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Health Care as a Social Issue
GA 73a

7 April 1920, Dornach

Translator Unknown

Without doubt, the questions raised by social problems are among the major concerns of many today. We are dealing with social issues wherever there is a genuine concern with present conditions in humanity's evolution and with the impulses that threaten the future. The contemporary way of viewing and dealing with social issues, however, suffers from a fundamental defect. This is the same defect that afflicts so much of our mental and moral life and indeed our entire civilization: the prevailing intellectualism of our age. The social problems are so often examined merely from the limited viewpoint of intellectualism. Whether the social question is approached from the "left" or from the "right," the overly intellectual aspect of each approach is revealed by the fact that certain theories become the starting point from which it is said that this or that ought to be established, that this or that ought to be abolished. Generally, little account is thereby taken of the human being himself, as if there were no individually distinctive qualities in each human being, as if there were only a generality, "man." No attention is paid to the uniqueness of the individual human being. This is why the entire consideration of social issues has become so abstract, something that rarely affects the social feelings and attitudes that are active between one person and another.

The inadequacy in our consideration of social issues is most clearly evident in the domain of health care, of hygiene. In so far as it is a public matter, concerning not the individual so much as the whole community, health care or hygiene—possibly more than any other social domain—is a subject suitable for social consideration.

It is true that there is no lack of advice, available either in talks or in the literature, concerning hygiene in public health. It should be asked, however, how does such advice about hygiene come into the social life? It must be mentioned that whenever individual rules concerning the proper care of health are promulgated as the result of medical or physiological science, it is generally the trust in a scientific field that provides the basis for accepting such rules, rules whose inner validity one is not actually in a position to test. It is purely on the basis of authority that statements about hygiene emerging from libraries, examining rooms, and research laboratories are accepted by large segments of the population. There are those who are convinced, however, that in the course of modern history over the last four centuries a longing for democratic regulation of all issues has arisen in humanity. Then they encounter this entirely undemocratic belief in authority demanded in the domain of health care or hygiene. This undemocratic attitude of belief in an authority conflicts with the longing for democracy that has reached a kind of culmination today, although often in a highly paradoxical way.

I know very well that what I have just said may seem paradoxical, because issues of health care are often simply not considered in relation to the democratic demand that matters of public interest concerning every mature citizen be judged by that community of citizens, either directly or indirectly through representation. It must certainly be said that it may not be possible for the views concerning hygiene, the hygienic care of public life, to be fully subject to democratic principles, because such matters do, in fact, depend on the judgment of specialists. On the other hand, should one not strive toward greater democratization than contemporary circumstances permit in a domain that is as close, as infinitely close, to the concerns of every individual, and thus to the whole community, as the care of public health?

We certainly hear a great deal today about the necessity for proper air, light, nourishment, sanitation, and so forth, but the regulations laid down to order these things cannot, as a rule, be tested by those to whom they apply.

Now please do not misunderstand me. I would not like to be accused of taking any particular side in this lecture. I would not like to treat in a one-sided way what today is generally treated one-sidedly, in a partisan way or from the standpoint of a certain scientific conviction. I have no desire to uphold ancient superstitions of devils and demons passing in and out of human beings in the form of disease, nor to support the modern superstitions that the bacilli and bacteria pass in and out of human beings, causing the different diseases. We need not occupy ourselves today with the question of whether we are really faced with the results of the spiritualistic superstitions of earlier times or with the materialistic superstitions prevalent today. I would prefer to consider something that permeates the whole culture in our time, especially in so far as this culture is determined by the convictions of modern science. We are assured today that the materialism of the middle and last third of the nineteenth century has been overcome, but this statement is not very convincing to those who really know the nature of materialism and its opposite. The most one can say is that materialism has been overcome by a few people here and there who realize that the facts of modern science no longer justify the general explanation that everything in existence is merely a mechanical, physical, or chemical process taking place in matter.

The fact that a few people here or there have come to this conclusion, however, does not mean that materialism has been overcome, for usually when it comes to a concrete explanation or forming a view of something concrete, even these people—and the others as a matter of course—still reveal a materialistic tendency in their way of thinking. True, it is said that atoms and molecules are merely harmless, convenient units of calculation about which nothing more is asserted than that they are abstractions; nevertheless, the considerations are atomistic and molecular in character. We are then explaining world phenomena out of the behavior or interactions of atomic and molecular processes, and the point is not whether we picture that a thought, feeling, or any other process is connected only with material processes of atoms and molecules; the point is the orientation of the entire attitude of our soul and spirit when our explanation is based only on atomic theory, the theory of smallest entities. The point is not whether verbally or in thought a person is convinced that there is something more than the influence of atoms, the material action of atoms, but whether he is able to give explanations other than those based on the atomic theory of phenomena. In short, not what we believe is essential but how we explain, how we orient our souls within. Here I must say that only a true, anthroposophically oriented spiritual science can help eliminate the defect of which I have spoken.

That this must be the case I would now like to show concretely. There is hardly anything more confusing today than the distinctions that are so often emphasized between man's bodily nature and his soul and spirit, between physical illnesses and the so-called psychological and mental illnesses.1In German, these illnesses are called Seelen-oder Geisteskrankheiten, diseases of the soul or spirit as opposed to diseases of the body. As Steiner is speaking here of the role of soul and spirit in bodily phenomena, it may be helpful to keep in mind the thought of soul-spiritual illnesses, though in the translation we have chosen the more commonly used English equivalents, psychological and mental illnesses. This view of the relevant relationships and distinctions between such facts of human life as a diseased body and an apparently diseased soul suffers from the materialistic, atomistic way of thinking. For what is really the nature of the materialism that has gradually come to be the world view of so many of our contemporaries and that, far from being overcome, is today in its prime? What is its nature? The nature of this materialism does not lie in observing material processes, in looking into the material processes that also take place in the human corporeality, in reverently studying the marvelous structure and activity of the human nervous system and other human organs, of the nervous system of the animal or organs of other living beings. This does not make one a materialist. Rather one is made a materialist through omitting the spirit from the study of these material processes, through looking into the world of matter and seeing only matter and material processes.

