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Anthroposophical Approach to Medicine
GA 314

Lecture I

Stuttgart, 26 October, 1922

I must ask my audience to be considerate with me to-day, because I have only just arrived after a very tiring journey and shall probably not feel able to speak to you adequately until tomorrow.

I want this first lecture to be a kind of introduction to the series I am to deliver here. I had not really intended to speak during the Conference, because I think the stimulus given by anthroposophical research to medicine and to scientific thought ought to be worked out by those who are specialists in the various domains. Indeed, all that comes from anthroposophical investigation in regard to medicine and, for instance, physiology, can be nothing more than a stimulus which must then be worked out empirically. Only on the basis of this empirical study can there arise valid and convincing judgments of the matters in question—and this is the kind of judgment that is needed in the domain of therapy.

These lectures, however, are given at the request of doctors who are working with us and I shall try to deal with just those points where Anthroposophy can throw light into the realm of medicine. I shall endeavour to show, first of all, that an understanding of the human being in health and disease can be enriched and deepened through anthroposophical conceptions.

By way of introduction, I may perhaps be permitted to speak of the sense in which the anthroposophical mode of thought should be understood to-day, in our own age. People so readily confuse what is here called Anthroposophy with older traditional ideas. I have no wish to waste words about the value of these old conceptions, or to criticise them in any way. But it must be emphasised that the conceptions put forward by me are founded on a basis quite different from that of the various mystical, theosophical and so-called gnostic ideas which have arisen traditionally in the course of human history. In order to make myself clear, I need mention only the main points of difference between the conceptions which will be put forward here and those of earlier times. Those earlier conceptions arose in human thought at a time when there was no science in our sense; mine have been developed in an age when science has not only come into being but has reached a certain—albeit provisional—perfection. This must always be remembered if we would understand the meaning and significance of our studies, for it applies to all that may be said and discovered by Anthroposophy in regard to the different domains of human knowledge and capacity.

You all know—there is no need to enlarge upon it—that in those earlier times man had a real but non-scientific conception of the super-sensible world. Medicine, too, was permeated with conceptions of the human being that did not originate, as is the case to-day, from empirical research. We need go back only to the age shortly before that of Galen, and, if we are open-minded enough, we shall everywhere find traces of spiritual conceptions of the being of man on which medical thought, too, was based. Permeating these conceptions of the form of man, of his organs and organic functions, were thoughts of the Supersensible. According to the modern empirical way of thinking, there are no grounds for connecting anything super-sensible with the nature and constitution of man, but in those older conceptions the super-sensible was as much a part of man as colours, forms and inorganic forces now seem to us part and parcel of the objects in the outer world.

Only prejudice will speak of those earlier ages in the development of medicine as if its ideas were merely childish, compared with those that have been evolved to-day. Nothing could be more inadequate than what history has to tell in this connection, and anyone who has the slightest understanding of the historical evolution of mankind, who does not take the point of view that perfection has been reached and that everything earlier is mere foolishness, will realise that even now we have arrived only at relative perfection and that there is no need to look back upon what went before with a supercilious eye. Indeed, this is patent when we consider the results that were achieved. On the other hand, a man concerned with any branch of knowledge to-day must never overlook all that science has accomplished for humanity in this age. And when—to use the Goethean expression—a spiritual conception of the human being in sickness and health strives to express itself to-day, it must work with and not against modern scientific research.

After what I have said, you will not accuse me of any desire to rail against the concepts of modern science. Indeed, I must emphasise at the outset that such a thing is out of the question and for a very fundamental reason. When we consider the medical views that were held in an earlier period of civilisation, we find that although they were by no means so childish as many people imagine nowadays, they did lack what modern science has been able to give us, for the simple reason that man's faculty of cognition was not then adapted to the study of objects as we approach them with modern empirical thought, which is assisted, moreover, by all kinds of scientific instruments. The doctor, or I might just as well say the physiologist or biologist of olden times, had an entirely different outlook from the outlook of modern man. In the ages that really came to an end with Galen, medical consciousness had quite another orientation. What Galen saw in his four elements of the human organism, in the black and yellow gall, in the phlegm and in the blood, was utterly different from the modern conception.

