Course for Young Doctors

Lecture II

Dornach, April 22, 1924

Today I should like you really to speak out what is in your minds so that the discussion can center around it.

Question: A question in the hearts of all of us is how to succeed with the meditations that we have been given. At what times ought we to do them, ought they to be done in rhythmic sequence, how ought they to be done, ought those given at Christmas to be done at the same time as the others? We think that at any rate most of us feel rather oppressed with all the substance that is contained in the meditations and we do not yet know how to live with them properly.

In these things one really ought not to give such strict indications for this would be to encroach too much upon the freedom of the individual. If things are looked at in the right way it is not likely that there will be any feeling of oppression. When the meditations were given here at Christmas it was also indicated in which direction they move the soul. It was said — and the same applies to the meditations that are now being given in the First Class — that with these meditations it is rather different than when someone comes and wishes to have a personal meditation. In the case of a personal meditation one must naturally indicate whether the meditation should be done in the morning or the evening, how the person must act in the sense of this meditation, and so on. These meditations are intended to be part of the esoteric life of the individual according to his capacities and his karma. They then lead of themselves to the individual not remaining in isolation but unfolding within himself the impulse to recognize those who have similar aspirations. Such meditation must be regarded as a personal meditation.

So far as the other kind of meditations are concerned it would be good if they were done at a definite time or in special circumstances, or when accompanied by definite circumstances. In giving all meditations like those of the esoteric instruction given at Christmas, one has in mind the goal that is striven for. And then it is a matter of using the circumstances of one's life, the special situations of one's life, to make such meditations. Such meditations are done when one finds the necessary spare time for them — the more often the better. They will always have their effect. Precisely with such meditations the striving should be for personal development. One should try to find the link from the results that happen in the spiritual life, and one will, moreover, find it. In reality, the feeling of oppression would come if definite rules were laid down in regard to individuals or a group doing them at the same time as you say. Moreover this would lead to the meditation losing something that it really ought to have. Every meditation, you see, is impaired if one starts from the feeling that it is one's duty to do it. You must bear this well in mind. Every meditation is impaired by the feeling of being obliged to do it. Therefore in the case of the personal meditations it is absolutely necessary for this personal meditation gradually to become something that the human being feels in his soul to be like a thirst for meditation. Those who really thirst for their meditation just as a man eats when he is hungry, do their morning and evening meditations in the best way. When meditation becomes something without which a person cannot exist, when he feels that it is part and parcel of the whole life of his soul, then he has the right attitude to meditation.

With the other meditations, what matters is the inner desire, the inner will to become a physician and to say to oneself: “This is my path and I will meditate as often as I possibly can. I realize that when I do the one or the other meditation, it has this or that aim.” Out of the free, inner will of man, therefore, there must arise the urge to such meditation, to the carrying out of such a meditation. It is really inconceivable how anyone can feel a sense of oppression. For why should anything for which one thirsts inwardly, also give rise to a sense of oppression? If it oppresses, it has already been made into a matter of duty and that is just what meditation should never be. It should never be a matter of duty. Precisely when it is a question of becoming a physician, the following ought to be taken in the very deepest sense: The conception of becoming a physician ought not to be as it is today, namely, entering a profession. One ought really to become a physician because of an inner calling, an inner devotion to healing. This general urge to be able to heal is the true accompaniment, and one is then led towards the goal. Perhaps in few professions is it so harmful as it is in the profession of the physician to think of this profession as an external duty. Love for humanity must be implicit in the physician's profession. A physician should find his bearings quite naturally in his work.

Now, although in modern medicine, in modern medical studies, it is not very favorable for real healing when people become physicians just because they must become something or other and because the medical profession seems for some reason to be desirable, it is still worse when someone thinks he can become a physician artificially, through meditation, without feeling this thirst of which I have spoken. If the aim is a true one, ancient esoteric methods of development demand infinitely more than an external decision; and they do much more harm than external circumstances of life if they do not spring from the right attitude of soul. But you must also have a right conception of what I have here called the “attitude of soul.” What we call karma is not, as a rule, taken very seriously in life. An inner vocation arises, of course, because karma has put a person in a certain place. We must realize that to follow something out of a sense of duty is injurious, but to follow karma is something that accords entirely with the direction of human evolution. The karma of all of you has brought you to work in medicine, and now if only you will look deeply enough within yourselves you will find that you really do feel the thirst of which I have spoken. And you will find, too, the moments and hours when you want to do such meditations.