What spiritual science must assert, however, is this (and today I am only able to summarize this point): wherever material processes appear outwardly to the senses—and these are the only processes that modern science will admit as observable and exact—they are but the outer manifestation, the outer revelation, of activities behind which and in which lie spiritual forces and powers. It is not characteristic of spiritual science to look at a human being and say, "There is his physical body—this body is a sum of material processes, but the human being does not consist of this alone. Independent of this he has his immortal soul." It is far from characteristic of it to speak like this and to build up all kinds of abstract and mystical theories and views about this immortal soul that is independent of the body. This does not at all characterize a spiritual world view. It can definitely be said that, in addition to his body, which consists of material processes, the human being also has an immortal soul, which then enters some kind of spiritual realm after death. This does not make one a spiritual scientist in an anthroposophically oriented spiritual science. We can be spiritual scientists in the true sense only if we realize that this material body with its material processes is a creation of the soul element. We must learn to understand, down to the smallest detail, how the soul element—which was already active before birth, or, let us say, before conception—fashioned and molded the structure and even the substantiality of the human body. We must really be able to perceive everywhere the immediate unity of this body and the soul element and how, through the working of the soul-spiritual in the body, the body as such is gradually destroyed. This body undergoes a partial death with every passing moment, but only at the moment of death is there a radical expression, you could say, of what has been happening to the body in each moment as the result of the soul-spiritual. We are not spiritual scientists in the true sense until we perceive concretely and in detail this living interplay, this continuous influence of the soul in the body, and endeavor to say: the soul element incorporates itself into the entirely concrete processes, into the functions of the liver, the process of breathing, the action of the heart, the working of the brain, and so forth. In short, when we describe the material part of the human being we must know how to portray the body as a direct result of the spiritual. Spiritual science is thereby able to place a true value on matter, because in the separate concrete, material processes it observes not merely what is confirmed by the eyes or yielded by the abstract concepts of modern science through outer observation; spiritual science is spiritual science only when it shows everywhere how the spirit works in matter, when it regards with reverence the material workings of the spirit.

Such a view guards one against all the abstract chit-chat about a soul independent of the bodily nature, for where the life between birth and death is concerned, man can only spin fantasies about this. Between birth and death (with the exception of the time of sleep), the soul-spiritual is so utterly given up to bodily activity that. it lives in it, lives through it, manifests itself in it. We must be able to study the soul-spiritual outside the course of earthly life, realizing that human existence between birth and death is but the outcome of the soul-spiritual. Then we can behold the really concrete unity of the soul-spiritual with the physical bodily element. This is an anthroposophically oriented spiritual science, for then it becomes possible to see the human being with all his individual members as an outcome of the soul-spiritual.

The mystical, theosophical views that evolve all kinds of noble-sounding, beautiful theories about a spirituality that is free of the body can never serve the concrete sciences of life, they can never serve life. They can serve only the intellectual or psychological craving to be rid of the outer life as soon as possible, and then they weave all sorts of fantasies about the soul-spiritual in order to induce a state of inner satisfaction.

In this anthroposophically oriented spiritual movement it behooves us to work earnestly and sincerely to develop a spiritual science that will be able to enliven physics, mathematics, chemistry, physiology, biology, and anthropology. No purpose is served by making religious or philosophical statements to the effect that the human being bears an immortal soul within him and then working in the different branches of science just as if we were concerned only with material processes. Knowledge of the soul-spiritual must be gained and applied to the very details of life, to the marvelous structure of the body itself. You will come across many mystics and theosophists who love to chatter about the human being as composed of physical body, etheric body, astral body, and ego, and so forth, yet they haven't the least inkling what a wonderful manifestation of the soul life it is when a person blows his nose! The point is that we must see matter not simply as matter but as the manifestation of the spirit. Then we will begin to have healthy views concerning the spirit, views that are full of content, and with them a spiritual science that may be fruitful for all the other sciences.

This in turn will make it possible to overcome the specialization in the various branches of science resulting from the materialistic trend of scientific knowledge. I have no desire whatever to deliver a diatribe against specialization, for I am well aware of its usefulness. I know that certain things must be dealt with by specialists simply because they require a specialized technique. The point I would make is that the person who holds fast to the material can never reach a view of the world that is applicable to life if he becomes a specialist in the ordinary sense. For the range of material processes is infinite, both outside in nature and within the human being.

For instance, we may devote a long time—as long, at any rate, as professional people devote to their training—to the study of the human nervous system. If material processes are all we see in the working of the nervous system, however—processes described according to the abstract concepts of modern science—we shall never be led to any universal principle upon which a world view can be based. As soon as you begin to look at the human nervous system, for example, from the viewpoint of spiritual science, you will find at once that this nervous system cannot be considered without your finding the spirit active there, which leads us inevitably to the soul-spiritual underlying the muscular, skeletal, and sensory systems, and so on. The spiritual does not separate into single parts as does the material. Characterized very briefly, the spiritual unfolds like an organism with its members. Just as I cannot truly study a human being if I look merely at his five fingers and cover the rest of him, so in spiritual science I cannot study a single detail without being led by perceiving the soul-spiritual within this detail to a whole. If I were to become a brain or nerve specialist, I would still be able, in observing this single member of the human organism, to form a picture of the human being as a whole—I would reach a universal principle in relation to a world view, and I could then begin to speak about the human being in a way comprehensible to every healthy-minded, reasonable human being.

This is the great difference between the way that spiritual science is able to speak about the human being and the way that specialized, materialistic science is bound by its very nature to speak. Take the simple case of a textbook in common use today that is based on such a specialized, materialistic science. If you do not know very much about the nervous system and try to read a textbook on the subject, you will probably lay it aside. If you do manage to get through it, you will not learn much that will help you to realize the worth and dignity of the human being. If, however, you listen to what can be said about the human nervous system on the basis of spiritual science, you will be led everywhere to the entire human being. Spiritual science so illuminates the entire human being that the idea arising within you suggests the worth, the essence, and the dignity of the human being.

The truth of this is nowhere more evident than when we observe not the healthy human being in his single parts but a person who is ill, where there are so many deviations from the so-called normal condition. When we are able to observe the whole human being under the influence of some disease, everything nature reveals to us in the sick person leads us deeply into cosmic connections. We are led to understand the particular constitution of this human being, how the atmospheric and extraterrestrial influences work upon him as the result of his particular constitution, and we are then able to relate his human organization to the particular substances of nature that will act as remedies. We are thereby led into wider connections. When we add to our understanding of the healthy person all that we are able to learn from observation of the sick person, a profound insight will arise into the interconnections and deeper significance of life. Such insight, however, becomes the foundation for a knowledge of the human being that can be shared with everyone. True, we have not as yet accomplished very much in this direction because spiritual science has only been able to be active for a short time. The lectures given here must therefore be thought of merely as a beginning.2Rudolf Steiner is referring here to a number of lectures given by various scientists during the medical course at the Goetheanum in Dornach. By its very nature, however, spiritual science is able to work upon and develop what is contained in the separate sciences in such a way that what everyone should know about the human being can be introduced to everyone.

