Course for Young Doctors

(Five lectures given to physicians of the Medical Section,
Easter, 1924. This translation has been made from a
shorthand report not revised by the lecturer.)

Lecture I

Dornach, April 21, 1924

In the gathering held here just after the Christmas Course we turned our attention to things that can deepen medicine in an esoteric sense. And we tried — to the extent to which this is possible in such brief meetings — to penetrate into the esotericism of medicine, in the way that is suitable for younger medical aspirants today. In formulae for further contemplation and elaboration, we received things that can quicken the sense for medicine and emphasis was laid upon the necessity of having this sense for medicine.

I picture to myself that you have worked upon these things for a time, my dear friends. Naturally, my idea of this work is not that people sit down and ponder about such things theoretically, but that from time to time, when the inner need is felt, they let these things work upon and develop the soul. It was inevitable, from the very way in which these things came before us, that one perfectly definite fact should emerge — a fact which I believe to be of importance for our gathering now. Because of the very concentrated form in which the esoteric things were given at the first gathering, one or another, to a greater or lesser degree, must have realized that it was necessary to face certain inner difficulties. The purpose of esoteric teachings is not always to make life as easy as possible for us. In a certain respect the opposite is certainly the case. They are also there in order to make life more difficult, to make us realize the difficulties of understanding the world, of really getting to know the world and human beings. So that when we become alive to these difficulties, we take the opposite path of development from that which is so often taken in our civilization today. We take the opposite to a superficial path of development. It is only by becoming alive to the difficulties existing as between the outside world and the human being that a person can be deepened in soul. I think, therefore, the best way now will be if, bearing these inner difficulties in mind, you will bring them forward in the form of questions and we will then make matters that can really promote the development of our subject into the theme of our discussions. I would ask you, to begin with, to tell me what inner and outer difficulties have arisen in your own circle. Difficulties will have arisen both for the practitioner and for the student. There are a number among you who are now approaching the end of their studies; they will have found quite specific difficulties and we will try to find their solution. All of you have received the first circular letter and you will have realized that in connection with definite questions there is a very great deal to say. I would like to ask if any question, definite or indefinite, has arisen, for such questions will surely lead us further. In this way we shall get away more from theoretical study and reach matters which lie in the realm of actual experience.

Question: A participant asked about the course of the year, the Calendar of the Soul, definite constellations of the stars and whether one must be consciously aware of these.

That is not essential. You mean observation of the constellations as they are at a particular time. It is, of course, a help if one is able to look at the visible constellations. But if I have understood you aright you mean: How are things, really, if we allow the formulae we have been given to work upon the soul? These things work through their own inherent mantric power; orientation in the outer world according to the stars can, of course, be a help but you must remember the following. Take the most striking example of a human-cosmic relationship that can still be observed today, namely the menses. It is obvious that they are determined cosmically yet they are not so determined in the present epoch. They were cosmically determined in a much earlier phase of cosmic evolution in which our earth was also involved. Then, in the course of time, they became independent, were emancipated from the external cosmos, so that nowadays there is no direct dependence. Therefore, one cannot say nowadays that the phases of the moon are coincident with menstruation. This cannot be said. But it is certainly true to say that there was once a time when the one coincided with the other; then they separated. The moon phases exist on their own. Menstruation takes its own independent course. Here is one example of separation. The other that I will mention is not governed by the phases of the moon but by the daily phases of the moon. Ebb and flow were once coincident with certain influences of the moon. Again there was separation. The moon is on its own, ebb and flow on their own.

These things also hold good in the working of mantric power. Mantric power is certainly of such a nature that what happens in the human being as a result of it was at one time coincident with cosmic processes, but separation has now taken place, so that a proper orientation is necessary. If we want this help from the outside world we must say to ourselves first of all: What is to happen in the inner being is inscribed in the cosmos. But in contemplating this we must make ourselves inwardly independent and be able to experience inwardly and quite on our own, emancipated from the cosmic happenings. Therefore it is not unconditionally necessary to reckon with the constellations of the stars in the working of a mantram. Equally it cannot be a question of the menses being regulated according to the external phases of the moon, because the menses have become a process of the world of nature. Today it is the case that the whole of our inner life that is to be influenced by mantrams must take place in emancipation from the outer cosmos.