Now just when one takes up such a serious profession in all earnestness, the following (which has happened frequently since the Christmas Foundation Meeting) really should not be. It is not connected directly with medical work, but it is connected very strongly with the “human universal” inasmuch as it exists within the general Anthroposophical movement, and so it is also of importance to you. I shall speak about it in another place, but because it holds good very specially for you, I will say it here too. It was said at the Christmas Foundation that a new character must come into the Anthroposophical movement, that inner work must be done. Now many people drew a strange conclusion from this. There are people within the Anthroposophical movement who have definite positions and offices. Such people have written: Yes, I understand perfectly that a new character is to come into the Anthroposophical movement. I place myself entirely at the disposal of this, I do not want to remain in my old position. But this can never lead to anything. It can only lead to something when the person concerned knows that at the place at which he stands he must find his development, find it in reality, also in connection with the faculties which he uses and applies. This, naturally, is the case with you who have begun to work in the medical profession. You must regard it as karma and you must realize that your work in the future will be tremendous. You must realize, secondly, that the thirst of which I have spoken, the thirst to approach the true preparation for medicine by way of meditation, is also to be found in the soul.

This is what I wanted to say about the practice of meditation. Each meditation should enlighten and support the other. It may well be that some one meditation has worked strongly, and now you must do a different one in order to strengthen the effects still more. You do one meditation once, twice; you do another twelve times. This is something that comes when you really take to heart what is given as a meditation, when you experience it inwardly, and also when you take to heart what has been said about the goal of meditation. We must use this opportunity for developing much that was touched upon at Christmas.

Question: My conception was not that it was a question of meditating at definite times, but in spite of that I was aware of a sense of oppression because I considered it a duty to do this meditation and often I was not really fresh enough to feel it as a need. Perhaps this is due to the fact, in my case at least, that up to now I have not had the attitude that one ought to have as a physician, that I have not had the real will to heal. I think it has been the same with one or two of us. Many of us have not become physicians in order to heal, but we have become physicians because of the great interest that we had in getting to know the nature of man, his conditions of disease and his normal conditions. We approached medicine entirely from the side of knowledge. Up till Christmas the will to heal was something entirely foreign to me; and so, to begin with, my work made me very unhappy because I had a great deal to do and at the beginning was too tired for meditation. But this work brought me more together with patients so that now I have an inkling of what it means to have the will to heal, and I think that now I shall be better able to meditate because this springs from a real need. Meditation can then really be seen as a path to the goal. Precisely this devotion to human destiny, this sympathy that one feels as a physician for everyone — this, and the will to heal which was not indicated through one's studies which lead to medicine more from the side of knowledge — is surely something that, until recently, has caused difficulties to many of us.

You must remember the following. When, in the sphere of medicine you divide these two things, the side of knowledge and the will to heal, it is a contradiction of the reality. It is very important to realize what is at stake here. Knowledge of the nature of man is necessary in many different fields of human activity. In pedagogy, for example, the essential starting point is a knowledge of the nature of the human being. In other domains, too, there must be knowledge of the nature of man if we have an eye to realities. Knowledge of the nature of man is essential for everyone who wants to get beyond superficialities. It is necessary for everyone. The fact that knowledge of the real nature of man is not sought for in many fields of activity is a consequence of the errors into which modern civilization has lapsed. In a certain sense this knowledge is sought for — although it cannot be found there because it can only be found today by way of Anthroposophy. It is sought for by theologians (I mean by the ordinary theologians). All kinds of people are looking and seeking for knowledge of the being of man. The only ones who are not seeking for it are the lawyers, because jurisprudence today is something which simply cannot be said to take hold of the realities of the world. The essential thing is that knowledge of the human being has to be somewhat specialized in the various domains of life. The physician needs a rather different kind of knowledge from the educator — a rather different kind only. It is necessary for educators to know as much as possible about education. There ought certainly to be connecting threads; there should be a hither and thither between the one and the other field of activity, based upon knowledge of the human being.

So far as concrete details of knowledge of the human being are concerned, the following must be remembered. You spoke about knowing the conditions of disease in a human being. This is a preconception—the outcome of materialism. In itself it is a materialistic preconception. Taken in the concrete, what does it mean to know the conditions of disease in the human being? How can I know anything about a disease that is localized, let us say, in the liver, in the spleen, in the lungs, in the heart? How do I get knowledge of it? When I know what kind of healing process might be capable of overcoming the process of disease. In reality the process of disease is the question and one remains at a standstill at this point if one's only aim is to get knowledge of the process of disease. The answer is the healing process. We know nothing at all about a process of disease when we do not know how it can be healed. Understanding consists in the knowledge of how the morbid process can be eliminated. Without the will to heal there can be no medical study in the true sense. To know conditions of disease means nothing. Without passing on from the pathology to the therapy one would simply be concerned with the pathological aspect, imagining that one was thus getting knowledge of the human being. One would simply be describing a diseased organ. But a description of this kind is quite inadequate; is not of the least value. So far as mere description and abstract knowledge are concerned there is no essential difference between a healthy or a diseased liver. In the sense of natural science there is no distinction to be made between a healthy and a diseased liver. The most that can be said is that a healthy liver is more frequent than a diseased one. But this is an external condition. If you want to get knowledge of a diseased liver, you must go into what is able to heal the diseased liver.