When Galen describes all this and we understand the terminology—as a rule, of course, words handed down by tradition are not understood—we get the impression of something vague and nebulous. To Galen, it was a reality; in what he called phlegm he did not see the substance we call phlegm. To him, phlegm was not only a state of fluidity permeated with life, but a state of fluidity permeated with soul. This was as clear a perception to him as our perception of the red or blue colour of some object in front of us. But precisely because he was able to perceive something outside the range of modern scientific perception, Galen was not able to see many things that are brought to light to-day by our scientific consciousness. Suppose, for example, a man with not so very abnormal sight looks through spectacles, and by this means the contours of objects become more definite. As the result of modern empiricism, all that was once seen in a cloud, but none the less permeated by Spirit and soul, has disappeared and given place to the sharp contours of empirical observation. The sharp contours were not there in olden times. Healings were performed out of a kind of instinct which was bound up with a highly developed sensitiveness to one's fellow-men. A sort of participation in the patient's disease, which could even be painful, arose in the doctor of olden times, and on the basis of this he set about his cure.

Now for the reason that the advance to objective empiricism is rooted in the evolutionary process of man, we cannot merely brush it aside and return to the old. Only if we develop certain atavistic faculties shall we perceive Nature as the ancients perceived her, in all domains of knowledge, including that of medicine. When we pass out into modern culture, equipped with the kind of training given in our elementary schools—not to speak of higher education—it is simply impossible to see things as the ancients saw them. It is impossible, and moreover, if such a thing were to happen, a man would be regarded as being if not gravely, at any rate mildly pathological, not quite ‘normal’—and, indeed, not altogether unjustly. For there is something pathological to-day in all instinctive ‘clairvoyance,’ as it is called. Upon that point we must be quite clear. But what lies in our power is to work our way up to a perception of the spiritual by developing inner faculties otherwise latent in our being, just as in the course of generations the eye has worked itself up from indefinite vision to clear, concrete vision.

To-day, then, it is possible to develop faculties of spiritual perception. I have described this development in my book, Knowledge of the Higher Worlds and How to Attain It, and in other writings. When these faculties have developed in a man he perceives, to begin with, a world not previously visible to him, a world embracing a spiritual Cosmos as well as the Cosmos revealed to sense-perception to-day, including all the discoveries and calculations of astronomy. To the material Cosmos that is permeated with natural law, a spiritual Cosmos is added. And when we seek to discover what exists in this spiritual Cosmos, we also find man. We contact a spiritual universe, a universe permeated with soul, where man has his rightful place.

If we pursue ordinary science, we begin either with the simplest living being or with the simplest form of life—the cell—and then trace the simple on into the more complex, ascending thus from what most resembles purely physically organised substance to the highly intricate organism of man. If we seriously pursue Spiritual Science, we begin really at the other end. We descend from a comprehension of the spiritual in the universe, regarding this as complex, and the cell as the simplest thing in the organism. Viewed in the light of Spiritual Science, the universe is the summit of complexity, and just as we elaborate our own act of cognition in order, let us say, to pass from the cell to the human being, so do we progressively simplify what the Cosmos reveals and then come to man. We go an opposite way—that is to say, we begin at exactly the opposite starting-point—but when to-day we thus pursue Spiritual Science, we are not led all the way into the regions embraced by material empiricism. I lay great stress upon this point and hope there will be no misunderstanding. That is why I must ask you to-day to forgive certain pedantic ideas.

It is quite conceivable that someone might think it useless to adopt the methods of empirical thought in physiology or biology. What need is there for any specialised branch of science?—he might ask. One develops spiritual sight, looks into the spiritual world, arrives at a conception of man, of the being of man in health and disease, and then it is possible to found a kind of spiritualised medicine. As a matter of fact that is just the kind of thing many people do, but it leads nowhere. They abuse empirical medicine but they are, after all, abusing something which they do not understand in the very least. There can be no question of writing off empirical science as worthless and taking refuge in a spiritualised science brought down from the clouds. That is quite the wrong attitude to adopt.