In connection with other subjects I have often had to speak of this as the difference between Eastern and Western esotericism. The whole standpoint of the oriental is this: the human being has come forth from the cosmos, he must return there, he must be united with the cosmos again. Think of the posture of the Buddha. It is a return to earlier conditions. This is shown by the Buddha's whole posture, the crossing of the legs one over the other, the elimination of the limb structures. The position of the arms, too, is such that the whole relationship to the earth is paralyzed. We see how the human being again members himself into the cosmos. He goes back again. So it is, in reality, with the whole of Eastern esotericism. It is a going backwards. Our Western esotericism can only be a going forward, an ever-increasing emancipation. For this reason it is not so inwardly comfortable and when applied in certain domains particularly it does not make for inner ease.

Of course, if you have some specific, pathological condition before you, and when you look at the constellations you find, for example, that the condition definitely set in when Saturn was in opposition to the moon, this naturally has a certain significance. For if you now come as a healer with Saturn and moon, that is to say, in earthly terms, with lead and silver, saying: I will apply the lead cosmically and the silver in the earthly form, trying to pulverize it, to dissolve it; I will change it into the earthly form, thereby producing the same constellation that is expressed in the heavens in the opposition to the moon, then you can heal in the sense of the cosmic forces. But at the same time you bring the human being into a condition which throws him back into earlier stages of evolution. Whereas if you take your start directly from the given earthly state — the connection of the human being with lead, with silver — then you are working in something that is in a process of emancipating itself within the human being and you are looking not into the past but into the future. In this case you will certainly be doing something similar, but you get at it from within, by getting to know the nature of the lead and the silver, realizing that the lead works as substance, the silver through what it actually becomes when it is broken into pieces, dissolved, resolved into atoms. But you are comparing it with the human nature that is already emancipated, not with the cosmos. This is the way in which one must proceed. Therefore it may certainly be a help to think about the actual constellations of the stars. But to begin with, we shall have to use all our power to lend ourselves to the inner activation of soul by the mantric formulae we have been given, and seek for everything more from within.

Question: What must I do out of the ego when I am meditating?

From out of the ego? Meditation consists, does it not, in the following. As a modern person you feel that you must understand every sentence. This is emphatically an activity of the ego in the present incarnation. Everything you do intellectually is an activity of the ego. In the present incarnation the intellect predominates and everything else is overshadowed by the ego, works upwards at the most like a dream, and is unconscious. In contrast with this, meditation means elimination of this intellectual striving and, to begin with, taking the content of the meditation just as it is given — purely according to the sounds of the words. When you approach the content of the meditation intellectually you bring your ego into movement before you absorb the meditation, for you think about the content; it is outside you. If you let the meditation be present in your consciousness just exactly as it is given, not cogitating over it at all but simply letting it be in your consciousness, then your ego is working in you not from the present incarnation but from the past. You hold the intellect still, simply transporting yourself into the word-content which you hear inwardly, not outwardly; you transport yourself into this word-content and as you do so your inner being works within the content of the meditation — the inner being which is not that of the present incarnation. But thereby the content of meditation becomes — not something for you to understand merely — but something that works within you in reality; so that finally you become aware of: Now I have experienced something I was unaware of earlier.

Take a simple meditation which I have often given: “Wisdom lives in the Light.” If we think about this we can extract many very clever things but equally frightfully stupid things from it. “Wisdom lives in the Light” is there in order to be heard inwardly. When you hear this inwardly that within you which listens does not come from your present incarnation but what you have brought with you from former earthly lives. It is this that thinks and experiences, and after some time there lights up within you something you did not know before, that you cannot think out with your own intellect. Inwardly you are much further than your intellect. Your intellect contains only a tiny extract of what is really there.

