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Anthroposophical Spiritual Science and Medical Therapy
GA 313

Lecture IV

Dornach, April 14, 1921

Yesterday I said that certain complexes of symptoms are condensed in the phenomena of falling asleep and awakening. It is most important first to study the symptoms that are condensed in the process of falling asleep. To fall asleep inadequately always indicates that the astral body is clinging to the physical and etheric organs, especially to the latter. (I will use these terms this time since you are now all quite familiar with them.) The astral body is too strongly bound up with these other members. This clinging of the astral body is at once evident to the spiritual investigator because, when sleep should appear, the physical and etheric organs continue to function as in the waking state, whereas in the normal person their function is clearly dampened down.

Ordinarily we cannot learn the real significance of this inadequate falling asleep; hence we must acquire a comprehensive view of the phenomena in the waking state that accompany this inadequate falling asleep. We then may notice that everything revealing an involuntary functioning of the organism is a concomitant of falling asleep inadequately. Thus any involuntary twitching of the lips or blinking of the eyelids, any excessive movement of the fingers and the like—any movement that is not an expression of an inner process, any fidgeting—all these are waking concomitants of not falling asleep properly. Obviously this process can be observed only when it manifests outwardly. When such fidgetiness occurs with regard to the internal organs, a certain capacity to perceive such things must be acquired so that one understands how to relate ertain phenomena.

For example, in patients suffering from anemia you may hear rushing sounds in the blood vessels on the right and left sides of the neck. These murmurs or bruits are noticeable in every person when he turns his head far to the left or right, therefore initiating a powerful unfolding of his astrality. Such an unfolding of astrality always arises when a movement that would normally be carried out voluntarily is carried out involuntarily. Whenever an otherwise voluntary movement—that is, a movement dependent on the ego—is made involuntarily, the astrality is too strongly exerted, too strongly engaged, is too strongly pressed into the organ. This is what we are dealing with in fidgety movements. Thus through such indirect observations, attention can be directed to the fidgetiness of the internal organs.

Now we must add that in patients who fall asleep inadequately there is always an underlying irregularity that cannot be countered by direct, outer methods. This irregularity is not closely connected with what I had to say yesterday about magnetic and electric fields, for example. Such things have very little to do with everything accompanying inadequate sleep. Thus in such cases it is necessary to make use of remedies. If we encounter a complex of symptoms that can be grouped together under the formula, “falling asleep inadequately,” we must apply remedies, and in particular plant substances in which processes must first be called forth by cooking, burning, etc. Such remedies will play a large role in cases of inadequate falling asleep, when the disease is in the human thoracic cavity, because there we always find an irregular clinging of the astral body to the organs. All remedies obtained by combustion, by reducing the substance to ashes, or extracted from the roots by boiling will be very valuable here. Everything that remains as force in root extracts and plant ash should play a very important part in such cases.

On the other hand, everything that I described yesterday will play a significant role in cases of inadequate awakening. To wake up inadequately always shows that the astral body enters too little into the organs. In diseases of the chest, this incomplete penetration by the astral body means something different from what it means in generalized diseases of the human organism. In the latter, one must try to bring in the entire astral body. This has to do with what I said about the effects of arsenic. Arsenic is effective when we have to treat an astral body already permeated by the ego, whereas when we want to treat the astral body alone, it will be especially important to apply the methods about which I spoke yesterday. In cases of inadequate awakening, we will always find something accompanying the waking process, what might be called numbness, a tendency to hold on to a dulled state of consciousness. Thus the symptoms that accompany inadequate awakening are essentially soul phenomena. Therefore it is particularly important in cases that show some defect or other in the chest organism—and at the same time the accompanying soul phenomena—to use the magnetic or electric fields curatively.

At this point I will try to answer a question put to me yesterday concerning the difference between treatment by direct current and by alternating current. (In the course of these lectures I will try to answer all your questions, so far as time permits.) In cases where one is treating a weakened individual—that is a person clearly suffering from malnutrition or the like—where the disturbance proceeds more from the lower portion of the middle human being, it is better to use an alternating current. If the disturbance clearly proceeds from the upper human being, it is better to use a direct current. However, the difference is not very great, and if you use one in one case and the other in another case you cannot make too great a mistake.