Now it must be remembered that spiritual-scientific investigation does not lead to the same things that can be examined under the microscope. If anyone tries to pretend that with the methods of Spiritual Science he has found exactly the same things as he finds under a microscope, he may safely be summed up as a charlatan. The results of modern empirical investigation are there and must be reckoned with. Those who seriously pursue Spiritual Science must concern themselves with the phenomena of the world in the sense of ordinary empiricism. From Spiritual Science we discover certain guiding lines for empirical research, certain ruling principles, showing us, for instance, that what exists at some particular place in the organism, must also be studied in reference to its position.

Many people will say: ‘Yes, but a cell is a cell, and purely empirical observation must determine the distinguishing feature of this cell—whether it is a liver-cell or a brain-cell and so on.’ Now that is not correct. Suppose, for example, I walk past a Bank at 9 o'clock in the morning and see two men sitting there side by side. I look at them and form certain ideas about them. At 3 o'clock in the afternoon it happens that I again walk past the Bank. There are the two men, sitting just as before. The empirical state of affairs is exactly the same—allowing for very slight differences. But now, think of it: one of the men may have remained sitting there for the whole six hours. The other may have been sent out on quite a journey directly after I first passed the Bank, and may have only just returned. This changes the picture fundamentally and has nothing to do with what I actually perceive with my senses. So far as my senses are concerned, the same state of things presents itself at 9 o'clock in the morning and 3 o'clock in the afternoon, but the objective fact must be judged from its connections, its attendant circumstances.

In this sense our conception of a liver-cell must differ essentially from our conception of a cell in the brain or the blood. For only if it were correct to say, for the sake of example, that the basis of everything is a primeval germ-cell which has been fertilised and that the whole organism can be explained by a process of simple fission and differentiation of this primeval germ-cell—only then could we proceed to treat a liver-cell exactly the same as a brain-cell in accordance with the purely empirical facts. Yes, but now suppose that this is by no means correct; that by virtue of its very position in the organism the relation of a liver-cell to forces outside man, outside the bounds of the skin, is not at all the same as the relation of a brain-cell to these forces. In that case it will not be correct to look on what is happening merely as a continuation of the process of fission and subsequent location in the body. We must rather assume that the relation of the brain-cell to the universe outside is quite different from that of the liver-cell.

Suppose a man looks at the needle of a compass, finds it pointing from South to North, from North to South, and then decides that the forces which set the needle in this direction lie in the needle itself. He would certainly not be considered a physicist to-day. A physicist brings the needle of the compass into connection with what is called terrestrial magnetism. No matter what theories may be evolved, it is simply impossible to attribute the direction of the needle to forces lying within the needle itself. It must be brought into relation with the universe.

In the study of organic life to-day, its relations to the universe are usually regarded as quite secondary. But suppose it were indeed true that merely on account of their different positions the liver and the brain are actually related quite differently to cosmic forces outside man. In that case we could never arrive at an explanation of the being of man by way of purely empirical thought. An explanation is possible only if we are able to say what part the whole universe plays in the moulding of the brain and again of the liver, in the same sense as the Earth plays its part in the direction taken by the needle in the compass.