Think what it will mean if spiritual science succeeds in transforming science in this way, succeeds in developing forms of knowledge about the human being in health and illness that are accessible to general human consciousness. If spiritual science succeeds in this, how different will be the relations of one human being to another in social life; what a greater understanding one person will have for another, far greater than there is today when people pass one another without the one having the slightest understanding for the particular individuality of the other. Social issues will be removed from intellectual considerations when the most diverse realms of life are based upon objective knowledge and concrete experiences of life. This is evident especially in the domain of health care. Think what a social effect it would have were there to be a real understanding of what is healthy in one person, what is unhealthy in another; think what it would mean if health care were taken in hand with understanding by the whole of humanity. Certainly this does not mean that we should encourage scientific or medical dilettantism—most emphatically not—but imagine that a sympathetic understanding of the health and illness of our fellow man were to awaken not merely feeling but understanding, an understanding that grows from a view of the human being—think of the effect it would have in social life. Then indeed it would be realized that social reform and reconstruction must proceed in their separate realms from expert knowledge, not from general theories—whether from Marx or Oppenheimer—which lose sight of the human being as such and want to organize the world on the basis of abstract concepts.3Karl Marx (1818-1883); Franz Oppenheimer (1864-1944), an economist. Healing can never spring from abstract concepts but only from a reverent awareness of the individual spheres of life. And hygiene, the care of health, is very special because it leads us most closely to the joy of our fellow man through his healthy, normal way of life, or to his sufferings and limitations through what lives in him more or less as illness.

This is something that directs us immediately to the particularly social way in which spiritual science can be active in the domain of hygiene or health care. For let us say that someone nurtures the knowledge of the human being in this way, the knowledge of the healthy and sick human being; if he now specializes to become a physician, and if such a person is placed within human society, he will be in a position to bring about enlightenment within this society, he will find understanding. The relationship of such a physician to society will not be merely the usual one in which, unless one is the doctor's friend or relative, one goes to the physician's house only when something hurts or has been broken; rather a relationship will develop in which the physician is continuously the teacher and advisor for a prophylactic health care. In fact, there will be a continual participation of the physician not only in treating an illness that he discovers in someone but in maintaining a person's health in so far as this is possible. A living social interaction will take place between the physician and the rest of society. In turn, medicine itself will be illuminated by the health of such a knowledge. Because materialism has extended itself even into medical considerations in life we have become truly entangled in some strange conceptions.

Thus on the one hand we have all the physical illnesses. They are investigated by observing the abnormalities of the organs or the various processes that are thought to be of a physical nature and are to be found within the boundaries of the human skin. Then the goal is to seek to rectify what is found to be wrong. In this case, the view of the human body in its normal and abnormal conditions is completely materialistic. Then, on the other hand, there are the so-called psychological or mental illnesses.' As a result of materialistic thinking, these are considered to be merely diseases of the brain or nervous system, although efforts have also been made to find their causes in the organ systems of the human being. Because there is generally no conception of the way in which the soul and spirit work in the healthy human body, however, it is impossible to arrive at a conception of the relationship of mental illness—so-called men-tal illness—to the rest of the human being. Thus mental illness is even thought about materialistically by that curious hermaphroditic science, psychoanalysis, though it definitely does not understand the material either. Mental illness stands there without our being able to bring it together in any meaningful way with what actually takes place in the human organism. Spiritual science is now able to show—and I have recently drawn attention to this—that what I have been speaking about here is not merely a program but is something that can be pursued in detail, as has been attempted during the opportunities offered here in the recent course for physicians.4Rudolf Steiner, Spiritual Science and Medicine, 20 lectures given in Dornach, 1920, Rudolf Steiner Press, London, 1975. Spiritual science is able to show in detail how all so-called psychological and mental illnesses have their source in disturbances of the organs, in organ deterioration, in enlargement and shrinking of the organs in the human organism. A so-called mental illness arises sooner or later whenever there is some irregularity in an organ, in the heart, in the liver, in the lungs, and so on. A spiritual science that has penetrated to the point of knowing the spirit's activity in the normal heart is also able to discover in the deterioration or irregularity of the heart the cause of a diseased life of spirit or soul, called mental illness today.

The greatest fault of materialism is not that it denies the existence of the spirit; religion can see to it that due recognition is given to the spirit. The greatest error of materialism is that it provides us with no knowledge of matter itself, because, in effect, it considers only the outer side of matter. It is just this that is the defect of materialism, that it lacks insight even into matter. Take, for example, psychoanalytical treatments where attention is merely directed to something that has taken place in the soul and is described as a "complex,"" which is a pure abstraction. A more appropriate way to pursue this would be to study how certain soul impressions, which were made on a person at some period of his life and are normally bound up with the healthy organism, have come into contact with defective organs, e.g., with a diseased rather than a healthy liver. It must be considered that this may have happened long before the moment when the defect becomes organically perceptible.

There is no need for spiritual science to be afraid of showing how so-called psychological or mental illness is invariably connected with something occurring in the human body. Spiritual science must show emphatically that when merely the soul element, the soul "complex""—a deviation from the so-called normal soul life—is studied, the most that can be achieved is a one-sided diagnosis. Psychoanalysis, therefore, can never lead to anything more than something diagnostic, never to a real therapy in this domain. In mental illness, therapy must proceed by administering therapy for the body, and for this reason there must be detailed knowledge of the ramifications of the spiritual in the material. We must know where to take hold of the material body (which is, however, permeated with spirit) in order to cure the disease of which abnormal conditions of soul are simply symptoms. Spiritual science must emphasize again and again that the root of so-called mental or psychological illnesses lies in the organ systems of the human being, but it is possible to understand abnormal organ function of the human being only when the spirit can be pursued into the minutest parts of matter.

Looked at from the other side, all those phenomena of life that seemingly affect merely the soul or work in the soul element—for instance, all that is expressed in the different temperaments and the activity of the temperaments in the human being, what is expressed in the way the child behaves, plays, walks—all this is studied today only from a soul-spiritual point of view, but it also has its bodily aspect. Faulty education of the child may come to expression in later life in some familiar form of physical illness. In certain cases of mental illness, we must often look to the bodily element and look for the cause there; however, in certain cases of physical illness, we must look to the spiritual in order to find the cause. The essence of spiritual science is that it does not speak in abstractions about a nebulous spiritual aspect as do mystics or one-sided theosophists; rather it traces the spirit right down into its material workings. Spiritual science never conceives of the material as modern science does today, but it always penetrates to the spirit in all study of the material. Thus it is able to observe that an abnormal soul life must inevitably express itself in an abnormal bodily life, although the abnormality may, to begin with, be hidden from outer observation.

On all sides today, people form entirely false pictures of a serious, anthroposophically oriented spiritual science. This may have a certain justification when they listen to people speak who do not truly penetrate to what is actually important but speak only of abstract theories such as that the human being consists of such and such, that there are repeated earthly lives, and so forth. These things are, of course, full of significance and beauty; but the point is that we must work earnestly in this spiritual scientific movement, truly entering into a particular subject, into the individual spheres of this life.

In the widest sense, such a spiritual scientific movement leads again to a socially minded community of human beings, for when one is able to perceive how a soul that appears sick radiates its impulses into the organism, when one can really feel this connection between the organism and the soul that appears to be ill—feels this with understanding—and when on the other hand one knows how the general ordering of life affects the physical health of the human being, how the spiritual, which apparently exists in social arrangements only outwardly, works into the physical care of health of the human being, then one will stand in a completely different way within human society.

