy. Actually, we don't really know what is going on, and above all, the big difference between a real remedy and one that is not a real remedy is that with a real remedy, we understand the process and know how it affects the whole of human life. If today you heal something by any means, you cannot know what will become of it in five years. But if you understand the process completely, you do not need statistics. With our remedies, it is never a matter of statistics. You will see from the book that is about to be published how it is not dependent on statistics whether a remedy works or not, but on the study of the individual case. If you have a box of matches and try the match, you will not burn all the matches, but you know when you have burned a match that each one can burn. Likewise, you know that each process must proceed as you know it. It is therefore not a matter of statistics, but of understanding the individual case. Therefore, we will always have great difficulties when people say: Give out your remedies, they should be tried! — But that does nothing; it does not create trust in the remedies. Of course, our remedies will produce extraordinarily favorable results statistically, but the usual cases are either not correctly diagnosed or are cases where additional remedies have yet to be administered. Now, I believe that the essential thing when it comes to such remedies, which heal without being understood, is, above all, to really understand how things work. You see, it is remarkable that even the trial leads to all sorts of interesting things. Today, all kinds of remedies for syphilis appear. Arsenic plays a role everywhere. Why is that? With us you hear: Arsenic is something that stimulates the astral body to do so when it is lethargic, to stimulate it to intervene more in the physical body. This astral body is made active by introducing arsenic into the human being. These remedies, discovered by trial and error, are actually based on this effect on the astral body. Of course, you can also see how they are mistaken, how they are caused by an illusion. One relies on the penetrating effect of arsenic in cases where the astral body can really become so strong through arsenic. And in the case of syphilis, only arsenic really cures. So with all such remedies, one must always see through the effectiveness of the remedy. One should always strive to see through the effectiveness of a remedy. Our way of thinking must therefore become more and more known, and that is precisely what we want to achieve through the book, namely to introduce it into the medical way of thinking to be cultivated here and not so much to point out the remedies. It will also be important to point out the way of thinking for remedies that are not indicated by us. After all, there are good remedies outside our area, and if necessary one gives this or that.

> Second question: When we were here last time, we talked about bronchial asthma. You indicated as a remedy that one should meditate on breathing. Are we justified in giving such a meditation in such cases? I didn't know what else to do, I found a saying by Goethe:
> In breathing there are twofold blessings:  
> To draw in air, to discharge it,  
> The former presses, the latter refreshes;  
> So wonderfully is life combined.  
> You thank God when He presses you,  
> And thank Him when He releases you again.
> I didn't know if that was right.

Dr. Steiner: You see, in such matters one must accept that because you are going half-spiritually or three-quarters spiritually for my sake, you also have something spiritual in your response when the attitude I have spoken of today is present. This being rooted in the earthly, then in the cosmic through the head, if the doctor has learned to think and feel spiritually and to behave in the same way towards the patient, then one can take responsibility for something like that. But if you approach the sick with an attitude that is often shaped by a materialistic world view, if you approach the sick with an attitude that is indifferent to the soul, then you can usually achieve the opposite of what you actually want to achieve with such things, even if they have nothing to do with the soul. You see, there are really many people who work with such things over and over again – and today it is not completely ruled out for doctors either – who work with such things. They will sometimes bring about relief, even if it is not a cure. If the sick person is strengthened by it, then this relief can really lead him to healing. But if people ask whether you can really achieve something like that, I have to say that if you really love the sick person, then it will be possible. But if you are indifferent towards the patient, then it will not help.

You should really have the courage to heal. That is why I have always mentioned the courage of healing here with our institute, where this is the case. It is the worst thing a doctor can do, even when a patient is very seriously ill and you want to cure him, to think of death. As a doctor, you should forbid yourself to think of the patient's death as a possibility. After all, the imponderables are so strong. It is an immensely strengthening force when you, under all circumstances, send the thought of death away to the very end – to the very end! — and think only of what I can do to save the patient's life force, to save what can be saved. If this attitude is developed, many more people will be saved than if the opposite attitude is developed, which somehow predicts death from these or those things. One should never do that. And one must indeed take such things into consideration. Then one is justified in having the courage to heal.

> Question: If one works as an assistant at a hospital and has to prescribe morphine and other drugs to patients, can something one does to the patient that is wrong be counteracted by something else, by one's attitude towards the patient, for example?

Dr. Steiner: Much can be achieved through the attitude. But if the interventions are necessary with physical substances, then these should be taken directly from the plant kingdom, not derived preparations, depending on how necessary it is to use the juice of the poppy plant directly. And not with an awareness of the inner process, on the contrary, by focusing on the outer form of the plant, on what is pleasing about the plant. It is difficult to give rules in such matters, because even when one is obliged to give the remedy, one's attitude is of great importance in picking up what comes to light in the patient. You have to pay attention to the mood that arises in the patient through the remedy, then you can intervene. The patient has become more transparent through the remedy in terms of helping. We will continue tomorrow, when I ask you to ask anything you have on your mind.