Suppose we are tracing back the stream of heredity. We go to the forefathers, pass on to the present generation and then to the progeny, both in the case of animals and of human beings. We take account of what we find—as naturally we must—but we reckon merely with processes observed to lie immediately within the human being. It hardly ever occurs to us to ask whether under certain conditions it is possible for cosmic forces to work in the most varied ways upon the fertilised germ. Neither do we ask: Is it perhaps, impossible to explain the formation of the fertilised germ-cell if we remain within the confines of the human being himself? Must we not relate this germ-cell to the whole universe? In orthodox science to-day, the forces that work in from the Cosmos are secondary. To a certain limited extent they are taken into consideration, but they are always secondary. And now you may say: ‘Yes, but modern science leads us to a point where such questions no longer arise. It is antiquated to relate the human organs to the Cosmos!’ In the way in which this is often done, it is antiquated. The fact that as a rule such questions do not arise to-day is due entirely to our scientific education. Our education in science confines us to this purely objective and empirical mode of research, and we never come to the point of raising such questions as I have indicated by way of introduction. But the extent to which man is able to advance in knowledge and action in every sphere of life depends upon the raising of questions. If questions never arise, it means that a man is living in a kind of fog. He himself is dimming his free outlook upon reality, and it is only when things will no longer fit into his scheme of thought that he begins to realise the limitations of his conceptions.

Now I think that in the domain of modern medicine there may be a feeling that the processes taking place in the being of man are not wholly reconcilable with the simple, straightforward theories upon which most cures are based. There is a certain feeling that it must somehow be possible to approach the whole subject from another angle. And I think that what I shall have to say in this connection will mean something to those who are specialists in their particular branches of science, who have practical experience of the processes of health and disease and have realised that current conceptions and theories are too limited to grapple with the intricate organism of man.

Let us be quite honest with ourselves. During the nineteenth century a kind of axiom was put forward by nearly every branch of scientific thought. With a persistence that was enough to drive one to despair, it was constantly being said: ‘Explanations must be absolutely simple.’ And indeed they were! Yes, but if facts and processes are complicated it is prejudging the issue to say that the explanations must be simple. The thing is to accustom ourselves to deal with their complexities. Unspeakable harm has been done in the realms of science and art by the insistent demand for simplification. In all her manifestations, small and great, Nature is highly complicated, never simple. We can really grapple with Nature only if we realise from the outset that the most seemingly comprehensive ideas are related to the reality just as photographs of a tree, taken from one side only, are related to the tree. I can photograph the tree from every side and the photographs may be very different. The more photographs I have, the more nearly will my idea approximate to the reality of the tree.

The prevalent opinion to-day is this: such and such a theory is correct. Therefore some other theory—one with which we do not happen to agree—must be wrong. But that is just as if a man were to photograph a tree from one side only. He has his particular photograph. Somebody else takes a photograph from another side and says to the first man: ‘Your photograph is absolutely false; mine, and mine alone, represents the truth. In short, my particular view is correct.’ All controversies about materialism, idealism, realism and the like, have really taken this form. They are by no means dissimilar to the seemingly trivial example I have given. At the very outset of our studies I ask you not to take what I have to say as if it were meant to tend in the direction of materialism, idealism, or mysticism, but merely as an attempt to go straight for reality to the extent which the capacity of human thought permits. Materialistic conceptions often achieve great results when it is a question of mastering reality, but the spiritual aspect must be introduced as well. If it is impossible to keep the various aspects separate, our ideas will appear rather as if one took many different photographs all on the same plate. Indeed, many things are like this to-day. It is as if photographs from many different aspects had been taken on one plate.

Now when the forces lying latent in the soul of man are energised by the methods outlined in my book Knowledge of the Higher Worlds, we rise above the ordinary condition of knowledge—to which the latest phase in biology pays special devotion—and reach what I have described as Imaginative Cognition. A still higher level is that of ‘Knowledge by Inspiration,’ and the highest—if I may use this expression—is that of true Intuition, Intuitive Knowledge. In Imaginative Knowledge one comes to pictures of reality, knowing very well that they are pictures, but also that they are pictures of reality, and not merely dream-pictures. The pictures arising in Imaginative Cognition are true pictures but not the reality itself. At the stage of Knowledge by Inspiration reality begins to stream into these pictures, something lives within them; they tell us more than the picture alone. They themselves bear witness to a spiritual reality. And in acts of Intuitive Knowledge we live within the spiritual reality itself.—These are the three stages described in Knowledge of the Higher Worlds.