A true understanding of the human being will be gained, and we will treat each other quite differently. Individual character will be understood quite differently, knowing that one person possesses certain qualities and another possesses quite different ones. We will learn how to respond to all variations, to see them in relation to particular tasks; it will be known how to make use of the different temperaments in human society in the right way and particularly how to develop them in the right way.

In relation to health care or hygiene, one domain of social life in particular—that of education—will be most strongly influenced by such a knowledge of the human being. We cannot, without a comprehensive knowledge of the human being, evaluate the consequences of allowing our children to sit in school with bent backs so that they never breathe properly, or the repercussions of never teaching children to speak the vowel or consonant sounds loudly, clearly, and in a well-articulated way. As a matter of fact, the whole of later life depends on whether the child in school breathes in the right way and whether he is taught to speak clearly and with good articulation. I say this merely by way of example, for the same thing applies in other realms. It is an illustration, however, of the specific application of general hygienic principles in the sphere of education. The whole social significance of hygiene is revealed in this example.

It is also apparent that, rather than further specialization, life demands that the specialized branches of knowledge be brought together to form a comprehensive view of life. We need something more than educational norms according to which the teacher is supposed to instruct the child. The teacher must realize what it means for him to help the child to speak clearly and articulately. He must realize what it will mean if he allows the child to catch his breath after only half a phrase has been spoken and does not see to it that all the air is used up in the phrase being uttered. There are, of course, many such principles. A proper appreciation and practice of them, however, will live in us only when we are able to measure their full significance for human life and social health; only then will they give rise to a social impulse.

We need teachers who are able to educate children on the basis of a world view that understands the true being of man. This was the thought underlying the course I gave to the teachers when the Waldorf School in Stuttgart was founded.5Rudolf Steiner, The Study of Man, lectures given at the founding of the Waldorf School in Stuttgart, 1919; Rudolf Steiner Press, London, reprinted 1981. All the principles of the art of education that were expressed in that course strive in the direction of making human beings out of the children who are being educated, human beings in whom lungs, liver, heart, and stomach will be healthy in later life because as children they were helped to develop their life functions in the right way, because, in effect, the soul worked in the right way.

This world view will never give a materialistic interpretation to the ancient saying, "A healthy soul lives in a healthy body"" (Mens sana in corpore sano). Interpreted materialistically, this means that if the body is healthy, if it has been made healthy by every possible physical method, then it will, of itself, be the bearer of a healthy soul. This is pure nonsense. The only true meaning is that a healthy body shows me that the force of a healthy soul has built it up, has molded it and made it healthy. A healthy body proves that an autonomous, healthy soul has worked in it. This is the true meaning of this saying, and only in this sense can it be an underlying principle of true hygiene. In other words, it is quite inadequate to have, in addition to teachers who are working from an abstract science of education, a school doctor who turns up every fortnight or so and goes through the school with no real idea of how to help. What we need is a living alliance between medical science and the art of education. We need an art of education that teaches the children in a way conducive to real health. This is what makes hygiene or health care a social issue, because a social issue is essentially an educational issue, and this, in turn, is essentially a medical issue, but only if medicine, hygiene, are fructified by spiritual science.

These matters are extraordinarily significant in relation to the theme of hygiene or health care as a social issue. For if one works with spiritual science and if spiritual science is something concrete for the human being, then one knows that contained within spiritual science is something that distinguishes it from what is contained in mere intellectualism—and natural science in the present is also mere intellectualism—from what is contained in mere intellectualism or in a merely intellectually developed natural science or in a merely intellectually developed history or jurisprudence today. All the sciences today are intellectualistic; if they claim to be experiential sciences, this is based only on the fact that they interpret intellectually their experiences based on sense observation. What is offered in spiritual science is essentially different from these intellectually interpreted results of natural science; it would be most unfortunate if what lives in our intellectualistic culture were not merely a picture but a real power that worked more deeply on the human being. Everything intellectualistic remains only on the surface of the human being. This sentence is to be taken very comprehensively.

There are people who study spiritual science only intellectually, who make notes: there is a physical body, etheric body, astral body, ego, reincarnation, karma, and so forth. They make notes of it all, as is the custom in modern natural or social science, but they are not sincerely devoting themselves to spiritual science when they cultivate this way of thinking. They are simply carrying over their ordinary way of thinking into what they encounter in spiritual science. What is essential about spiritual science is that it must be thought in a different way, felt in a different way, must be experienced not in an intellectual way but quite differently. It is for this reason that by its very nature spiritual science has a living relationship to the human being in health and illness, but a relationship altogether different from what is often imagined.

By now, some people must be sufficiently convinced of the impotence of our purely intellectual culture in dealing with those suffering from so-called mental illnesses. One who suffers from such an illness may say to you, for example, that he hears voices speaking to him. No matter what intellectual reasoning you use with him, it proves useless, for he makes all kinds of objections, you may be sure of that. Even this might indicate that one is dealing here with an illness not of the conscious or unconscious soul life but of the organism.

Spiritual science teaches, moreover, that one cannot come to grips with these so-called psychological and mental illnesses by means of the kinds of methods that take recourse to hypnotism, suggestion, and the like; one must rather approach mental illness by physical means, which means by healing the organs of the human being. This is exactly where a spiritual knowledge of the human being is essential. Spiritual knowledge knows that so-called mental illnesses cannot be affected by soul or spiritual procedures, because mental illness consists precisely of the fact that the spiritual member of the human being has been pressed out, as it were, as is normally the case only in sleep. As a consequence, the spiritual member grows weak, and we must cure the bodily organs so that the soul and spirit may be taken up again in a healthy way.

When, as a result of spiritual scientific work, Imagination, Inspiration, and Intuition arise, they are able to penetrate into the whole organism, as they proceed not from the intellect or the head alone but from the entire human being.6See chapter five in Rudolf Steiner's An Outline of Occult Science, Anthroposophic Press, Spring Valley, N.Y., reprinted 1984. Through real spiritual science, the physical organization of the human being may be permeated with health. The fact that there are dreamers who feel ill or show signs of the opposite of health in their spiritual scientific activities is no proof to the contrary. There are so many who are not really spiritual scientists at all but who simply amass intellectually vast collections of notes about the results of spiritual science. Spreading the real substance of spiritual science is in itself a social hygiene, for it works upon the whole human being and regulates his organic functions when they develop extreme tendencies in one direction or another, either toward dreaminess or the reverse. Here we have the overwhelming difference between what is given in spiritual science and what appears in merely intellectual science. The concepts arising in the domain of intellectualism are far too weak to penetrate the human being and to work healthily upon him, because they are merely analogies. Spiritual scientific concepts, on the other hand, have been drawn from the entire human being. Lungs, liver, heart, the entire human being and not the brain alone have participated in building up spiritual scientific concepts, and what they have derived from the strength of the entire human being adheres to them, penetrates them, as it were, in a sculptural way. If one then permeates oneself with such concepts, if one receives them cognitively through the sound human intellect, they work back again onto the entire human being in a hygienic, health-engendering way. This is how spiritual science can penetrate and give direction to hygiene, health care, as a social concern.