Upon what does healing depend? It depends upon knowing which substances, which forces must be applied to the human being in order that the process of disease may pass over into the healthy process. Such knowledge is transmitted, for instance, by the fact that one knows: Equisetum, within the human organism, takes over the activity of the kidneys. When, therefore, the activity of the kidneys is not sufficiently cared for by the astral body, I shall see that they are cared for by equisetum. I give support to the astral body by means of equisetum arvense. Here for the first time is the answer to what is really happening. The same process in the external world which leads to equisetum also takes its course in the human kidneys. The equisetum process must be studied in connection with the kidneys. This leads us to the domain of healing.

Thus it can never be a matter of pathology in a merely abstract sense or of a description of conditions of disease — all this amounts to nothing in reality. Our picture of a condition of disease should be that such and such a remedy works in such and such a way. The feeling that we have about knowledge in all domains of life should lead on to reality, not to formalism. It was always so when knowledge was everywhere connected with the Mysteries. In the Mysteries, knowledge was inevitably withheld from those who merely desired it in the formal sense and imparted only to those who had the will to lead over this knowledge into reality. Is that an answer to your question?

Question: I may have expressed myself rather radically when I spoke only about health and disease. In point of fact, I do consider the way in which the human being should be healed also to be a part of knowledge. I meant something rather different, namely, that one may know how a person can be healed but may not have the will to heal him. Up to now I have not, inwardly, had the impulse only to understand the human being in order to heal. I had not the impulse to let the whole of my work and studies and knowledge be filled entirely with the realization: I must be capable of healing the human being.

That is hypertrophy of knowledge.

Question: This is a fact with me and I wanted to speak about it because it is so. Perhaps it sounds very strange.

What I am going to say may sound very trivial and simple. It is as well that this kind of attitude cannot make clocks, for if it could, you would have clocks put together quite correctly according to the clock maker's art, but they would not want to go. By letting his will hypertrophy towards the one side or the other, a person can develop this or that, but the result will be of such a nature that it is not in line with the healthy evolution of human nature. Knowledge of healing should simply not exist without the will to heal. Today you ought to be speaking of something quite different. You should really be saying: “Yes, I have studied medicine for a short time and now I have an ungovernable will to heal. I must restrain myself so that this will which comes from knowledge does not break loose in such a way that I want to heal all the healthy people!” This is really not a joke. The voice should be a voice of restraint. It should simply not be possible to say: “I have striven for the knowledge of healing but not the will to heal!” For a knowledge that is real cannot separate itself from the will — that is quite impossible.

Question: I think that what was expressed in the previous question is a condition brought about by the kind of studies that are pursued at the universities. It seems to me to be a final result of such studies. The aim of all medical science is really knowledge, without leading over to the therapeutic aspect. In the lecture halls and the clinical courses one hears a little about diagnosis and when the professor does not know what to do until the new patient is brought in, he throws in a few words about the therapy. In a course on gynecology once, the lecturer spoke about the work of the physician in his practice. “Has it not struck you,” he said, “that in reality so little is said about therapy? You will realize this for the first time when you begin to practice. That is what happened to me. I had a head full of knowledge and then I realized the other.” Then he said that five minutes were given to the therapy and forty minutes to the diagnosis. Nobody realized that during all their studies they had heard nothing about therapy. This leads me to a question, because this fundamental attitude of modern science causes me many difficulties and conflicts. As a physician I was looking for something different in scientific medicine. This entirely superficial attitude which leads to all kinds of things, especially in diagnosis, often gives rise to results that are really repellent. Let me give an example. A patient came to me and asked, could I not help her? She suffered from recurrent inflammation of the frontal sinuses and she had been many times to a specialist. Among other things perforation had been done by way of the nose. She said she could not bear it any longer, she felt that the whole interpretation of her condition was too physical, and she asked if I could not help her in some other way. This attitude that the patient had realized is universal. It simply gropes on the surface and leads nowhere. It can only remain on the surface and it cannot lead to the real state of the case. And so I have often asked myself: Is it really good or indeed is it necessary to go so deeply into these methods which are considered a sine qua non in medical studies — methods which simply reach the point of monstrosity in gynecological research and simply have no relation to the final outcome? Is it necessary to go through all these things? I have the feeling that any instinct for healing which may exist is suppressed entirely by going through these things. I would like to mention something told to me by a former colleague. He was speaking of a peasant doctor in the Bavarian Alps who used to perform all kinds of orthopedic cures with such skill that he became famous. An orthopedic specialist in Munich got to hear of what this man was doing, went to see him and told him that he should come to him in his clinic. This man saw all the apparatus in the clinic and the specialist told him to show him how he worked. The peasant doctor looked at it all and from then onwards he could no longer cure people. Ought we to go through all the methods of scientific medical training or ought we to avoid them as far as is at all possible?