Now these three modes of higher knowledge give us, to begin with, an understanding of spiritual worlds, of a spiritual universe and of man as a being of Spirit and soul; they do not, in the early stages, reveal to us the findings of empirical research in the realm, say of, biology. When Imagination, or Inspiration, or Intuition, is used for gaining understanding of the being of man, a different way is followed.

Take, for instance, the structure of the human brain. It does not perhaps strike physiologists and doctors as very extraordinary, but to those who call themselves psychologists it is remarkable in the extreme. Psychologists are a strange phenomenon in our civilisation because they have managed to develop a science without subject-matter—a psychology without a soul! Think for a moment of a psychologist who takes his start purely from empirical science. In recent times people have really been at a loss to know what to make of philosophy, because it has been impossible to know whether philosophers know anything or not. Scientists, however, are supposed to know something, and so certain scientists who dabble in philosophy have been given Chairs of Philosophy. Current opinion has been this: the scientists must have some knowledge, because although it is quite possible in philosophy to talk round and round a subject, it is not possible in science to talk hot air about something that has been observed under a microscope, through a telescope, or by means of Röntgen rays. All these things can be tested and proved, but in philosophy it is not so easy to prove whether or not a man is talking out of the clouds.

And now, think of how Theodor Ziehen speaks of the structure of the brain. In this connection I once had a very interesting experience, and perhaps I can make the point more concrete by telling you a certain anecdote. Many years ago I once attended a meeting where an eminent doctor was speaking about the structure of the brain. He analysed the structure of the brain in relation to the soul-life of man from a point of view which might justly be called materialistic. He was an out-and-out materialist, one who had analysed the structure of the brain quite well to the extent to which it has been investigated in our times, and he then proceeded to explain the life of soul in connection with the brain and its structure. The chairman of the meeting was a follower of Herbart, and he, therefore, was not concerned with analysing the structure of the brain but the life of conception and ideation, as Herbart, the philosopher, had once done. He—the chairman—then said the following: ‘Here we have something very remarkable. The physiologist or the doctor makes diagrams and figures of the structure of the brain. If I, as a Herbartian, make drawings of the complicated associations of ideas—I mean a picture of the ideas which associate and not of the nerve fibres connecting one nerve-cell with another—if I, as a genuine Herbartian who does not concern himself with the brain as a structure, make symbolic diagrams of what I conceive to be the process underlying the concatenation of ideas, my drawings look exactly the same as the physiologist's sketches of the structure of the brain!’

This comparison is not unjustified. Science has taught us more and more about the structure of the brain. It has been proved in ever greater measure that the physical structure of the brain does, indeed, correspond in a marvelous way with the organisation of our life of ideation. Everything in the life of ideation can be found again in the structure of the brain. It is as if Nature herself had intended to create in the brain a plastic image of man's life of ideation. Something of the kind strikes us forcibly when we read statements like those of Meynert—nowadays they are already considered rather out-of-date. Meynert was a materialist, but an excellent brain-physiologist and psychologist. What he, as a materialist, tells us is a wonderful contribution to what is discovered when the actual brain is left out of account and we deal only with the way in which ideas unite, separate, etc., and then draw figures and diagrams. In short, if anything could make a man a materialist it is the structure of the human brain. At all events this much must be admitted: If, indeed, the Spirit and soul exist, they have in the human brain so perfect an expression that one is almost tempted to ask why the Spirit and soul in themselves are necessary for the life of ideation, even if people still hanker after a soul that can at least think. The brain is such a true mirror-image of the Spirit and soul—why should the brain itself not be able to think?

All these things must of course be taken with reservations. To-day I only want to indicate the tenor of our studies as a whole. The human brain, especially when we begin to make detailed research, is well calculated to make us materialists. The mystery that really underlies all this clears up only when we reach the stage of Imaginative Knowledge, where pictures arise—pictures of the spiritual world not previously visible. The pictures actually remind us of the configurations in the human brain formed by the nerve-fibres and nerve-cells.