You will have noticed that in this realm of human health and illness dietary considerations can become quite important. This is because a subtle transition appears here from effects of a more dynamic kind, effects applied to the human being from outside, and those effects worked through by the human being himself in the transformation of plant substances. However, you will understand that because we are dealing with the region of rhythm, with phenomena based on the rhythmic functions in the human organism, there is no place for fanaticism in judging the healthy or diseased individual. There must really be no fanaticism of any kind in medical art—for example, fanatical adherence to an uncooked diet. A raw food diet also entails the exclusion of cooked plant substances obtained from the part of the plant lying toward the root, and this generally has definite consequences for the human organism: it slowly undermines the health of the respiratory system. A destructive influence on the human organism of this kind can continue for a long time, since it is not so easy to destroy this organism, but fanatical adherence to uncooked food will in time lead to shortness of breath or similar symptoms.

Someone may reply, “That may be true, but I have had excellent results with a fruit diet.” But you must then note that fruits are not roots; fruits have been worked upon strongly by outer sunlight. In them an extra-terrestrial process has been intensely brought to completion. One comes very close to the process of cooking when making use of what is dynamically present in fruits. Thus if you let certain patients eat fresh fruits rather than raw roots, you do much less harm. It is best not to be fanatical in either direction; both directions must be dealt with individually. There may well be cases in which it can be clearly determined that the irregularity in the chest system comes from the circulation and not from the respiratory rhythm; it can be proven that this problem derives from the circulation rather than the respiratory rhythm. Then it is necessary to pay attention to what plays into the circulation from the digestive activities. In such cases, what is lacking can be properly assisted by a diet of raw fruits. It is quite correct, in this individual case, a diet of raw fruits could be indicated. On the other hand, if I have a patient whose symptoms suggest that the cause of the inadequate functioning of his chest system is in the breathing, I will not be able to achieve anything by such means, and in fact I may only do harm. In this case I must instead prescribe a diet of boiled roots. In dealing with this very labile system we come to realize how serious the consequences of fanaticism can be in one direction or another.

In this first stage of our studies we must take into account one further thing in order to understand this system completely and not have to return to it. This is a process in the human organism that frequently escapes outer observation entirely and remains unnoticed to the detriment of human health. We should consider this here, in the first stage of our studies, this being the more pathological-therapeutic stage, whereas the next part should be more therapeutic-pathological in character.

In my more public lectures I have had occasion to speak on philology; I haven't had the opportunity to introduce this in the scientific courses, but it could equally well have been considered there. In the public lectures I said that the peculiar processes that come to more outward expression in the organism during puberty discharge themselves more inwardly during the time between birth and the change of teeth, when the child is learning to speak. These processes that occur between the astral body and the human etheric and physical bodies underlie the acquisition of speech and all the changes in the human organism connected with learning to speak. These processes should be carefully observed in the child as learning to speak runs parallel with changes in the rest of the organism. One ought to follow these changes backward toward birth, that is, from the radical change at the second dentition to the time of acquiring speech. However, in addition to the change of teeth there is an equally significant change, only it is more inward and does not express itself as obviously as the change of teeth or the acquisition of speech, which can be observed by anyone because they appear outwardly. This other change is almost more important than these in human health and illness, though they are given more attention because they are outwardly manifest. This other change is actually much more significant and occurs between the change of teeth and puberty. It is a process that lies midway between those events and is due to the fact that the ego—which, in the sense explained elsewhere, is completely born exoterically only around the twentieth year—is born inwardly in the same way that the astral body is born in the acquisition of speech. This process reaches its culmination between the ninth and tenth years of life.

Please consider now the following: What is latent in the human being regarding his ego, waiting to unfold, is almost entirely overlooked. The ego dwelling in the human organism really does something quite special. Everything else—the physical, the etheric, and also the astral in the human being, which only comes into contact from within with what is outside the human being by means of oxygen—all these components of the human entity are very strongly bound to the inner aspects of the human being. During sleep the ego takes only the astral with it out of the human organism. The astral body has a strong affinity for the physical, and especially for the etheric body. But this is not the case with the ego. It is here, taking into account the ego especially in its relation to the outer world, that the far-reaching difference between the human being and the animal is revealed.