After all, you must take what is given in Anthroposophy absolutely concretely and objectively. Just think about the following: With the change of teeth the human being really renews his whole physical body. This must be taken as a fundamental fact. That the human being gets second teeth is really only the most external symptom of all, merely, a fragment of what is going on. Just as the so-called milk teeth are replaced, so is the whole human organism replaced. After the change of teeth, so far as his physical substance is

concerned, the human being is entirely new in comparison to what he was when he was born. The modern view which jumbles everything together is that the human being is born, passes through a metamorphosis with the change of teeth and then goes on developing. It is not like this. The truth is that when the human being comes physically into the world he has, as well as the so-called milk teeth, a body that is a product of hereditary development. He has received a body that is the product of what is contained in the whole line of ancestry. The physical body of the first seven years — if we express it in figures — comes from here. From the seventh to the fourteenth year the human being has a body, too, but this body has not been produced from the first by transformation. What the human being has brought with him to the earth has intervened here.

Picture it as follows: the human being has had his body. This body which has come to him from the line of heredity is a model; he has it as a model. Into this body he takes earthly substance. If he were to work only with the forces he brings with him from pre-earthly existence he would elaborate this earthly substance which he takes into his body in the first seven years into quite a different form. He would call forth quite a different form. He does not come at birth with the tendency to give form to a being with eyes, ears, nose, like the being who stands on the earth. He enters with the tendency to structure the human being in such a way that very little is structured by way of the head through his pre-earthly being; it is especially upon everything else that the greatest care is expended. What is stunted in the embryonic life is developed in the astral, in the ego organization. Of the physical embryo, therefore, we must say: Physical nature in the embryo is developed in a wonderful way but the pre-earthly human being has very little indeed to do with it. On the other hand the pre-earthly human being plays the very greatest part in all that lies around the embryo. It lives in what is demolished in the physical world, amnion, chorion, and so on. Within this lives the pre-earthly man.

You can picture it rather like this. To begin with, the cosmos is copied. This is what the human being wants, in reality, to do when he has come down from the pre-earthly into earthly existence. Why does he not do it? Because a model is already provided. And in accordance with this model, with the substances received, he transforms the pre-earthly during the first seven years of life. His inherent tendency would be to form a more spherical being, a being organized into a sphere. This is transformed in accordance with the model and so the pre-earthly forces work out this second physical man who is there from the seventh to the fourteenth years, but to begin with, by adhering to the model which comes from the forces of heredity.

There, you see, you have two, actually distinguishable entities of forces in the human being. How can you understand these force entities? Take, with the outlook and feeling of the physician, the book Occult Science and read where the earth's evolution is spoken of. At first there is a Saturn evolution, then a Sun evolution. If you follow the description of the Earth evolution you will find that until the separation of the sun, sun, moon and earth were one, combined together in one. Afterwards there is a separation of earth and sun, earth and moon. Up to the middle of this evolution, therefore, the human being lives in the cosmos. He lives in sun and moon just as he lives in the earth. After the separation of the sun he lives outside the sun; after the separation of the moon, outside the moon. Until the separation of the sun, therefore, the cosmic forces were working upon man's nature; those forces, too, which are today outside the earth in the moon and in the sun were working in the human being because he belonged to the world in which the sun and moon were still present. There followed for the human being an evolution during which sun and moon were outside.

There was a phase of evolution which contained within it all that today is both earthly and of the nature of sun and moon; later on, the extra-earthly emancipated itself from the earthly. The earthly went on along its own path, it dried up, hardened, became physical — and you find this today in the stream of heredity; it has densified within the stream of heredity. What the human being has received since the separation of the moon and sun lies in the forces working in from the cosmos. That is the point. So that in the model that is received in order that the second man may be elaborated, you have a model that really represents a primeval, artistic principle given by father and mother, originating when sun and moon were still united with the earth. It was then that the forces which really give the human being his earthly configuration were developed. For you will readily understand that the configuration of the human being is an earthly one. Try to think of the being of man entirely removed from the earth. What could be done with it? You would be extremely unhappy if after death you were to make use of anything like legs. Legs have purpose only when the earth's forces of attraction pass through them, when the legs are within the sphere of the earth's forces of attraction. Legs — and arms and hands, too — have meaning and purpose only on the earth. So that a whole section of the human organism, in the way it is developed, has purpose only when we are earthly man. What we are as Earthly man has no meaning so far as the cosmos is concerned. Therefore when we come to the earth as beings of spirit and soul, our wish, to begin with, is to form quite a different organization. We want to build a sphere and to generate all kinds of configurations within this sphere, but we have no wish for this being with whom the cosmos itself can do nothing. This being is given us as a model and we build up the second man in accordance with this model.

