Course for Young Doctors

Lecture V

Dornach, April 25, 1924

I should still like to add something to what we have been studying, and afterwards to consider the more general theme to which certain of your questions relate.

I want to speak now of something that it is well to consider only after we have listened to what has been given here in the last few days. It is not well to give the general truths first but only to pass on to them when certain things have already been learned. Only so can general truths receive their proper coloring.

We will now picture to ourselves that each of the four members of man's being — physical body, etheric body, astral body, and ego has its own special structure. The structure of physical body and etheric body is one of space and time. The structure of astral body and ego is purely spiritual. A purely spiritual structure is not governed by space and time. It is possible, nonetheless, to make a picture of the spiritual structure so that we can have a conception of it. This can be done in imaginative consciousness. Hold it firmly in your minds, my dear friends, that on the one side we have to do with a physical etheric structure which in the sleeping human being is separated from the structure of spirit and soul, and, on the other side, with the structure of spirit and soul.

In the sleeping human being we have a physical etheric structure which has sent out the ego and astral body, and again we have the structure of spirit and soul that is separated from physical body and etheric body. These two structures are very different from each other. The physical-etheric structure is differentiated into the single organs, as an organism that has, so to speak, driven out the single organs from the center of life. The astral body and ego structure have, however, been driven inwards from outside — it is as though space and time had been left free by this process. The essential thing is that the physical-etheric structure and the structure of spirit and soul are fundamentally different from one another. In the human being as he stands in the physical world in waking consciousness, the spirit and soul (astral body and ego) are inserted into the physical-etheric organization — to use a form of expression that is not absolutely accurate but enables us to visualize the state of things. To a certain degree they permeate each other. So that every physical organ that is warmed through and irradiated by the etheric body is also filled with life, inasmuch as the cosmos works through the etheric body, and in every physical organ ego organization and astral organization are working, when the human being is in waking consciousness.

And now think of the following: Suppose that astral organization and ego organization impress their own structure upon some organ or system of organs. In other words, something that ought to maintain its physical and etheric structure receives a spiritual structure, becomes an image of the astral and ego organization. This, speaking quite generally, is the cause of physical illnesses. Speaking generally, the cause of physical illnesses is that the body of the human being is becoming too spiritual, in some parts or as a whole. Hence, as was well-known in olden times, real and devoted study of the sick human being throws tremendous light upon knowledge of man as a being of spirit.

In ancient times quite a different idea prevailed of man's nature. Therefore I do not say the following in any sense for the purpose of suggesting that this conception should be re-adopted or made the basis for modern methods. In olden times, when conceptions of the human being were more robust, a man who held heretical views was burned, if such a fate was deemed necessary for the salvation of his soul. These heretics were burned for the salvation of their souls — so at least it was alleged. They were burned in order that they might be freed from what, after their death, would cause them the most terrible sufferings. This procedure was, in earlier times, the outcome of a form of vision; later on, of course, it assumed a really brutal form. Views about the human being were more robust and so it might happen that a certain preparation of melissa (balm mint) would be given to someone who might be regarded as healthy. When he took melissa that had been prepared in a certain way, his consciousness would become slightly dreamy. He became more dreamy than he was before taking the melissa preparation. In this condition, faint imaginations entered into his consciousness. If, for instance, a man was treated in a certain way with henbane (Hyoscyamus niger) he became very susceptible to inspirations. Such investigations revealed that if the solar plexus was stimulated by means of henbane, it was permeated with spirit; in such a case, astral body and ego organization take firm hold of the solar plexus. Or it was noticed that the whole blood supply of the cerebrum became stronger — to a slight extent, but the effect was very significant — by the administration of melissa juice, because the ego organization takes a firm hold by way of the cerebrum. And so the whole human being was tested for the purpose of finding out how he could become spiritual and of perceiving how the single organs could become more spiritual.

It is a preconceived notion to imagine that we think with the head. This is simply not true. We think with legs and with arms and the head beholds what is going on in the arms and legs and receives it into the pictures of thought. I said at Christmas that man would never have learned the law of angles if he had never walked. He would never have learned the mechanical laws of equilibrium if he had had no experience of them through his own center of gravity which lies in his subconsciousness. When we come to the astral body which unfolds these things in the subconsciousness, the human being appears to us to be extraordinarily wise, even if he is often a fool in the physical world, because the geometry that comes to expression in walking, for instance, is all known — if I may put it so — in the subconsciousness, and then perceived by the brain.