In taking up nourishment we introduce substances from the outer world into ourselves. These must be transformed within us. What is it that brings about this fundamental transformation of outer substances? What brings this about? In truth, this is brought about by the ego. The ego alone is sufficiently powerful to stretch out its feelers, you could say, right into the forces of outer substances. To put it schematically, an outer substance possesses certain forces that must first be destroyed (dekombiniert) if they are to be re-constituted in the human organism. The etheric and astral bodies only walk around the substances, as it were; they have no power to penetrate to the inner aspect of the substances, so they just circumvent them. It is the ego alone that really has to do with the penetration of substances, with truly entering into the substance. If you introduce food substance into the human organism, it is at first inside the human being. But the ego overlaps the entire human organism and enters directly into the food substance. The inner forces of the food substance and the ego begin to interact. Here the outer world in regard to chemistry and physics and the inner world in regard to “anti-chemistry” and “anti-physics” overlap. This is the essential aspect.

Now in a child, this penetration of substances is regulated from the head until the change of teeth begins. The child is born in such a way that forces received by way of his head during embryonic development are then active in the human being in working through substances from within. But in the period between the change of teeth and puberty, which culminates between the ninth and tenth years, the ego that works from out of the lower human being, the lower ego, must meet the higher ego. In the child it is always the ego working from the upper man that works through the substances until the time indicated. Of course, I am referring to the instruments of the ego. The ego is indeed ultimately a unity. But the instruments of the ego, the polarity of the ego—that is the meeting of the lower ego with the higher—only establish a proper relationship in the way I have described. Thus the ego must enter the human organization at this time in the same way that the astral body must penetrate the human organization in learning to speak.

With all this in mind, observe the phenomena that can be seen in children from about the eighth or ninth to the twelfth or thirteenth year. Study from this viewpoint just those phenomena that it is so necessary to observe in children of elementary school age. You will find their outer expression in a seeking of the human organism for a harmony, a harmony that must be established during life between the substances taken in and the inner organization of the human being. Observe carefully how the head can be reluctant, at this time, to take in the inner forces of the substances, and how this comes to expression in headaches at about the ninth, tenth, or eleventh year. Observe further the accompanying metabolic disturbances in the secretion of gastric acid, for instance. Observe all this, and you will see that there are children who suffer continually from this inadequate adjustment of the ego from below and from above.

If such matters are carefully noted, one learns how to deal with them and as a rule they then disappear. They correct themselves gradually after puberty, when the astral body appears and makes good what the ego cannot do. They die away gradually between the fourteenth or fifteenth year and the twentieth or twenty-first year. Children who are sickly between the change of teeth and puberty can afterward become extraordinarily healthy. It is very instructive to observe this. You will often have found that sickly children, especially those whose illness is manifested outwardly in digestive ailments, in an irregular digestion, become quite healthy later if carefully treated. It is especially important in dealing with such cases to be extremely careful as to the diet prescribed. Splendid results can be achieved if the parents or teachers of such a child do not continually overload him with all kinds of food and with continuous persuasion to eat. That just makes the matter worse. Rather try to find out what the child can digest easily and give this frequently in small portions throughout the day. One can do these children a great service in this way. On the other hand, it is quite wrong to believe that anything is achieved by overfeeding.
In addition, we must take care that these children do not have too much school work, for this would only aggravate their condition. Thus if we allow them the necessary rest, we assist in this inwardly necessary digestive activity in response to smaller portions of food. There is hardly any area in which more transgressions are made than this one, in relation to which the above suggestions are made. If healthy human development in this direction is hindered, all sorts of tendencies to illness from this stage in life may remain throughout life.

People often complain that we give very little homework at the Waldorf School. We have good reason for this. A system of education corresponding to reality does not heed the abstract principles—or abstractions generally—applied in many spheres of life today. Instead it takes into account everything that has to do with the real development of the human being, and it is important, above all, not to burden children with homework. Homework is frequently the concealed cause of bad digestion. These things are not always manifested outwardly until later, but they nevertheless have their influence. It is remarkable that super-sensible study of the human being leads one to see an indication in an early stage of life of what is being prepared for a later period.

There is always a danger of the ego not being properly interlinked—if I may express it in this way—with the organism from below upward. This danger is really very great for almost all people, and especially for those in our time who are not of robust peasant stock. There is still a marked difference between those of peasant stock and the rest of the earth's population. One must draw a dividing line here. The rest of the population is very susceptible to the dangers arising when the ego is inadequately interlinked with the organism. The organism is then fundamentally ruined before the ego ought to insert itself. With regard to the respiratory system—also the head system—the female is more sensitive to the peculiarly labile equilibrium present there. The male is more robust regarding his chest organs, that is, less sensitive though not more stable. The same troubles can appear, but their outer expression is weaker. The female is more sensitive to the troubles arising there. What I have described as a seeking for the proper interlinking of the ego ends in a healthy human being or in anemia. Anemia (Bleichsucht) is a direct continuation of everything that happens abnormally in this way in the period from age seven onward. Anemia does not appear until later, but it is an intensified result of what was not observable in this direction in the preceding period of life.