What, then, is this Imaginative Knowledge, which functions, of course, entirely in the super-sensible world? If I were to attempt to give you a concrete picture of what Imaginative Knowledge is, in the way that a mathematician uses figures to illustrate a mathematical problem, I should say the following: Imagine that a man, living in the world, knows more than sense-cognition can tell him because he can rise to a world of pictures which express a reality, just as the human brain expresses the life of soul. In the brain, Nature has given us as a real Imagination, an Imagination that is real in the concrete sense, something that is attained in Imaginative Knowledge at a higher level.

This, you see, leads us more deeply into the mysteries of the constitution of man. As we shall find later on, this marvelous structure of the human brain is not an isolated formation. Through Imagination we behold a super-sensible world, and it is as though a part of this world had become real in a lower world; in the human brain a world of Imagination lies there, in concrete fact, before us. I do not believe that anyone can speak adequately about the human brain unless he sees in its structure an Imaginative replica of the life of soul. It is just this that leads us into difficulties when we take our start from ordinary brain-physiology and try to pass to an understanding of the life of soul. If we confine ourselves to the brain itself, a life of soul over and above this does not seem to be necessary. The only persons with a right to speak of a life of soul over and above the brain are those who have a knowledge of it other than that which is acquired by customary methods. For when, in the act of spiritual knowledge, we come to know this life of soul, we realise that it has its complete reflection in the structure of the human brain, and that the brain, moreover, can do everything that the super-sensible organ of soul can do by way of conceptual activity. Down to its very functions the brain is a mirror-image. With brain-physiology, therefore, no one can prove or disprove materialism. It simply cannot be done. If man were merely a being of brain, he would never need to say to himself: ‘Over and above this brain of mine, I possess a soul.’

In contrast to this—and I shall now describe in an introductory way something that will be developed in the subsequent lectures—let us consider a different function of the human organism, not the life of ideation, but the process or function of breathing. Think of the breathing process and of what passes into consciousness with regard to it. When we say to ourselves: ‘I have an idea which reminds me of another idea I had three years ago and I link the one to the other’—we may well be able to make diagrams, especially if we take a series of ideas. Such diagrams will bear a great resemblance, for instance, to Meynert's sketches of the structure of the brain. Now this cannot be done when we try to find an expression in the organism of man of what is contained in the breathing-processes. We can find no adequate expression of the breathing process in the structures and formations of the physical organs. The breathing process is something for which there is no adequate expression in the human organism, in the same sense as the structure of the brain is an adequate expression for the life of ideation and perception.

In Imaginative Knowledge pictures arise before us, but if we rise to knowledge by Inspiration, reality streams through the pictures from behind, as it were. If, then, we rise to Inspiration and gaze into the super-sensible world in such a way that the Imaginations teem with spiritual reality, we suddenly find ourselves standing in a super-sensible process which has its complete analogy in the connection between the breathing process, the structure of lungs and arachnoidal cavity, central canal of the spinal cord and the continuous flow of the breath into the brain. In short, if we rise to Inspiration, we learn to understand the whole meaning of the breathing process, just as Imaginative Knowledge leads to an understanding of the structure of the brain. The brain is an Imagination made concrete; everything connected with the breathing process is an Inspiration made real, an Inspiration brought down into the world of sense. A man who strives to reach the stage of Knowledge by Inspiration enters a world of Spirit and soul, but this world lies there tangibly before him when he observes the whole breathing process and its significance in the human organism.

Imaginative Knowledge, then, is necessary to an understanding of the structure of the brain; Knowledge by Inspiration is necessary before we can understand the rhythm of breathing and everything connected with it. The relation of the breathing process to the Cosmos is quite different from that of the brain. The outer, plastic structure of the brain is so completely a mirror-image of the Spiritual that it is possible to understand this structure without penetrating very deeply into the super-sensible world. Indeed, we need only rise to Imagination, which lies quite near the boundaries of ordinary cognition. The breathing process cannot be understood by means of Imagination; here we must have Inspiration, we must rise higher in the super-sensible world.

