Throughout all its members, the human organism unfolds activities which can only have their origin in the organism itself. Whatsoever is received from outside, must either merely provide the occasion for the organism to unfold its own activities, or else its activity in the body must be such that the foreign activity cannot be distinguished from an inner activity of the body once it has penetrated it.
Man's essential food contains carbohydrates for example. To a degree these are similar to starch. As such they are substances which unfold their activity in the plant. They enter into the human body in the state which they can achieve in the plant. In this state starch is a foreign body. The human organism does not develop any activity which lies in the direction of what starch can unfold as activity in the state in which it enters the body. For example, what develops in the human liver as a substance similar to starch (glycogen), is something different from plant starch. On the other hand grape-sugar is a substance which stimulates activities that are of a nature similar to the activities of the human body. To develop an effect that plays any real part in the body, it must first be transformed. It is transformed into sugar by the activity of ptyalin in the mouth.
Protein and fats are not altered by ptyalin. To begin with they enter into the stomach as foreign substances. Here the proteins are so transformed by the secreted gastric pepsin that breakdown products as far as peptides arise. The peptides are substances whose impulses of action coincide with those of the body. Fat, on the other hand, also remains unchanged in the stomach. It is only changed when it comes in contact with the pancreatic secretion, where it gives rise to substances that appear on examination of the dead organism as glycerine and fatty acids.
Now the transformation of starch into sugar continues through the whole process of digestion. Transformation of starch also takes place through the gastric juice if it has not already been accomplished by the ptyalin.
Where the transformation of starch is achieved by ptyalin, the process stands at the boundary of that which takes place, in man, in the domain referred to in the second chapter as the organization of the ego. It is in this domain that the first transformation of the materials received into the human body from the outer world takes place. Glucose is a substance that can work in the sphere of the ego-organization. Corresponding to it is the taste of sweetness, which has its being in the ego-organization.
If sugar is produced from starch through the gastric juice, this shows that the ego-organization penetrates into the region of the digestive system. For conscious experience, the sensation of sweet taste is absent in this case; nevertheless, the same thing that goes on in consciousness- in the domain of the ego-organization while the sensation sweet is experienced, now penetrates into the unconscious regions of the human body, where the ego-organization becomes active.
Now, in the regions of which we are unconscious, the astral body, in the sense explained in Chapter II, comes into play. The astral body is active when starch is transformed into sugar in the stomach.
Man can only be conscious through that which works in his ego-organization in such a way that this is not overwhelmed or disturbed by anything, but able to unfold itself to the full. This is the case in the domain where the ptyalin influences lie. In the realm of the pepsin influences, the astral body overwhelms the ego-organization. The ego-activity becomes submerged in the astral. Thus, in the sphere of material substance, we can trace the ego-organization by the presence of sugar. Where there is sugar, there is the ego organization; the ego-organization emerges where sugar arises in order to direct the sub-human (vegetative and animal) material towards the human.
Now sugar occurs as a product of excretion in diabetes mellitus. Here the ego-organization appears in the human body in such a form that it works destructively. If we observe it in any other region of its activity, we find that the ego organization dives down into the astral. Sugar, directly consumed, is in the ego-organization. There it induces the sweet taste. Starch, consumed and transformed into sugar by ptyalin or in the gastric juice, reveals the action in the mouth or in the stomach, of the astral body working with the ego-organization and submerging the latter.
However, sugar is present in the blood as well. The blood, as it circulates with its sugar content, carries the ego-organization through the whole body. But there through the working of the human organism the ego-organization is everywhere held in equilibrium. We saw in Chapter II how the human being contains, besides the ego-organization and astral body, the etheric body and the physical. These also take up the ego-organization and retain it in themselves. As long as this is the case, sugar is not secreted in the urine. How the ego-organization carrying sugar is able to live, is shown by processes in the organism bound up with sugar.
In a healthy man sugar can only appear in the urine if consumed too copiously as sugar, or if too much alcohol is consumed. Alcohol enters directly into the processes of the body without intermediate products of transformation. In both these cases the sugar-process appears independently as such, alongside the other activities in the human being.
In diabetes mellitus the case is as follows: the ego-organization, as it submerges in the astral and etheric realm, is so weakened that it can no longer effectively accomplish its action upon the sugar-substance. The sugar then undergoes the processes in the astral and etheric realms which should take place in the ego-organization
Diabetes is aggravated by everything that draws the ego organization away and impairs its effective penetration into the bodily activities: over-excitement occurring not once but repeatedly; intellectual over-exertion; hereditary predispositions hindering the normal co-ordination of the ego-organization with the body as a whole. At the same time and in connection with these things, processes take place in the head system which ought properly to be parallel to the processes accompanying activity of the soul and spirit; they fall out of their true parallelism because the latter activity takes place either too slowly or too quickly. It is as though the nervous system were thinking independently alongside of the thinking human being. Now this is an activity which the nervous system should only carry out during sleep. In the diabetic, a form of sleep in the depths of the organism runs parallel to the waking state. Hence in the further course of the disease a morbid degeneration of nervous substance takes place. It is a consequence of the deficient penetration of the ego-organization.
The formation of boils is another collateral symptom in diabetes. Boils arise through an excessive activity in the domain of the etheric. The ego-organization fails where it should be working. The astral activity cannot unfold itself because at such a place it only has power when in harmony with the ego-organization. The result is an excess of etheric activity revealing itself in the formation of boils.
From all this we see that a real healing process for diabetes mellitus can only be initiated if we are in a position to strengthen the ego-organization of the patient.