In this regard, we must now point to an exceptionally important distinction. When we study the circulatory system, we must distinguish the actual circulation—which is a sum of movements—from the metabolism which is intimately interwoven with this circulation, inserting itself into it in a sense. In the circulatory system there is an equilibrium between the metabolic system and the rhythmic system, whereas in the respiratory organism we find the equilibrium between the rhythmic organism and the nerve-sense organism. Thus when you study this middle aspect of the human being, the chest system, you must realize that it is organized polarically in two directions. Through the breathing it is organized toward the head, and through the circulation it is organized toward the metabolic-limb system. Everything within the metabolism itself, or that is intimately connected with the metabolism in man's capacity for movement—which is of great importance especially during the first or ascending half of life—inserts itself as metabolic forces into the forces of circulation. This insertion upward from the metabolism must then advance a stage further.

Hence, in the process I have described we have to do with an advance, with a further stage of the activity developed by the ego in metabolism, already in the taking up of substances and then in laying hold of their inner forces. What we are dealing with here is a movement upward through the circulation and breathing into the head system, and all this must be properly coordinated in the period between the change of teeth and puberty. The egö s grasp of forces of outer substances must move upward through circulation and breathing to a proper intervention in the head system. It is a very complicated process we are dealing with here. We can really study this process by trying to grasp its influence within the “outer” digestive tract, where the substances are still quite similar to their outer states, where the substances are grasped only weakly by man's inner being. For what is the first stage in dealing with outer substances? What does the ego do when it first takes hold of outer substances?

The first activity of the ego in laying hold of the forces of outer substances is accompanied by sensations of taste. Tasting—that is, working through outer substances in a way that finds subjective expression in tasting—is the first stage of laying hold of the outer forces. It then proceeds further inward. But tasting also extends further inward. The “inner” digestive organism that lies on the other side of the intestines and transfers substances into the blood is still a tasting, but a tasting that grows ever weaker. It extends upward until, in the head organism, the tasting is opposed and thereby dampened down. The activity of the head in regard to tasting consists in the damping down of tasting, it opposes it. This process must take place properly. Then, of course, the ego lays hold of the substances as they proceed further; the ego grasps them more strongly than is the case in tasting, which is subjective and merely external. This process that takes place in the outer digestive tract is strongly influenced by mineral salts.

You will be able to harmonize every aspect of what I am now saying with what I said in the last course. You will see that what I am now saying is essentially bringing to completion what was said then. We have to ask ourselves, “What really is a remedy from the outer kingdoms of nature?” This is a fundamental question for medicine. What is a remedy?

Anything that the organism can digest in its healthy state is not a remedy. We can only speak of a remedy when we introduce into the organism something it cannot digest in a healthy state but is able to digest only in an abnormal condition, that is able to be digested, therefore, only in an abnormal human organism. We provoke the abnormal human organism to digest something that the healthy human organism does not digest. The healing process is a continuation of digestion, but a digestion carried step by step into the interior of the human organism.

Among the symptoms accompanying the condition seen in its most pronounced form in anemia we find these: fatigue, lassitude, and inadequate falling asleep and awakening. If all these symptoms appear, as can happen with most children during the period of development mentioned today, then it is necessary first to experiment with the outer digestive tract. There one must apply the mineral element, and yet not completely mineral. If you do this, you will obtain results. In the first place, these things could be observed through the symptoms that arise. For example, you may find that definite symptoms arise, all of which point to the need for the ego to take hold outwardly of the forces of outer substances. This process could be assisted by carbonate of iron. Ferrum carbonicum is a remedy that can act as a support for the weakness when the ego ought to be taking hold outwardly.

Let us go a stage further and consider an inadequate intervention of the ego within the circulatory organism. We will notice that this inadequate intervention of the ego in the circulatory organism can be supported by ferrous chloride (ferrum muriaticum)—that is, by a still more purely mineral remedy.