Now when the organization of spirit and soul takes too strong a hold of the physical-etheric organization, physical illness ensues. In former times, therefore, the spirit in the physical organs was investigated because everything that can be spoken of as a gift from above is spiritual, of the nature of spirit and soul. But a distinction has to be made here. What the human being received, in a purely spiritual way, as a gift from above, was called a gift and retained this name. But now take a substance like belladonna for example.

Whereas in ordinary plants the physical and etheric principles are at work, there are others where the cosmic astrality works very strongly from outside, where the spiritual element — either the astral or what corresponds in the cosmos to the ego organization—works upon plants or animals. Poisons are then produced instead of the gifts bestowed by the spirit. But the poisons are a true correlate of the spiritual because, in plants and animals, they are the element of cosmic astrality which transcends the plant nature proper. By administering henbane we lead over the astral contained in the warmth mantle of the earth (which marks the boundary of the atmosphere) into the solar plexus and thereby into the diaphragm of the human being. Melissa, which is not a poison in the real sense, produces a gentle working of the spiritual which shows itself only in a form of slight stupor. In melissa, the poisoning process is in statu nascendi. This leads to the principle: physical illness arises when the physical organism or its parts are becoming too strongly spiritual.

But a different condition may set in. It may happen that when a human being is in waking consciousness, the soul-spiritual structure of his astral body or ego organization is transferred with too much strength into some physical organ. But instead of impressing itself upon the physical organism the physical organism forces physical structure upon the structure of spirit and soul, so that when he is asleep the human being becomes, in his astral body and ego, an image of his physical and etheric body. He takes the physical structure into his astral body and ego.

Here we have the difference in the two forms of irregularities which may appear. Even to observation they differ quite essentially. When a human being is ill, the sick organ is, strange to say, spiritualized. It becomes clearer. As though from outside, from its surface inwards, it is laid hold of by spirituality. Long before any definite traces are noticeable in the color of the skin and the like, a sick man appears transparent — shall I say — to occult sight and the spirit and soul is pressing into the transparency.

We notice the opposite condition, where the organization of spirit and soul is taking on the structure of the physical and etheric, when a man in his life of soul and spirit is really asleep. Then he becomes a ghost, a fleeting, wavering ghost of his physical body. He remains like his physical body. He truly becomes a specter of his physical body, and all the crude experiments that are made by spiritualists in connection with manifestations, as they are called, are due to the fact that the spirit and soul in the medium is weakened. That is indeed obvious. In some hidden way, this is what happens. In a dark room the weakened astral body and ego can take on the forms of the organs to the point of visibility. The manifestations are real, but illicit.

Now all so-called mental diseases are due to the spirit and soul — astral body and ego organization — assuming the physical and etheric structure. All so-called mental illnesses are due to this. We may therefore say: Physical illnesses are due to the physical organism or its parts becoming spiritual. Mental illnesses are due to the astral body or ego organization, or one of their parts, taking form in the physical or etheric sense. This universal truth is a very good guiding principle.

These things have a bearing, too, upon questions put by individuals about the connection between medicine and pedagogy, for in the child's organism we have before us every grade between these two extremes. The astral and ego organization in one child will tend to make the physical and etheric body spiritual. In another child the tendency of the astral and ego organization will be to allow the physical and etheric to give them form. Between these two extremes there are all kinds of intermediate stages. This fundamental principle also comes to expression in the temperament. When the astral body and ego organization have a vehement tendency (not as in insanity but of a kind that is controllable) to assume forms belonging to the physical and etheric body, we have the melancholic temperament. When the astral body and ego organization have the tendency to impress their structure on the physical and etheric body, we have to do with the choleric temperament. The phlegmatic and sanguine temperaments lie in between. In the phlegmatic temperament the astral body and ego organization have a tendency, but only in a certain sense, to assume the structure of the physical and especially of the etheric body In the sanguine temperament, the vital principle in the etheric body is strongly influenced by the astral body. So this principle also comes to expression in the temperaments.

What, in radical cases, is the guiding principle for the physician, namely, knowledge of how the spirit and soul and physical-etheric are interlinked in the waking consciousness of a human being, is also a guiding principle for educators, although they have to deal with latent conditions. Pedagogy and medicine are mutual continuations, the one of the other.

