128. The Introduction of Our vade maecum

A brief sketch of the introduction of our Vademecum, written for van Leer.

I. What is the aim of our new medical method?

The new medical method that is being announced here differs from the old one in that it is based on a different understanding of the human being. The old method, which has developed from the scientific views of modern times, seeks to gain all knowledge of the human being by breaking down the physical organization and rebuilding it in thought.

But man is not merely a physical organization. He is equally a superphysical one. This is revealed in his soul and spiritual experiences and activities. Just as the physical organization is the foundation of the soul and spiritual ones, so these are the formers and quickeners of the physical ones.

Without insight into this fact, no real knowledge of either the healthy or the sick human organism can be acquired.

Therefore, the new medical method adds the superphysical to the physical knowledge of the human being. Its essential point is that it comes to the realization that processes which, when they develop as spiritual processes in relative isolation from the physical processes in the human organism, represent the true nature of the human being, immediately become harmful when they come into the wrong connection with these physical processes.

The physical organization of the human being develops in such a way that it is able to be the carrier of the soul or spiritual. However, it must not enter into a connection with the soul and spiritual that goes beyond a certain measure. If it does, the person becomes ill.

The fact that a person is exposed to illness can be attributed to the same reason why he can be a spiritual and soulful being.

Only by observing the spiritual in the physical can one gain an understanding of the nature of illness. In the physical organization, the abnormal processes are recognized only as changes that are subject to natural laws in the same way as the normal ones. They can only be recognized in their characteristic nature as disease processes if one can pass from the physical to the superphysical. Because, as paradoxical as it sounds, a person falls ill when something in his physical organization develops too strongly towards the spiritual.

And only from such an understanding of illness can a real therapy arise. For all extra-human substances and processes stand in a certain relationship to the human being. If one introduces such an extra-human substance or extra-human process into the human being, then everything in the human being that has a physical effect outside the human being has a superphysical effect inside the human being. This is counterbalanced by the fact that everything that has a physical effect inside the human being also has a superphysical effect in the extra-human world.

In the case of a true knowledge of man in his relationship to the external world, one can always find a substance or a process in the extra-human world that transforms an incorrect relationship between the superphysical and physical in man into a correct one. But such knowledge is only possible through insight into the superphysical of man.

Therapy without knowledge of the superphysical in human nature is an illusion. The fact that this is so is the reason for the dissatisfaction with conventional medical methods, which only want to build on the physical human being.

Physical science is only beneficial as the basis of inanimate technique; therapy needs a science that goes to the spiritual. The medical method recommended here aims to provide such a science. The essence of it is that it provides remedies based on physical and spiritual knowledge of the human being. And only through this can one recognize the healing power of substances and processes.

In testing these remedies, we will see how the sick human organism changes under their influence and thereby gain confidence in them.

II. Pathology and therapy in the new (anthroposophical) method.

The nature of the new remedies

The processes that take place in the human organism are not the same as those in the rest of nature.¹ Therefore, we cannot learn about them in the same way as we learn about the human organism. Only when a human being has become a corpse do the same processes take place in him that can be recognized through sensory observation and the intellectual operations based on them. As long as a person is alive, feeling and thinking, he continually wrestles his organism from mere natural processes. Processes take place in him that cannot be grasped by external knowledge of nature.

To regard the external knowledge of nature as the only possible knowledge is to renounce insight into the human being. But this external knowledge of nature can be contrasted with another. It is based on a spiritual view to be developed in the human soul. The abilities for this view are just as dormant in the everyday human nature as the soul powers that arise in later life are in the very young child.

A first ability that can be developed is the ability to think and the power of memory. These can be increased purely spiritually through exercise, just as muscular strength can be increased through exercise. This is achieved by repeatedly concentrating on very clear thoughts. In this way, one supplies one's thinking with strength from the depths of one's being. But one must direct all attention to the inner thinking activity itself. One must have thoughts, not to depict a thing or a process of the external world, but only to live with all one's inner strength in the thought. You then experience that thought, by virtue of your inner human nature, draws to itself a power that it had previously allowed to sink into the depths of the subconscious, so as to have nothing within itself and thus be able to absorb the impressions of external nature.

This submerged power is rediscovered in inner experience. Thinking becomes something that fills the human being like muscular strength. One feels a second person within oneself.

Once one has experienced this “second person” within oneself, one has also experienced a “second world” in the whole world. Here it is called the etheric world.

In this ethereal world, the human being, with his ethereal organization, is present in the same way that he is present in the physical world with his physical organization. However, this ethereal world has completely different laws than the physical world.

The substances that man takes in through nutrition are on their way to becoming purely physical in nature, or they are purely physical substances from the outset, e.g. table salt. But even that which man takes in from the plant or animal kingdom is on the way to becoming purely physical. After all, it is subjected to purely physical processes by dissolving, cooking, etc.

This purely physical aspect must begin the process of revitalization in man. This happens by incorporating it into the work of the etheric organization.

In the etheric organization, purely physical effects cease. Growth, nutrition, etc. are superphysical processes that are carried out by the etheric organization.

If the organism is strong enough to take care of the transformation of physical forces in its etheric part to a sufficient extent, then it is healthy. If this is not the case, if the etheric organization is too weak, then it becomes ill. It then contains substances or processes that are justified in extra-human nature, but which represent something alien within the human being.

The pathological part of medicine consists of the recognition of this foreignness in man.

If the organism cannot carry out the necessary transformation by itself, then it must be supported by external means.