In many other ways too—now I can only offer an example—spiritual science will be able to lay down guidelines for the life of humanity in the domain of health, if it gains a firm footing in the world. Here let me give just one brief indication. The relationship of the waking human being to the sleeping human being, the great difference between the human organization in waking and sleeping, is one of the subjects that spiritual science must study again and again. How the spirit and soul act in waking life, when they permeate each other in the bodily, soul, and spiritual aspects of the human being, how they act when they are temporarily separated from each other in sleep—all these things are studied conscientiously by spiritual science. Here I can do not more than refer to a certain principle that is a well-founded result of spiritual scientific investigation.

In our life we occasionally see so-called epidemic illnesses that affect whole masses of the population and are therefore essentially a social concern. Ordinary materialistic science studies these illnesses by examining the physical organism of the human being. It knows nothing of the tremendous significance that the abnormal attitude of the human being to waking and sleeping has for epidemics and the susceptibility to epidemic illnesses. What takes place in the organism during sleep is something that, if it becomes excessive, predisposes the human being to so-called epidemic illnesses. There are people who, as the result of too much sleep, initiate certain processes in the human organism, processes that ought not be set in motion because waking life should not be broken up by such long periods of sleep. These people have a much stronger predisposition to epidemic illnesses and are less able to resist them.

You yourselves can assess what it would entail to explain to people the proper proportion of sleeping to waking. Such things cannot be dictated. You can, of course, tell people that they must not send children with scarlatina to school, but you cannot possibly dictate to people in the same way that they must get seven hours of sleep. And yet this is much more important than any other prescription. People who need it should have seven hours of sleep, and others for whom this is not necessary should sleep much less, and so on.

These matters, which are so intimately connected with the personal life of human beings, have a tremendous effect upon social life. How these social effects come about, whether a larger or smaller number of people are obliged, owing to illness, to be absent from their work, whether or not a whole region is affected: all these things depend upon the most intimate details of man's life. Here hygiene plays an immeasurably important part in social life. Regardless of what people may think about infection or non-infection, with epidemics this element really plays a part in social life. Here external regulations are of no avail; the only thing you can do is to educate people within society so that they are able to understand the physicians who are trying to explain prophylactic measures. This can give rise to an active cooperation in the maintenance of health between the physician who understands his profession and the layman who understands the nature of the human being.

I have described here an aspect of hygiene or health care as a social issue that is utterly dependent on a free spiritual life. We must have a spiritual life in which within the spiritual realm there are those engaged in nurturing this spiritual life, even in so far as it extends into the various practical domains such as hygiene; they must be completely independent of everything that does not yield pure knowledge, that does not bring about the nurture of the spiritual life. What the individual can achieve for the greatest benefit of his fellow man must grow entirely out of his own capacities. There should be neither governmental norms nor a dependence on economic powers. The individual's achievements must be placed entirely in the sphere of the intimate, personal connections that only exist between individuals, in the trust, based on understanding, that those who require the services of a capable person can bring to that person. There, a spiritual life is needed—independent of all authority, governmental or economic—which is active in a manner that arises purely out of spiritual forces. If you consider what can bring about a hygiene intimately united with insight into human nature and social behavior, you will also recognize that the spirit obviously must be managed by those who nurture it; not the specialists active as experts in governmental agencies but rather those active in spiritual life must be the sole managers of this spiritual life. This becomes especially clear if one goes into the individual branches of activity, such as hygiene, with real experience, as is required by the separate, concrete realms "“ and this could be shown to hold good in other realms as it does for hygiene. When hygiene or health care exists as a real social institution, based on social insight arising from the free spiritual life, then the economic aspects of such a hygiene can be handled in a totally different way, especially if the independent economic life is constituted as I have described in my book The Threefold Social Order.7Rudolf Steiner, The Threefold Social Order, Anthroposophic Press, Spring Valley, N.Y.

If the forces for the nurture of hygiene or health care that are latent in society, resting in its womb, as it were, are taken up with human understanding, if they result in social institutions, then out of the independent economic life, without consideration of dependence on profit or governmental impulses, can emerge what is necessary to support a genuine hygiene. Only then will the kind of idealism enter economic life that is necessary for the nurture of hygiene in human life. If the mere profit motive prevails in our economic sphere, it always has the tendency to become increasingly incorporated into the political state, and the generally accepted opinion is that one must produce what yields the most profit. If this idea continues to prevail, then the independent impulses of a free spiritual life cannot manifest in the domain of hygiene or health care, and spiritual life will then become dependent on political or economic forces; then the economic will govern the spiritual, but the economic must not prevail over the spiritual. This fact is most evident to one who wants to arrive at what the spirit demands in the economic life, to one who wants to serve a genuine and true hygiene.

The forces of the free spiritual life in the threefold social organism arrive at the insight which becomes a matter of public concern; an understanding of the human being becomes a public concern in the threefold social organism. The human being must stand within a free spiritual life in order that a firmly grounded hygiene can be nurtured. On the other hand, people must develop the idealism through which the products of the economic life are met with an understanding that results not merely from a sense for profit but out of insights emerging from the free spiritual management of hygiene or health care. Once this insightful, social human understanding has arisen, this human idealism, there will emerge a willingness to work economically simply because the social situation of humanity requires hygienic service. If these requirements are met, people will be able to meet democratically in parliaments or other such gatherings. For then, out of a free spiritual life, the recognition emerges of the necessity for hygiene as a social phenomenon; attention to what is necessary for hygiene as a social issue emerges from an impartial and professionally managed economic life through the high intentions that would be developed within it. Then mature human beings will deliberate on the ground of the economic life out of their insight and understanding of the human being as well as out of their relations to an economic life at the service of hygiene. Then people will be able to meet as equals within the legislative, rights, or economic life concerning the measures that are necessary regarding hygiene and the care of public health.

Were all this to come about, however, laymen or dilettantes would not do the healing; rather, the mature person will encounter as an equal and with understanding whoever advises him on matters of hygiene, namely, the experienced physician. For the layman, the understanding of the human being that is nurtured in social life, with the help of the physician, makes it possible to meet expert knowledge equipped with understanding, so that in a democratic parliament the layman is able to say "yea"" with a certain understanding and not merely out of pressure from authority.

When we consider impartially how the spiritual, legislative, and economic members of the social organism work together in such a special domain, we discover the complete justification of the idea of the threefold nature of the social organism. This idea is met with disapproval only when it is understood merely abstractly.

Today I was able to give you no more than a sketchy indication of what speaks for the necessity of the threefolding of the social organism if one thinks correctly about a particular, concrete domain such as hygiene. If those paths are followed, toward which I have only been able to point today in their beginnings, one will see that whoever meets the impulse of the threefold social organism with abstract concepts will work against it in a certain way. Such a person will generally bring up the obvious objections. Whoever enters the various domains of life with a full inner understanding, however, entering into the individual realms that matter so much in social life, whoever truly understands something in a concrete realm of life and takes the trouble to understand something about true practical life in any domain, will be led again and again in the direction that has been suggested by the idea of threefolding the social organism.