Let us go a stage further still, to what we encounter in the breathing organism. Here we can find special support for the ego through plant-acids. And if we go yet further, to the head system, we can support the ego by pure metals. These, of course, must not be used in their outer form as pure metals, for they then have no proper relation to the human organism. We must apply the finest forces of these metals. Last year I therefore said that the human organism does not allow itself to be treated with metals allopathically. The organism itself acts homeopathically; it breaks up the metals itself as they move from the digestive system to the head organism. The organism can, of course, be supported in this activity through potentization.

You will see, however, that we can learn from this something about potentization. (We will return to these things later from another viewpoint.) First one must form a mental picture of the real center of the deficiency. The deeper this center lies—the farther from the head organization—the lower the potency required. The nearer this center lies to the head organization, the higher the potency we must apply. Of course, what approaches the head organization can come to expression outwardly in all kinds of ways.

If you proceed properly from this viewpoint—that is, from the ego's laying hold of outer substances—you will be able to gain insight into the symptoms you encounter. This leads us back to what I have said today and have often emphasized elsewhere: that the human organism is not simply something we can draw with lines; that is only the solid part. The human organism in essence is organized fluid, organized air, organized warmth, and the ego has to intervene in these various members of the organization.

The ego's intervention in the warmth conditions of the body is especially subtle and important; it does this in the following way: When a person is born we have initially an imprint of the ego and this is present in the head. This imprint is active during childhood. In order to do this, the ego must offer its being [Sein] from below upward. It must intervene in this way. This finds expression in the ego-imprint, that we have in the head, permeates the organism with warmth during childhood. It has something to do with the human organism being suffused with warmth. But this warming follows a descending curve; it is strongest at birth, since it proceeds from the head, and then moves in a descending curve. As human beings we are compelled in later life to compensate from below upward for what unfolds there in the warmth curve. We have to maintain its proper level from below through the ego's intervention in these warmth conditions. We must later oppose the descending curve by this other ascending curve. The latter depends essentially on the ego laying hold of the ascending forces of substance gained in food and leading them over into the circulation, the breathing, and then into the head system.

Now imagine that this is not taking place in the right way, that the transference of the inner forces of the outer world's substances into the human organism is too weak, that it is not developed with sufficient intensity. Then insufficient warmth is introduced into the organism by way of the ego. The head, which is now only developing the descending curve, lets the body become cold. This occurs at first at the periphery. You should observe that those individuals who suffer from this further development of the condition of lassitude, due to all I have described, have cold hands and feet. This is palpable, for you can sense here how the process that was accomplished in childhood from above downward through the imprint of the ego is not being met in the necessary way by the active ego, by the ego that must be developed and that carries warmth right into the outermost periphery of the limbs.

This will show you that we have what you could call pictures in what manifests outwardly in this way; for as soon as you apply yourself to perceiving things pictorially, as soon as you take into account the interplay in the human being of the various forces above with the forces below—if you consider these so delicately that you arrive at a pictorial impression—you have pictures. In cold hands and feet you have pictures of something that is taking place in the entire human organism and appears in this way. One learns to make use of symptoms so that from them there springs forth a knowledge of the whole human being. If a person has cold hands and feet, it is a profound sign that the ego is not intervening properly in later stages of life. If we are attentive to such things, if only we enter into what spiritual science has to say out of its considerations, we gain a connection with the human organism. Otherwise we will see that through inattention we gradually lose touch with a real, penetrating insight into the human organism. If only we can enter into what spiritual science has to offer, we receive a connection with the human organism, we grow into it.

Consider the following, for instance: Spiritual science continually impresses upon us the fact that in mari s power to hold himself erect there lies something connected with the development of the ego from below upward. This power of holding himself erect is at first expressed only outwardly in a certain sense. It is supported by what streams from above downward. When the change of teeth is accomplished, when this force of erectness has done its work in the proper way, this elementary force of erectness comes to a full stop and now transfers its influence to the inside. Now the balance of the forces that work upward from below and downward from above must be created within.

Then the forces from above downward and from below upward appear in contrast. They meet each other. In this one-dimensional encounter, as you could call it, between forces from above and forces from below, one can see especially what is taking place in this period. Just observe what especially fatigues people with a tendency to anemia. They become most tired when they climb stairs, not when they walk on the horizontal. This points directly to the phenomena that we have been studying. People with a tendency to anemia will always complain about climbing stairs. Thus by looking at the symptoms, by observing what comes to living expression in a process of becoming, we can get a hold of what stands spiritually behind the human being. Then we can come to the point where we learn simply to read what needs to be done in response to these abnormal conditions from what we have gained through diagnostic pathology. We will take this further tomorrow.