In the first life-period, therefore, there is a perpetual struggle between what comes from us out of the previous incarnation and what comes from hereditary development; the two elements fight with each other. The illnesses of childhood are the expression of this fight. Just think how intimately the whole inner being of soul and spirit is bound up with the physical organization during early childhood. When the second teeth appear you can see how they push up against the first, how they still have tussles with each other, and in this same way the whole second man has tussles with the first. But within the second man there is the super-earthly being; in the first a foreign, earthly model. These two work into one another and if you observe this inter-working truly you can see how, if the inner man, who as a being of soul and spirit was present in pre-earthly existence, has too much the upper hand for a time, working into the physical very strongly and having, willy nilly, to adjust itself by dint of effort to the model, that it damages the model by striking up against it everywhere, saying: I want to get this particular form out of you — then the fight expresses itself as scarlet fever. If the inner man is tender, so that there is a continual shrinking back, a wish to mold the in-taken substances more in accordance with their own nature, and resistance is put up to the model, the struggle comes out as measles. What is, in reality, a mutual struggle expresses itself in the illnesses of childhood. Moreover, it is only possible to understand truly what comes later if these things can be properly reckoned with.

It is, of course, very easy for the materialists to say that all this is stupid, because children still retain a likeness to their parents after the change of teeth and not only up till that time. Such talk is nonsense. The fact is that one being is weaker, directs himself more in accordance with the forces of heredity, builds up the second man with a greater resemblance to the model. This naturally comes out in the appearance, but the same thing has been going on when the being has adjusted itself more in accordance with the model. On the other hand, there are human beings who after the change of teeth become very unlike what they were before. In such cases what comes from the pre-earthly life of soul and spirit is strong and they adhere less to the model. We have therefore simply to see these things in their right connection.

The following, too, must be remembered. Everything that has to be taken in must, in the first place, be taken in by the child and elaborated inwardly in such a way that the ego and astral body enter into intimate contact with the foodstuffs. Later on this need not be the case any longer. The human being is never afterwards in the position of being so strongly compelled to work out, according to a model, something that is independent as is the case during the first seven years of life. During those years he must work up in his ego and astral body everything he takes in; he must work it up in such a way that it can be molded in accordance with the model. This process must be helped; and the world has arranged for it, inasmuch as milk is able to bear a very great resemblance indeed to an etheric structure. Milk is a substance which really still has an etheric body and because this substance, when it is taken by the child, still works up into the etheric, the astral body is able at once to take hold of the milk and then there can arise the close inner contact between what is thus taken in and the astral body and ego organization. For this reason there is an inward, intimate connection in the child between the external foodstuffs and the inner organization of spirit and soul.

In the whole way in which the child drinks milk you can actually see how his astral body and his ego are taking hold of the milk you can see it with your very eyes. And now, as a physician, you must realize the remarkable process of working up what is going on. On the one side, meditate in mantrams, letting the mantram work upon you, freeing your forces of soul on the one hand; and on the other hand, meditate simply upon the child. Picture to yourself how the being of spirit and soul comes down and makes its way to the physical foodstuff, ignoring the model to begin with, and then picture what is going on between the being of spirit and soul and the foodstuff — a process that is now directed in accordance with the forms contained in the model. If you form a true picture of an excessively strong working of the spirit and soul, the picture crystallizes into that of scarlet fever. A picture of a too feeble working of the spirit and soul which wavers in the face of the model and becomes the picture of measles.If you picture these things in meditation you carry over ordinary meditation into medical meditation. It is dreadful that people today want to grasp everything with the intellect. In medicine really nothing can be grasped with the intellect. With the intellect one could at the very most grasp the diseases of the minerals — and there it is not a question of curing. Everything medical must be grasped by direct perception and the faculty for this has to be developed.