This idea did not arise out of a dreamy or abstract idealism; it arose as a social demand of our time and of the near future, especially out of the concrete and sober observation of the individual domains of life. By penetrating these individual domains of life with what is active out of the impulse for threefolding the social organism, one will find for all these domains just what they so desperately need today. This evening I only wished to give a few indications concerning how what emerges out of spiritual science regarding the social life can penetrate human society as a social concern, arising out of a socially nurtured understanding of the human being. Striving for a realization of the threefold social organism can fructify what can be accepted today only on the basis of belief in authority, through a completely blind subjection. Through the enrichment that hygiene or health care can receive from a medicine fructified by spiritual science, it can become a social, a truly social concern. It can become a democratically nurtured, common public concern in the truest sense.

In the discussion following the lecture, Rudolf Steiner added the following comments in response to prepared questions.

In matters such as I have discussed today, it is essential that one be able to enter into the whole spirit of what has been expressed. For this reason, it is difficult at times to give appropriate answers, for the questions have already been formulated in such a way that they bear the stamp of contemporary thinking and attitudes. Before answering such questions, it may first be necessary to reformulate them or at least to provide some sort of appropriate explanation. Having said this, I will begin at once with the question that may appear to many of you to be so exceedingly simple that it ought to be able to be answered with a few sentences or even with one sentence:

"How can a person rid himself of the habit of sleeping too long?"

In order to answer this question appropriately, it would be necessary for me to give an even longer lecture than I have already given, because I would first have to bring various elements together. It is possible to say the following, however. The intellectual attitude of soul is almost universal in humanity today. It is particularly those who believe they are judging or living out of feeling or who believe, for one reason or another, that they are not intellectual who are most subject to the intellectual attitude of soul. The fundamental character of the intellectual soul and organ life is that through it our instincts are destroyed. The correct instincts of the human being are destroyed. It is actually so that one must point to primeval humanity, or even to the animal kingdom, to discover instincts that are not yet entirely destroyed. On another occasion a few days ago, I pointed to a very telling example. There are birds who, out of greed, feed on certain insects, for instance spiders. After consuming these spiders, which are poisonous to them, the birds get convulsions, seizures, and die a miserable, agonizing death soon after swallowing the spider. If henbane is in the vicinity, however, the bird flies there, sucks the healing sap from the plant, and thus saves its own life.

Now, just think how there we see developed something that in the human being is shriveled down to the few reflex instincts such as the movements we make without any deep deliberation to encourage the departure of a fly that has alighted on our nose. A defensive instinct arises in response to this insulting stimulus. In the bird feeding on the spider, the consequence of the effect the spider has in the bird's organism is a defensive instinct to this insult, driving it to do something very reasonable. We would still be able to find such instincts among ancient populations if only we interpreted history properly. In our time, however, we have different experiences.

It has always been exceedingly painful to me, accustomed as I am to seeing a fork, knife, and spoon next to a plate, to see instead a scale next to the plate of someone sitting down to eat. This really happens! Such a person weighs the piece of meat and only then knows how much meat he should eat for his particular organism. Just think how bare of all truly original instincts humanity has become to require such a measure! The important thing, then, is that one not remain stationary within intellectualism but rise instead to a spiritual scientific way of knowing. You will now believe that I am speaking pro domo, even if also pro domo of this great house, but I am not speaking pro domo. I am really speaking about what I believe to have recognized as the truth, quite apart from the fact that I myself represent this truth. It can readily be seen that if one penetrates not only into what is intellectual but into what needs to be grasped by way of spiritual science and which therefore confronts humanity more in a pictorial sense, it becomes noticeable that by taking hold of knowledge not accessible to the mere intellect one is again led back to healthy instincts, if not in a single life then perhaps -more so in those matters that lie in the underpinnings of life. Whoever concerns himself, be it ever so briefly, with developing this completely different soul attitude, which must be developed if one really wants to understand something of spiritual science, will again be led back to healthy instincts in matters such as the proper requirement for sleep. Animals do not sleep too much under normal conditions, and primeval man did not sleep too much either. It is only necessary to educate oneself again to have healthy instincts, which were lost by virtue of the intellectual culture prevalent today. It can be said that a truly effective means of ridding oneself of the habit of sleeping too long is to be able to take up spiritual scientific truths without falling asleep as a result. If a person falls asleep at once upon hearing spiritual scientific truths, then he will be unable to rid himself of the habit of sleeping too long. If one succeeds, however, in being truly present inwardly while working through spiritual scientific truths, then this inner human aspect will be activated in such a way that one can actually discover the exactly appropriate time needed for sleep for one's own organism.

Again, it is exceedingly difficult to give intellectual rules prescribing the amount of sleep an individual person requires who is suffering, let us say, from a kidney or liver disorder that has not made him ill in the ordinary sense. As a rule, such a prescription would not lead to anything of consequence. To induce sleep in an artificial way is not the same as when the body, out of its own need for sleep, refuses the entry of the spirit only for as long as is necessary. It can thus be said that a proper hygiene emerging out of spiritual science will also bring the human being to the point at which he can determine in the right way the proper amount of sleep for his own organism.

The other question that was posed here also cannot be answered so simply: "How can a person know how much sleep he needs?"

I would like to say that it is not at all necessary to reach the answer through discursive thinking; that is not necessary at all. It is necessary to acquire those instincts that can be acquired not by receiving collections of notes out of spiritual science but by the way in which one understands spiritual science if it is understood with full inner participation. Once this instinct is achieved, a person is able to discern in an individual way how much sleep is appropriate for him. This is what can be said as a rule in response to such a question. As I said, I can give only a kind of direction for how questions like this can be answered; this may not be what is expected, but what is expected is not always what is right.

"Is it healthy to sleep in a room with the window open?"

Such a question, too, cannot actually be answered in general terms. It is certainly conceivable that for one person, sleeping in a room with an open window is very healthy, depending on the particular construction of his respiratory organs; for another person, however, it might be better to air out the room before sleeping and then close the windows while sleeping. What is necessary, in fact, is to gain an understanding of the relationship the human being has to his environment in order then to be able to make a judgment in each individual case in accordance with this understanding.

"How, from a spiritual scientific point of view, do you explain the development of mental disturbances associated with crimes that are committed, that is, how, in such a situation, can one recognize the bodily illness which lies at the foundation of the mental disturbance?"