To understand the metabolic process we must rise higher still. The metabolic process is really the most mysterious of all processes in the human being. The following lectures will show that we must think of the metabolic process quite differently from the way in which it is thought of in empirical physiology. The changes undergone by the substances as they pass from the tongue to the point where they bring about something in the brain cells, for instance, cannot, unfortunately, be followed by means of purely empirical research, but only by means of Intuition. Intuition leads us beyond the mere perception of the object into the very object itself. In the brain, the Spirit and soul create for themselves an actual mirror-image, but they remain, in essence, outside this image. As Spirit and soul they influence and pass into the breath-rhythm but constantly withdraw. In the metabolism, however, the Spirit and soul submerge themselves completely; as Spirit and soul they disappear in the actual process. They are not to be found—neither are they to be found by empirical research.

And now think of Theodor Ziehen's subtle descriptions of the structure of the human brain. It is, indeed, also possible to make symbolic pictures of the memory in such a way that the existence in the brain of physiological-anatomical mirror-images of the faculty of memory can be proved. But when Ziehen comes to the sentient processes, there is already a hitch, and that is why he does not speak of feelings as independent entities, but only of mental conceptions coloured with feeling. And of the will, modern physiologists have ceased to speak I Why? Very naturally they say nothing. Now when I want to raise my arm—that is to say, to accomplish an act of will—I have, first of all, the idea. Something then descends into the region that, according to current opinion, is wholly ‘unconscious.’ Everything that cannot be actually observed in the life of soul, but is none the less believed to be there, is thrown into the reservoir of the ‘unconscious.’ And then I observe how I move my hand. Between the intention and the accomplished fact lies the will, which plays right down into the material nature of the physical organism.

This process can be followed in detail by Intuitive Knowledge; the will passes down into the innermost being of the organism. The act of will enters right into the metabolism. There is no act of will performed by physical man which cannot be traced by Intuitive Knowledge to a corresponding metabolic process. Nor is there any process of will which does not find its expression in demolition, dissolution—call it what you will—within the metabolic processes. The will first demolishes what exists somewhere or other in the organism, in order that it may act. It is just as if I had to burn up something in my arm before being able to use this limb for the expression of my will. Something must first be done away with, as we shall see in the following lectures.

I know that this would be considered a fearful heresy in science to-day, but nevertheless it will reveal itself to us as a truth. Something that is of the nature of substance must be destroyed before the will can come into play. Spirit and soul must establish themselves where substance existed. Understanding of this belongs to the very essence of Intuitive Knowledge, and we shall never be able to explain the metabolic processes in the human being unless we investigate them by its means.

These three processes—the nerve-sensory process, the rhythmic processes (breathing and blood circulation) and the metabolic processes—include, fundamentally speaking, every function in the human organism. Man is really objective knowledge, knowledge made actual—no matter whether we merely observe him from outside or dissect him. Take the human head. We understand what is going on in the head when we realise that there is such a thing as Imaginative Knowledge; the processes in the rhythmic system become clear when we know of the existence of Knowledge by Inspiration; we understand the metabolic processes when we know of the existence of Intuition. Thus do the principles of reality interpenetrate in the being of man. Take, for example, the specific organs of the will—they can be understood only by an act of Intuitive Knowledge.

As long as we apply a rigidly objective mode of cognition to the being of man, we shall not realise that he is, in fact, not at all as he is usually supposed to be. Modern physiology knows, of course, that to a great extent the human being is a column of fluid. But now ask yourselves quite honestly whether physiology does in fact reckon with man as a column of fluid, or whether it does not proceed merely as if he were a being consisting of solid forms. You will probably have to admit that little account is taken of the fact that he is essentially a fluidic being and that the solids have merely been inserted into this fluid. But, as a matter of fact, man is also an airy, gaseous being, and a being of warmth as well. The solid part of man can well be understood by means of ordinary objective cognition. Just as in the laboratory I can become familiar with the nature of sulphide of mercury, so by chemical and physical investigation of the human organism I can acquaint myself with all that is solid. It is different with the fluids in the being of man. The fluids live in a state of perpetual integration and disintegration and cannot be observed in the same way as the stomach or heart are observed and then drawn. If I make drawings of these organs as if they were solid objects, a great deal can be said about them. But it is not the same if we take this watery being of man as something real. In the fluids something is always coming into being and disappearing again. It is as if we were to conceive of the heart as continually coming into being and disappearing—although the process there is not a very rapid one. The watery being of man must be approached with Imaginative Knowledge.