You cannot notice this process in a grown-up person. The digestive tract takes over the foodstuffs — it is a process transacted inwardly; whereas in the child, astral body and ego take over the foodstuffs. Unfinished forms of human nature have there to be directed and fashioned in accordance with the model. When you meditate upon the child, you see a mighty metamorphosis going on. You see the spirit and soul lighting up, as it were, and the in-taken foodstuffs cast into darkness and shadows; you see there how the second man is formed out of light and darkness, in colors, as it were. You see how the pre-earthly in man is a brightness and how the external foodstuffs are a darkening. In the child a brightness comes upon the darkness, a brightness that comes from the pre-earthly. The milk goes in as darkness. The brightness and the darkness together give rise to manifold colors. What is white in the physical is black in the spiritual; always the opposite.

These things make it possible for the ego to be active in quite another way than is usual in life. What a feeble effort it is that we make in the act of ordinary, intellectual thinking. Intellectual activity is man's greatest weakness. He simply carries one concept to another. But if you observe the child in the way now described you will meditate in such a manner that your ego organization is thoroughly involved in the effort.

These things, in their further course, must also be heeded in our pedagogy. In a school like the Waldorf School we have children between the ages of seven and fourteen. At this age things have changed. The second man has been developed. The child before us has been molded out of pre-earthly existence according to the model that has been cast off; forces of heredity, naturally, have remained in the child. They have been brought into the model, into the imitation of the model. The child is now much too unearthly. For now the forces that come from beyond the earth have worked on the child with special strength and the swing of the pendulum has gone to the opposite side. Formerly, this was externally visible in the human being; he was entirely the product of heredity. Now that which is to be seen externally has arisen entirely from within. It is the external world that has now to be mastered. What has hitherto worked without consideration for the earthly world, with consideration only for the human model, must direct itself to the outer world. Between the seventh and fourteenth years, astral body and ego organization must work in such a way that this super-earthly being is again adjusted to the external conditions of earth existence. This process has its culmination at puberty. At that age the human being is placed wholly within earthly conditions; he enters into his relationships with earthly conditions; the earthly is membered into his being. Therefore the element of greatest importance in the generation of the second man between the seventh and fourteenth years is what the human being brings with him from pre-earthly existence. For this reason his own specific karma only begins to work after puberty. Then the earthly works in. A culmination is reached at puberty and the third man now begins to develop.

The second man — so far as the substance is concerned — is thrown off and the third man is developed. The process does not reach so far as actual form, it only gets as far as life. If it were to get to form, we should get third teeth, because the human being is now governed by external conditions. Within these outer conditions it is the case that the human being again takes in what is extra-human. When he was being governed by the model he was directed entirely in accordance with the human. So long as he was governed by the model he was governed by something passed on by heredity. But in this there lies, in reality, something that is dried up. Since the separation of the sun it has really broken off from the root of his being and is dried up, withered. Therefore the forces of heredity contain the most pathological forces and when he is governed by the model the human being really absorbs innumerable causes of illness. He absorbs few such causes during the period after the change of teeth because then he is governed by the external world; climate, everything contained in the outer air, etc., are less harmful. Between the seventh and fourteenth years the human being is healthy; then again there begins a period when he is again susceptible.

All these conditions must be observed in such a way that you have the picture of man in your mind. If you have this picture of man in mind, then you also meditate rightly. Then you will be able to combine what you learn with what you meditate upon and what you have learned does not remain theory but becomes practice, because you uncover the power that enables you to perceive these things. This is what is so urgently needed today. It is impossible to achieve anything in medicine so long as we persist in thinking that evolution goes forward in a straight line. The human being is in reality constituted from separate streams of development which take their course in periods of seven years; what comes later is linked to what is earlier; it is not a one-sided continuation but different conditions are always intervening. Continuous evolution in this sense, where the earlier alone is the cause of the later, is only to be found in the mineral kingdom, less in the plant kingdom and least of all in the human kingdom.