If one were to try to deal with this question thoroughly, it would really be necessary to enter into a discussion of all criminal and psychiatric anthropology. I would simply like to say the following: first, in considering such matters, one must presuppose that the organic predisposition of someone who becomes a criminal is abnormal right from the outset. In this direction, you need only follow up the relevant studies by Moriz Benedikt "“ the first really significant criminal anthropologist8Moriz Benedikt (1835-1920), professor of neuropathology at the University of Vienna; founder of criminal anthropology. "“ and you will see how in fact the pathological investigation of the forms of single human organs can be brought into connection with this predisposition to criminality. There you already have an inherent abnormality, although materialistic thinkers, such as Moriz Benedikt, naturally draw the wrong conclusions from their findings, because it is certainly not an absolute requirement that whoever shows signs in this direction is inevitably a born criminal. What is important is that one is definitely able to work on the defects within the organism "“ I mean the organ defects, not the already existing mental illness, but the organ defects "“ and to have an effect especially through education and later through the appropriate spiritual element, if only the state of affairs is studied from a spiritual scientific point of view. Therefore the conclusions arrived at by Benedikt are not correct. Such organ defects can already be discovered, however.

Then one must also be clear about the fact that there are also non-intellectual elements in ordinary human life, more in the realm of feelings or emotions, which set off reactions. These work first on the glandular activity, the secretory activity, but from there they have an influence on the other organs. In connection with this issue, I would advise you to read an interesting little book concerning the mechanics of emotions that has been put out by a Danish physician.9Carl Georg Lange (1834-1900), professor of pathology in Copenhagen. There you can read much that is of value for the topic under consideration. Take the bodily predisposition that can be traced in everyone who truly comes into consideration as a criminal; add to that everything that has had consequences for the apprehended criminal, consisting of emotional disturbances and the continuation of these emotional disturbances into the organs; then you have the path by which to seek for those defective organs which as a consequence bring forth mental illness, specifically the mental illness associated with committing a crime. In this way, we must attempt to obtain a clear idea about such connections.

"What is the relationship of theosophy to anthroposophy? Is the theosophy which was presented here previously no longer fully recognized?"

I would simply like to say that nothing has ever been presented here other than an anthroposophically oriented spiritual science, and what has been presented here today has always been presented in this way. The common identification of our presentations with so-called theosophy is simply based on a misunderstanding. This will remain a misunderstanding because, within certain limits, anthroposophically oriented spiritual science moved for a time within the framework of the Theosophical Society; even in the framework of that society, however, the representatives of an anthroposophically oriented spiritual science never presented anything other than what is presented here today. This was tolerated in the Theosophical Society only so long as matters didn't look too heretical. The anthroposophists were thrown out, however, as soon as it was noticed that anthroposophy was something completely different from the abstract mysticism manifested so often in theosophy. This expulsion was undertaken by the other side, but what is presented here never had any other form than it has today. Of course, those who concern themselves with matters superficially and who listen only to those who haven't gotten beyond a superficial comprehension as members of the Anthroposophical Society "“ for one needn't always be outside in order to understand anthroposophy superficially or to confuse anthroposophy with theosophy; one can also be in the Society "“ those who therefore achieve only a superficial knowledge of what is going on get confused about the issues. What I have characterized here today regarding a particular area has never been presented here in any other way.

Of course there is continuous work, and certain things may be said today in a much more precise, thorough, and intensive way than was possible fifteen, ten, or even five years ago. This is just the nature of working, that one progresses in the formulation of making oneself understood in such difficult matters as spiritual science. It is really unnecessary to engage in any discussion with those who, out of ill will, attribute to us all kinds of changes of world view because of a more recent, more complete expression of something said incompletely on an earlier occasion. Discussions with such ill-willed persons are really a waste of time, because spiritual science, as it is meant here, is something living and not something dead. And whoever believes that it cannot progress and wants to nail it down where it is and where it once was, as happens so often, does not believe in what is living; he would prefer to make it into something dead.

"Would you please say something about the origin of an epidemic such as influenza or scarlet fever? How does it come about if not by the spreading of bacteria? In many illnesses the causative agent has been scientifically determined. What is your position in relation to this issue?"

If I were also to deal with this question concerning which I have indicated that I do not wish to take sides, I would have to give another entire lecture. Nevertheless, I would like to direct your attention to the following: a person may be impelled, in accordance with his knowledge, to direct attention to the fact that for illnesses accompanied by the occurrence of bacilli or bacteria, there are deeper causes "“ acting as primary causes "“ than the mere occurrence of bacteria; such a person does not assert that bacteria don't exist. It is one thing to assert that bac-teria exist and that they increase during the course of an illness; it is quite another to seek the primary cause of the illness in the bacteria. What needs to be said regarding this I have developed in great detail in the course that is being held here now [4], but it takes time to deal with the issues properly. This also applies to certain elements that must be considered before this question can be dealt with, and this cannot be done so quickly in a question-and-answer period such as this. Nevertheless, I will point out the following, the human constitution is not such a simple matter as one often imagines. The human being is a multi-membered being. Right at the beginning of my book, Riddles of the Soul,10Rudolf Steiner, Von Seelenrätseln, 1917; excerpts of this are published in English under the title, The Case for Anthroposophy, Rudolf Steiner Press London, 1970. I stated that man is a threefold being. First there is what can be called the nerve-sense man, then the rhythmic man, and thirdly the metabolic man. This is the human being. These three members of human nature work into one another and may not, if the human being is to be healthy, interact with one another without in a certain way maintaining a separation of the different realms. For example, the nerve-sense man, which is far more than contemporary physiology imagines it to be, may not extend its influence without consequences on the metabolic man, unless its effects are mediated by the rhythmic movements of the circulatory and respiratory processes which, as is well known, extend into the outermost periphery of the organism. This working together, however, can be interrupted in a certain way. This working together is brought about by something very specific. (When such questions are posed "“ if you will pardon me "“ one must also answer in accordance with the facts; I will attempt to be as decent as possible, but it is nevertheless necessary to say a few words that must also be listened to as related to the facts.) It is so, for example, that in the lower man processes occur that are incorporated into the entire organism. If they are incorporated into the entire organism, then they will work in the right way; if, however, they are heightened by various processes, either directly in the lower body, so that they become more active, or through the corresponding processes, which are always there in the human head or in the human lung being diminished in their intensity, then something very curious takes place. Then it becomes evident that, in order to have a normal life, the human organism must develop processes that may develop to the extent that they are integrated into the entire human being. If a process is heightened excessively, however, then it becomes localized; a process arises, for example, in the lower body of the human being, through which there is an improper separation of what goes on in the head or lung, which corresponds to certain processes in the lower body. Processes always correspond to one another in such a way that they proceed parallel to one another; thereby what ought to be present in the human being only to a certain extent, whereby he maintains his vitality, the soul- and spirit-bearing vitality, is brought beyond a certain level. This then encourages an atmosphere, as it were, in which all kinds of lower organisms, all kinds of tiny organisms, can develop. The nurturing element for these small organisms is always present within the human being, only it is spread out over the whole organism. If it becomes concentrated, it provides the life soil for small organisms, for microbes. The reason they can thrive there, however, must be sought in the exceedingly fine processes in the organism which then prove to be the primary cause.