When you approach the question in this way, it becomes extremely important. You are right in thinking that I did not want to speak about personal characteristics of the prior questioner but to describe the attitude that inevitably arises from the modern methods of study. The true kind of medical studies would never lead anyone to desire knowledge of conditions of disease or processes of healing without at the same time having the will to heal. Such a thing would never arise out of true medical studies. It arises because of the way medical studies are arranged today. It must be admitted on the one side that by far the greatest part of what the medical student has to learn today in his various courses has nothing fundamentally to do with healing as such as therefore burdens the mind with all kinds of impossible things. In modern medical training it is more or less the same as it would be to make a sculptor, let us say, learn first of all about the scientific properties of marble and wood with which, in reality, he is not concerned. A great deal of what is contained in the medical textbooks today or is done in clinics has little to do with medicine in the real sense.

The moment you pass on from the physical description — this was what the lady of whom you spoke felt to be too physical—the moment you pass on to the etheric body, most of the things in the medical textbooks lose their significance because the moment you come to the etheric body the organs present quite a different aspect. When you pass from the physical to the etheric body, intellectual knowledge alone will get you nowhere. You will learn much more if you learn how to sculpture, if you learn the hand grip, the feeling for space that is needed by the sculptor.

So far as knowledge of the astral body is concerned, you learn far more when you can apply the laws of music. From music you learn an enormous amount about the forming of the human organism, how this process of formation develops out of the astral body. Inasmuch as the human being is organized for movement, for activity, he is built up, in reality, like a musical scale. Here (back of the shoulders) begins the tonic; then it passes over into the second, then into the third in the lower arms, where there are two bones because there are two thirds. This brings you to truths quite different from those which are considered nowadays to pertain to a real knowledge of the human being and quite a different course of teaching would really be necessary for one who is approaching medicine in the true sense.

The modern form of teaching has arisen from the fact that therapy has become nihilistic. Not only in the Viennese school of medicine has this been the case, but everywhere it is the same. Among the professors and lecturers who represent the various scientific faculties there have, at least, been serious minds who, in spite of all their shortsightedness, were, at any rate, scientific. At all events a certain earnestness was present. But when one comes to those who lecture about remedies, the earnestness ceases. The lecturer himself has no fundamental belief in what he is lecturing about. The earnestness stops at the point where the therapy begins.

From where, then, is the will to heal to proceed? It must proceed from a course of medical studies such as I outlined in connection with the course given at Christmas, where I spoke of what the sequence of studies should be. That, of course, is very different from the things that go on today and do not lead to a real art of medicine. In most cases, the practitioner has to learn things by dint of great effort when he has left his medical school. This is often not an altogether easy matter because the things he has learned are not only useless but actually harmful to him. He cannot see the real process of disease because all sorts of things are memorized in his head and he cannot see the process of disease in its reality. That is the one side.

But now, you are a group of young physicians. In the spiritual sense you have to be something more. The best way to attain that would be to say: Leave all medical studies alone, there is no true medical faculty today where you can study medicine in the real sense—come here and learn the essentials. In the radical sense, that is what one would say. But where would you be then? The world would reject you, would not recognize you as physicians. The only course open to the young physician is to go through the whole thing and then be healed by what he can learn of medicine here. With all the repugnance that you may feel, you must take the orthodox and regular course of study. There is no other alternative; it is absolutely necessary. That is the other side of the picture.

People like magnetic healers and amateurs who dabble in medicine abuse the university schools, but that is no use at all. Those who know how things are and who are led by experience to real understanding — they will be the true pioneers of reasonable medical study. This should be your endeavor: to awaken public opinion about the state of affairs. You realize, of course, that it is not you alone who speak as you have done. There are many physicians who speak in the same way, but they need what can be given here. And why? When one is an intelligent person today and becomes a physician, having passed through the university, one can, of course, criticize orthodox medicine. One has passed through the whole thing and knows what one lacks. But this knowledge can become effective only when one has got something to put in its place. Only then can it be effective. This, of course, is the other side. And so you must not take what I am saying here in the sense that I have any desire to hold back young physicians from completing their study. Bad as it may be, it is still necessary today to eat the bitter apple. When it is possible to speak on the platform of things which ought not to be — then and only then will there be a gradual improvement.