An example will serve to illustrate how this may be the case. Suppose that the etheric organization proves to be too weak to give certain substances the consistency they need to fit into the bone structure in such a way that the bones are in the right proportion to the whole life process. The bones then withdraw too much into their own being. They withdraw their life from the organism. If this is observed in the right way, introducing lead into the organism in very small amounts has the same effect as if the etheric organism had just been strengthened in the direction in which it had previously been deficient.

The therapeutic part of medicine consists in the knowledge of how the alien within man can be overcome so that the transformation of the physical can take place in the appropriate way.

However, man has not yet been fully understood if only the etheric organization has been grasped apart from his physical organization.

It is possible to develop other powers of the soul, besides thinking, to a spiritual contemplation.

When one has experienced the strengthened thinking that leads to the etheric world, one can suppress it through the inner power of the soul. In the normal process of life, sleep must occur through such an inner process. However, one can also train oneself not to let the soul fall asleep when suppressing the intensified thinking. The consciousness then remains awake, even though no more impressions come from outside. A real spiritual world then reveals itself to this consciousness. A spiritual world is added to the ordinary world. In this spiritual world one recognizes a third human organization, a kind of “third person”. One can call it the astral organization.

We now recognize that in our conscious or semi-conscious life, the sensations of our organs, our dark sense of life, our vague sensing of the organism in general, all these emanate from this astral organization. Hunger and thirst, satiety, fatigue, etc. also emanate from it.

Furthermore, it can be seen that this astral organism is not only the carrier of these conscious or semi-conscious states, but that this is only one side of its activity, the one that is inclined towards the consciousness of the soul. The other side extends down into the subconscious organic processes. The same astral body, for example, brings fatigue to consciousness; the same lives in the organs that produce fatigue.

However, the right balance must now prevail between these two sides of astral activity. This can only be the case if the etheric organization is placed in the right way between the activity of the astral and that of the physical organization. If the etheric organization is too weak, it is unable to keep the astral sufficiently far from the physical; the astral then intervenes too strongly in the physical.

For the normal life of the human being, it is necessary that the astral is kept sufficiently far from the physical and only functions as soul. For if the soul element encroaches too strongly upon the physical, the processes in the physical approach extra-human processes. The human organs themselves become foreign bodies, which then act like something alien that penetrates the human being and that cannot be transformed by the weak etheric organization.

Man owes the lower part of his mental abilities to the astral organization; but through it he is also exposed to illness in that this organization is not sufficiently separated from the physical organization in certain cases and thus something alien is incorporated into this organization in the wrong way.

We must know the extra-human substance or process that drives the astral out of the physical. And we will have a remedy for this substance or process.

All healing is therefore based on understanding the connections between the physical and the superphysical in the human organization, and then, when these connections take on an abnormal character, to find the means in the extra-human nature to counteract the abnormality.

There is a polar contrast between the purely physical and etherically oriented processes in the organism and those on which consciousness depends. The stronger the former are, the more the latter must recede. A physical-organic process that is effective in and of itself, according to its own forces and laws, suppresses consciousness.

The physical processes, which are the carriers of consciousness, cannot continue in their own way and according to their own laws if consciousness is to arise. They must be regressed, paralyzed, even destroyed in their very nature. What one recognizes in spiritual contemplation as the astral organization paralyzes the etheric organization. In order to shape the indeterminate, half-conscious and subconscious experiences, the life processes dependent on the etheric organization must be paralyzed.

But this does not give the whole human organization. Spiritual vision, which encompasses the astral organization, can go further. Then a fourth organization, a “fourth human being”, the ego organization, comes to the fore.

This ego organization counteracts the physical organization in the same way as the astral organization counteracts the one that depends on the ether organism. In the human being, physical substance must continually form itself in a living way. This corresponds to the activity of the physical and etheric organism. The latter carries out its processes by simultaneously dissolving in the liquid element that which wants to form into solid forms. The astral organization paralyzes the life-giving activity. This happens by simultaneously converting the liquid into the air-like. An example of this activity is the breathing process. It carries the living liquid of the organism into the air-like of the inhaled air and thus paralyzes it to such an extent that it can be the carrier of semi-conscious or subconscious soul processes.

The ego organization participates in these processes. But it takes everything that happens even further. It immerses all the processes taking place in the solid, liquid and gaseous forms in the organism's thermal differentiations. In the manifold heat processes of the organism, the ego organization continually transforms all the substance and all the processes of the organism in such a way that the organism can become the carrier of self-conscious soul life. If the force with which this transformation occurs is too strong or too weak, illness occurs. The task is then to recognize through diagnosis where the deficiency lies in the intervention of the ego organization. It may, for example, lie in an overall weakness of the ego organization, so that it does not process enough warmth in the body; it may lie in the fact that one organ system receives too much or too little influence from the ego organization at the expense of another, etc.

In all these cases, it is possible to bring the ego organization to its proper level. If one is familiar with the processes of destruction in the natural world, one can always find a substance or a process that, when introduced into the body, will help the ego organization. For example, it can be diagnostically determined that too little warmth is supplied to some organ. A substance that releases oxygen is introduced into the organism, which releases oxygen because it has been previously subjected to a process that gives it this ability. This can compensate for the damage.

In this way, a truly rational therapy is established with the help of insights into the superphysical in human nature. One arrives at an exact understanding of the effect of the remedies in the human organism as a whole. In such a medical way of thinking, all mere trial and error with remedies is overcome. This is how the remedies recommended by the pharmaceutical laboratory at the Goetheanum came about. They are the result of a rational and exact medical way of thinking. Some are similar to what has already been used. Here, the new way of thinking provides the necessary insight into why the remedy works. But by far the majority are new remedies because their healing effect only arises from the new medical knowledge of the nature of the human being outlined here. —