I am really not speaking out of an antipathy for the bacillary theory. I certainly understand the reasons people have for believing in the bacillary theory. You must believe that if I did not have to speak this way because of the facts I could well recognize these reasons. Here, however, we have a knowledge that necessarily leads to the recognition of something else which impels one to speak in the following way: I see a certain landscape in which there are many exceedingly beautiful and well cared-for cattle. I now ask, why are there favorable conditions in that area? They come from the beautiful cattle, I determine. I explain the conditions of life in this area by explaining that beautiful cattle have moved in from somewhere and then spread over the landscape. "“ Don't you agree that such an explanation does not correspond with the facts? Instead, I must look for the primary causes: the diligence, the understanding of the people in that area, and they will explain to me why such beautiful cattle develop on this soil. I would give quite a superficial explanation if I were to say: here it is beautiful, a nice place to live, because beautiful cattle have moved in. The same logic is applied when I find a typhus bacillus and then claim that a patient has typhus because typhus bacilli have moved in. To explain typhus, entirely different factors are necessary than merely to draw attention to the typhus bacillus. In submitting to such erroneous logic one is led astray in many other ways. The primary processes that provide typhus bacillus with the foundation for its existence certainly bring about all kinds of other problems that are not primary. And it is very easy to confound completely or even interchange what is secondary with the actual original form of illness. This is as much as I can say now that could lead to a proper perspective on these issues and show what must be done in order to put in its proper place what is justifiable within limits.

Maybe you can see, nevertheless, from the way in which I have given this answer "“ even if I have done so only sketchily and could easily be misunderstood "“ that I am not at all concerned here with the popular hollering about the bacillary theory; we are interested rather in studying these matters very seriously.

"Please give us a few examples of how bodily organic disturbances bring about soul-spiritual illnesses."

This question would naturally, if it were answered thoroughly, lead much too far, but here, too, I will point out just a few things. You see, in the historical development of medical thinking it is not, as is presented today, that the healing art began with Hippocrates and then developed further. So far as can be traced, very curious things are found in Hippocrates' writings, and rather than the mere beginnings of contemporary intellectual medicine we have in Hippocrates remnants of an ancient, instinctual kind of medicine.

In addition, we find something else, however. In this ancient, instinctual medicine, as long as it was still valid, one did not speak of psychological depressions of a certain kind, which is indeed a very abstract kind of expression; rather one spoke of hypochondria, i.e., cartilage in the lower body. It was known, therefore, that when hypochondria occurred, one was dealing with disturbances in the lower body, with a hardening in the lower body. One cannot say that the ancients were more materialistic than we are.

Similarly, it can very easily be shown that certain chronic lung defects are definitely connected with what could be called a false mystical sense of the human being. And so one could point to all kinds of things completely apart from what the ancients suggested for the organic realm with the temperaments, again all corresponding to a proper instinct. For them, the choleric temperament originated out of the white gall; the melancholic temperament arose out of the black gall and whatever the black gall brings about in the lower body; the sanguine temperament arose out of the blood; and the phlegmatic temperament arose out of the phlegm, what they called phlegm. When they saw deviations of the temperaments, these suggested deviations in the corresponding organic aspects. How this was regarded in the instinctual medicine and hygiene may again become part and parcel of a soul attitude in a strictly scientific way and can be supported from the standpoint of our contemporary knowledge.

Here is another question concerning which great misunderstandings can arise: "Do you know about iris diagnosis? Do you acknowledge it as a valid science?"

It is generally correct that in an organism, and especially in the complicated human organism, conclusions regarding the whole can be arrived at out of all kinds of details, if these details are looked at in the right way. Furthermore the role that the isolated part plays in the human organism is very significant. What the iris diagnostician investigates in the iris is on the one hand very isolated from the rest of the human organism; on the other hand, it is inserted into the rest of the organism in a remarkable way so that it is actually a very expressive organ. Especially in such matters, however, one ought not to schematize, and the error in such matters often lies in the fact that a schema is made. It is definitely so, for example, that people with different soul and bodily constitutions show different signs in the iris from other people. A prerequisite, then, for a meaningful application of this technique would be such an intimate knowledge of what happens in the human organism that whoever had this knowledge actually would no longer need to look into a single organ. To be dependent on an intellectual adherence to certain rules and schemas is of little, if any, value.

"What relation do diseases have to the course of world history, especially those that have arisen more recently?"

A whole chapter of cultural history! Well, I will only comment on the following: in order to study history one must have a sense for what can be called symptomatology; that is, much of what is taken today as history can be considered only a symptom for what lies much deeper, that is, the spiritual stream carrying these symptoms. Thus what resides in the depths of the development of humanity is also symptomatic or comes to expression in this or that disease of an era. It is interesting to study the relationships between what works in the depths of the evolution of humanity and what takes its course in the symptoms of this or that disease. The existence of certain diseases may point to impulses in historical development that could elude a symptomatology not applying such a method.

This question, however, could lead to something else, which is "˜also not unessential when one pursues the history of humanity. Diseases, regardless of whether they occur in a single person or in a society by way of an epidemic, are in many instances also reactions to other excesses. From the point of view of public health, these other excesses may be taken as much less serious; from a moral or spiritual point of view, however, they are nevertheless considered to be very serious. But you must not apply what I just said to the question of healing or hygiene, for that would be very wrong. Diseases must be healed. In hygiene, it is important to be active in furthering or helping the human being. One may not say, "I will first see whether it may be your karma to have this illness. If so, I must let you have this illness; if not, then I can cure it." This way of looking at the issue is not valid if one is concerned with healing. What may not be valid regarding our intervention in the case of helping another human being, however, may nevertheless be objectively valid in the world outside. And there it must be said that much of what develops as a disposition to moral excesses engraves itself so deeply into the organization of the human being that reactions then appear in certain diseases and that the disease is the suppression of a moral excess.

In the individual person it is not of much significance to pursue these things, because the individual ought to be allowed to go through his individual destiny, and one really ought not to meddle in this, just as one doesn't meddle with the personal mail of other persons, unless, from the viewpoint that is so close at hand, it is "opened by government decree in times of war." Just as little as one ought to snoop into other people's personal mail, so little ought one to meddle with another person's individual karma. With the history of the world it is a different matter, however; there one ought to be concerned, because there the individual human being plays, you could say, only a statistical role. One must always point out that statistics are very helpful in letting life insurance companies know what the mortality rate is according to which they can determine their rates. These things are quite accurate. The calculations are correct and everything is very scientific. But one needn't simply die at the moment that has been specified by statistics; one also needn't live as long as has been calculated. Other issues arise when the individual human being comes into consideration. If groups of human beings, or even the whole historical development, come into consideration, however, it can be very helpful not to be superstitious but rather to be very scientific. If one studies to what extent symptoms of an illness occur that are corrective for other excesses, then one can, in fact, already look for certain repercussions of the illness or at least a calling forth by the illness of something that would have occurred in a completely different form if the disease had not arisen.

These are only a few indications of how something might be considered that is touched on by this question.

Now, however, our time has progressed so far that we will follow the others who have already left us.