In this connection, you see, there is still a great deal to be done. I think I have already told the story of how I was once invited to speak about some medical subject to a group of physicians in Zurich. A professor of gynecology was also there. I saw that he had come with the attitude: “Well, we will listen to this lunatic so that at least we can abuse him, being justified by the fact that we did actually hear what he had to say” He came quite honestly in order to be amused by listening to a lunatic. His manner grew stranger and stranger and he listened in a most peculiar way. It was very unpleasant for him to find that he was not listening to a lunatic, that it could not all be put down as pure nonsense. I myself found it most amusing. I said to him: “This has made a strange impression on you, professor.” He replied: “Yes, one simply cannot speak about it. It is decidedly a different point of view.” It is, after all, a sign of progress when one gets to the point where people say: “It is a different point of view.”

What is it that has arisen by the side of scientific medicine which, after all, still towers above anything that has been achieved by the medicine of amateurs? I know that laymen have made progress. But it amounts to nothing. The valve in a steam engine was invented by a small boy one day when he was bored. One could not say of him that he was really capable of constructing engines because he invented the valve. Those who abuse scientific medicine today are really not justified in abusing it for they are talking about something of which they have no knowledge. What we have to achieve is not to mix up anthroposophical conceptions in medicine with what is already in existence. If in doing so we succeed in showing that we are sincere and serious, then great progress will have been achieved.

As you are young, I would like especially to lay this on your hearts. Let the aim of all the esotericism you receive be to make you capable of working also in the world, so that the real will to heal may unfold. Your aim cannot be to shut yourselves off, each one in the chamber of his heart. You must work to the end that medicine shall make real progress, just as the aim of educators is to enable education to make progress.

It is not possible for me to speak in detail of how most things that go on today in medical studies are really not essential for the understanding of the healthy and the sick human being. But if you study what I have given in the various lecture courses and cycles, you will find it. Suppose when a baby is born we were to ask ourselves how it should be fed, imagining that it is not possible to feed a baby properly before one has given him some idea about the nature of the foodstuffs: so it is with many things today. What I mean to convey is that one should have the intuition to understand a process spiritually, not physically. In diagnosis it is often more necessary to go back to the early causes which may lie at a definite time, very far back in the case of some patients. Methods are taught today for recognizing the condition of the diseased or the healthy organism at the actual time when the patient comes. But what is lacking is the kind of thinking which enables one to say to the patient: Fifty years ago this or that happened to you and that is the primary cause of your illness. As a rule, physicians depend upon what the patient himself says, and that is unreliable. The first cause is the external cause — it comes from outside. A physician in Christiania once brought a man of sixty to me. He had all kinds of eczema which it was easy to diagnose. But nothing that was applied was any help. The physician brought him to me, and the state of things was quite clear — I mention one example from hundreds — if one is to help in such a case, one must know the real starting point. In this case it was not very difficult. I very soon discovered that thirty or thirty-five years previously the man must have suffered from severe poisoning. This was still working in him. I told him to try and remember what had happened to him thirty-five years before. He told me that nobody had yet asked him such a thing. He said that he was in school and beside his classroom there had been a chemical laboratory where he had seen a glass containing liquid. He was thirsty and he drank the liquid. It was hydrochloric acid and he was severely poisoned.

It is very important to know such things. They lead one beyond the condition of the moment. Thus it is often important, for example, with certain conditions of hysteria, to know whether the person concerned has undergone the shock of having been nearly drowned. These things must be gone into. We go into them quite naturally when we have real sympathy for the human being whom we want to heal, and all medicine must take its start from sympathy with the human being. If this sympathy is lacking, the most significant things will be forgotten. That is what must be remembered in this direction.

Do all of you intend to come tomorrow? If so, we will say more about these things. I wanted now — without giving any explanation, for that I will do tomorrow — to give you certain lines which may become a central meditation. If you think about these lines again and again they will help you to realize what is built into the human being out of the cosmos, out of the earth's periphery, and by earthly forces. If you ask yourselves in connection with the formation of the eye: How is the eye formed from the cosmos? — if you ask yourselves how a lung is formed out of the forces of the earth's periphery, out of the planetary forces moving in the elements of air and water — if you ask how metabolism in the human being arises in connection with the earthly — then, if you will meditate on these questions in the light of the following lines, you will learn to look into the real nature of the human being.