Now what you have to do, my dear friends, is to strive with might and main to attain imagination in your conception of man's being. I should therefore like, in this connection, to give you a few fundamental indications.

The form of the human being in the embryonic state is familiar to you as a picture — or at any rate can become so. We know today what the embryo looks like in its earliest stages and the form it takes later on, and from this you can make a connected picture of the human being in the embryonic state. You can also form a connected picture of the human being during childhood. You must try to make both the first and second pictures as intense as possible, as though your thinking were actually touching them, so that it seems as if the embryo were tangible to your thinking and you were inwardly following its forms. Then, in your thoughts, expand the embryo to the size of the child in an equally intense mental picture which you can look at and observe. Then, inwardly metamorphosing the mental picture of the embryo, let it pass into the picture of the child. If you really carry this out, you will be aware of certain difficulties. You will feel: If I enlarge the head of the embryo to the size of a child's head, it becomes very big. I must compress it. I must also inwardly crystallize, as it were, all that in the embryo is still watery and fluid, being part of the fluid man so that it becomes the embryonic brain. Then you will have to stretch and give shape to the limbs in the embryonic state. Inwardly you will have to carry out an act of plastic activity by letting the unplastic limbs of the embryo pass over to become the limbs of the child. It is an extraordinarily interesting inner occupation to let the embryo pass over into childhood in inner contemplation.

Then, going further, you can make the same experiment with the child and the grown-up person. Here there will be greater difficulty. The differences between embryo and child are very considerable and you will have to be extremely active inwardly if you are to succeed. But when you compare childhood with the prime of life, the differences will not be so great. The difficulty will be to fit the one into the other. But if you succeed in this, the imagination of the human etheric body will actually come to birth within you, and comparatively soon.

Shove man's earliest time
[- the embryonic life -]
On into childhood,
And carry childhood on
Into the days of youth.
There will appear to you, condensed, Human ether being
Behind the body's structure.
[- physical body in its structure -]

Schiebe die Frühzeit
[ - Embryonalzeit -]
In des Kindes Alter,
Und des Kindes Alter In die Jugend Zeit.
Dir erscheint verdichtet Menschenäthersein
Hinter Körperwesen.
[ -physischer Leib in seiner Struktur-]

Here you have a guiding principle which you can use just as well as the others I have given during these lectures. But you must fully realize that the acquisition of imaginative consciousness demands effort. It is not to be attained by mere beckoning but only by strenuous work.

Now you can go still further. You can try to picture an old, sclerotic man — old men are, to a certain extent, sclerotic — feeling that you are touching him and in this act of spiritual touching you get the impression that he is really hollow. The impression you get when you touch an old, sclerotic man spiritually is not as if he were more solid, harder, but, on the contrary, as if he were sucking at you. In this spiritual touching the feeling is as if, in the physical world, you were to run a moistened finger along the foam of a breaking wave or along the surface of clay. This, as you know, gives the impression of suction. So it is, spiritually, with a sclerotic old man. You must develop this experience of touch in your visual picture of the old man. This applies not only to the visual act but to any one of the twelve senses, also to the sense of life (Lebenssinn). So you have a picture of age, with its density, which seems to exercise suction. And now just as in the first instance you let the picture of the embryonic period pass on into the picture of childhood and then into that of the prime of life, maturity — now let the picture of old age pass backwards. Picture the mature human being and let your touch experience of the aged man pass back into the picture of man in the prime of life, who does not seem to suck but stands in the world full of vigor. When you let the picture of the embryonic structure pass over into the structure of childhood, you carried out a spatial metamorphosis — what happens now is that with old age you have the impression of a being who has been hollowed out, who sucks all the time, and this hollow being seems to be filled with force and energy when you let the picture pass back into the age of maturity. Whereas the first picture of abounding strength is connected with an experience of being very slightly paralyzed, when the picture of the old man is let pass backwards, vigor seems again to come into his bones and into the whole structure of his solid organism. More care must be taken when this inner process is being carried out. And then the picture of the prime of life must be carried back to that of youth. This is an easier thing to do. We picture a man who already has one or two wrinkles and then let him be merged into the picture of a young, chubby-faced person. When we succeed in doing this, we get the impression of the etheric body being animated, beginning to ring and sound. This gives us an impression of the astral nature of the human being. And so you have a guiding principle for the ascent to inspiration.

Shove old age's density
Back into the prime of life,
And the prime of life
Back into the life of youth.
There will ring forth in cosmic tones The working of man's soul
[— astral body —]
Out of the Ether life.