The importance of the organic functions in the human organism, and their connection with the circulation, are of course well known, but how these functions play into one another—that follows precisely the pattern of Inspiration. Only through Inspiration can the airy part of man be understood.

And now let us pass to the warmth in the human being. Try to realise that man is something very special by virtue of the fact that he is a being of warmth; that in the most various parts of his structure warmth and cold are found present in the most manifold ways. Before we can realise how the Ego lives in the warmth in man, we must ourselves live in the process. There must be an act of Intuitive Knowledge.

Before man can be known in his whole being—not as if he were simply a mass of solid organs with sharp contours—we must penetrate into the organism from many different angles. Just as we feel the need to exercise Imagination, Inspiration and Intuition as we pass from the brain to the other organic phenomena, so it is when we study the aggregate states of matter within him. The solid part of man, his solid bodily nature, hardly differs at all from the state in which substances exist outside the human organism. There is an essential difference in the case of the fluids and gases, and above all in the case of the warmth. This will have to be considered in the next lecture. But it is, indeed, a fact that only when our observation of man widens out in this way do we realise the full significance of the organs and systems of organs.

Empirical physiology hardly enables us to follow up the functions of the human organism further than the point where the chyle passes from the intestines into the lymphatic vessels. What follows is merely a matter of conjecture. All ideas about the subsequent processes in the substances we take in from the outside world, for instance the processes in the blood stream, are really nothing but fantasy on the part of modern physiology. The part played by the kidneys in the organism can be understood only if we observe the katabolic processes side by side with the anabolic processes, which today are almost invariably regarded as the only processes of significance. A long time ago I once said to a friend: ‘It is just as important to study those organs which are grouped around the germ of the human embryo, and which are later discarded, as to study the development of the germ itself from conception to birth.’ The picture is complete only when we observe the division of the cells and the structure arising from this, and also trace the katabolic processes which take their course side by side with the anabolic processes. For we not only have this katabolic process around us in the embryonic period; we bear it within us continually in later life. And we must know in the case of each single organ, to what extent it contains anabolic and to what extent katabolic processes. The latter are, as a general rule, bound up with an increase of consciousness. Clear consciousness is dependent on katabolic processes, on the demolition of matter.

The same must be said of the excretory processes. The kidneys are organs of excretion. But now the question arises: Although from the point of view of material empiricism the kidneys are primarily excretory organs, have they no other purpose in the constitution of man beyond this? Do they not, perhaps, play a more important part in building up the human being virtue of something other than their excretory functions? If we then follow the functions still further, passing from the kidneys to the liver, for example, we find this interesting phenomenon:—The kidneys secrete in the last resort, outwards; the liver, inwards. And the question arises: How is the relation of the kidney process to the liver process affected by the fact that the kidneys send their excretory products outwards and the liver inwards? Is the human being at one time communing, as it were, with the outer world and at another with himself?

Thus we are led gradually to penetrate the mysteries of the human organism, but we must bring to our aid matters that are approached in the ways of which I have to-day given only preliminary hints. I will proceed from this point in the following lectures, showing how these things lead to a true understanding of pathology and therapy, and how far they may become guiding principles in orthodox empirical research. No attack on this kind of research is implied. The only object is to show that guiding principles are necessary.

I am not out to attack scientific research or scientific medicine in any sense. My aim is to show that in this scientific medicine there is a mine of opportunity for a much wider knowledge than can be attained by modern methods, and above all by the current outlook on the world.~ We have no wish to scoff at the scientific mode of observation but on the contrary to give it a true foundation. When it is founded upon the Spirit, then, and only then, does it assume its full significance.

To-morrow I will speak further on this subject.