Let us try to picture the plants. How do people proceed today when they picture the plants? There is the soil of the earth. The seed is pictured as being laid into the soil and then the plant grows out of this. People are naive enough to think as follows: Hydrogen is a very simple molecule, consisting of two atoms. All kinds of things are imagined to form combinations. Alcohol is certainly a very complicated molecule. Carbon is there combined with hydrogen and oxygen and then one has something more complex. And now there come still more complicated substances with more and more complicated molecules. There was a period during the eighties and nineties of the last century when the titles of these were very complicated, consisting of more than three lines in length. Yes, the molecule has become terribly complicated! And now still more so. Then it becomes a seed, and a seed is a most highly complicated combination. Then the plant grows out of the seed. But all this is nonsense. The basis of the seed formation is, in reality, that earthly matter tears itself away from the principle of structure and passes over into chaos, becomes chaotic, contains no more forces of matter in itself. Then, when no earthly structure is present, what is working out of the cosmos can assert itself. The cosmic declares its readiness to mirror the cosmic structure in the minute. In the seed formation the “nothingness” asserts itself over against the earthly and the cosmos works into the nothingness.

Frau Dr. Kolisko could tell you an interesting fact which entirely confirms this. During investigations into the function of the spleen we took small rabbits and excised the spleen. In spite of this the rabbits were quite well. They did not die of the operation, but a long time afterwards, from colds. It was quite possible to see how the rabbits live on without the spleen. When one of the rabbits died, we were able to see what had happened and in the place of the spleen there had appeared tissue which had assumed a decidedly spherical form. What had really happened? We had excised the physical spleen and by doing this had artificially driven earthly substance into chaos, made it accessible to the cosmic forces, and something resembling a seed formation had come into being. There had arisen, in an extremely primitive form, something that resembled the structure of a seed — an image of the cosmos. This quite harmless vivisection, therefore, confirmed a matter of great significance, for this is what appears to spiritual-scientific observation.

Take a quartz crystal. It is an earthly thing. Why? Why is the quartz crystal an earthly thing, retaining its form really in a very pedantic, rigid way? The quartz gets its form from an inner force and if you break it apart with a hammer the single parts always retain the tendency to be six-sided prisms, self-contained, six-sided pyramids. This tendency is present. You can as little rid the quartz of this tendency as you can get pedantry out of a man who is pedantic by nature. You may atomize a pedantic person, but he will still remain pedantic. The quartz does not allow itself to come to the point where the cosmos can do anything with its forces. Therefore the quartz has no life. If the quartz could be pulverized to such a degree that in the single fragments it no longer had the tendency to be governed, in the single fragment, by its own forces, something living and cosmic would grow out of the quartz. This is what happens in the formation of a seed. In the seed, matter is driven out to such a degree that the cosmos can intervene with its etheric forces. The world must be seen as a perpetual entering into chaos and again an emergence from chaos. What is contained in quartz also came at one time from the cosmos, but it remained at a standstill, has become Ahrimanic. It no longer exposes itself to the cosmic forces. As soon as anything enters into the realm of the living it must always pass through chaos.

This again is something which will help you to meditate in the sense of medicine. And you can also picture the developed plant—how it grows from leaf to leaf, and so on. You come to the formation of the seed in the fruit. Whereas you otherwise picture the seed plant as brightness it now becomes dark, quite dark. Then again comes the light, when the forces from outside take hold. In this way, too, you can make an imaginative picture from the being of the plant. When you are aware of an object which you call “plant”— then it is an imaginative meditation. You should not remain in the sphere of the intellectual but in the sphere of the concrete, inner picture. The intellectual element is merely there for the purpose of presenting what is known, in the form of thoughts.

Suppose you write down the word Menschenkind. This word is taken from something that has been perceived. Very well. The word Menschenkind reminds you of a Menschenkind (a human child). But suppose you take the word and say: I like the i, so I will put that first, I like the n, so I will put that next, then the sch and so on. You can put the word together in a different way but nothing that you can make anything of will come out of it. This is what people are doing with concepts all the time. The concept is only the spiritual term for the perception. People separate and combine concepts and think in acts of thinking. They do this, too, when they are observing the external world. They cover up observation with thinking and so they live today outside reality. This is possible as long as one is working with the science that stands outside reality, with geometry and arithmetic. But if we want to go in for medicine we cannot stand outside reality. If we do, then we also stand outside reality in medical practice itself.