Schiebe die Altersdichte In die Menschenreifezeit,
Und das reife Alter
In das Jugendleben.
Dir ertönt in Weltenklängen Menschenseelenwirken
[ - der Astralleib also -]
Aus dem Ätherleben.

You will realize from what I have told you that guiding lines for meditation are not given out as a commandment but are based upon things that can be understood. When a human being is guided to meditation in the proper way, conditions are not as they once were in the ancient East, when both the upbringing of children and the development of old age rested upon quite different foundations. When somebody is given meditations today, they are of such a form that he realizes and understands what he is doing with himself. In the East the child was under the guidance of his Dada. This meant that the child was taught and brought up according to the Dada's mode of life. The child learned no more than he was able to learn by watching the Dada. When a grown-up man wished to make progress, he had his Guru. And the Guru taught in no other way than: thus it is and thus it shall be done. The difference in our Western civilization is that an appeal is always made to the free spiritual activity of the human being, so that he is fully aware of what he is doing. He also has insight into how inspiration arises.

If with the powers of healthy human intelligence we have grasped how physical illness and spiritual illness work — and the things I have told you today can be understood by healthy human intelligence — if we go on to realize what we should achieve in meditation, we have reached, with the powers of healthy human intelligence, the boundary of what can be attained. Healthy human intelligence can acquire everything that proceeds from Anthroposophy. When things begin that are not to be understood by healthy human intelligence, then it is right for this intelligence to work only so far as that boundary, and no farther. It is like standing by an lake — a boundary is there, too. We look towards it from the shore. Truly, the healthy human intelligence leads right up to this boundary. No criticism ought to be leveled at you for spreading an obscure, mystical view of the world, for it should be one that is attainable by all healthy human intelligence. When I once said the same thing in Berlin, an article that was written about the lecture, said: Healthy human intelligence can comprehend nothing whatever about the spiritual world and a form of intelligence which does grasp something about the spiritual world is ill; it is not healthy. This was what was held up against me.

I want still to say something else. Your medical studies oblige you to look very intimately into the whole nature and being of man and as young men and women you are in a special position. In all seriousness we must take the fact that the Kali Yuga has passed, that we have entered a new Age of Light although for the reason that the old continues through inertia, humanity is still living in the darkness. From the spiritual universe, light is shining in; as human beings, we are entering an Age of Light; only we must make ourselves fit to realize the intentions of this Age of Light. Young people are especially predestined for this and if with the necessary earnestness they unfold a definite consciousness of why they have been born precisely at the beginning of the Age of Light, it will be possible for them to adjust themselves to what is really demanded in the sense of the true evolution of humanity. And what is demanded now is that we shall look into the human being if we want to explain the world, just as formerly men looked at nature in order to see how the human being is built up out of the forces and processes of nature. Man and his being will have to be understood and the single nature processes as specializations, one-sided processes of what is going on within the human being. When this point is reached a certain inward quality in all the activities of human feeling and the human mind will arise — a quality that has been sought for, although in a rather tumultuous fashion.

Think only of how youth began to deify nature when the Youth Movement of the Age of Light began. It was all abstract, however vitally the impulse may have been felt. The true path of spiritual development for the young man or woman today must lead to the unfolding of intimate feelings for his connection, as a human being, with the world — there must be intimate, tender feelings and what the young absorb spiritually must no longer be a science for the intellect. In that he remains cold — it has always been so. Science must take a form in which every stage that is reached means that one becomes a different human being in feeling and in mind, and acquainted with something that has been forgotten. We also learned to know nature before we came down into the physical world. But then, nature had a different appearance. When a young human being today is led to a coarse, robust, external way of looking at things, the deathblow is struck at what he experienced in pre-earthly existence. If we could succeed in feeling that an old acquaintance of pre-earthly life had entered into our external, material way of looking at things, then feeling would flow into knowledge and understanding. And like a bloodstream, a spiritual bloodstream, this must go through the whole of scientific life, above all through the whole education and teaching of the human being. It is this intimacy with reality that must be acquired in science. Truly the modern age was lacking in understanding in this respect.

Comparatively early in my life I tried to show how the human being, when he confronts the outer world of sense, really has only the half reality, and how he only reaches the whole reality when he unites what arises within him with the outer, material reality. And to begin with, because the times were quite different then — things have always to be prepared — I had to present it in terms of a theory of knowledge. When you read my little book Truth and Science (Mercury Press, 1993), try to let the spiritual rise up into the mind and heart, the spiritual that wells forth from within. Thereby the first step is taken towards this “making inward” of science, especially towards a heart-filled receptivity to world reality. The physician has particular opportunities for this intimate experiencing of reality and therefore the physician, just because he is a physician, can be the person who can make the abstractness prevalent in the other Youth Movement composed of those who are not destined to be physicians, more concrete, more full of heart. A young person today who has some real knowledge of medicine has the advantage when he comes together with someone else who knows nothing but jurisprudence and is, consequently, to be pitied. Medicine can be deepened as we are deepening it here, but with law this is quite impossible. Even up to the beginning of the eighteenth century, something of the spirit still remained in medicine; in jurisprudence spirituality ceased far away in the Middle Ages, when men no longer even dreamed of the spirit and had nothing but recorded statutes. The physician who from the very beginning comes to grips with the most concrete facts of life can have an extraordinarily good effect upon the rest of the youth.

It would be good if you, as physicians, would interest yourselves, too, when opportunity arises, in the educational work that is being done in the Anthroposophical movement. There would be nothing to prevent this if you are in real earnest. The information contained in the Waldorf School Seminary courses cannot be given to everyone, but when somebody shows genuine interest there is nothing against your getting these courses if you really study them from the medical point of view, remembering the close relationship that existed in ancient times between healing and education.

In these days we have quite got away from the conception of man as a being who comes into earthly life burdened with sin, because the modern mind simply does not know what sin really is. What is it that took form as the notion of sin? It is what I have spoken of here as the law of heredity — this is the inherited sin. Individual sin, too, is something that the human being has to overcome in the second half of his life. He has to overcome the sinful model, which comes from heredity. We can also say the sick model, according to ancient conceptions. If the human being were to retain, as his body, what works in his model up to the change of teeth, he would carry it within him his whole life long and at nine years of age he would be a man — how shall I put it?—the whole of his skin would be covered with a kind of moist eczema and if the condition continued he would get little cavities all over his body, would look like a leper, and if he lived on at all the flesh would fall away from his bones. Man is born as a sick being into the world and to educate him, that is to say, to understand and guide what is working according to the model, is the same thing as a mild healing process. Within the Youth Movement and when speaking of education, you should consider yourselves as healers. You can indicate the remedies — which in the first place, of course, remain a spiritual matter — but can certainly be applied physically when a child's condition becomes pathological. In pedagogy, too, there is an art of healing, only it is on another level, another plane. On the other hand, when a patient gives no help at all by working with any guiding principle we may give him for his own subjective consciousness, for the understanding of his illness, for pessimism or optimism in his conception of life — when we simply cannot work educationally — it is exceedingly difficult to help him medically. If the patient — I do not say that he must have blind faith in the remedy for that would be an exaggeration — but if the patient, simply through the individuality of the physician, is brought to a point where he feels the physician's will-to-heal, the reflex action in him is that he will be filled with the will to become healthy. This interplay of the will-to-heal and the will to be healthy plays a tremendous part in the therapeutic process. We can therefore say that there is a reflection of education in healing, and in education a reflection of healing.

Very much depends today upon human beings in the world coming together in the right consciousness. If, therefore, medical youth comes together with the other youth in the right consciousness, the result will certainly be that the medical youth can work very fruitfully on the others. But what is so necessary is to sharpen the consciousness in both directions.

These are the things that I would fain have laid into your souls and hearts, now that you have come here again. I hope they have helped to strengthen still more the bonds between your souls and the Goetheanum and that even in such a concrete domain as that of medicine, the Goetheanum will find human beings who carry out into the world those things that can be found here. You will think rightly about this if you will also feel yourselves as part of the Goetheanum and will often turn your thoughts to what the Goetheanum desires for the world and the growth of civilization. And so the ties of heart that you can form with the Goetheanum may be a very great help to you in the tasks before you. This is what I have had in mind in giving these more intimate addresses and I believe that we shall be able to achieve much if, after what must be the last lecture now, you will carry this feeling out into the world. Thereby we shall also remain together and the Goetheanum will feel itself a center with a definite task. Then the Goetheanum will be a real Goetheanum and you, true Goetheanists. And at the same time, out yonder in the world you will be the supporting pillars which the Goetheanum needs. If things go on in this way, everything will be well.